Erin Perry O’Donnell 0000-00-00 00:00:00
Lion - Researcher Tests Revolutionary Device Blinded by a roadside bomb in Iraq, Marine Cpl. Mike Jernigan sat with a “lollipop” in his mouth at the University of Pittsburgh Medical Center. The rectangular high-tech device was connected to the pair of dark glasses he wore that were outfitted with a tiny video camera. Jernigan was ready to test, not exactly his vision, but his ability to make out shapes and, ultimately, the chance to move about a room without a white cane, reach for a can of soda or pick up a dollar bill or keys that fall to the ground. Gale Pollock, a Lion and the executive director of the medical center’s Louis J. Fox Center for Vision Restoration, placed ordinary white felt shapes on a black felt screen. Jernigan paused for a few seconds each time and described what he thought he saw. “Circle.” “Horizontal line.” “Diagonal line pointing up.” He was right each time. The BrainPort device he wore used his tongue to stimulate his visual cortex and sent sensory information to the brain. “Users can tell the shape of objects and recognize letters and numbers,” said Pollock. “The device allows them to have about an 80 percent grainy black-and-white ‘picture’ of their environment–not what you and I enjoy for sight but a huge improvement after having no visual input at all.” The few people who have testdriven the BrainPort compare it to having pictures drawn on their tongues with champagne bubbles–like the childhood game of drawing on someone’s back. It’s called sensory substitution: the brain converts what you feel to an image for your mind’s eye. Pollock has embarked on a research study of BrainPort, made by Wicab in Middleton, Wisconsin. The study’s goal is to establish methods for visual function testing in visually impaired people and to see to what extent the BrainPort can help them maneuver around obstacles and perform other everyday tasks. “I know that the biggest desire verbalized to me by the vision impaired community is to improve their mobility and independence,” says Pollock. “One of the things we don’t know is how quickly will their interpretation of this information accelerate? Is it like learning the alphabet before we learn words and start to read sentences and paragraphs? “We start with single pieces of information and then build upon it to read more and more rapidly as we develop that skill. Will they be able to process larger and larger chunks of information so that they can actually read without processing a single letter at a time? We don’t know.” The project combines two of Pollock’s passions: giving sight to the blind and helping injured veterans. She retired two years ago as a major general in the Army Nurse Corps, where she spent 36 years treating the nation’s war injured and ill veterans. Now, she wants to make the BrainPort available to veterans by including them in the study. “The people I know who are the most aggressive and will try new things are service members,” Pollock said. “Giving them an opportunity to help others who are vision impaired seemed like a good way to use their talent.” Pollock saw a demonstration of the BrainPort while serving as acting surgeon general for the Army. She asked two sightless servicemen to test it out. “They both said it’s an incredible thing and to please get it. As an Army nurse, when one of my patients asks me to do something, I’m going to move mountains to get it.” Right now, the mountain in her way is funding. Because the BrainPort is still experimental and has not been approved by the U.S. Food and Drug Administration, the researchers must purchase the units outright. The total bill comes to just under half a million dollars. But that hasn’t stopped Pollock from getting started. The Center for Vision Restoration will train people to use the BrainPort and chart their progress with visual acuity tests and MRI and PET scans. Pollock hopes to have 30 testers during the next few years, mostly servicemen and women if possible. It would be cruel, she says, to give them access to even a simulation of sight and then take it away. So Pollock is mobilizing the resources of her fellow Lions to help buy 30 devices for the study’s participants to keep. Pollock first joined Lions in 2001 while stationed at Fort Benning, Georgia. At the time, she was serving as the 22nd chief of the Army Nurse Corps. Commanders at her level were asked to set an example by joining a civic organization. “Lions really resonated with me because I’m interested in taking care of people who are struggling,” Pollock said. “That’s what I do as a nurse.” In 2004, Pollock learned she was going to be promoted to major general, and she thought it would be a good idea to sit in on congressional testimony–something she’d never done. At the hearing she selected, three military surgeons general testified about early figures on war casualties in Iraq and Afghanistan. Sen. Daniel Inouye of Hawaii had a question for them: what were they doing for blinded troopers? The surgeons general said it wasn’t that big of a problem. “The senator recoiled as if they’d struck him, and then finally he said, ‘Oh, really?’ ” Pollock recalls. “All my nursing antennae went wild.” Pollock did some digging, and learned that 10 to 13 percent of injuries in the war were eye injuries. She and her staff put their findings into a white paper, which became the basis for legislation that established the Vision Center of Excellence for the Veterans Administration and the Department of Defense. It was only the beginning. Pollock seemed to find her calling in helping the blind, especially those who were losing their sight on the battlefield. “If an IED [Improvised Explosive Device] is powerful enough to rip off an arm or leg,” she said, “why not a pool of water on your face?” But she also learned that eye trauma is only the tip of iceberg. More than 34 million Americans suffer either blindness or severe vision impairment that affects their quality of life, she said, and seven out of 10 vision-impaired people stop leaving their homes altogether. Pollock eventually realized that assistive devices for disabled limbs get more sophisticated