All language subtitles for NOVA.S49E04.Augmented.1080p.WEBRip.x264-BAE_track3_[eng]

♪ ♪

♪ ♪

♪ ♪

Today I think it will be
probably around four,

six or four.

We're local,
so we're not flying out...

STYLIST:
I think you're good...

I can't believe you filmed that.

(indistinct chatter)

(indistinct chatter)

SPEAKER:
About innovation,

and really coming into some
really innovative...

(indistinct)

This is a gentleman who really
has reinvented bionics.

And we say the
Six Million Dollar Man?

I think he's more the
100 Million Dollar Man.

Professor Hugh Herr from MIT.

(cheers and applause)

HUGH HERR:
Here you can see my legs,
24 sensors,

six microprocessors, and
muscle tendon-like actuators.

I'm basically a bunch of nuts
and bolts from the knee down.

I'm a bionic man,
but I'm not yet a cyborg.

When I touch and move my
synthetic limbs,

I do not experience normal touch
and movement sensations.

If I were a cyborg
and could feel my legs,

it would fundamentally change
my relationship

to my synthetic body.

♪ ♪

Muscles within the body

can be reconfigured
for the control

of powerful motors

and to feel and sense
exoskeletal movements,

augmenting humans' strength,

jumping height,
and running speed.

During the twilight years of
this century,

I believe humans will be
unrecognizable

in morphology and dynamics
from what we are today.

Humanity will take flight
and soar.

♪ ♪

(machine whirring)

(strikes match)

♪ ♪

I don't use the word disabled.

The word disabled implies
that there's a weakness.

Just because a person has
an unusual body

or mind doesn't mean
there's weakness.

Society is obsessed with
this idea of a normal human,

a normal body, a normal mind.

And that we're so convinced
that normalcy

is the pinnacle of capability.

That's now collapsing,
it's breaking down.

♪ ♪

As a young man,
I imagined a future

where artificial limbs weren't
these passive, inert tools.

MATTHEW CARTY:
If we are able

to come up with a better way
of doing amputation,

that fully augments
a person's ability

to achieve increased levels
of function,

that is a much different
package.

♪ ♪

HERR:
I think in 20 years,

limb amputation will not be
a disability,

and there'll be several
dimensions

that are actual augmentation.

♪ ♪

(birds chirping)

(indistinct chatter)

(birds twittering)

HERR:
It's a giant bird's nest.

(sighs)

Most of my hardest rock climbs
were done in these babies.

INTERVIEWER:
Is there a reason to keep
them kind of short

and stubby?

Yeah, it's an advantage.

You can get your center of mass
closer to the wall

if your feet are baby-sized.

♪ ♪

(voiceover):
I would love to become a cyborg.

I don't have yet that bilateral
brain connection

between my nervous system

and my synthetic powered ankles.

I would love to experience that
neurological embodiment

that I can architect my own body
and it can become me.

It can become part of
my own identity.

I would love to experience it.

I'm lucky.

Both of my legs were amputated,

and that affords me the ability
to adjust my height.

Here, I'm really tall.
(audience laughter)

Like, really, really,
really tall.

Think Inspector Gadget.
(audience laughter)

INTERVIEWER:
Do you think back to your
accident and say, like,

I wish it didn't happen
or was it, like, a gift?

HERR:
I don't regret

the change in my body at all.

Regarding the scratch
that I experienced, it's...

I think it's pretty cool.
(chuckles)

HERR (voiceover):
I sometimes have nightmares

where I see myself at the age
of 11, 13, 15,

up thousands of feet without
a rope in a remote region.

It's watching a time bomb
about to go off.

And I wake up sweating
and terrified.

♪ ♪

I was, I believe, six years old
when I first went rock climbing.

And it was near my parents' farm

in the foothills of
Pennsylvania.

My brothers and I, we saw
climbing on the television.

Henry Barber was being filmed

climbing a rock in Wales.

And we're like, "What's that?

We want to do that."

And we actually went out
and bought a how-to manual

from an outdoors shop
on how to climb.

And we'd go into the woods
of Pennsylvania

and be looking up
what a piton is,

and when a carabiner is...
(chuckles)

And making our way up this
mossy, wet cliff.

It's truly remarkable

that we lived through
our childhood, actually.

(chuckling)

ALISON OSIUS:
Hugh just wanted to climb.

He wanted to climb all the time.

It was dark, he wanted to climb,
it was freezing cold,

and nobody else wants
to be out there,

and people are breathing in,

huge clouds of frost are coming
out of their mouths,

and Hugh is up there climbing.

HERR:
It immediately became
an extraordinary passion

and it only increased with age.

By the time I was 11, 12, 13,
it's all I thought about.

JEFF BATZER:
I would say that
there was just a,

a natural chemistry.

You know,
Hugh and I liked each other.

The rock climbing definitely
brought us together.

We shared a remarkable passion
for climbing.

That led to, you know,

Jeff being my
full-time climbing partner.

BATZER:
And so we would just get
together and climb a good bit,

and ended up going on all these

New York Shawangunks
climbing trips.

That was the east coast Mecca
for rock climbing.

And he would rope up and he may
take a fall or two,

and in some cases not fall

on a really hard climb,
and he'd pull it off.

And that word,
in the climbing world,

gets around really quickly,

and so he became known
as Hot Hugh.

HERR:
By ten, 11 years old, I was a,
considered a child prodigy.

I had national recognition
for my climbing prowess.

I studied Zen and meditation.

I would often sit alone,

and kind of rock back
and forth and meditate for...

I mean, my poor parents
thought I was mad.

♪ ♪

BATZER:
I always said that Hugh
was known in the United States

as being in the top handful
of the best climbers,

even though he's only, you know,
15, 16 years old,

and when we were on
Mount Washington he was 17.

♪ ♪

ANNOUNCER:
At 6,288 feet,
the view is the beauty

and the weather, the beast.

OSIUS:
This is like
so many of these events

where it's never just one thing,
it's an accrual.

It's a whole series,

and if you could change
any one of those things,

it wouldn't happen.

BATZER:
I wanted to go
to Mount Washington.

