Attempting things that no one else quite understands – and when you are just groping along yourself — has its certain virtues. There are few second guessers since even the objective of the project shifts daily. The key element that guided us when creating the CPR simulator was only “Will it work?” But even that criterion was flimsy. The fragility of the concept in those early days led us to what answered only by what we thought it could eventually do…A dream defined. The system, as I described designing with the CPR doctors, would have two screens, and a full-sized manikin which would lie on the ground. A light pen would allow the user to interact with the screen (much as touch screen does now). If the screen asked you to touch a random list of actions in the correct order, you did so with the light pen and the computer recorded your answers.
As the CPR Learning System took shape, it required two separate and distinct activities coming together.
1. It was imperative that we create a manikin ( mannequin anyone?) which was realistic enough to allow the student to practice moves in the right places, and to look for signs of life or ascertain the need for CPR. To accomplish this we had to take an existing manikin, used by current classes, and embody sensors to tell us that the student actually knew what to do, and could actually perform it on the manikin.
The realistic vinyl manikin used by American Heart in its CardoPulmonary Resuscitation (CPR) classes had been supplied for some years by a Norwegian company, Laerdal, which had a good business supplying these relatively inert teaching manikins to the American Heart Association, the Red Cross, various rescue units, and a fair number of hospitals. All of these organizations gave classes on the inert Resuci-Annie manikin, which did have lungs that inflated, a neck that would tilt back, and a breastbone that would provide realistic resistance to the student. Because they foresaw a new business blooming, the Laerdal people were quite cooperative with getting us manikins to rip apart and “sensitize.”
The sensors we implanted in Annie not only had to read the precise actions of the rescuer, they had to communicate that to our Apple 3 computer, by means of a special card we built to insert into that small inexpensive machine. (We had to design in a reasonable cost for these in from the start). The location of the hands had to be sensed, and the depth and duration of compressions had to be timed to make a graphic pattern on the second, non-video screen. The lung expansion was followed with piso-electric fabric, and the student was inferred to be checking for breath with a photo-electric sensor that assumed nearness of the students face or hand checking for breathing. We would have to do a similar set of sensors for a baby manikin, except we also used mercury switches to read position of the head (down below the feet when freeing an obstructed airway) and the neck position when the student/rescuer was blowing breath into the baby.
2. The interactive Video screen had to present realistic situations, and also the learning and testing segments, in one concise package. Jane Sallis, who I had worked with before at Texas Instruments, put in an incredible number of days on the CPR video disc. I told her every day we wasted in getting this done we should imagine dead victims piling up on our doorstep (; I was a fairly crude motivator, but she later admitted it worked). We had to plan perfectly for each of the 54,000 stoppable frames, which would then be given sound by our interactive audiotape, which we had pioneered at an earlier stage. In those days, any videodisc required exquisite planning because an original high quality videotape had to be sent to Japan by one of the three nascent videodisc makers, and all of their early processes took over two months. If this all sounds like it was high speculative, it was. But first, we had to get the support of someone like Sony, which we hoped would be able to market psychic benefits of being involved with a national rescue effort. It was at that point merely a demo interactive videotape with a wired manikin and pieces hanging out the sides. Mostly it was held together by sheer belief.
As I say, it was critical that we enlist a leading-edge partner with a videodisc operation, and I was the one who had to sell this all to Sony. For that I had to take a trip to New York City and the SONY building on 59th Avenue to sell this off the wall project. The prototype equipment and its trial programming had been iffy when I left and I was wary of prematurely blowing this opportunity, and thought I might stall it a bit, but Jane said that is what opportunity looks like – something no one else understands or wants and that you step up for.
I will always remember taking this kludgy conglomeration of spit and bailing wire electronics from Dallas to the slick, spiffy executives at Sony in Manhattan. The manikin – Annie – in its large shipping crate, and the tape player we connected to the computer to manage the interactive experience with the sensitized manikin, all this in an awkward stack of shipping crates which I could put on a small platform dolly and get from here to there: Airport to hotel with a big tip for the yellow cab to put these crates in the trunk and the back seat. Then the next morning 17 blocks from the hotel up to 59th Street…except that the rain bucketed down as I stood in front of the hotel waiting for a cab, and the cabs never stopped. I figured if I rolled the stack out to a busier street there would be more chance of getting a cab. It continued to bucket and I continue to be ignored by cabs full of happy dry people who wondered what in the hell I was rolling along the street, parting streams of water now…walking toward a 10 am appointment with Sony that would determine the future of the CPR Learning System, and a lot else.
