BIG READ: When man meets machine - Amal Graafstra and his bio-hacking body

Do this man’s hands hold the key to the future of medical implants? John Hearne plugs into the integration of man and machine.

Amal Graafstra

AMAL GRAAFSTRA had a simple problem. He wanted quick, easy access to his office and didn’t like the conventional options. Instead, he began exploring biometric authentication; things like retinal scanning, hand geometry, facial recognition, and fingerprints.

“Access card technology based on RFID was cheap, reliable, and could be hardened against the elements and vandals.”

RFID stands for radio frequency identification. RFID microchips are everywhere these days. As Graafstra points out, you’ll find them in access cards, and they’re also used in factories to track the progress of a product through the assembly line. Pets have been injected with RFID tags for years in order to help identify them definitively.

This deployment of the technology is what interested Graafstra. Rather than carry an access card in his wallet, he opted to implant two RFID tags in the webbing between the thumb and index finger of each hand. These implants are 2mm by 12mm cylindrical tags; about the size of a grain of rice. They are passive devices; they have no battery and remain completely inert until they are held close to an RFID reader, or a near-field communication (NFC) device like a smartphone.

Graafstra uses his implants to unlock doors and phones, to log in to his computer and even start his motorbike, all with just a wave of his hand. He can also share contact details, Youtube videos, and Facebook pages with friends by letting them scan his implant with an NFC-enabled Android or Windows-based smartphone. The advantages of the implant are obvious. You can’t lose it, and unless you encounter a particularly tenacious and bloody-minded thief, it’s pretty theft proof.

Proponents of chip implantation point out that as it stands, there is no single convention for communicating with the range of machines that facilitate our lives. Card readers, ATM machines, smartphones, and building access panels all rely on a myriad of different technologies, from PINs to chips to magnetic strips and security questions. A single RFID implant could provide the single means by which we engage with the technology our lives have come to depend upon.

Graafstra now describes himself as an “adventure technologist” and is the founder of biohacking company Dangerous Things, based in Seattle. His company sells implant self-injection kits; $99 (about €74) will get you two RFID tags, preloaded in an injection kit assembly.

“The tags are small enough to be installed by a professional body piercer using a piercing needle,” says Graafstra, “just like they would a piece of large gauge body jewellery.”

If your piercing specialist is a little too squeamish to tackle the job, Dangerous Things will provide “free phone consultations for qualified professionals that are in your area who would like to learn how to install our products”.

The risks, he says, are low. There could be infection if the environment in which the procedure takes place isn’t clean. However, Graafstra says that he has had his two implants for nine years without issue.

“Once placed, the device is fairly resilient but if one should break, swelling and slight to severe pain could be expected. If this occurs, any general practice doctor should be confident enough to remove the device with the help of a local anaesthetic and a scalpel.”

But what about Big Brother? If you’ve a chip in your hand, doesn’t that mean your movements can be tracked? Graafstra says the fact the chip has such a short operational range — about 2.5cm — tracking is not technically feasible. Yet.

Which is not to say that the whole area hasn’t become the subject of paranoia and conspiracy theorising. Google “microchip implant” and you’ll turn up any number of sites which link the technology with everything from state control to the end of the world.

One rumour which has clung to Barack Obama’s contentious Affordable Healthcare Act like a bad smell is that under the terms of the bill, all Americans will be obliged to accept RFID chip implants. The ObamaCare Facts website deals with so many emails about the myth it has set up a webpage to scotch it. The rumour sprang up as a result of an old version of the act which included a section that allowed for data to be collected from a class of devices that included RFID chips. Despite the fact that the final wording removed all references to data collection, the ideological battles that rage around the act continue to breathe life into the rumour.

Even more bizarre is the link between RFID chip and the Book of Revelations. Verses 16 and 17 of chapter 13 run like this: “And he causes all, the small and the great, and the rich and the poor, and the free men and the slaves, to be given a mark on their right hand or on their forehead, and he provides that no one will be able to buy or to sell, except the one who has the mark, either the name of the beast or the number of his name.”

The range of Christian sects that believe we are approaching the end of days are constantly parsing and scanning Revelations for evidence to justify this gloomy prospect. They’ve picked up on the possibility of implanted chips growing in popularity, to the point where they drive out all other forms of payment.

Ultimately, they envisage a world where, if you want to buy a litre of milk in the local shop, you won’t be able to do it without a chip in your hand, thereby fulfilling the prophecy; the chip becomes the mark of the beast.

Muslims have also reacted coldly to the idea of implants. Bodily modifications — tampering with the work of Allah — are forbidden in Islam.

Privacy fears have prompted a range of state legislatures in the US to write all kinds of anti-chip legislation into law. Wisconsin, North Dakota, and California have implemented bans preventing employers from insisting on chip implants, while the Georgia senate went a step further. Not alone is it a crime for an employer to insist on implanting workers, any voluntary chipping has to performed by a physician and sanctioned by the Georgia Composite Medical Board.