I said to Hugh, I said,
"I'd really like to do

"one of the ice gullies,

"but go to the top
of the mountain

"because I want to train more
for doing peaks

and things like that,"
and Hugh said, "Sure, you know,

glad to do that."

We knew it was going to be
a little more dangerous

than the other things
we had done.

♪ ♪

OSIUS:
Hugh and Jeff drove up
to New Hampshire.

BATZER:
I probably dominated things
with the music there,

but it was probably mostly
The Police on the way up.

And I can remember just remember
listening to this one song

that says, "You'll be sorry
when I'm dead." (laughs)

STING:
♪ You'll be sorry
when I'm dead ♪

♪ And all this guilt
will be on your head ♪

♪ I guess you'd call it
suicide ♪

(song echoes and ends)

(footsteps crunching)

BATZER:
The first night when we got
there was just to get up

to stay overnight on
the mountain at Harvard Hut.

You know, there was very much
that warning

to the Appalachian Mountain Club
folks, that were very careful,

I think, to warn people like,

"Hey, do you know what
you're doing here?

You know, you're going to go up
into a really rough realm."

And so there would have been
a bit of that, too.

That next morning is where
we wanted to choose a route

going up through
Huntington Ravine,

where there are a number
of different ice climbs.

So, we decided, really,

I think it was that morning,
to do O'Dell's Gully.

Hugh led it,

and did a number
of pitches on up through.

And at one point I had

these heavy Gore-Tex mittens,

and I had slings that were
Velcroed on,

and so I could let them
hang down,

so I could work on the tools
and take screws in and out.

So, the one time I did that,
the sling came open

and I looked
and the mitten was gone.

So that would come in later on

as far as being a major problem
with,

you know, trying to keep my
hands from becoming frostbitten.

(wind gusting)

So, we're at the top
of O'Dell's Gully,

which is 800 feet
from the ground.

We decided we would drive on,

and actually try to get
to the summit,

and just try to knock
that all off.

Maybe about 20,
25 minutes or so,

and these little wispy wind
gusts

and snow that was coming down

turned into just
hurricane force winds.

HERR:
Above Huntington's, we probably
walked five minutes at the most.

That was the critical decision
that led to the accident.

You know, among the mistakes
that they made

was that they didn't have
a compass,

they didn't have a map
and compass.

And they were using the wind.

And so when they turned around
to walk down,

they did not realize that
the wind had changed

and so they walked in the
wrong direction.

(wind blowing)

Instead of going down
where they had come from,

they went down the wrong side,

and they went into the
Great Gulf,

which is an immense wilderness.

♪ ♪

BATZER:
So the day goes on, you know,

half an hour after half an hour
starts going by

and we're like,
"Man, what is going on here?"

At some point we've got
to break through

to something
that looks familiar here.

We still thought we were
in Huntington Ravine.

We thought if we go out,
we hook to this one side

we're going to hit
the Harvard Hut eventually,

we'd at least be able to get
there, no big deal.

OSIUS:
At a certain point,
they realized they were lost.

But at that point,

it was better just to keep going

then try to go
all the way back up.

BATZER:
We'd gone for hours now,

and going in toward evening,
and we're thinking, "Okay,

"this is starting to get
a little more serious.

"We don't have anything to eat.

"We don't even have water
with us.

Just some awful events happened
that night.

There was a river over
in that Great Gulf area.

Well, let's just follow this,

which is going downhill,
at least.

You know, maybe that'll get
to something eventually.

And what happened was,
Hugh fell through the ice

and was soaked
from the waist down.

Maybe within an hour or so,
it happened again.

We were always right next
to each other,

and he would go through,

and the next time he went in up
to here.

You know, it's minus
20 degrees Fahrenheit

and your feet get wet.

It's a rapid decay.

(wind blowing)

OSIUS:
They crawled under a rock

and they were just trying
to keep each other warm

and give each other hope.

BATZER:
So we broke a bunch
of these trees

and got a pile of these branches

and laid them on top
of the snow,

so we were off of the cold snow.

What we did is made a huge pile
of these

that we put on top of us,
like a sleeping bag.

And we were just encased in
these branches in this cave.

Given my experience
in the mountains,

I personally did not believe
we would last a night.

What I didn't estimate

is the power of being
with someone else.

That's critical because if
you're with another human being,

you can hug them.

And you, you dramatically reduce
the surface area

of the dual body,
but you double the heat source.

So, by hugging someone,

you can stay alive for
a remarkable amount of time

in those subarctic conditions.

♪ ♪

(birds chirping)

BATZER:
Sunday morning was
a beautiful morning.

Calm, very cold.

OSIUS:
They had no idea

that there was
this whole search going on

on the other side
of the mountain.

BATZER:
We didn't come back,
so the cabin caretaker,

he alerted
the Appalachian Mountain Club

that these kids didn't
come back.

OSIUS:
People fanned out and were
checking all the routes

that you'd expect,
the known routes and gullies.

(footsteps, heavy breathing)

BATZER:
What we did was follow
these trail markers.

And this moving was just
very slow.

OSIUS:
As they kept walking,
Hugh started falling over.

By the time my eyes realized
I was falling,

it was too late to react.

So, I'd walk three paces
and just fall over.

It was just
a very strange feeling.

♪ ♪

BATZER:
Monday morning, basically,
we're definitely thinking

we could die, you know,
at that point.

So that morning, I started going
out through this deep snow,

trying to follow this path and,

oh, maybe made it for
a couple of hours

and just praying,
trudging along.

OSIUS:
He walked and walked and then he
found himself crossing tracks.

And for a second
he was really excited,

thinking they were someone's,

and then he realized
they were his.

BATZER:
So I decided,
the strength I have,

I'm going to return back
to Hugh.

I just fell back beside him

and I said to him, I said,
Hugh, I said, I'd failed.

I couldn't get out.

He said, "That's okay, Jeff."

And we didn't say another word
for maybe a couple of hours.

♪ ♪

(wind gusting)

HERR:
The process of freezing to death

is actually very pleasant.

Even though it was minus 20
and constantly snowing,

it felt warm.

♪ ♪

BATZER:
I can remember just having
this thing

where I just started
to hyperventilate.

♪ ♪

HERR:
I think we both gave up
the fight to live.

