Amputee thinks, and his new arm listens

DAYTON, Tenn. — Jesse Sullivan has two prosthetic arms, but he can climb a ladder at his house and roll on a fresh coat of paint. He's also good with a weed whacker, bending his elbow and rotating his forearm to guide the machine. He has even mastered a more sensitive maneuver: hugging his grandchildren.

The motions are coordinated and smooth because his left arm is a bionic device controlled by his brain. He thinks, "Close hand," and electrical signals sent through surgically rerouted nerves make it happen.

Doctors describe Sullivan, 59, as the first amputee with a thought-controlled artificial arm.

Researchers encouraged Sullivan, who became an amputee after an industrial accident, not to go easy on his experimental limb.

"When I left, they said, 'Don't bring it back looking new,' " Sullivan said with a grin, his brow showing sweat beneath a fraying Dollywood amusement-park cap. At times, he has been so rough with the bionic arm that it has broken, including once when he pulled the end off while starting a lawn mower.

That prompted researchers to make improvements, part of a U.S. government initiative to refine artificial limbs that connect body and mind.

The National Institutes of Health has supported the research, joined more recently by the military's research-and-development wing, the Defense Advanced Research Projects Agency (DARPA). The Army Medical Command says 411 U.S. troops in Iraq and 37 in Afghanistan have suffered wounds that cost them at least one limb.

Although work that created Sullivan's arm preceded the research by DARPA, he said he's proud to test a type of bionic arm that soldiers could someday use.

"Those guys are heroes in my book," he said, "and they should have the best there is."

"We're excited about collaborating with the military," said the developer of Sullivan's arm, Dr. Todd Kuiken, the director of neuroengineering at the Center for Artificial Limbs at the Rehabilitation Institute of Chicago, one of 35 partners now in a DARPA project to develop a state-of-the-art arm.

Sullivan's bionic arm represents an advance over typical artificial arms, such as the right-arm prosthesis he uses, which has a hook and operates with sequential motions. There is no perceivable delay in the motions of Sullivan's flesh-colored, plasticlike left arm. Until now, it has been nearly impossible to recreate the complex motion of a human arm.

"It is not as smooth as a normal arm, but it works much smoother than a normal prosthesis," Kuiken said.

Sullivan lost his arms in May 2001 after suffering electrical burns while working as a utility lineman. Seven weeks later, due to what Sullivan calls being in the right place at the right time, he was headed to meet the Chicago researchers.

"Jesse is an absolutely remarkable human being, with or without his injuries," Kuiken said.

Sullivan said his bionic arm isn't much like the one test pilot Steve Austin got in the 1970s TV series "The Six Million Dollar Man."

"I don't really feel superhuman or anything," he said.

"It's not magic," added his 4-year-old grandson, Luke Westlake, as he placed a nut in Sullivan's grip and challenged "Paw-Paw" to crack it open.

Not magic but high-tech science makes the bionic arm work. A procedure called "muscle re-innervation," developed by Kuiken and used on five additional patients so far, is the key.

For Sullivan, it involved grafting shoulder nerves, which used to go to his arms, to his pectoral muscle. The grafts receive thought-generated impulses, and the muscle activity is picked up by electrodes. These relay the signals to the arm's computer, which causes motors to move the elbow and hand, mimicking a normal arm.

"The nerves grow into the chest muscles, so when the patient thinks, 'Close hand,' a portion of the chest muscle contracts," according to a fact sheet of the Chicago institute.

Kuiken added: "Basically, it is connecting the dots, finding the nerves. We have to free the nerves and see how far they reach," and connect to muscles.

About three months after the surgery, Sullivan first noticed voluntary twitches in his pectoral muscle when he tried to bend his missing elbow, the institute said. By five months, he could activate four areas of his major pectoral muscle.

Trying to flex his missing elbow would cause a strong contraction of the muscle area just beneath the clavicle. When he mentally closed his missing hand, a signal could be detected on the pectoral region below the clavicle, and when he tried to open his hand, there was a separate signal. Extending his elbow and hand caused a contraction of the lower pectoral muscle.

When Sullivan's chest was touched, he "had a sensation of touch to different parts of his hand and arm," the institute reported. "The patient had substituted sensation of touch, graded pressure, sharp-dull and thermal sensation."

Sullivan said of the thought-controlled arm: "When I use the new prosthesis, I just do things. I don't have to think about it."

Kuiken described the procedure on Sullivan as the first time such a graft has been used to control an artificial limb.

Gregory Clark, an associate professor of bioengineering and prosthetics researcher at the University of Utah, agreed, adding that a conventional prosthetic limb is "limited in a number of ways in the types of movements. Moreover, it can do only one of those movements at any particular moment."

Clark said a natural arm is capable of 22 discrete movements. Sullivan's bionic limb is capable of four right now, though researchers are working to make them better.

"Four is wonderful," Clark said.

Sullivan said his bionic arm allows him to rotate his upper arm, bend his elbow, rotate his wrist and open and close his hand — in some instances simultaneously.

He and Kuiken were set to attend a Washington, D.C., news conference today with Claudia Mitchell, the fourth person and first woman to receive the bionic arm. Mitchell, 26, had been injured in a motorcycle accident.

"I can carry a tray," Mitchell said. "I can open a jar. I can hold my Dagwood sandwich. I can hold fruit and vegetables while I cut them up. I can peel a banana.

"This makes daily life much easier, especially in the kitchen. ... That's where I found the most difficulty in doing things with one hand."

Sullivan, trying his new arm at increasingly challenging tasks, acknowledged he has good days and bad ones.

"At first, I couldn't watch when he tried doing this stuff," said Sullivan's wife of 22 years, Carolyn.

She said she first thought after the accident that he was going to die. She gave up her catering business to tend to him around the clock. But eventually he forced her to occasionally run errands and leave him alone.

"He finally got mad and yelled at me and told me to go to the store," she said, laughing.

Enormous lifestyle adjustments that the injuries and rehabilitation required were not as hard as might be expected, Carolyn Sullivan said.

"For some reason, we just sort of rolled into it," she said. "I just knew he wasn't going to let anything keep him down."

She said medication helps control his pain, and sometimes he resorts to self-hypnosis.

"They taught him how to do that," she said, adding that she doesn't consider herself to be a caretaker.

"I do all the yardwork," Jesse Sullivan said. "I take out the garbage."

He can even hold a fork to eat.

And there's another task the bionic grandfather of 10 looks forward to mastering: casting a fishing line.

Material from the Chicago Tribune is included in this report.