In this distinguished audience I am sure that there are many individuals, be they bioengineers, theoreticians, experimental laboratory scientists, educators, administrators, industrialists or physicians, who have experienced the phenomenon of discovering that what they have believed in, what they have created by years of hard work, what they have defended vigorously while having some minor internal doubts, was true and real and valuable after all.
Those of us who have worked with consolidation of widely diversified experimental data into a compactly accessible form, unified by a package of quantitative theoretical algorithms, easily manipulable mentally or by machine, know the successive skirmishes that leave us alternately convinced that logically and mathematically the idea must be true but does not “feel” right deep down inside us, and then after a few changes it feels right but does not convince us fully of its logical integrity. Eventually, when our colleagues have knocked off a few logical non-sequiturs and we have refuted and tested the idea to ourselves in a thousand different variants, we come to the point where “gut feel' and logic match fully and we are momentarily satisfied. Until we have heard it back from the scientific journals, from textbooks and monographs and from the public press, we do riot believe it with the same confidence that we have that the sun will set and that an election will be somewhat crooked.
The engineer knows this same feeling when his system works safely, efficiently and profitably, the physician when his diagnostic procedure or therapy is widely accepted, put into everyday use and demonstrated to be effective and practical.
Today I want to tell you of a dream that Sam Talbot and I shared, in which we both believed implicitly, logically and by intuition, but which we hardly dared voice even to ourselves and. certainly not to the world at large for fear of being found ridiculous.
This dream involved the hope and belief that a quite new and different life
science, involving sweeping quantitative generalizations, could be stimulated
into being, hopefully within our lifetimes, and that from this science, a biomedical
technology or bioengineering could be developed that could. materially speed
arid bring to bear on human welfare the fruits of this hard won body of theory
and. application principles. We seriously aspired to bioengineer a bioengineering
science, and there you see the basis of my title of today's presentation. Neither
of us wanted particularly to build personal empires or to gain widespread publicity
or recognition, but we did. both hope to see the dream emerce.
3am did not live to see this dream realized and the past decade has made distressingly slow progress, even though the Biophysical Sciences, including of course Bioengineeririg, have probably expanded tenfold in recognition and material involvement during that time. Given another decade and one or two social organizing foci, I might just possibly see it become “really” true.
Sam Talbot's bioengineered world of bioengineering and mine matched in every major aspect, but they differed tremendously in scope, in detailed content, in categorization, in strategies and tactics, and from these differences I have learned a ~zood deal, as we should have, from a dozen if not a hundred individuals who shared this goal then, and perhaps several thousand who hesitantly feel their way into it now. It is indeed a dangerous mission that can and will consume many participants.
I would like today to select a few vignettes from the many years I knew Dr. m albot and in which we interacted frequently, vigorously and in different subject areas, often even a little acrimoniously, but always as established best of friends. By pointing out some of our failures as well as a very few successes, perhaps his influence can be brought even more strongly to bear on the present generation of bioengineers and thus honor him more to his liking, than by other memorials.
My first scene is set in an economy priced room in, as I recall, the Barbizon
Plaza Hotel in New York. The time is 1956. Four of us, Sam Talbot, Kenneth Cole,
Ernst Pollard and I, have been nominated by an organizing committee in a stormy
steering committee session in Atlantic City durmn~ the previous annual meeting
of the Federated Societies of Experimental Biology and Medicine to organize,
as we saw best, a society to represent Biophysical Science. We were building
the skeleton that was to become the Biophysical Society at Columbus the following
year. All four of us were considered compromise candidates, diversified and
different in interests, appropriate to represent physical science, biological
science, theory and engineering, and none of us aggressive enough, or power
hungry enough, to seek a dictatorship. Perhaps that was wise, perhaps not. We
had scrounged a few scraps of travel money from the Air Force and the Hartford
Foundation to permit us to hold a few meetings during the year, and we had early
decided that the four of us were not sufficiently knowledgeable and influential
to be adequately representative to carry out our task, so each of us was
given two peremptory nominations. to fill out visible gaps in our committee
and to give us a body of twelve, big enough to be representative and do appreciable
work, small enough to function as a unit.