We actually rationalize that
the sooner we died, the better.

♪ ♪

So we actually stopped hugging
each other.

OSIUS:
It's hard to imagine

that they could have survived
another night.

(footsteps)

And then by incredible miracle,

Cam Bradshaw,

a 28-year-old hut manager,
was out snowshoeing

and she saw these weird tracks
and she thought, "Oh,

that must be a moose," because
they were so inconsistent.

So she tracked them for
a long time.

♪ ♪

BATZER:
It was about 2:30, just heard
some noises over in the trees,

real close to us

and could see this girl,
you know,

fighting her way through the
trees, you know.

She came upon us
and was standing there.

And at first we were silent,

because we didn't trust
our minds.

And then we shouted
and she responded.

(laughs)
So...

And she said, "Are you
the guys that are missing?"

And they said,
"Yeah, that's us."

And then everything went
into motion really fast.

She went hurrying down the trail

and I think she found some
skiers

and they went even faster
and they got to the road,

and they got word to people.

♪ ♪

(helicopter rotors beating)

And then the helicopter came in

and got them.

You know,
a really good extraction

just before it got dark.

♪ ♪

BATZER:
Actually said to Hugh,

I was cheering him on when
nobody was around,

"Just, come on, Hugh,
hang in there,

we need to make it
a little bit longer."

HERR:
We felt tremendous elation

because we went from
being certain of death to,

gosh, we might live.

BATZER:
Little did we know

what our bodies would have
to go through

in these next days and all that
in the hospital and everything.

♪ ♪

One of the staff said,

did you know that somebody
had died trying to rescue you?

So, I broke down and cried

and just couldn't believe
that that happened.

HERR:
Immediately following the
accident, my emotional state

wasn't that of pity.

It was that of extreme anger.

I completely blamed myself
for the accident

and for the death of a rescuer,
Albert Dow,

was struck by an avalanche
searching for myself

and my partner, Jeff Batzer.

♪ ♪

OSIUS:
Albert was out there trying
to help somebody else.

He and Michael Hartridge
checked Huntington.

Apparently,
a cornice collapsed above

and they got hit from behind.

(wind blowing)

Michael was able to reach
into his anorak pocket

and pull out the radio and say,
"We've been avalanched."

And then when the others
got to him,

it was apparently the most eerie
sight anyone had ever seen,

to see this one dachstein mitten
waving above the snow.

♪ ♪

And so they dug out Michael,

and they were looking
for Albert,

and it took a little while,
and then they found him.

♪ ♪

CARYL DOW:
His neck had been broken.

Probably hitting a tree,

and he was killed instantly.

Immediately, the impact
was shock, absolute disbelief.

SUSAN DOW:
It wasn't anger, it was like,

"How could this happen?"
You know?

And, and that was much more
my reaction than anger.

I was thrilled
that they had survived.

I think it would have been far
worse for me if they had died,

because then it would have
been in vain, in some ways.

And that, just, to me,
would have been unacceptable.

HERR:
For a very long time,
I was enraged.

But still having hope

that I could climb out of the
ashes of the, of the accident,

and in memory of the rescuer
Albert Dow's,

in memory of his sacrifice,

to actually do something
with my life

and to contribute to humanity.

BATZER:
I went into surgery after
six weeks

where they worked on my fingers
on my right hand,

and removed those, and then also
the toes in my right foot.

And then a couple of days later,

I had my left leg removed
six inches below the knee.

And then a couple days later,

Hugh had both of his legs
removed,

about seven inches below
the knee.

♪ ♪

HERR:
Lying in the hospital
with my limbs amputated,

my future was just a black hole.

I had never met anyone
with limb loss.

I'd never met anyone that
used a prosthesis.

So I had zero information
on what life would be.

I asked my rehabilitation doctor
what I would be able to do.

He said,
"What do you want to do?"

And I said,
"Well, I want to drive a car,

"I want to ride my bicycle,

and I really want to return
to mountain climbing."

And he, without hesitation,
said I'd be able to drive a car,

but with hand controls,
but I'm afraid

you'll never be able to ride
a bicycle

nor mountain climb again.

♪ ♪

I received my first pair
of limbs.

The mechanical attachment
of the limb to my residuum

was actually made
of plaster of Paris,

and they told me,
even if you can and want to,

do not walk without crutches
or canes,

because we're afraid
the plaster will crack.

I cried for about 24 hours.

And I think it's
a common experience

for people that go through this.

They shake their head,

in this day and age
of space travel

and automobiles,
are you kidding me?

Are you kidding me?

And so I sheepishly

took what was given to me
for prostheses,

and with my brother, we ventured

into the same mossy wet cliffs
in Pennsylvania

shortly after
my limbs were amputated.

I can barely walk,
but once I was at the cliff

gripping the rock with
fingers and toes,

I just felt completely at home.

It was silly of me to listen
to the doctor.

It was silly because
he didn't know me,

and it seemed that
he didn't know technology.

I began tinkering
and designing variants

of my prostheses

that were more conducive
to the vertical world

of rock and ice climbing.

♪ ♪

JIM EWING:
Hugh, climbing as strongly
as he did back then,

was kind of a challenge
to people; it was, you know,

kind of putting his finger
in their eye.

So, people were looking
for excuses

for why he was a stronger
climber than they were, perhaps.

Maybe he can stand on smaller
edges than everybody else,

or maybe he can extend
his leg longer

so he can reach the hold easier,
but having witnessed

the struggles
that he went through

as a bilateral amputee,

that's, that's a bunch
of hogwash.

HERR:
I realized firsthand

the extraordinary capacity
of technology

to heal, to rehabilitate,
and in my own case,

to extend physicality beyond
natural levels.

And that is what inspired me
to go to school,

and to more deeply learn
mathematics,

engineering, and design.

Because I thought to myself,
if I had this level of success

with just skills
in the machine shop,

imagine what I could do

if I deeply understood
physics and engineering.

So there I found myself
in mathematics class.

♪ ♪

(crowd cheering)

(explosion)

(people screaming)

POLICE RADIO VOICE 1:
What was that on
Boylston Street?

POLICE RADIO VOICE 2:
833, something just exploded
at the finish line.

