452- The Lows of High Tech

Episode Summary

Title: The Lows of High Tech - Britt Young is a tech writer who was born without part of her left arm below the elbow. As a child in the 1990s, she got one of the first myoelectric prosthetic arms. - Myoelectric prosthetics are battery-powered and can be controlled by muscle movements in the residual limb. But Britt's prosthetic hand could only open and close, so she stopped using it in high school. - In the 2000s, advanced prosthetics saw major innovations driven by DARPA and the wars in Iraq/Afghanistan. These "bionic" limbs aim to look futuristic. - In 2018, Britt got a new multi-articulating myoelectric hand. She and her friends were excited by its cyborg aesthetic, but it was uncomfortable and couldn't do basic tasks like turn a doorknob. - The $70,000 prosthetic hand was not the life-changing assistive device Britt expected. She still uses a simpler, non-articulating prosthesis for specific activities. - The hype around high-tech prosthetics promotes an unrealistic idea of what they can do. People with limb differences adapt in varied ways, not just through technology.

Episode Show Notes

Britt Young, the author of the article "I have one of the most advanced prosthetic arms in the world — and I hate it" guides us through the highs and lows of high tech prosthetics.

Episode Transcript

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Go to B-O-M-B-A-S dot com slash 99 P-I and use code 99 P-I for 20% off your first purchase. That's Bombas. B-O-M-B-A-S dot com slash 99 P-I code 99 P-I. This is 99% invisible. I'm Roman Mars. Britt Young is a geographer and tech writer based in the Bay Area and she loves a good theme party. SPEAKER_09: My whole life I've done some silly themed parties. SPEAKER_06: And when she says silly, she's not exaggerating. SPEAKER_11: Producer Vivian Lay. SPEAKER_06: She told me about a party she threw once based on an obscure sitcom about a rural Canadian farming community. She also used to host annual ragers in honor of Billy Mays. You know, that guy from the OxiClean infomercials. SPEAKER_10: Roman Mars here for 99 P-I. SPEAKER_06: But a few years ago, she threw her wildest party yet. It was an arm party. SPEAKER_11: Britt has what's called a congenital upper limb deficiency. In other words, she was born without the part of her arm just below her left elbow. This latest celebration was a farewell to her boring old prosthesis and a welcome home to her brand new multi articulating bionic hand. SPEAKER_09: We had a friend who played bartender and we had a bunch of arm themed cocktails. There was Armageddon, pink armadillo, a bunch of things like that. SPEAKER_06: There were also arm themed games like Arm Twister, which was normal Twister. SPEAKER_09: But anytime that you needed assistance, you could grab a free prosthetic arm to reach yellow five easier or whatever. SPEAKER_11: She even christened the high tech arm by cutting a cake with it. SPEAKER_00: I'm really trying to be Twitter famous so please tweet it. And this is not going to work. SPEAKER_09: Yeah, yeah, yeah. It just opened. So that's the that's the what's it called? It's a fist. SPEAKER_06: This is the sound of Britt giving me a little demo of how her prosthetic hand works over Zoom. We ended up playing sort of a game of cyborg charades while she cycled through the different grip modes of her prosthesis. SPEAKER_09: I call this one the Obama talking point. It's the thumb resting on top of the index finger and you're like, so you go, yes. This one might be like, I am a sophisticated cyborg and I am handing you my credit card. And so this one is like Italian. SPEAKER_11: This prosthetic hand has a sleek carbon fiber casing with specific pre-programmed grips that she can control just by flexing the muscles in her residual limb. She can use a precision pinch to pick a hairpin up off the table or a Hulk style power fist to squeeze objects. This kind of assistive technology has been life changing for a lot of people who have limb differences. But for Britt in particular, it hasn't been life changing at all. SPEAKER_06: In fact, her cutting edge bionic arm has been a pretty major disappointment. SPEAKER_09: It's just not, it's not what you imagine. It's not like, well, I'm like everyone else now. It's something different. It's something different. SPEAKER_11: Prosthetics go back thousands of years. The earliest known prosthesis is actually a wooden toe that dates back to ancient Egypt. But while we've had prosthetics forever, we've only seen major advancements in their design in the last couple hundred years, mostly thanks to the military. SPEAKER_02: Their development is intricately, intimately, inextricably tied to the military. SPEAKER_06: This is David Serlin, associate professor of communication and science studies at UC San Diego. He says that the first major leap in prosthetics came after the Civil War, which was considered the first modern war. SPEAKER_02: The scale of damage from weapons was unprecedented. And so people hadn't really seen what prosthetics could do on kind of the scale that they would soon come to understand. By the end of the war, tens of thousands of soldiers suffered amputations and needed help SPEAKER_11: getting back to their lives. In response, the federal government began subsidizing artificial limbs for Union soldiers and prosthetic companies sprang up to meet the spike in demand. SPEAKER_06: In the process, available prosthetic technology for both veterans and civilians grew exponentially. Prosthesis evolved from rudimentary wooden