Standing Tall Atop Technology: Retiring the Wheelchair

Once when I was young, around 9 I think, I slipped while exploring tide pools at Crystal Cove State Park in California and fell on a sharp rock. It stabbed me just below my right knee. It was quite a violent blow and it caused quite a trauma in the moment; I think my body still remembers it because my leg is demanding I touch the scar as I write this! Yet it did not hurt. Quite the contrary, I could not feel anything at all. For a brief yet timeless moment, I was paralyzed. I will never forget the feeling. I was not afraid or sad; I was stunned and morbidly curious. Suddenly I could “hear” my previously quiet motor system yelling, screaming at my legs to move; but they simply would not. I tried and tried from inside my mind to will my legs to move and they just could not. As I experimented with this new problem and the delirious state of shock took firmer hold, I actually ended up finding it funny. I remember my mom yelling to me asking if I could get up, to which out I sort of half-chuckled and replied, “I can’t.”

Every time I recall this story I am thankful that control quickly returned, and that I can move my legs today. After that moment I became aware of just how precious it is to have control over one’s limbs, and how fragile the human body really is. The experience left me with a lasting impression and a heightened appreciation for the power of walking. To have something taken from you shows you how beautiful it is. I think of those who have found themselves bound to wheelchairs and it saddens and frustrates me. There has to be a way to bring their mobility back, to give them the gift of walking again! Now, as the 21st Century gets firmly underway, there is hope on the horizon.

The World Cup demonstration signaled the world: a new era is dawning; an era where standing tall is a reality for all.

The wheelchair is a powerful enabling technology, but it is also an ancient technology; it has unfortunate and intractable trade-offs. Being in a wheelchair places you in a kind of nether state, just below full mobility and full participation. You are seated while others stand, always looking up. You cannot take the stairs. You cannot drive an unmodified car. You are not part of the "main" world; you are part of another world imposed on you by the limits of an ancient technology. Thanks to human decency expressed in laws like building codes requiring ramps wheelchair users are integrated into society, but those measures will never be enough to fully empower. Wheelchairs do not provide an equality of experience for those who must use them. Wheelchairs are a flawed technology, a compromise from an ancient time.

The long era of the wheelchair is finally beginning its end. Exoskeletons will bridge the gap and grant real mobility and independence to the previously chair-bound. No longer will paralyzed or otherwise immobile people be forced to sit while others stand; they too will be at eye level with their peers.

I think this will be a boon not just for the physical well being of those who have found themselves in wheel chairs, but for their mental well being too. No one wants to feel helpless, or somehow less than others. Every individual should have the right to be in charge and in control of his or her life and exoskeleton technology enables this more than ever before. Those who would have been locked to a chair in the previous century will literally be able to stand tall and reclaim a huge part of their lives.

Sophie Morgan using Rex, a joystick-controlled exoskeleton.
 “Until you have been in a wheelchair for years you cannot understand what it’s like to stand up, physically or emotionally,” says Sophie. 
“It was a bizarre feeling. I’m 5ft. 10in. And the floor looked so far away. I felt safe, but it was all an emotional blur. Afterwards I couldn’t believe that I had been walking around, and wanted to do it all over again.”
Her boyfriend Tom said, “it was the first time I’ve seen her standing up.”
“It was wonderful to be eye to eye with each other. We just hugged and hugged,” added Sophie…
 

While the World Cup demo may have seemed clunky, it was quite unique and revolutionary. Unlike previous exoskeletons that are controlled by joysticks or controllers, the World Cup suit was controlled by thought. This is a major shift as well, granting the fluidity of experience that comes with action mirroring intent directly. So much of the power of walking comes from its ability to fade away from conscious thought, to let us ferry ourselves around our daily lives without any need to think how we’re doing it. My brief brush with having my normally unconscious cycle of intent to action broken showed me how powerful it is. Giving this fluidity back to chair-bound people will be monumental. They will once again be able to move with action mirroring intent, able to navigate the world on their terms.

With this tech costs are still high and performance is clunky, but that is only temporary. Exoskeletons and the brain computer interfaces that will make them fluid to use are digital technologies, and as such they are enjoying the benefits of rapid exponential progression. Over the coming years exoskeletons will get better, faster, cheaper, smaller and “smarter” to the point where they be fluidly controlled by thought alone and even may be able to fit under clothes. Like all truly powerful enabling technology they will fade away into the background of their users' lives. I think we'll see this quality of exoskeleton before 2020 at a cost that is manageable for a middle class individual, with further cost reductions on the horizon.

Yet exoskeletons are just the beginning. Eventually we will have the medical prowess to repair any damage, and even augment beyond physical limits. For now, exoskeletons will be an incredible bridge technology enabling a better quality of life.

“The future is already here — it's just not very evenly distributed.”

It will be interesting, and somewhat troubling, to watch the progression in mobility and rehabilitation technology during the first half of the 21st century. We may see overlaps of technological fixes, with biological fixes emerging while exoskeletons are still being refined.

The progression may be: first richer people get exoskeletons while poorer people are still relegated to wheelchairs, then poorer people will get exoskeletons while richer people have moved on to biological fixes, then poorer people will get the fixes while richer people perhaps have moved onto augmentation.

Although I personally think that augmentation will be a surprisingly level playing field of cost and adoption. Synthetic biology is shaping up to have very strong grass-roots potential. But that’s a discussion for another time…

Still with the state of financial equality on Earth, and particularly medical care in the US, the benefits of exoskeletons will be unevenly distributed at first. Decent ones are on the market as of 2016 for $40,000. But like all digital technology, exoskeletons will become a commodity eventually. 

From exoskeletons to stem cells, new technology is seeing wheelchairs nearing the end of use.  In the 21st century we will finally be able to retire a technology that has been with us since the 6th century BCE. We will finally be able to grant every human true mobility and control over their lives, to let them stand tall and walk on their terms.

A few generations from now, kids will learn of the amazingly progressive and empowering laws in the US and other nations that helped wheelchair-bound people integrate with society, and it will likely just confuse them.

"Why build ramps? Why didn't you just fix everyone’s legs? Or give them new ones!"

"Because we didn't know how… but we learned."

- JH