17 blocks and no cab would even turn down any street I happened to be on. “Just get a cab,” someone at Sony had told me as I sat in Dallas a few days before. 17 blocks crossing streets up to my ankles in running water, pushing the heavy stack of equipment no one wanted to pick me up with. Finally, a block away from the Sony building, a yellow cab stopped beside me. It would take more time to load and unload the stuff than push the stack this last block. “Fugetabout it” I said in my best New York accent.
It was one of those days which began with disaster, and as if responding like true champions – every piece of electronic equipment that had sloshed for an hour through the honking downpour mid-town Manhattan…every piece worked perfectly. The Sony people had seen about everything in the world and New Yorkers have seen everything in the world on their streets, and none of them had seen anything like it. They could understand what this interactive videotape system would look like when it used their videodisc. Sometimes, and just a very few times, you can find people who are ready to take the same leap you are taking, and understand exactly what you are doing. I credit Dan Harris and several more of those whose job it was to introduce the videodisc to the U.S. with “getting it” immediately, and pulling others in from all the floors to see this crazy system that was perfect for showing off the interactivity of their videodisc.
That was a successful meeting, though I was dripping wet through all of it and could have been electrocuted at any moment of my demonstration. I believe they got a truck to get the stack of stuff back to the hotel. That was the success of the day, and they quickly agreed to get our videodisc made and wanted to take the system to several shows where they were showing off the videodisc. That was a few months out, and required a lot of shipping, but those first shows such as the Consumer Electronics show in Las Vegas, drew a lot of interest for Sony, and for us. They had these little forums of people to ask questions in side rooms, and I was basking in the general appreciation and interested questioners when I got blindsided.
“Why do you have to use a young girl for the manikin? That looks extremely sexist to me…”
I looked out and there were several women, of all ages and diversities, nodding their heads at me.
“Well, the Laerdal people have done studies, with male manikins and mustaches…and the response is uniformly low for them and totally, uniformly – from men AND from women – they are more comfortable with the young girl. “ I hoped I was convincing enough with this… but I was not.
“That’s a bunch of male chauvinist pig crap done by male chauvinist sexist marketing types…I don’t see we should believe this crap at all.”
A lot of female heads were nodding in support and grumbling louder too. I had never expected I would be on the verge of a protest march from having tried to do good in the world. So when the grumbling subsided for a second, I tried one last thing.
“I would like to tell you the real reason, the original reason for having the manikin be a young girl…”
“Because men like the idea of working on her…”
“No,” I said, “It’s because of her father.”
The crowd quieted, but the questioner remained standing, hands on her hips. Her hunched glare said Go on.
“Mr. Laerdal had a doll-making company in Stavanger, Norway, and was fairly successful at it. He had a summer home on a lake back in the Norwegian mountains where he took his large family and their friends on holidays. One summer day they were all swimming out into the lake and someone shouted Annie, and in a few minutes they dragged Annie, Mr. Laerdal’s lovely young daughter, up on the beach, and everyone tried to revived her, but she died there on that beach, that day. Mr. Laerdal was so aggrieved that he made a life-mask of his daughter Annie, and later decided to make a manikins to teach lifesaving. He closed his doll-making company, even though it was very successful, and dedicated the rest of his years and his fortune to making manikins in Annie’s image so that thousands – or maybe millions — of other lives would not be lost in that way. So that is the one we use…in a way…that’s Annie there today.”
The crowd was very quiet now, and began to shuffle away from the standing questioner, many leaving the room without further comment. She finally stood alone in the group of empty chairs, which sort of ended my presentation.
“So OK,” she said, “I’m not going to clap…but that sounds like a reason.”
Needless to say, the help of Sony was invaluable. They gave us one of their first four videodisc players to come into the country, and supplied all the videodisc processing once we had the original videotape. Later, these pieces would have to be programmed to operate together in one seamless experience. However getting to that point, riding like the wind on hypothetical constructs, was anything but seamless.