Makers of bionic arms and legs also fight an uphill financial battle. “You have a high-end product with a small market and that does make it challenging,” says McLoughlin. “This is not like investing in a Facebook or a Google; you’re not going to make your billions by investing in prosthetic limbs.” Meanwhile, government money for advanced prosthetics could get tighter in coming years. “As the wars wind down, funding for this kind of research is going to drop off,” orthopedic surgeon Roy Aaron predicts.
Then there’s the cost of purchasing a prosthetic limb or artificial organ. A recent study published by the Worcester Polytechnic Institute found that robotic upper limb prosthetics cost $20,000 to $120,000. Although some private insurance companies will cover 50 to 80 percent of the fee, others have payment caps or cover only one device in a patient’s lifetime. Insurance companies are also known to question whether the most advanced prosthetics are “medically necessary.”
Herr believes that insurance providers need to radically rethink their cost-benefit analyses. Although the latest bionic prosthetics are more expensive per unit than less-complex devices, he argues, they reduce health care payouts across the lifetime of the patient. “When leg amputees use low-tech prostheses, they develop joint conditions, knee arthritis, hip arthritis, and they’re on continual pain medication,” says Herr. “They don’t walk that much because walking is difficult, and that drives cardiovascular disease and obesity.”
Other trends, however, suggest that artificial limbs and organs may continue to improve and become more affordable. In the developed world, people are living longer than ever, and they are increasingly facing failures of one body part or another. The number one cause of lower-limb amputation in the United States is not war but diabetes, which in its later stages—especially among the elderly—can hamper circulation to the extremities. Moreover, Donoghue believes the brain-prosthetic interface he’s working on could be used by stroke patients and people with neurodegenerative diseases to help restore some degree of normalcy to their lives. “We’re not there yet,” Donoghue admits, adding: “There will come a time when a person has a stroke and if we can’t repair it biologically, there will be an option to get a technology that will rewire their brain.”
Most of those technologies are still years away, but if anyone will benefit it will be Patrick Kane, a talkative 15-year-old with chunky glasses and wispy blond hair. Shortly after birth, he was stricken by a massive infection that forced doctors to remove his left arm and part of his right leg below the knee. Kane is one of the youngest persons to be fitted with an i-limb prosthetic of the sort Meyer showed me.
The thing Kane likes most is the way it makes him feel. “Before, the looks I got were an ‘Oh, what happened to him? Poor him,’ sort of thing,” he says as we sit in a London café. “Now, it’s ‘Ooh? What’s that? That’s cool!’” As if on cue, an elderly man at the next table chimes in: “I gotta tell you something, it looks amazing. It’s like a Batman arm!” Kane does a demonstration for the man. Such technology is as much about changing the way people see him as it is about changing what he can do.
I ask Kane about some of the far-out advances that might be available to him in the coming decades. Would he want a limb that was bolted to his skeletal system? Not really. “I like the idea that I can take it off and be me again,” he says. What about a prosthetic arm that could directly interface with his brain? “I think that would be very interesting,” he says. But he would worry about something going wrong.
Depending on what happens next, Kane’s future may be filled with technological marvels—new hands and feet that bring him closer to, or even beyond, the capabilities of a so-called able-bodied person. Or progress might not come so fast. As I watch him dart across the road to the bus stop, it occurs to me that he’ll be fine either way.