The truth though is that apart from a few academics and hobbyists, implanting microchips isn’t exactly taking off. In fact, its heyday may well be over.

Back in 2004, the VeriChip Corporation received preliminary approval from the US Food and Drug Administration (FDA) to market an implantable chip designed to retain medical info that could be accessed in the event of an emergency. Participating hospitals would run a handheld VeriChip scanner over the implant, giving them access to a secure page on the company website which would contain medical information that the patient had lodged with the company. That was the theory at least. There were initial reports that over 80 hospitals had agreed to acquire a scanner, but the company was later sued by shareholders for making false and misleading statements about these hospital acceptance figures.

Worse was to come. In 2007, it emerged implants almost identical to the VeriChip ones had caused cancer in hundreds of lab animals. VeriChip’s stock price collapsed. Though the company soldiered on with the technology, the market’s appetite for it more or less dried up. Within three years, the company had discontinued the implantable human microchip.

Nor has the security industry demonstrated any enthusiasm for the technology. Apart from Amal Graafstra’s adventures in self-implanting, there are very few stories of implanted tags being used to regulate access to buildings. The same year the first reports of cancer leaked out, an Ohio surveillance company implanted chips in the hands of two of its employees as a means of limiting access to its secure video tape room. When the company closed, the two employees disappeared into the ether. There’s no record of what happened either to them or their implants.

Perhaps the most high-profile case was that of Rafael Macedo (right), the Mexican attorney general. In 2004, he announced he and 160 members of his staff had been implanted as part of a initiative to limit access to a records room.

But it’s not just religious beliefs or privacy concerns or simple squeamishness that have limited the growth of the implant as security device. There’s also the fact that they’re not all that secure. Software researchers say cloning them is relatively easy. One software security expert from Massachusetts, Jonathan Westhues, built a handheld device which could steal a chip’s data when held close to the implanted hand.

Other adventures in human microchipping have been gimmicky at best. Ten years ago, the Baja Beach Club in Barcelona began running “Implant Nights”. White-coated lab techs drifted through throngs of night-clubbers with a hypodermic and a bag of chips. Thereafter, implantees could sweep past bouncers and open VIP doors with a wave of their implanted hands. They could even pay for drinks by having their chip scanned; the ID number on the chip linked up with the patron’s bank details which were stored on the club computer. Clubs in the Netherlands, Scotland, and the UK quickly followed suit before the fad died away.

Resistance breaks down

However, there is another side to implanted technology that’s slowly breaking down resistance to the idea. Mark Gasson is a lecturer at the University of Reading and a member of the Cybernetics Intelligence Research Group.

“Many people think that implanted technology is science fiction,” he says, “and forget that medical devices form very intimate links with the human body.”

The pacemaker, for example, has been with us since the 1950s and helps to control abnormal heart rhythms. In the years since the first pacemakers were developed, research has become focused on deeper integrations of man and machine.

Take transcranial direct-current stimulation, or tDCS for example. Despite the portentousness of the phrase, it’s actually possible to perform tDCS in the comfort of your own home. All you’ll need is some wire, a couple of wet sponges, crocodile clips, and a nine-volt battery.

Studies have shown that by applying a very low current to specific areas of the brain, you can effectively increase its plasticity, that is, the way in which it changes as a result of experience. Though originally developed to help stroke victims, tDCS has been deployed with healthy subjects with reportedly remarkable effects. Depending on what parts of the brain you stimulate, you can increase motor functions, mathematical ability, attention span, co-ordination, verbal fluency and memory. A recent study by the University of New Mexico found that tDCS had the capacity to double the learning performance of test subjects.

Then there’s deep brain stimulation, or DBS, the big brother of tDCS. This is not something you can try at home, unless you live with a team of specialised neurosurgeons.

Electrodes are implanted into specific areas of the brain. Wires run from these electrodes to a device called a brain pacemaker implanted just under the skin, usually in the chest. The pacemaker is calibrated to deliver electrical impulses to those parts of the brain targeted by the neurosurgeon. Directing electrical pulses using devices like these has so far proved effective in treating a range of both movement and affective disorders; conditions like Parkinson’s, epilepsy, and chronic pain, as well as depression and obsessive compulsive disorder.

Though the surgery is complex, the treatment itself is not. The pacemaker is essentially a dumb device that just keeps on delivering electrical impulses to the targeted area, no matter how symptoms wax and wane. Now however, Medtronic has developed the first smart pacemaker. This device differs from legacy brain pacemakers in that it constantly analyses brain activity, then alters the charge depending on what’s required. The symptoms of conditions like Parkinson’s can vary substantially from day to day, even from hour to hour. This new generation of pacemaker can increase or decrease the dosage as required, and shut down at night when there’s no stimulation needed.

