Extreme Engineer

Jerry Weisman always knew he wanted to be an engineer. After first considering aeronautical engineering, he wound up enrolling in mechanical engineering at The Cooper Union in New York. He later became aware of the field of bioengineering and the research being conducted at the University of Vermont. He selected the mechanical properties of bone for the topic of his senior design project. He found it interesting and decided to go to grad school at the University of Vermont in biomechanics. However, it wasn't until he began commuting to campus with a physical therapist that he discovered rehabilitation engineering and the reward of applying engineering knowledge to make a big difference in the lives of individuals with disabilities.

Jerry says there is no greater satisfaction than designing something for someone so they can do something that they previously couldn't do. His work allows people with disabilities to do something they couldn't do before. Many times this makes a difference for them in being able to attend school, to do a specific job or even be employed, or to live independently. One of the most memorable projects Jerry worked on was helping a cable lineman go back to work at the top of the pole after a devastating spinal cord injury that left him paraplegic. The man wanted to return to his old job outdoors because he didn’t like working indoors. See the interview below for more about this interesting story.

Rehabilitation engineering has changed a great deal from when Jerry first started in the 1970s. Back then there wasn't a lot of technology available to use. Almost everything had to be created from scratch. So many of the things we take for granted today—voice recognition technology, scanners for computers, many remote control devices and environmental control units—are the result of technology developed by rehabilitation engineers. Today the proliferation of technologies and devices provides the rehab engineer with many more tools to work with, but applications are specific to each individual and even in working with people with similar disabilities, the job is never the same. With the range of technology available today, rehabilitation engineers now typically specialize in areas such as seating and mobility, computer technology adaptations, augmentative and alternative communications, or technology for sensory impairments.

Jerry says while medical knowledge augments this engineering specialty, the core is still being a good engineer. Most rehab engineers have undergraduate degrees in electrical, mechanical, or bioengineering. Many have graduate degrees in engineering and some go to medical school.

Read on to learn more about this very rewarding specialty of engineering.

An Interview with Jerry Weisman, M.S.M.E.

JETS: How did you become a rehabilitation engineer?

WEISMAN: I had always wanted to be an engineer. When I was applying to colleges I decided I wanted to be an aeronautical engineer and design planes. When I interviewed with NYU in 1969, the professor asked me what to I want to be when I grow up. I said that I want to be an aeronautical engineer. He asked, “What do you want to do?” and I said, “I want to design airplanes.” And he said,” Well you know the only people who have enough money for designing airplanes is the government, and do you know what kind of planes they are designing?” The answer was war plans. I knew I didn’t want to work in the defense industry. It wasn’t any moral statement —we have to have a defense industry —but I just made the choice that it wasn’t something I wanted to do. So I decided to go to college as a mechanical engineer. I wound up going to grad school, and in grad school I wound up studying bioengineering and biomechanics.

JETS: Why did you choose that?

WEISMAN: Mostly it had to do with wanting to live in Vermont. About the only thing I could to do in Vermont was go to school. So I went to University of Vermont and went to the mechanical engineering department to find out what they were doing. There was a guy doing research in bioengineering. I thought that was really cool. I did my senior design project on the mechanical properties of bone. I thought that was interesting, and I wound up going to grad school in biomechanics.

I commuted to school with a physical therapist. At the time she was working with kids with severe disabilities and needed somebody to make special wheelchair seats. There was basically only one brand of wheel chair available, and it didn’t have special seating or anything like that. She knew what she needed in terms of supporting the kids. She said that if she found someone who could build them, they didn’t know she was talking about. If she found someone who knew what she was talking about, they didn’t know how to build them. I said to her, “I know what you’re talking about, and I know how to build it.” So that’s how I got into rehab engineering. I started to make her wheelchair seats.

Back in 1976, I started what was probably one of the first rehab engineering companies in the country, called Vermont Rehab Engineering—making simple assistive technology. I was still a grad student. I realized after a couple of years, that I really didn’t know anything about rehab engineering. So I decided to learn everything I could about it and make a living, then I’d come back to Vermont and do this again. The first job I got was at what was then called the Veteran’s Administration Prosthetics Center (VAPC) in New York City.

At the time the VAPC was the preeminent rehab engineering center in the world. They had been in existence since the late 1950s and had done all the primary research on amputees on veterans coming out of WWII. Ultimately they changed their name to the VA Rehab Engineering Center. By the time I got there, we were dealing with Viet Nam Vets, and they had different needs. The Viet Nam Vets were coming back much more severely disabled. They had helicopter evacuations that they had never had in any previous war. If someone got hurt, they were back in the U.S. in two days. In any previous war those guys would have been dead. What we wound up seeing were lots of guys with spinal cord injuries who would have never made it through a previous war. So there were different needs. So we got started working on things like powered wheel chairs, the whole industry of environmental control systems was developed out of VAPC.