Sam and I were meeting in my room the night before the whole committee meeting, trying to plan a systems-approach to an effective society to represent our several interests mutually in biomathematical theory, in Biophysical experimental science, in Medical science and in other Bioengineering. We were terribly naive but not totally devoid of ideas.
As usual at such tribal war councils one had to have something on which to nibble - nuts, popcorn, or the equivalent. As it happened, I had a can of fried grasshoppers on hand and Sam ate his share as we worked far into the night planning strategy for the morrow's meeting of the whole committee, and then he noticed the label on the can, and being the strict conservative that he was in such matters, was shocked to his core. I insisted that he eat one more grasshopper knowingly, to see whether it tasted different, and he did, but certified that it expanded and expanded as he chewed and would hardly go down.
What did we do right? What did we do wrong? We did an excellent job of diversifying and representing but we seriously underestimated the personal psychological security problem that limits the diversity of a cluster of
individuals who can work together within a common jargon and set of objectives. Now some twenty years and at least ten societies later, we see that we should have divisionalized, and not required universal tolerance and mutual understand ir.~ of technically detailed problems across the whole field by all the potential members.
We were so naive that not once did we even mention marketing techniques and constraints, not once did we project our society design into the predictable movements of the next decade where its growth could have been spectacular, had it had a sense of socio—economic influences on a new science. Even now many of us do not credit the legitimate scientific leadership that inheres within the body of the intelligent public, and I do not by any means refer here to mere exploitation of currently popular bandwagons.
Recently I have had occasion to try out on a variety of groups of laymen, of bioengineers, of health administrators and of computer scientists and medical scientists the concept of a revised health delivery system focusing on the individual recipient of the care rather than on the agency or individuals providing the care, and involving two major system differences; first a whole— life medical record miniaturized, and in the primary care of the individual, not the doctor, the hospital or a national super-information center, and secondly a system organized around individually parameterized health testing, diagnosis, treatment and care utilizing basically an ergodic statistical model for the individual, not simply a population central tendency, with some bow to dflspersion of “normality”.
To my amazement, laymen understand and accept these ideas, when spelled out
in simple terms, much more readily than do our colleagues immersed in health
science traditions. Very possibly such ideas do have to leak back into basic
science and biomedical engineering via Reader's Digest and the daily newspapers
as a normal and important system constituent and safety factor.
Sam and I talked extensively about systems theory and Its adequate representation in the Biophysical Sciences that night in New York, but his systems were those of mechanical and electrical feedback networks and their equivalent physiological systems, not the systems-engineering of a bioengineering science that operates on much the same principles but on a vastly different data base. He would have been appalled had I mentioned a systems feasibility test of a bioengineered health delivery system at an economy rate of only one billion dollars, yet here is reality and we must study such systems science where it now resides - in large planned industrial and some military and national communications systems.
Only recently has there been some timid approach in bioengineering circles
to control systems utilizing multiply redundant hierarchically organized adaptive
designs for modeling human behavior or for mediating human control of physical
environment. The mathematics for such designs is largely unfamiliar or inaccessible
and we are most hesitant to enter the complicated maze of control disease and
human control system therapy. Work here is urgently needed for we have all around
us the folk wisdom recognition of this area of health science in the mysterious
forms of transcendental meditation, biofeedback training, etc., which are often
very dangerous when pursued vigorously without sound theoretical basis and extensive
proving. How many of you indulge in regular mental jogging to supplement muscular
jogging?
