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RESEARCH IN THE SERVICE OF MAN: BIOMEDICAL DEVELOPMENT, EVALUATION OF EXISTING FEDERAL INSTITUTIONS

FRIDAY, MARCH 3, 1967

U.S. SENATE,
SUBCOMMITTEE ON GOVERNMENT RESEARCII,
COMMITTEE ON GOVERNMENT OPERATIONS,

Washington, D.C. The subcommittee met, pursuant to recess, at 10:05 a.m., in room 3302, New Senate Office Building, Senator Fred R. Harris (chairman) presiding:

Present: Senators Harris and Hansen.
Also present: Dr. Steven Ebbin, staff director.
Senator HARRIS. The subcommittee will be in order.

We are resuming today our hearings on "Research in the Service of Man: Biomedical Development, Evaluation of Existing Federal Institutions.”_Our first witness today is Dr. Eric Walker. We are honored to have Dr. Walker, who is president of the Pennsylvania State University, University Park, Pa.

Without objection we will place in the record a biographical sketch concerning Dr. Walker.

Biographical Sketch: Dr. Eric A. Walker President, The Pennsylvania State University, University Park, Pennsylvania. Doctor of Science 1935.

Background Data : Instructor, Assistant Professor, Associate Professor, Head, Department of Electrical Engineering, Tufts College; Head, Department of Electrical Engineering, University of Connecticut; Associate Director, Harvard Underwriter Sound Laboratory; Head, Department of Electrical Engineering, Director, Ordnance Research Laboratory, Dean, College of Engineering and Architecture, Vice President and President, The Pennsylvania State University.

Member and past chairman of the Naval Research Advisory Committee. Past member and chairman of the National Science Foundation Board. Past president of the Engineers' Joint Council and American Society for Engineering Education.

Awards: Horatio Alger Award, the Navy's Distinguished Civilian Service Medal, the Golden Omeah of the Electrical Insulation Industry, the Lamme Award of the American Society for Engineering Education.

President, the National Academy of Engineering.

Senator HARRIS. Dr. Walker is also president of the National Academy of Engineering.

Dr. Walker we are very pleased you are here. I believe you have a prepared statement, and you may proceed with it or however you desire.

TESTIMONY OF DR. ERIC A. WALKER, PRESIDENT, NATIONAL

ACADEMY OF ENGINEERING, WASHINGTON, D.C.; AND PRESIDENT, PENNSYLVANIA STATE UNIVERSITY, UNIVERSITY PARK, PA.

Dr. WALKER. Thank you, Mr. Harris.

Mr. Harris and gentlemen, I am Eric A. Walker, president of the Pennsylvania State University and president of the National Academy of Engineering. I have been asked to express my opinion on the adequacy of current Federal programs in the general area of biomedical development and application. I believe that there are a number of opportunities for improvement in this area, and I would like to suggest one that in my opinion deserves more attention than it seems to be getting. I am referring to the relationship which exists, or should exist, between medical and biological science on the one hand and engineering and technology on the other.

I think there is plenty of evidence of the general good that can come from cooperative effort between these two areas. In recent years we have seen the effects of such cooperation in the form of new and ingenious equipment for medical treatment, improved tools for surgery, the use of computer techniques for diagnosis of illness, and the development of such remarkable devices as the mechanical heart. And there is every indication that further advances in health and human welfare could result from increased application of engineering skill to our growing biological and medical needs. Yet when one considers the potentialities, remarkably little is being done in this area.

One of the reasons for the slowness of our progress is, I believe, the general lack of communication between these two groups within the scientific community. Traditionally, engineers and biologists have had very little professional contact, and neither the needs nor the possibilities in one discipline are understood by members of the other. There is a language barrier between the two groups, a significant difference in the approach, in each case, to the solution of specific problems. For one thing, engineers are used to thinking in very precise terms, whereas biologists must accept wide variations in their measurements and in the application of their principles. An engineer likes to design his devices on the basis of exact specifications, but the biologist can never be exact about many of the things with which he must deal the size of the heart, for example, or the diameter of the aorta, or the length of the femur. Thus, even when there is some degree of contact between the two, the engineer finds it difficult to understand biological needs because he cannot give expression, with his customary precision, to the specific requirements involved.

More than this, the engineer has very little incentive to apply his skills to biological and medical needs. Very few large companies have accepted the fact that there is a profit to be made in the manufacture of biomedical devices, and thus very few engineers have been called upon to learn enough about the subject to be of any real help. Although there are many engineers who are aware of the possibilities, and who would be interested in having the opportunity of applying their skills to the design of biomedical equipment, circumstances in general have not been conducive to the kind of cooperation that is necessary.