peg legs to artificial limbs that had hinges at the ankles and knees to reproduce a natural gait. SPEAKER_11: Then decades later, World War II led to even more prosthetic innovation. SPEAKER_02: Engineering science, material science, those are all percolating in the 30s and 40s. And they really take off during and after World War II. In the Soviet Union and the U.S. and Britain, the development of what we think of as prosthetic science, they really become industries. SPEAKER_06: In the United States, a team of military personnel, engineers and prosthetists came together at the request of the Surgeon General of the Army to form the Committee on Prosthetics Research and Development. They wanted to figure out how to actually develop prosthetics into a proper field of medicine. SPEAKER_11: And the biggest challenge was developing a good artificial hand. Prosthetic legs are simpler to design and users tend to have higher satisfaction rates with them. But creating a hand that incorporated robotics wasn't possible until well into the Cold War. SPEAKER_02: The 60s and 70s, there were all of these engineering sciences that develop between, let's say, the military and MIT or Northwestern. So instead of just developing napalm, they're also developing technologies that allow you to use batteries for what are called myoelectric arms. SPEAKER_06: A myoelectric arm is a battery-powered prosthesis that can be controlled by movements on the residual limb. In the early 1990s, Britt actually became one of the youngest children in the country to get one. I wasn't the first, but I was part of one of the earliest cohorts of babies, basically, SPEAKER_09: using myoelectric hands. SPEAKER_06: At the time, these myoelectric hands were state-of-the-art compared to anything else on the market. But all that Britt's hand could really do was pinch open and shut. She worked with these devices all the way through middle school. SPEAKER_11: And it was a real crowd pleaser in the seventh grade. SPEAKER_09: It was like a party trick in middle school. We were like, hey, I can crush a can. And you know, that's fun for a while. But as Britt got older, she realized just how useless her myoelectric hand really was. SPEAKER_09: If you think about it, how many tasks in your day do you need a slow-moving, grinding, clicking thing that will grip in a single motion, more like a pinch? It couldn't even grab a piece of paper. It would just slide right through. SPEAKER_06: And by the time she got into high school, she was pretty over it. SPEAKER_09: This thing doesn't help me. It's heavy and I'm just going to quit. So I went exclusively to passive arms after that. SPEAKER_11: A passive prosthesis, also called a cosmetic prosthesis, is a device that closely resembles a quote unquote natural limb. It doesn't crush any cans or get you any attention. In fact, it serves the opposite purpose to help you blend in. SPEAKER_09: Something that I had deeply ingrained in me over my lifetime that like I needed to wear this or else people are going to treat me differently. They're going to look at me funny. I need to wear this so that I am undetected and that I can conform and that my life runs smoother. SPEAKER_06: After her bad experience with the myoelectric arm, she had no interest in dabbling in advanced prosthetics anymore. She was resigned to just staying undetected. SPEAKER_11: That is until a few years ago when her prosthetist reached out. SPEAKER_09: They got in touch with me and they said, you know, there's been a lot of changes in prosthetic arm technology. Things are a lot more sophisticated. SPEAKER_06: In the years since Brit stopped using power devices, innovation in the field had gone into hyperdrive. These new advancements in prosthetics were driven in the early 2000s by a renewed sense of government responsibility to compensate for the inadequacies of the American health care system. No, I'm just kidding. It was because of the military again. The Iraq war was a really big turning point in prosthetics in the U.S. but also in parts SPEAKER_09: of Europe. In 2006, DARPA launched the Revolutionizing Prosthetics Program in response to the wars SPEAKER_06: in Iraq and Afghanistan. They wanted to address the shortcomings of available prosthetics for veterans with amputations by building the ultimate powered hand that would be sleeker and multi articulating, meaning the individual digits on the hand could move and form different grip patterns. SPEAKER_11: And this time around, they wanted these new high tech prosthetics to look bionic. SPEAKER_02: The goal 30, 40 years ago in prosthetics was to make things look realistic and to be able to pass. SPEAKER_06: David Sirlin again. SPEAKER_02: But now you do tend to see prosthetics that are the last thing that they're interested in doing is looking like the quote unquote real thing. They will have articulated fingers or articulated joints, but they're not looking to mimic the way that the human like flesh colored elbow joint or knee joint or finger joints look. In fact, what they look more like are robots out of Star Trek or Star Wars. SPEAKER_06: We'd seen articulating bionic limbs in movies and comic books for decades. And now it seemed like real world prosthetics were finally getting closer to our sci fi dreams. SPEAKER_09: Like I mean, we've always had sci fi movies be the standard for what we want in the future, right? And there's just like this turn in like, OK, what's possible? SPEAKER_09: And there seemed to be kind of like a weird alignment in the early 2000s where what was potentially possible