Let us turn now to my very first intensive interaction with Sam Talbot. This was in the early SO's when he was much interested in optics, particularly of the human visual system, with electronic displays and with the theory of vector electrocardiography. Sam built one of the very first spherical polar coordinate analog spatial resolvers utilizing my, then rather novel, double cathode ray stereoscopic display technique. He contributed insight into the human perceptual optics involved and maintained skepticism over the general utility of this method we both admired. Until very recent months he was right, as the technical requirements of a double optical display were so restrictive as to make it virtually useless. Now suddenly, with the advent of PLZT electro optic lenses, that shared enthusiasm springs back into prominence. Utilizing a common raster TV system, black and white or color, or a special random access scope, we can now see directly in a geometric three-space and can add two color dimensions to give us a time parametric five orthogonal dimensional phase-space display in which to realize the bioengineering ideal not only of a computer-aided human but of a human-aided computer cluster analysis for generalized pattern recognition.
Talbot never thought of the stereo-oscilloscope as more than a lame picture maker of a pictorial geometric three-space. Today I am sure he would be joining us in the pursuit of this class of displays as a meta-linguistic communication between the computer and the human widest gauge receptor system -our binocular stereoscopic, trichromatic saccadic or tracking mode visual sense. While it has not yet been realized technically, we can hope for electro optical accommodative base systems that can even allow us to see that last elaboration.
One more very happy Sam TaJ.bot vignette I cannot resist even though it underscores my ineptness in assessing the magnitude and duration of a fundamental problem in Bioengineering or bioengineering~ science. This is the s~a of the Cordon Conferences for Biomathematics.
Sam and I agreed fully that Biophysical Science was sorely lacking in adequate and well developed mathematical representation for biological and biomedical phenomenology and that manipulable biomathematics outside the standard and good biostatistics and the kinds of mathematics constructed for life science from physical science by bioengineers and by unusually imaginative contributors such as Rashevsky, Wiener, and a few others, was needed.
Bushing in where angels feared to tread, I undertook to organize a new Cordon
Conference on Biomathematics to stimulate what I thought would be an automatic
outflow of new insight~. and inspiration, just by asking good people to give
thought to an announced meritorious cause.
As usual, I asked ever-willing Sam Talbot to help, and he responded as always with sound, conservative advice and substantial contribution, not only to the first but also to the second conference. One complication threatened to prevent Sam from participating - he had recently married and felt that he ought not to be subjecting his newly acquired wife to the rigors of Proctor Academy and a motley crew of biomathematicians. We persuaded him that this need not be a bad honeymoon extension, especially since she was also a scientist and educator. We profited doubly by becoming acquainted with a new and delightful person and another aspect of Talbot and his diverse talents.
From the Gordon Biomathematics Conferences it became evident that we had
a lone way to go before we had adequate mathematics and computer implementation at hand to enable us to tackle Bioscience frontally.
What was lacking? Certain gaping holes appeared to me that I have been trying to patch during the intervening decade with now a glimmer of success; a total lack of good dimensioned and scaled optimization theory applicable to human systems problems and an epidemiological data base on which to have it operate, a formalization of the equivalence and interaction between heredity and environment matched with their engineering counterparts of feedforward and feedback, both systems parlaying their successes upward through a series of higher and specialized linguistic or code levels, a biomathematics of interpenetrating informational domains, a family of non-Huygenian holographic memory and computational models to serve the new task along with, of course, quite new and unfamiliar computers designed to implement such biomathematics. If you doubt the unfamiliarity of this field, ask your nearest control scientist to outline the basic principles of feed forward one to one as contrasted with feedback.
I.!y last view of Talbot was as he undertook to build an educational research establishment at Birmingham to come somewhere near his ideals. had had very valuable help from Sam in evaluating and guiding NIH study projects, both in biomedical engineering as such, and in bioengineering where I think we both felt there was too much academic self replication that this had to be remedied by design, not by chance. He was unable to complete his trial run, and perhaps it is well, because even with valiant efforts, only now are we beginning to hear seriously of the concept of a mathematical, biophysical, bioengineering oriented second track in medical education, and of the Doctor of Clinical Engineering, all logical sequels to the plans we hoped would be realized by the early l970's at latest.
We section education and perhaps we could use the massive insight being generated
in this Sam Talbot memorial series to stimulate into being the much greater
biomedical engineering he and some others dimly but surely foresaw a decade
and more ago. But specifically how?