Thus the extensive resources that exist in both areas have been largely unused for any joint effort of this type, and the traditional lines that exist between the two disciplines have, in general, not been crossed. In the colleges and universities throughout the country, there are some 1,100 departments of biology. And there are about 240 departments of mechanical engineering and an equal number of electrical engineering departments. Yet where biology and engineering come together in departments of biomedical engineering, we find only six in the whole United States.

What it comes down to is that, with very few exceptions, we are operating under the principle that if we support enough basic research in biology on the one hand and enough research in the hard sciences on the other, the knowledge that is gained through this research will somehow find its way into the production of the devices that are needed by our physicians and surgeons and medical scientists.

Now I submit that this is not the way the process works best—in this area, or indeed in any other. There is no doubt that in many

instances the research we have been conducting in this country on such a massive scale has provided us with the basic knowledge we need to design and manufacture a great variety of useful goods and products. And I believe that we must continue to support our research efforts to the fullest extent possible. But research is not engineering, and I cannot help reflecting that our belief in basic research as a necessary preliminary to useful application has, particularly in the area of biomedical science, tended to blind us to the converse method of achieving the ends we seek.

It seems to me that the old principle that necessity is the mother of invention applies with particular appropriateness here. Instead of taking the basic knowledge that has been uncovered for its own sake and trying to find useful applications for it, we should be starting at the other end of the operation. We should be specifying the needs, outlining the requirements, and when we have a clear-cut understanding of just what it is we want, we should seek out the knowledge necessary to accomplish our ends. Of course the two processes work hand in hand, and both are needed, but I cannot help feeling that all too often, in our large-scale plans and programs, we have tended to neglect the latter.

I think that in the area of biomedical engineering, we might well follow the example of the Department of Defense in this respect. As you know, many of our sophisticated weapons of war are developed in Government laboratories that were set up for the specific purpose of developing them. These laboratories are assigned the task of producing devices that can be produced by making use of the knowledge we already have. They are essentially engineering laboratories. And their job is to apply the knowledge that exists in the various disciplines to the specific problem at hand. The need is specified first, and the process proceeds from there.

It seems to me that such a system of in-house laboratories might be very useful in our health sciences as well. Such labs would serve as ideal places to bring together the knowledge and skills of the biologist on the one hand and of the engineer on the other. Needs could be specified, limitations and possibilities thrashed out, and a genuinely cooperative effort established.

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At the same time, this sort of Government-sponsored cooperation could, I believe, serve as an effective stimulus for similar arrangements in colleges and universities throughout the country. Programs involving both engineering schools and biology departments could, with the proper incentive from the Federal Government, be rapidly developed. I would estimate that at least 50 educational institutions throughout the country would be interested in such programs if they were properly administered.

And the incidental benefits to the scholarly world would, in my opinion, be incalculable. Quite aside from the direct benefits to our health services, such cross-pollination of two traditionally isolated disciplines would be extremely beneficial to both in broadening their outlooks and tearing down the confining restraints of scholarly parochialism. Certainly as far as our engineering schools are concerned, I personally believe that this kind of interdisciplinary activity would be extremely profitable and healthful.

Senator HARRIS. Thank you very much, Dr. Walker. I agree with the general thrust of your statement. Increasingly, there have appeared in these hearings two or three areas where I think we might in the subcommittee have more specific interest in the future. One might be the private sector and what kind of increased role it might have in medical research and application of medical knowledge.

The other is the interdisciplinary field of bioengineering or engineering in medicine. Yesterday, Dr. Chauncey Starr, whom you know quite well—he is dean of the College of Engineering at UCLA—suggested that it might be wise to form in the National Institutes of Health a new National Institute of Engineering and Medicine, or National Institute of Bioengineering. He pointed out that in this year's administration budget request to the Congress, there is a little over $300,000 requested for moving into the field of bioengineering, though there is as yet no stated plan to establish such an Institute. I wonder if you might comment on that suggestion.

Dr. WALKER. Yes, sir. I do know Chauncey Starr very well, and we did not collaborate on our testimony, but I agree with him completely, and I think this is exactly the idea I have in mind, that we should start such an Institute.

But I think we would have to tell that Institute that its business is to produce the machines that we need, not to conduct research, but to do the engineering, the design, the building, the testing, and if the machine is successful, to show people how to use it, how to maintain it, and even how to sell it.

This is the sort of thing, you see, that private industry is reluctant to do, because there isn't enough money in it. You can't get a very high price for a piece of medical equipment that the final user, the patient, can't see.

Senator HARRIS. Do you mean that the National Institute of Bioengineering would itself construct a thing like an artificial kidney, an improved artificial kidney? Is that what you have in mind ?

Dr. WALKER. Yes, sir. May I give you a personal experience on this?

Senator HARRIS. Yes.

Dr. WALKER. About 15 years ago, Isidor Ravden, who was then the dean of the Medical School at the University of Pennsylvania, and I got together on this subject and we decided to try a pragmatic test.

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