POLICE RADIO VOICE 3:
Two devices just went off
at Boylston and Exeter.

All units, extreme caution.

CARTY:
I'll never forget when we heard
about the bombing.

(people screaming)

Someone came into the O.R.
and said,

"I think there has been
a bombing at the marathon."

I also happened to be on call

for plastic surgery
at the Brigham on that day.

POLICE RADIO VOICE 1:
Delta 984, sir, go.

POLICE RADIO VOICE 3:
We need help
from the medical tent.

Get as many people as you can up
here from the medical tent.

CARTY:
Here were all these young,
healthy patients

who had amputations in the field

or were requiring amputations
after the fact

because of the severity
of their injury.

But they still had material

that could be used for
reconstructive purposes

that we were throwing away
at the time,

because that's how
standard amputations are done.

(sirens, police radios)

If we are able to come up with
a better way of doing amputation

that fully augments
a person's ability

to achieve increased levels
of function,

that is a much different
package.

So, what the marathon inspired
was really, frankly,

for me to get off my ass...
(chuckles)

and crystallize this into
something

that was operationalizable.

♪ ♪

TYLER CLITES:
For hundreds,
thousands of years,

amputation has been viewed
as a procedure that's done

when there are no other options.

So we try to fix it in
all these different ways.

And that doesn't work.

And the last thing we do
is we take the leg.

Because of that, not much
scientific effort has been put

into changing the way
that that surgery is done.

And so, fundamentally,
the surgery hasn't changed

since, really,
the Civil War era.

♪ ♪

CARTY:
Now, to understand the
limitations

of traditional approaches
to amputation,

it's critical
to first understand

how our limbs work normally.

Muscles in our limbs work
in tandem with each other,

with each pair joined by
a tendon.

So when I bend my wrist,
muscles on one side contract,

and complementary muscles
on the opposing side stretch.

Or, when I point my foot up,

a muscle in the front of my
leg contracts,

and a muscle in the back
expands.

Sensory nerves located in
muscles and joints,

called proprioceptors, detect
each stretch and contraction

and send signals to the brain
via the nervous system.

The brain actually uses
this awareness of the movement

of those muscle pairs
and creates a spatial,

almost visualized, map
of where the limb is in space.

This feedback is how we sense
the motion of our limbs

and joints and their position
with exceptional accuracy.

It's how I can touch my nose
with my eyes closed.

Or walk up a flight of stairs

without having to look down
at my feet.

We call this proprioception,

and it's essential for our
ability to move naturally.

♪ ♪

SHRIYA SRINIVASAN:
Proprioception is our ability
to sense the world around us.

It's the way that we know
our joints move in space,

how fast they're moving,
how hard they're pushing,

how stiff they are.

The amputation paradigm today

basically throws sand over the
whole thing and calls it a day.

And so it leaves
all these wires just hanging.

Nothing's connected properly.

CARTY:
In a standard below-knee
amputation,

there's an incision that's made
in the front part of the leg.

And we go down and we basically,
we cut the bone,

and the tissues in the back part
of the calf

are left a bit longer and
essentially are able to flap up

and provide coverage
at the end of the limb.

That muscle flap turns
into a big ball of scar.

It provides good padding,

but the muscle pairs are no
longer connected,

leading to the loss of
proprioception

in the residual limb.

If that patient thinks about
moving their phantom ankle,

muscles in the front part
of their leg may contract,

but the ones in the back no
longer stretch in connection,

and vice versa.

This causes the brain to receive
conflicting

and confusing signals,

creating all sorts of issues
for the patient,

including phantom limb pain,

and difficulty using
the newest prosthetic limbs.

HERR:
So my limbs were amputated,
obviously,

in a conventional way.

What that means is

the muscles in my residuum here

were stitched down
a constant length.

When I try to move
my foot ankle,

it feels like my feet
are in rigid ski boots.

CLITES:
Now we have all this technology.

We have advanced robotic limbs,

we have advanced ways of talking
to nerves and muscles,

and yet we're still
doing amputation the same way.

So, our goal in designing
this procedure

was to fundamentally
change the way

that amputations are done

to optimize the limb for
communication

with an advanced
external robotic device.

HERR:
The inception of the idea

came from little domains
of knowledge

of how, A, the musculoskeletal
system works

linked to the nervous system,

and, B, knowledge about
how the body is controlled,

and how robots are controlled.

And I also knew that
the fundamental motor unit

of biological systems is not
one muscle,

but two muscles working in
agonist-antagonist pairs.

It's fundamental to how
we work as humans.

So one day I just thought of,

let's link them
and take two motor nerves

and get the motor nerves
to grow in

and create
a little biological joint.

My level of education
in surgeries was almost zero.

So I did not know what
was possible.

How are you feeling?

Yeah, they just
got the IV in you?

Just now, yeah.
Okay.

HERR:
It was around then that I met
Matt Carty.

CARTY:
Hugh and I were both interested
in revamping limb amputation,

and ultimately decided to focus,
at least in part,

on how we restore
proprioception.

We had done a series of early
conceptual drawings

and discussed the idea of
creating a biological joint

to maintain the muscle pairings

typically lost during
amputation.

Using tendons and bones we
typically throw away,

we designed a series of pulleys
and small pivot points

to connect muscles, so that they
work in the dynamic way

they were intended to by nature.

Our hope was that by restoring
proprioception,

patients would be able to not
only perceive

where their phantom limb was
in space,

but actually would be able
to better use a prothesis

that was specially adapted
to their modified limb.

By the time

we had ironed out those details,

we felt pretty confident
that we would be able

to do this safely in
a live human being.

The first subject we looked for,

someone that was
generally healthy.

Someone that was mentally
prepared, mentally tough.

We then needed somebody who,
of course, needed an amputation.

INTERVIEWER:
All right, I think
we're ready to go.

CARTY:
I like to make the comparison to
recruiting the first astronaut.

INTERVIEWER:
Just count to five
one more time.

One, two, three, four, five.

♪ ♪

♪ ♪

JIM EWING:
We're on our way to Boston,

to...

say goodbye to my left foot.

CATHY KING:
How are you feeling emotionally?

