I previously wrote about the government cutting the soldier of the future LandWarrior program. The point of my post was the myriad next-generation medical developments destined to come from the program that would be lost in the military cutbacks. The post was picked up widely including slashdot and grandrounds. Many commenters were angry at the concept of spending hundreds of millions of dollars on military development to get medical byproducts rather than spending less money more efficiently directly on medical development. The point of that post and this one is not to say war is great because it leads to medical advances. Here I will review why and how breakthroughts come from the military and not from other avenues which is suprising (and upsetting) to many.
This military effect applies to all science and not just medicine. A summary of this concept is here. As they write:
The sheer scale of military funding for science since World War II has instigated a large body of historical literature analyzing the effects of that funding, especially for American science. Since Paul Forman’s 1987 article “Behind quantum electronics: National security as a basis for physical research in the United State, 1940-1960,” there has been an ongoing historical debate over precisely how and to what extent military funding affected the course of scientific research and discovery. Forman and others have argued that military funding fundamentally redirected science—particularly physics—toward applied research, and that military technologies predominantly formed the basis for subsequent research even in areas of basic science; ultimately the very culture and ideals of science were colored by extensive collaboration between scientists and military planners. A more traditional view (consistent with that of many of the involved scientists themselves) has been defended by Daniel Kevles, that while military funding provided many new opportunities for scientists and dramatically expanded the scope of physical research, scientists by-and-large retained their intellectual autonomy.
What are some examples of military medical offshoots?: microwave therapies for tumors, ultrasound diagnostics, active prostetics, head mounted endoscopic displays, surgical robots.
Why does military research lead to these bold new medical developments rather than medical research directly? To put it simply, because they can and have to. I have spoken to quite a few venture capitalists while reviewing devices for development and commercialization. Universally they tell me of the enormous costs of development and the fixed time frame to commercialize. Products looking too far in the future or with too high development costs are often simply too much risky business to bet on.
The military is different for better or for worse. First a budget overrun of 500% can be absorbed by the military while it can spell death for a medical start-up. In times of war, there is often no limit to the resources that can be expended to achieve an important goal. A review of the history of medical breakthroughts resulting from wars can be found here. Medicaladvances achieved during the civil war are reviewed here WWI here In addition, the military has a R&D arm that focuses on very long term high risk huge payoff projects– DARPA.
Defense Technology International has a lead article about DARPA and Risky Business Research that no one else will do. As they write about DARPA:
The mission of the Defense Advanced Research Projects Agency (Darpa) is “to maintain the technological superiority of the U.S. military and prevent technological surprise by sponsoring revolutionary, high-payoff research that bridges the gap between fundamental discoveries and their military use.” Its traditional strength has been its ability as a small, technology seed money agency with an expert technical staff and minimum bureaucratic red tape to respond to emerging military needs and technological opportunities and to independently pursue revolutionary solutions. In fact, to maintain its entrepreneurial atmosphere and flow of high-risk technical ideas, Darpa rotates program managers in and out of the agency, with most of them serving only 4-6 years.
Dr. Anthony J. (“Tony”) Tether, Darpa’s director since 2001 says of the agency:
Darpa’s job is to show that something is technically feasible. It doesn’t mean that people are automatically going to use it, because there are funding and other issues involved. But they can’t say that it can’t be done.
While we’re on the subect- here are some more things coming down the pike from the military courtesy of defensetech.org
Remore control neural activation covered here
Details of this emerged in a heavily-censored document released to Ed Hammond of the Sunshine Project under the Freedom if Information Act. Called “Sensory consequence of electromagnetic pulsed emitted by laser induced plasmas,” it described research on activating the nerve cells responsible for sensing unpleasant stimuli: heat, damage, pressure, cold. By selectively stimulating a particular nociceptor, a finely tuned PEP might sensations of say, being burned, frozen or dipped in acid — all without doing the slightest actual harm
While using this to remotely trigger pain or disable an attacker sounds ominous, the same technology could lead to revolutionary pain blocking or anesthetic techniques.
New trauma surgery development is here and remote vehicles as prototypes of implantable rovers here.
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I have always been amused by people who decry the use of dollars for basic and bluesky research, citing waste, and worse, the lack of proof-in-advance that these efforts will amount to anything. Much of the work financed by DARPA is forward-looking by as much as 20 years. The common lack of perspective exhibited by most people asked to guess a year out (and mostly failing), puts their lack of imagination and expertise at serious cross purpose with their criticisms of advanced research efforts. The work by my company, XVIVO (www.xvivo.net), to visualize a few ‘results’ of these black budget efforts using realistic 3D animation is sometimes the only way to open the eyes of the powerful, but imagination-impaired: to allow them to GROK what the visionaries have in store for us. Most of the work XVIVO has done has specifically been in prognosticating what future combat medical advances will look like in future urban battle scenarios (who can honestly say there will be fewer of those?). Which of these critics could be against swapping the ‘golden hour’ for combat casualty retrieval and stabilization, for an intelligently automated ‘golden five minutes’, especially when one of their loved ones could be in the line of fire? The spinoff uses in modern civil life, BTW, would be simply astonishing, and worth every penny of investment R&D.
David Bolinsky/XVIVO Partner
David–
Thanks for your keen insight. Your comments about how so many people cannot see the practical impact of future reaching programs like DARPA’s echos my thought and so many of the comments on my piece here at at slashdot. I know your company’s work well and am a fan myself. Particuoar notables are the inner life of the cell and the DARPA trauma pod (you are probably unaware of this but I personally have seen this animation piece in talks at international meetings from 4 physicians – all insinuating that they made it!). Credit must go to xvivo , DARPA , and my friend Rick Satava, MD who WAS instrumental in making it and sharing the video with so many in surgery and gynecology. for those interested check it out here: DARPA trauma pod and read about more 2007 DARPA programs and medicine here:
http://docinthemachine.com/2007/02/10/darpaachievements/
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The reason that venture capitalists wouldn’t do these things now is because they know the government will do it for them, they can probably get cushy government contracts to produce it, and they have high taxes and regulation. If the government didn’t fund it, someone would, I guarantee you. Do you really think that no one would have come up with microwave technology or surgical robots sans the government?
The Europeans’ GPS system is much more accurate than others, and that’s the EU, one of the most notoriously wasteful and inefficient bodies in the world. You really think a private company allowed to develop that technology couldn’t have made a better system?
The government pays contractors $900 million in bonuses for a job they completed $10 billion over budget and two years late. It’s the most inefficient mass of inefficiency that ever existed. If the government wasn’t involved in this madness, that money would be with the consumer and entrepreneur from lower taxes. The defense’s budget is exactly equal to corporate taxes in the US, currently. Cut corporate taxes by half that, and those venture capitalists will have a lot more money to invest in– and needless to say, they won’t be two years late and $10 billion over budget.
Who cares if a medical start-up dies? They must not have been doing something right. In a free market, the best companies go on and the worst die out, and new ones spring up to take their place.
However, when the military goes 500% over budget, it’s robbing every person in America who works hard and pays taxes. It has no accountability for that, either. That is a travesty.
Interestingly, the best spinoffs from the military– internet and GPS– are actually the ones most related to the military’s actual aims of defense. It could still fund defense-related things, but the mechanical elephants need to be left to private companies.
Great post.Thanks a lot.
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Really a very interesting and helpful blog and the posts.
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