technologically started to line up more with like this vision of what is going to be attainable. It's got a hell of a grip. SPEAKER_09: And that is like perfectly replaceable prosthetic limbs. You have a metal arm? SPEAKER_12: That is awesome, dude. SPEAKER_11: So in 2018, tempted by all of these new advances in the technology, Britt decided to get her first myoelectric prosthesis in over 15 years. SPEAKER_09: There was a lot of anticipation that was being built amongst my friends and myself for what at the time seemed like the coolest, most life changing, cutting edge prosthetic arm that I would receive in my life. And I thought it was kind of time to do something really dumb and silly about it, like throw SPEAKER_11: an arm party. SPEAKER_00: And this is not going to work. SPEAKER_06: She was embracing her cyborg future and it looked awesome. People were like, like when I'm wearing a dress and like a little heel and then there's SPEAKER_09: this like stormtrooper, like very aggressive looking kind of militaristic hand, like look badass. People love it. They just, they want to see tricks. They want to see like how it moves. It was, I mean, like I liked the attention and it felt like middle school again. SPEAKER_06: But a lot like when she was in middle school, Britt quickly realized that this high tech piece of machinery wasn't all that it was hyped up to be. It was heavy. It was hot. It was incredibly uncomfortable. But Britt still practiced with it every day, putting it on and trying to get her body used to the discomfort. SPEAKER_09: Maybe it's sort of like breaking in leather heels or something. We were like, I liked the way this looks and I think I will look sexy, but right now it's pain and you have to endure the pain. SPEAKER_11: And the pain wasn't really worth it. The point of assistive technology like prosthetic devices is to assist, but there are a lot of things this multi articulating hand couldn't do. Simple things like turning a doorknob. SPEAKER_09: So this thing cannot open a doorknob. Turning it. Cause that's, that's a, that's a forearm rotation. That's a wrist rotation. That's not going to happen. SPEAKER_06: And it wasn't like she could just make the hand do whatever she wanted. She was limited to only the grips that were pre-programmed on the device. If you want to do like a thumbs up and then go straight to like a hang 10, how, how, how no, no, no. SPEAKER_09: So it is multi articulating, but it is not individually articulating. Like there are presets and that's it. I can't like decide to use the middle finger. Oh, it's not even an option. No. Um, and also it's proprietary. So if you would like to change the grip patterns, you must make an appointment with your prosthetist. SPEAKER_11: There were actually only a few tasks that her bionic hand was helpful for, like holding an umbrella in one hand and a cell phone and the other at the same time. SPEAKER_09: Which now is not a problem because I live in the Bay area and it never rains. SPEAKER_06: And it was great for operating a potato ricer on Thanksgiving. Other than that, her $70,000 bionic hand has been kind of a bust. SPEAKER_09: So I made $70,000 Thanksgiving mashed potatoes. Is it worth it? SPEAKER_06: No. Which brings up another issue with advanced prosthetics, how absurdly expensive they are. Britt was lucky enough to have really good insurance, which paid for the bulk of the price, but a complex myoelectric arm can cost anywhere from 20,000 to a hundred thousand dollars. And even if you have good insurance, it can be a battle to get insurance companies to pay for even the most basic types of prosthetics, let alone the experimental high tech kinds. SPEAKER_11: But despite the high financial costs and all the functionality issues, Britt says a lot of people still choose these types of advanced prosthetics over low tech options in order to meet other people's expectations. SPEAKER_09: It seems like there's a little bit of an overbearing expectation that like, if you're missing a limb, then you need to have a cyborg arm. You need to be bionic because that's cool. It gets you cool attention. SPEAKER_06: Futuristic prosthetic technologies are exciting and draw a specific type of positive attention. And for a lot of people with limb differences, this attention can seem better than the alternative. SPEAKER_08: When we wear a prosthesis in public, we attract attention, but we're going to attract attention no matter what. So the person has to decide with what are they more comfortable. SPEAKER_06: This is Debbie Latour. She's an occupational therapist and does educational consulting for prosthetics design. Debbie also has a congenital limb difference and occasionally uses a powered hand. She actually really likes hers. SPEAKER_08: It's invaluable for doing things like typing. And I'm a university professor. I do a lot of bimanual activities. SPEAKER_06: And not using her prosthetic arm can come with its own problems. SPEAKER_08: If you've ever tried to push a grocery cart with one arm, I would challenge you to do it and be prepared to knock down a display at the end of an aisle. SPEAKER_11: Debbie may have a different relationship with her prosthetic hand, but she does agree with Britt that the way that high-tech limbs are viewed by people who don't have limb differences can be damaging. And a lot of that has to do with how we talk about them. SPEAKER_08: Oftentimes prosthetic technology is viewed as like the savior or the superhero type of thing that's going to give us all of these bion, because it's a bionic arm, it's going