I am absolutely terrified.

(Cathy chuckling)

But I'm also very excited.

C'mon, Hugh.

Oh, I see the family of ants.

Yeah, isn't that cool?
Yeah.

JIM EWING (voiceover):
Hugh and I first met maybe

in 1984 or 1985,
somewhere in there.

Here, you wanna carry that?

No.
Would you carry that?

HERR (voiceover):
Yeah, I was a climbing bum

living in New Hampshire,

and putting up first ascents

on the cliffs near North Conway.

That's where I met Jim,
we kind of...

lived in the same quarters.

JIM EWING:
Back around the time
that I met Hugh,

I had a much darker view
of the world.

I had kind of drawn all over
my climbing shoes

a bunch of weird designs,

and then I wrote on the side
of a left shoe,

I said, "Life sucks," and on
the right shoe, "Then you die."

And Hugh saw that,

with his legs off,
and he looked at me,

and he said, "Does life
really suck, Jim?"

And what do I say to a guy
who's sitting there,

bilateral amputee, like,

maybe it doesn't suck so bad.

HERR:
He's an extraordinary climber,
a very gifted climber,

and, you know, like me,
has been climbing forever.

This is Jim's number one love,

besides me and his daughter,
of course.

He's been climbing
since he was 12.

And from that moment,
I think he just took to it,

like it just hit his soul and a
spirituality for him, I'd say.

JIM EWING:
When I look back
on my climbing career,

the things that I cherish
the most are the experiences.

I don't always remember the name
of the climbs that I did,

but I remember the person
that I did it with.

I was seven the first time
my dad took me

outside rock climbing
and it was just me and him.

I liked it, but I was terrified.

We'd always go on trips,

and we'd definitely do a lot
of climbing then,

up until the accident.

JIM EWING:
The accident was
on December 26, 2014.

My daughter, Maxine,
and I were climbing a cliff

on Cayman Brac,
in the Cayman Islands,

that I hadn't been to before.

MAXINE EWING:
My dad was doing

a harder route
that I hadn't attempted,

and I was belaying him,
he was... pretty high up.

JIM EWING:
I started up the final headwall

and realized that I had kind
of the wrong sequence set up,

and so I went to step down

back to a ledge and take a rest,

so that I could figure it out.

In sort of shifting myself,
getting back to the ledge,

my right foot slipped off.

I fell maybe five feet,
and stopped briefly.

And then fell again, just a
couple of feet, stopped briefly,

and then went all the way
to the ground.

They tell me that I fell
approximately 50 feet.

I was breathing,
taking deep breaths,

I'd really gotten the wind
knocked out of me, so I said,

"As soon as I catch my breath,
I'll roll over

and get more comfortable."

And even though I never caught
my breath,

I tried to roll over anyway

and realized my pelvis
was broken.

I was calm.

Everybody else around me
was hysterical.

The injuries were my left ankle.

My talus bone was crushed.

I had fracture of the
left wrist.

And probably at the time
the worst injury was

I had a full pelvic ring
fracture,

front and back was completely
destroyed.

Then there were a bunch
of minor things

like compression fractures
in my vertebrae

and ribs that were torn away
from my sternum, bruised lungs.

Sounds like enough, really,
but it was, it was a lot.

KING:
I remember one time
approaching the ICU

with Maxine and I could hear
this, this screaming,

and I'm thinking to myself,
"Oh, my God, that's horrible.

Like, that can't be Jim."

And sure enough, it was Jim
and it was awful.

As a nurse, I've been a nurse
for nine years,

and I've never seen anything
like that.

(birds chirping)

Maxine had her own struggle and
process with this whole thing.

JIM EWING:
Unfortunately, I set things up

kind of carelessly that day in
a way that made it

impossible for her to hold
the fall.

MAXINE EWING:
There are occasional moments
where I felt

guilty and then I would tell
myself that it was my fault.

But I do know that it wasn't.

JIM EWING:
You know, I spent six months
basically off my feet.

It reached a point of recovery
that was unsatisfactory,

and then started going downhill.

Once the cartilage in the ankle
started to break down,

and the bone had died,
it was all downhill from there.

Every step was painful.

Stepping off a curb or having
a sudden change in angle

of the foot was excruciating.

KING:
The only option for the
pain relief

would have been to have
a fusion,

and that would have made him
lose a lot of mobility

and functionality,
and that would have put

a huge damper on all
of his outdoor activities.

JIM EWING:
That was when I started really
thinking about amputation.

I contacted Hugh

to talk about what life would
be like for me

if I chose to have my foot
amputated.

(indistinct chatter)

HERR:
In the beginning, it was just
trying to help him as a friend.

And we met several times,

and he relayed to me how much
pain he was in.

At one point, we were sitting in
my car just outside the lab,

and he just started to weep

'cause he was in so much pain.

He just, he sat there in my car
and sobbed.

That was... (sighs)

And that's, I think, that's when
I realized that, you know,

pursuing an amputation would,

would dramatically improve
his life.

Just getting rid of that pain
is just a necessity.

There's no life with
such excruciating pain.

It never stops.

A lot of those early
conversations was me

describing to him exactly what
my life is like,

what I'm able to do,
what my limitations are,

and also where technology's
going,

where we'll be five years
from now,

ten years from now, and so on.

And of course, I mentioned what

we were working on, and...

I had basically no expectation

that he would want to be
the first human

to undergo this procedure.

So I was actually surprised,
in the end,

how everything unfolded.

(chuckles)

I think right then and there

I decided that was time
to amputate.

There was a pretty long vetting
process that we did together,

and he needed to think
about things,

and we needed
to think about things.

♪ ♪

JIM EWING:
You know, I thought,

I'm just this guy from Maine

and I'm meeting this big
Boston surgeon,

but Dr. Carty put me at ease
pretty much straight away,

and he stayed in the room with
me, answering lots of questions.

We needed to be sure
that Jim understood

that this was a little bit
of a black box

and that we're going to be
making up some of it

as we went along.

And he was very thoughtful,

and at the end of the day

provided consent
and then we moved forward.

♪ ♪

KING:
If someone said to me,
"You have to cut that foot off,"

if I had to put myself in his
shoes, it would be terrifying.