In the late 70s you literally had to get up off the sofa and turn off the television. Today people will spend a half hour looking for the remote. Think of all the different appliances we use all the time today to do things like turn on the light. Today we have things like the X10 system that does all that and is commercially available. What we developed specifically for people with disabilities has now become commonplace and generally available for anybody. We all have scanners for our computers. Those scanners were originally developed so that blind people could read printed books. We can talk to our computers now. For $100 today you can get software to dictate and talk to your computer. The systems we had in the 1970s cost $50,000. That technology was originally developed for people with disabilities who had no way of accessing a computer— and they were mainframe computers at the time.

I saw gunshot victims who were C1 quads who couldn’t move anything below their neck. All they could do was talk, and they were hired as computer programmers because they could talk to the computer—but it cost $50,000. Now it costs $100. And now every time you pick up the telephone you’re talking to a computer because everybody has voice recognition on their answering machines.

JETS: What would you tell students today about why they should go into this field?

WEISMAN: I’d tell them the same thing my father told me. After I was already an engineer, my father told me I should do good things for people. There’s a lot of ways to do good things for people, but being in this field, you get the most immediate gratification in terms of helping people. It’s not like being an engineer in a big company where you’re designing a product, and you don’t really get to see the people who are using your design. In this business, whatever it is that you do, you’re working with a person. There’s no greater satisfaction at all as far as I’m concerned than to design and build something that allows somebody to do something that they couldn’t do before. It’s not just to make things easier or to help them do it better. And there’s no greater satisfaction. If you like tinkering and the whole concept of engineering, then this is the best in terms of getting gratification for what you do. The fact that you’re helping somebody is a side benefit.

JETS: What are some projects that stand out in your mind as the most rewarding or most successful?

WEISMAN: There are a couple that come to mind. One that I will always remember is when we worked with a 12-year old kid with cerebral palsy. He used what was known as a Mulholland wheelchair. That was what you used if someone needed heavy-duty seating. The parents came to us and asked if we could make it a powered wheelchair, so that their son could operate it by himself. We did exactly that. We had the ability to buy an accessory package for the wheelchair, and we came up with a control. We determined that the way he was going to be able to operate his chair was with his chin. So we developed a chin control wheelchair. We built the chair. Then he and his father came up, and we put him in the wheelchair and took him to the gym. This was the first time the kid had ever been in a powered wheel chair. There was plenty of room so we didn’t have to worry about him crashing into the walls. The look on his father’s face was the same look you see on a father’s face the first time a kid gets into a car by himself. But then the kid got in the wheelchair and could drive the thing immediately. He wound up going in and out of the bleachers in the gym. The look on the father’s face was priceless because this was the first time the kid was able to get from point A to point B all by himself. For 12 years whenever he wanted to go from point A to point B, somebody took him. This was the first time he was in control of going from one place to another. I followed up quite a few years later and he was working in a sheltered workshop in his powered chair.

Another job I did that was a lot of fun was helping a cable company lineman, who worked at the top of the pole, back to work after an accident. He had fallen off the pole, broken his back, and become paraplegic. He went off to Colorado for a year of rehab. He came back, and the company he worked for wanted to put him back to work. They did what they thought was the right thing to do; they put him to work in the warehouse. After a couple of months, he said he didn’t like that job. He said that he didn’t become a lineman to work inside. What he liked about being a lineman was working outside—even in New Hampshire in the winter. He said he wanted to work at the top of the pole again. The company thought he was crazy, but he said he could do it. They said, “How?” He said, “You all use bucket trucks. I can use the bucket truck to get to the top of the telephone pole.” They said, “Sure. Show us.” We got everybody from the New Hampshire Department of Labor to his insurance company to come down. There was a whole group of people in the parking lot. He used long-leg braces and could walk around with braces. We also made some modifications to the truck. From the waist up, he had no problems at all. In fact, his nickname was “Horse”. It turned out that the only problem he had was getting into the bucket. The bucket came down to within four to five feet of the ground. So he slung a belt over the top of the bucket, did a chin up, and slung himself into the bucket. Once he was in the bucket you couldn’t tell he was paralyzed and he went back to work at the top to the telephone pole.

In rehab engineering the goal is to put people back to work at the same job in the same company. If you can’t do that, the second choice is different job at the same company.