to give us superhuman capacities. But it's a process. SPEAKER_11: If you spend too much time on Twitter, like me, or you watch a lot of local news, then you've probably come across a very specific type of viral video about advanced prosthetics. They're feel-good videos that feature a child with a limb difference being given a bionic arm with some sort of click-baity title. SPEAKER_09: Like baby receives prosthetic arm, look at their reaction, or 10-year-old opens up 3D printed arm for the first time, see how they squeal. SPEAKER_11: In 2012, a disability rights activist named Stella Young coined a phrase for exactly this type of video, inspiration porn. She specifically used the word porn because she sees it as the objectification of one group for the benefit of another. SPEAKER_09: The media has always been about prosthetics being like savior technologies and like feel-good fluff pieces. Look at this disabled kid or look at this disabled adult and now their life is better because of this tech. SPEAKER_06: You see this a lot in reaction videos of babies hearing for the first time after receiving a cochlear implant too. These stories give people an unrealistic expectation of what advanced prosthetic devices can actually do for users. And they show a very narrow version of what thriving looks like for people with a disability. SPEAKER_05: All those inspiration stories, all of those pity stories, all of those technology rescue stories, all of those are a way I think for us to just cognitively contain difference. And we can't imagine that difference actually might be a form of flourishing. This is Sarah Hendren. SPEAKER_06: She teaches design and fine arts at Oling College of Engineering. She is not a fan of these types of videos either. They teach us that the solution to someone having a limb difference is to build them a better hand or the solution to disability in general is to quote, fix a body. SPEAKER_05: The next time we meet somebody who's blind, the next time we accompany our aging grandparent to the theater, the next time we encounter a person with Down syndrome on the street, we can only think of, oh, where's the cyborg rescue for this person? Where is the kind of soft piano music swelling in the background? That kind of narrative. And that is a flattened way of seeing the world. SPEAKER_06: It's not hard for people interested in building assistive tech to get caught up in this narrative too. Hendren teaches a lot of engineering students, and she worries that this type of narrow representation can enforce the idea that high tech solutions are the only ones that matter. I say this with love. SPEAKER_05: It is a kind of slam dunk for like a young person who was interested in robotics who broadly wants to do good in the world. High tech prosthetic limbs looks like, you know, the center of that Venn diagram, but it can obscure then what assistive technology could really be. SPEAKER_06: It feels like the temptation for designers is to try to create an amazing new technology that can erase a person's disability. And maybe the better challenge is to try to design a world that can accommodate people with different types of bodies and different sets of abilities. SPEAKER_09: We've kind of chosen the messier way, which is like trying to make every person who is not quote unquote whole, whole again, when we could make kitchen counters or cars more accessible to begin with that are more adaptable. SPEAKER_06: In Brit's case, instead of selling her a $70,000 arm that makes it easier for her to use a potato ricer, maybe we could design a potato ricer that's a little easier for someone with a different type of body to operate. SPEAKER_11: A lot of people with limb differences can do tasks better with no prosthesis at all because they've developed their own adaptations. And for many others, the lower tech options are actually a lot more functional. There are things like split hook prosthesis, which are super reliable because they have no electronic components and don't attempt to resemble a hand at all. SPEAKER_06: There are over 2 million people in the United States living with a limb difference. And every single one of those experiences is different. Satisfaction with a prosthetic device can depend on which limb is affected or how many limbs are affected. And it depends on how high or low an amputation might be or whether or not you were born with it. There's no such thing as a one-size-fits-all solution to assistive tech. And we need to listen to what people actually need in order to navigate the world. SPEAKER_09: I want to make space for like, critiquing these things. Because otherwise then we just have to be grateful all the time for like whatever gets invented. SPEAKER_11: These days, Brit doesn't use her high-tech bionic arm and doesn't even wear a cosmetic prosthesis anymore. SPEAKER_06: But a couple of times a week, she uses an activity-specific device, which is a type of prosthetic socket with swappable attachments for things like exercising. It doesn't try to resemble a natural hand at all and is much simpler than her bionic hand. She has a clamp attachment so she can do kettlebell swings and another called a mushroom that she uses to do balanced push-ups. It's called that because it looks like a mushroom. SPEAKER_11: And it's not like Brit is anti-technology. Actually, she's surprisingly optimistic about it. SPEAKER_09: I do think that the technology will improve. I do think that there will be better options. And maybe in my lifetime, I'll get another arm that will help me do the potato ricing a little bit better. SPEAKER_06: But in the meantime, she's not going to just wait around for the perfect arm to get invented. She'll keep using her mushroom and her kettlebell clamp and sometimes no prosthesis at all. And she'll continue using all the strategies she's developed to navigate a world that wasn't built for her. SPEAKER_11: This story was produced by Vivien Leigh and edited by Chris Berube and Emmett Fitzgerald. When we come back, we have a story about how the world is not actually designed for you. 