♪ ♪

♪ ♪

JIM EWING:
How long are we expected
to be under today?

About four hours.

About four hours, okay.

A typical amputation usually
takes about two-and-a half,

Yeah.
And building in additional time

for what we're planning on
doing, I'm guessing around four.

Sure.

Okay.
Okay?

All right, my friend.

CARTY (voiceover):
To think that, here's a guy who

is jumping off this cliff,

no pun intended for him,

but we're all doing this
together,

and, um,

we were suitably nervous,

just because it was
a little bit unknown.

...is sixty...
For now.

Scared?

Emotional?

It's going to be good,
it's going to be great.

♪ ♪

Bye, hon, love you.
Love you, too.

Good luck, see you later!

♪ ♪

(machinery beeping)

♪ ♪

CLITES (voiceover):
We were invited to participate
in the actual amputation.

SRINIVASAN (voiceover):
We'd practiced and rehearsed the
surgery with Matt many times,

and so on that day, we were
there to just see it happen

and provide a little bit
of input wherever we could.

CLITES (voiceover):
I'm sitting up in an observation
room with a microphone,

it goes directly
to Dr. Carty's ear

as he's doing the surgery.

I'm telling him things like,

"Hey, we had talked about
putting these there,"

or "Hey, we should measure
that."

He's asking me questions
as we're going,

so it was very much
an interactive process.

CARTY:
This really was a reflection
of the fact

that we had been building up to
this for several years

before ever implementing it in
a human being.

So, part of the point
of our communication

was to remind each other
of all the steps

that we had defined in the
animal lab, and the cadaver lab,

to make sure that we did
it right

when it came time to do it
with Jim.

CLITES (voiceover):
It was great to be a part
of that.

(machinery beeping)

CARTY:
Things went fine,
he's safe, he's awake.

KING: Oh, awesome.

CARTY:
It's a complicated operation,

it's the first time anybody's
ever done it, so...

KING: Yeah.
it was, so we took time
in order to see everything.

This is Tyler,
this is Shriya.
Hi, Tyler.

CLITES:
Nice to meet you.

They both work with Hugh at MIT.

Oh, okay, you're observing
So, they're going to be
some of the,

yeah, they're gonna be
some of the bridge team

and as Jim starts working
with the prosthetic element.
Okay.

So, we'll get him through
the acute recovery,

and then we'll get working
in terms of his rehabilitation.

And then, as I said,

there'll be a, there'll be
a transition when,

when you all start seeing
these guys a lot more.

♪ ♪

JIM EWING (voiceover):
It's hard emotionally,

just day-to-day.

Sometimes it feels like

two steps forward,
a few steps back.

When I'm in a lot of pain,
you know,

I start to have doubts about
was this the right thing to do?

Of course, there's, there's
no going back at this point.

The pain that I experienced
in my ankle

before my foot was removed, that
is pretty much completely gone.

The only thing remaining
is the nerve pains.

I can actually stop the pain
a little bit temporarily

by just waving my hand or my
other foot below my stump

it, and if I look at it
and do that,

it just kind of tells my brain,
you know,

"You can forget about that pain,
that pain isn't actually there."

You're probably
the best possible person

that we could have as a first,

first patient
to go through this.

Because you're actually strong,
you have a lot of stamina,

you understand the broader
context of what

we're trying to do,
and you're also incredibly nice.

And so I really appreciate that,
I know, I know.
(laughs)

My daughter will laugh when
she hears that.
(laughter)

So what we can say today
is that things appear

as though they're continuing
to be moving

the way that we want them to be.

At this point, it's all about
healing and rehabilitation.

That's with regards
to the biology,

With regards to the
technological side,

we're going to soon segue to Jim

working with our partners
across town,

to get fitted with a prosthesis

that can utilize some
of the unique capabilities

that his revised limb
will offer.

♪ ♪

HERR:
The mission of my research group

is to advance

design technology that
normalizes,

or extends, human physicality.

♪ ♪

So here you see

the bit of the history of our
knee and ankle work.

This was the first mechanism

that we actually tested on
a human,

and their metabolic cost of gait
was reduced.

This was eventually
commercialized into a package

that looks like this,

called the BiOM Ankle,

and today I'm wearing
the most recent,

which is called
the emPower Ankle.

So here's the packaged battery,

a modular battery that just
snaps in,

and you push here to boot up.

We now have a product

that's been fit on
approximately 2,000 people,

half of which have been wounded
U.S. soldiers.

I've always been intrigued

by human augmentation.

It's a great human narrative.

It's about human improvement.

It's about technology and tools.

It's what humans do.

Oh, my God, I can't believe it!
(laughter)

It's just like I've got a,
a real leg!

HERR:
Of course, I'm not alone
in that excitement.

Every student in this lab
is just utterly fascinated

and intrigued by the process
of human augmentation.

CLITES (voiceover):
Hugh is my PhD adviser.

The logistics of our
relationship is that

I'm a research assistant
in the lab.

It's Hugh's vision,

and he delegates projects
to his students

and he's always very involved
in those projects.

And then we find ways to make
those things happen.

And kind of... we're the foot
soldiers, we do the groundwork.

EMILY ROGERS (voiceover):
We have so many different types
of projects going on, you know,

from the neural engineering
to mechanical design,

so they're...
you know, therefore

putting in a lot of hours trying
to get these projects done.

SRINIVASAN (voiceover):
It has been a challenging place,

and I love the challenge,

and I love the opportunities
that come with that challenge.

I probably work about 80 hours
a week, so quite a bit.

MATTHEW CARNEY:
I think it looks pretty sweet.

I don't know how well
it's going to work yet.

I think the expectations for us
are insane.

The way I always say it to
myself is,

Hugh's like, "At the end
of the day, I want new legs!"

(chuckles)

"Give me better legs...
What can we do, we're at MIT.

Make me nice legs."

Uh, but... and it's true,
like, what can we do?

I think it's important
to push hard.

(voiceover):
We're building a four degree of
freedom leg

that has a knee,

an ankle, a sub-taylor,
and an MTP joint.

It's a substantial improvement
over the BiOM,

according to the numbers, if it
actually performs that well.