If you can’t do that the next choice is the same job with a different employer, and the last choice is different job, different employer.

JETS: How has the field changed since you entered it?

WEISMAN: The field has changed significantly during the past 20 to 30 years. When I first started there was very little you could buy in terms of assistive technologies. You could buy a wheel chair — one company owned about 85 to 90 percent of the market — and it was basically the same chair they built in 1923. The choices were 16 inches wide vs. 18 inches wide, and you could get it in blue, green, red, or black. That was it. It was sling seat with vinyl upholstery. Today there are more than 100 manufacturers of wheelchairs. The range of product is unbelievable. In the 1970s wheelchairs weighted 55 pounds. A lightweight wheelchair today weighs less than 18 pounds. We have titanium wheelchairs today, and that makes a big difference —like the difference between wearing lead boots and regular shoes. There’s a big difference in pushing a wheelchair that weighs 55 pounds vs. 18 pounds.

The other thing that has changed—and it’s changed for everybody—is the level of assistive technology available. Keep in mind there was no such thing as a personal computer before 1982. Most people with disabilities didn’t have easy ways to read, write, or access information. Part of what the PC has done over the past 20 years is level the playing field. As long as someone with a disability can access a computer, then they have the same access to information and tools as anybody else. Access to technology has made a dramatic difference for people with disabilities.

The other thing that has made a tremendous difference is legislation. Two primary pieces of legislation [I think there’s a chunk of stuff missing here. Description of the ADA and IDEA] now stipulate that if you provide services to the public, you have to make your services available to all people—including those with disabilities. If nothing else this law ensures people with disabilities have access to built environment and access to telecommunication systems.

When I got into the profession, it was easy to be an expert in everything. I could be an expert in computers because there were none. I could be an expert in wheel chairs because there were two. I could be an expert in aug comm devices because there were only two of them. So it was easy to be a generalist and a pretty good expert in all of those things. It’s much harder now because of the proliferation of assistive technologies. So today rehab engineers specialize in a number of areas, primarily:

• seating and mobility;
• computer technology and the adaptations and accommodations for disabilities;
• augmentative and alternative communications; and
• technology for sensory impairments — primarily devices for the blind or deaf.

Another major change is the concept of universal design. Thirty years ago you designed products for the general population by designing for the average person. How you defined average person came from a database. The concept of universal design is the acknowledgement that there is no such thing as an average person and that you should design for the continuum of people—for the smallest as well as the largest, and you have to design it for the disabled person as well as the able-bodied person. If you think of people in wheelchairs, one solution is to give every person in a wheelchair a curb climbing wheelchair. The answer in the context of universal design is to put curb cuts in so every person has access to the curb. You don’t build steps in front of a building without also building a ramp or an elevator. All kinds of things happen when you design by way of universal design. For example, today everyone has luggage with wheels on it. The only reason we have wheeled luggage is because of curb cuts, because wheeled luggage wouldn’t work without curb cuts. The curb cuts were initially designed for people in wheelchairs, but they help other people as well.

You don’t make up a sign that requires 20-20 vision to see it. You design the sign so the letters are much bigger so you don’t need 20-20 vision to read it. You don’t design environments and products and assume that everybody’s able bodied and that everybody can do it the way “normal” people can do it. If you recognize that there’s a continuum of functional abilities then you can design the products and environments so that everybody has access to them in one form or another.

JETS: What’s exciting about rehabilitation engineering today?

WEISMAN: One thing that’s exciting is that every problem is different because every body is different. So even though two people may be T5 paraplegic, they’re going to have different needs and different functional abilities. So every time you solve a problem, every time you work with a problem—even though you recognize the problem and it’s like something you’ve done before—it’s still different. That’s part of where the creativity comes in. Rehabilitation engineering today is about doing the custom stuff. If you’re an engineer you’re doing new stuff, solving new problems — sometimes with existing technology.

JETS: If a student decides this is what he or she wants to do, what kind of program are they looking for?

WEISMAN: They’re looking for an engineering program —electrical, mechanical, biomedical—generally those three. Some schools have some undergraduate programs with specialty courses. As a rehabilitation engineer what you bring to the table is the engineering skills, so it’s important to be a good engineer first. If a student told me they want to be a rehab engineer, I’d suggest they think in terms of a master’s degree. I think as an undergraduate you really need to be a good electrical or mechanical engineer, then as a graduate student take those skills and knowledge and apply it to biomedical engineering or mechanical or electrical engineering. A few schools specifically offer graduate degrees in rehabilitation engineering.

Click here for more information on rehabilitation engineering and links to interesting Web sites.