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Your generous donation will give the IRC steady, reliable support, allowing them to continue their ongoing humanitarian efforts even as they respond to emergencies. Donate today by visiting rescue.org slash rebuild. Donate now and help refugee families in need. SPEAKER_11: This show is sponsored by BetterHelp. Do you ever find that just as you're trying to fall asleep, your brain suddenly won't stop talking? Your thoughts are just racing around? I call this just going to bed. It basically happens every night. It turns out one great way to make those racing thoughts go away is to talk them through. BetterHelp gives you a place to do that so you can get out of your negative thought cycles and find some mental and emotional peace. If you're thinking of starting therapy, give BetterHelp a try. It's entirely online, designed to be convenient, flexible, and suited to your schedule. Just fill out a brief questionnaire to get matched with a licensed therapist and switch therapists at any time for no additional charge. Get a break from your thoughts with BetterHelp. Visit betterhelp.com slash invisible today to get 10% off your first month. That's BetterHelp. Get a break from your thoughts with BetterHelp.com slash invisible. Your world has not been designed for you. In large part, it has been designed for the average person. Throughout your education, you've been given standardized tests and been graded by how well you perform compared to the average. Building codes, insurance rates, Dow Jones, all these measurements are based around the concept of an average. And it's okay. SPEAKER_04: We know you're not average. You're really special. Oh, thanks Avery Trofman. SPEAKER_11: Well, I mean it. SPEAKER_04: You're not average. No one is. Not completely. But the concept of average affects us all. SPEAKER_03: Everything seemed to be based around this reference point of average. And obviously everything about society is built this way, but I never really thought of it until I dug into this new science that I'm a part of. This is Todd Rose. My name is Todd Rose. I am the director of the Mind, Brain, and Education program at the Harvard Graduate School of Education. SPEAKER_04: He's also the author of the book The End of Average. But to get to that, first we have to start with the beginning of average because it wasn't always a thing. SPEAKER_11: The concept of average as we know it was pioneered by a Belgian mathematician and astronomer named Adolphe Quetelet. SPEAKER_03: So Quetelet is the person who actually coins the term the average man. And he is in like the 1830s. He is actually an astronomer in Belgium. SPEAKER_04: Today the way that most people get a handle on any set of numbers is to calculate the average. But in Quetelet's time, astronomers were some of the only people who did this. SPEAKER_11: Basically, averages were a way to compensate for the imprecise tools that astronomers were working with in 1830. SPEAKER_03: If you were trying to time the movement of Saturn, you would etch little scratches on your glass of your telescope and as soon as it crossed one, you'd start counting and you'd stop counting after it crossed the other and then you'd write it down. But you can imagine, like even if you're off by half a second, it's going to introduce a lot of error. And so they realized if they wanted to make sense of taming the heavens, they needed more precision in their estimates. SPEAKER_04: And they realized that if you had, say, 10 measurements and they were all slightly different, if you added them together and divided them by 10, you'd get a better approximation of the true measurement. SPEAKER_03: If you just average together our measurements, you're way more likely to be closer to the truth, right? And you end up getting kind of a bell curve of measurement errors. SPEAKER_11: Quetelet was the first to take this tool of astronomers and apply it to people. SPEAKER_04: In the early 1840s, Quetelet finds a data set of the chest measurements of 5,738 Scottish soldiers. Quetelet added together each of the measurements and divided it by the total sum of the soldiers and that result, 39 and three quarters inches, was one of the very first times a scientist had calculated the average size of a human feature. SPEAKER_03: But he brings with it the idea of truth, that the average chest size is true and that all the individuals are like error, that nature is striving for the average soldier. This means the average measurement is the true measurement, the Platonic ideal. SPEAKER_11: The perfect Scottish soldier has a chest that is 39 and three quarters inches, according to Quetelet. SPEAKER_03: So he's the one that decides not only is average mathematically useful, it's morally the way to think about people. And so he basically finds averages anywhere he can possibly find them. And he just has like a field day. He measures all kinds of other people and averages them. SPEAKER_04: He creates something called the Quetelet index for measuring ratios of