This has a way larger range
of motion

and more power, also.

MAN:
Has Hugh seen it yet?

CARNEY:
No.

I just built this at like
3:00 a.m. last night.

(chuckles)

(phone keyboard clicking)

I was just responding to Hugh.

He said, "Sexy."

I'll take that.
(chuckles)

I think he'll be happy with it
once he gets to wear it.

Especially...
hopefully, it'll perform better.

All right, let's do this thing.

HERR:
I take very seriously the
culture of the group.

It's critical

that I accept people
into the lab

that are passionate
about what we're working on.

In times when a lot of work

needs to get done,

it's probably at least 70 hours
a week.

In more mellow, relaxed times,
maybe 50 hours a week.

So, it's MIT, it's,
it's not a walk in the park.

CLITES:
I basically say,
T-one minus T-two,

which is the total torque
applied to the joint,

equals a dynamic equation
that represents the joint.

And that's the inertia matrix?

CLITES:
Yes.

(voiceover):
Often in research, one of
the problems that we have

is that the people doing
the research

are not the same people
affected by the thing

that they're researching.

(prosthesis whirring)

Hugh breaks that dynamic in
a very powerful way.

HERR (voiceover):
There's a very interesting
dynamic on how society views

the human body, and human
ability, and human disability.

My legs were amputated,
and the whole world says,

"Oh, that's such a sad story."

The whole world said,

"You're now a cripple
and your life is kind of over."

After 12 months post-surgery,

I started climbing better

than I achieved before my limbs
were amputated,

climbing wall surfaces that no
human had ever climbed before,

whether with biologic
or synthetic limbs.

And then suddenly,

the narrative changed overnight
to statements of,

"You're cheating,
that's not fair, how dare you."

To being a threat.

I actually had one competitor

that threatened to cut
his own legs off to compete.

♪ ♪

When we have all these bionic
interventions at our disposal,

the individual will be able
to design their own physicality,

design their own cognition
and emotional experience,

will be able to sculpt their
own identity.

In that future,

when we look at the normal,
innate biological body,

we will go... (yawns)...
"So boring."

(chuckles)

♪ ♪

KEISHA RAY:
I think society,
in response to enhancement,

in response
to bionic body parts,

will be a lot of people
who will be scared, right?

They may call out things like
cheating.

They may say that things are
unfair

if someone with bionic body
parts

has easier access to things.

And I think that's really
at the heart of it.

So, there's already disparities

that are beyond our control
that affect our lives.

You can think of disparities in
access to health insurance,

particularly private health
insurance.

So if Black and Latinx
people, for example,

have lesser access
to health insurance,

that means they have lesser
access to artificial limbs,

particularly those that are
very technologically advanced,

like bionic limbs.

One way that
we can rethink access

and make it more equitable
to people

is to rethink the way that
we think

about these artificial limbs
and bionic limbs.

We think of them as enhancement,

almost, like, cosmetic, right?

That you don't really need these
limbs to live a good life,

and if you do want them,

then you're going to have
to pay for them,

because we think of it similar
to, like, a rhinoplasty

or, you know, augmenting the
body in some cosmetic way.

But if we think about bionic
limbs as more of therapy,

as treatment,
as more of something

that helps people live an
average life,

then we can start to take away
some of the disparate access

to artificial limbs that are
very technologically advanced.

HERR (voiceover):
We want to really provide a
delivery platform for bionics

to everyone in the world.

So we want to launch
a mobile delivery platform

for bionic limbs

in Sierra Leone, Africa.

So the framework is to have
a mobile, rugged vehicle

and inside it has CT scanning,
3D printing,

computational computers.

And we'll literally drive around
from village to remote village

and build limbs
and fit people with limbs.

We not only want to, you know,

create the future of
functionality in bionics,

but we also want to create
the future

on how that technology
is delivered to people,

independent of where
they live across the world.

♪ ♪

When you look
at the human timeline,

us human animals are
extraordinary

at devising tools
and using tools.

I mean, no other animal
comes close.

(machinery whirring)

We design and build hammers,
and we pick them up

and we drive in nails.

♪ ♪

It's a tool,

it's separate from our bodies.

It's something we use, but it's
not an integral part of self.

♪ ♪

We're now entering a new era

of human technology interaction
that's non-tool-like,

where there's a seamless
integration

between human physiology
and electro-mechanics.

CLITES (voiceover):
I've been on this project since
I started my PhD.

When I came in, it was sort
of a set of ideas

that was in the process of
coalescing.

And then I started to drive
it through to where it is today.

How strong was the contraction?

Maybe, um... two.

CLITES (voiceover):
If we're successful here,
we hope that

we'll be able to demonstrate
the first real time

that a robotic limb

has been truly integrated with a
patient's sense of self

via proprioceptive sensation.

For that to happen,

a lot of different pieces
have to come together.

The surgery has to work.

The control system has to work.

The robotic limb has to work.

Any pain there?

Nope.

CLITES (voiceover):
Our goal in the first session
testing with Jim

was to get a sense for exactly
what

types of signals we would be
looking at,

and the ways in which we could
use those

to control the prosthesis.

CARTY (voiceover):
This type of technology,

these newer approaches
to prosthetic development,

hinge on use being able
to connect technology

to the human body.

The primary way we do that is
through the use of electrodes,

which are small wires that are
able to pick up the action

of muscles in Jim's limb and
transmit them to the technology.

There are two ways
that we can do that.

One is through
a surface-based electrode,

which is essentially a sticker
that goes on his leg,

and is positioned directly over
these moving muscles.

One of these wires is able
to pick up the motion

of these muscles and transmit it
to his prosthetic device.

CLITES:
Okay, go ahead and pick up.

CARTY (voiceover):
There's another version of this,
however,

which is referred to as
a needle electrode,

which basically goes through
the skin,

and is able to penetrate
directly into the muscle

and not only pick up information
like a surface electrode,

but actually receive
information back

in the form of functional
electrical stimulation.

At this point, we need to see
if this works,

and see if we can connect Jim's
body to this newer technology

through the use of these
electrodes.

CLITES (voiceover):
We focused our efforts primarily
on these needle-based electrodes

to get a sense for what it was
going to be like

to work with those

and what types of signals
we'd see from them.