A clinical study published in the New England Journal of Medicine shows that patients treated with DBS therapy reported a mean improvement of 26% in their disease-related quality of life compared with no improvements in patients treated with best medical therapy alone.

Another company, NeuroPace, is developing a device for epilepsy sufferers. Like Medtronic’s smart device, it too is constantly monitoring brain activity, and is specifically on the lookout for the telltale signals of an oncoming seizure. When detected, the device sends tiny shocks to the relevant area of the brain, and these shocks effectively prevent the incipient seizure.

Medications designed to prevent seizures already exist. However, researchers point out that not everybody reacts in the same way to medication. In some cases, it doesn’t work well, in others, it doesn’t work at all. As these devices develop, interventions can be customised for each patient.

In addition to improving relief for sufferers, brain pacemakers like Medtronic’s also point the way ahead for research. Every patient with a smart brain pacemaker is effectively collecting huge volumes of data, which will vastly improve clinicians’ understanding of neurology. As the dataset builds, researchers may be able to build maps which will chart how different conditions affect different parts of the brain, and this research can feed into the development of more effective therapies.

The new term is “electroceuticals”, and it’s all about swapping drugs for devices.

Much of this work if focused on neurons, which are the building blocks of the nervous system, designed to transmit information through the body. It is these circuits of neurons that are responsible for regulating the vast majority of the body’s organs and functions. The question thrown up by the evolving science of bioelectronics is whether or not these circuits can be manipulated to therapeutic effect. What if, instead of introducing drug molecules into the system, you could stimulate or inhibit these neural circuits to achieve the same ends?

Two years ago, American neurosurgeon Kevin Tracey successful implanted a vagus nerve stimulator into the neck of a rheumatoid arthritis sufferer who had struggled with debilitating pain for years. Within two months of surgery, he was back at work, driving a delivery truck.

One of the problems that has plagued devices like these is the same one that has beset all mobile devices. Batteries tend to be large and cumbersome, while recharging technology has hardly kept pace of the tech-nology underlying the devices themselves. Moreover, charging smartphones and wearable tech is still all about cables and sockets, features obviously unusable when it comes to implants.

Now however, researchers at Stanford University have developed a new way to wirelessly charge implanted electronics. This means that implants can now be made smaller — as small as a grain of rice — and go deeper into the human brain. Using this new technology, scientists have already been able to power tiny medical implants in animal test subjects.

These developments are largely uncontentious; few people are going to object to better ways of alleviating pain and the symptoms of disease. But there are also the applications that step over the line into science fiction.

If deep brain stimulation can have such positive therapeutic impacts, and its little brother tDCS has been proven to boost brain power, what might be gained by applying DBS in non-medicinal ways? Will it someday be possible to implant a device that will effectively upgrade the brain? Will we be able to augment our senses? Should that even be possible? As the technology advances, questions like these are increasingly losing their dorkishness and are acquiring something approaching relevance.

Mark Gasson at the University of Reading says: “We envisage a future where these two areas of implantable technology converge and medical technology becomes redeployed for application in healthy people for enhancement.

“People undergo very invasive surgery for cosmetic reasons and so it cannot be assumed that people will not do the same to have an implant if it is of real benefit to them. We will continue to look for ways to use medical implant technology to enhance us, and if there is real benefit, it may become commonplace.”

MEDICATIONS AT THE TOUCH OF A BUTTON

Researchers at the Massachusetts Institute of Technology have developed a programmable medical drug delivery implant which can dispense a whole range of medications to treat diseases such as diabetes, osteoporosis, heart disease, and cancer.

The device measures 20x20x7mm, and is designed to be implanted under the skin of the upper arm, abdomen, or buttocks. One of the first commercial applications will be as a contraceptive, delivering 30 micrograms a day of the hormone levonorgestrel, which is already used in a number of female birth control methods.

Contained within the device are micro-reservoirs sealed by an ultra-thin titanium and platinum layer that temporarily melts when a small electric current is applied, releasing the hormone into a woman’s body.

To activate the drug dispenser you simply press a button on a wireless remote control — and press it again to turn it off. “Communication with the implant has to occur at skin contact level distance — someone across the room cannot reprogramme your implant”, says the chip’s co-creator Robert Farra, president of MicroCHIPS of Lexington, Massachusetts.

An earlier version of a MicroCHIPS programmable implant is being used in a clinical trial to treat seven Danish women with osteoporosis. The implant delivers daily doses of the drug teriparatide, which stimulates bone formation.

A key concern is that the body tends to encapsulate implants in a protective layer of fibrous cells which can restrict the drug entering the bloodstream effectively. But in the Danish trials, absorption and distribution evaluations suggest that the drug had no problem diffusing through this layer and into the blood vessels, says Farra.

Researchers showed that over the course of one month, the implant was able to deliver up to 20 doses with the same levels of safety and therapeutic benefits as regular injections.

The new contraceptive device will begin pre-clinical testing in the US next year. The goal is to have it on the market by 2018.

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