average height and average weight. And actually, we still use it today. Because now it's called the body mass index or BMI. SPEAKER_03: Quetelet would say, if you talked about height, everyone, if they were optimally fed, if they were under the same environmental conditions, would have been average. So his view was that what you're striving for is the continual improvement of the average of the group. SPEAKER_11: And it wasn't all just physical. Quetelet combs through various data sets for marriages, murders and suicides and calculates the averages for them. He figures out there's such a thing as a normal suicide rate, which is really, really bizarre at the time, almost scandalous. SPEAKER_03: Nowadays when we're so used to the stability of big, massive amounts of data that it's hard to put yourself in their shoes. But like back then, they really thought that something like, say, suicide was such a personal decision that there couldn't possibly be any pattern there. But suddenly there were patterns of body size, of intelligence, of birth, of death. SPEAKER_04: People became statistics. Their behavior starts to become predictable. Suddenly human life went by the numbers. SPEAKER_03: So obviously the first interpretation is, well, wait a minute, maybe there's no free will, right? Maybe there's laws of society, just like there's laws of physics. And so that kickstarted a whole bunch of people like, you know, like Karl Marx, who loved Quetelet. SPEAKER_11: And he becomes a huge star. In his time, Quetelet was up there with the likes of Sir Isaac Newton. His science of averages was this remarkable cutting edge way to assess the health, wellness, and progress of populations. SPEAKER_03: He's really active at the 1820s, 1830s, 1840s, all the way into like the 50s and 60s. SPEAKER_04: And the 1860s brings us to the US Civil War. And to another super fan of Quetelet's science of averages, Abraham Lincoln. SPEAKER_03: When the Civil War is going in the north, Lincoln actually decides, I mean, they're kind of getting their butt kicked, frankly. SPEAKER_11: In large part because this war had gotten so huge and unwieldy, Lincoln doesn't really have a handle on the Northern Army. SPEAKER_03: And he's like, look, we don't even know who our soldiers are. We don't know how well fed they are. We don't know what kind of armor they need. We don't know anything about them. SPEAKER_04: Lincoln decided that the Union Army needed more information about its soldiers in order to best distribute resources. So he ordered this enormous study to assess the Union Army physically, medically, and mentally. SPEAKER_11: And then, in explicit obedience to Quetelet's new science, averages were calculated and reported. SPEAKER_03: They actually say, basically, we're following the father of this new field, Quetelet. SPEAKER_04: These freshly calculated averages informed the distributions of food rations and the design of weapons. SPEAKER_03: For example, if you were going to create muskets, well, how far is the trigger? And you could actually calculate average reach for a soldier. SPEAKER_11: This also affected military uniforms, which used to be all custom-sewn. But in the Civil War, so many people had to be outfitted that custom uniforms would be impossibly expensive. So the uniforms had to be mass-produced. But they couldn't be just all one big floppy size. SPEAKER_03: And so now they're realizing, oh, well, you know, if we break it into subtypes, like there's a large, and this is what we mean by it, you know, this big of a torso, this broadest shoulders, you know, small, medium, large, that's going to carry over into the way they think about the mass production of clothing. SPEAKER_04: Yep, the sizes small, medium, and large, which might be on your t-shirt tag, those came out of this massive Civil War study. So you can thank Quetelet and Lincoln for that. SPEAKER_11: This study in the Civil War was the basis for the American military's longstanding philosophy of standardized, average-based design. SPEAKER_03: And that's going to become the fundamental design philosophy from the Civil War forward. SPEAKER_04: So in 1926, when the Army was designing its first ever fighter plane cockpit, engineers measured the physical dimensions of hundreds of male pilots and used this data to standardize cockpit dimensions. Of course, the possibility of female pilots was never considered, of course. SPEAKER_11: The size and shape of the seat, the distance to the pedals and the stick, the height of the windshield, even the shape of the flight helmets were all made to conform to the average 1920s male pilot, which changed the way the pilots were selected. SPEAKER_03: You basically then select people that fit into that and then exclude people that don't. SPEAKER_04: And this cockpit design worked okay, up to World War II. SPEAKER_03: What happened was, though, is that in World War II, it became an Air Force war, right? That was the first time when the Air Force would be the determinant of who was going to win the war. And we absolutely ran out of pilots. SPEAKER_04: The government recruited hundreds of new pilots and expanded military aviation. They spent a bunch of money on fancy new planes. Although the cockpits were still designed for the average 1920s male pilot. SPEAKER_11: And this new big bad military force was going to fly the fastest and the highest and be the best. SPEAKER_03: But that's not what happened. They actually had a pretty massive decline in performance, including just a rash of deaths. SPEAKER_04: Pilots were dying all the time. Even