every day. For example, those missing limbs have benefitted immensely from advances in robotics. But resources for the blind have remained frustratingly low-tech in the 21st century. Not much progress has been made beyond white canes, guide dogs and Braille. In 2007, Pollock became the first woman named Commander of the U.S. Army Medical Command, and later that year she added the title of Deputy Surgeon General for Force Management. But retirement was on the horizon. With only a few months left on active duty, she traveled to Pittsburgh to make a presentation and met Alan Russell, director of the McGowan Institute for Regenerative Medicine at the University of Pittsburgh. Russell asked Pollock what she wanted to do after the Army. She said she wanted to run a vision restoration program. She knew that the center was investigating the nascent BrainPort, which looks a little like spy gear. A cable on one side of the dark glasses connects to a small pad, about the size of a postage stamp, that rests on the tongue. On the other side, a second cable connects to a handheld controller that allows users to zoom and adjust contrast. Wicab explains how it works: “The base unit translates the visual information into a stimulation pattern that is displayed on the tongue. The tactile image is created by presenting white pixels from the camera as strong stimulation, black pixels as no stimulation, and gray levels as medium levels of stimulation, with the ability to invert contrast when appropriate.” What the researchers in PittsBurgh want to know is whether users improve over time at interpreting the images they receive. Participants in the study will be asked to navigate an obstacle course at various intervals to gauge their fluency with the BrainPort– and provide some of the first evidence-based research into assistive devices for vision impairment. “How can we certify that someone is getting better? Can we say it improves people’s capabilities enough that it should be funded by an insurance company? That’s what our researchers are trying to do,” Pollock said. In February, she will join 75-year-old Navy veteran Butch Schultz on a walk from his home near Tampa, Florida, to Pittsburgh, where he will join the BrainPort study. Trekking between Tampa and Pittsburgh should take eight to 10 weeks. The idea for the walk came from Schultz, who used to ride in cycling marathons. That was before he began losing his sight 40 years ago, first in one eye and then both. His form of blindness was sudden, rare and never explained. Schultz’s response was to enroll in the Louisiana Center for the Blind and develop the skills to live independently. Twice widowed, he now lives alone, takes care of his own household and walks several miles a week. “I Was always a very positive, active individual. [Losing my sight] was a challenge but it made me a stronger person,” Schultz said. “That was one of my goals for doing this walk. I learned what a good attitude can do, and I want to present the same attitude.” Schultz and Pollock met through a mutual friend after Schultz, a Navy veteran, got some local publicity for being the first blind vet in central Florida to receive a KNFBMobile reader. It’s a Nokia cell phone that scans printed material and reads it back in seconds. In June, Pollock Announced he would also be the first veteran to receive a BrainPort. Raising funds for the device is Schultz’s motivation. But so is raising awareness for the blind, whom he feels are overlooked among the disabled. It doesn’t help that many blind people isolate themselves. Schultz co-founded a support group in his area, but says “it’s hard to get people to meetings. They really feel self-pity, that their life is over, and we cannot get these people out. So I’m hoping maybe this walk is going to help. The help is there for them, but they need to know where to go and how to do it.” Pollock has been contacting Lions clubs and district governors in the eight states along their 1,050-mile walking route, plus the District of Columbia, to ask for fundraising help. The duo will make presentations along the way in an all-out public relations blitz including potential appearances on Good Morning America and Oprah. Raising the total needed for the Brain- Port study will probably take two years, Pollock said. Already, she’s received pledges from two districts for about $55,000. “If we’re all working together, we’re going to be able to make the organization more visible, attract more members, raise funds and raise awareness. It’s a win-win-win, no matter how I look at it,” Pollock said. Pollock’s goal was to create an information clearinghouse for vision-impaired people and their families, especially as more young people come home from the war without their eyesight. With more support, they may not become housebound and sedentary, leading to other health problems, some of which are life-threatening. “Our cities are not supportive of the visually impaired. No wonder they stay home. It’s scary out there. I want to find ways to decrease that fear. We want people to know they don’t have to stop living as their sight decreases,” Pollock said. “But the information for people struggling with vision impairment and their families is so piecemeal.” In addition to the BrainPort study, Pollock said about two dozen researchers are working on other projects at the Center for Vision Restoration, including tissue regeneration, stem cell therapy to repair corneas and eye transplants. Pollock said she often reflects on Thomas Edison at work on the light bulb, and the countless hours of refining he must have done on his invention. She’s confident that the center’s work will be just as revolutionary for the visually impaired. “God sowed a seed that day I heard Senator Inouye. The more I heard, the more concerned I became. Why isn’t there an advocate for these people? They’re struggling,” she said. “I learned over my years in the military that–as a woman, as a nurse–I can be pretty stubborn. I can overcome barriers. I’m just going to help make your life better. I’m a nurse and that’s what I’ve always done.”
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