after the war ended, just in training, they could not control their planes. SPEAKER_03: It became kind of part of the culture of the Air Force where, hey, it's just really dangerous to fly. SPEAKER_11: No one knew what was going on. Some people thought, well, these ain't propeller planes anymore. Maybe these new pilots just can't deal with the new aviation technology. SPEAKER_03: And then they were like, well, maybe you got to train them better. And they did their better training programs and that didn't work. SPEAKER_04: After blaming the pilots, the training programs and the technology, it finally dawns on them. What if it's the cockpit? Maybe it doesn't fit us anymore. SPEAKER_03: Our first instinct is to think we've just gotten bigger as a people. So the old average from 1922 is just too small, right? We're just bigger and badder and like, let's build a better average. SPEAKER_04: So in 1950, researchers at Wright Air Force Base in Ohio were tasked with finding this new average. And one of those researchers was a man named Gilbert S. Daniels. SPEAKER_11: Daniels was a Harvard graduate who had written his thesis on the average sizes of his classmates' hands. He was 23 years old, small, skinny, nerdy, not a military man at all. SPEAKER_03: And he travels all over the country to different Air Force bases. And his job is to take these tape measures and just measure like 147 different dimensions of body size. It's got to be the most tedious job ever. SPEAKER_11: And as Daniels is traveling around from base to base, measuring thousands of airmen, he's realizing this incredible variability from person to person, even within this limited demographic of young men. SPEAKER_04: As he was measuring hands and legs and waists and foreheads, Daniels kept asking himself, how many pilots were actually average? So he reports back. SPEAKER_03: So he goes to them and says, look, I think I think there's a problem with the average. And he says, I just want to do this, this side study. I want to know if we take the 10 dimensions of size that matter most for design, like SPEAKER_11: say shoulder width, height, chest circumference, sleeve length, etc. SPEAKER_03: How many of these pilots are actually average on all 10 of those dimensions? SPEAKER_04: Daniels crunched the numbers. And of the 4,063 pilots he measured, not a single airman was close to average in all of the 10 dimensions. SPEAKER_03: None. Not one. And it got even worse. Like if you just used three dimensions of size, less than 5% of the pilots were average on those. So he quickly realizes like, wait, now you know the problem. If you are designing something for an average pilot, it's literally designed to fit nobody. SPEAKER_11: And in this new era of jet-powered aviation where pilots were making split-second decisions that could be life or death, it really mattered that pilots could reach what they needed to reach in a cockpit. The military sprang into action pretty much right away. SPEAKER_03: For the military to be willing to basically drop generations of design philosophy, right? Because it doesn't take them more than a few years to just be like, you can't design on average anymore. SPEAKER_04: Air Force engineers and contractors designed adjustable foot pedals and adjustable helmet straps and flight suits and adjustable seats. You just can't believe that we were building planes with no adjustable seats. SPEAKER_03: That's how much faith we had in the average person. SPEAKER_11: Once all the adjustable elements and other design solutions were put into place, pilot performance soared. And of course, now we take this for granted, that equipment should fit a wide range of SPEAKER_04: body sizes instead of standardized around one average. SPEAKER_03: You wouldn't buy a car that didn't have adjustable seats, right? That's just crazy. And it seeps into there pretty quickly in terms of automobiles. And then you see, what's interesting is the whole idea of ergonomics that all comes off of this period of time. SPEAKER_11: World War II jump starts the science of ergonomics, which is not just for office chairs. SPEAKER_07: Well, it's really the study of work is what you could boil it down to. But it really is a matter of matching people's capacities to the job. SPEAKER_04: This is Professor Carissa Harris-Adamson, director of the UCSF-UC Berkeley ergonomics program. SPEAKER_07: It's really important not to go with the average a lot of the time. If we want to incorporate, say, a handle into something, well, we'll look up the anthropometry data and make sure we identify the grip span that we think is best. Or if we're designing a crank and we want it to be at a certain height, then we will go back to the anthropometry data and figure out what makes the most sense to accommodate as much of the population as we can. SPEAKER_04: Keeping in mind that in the US, most of the measurements we base our designs on still come from the US Army. SPEAKER_07: That's primarily the source that we use in, say, ergonomic books or when we're designing for the workplace. And what we found is that those numbers are actually all pretty representative today, except for weight and abdominal girth. SPEAKER_11: Which is part of why the world is so hard for heavier people to navigate. SPEAKER_07: The military might be considered a more fit population than the rest of us. SPEAKER_04: So does this mean that military measurements affect the way our cars are designed? SPEAKER_07: Absolutely. The measurements of our military personnel over the years affect just about everything. SPEAKER_04: Military measurements are the most public and accessible. And they work OK. They're not perfect, sure, but they're getting more inclusive. SPEAKER_07: They've done a really good job in accommodating more of the population, given that women are now a very vibrant part of our military force. SPEAKER_11: When the military opted to design for a greater range of people, they designed for a greater range of opportunity. Take for example, Kim Campbell. SPEAKER_03: She was a fighter pilot and she flew an A-10 Warthog. And it's worth Googling. It is like the baddest looking plane you're ever going to see. SPEAKER_04: That's Todd Rose again, by the way, helping us tell the story of Captain Campbell. SPEAKER_11: In 2003, Campbell was sent on a mission to assist some Marines who were trying to take a bridge in Iraq. They were under heavy fire. But on her way back, her plane gets shot and she loses all control. SPEAKER_03: She has the option to eject right there and save her life. But then the plane spirals into Baghdad and kills a bunch of innocent people. So she says, like, I'm not going to do that. She stabilizes, which I don't even know how you do. And she flies back and then she says, look, I think I can land this plane. SPEAKER_04: And she lands the massive, damaged, uncontrollable plane. It's an incredible heroic feat, really unprecedented. So of course, Kim Campbell gets awards and distinctions. And she is someone who could have never been one of the best pilots in the world had the military not changed their design philosophy. SPEAKER_03: She's the beneficiary of a cockpit that's flexibly designed because she's like 5'4 and rail thin and doesn't look anything remotely close to an average-sized pilot. SPEAKER_11: When Kim gets into a cockpit, she has to put the seat all the way up and pull the pedals all the way out. But it fits. SPEAKER_03: This idea of equal fit as the foundation for how we think about real opportunity in society, I think has serious consequences for the future of design. SPEAKER_04: And this concept that fit makes opportunity, it's an important one for Todd because he believes that we can design environments and equipment and even entire systems to accommodate more and more people. SPEAKER_03: When we think about how we design environments, you know, in a lot of fields, we've made some progress around accommodating wider ranges of people. But actually in things like education, we still actually design for this mythical average person under the assumption that if you design something that fit an average person, it would actually fit most people. SPEAKER_11: By re-examining the concept of the average and acknowledging its limitations, we can maybe start to consider other ways of assessing and categorizing test scores or clothing sizes or wellness or happiness or worth. We can pave the way for more people who are outside of the average because really no one is average. That story was originally produced by 99PI alum Avery Truffleman back in 2016. 99% Invisible was produced this week by Vivian Lay and edited by Chris Berube, mix and tech production by Amita Ganatra, music by our director of sound Sean Real. Delaney Hall is the executive producer. Kurt Kohlstedt is the digital director. The rest of the team includes Emmett Fitzgerald, Christopher Johnson, Lasha Medan, Sofia Klatsker, and me, Roman Mars. Also thanks this week to Greg Martino from United Prosthetics. Britt Young is working on a book of essays about tech, the human body and disability. This episode was inspired by an article that she wrote for input mag called, I have one of the most advanced prosthetic arms in the world and I hate it. You can find a link to that on our website. We are part of the Stitcher and Sirius XM podcast family. Now headquartered six blocks North in the Pandora building in beautiful uptown Oakland, California. You can find the show and join discussions about the show on Facebook. You can tweet at me at Roman Mars and the show at 99pi.org. We're on Instagram and Reddit too. You can find links to other Stitcher shows I love as well as every past episode of 99pi and 99pi.org. SPEAKER_10: Roman Mars here for Stitcher. It's powered by podcasting and Sirius XM. It's powered by satellites whizzing through the sky. It's available for the low, low price of $0. That's right. $0. If you act right now, that's Roman Mars for Stitcher and Sirius XM. SPEAKER_01: Hey, look at you florist by day, student by night, student by day, nurse by night. Since 1998 Penn State world campus has led the charge in online education offering access to more than 175 in demand programs taught by our expert faculty. We offer flexible schedules, scholarships, and tuition plans to help you reach your educational goals online. Penn State world campus delivers on your time. Click the ad or visit worldcampus.psu.edu to learn more. That's worldcampus.psu.edu to learn more. SPEAKER_12: With the McDonald's app, you can get your favorite thing delivered to your door so you can eat your favorite thing while you watch your favorite thing at home. Order McDelivery in the McDonald's app. By participating McDonald's delivery prices might be higher than restaurants. SPEAKER_05: Delivering other fees may apply. SPEAKER_12: Welcome back to our studio where we have a special guest with us today, Toucan Sam from Fruit Loops. Toucan Sam, welcome. It's my pleasure to be here. Oh, and it's Fruit Loops, just so you know. Fruit. Fruit. Yeah, fruit. No, it's Fruit Loops. The same way you say studio. That's not how we say it. Fruit Loops, find the loopy side.