And we ended up seeing
a lot of noise.

I ended up spending a bunch of
time running around

trying to denoise the signal,
and had trouble with that.

Rest, two, three.

Dorsiflex, two, three.

Rest, two three.

Do it one more time, invert.

It's too...
it's not behaving.

♪ ♪

(voiceover):
So about a month after
the first session,

we put the needles back in
and we recreated the test setup

from the first session and we
also had the robot present.

And we're kind of focusing
our efforts on that.

The EMG signals were still not
where we ended up

wanting them to be,
but they were better,

and so we were able
to connect Jim

to the robot for the first time.

I want you to cycle up and down.

(prosthesis whirring)

Stop.

(voiceover):
There wasn't much of a feeling
of connectedness to it.

CARTY:
Is there any value in
calibrating

his control with
his right leg first?

It's the electrodes that were...

yeah, I think the controls
are...

I mean, they're, they're...
we know they work.

Um, I think something's
happening with the signal.

Tap your foot.
(prosthesis whirring)

JIM EWING:
The movements are very sensitive

and very subtle,

just the slightest contraction
causes movement.

I'm trying to make it so you
don't have to work harder.

Right.

Would you like it to be
less sensitive?
No,

I think I want it like this
for right now,

and let my brain adapt
to the softer motions.

Okay.

(voiceover):
Jim is the right person
for the job.

Part of it is that he is

unselfishly willing to sort of
put himself out there

and try something new,

not knowing exactly
what's going to happen.

Painful?
Stop yup, yup, yup.

Okay.
(groans)

Where was that?
That was on the surface.

JIM EWING (voiceover):
I can speak to them
about what I'm sensing

and what I'm feeling
with the robot leg.

That's the big toe.

What's actually happening with
the big toe?

I feel like I'm
just bending it over.

With the big toe?

With just the big toe.
We might be in the,

the electrode might be
in the wrong muscle.

HERR (voiceover):
So much of it is the human
telling the researchers

what he or she feels.

So we needed that very robust
level of communication

with the patient.

That's about
a 60 percent contraction.

CLITES (voiceover):
The things that we're doing here
in this lab,

Jim will not take home with him.

So, we're a research
institution.

What we're doing is pushing
forward the boundaries

of human knowledge in this area.

The hope is that it will lead
to commercial products

that are covered by insurance,

that people are able to go out
and purchase

and put on and take home
and use.

But are our goal here is not
to create something

that Jim would then take home.

How's it going?

CLITES:
We're still,
we're still working;

we're still getting some data.

We're doing some stim now.

HERR:
Okay, cool.

Call you later.

All right, sounds good.

(quietly):
Call me, baby.

What are you guys working on
now?

We're moving on
to electrical shocks.

(laughter)

Tyler likes to call it
stimulation.

(laughs)

CLITES:
Shock therapy.

You know, Tyler, you don't have
to turn it up quite so high.

(laughter)

♪ ♪

CLITES (voiceover):
We got off to a slow start.

Jim, contract.

And relax.

(voiceover):
We were worried at first

because we spent
quite a bit of time

placing the fine wire
electrodes,

which are the ones
that go into the muscle.

Continue to bump,
and see if there's a...

Right there.

You relaxed, Jim?

Contract, relax.

(voiceover):
We had him put his liner on
and then the socket on over it.

The hope was that that would
help pull things in place.

We left the clinical space,

came down here,
plugged the electrodes in,

and none of them were working.

Tyler, we're sure that none of
these are,

none of these are working?

I'm double checking.
All right.

One of them is disconnected
right now, by the way.

CLITES:
Yeah, I know,
it's the LG.

Can you lift the liner?

Sorry, lift the socket
off the chair.

Just going to hold that up.

CARTY (voiceover):
There were a couple of
challenges

that we didn't anticipate
with the needle electrodes.

First of all, it was difficult
to find Jim's muscles

the first time.

The needles were actually
a little bit painful for him

for placements,
so we needed to make sure

that he was comfortable
with us placing them.

They tended to fall out when
he put on his socket,

and the stickers weren't
adhering appropriately

in order to hold them in place.

So, it was basically a failure.

CLITES (voiceover):
So that was, that was tough,

it caused us to kind of pause
and reconsider our options.

And what we decided to do is
move forward

with some of the surface
electrodes that we had

so that we could give Jim
the opportunity

to at least control
the prosthesis.

And we weren't sure
how well they would work.

Invert.

It's close.

There you go.
CARTY:
Wow.

Got it.

Tell me how it feels compared
to last time.

Much smoother,

more matching what I'm doing
in my brain.

Last time you were complaining
about it

being very, very sensitive.
Yeah.

So now it's much less sensitive.

Do you feel that?
Yeah.

Okay.

It's more predictable.

I mean, it's more
what I think I'm doing.

CLITES (voiceover):
It was really
immediately apparent

that things were going well.

♪ ♪

Okay, very gently.

Gabby, can you power it up?

How does it feel having it on?

It's pretty amazing, actually,

to have the foot moving

in the directions that
I'm thinking it's moving.

I mean, it...
looking at it sitting over here,

is not the same
as it being there.

That's really good to know.

(voiceover):
As soon as we put the robotic
prosthesis

onto Jim's socket
and mounted it to his leg,

there was this moment where
he just sort of

started to play with it.

(prosthesis whirring)

It's really cool to feel it
through my knee.

Feels like there's a foot there.

♪ ♪

This is intuitive for him,

that's huge,
it's like the iPhone.

CLITES:
Hugh's going to be pissed.

(chuckles)
Why?

He wasn't here.

He's also gonna be pissed that
you're way better at this

than he is.

It's his own damn fault.
Yeah.

Trying to flip the block over
here.

Nice, that was awesome.
Yeah.

All right.

JIM EWING (voiceover):
The muscle actions aren't
exactly the same

as a natural foot.

My brain had to adapt
a little bit

to make things work
the way I wanted,

but it happens so quick.

Literally, within minutes
of having it all connected,

it starts becoming part of me.

That's what we're going for,
you know.

To whatever extent we can get
people to feel

as though they haven't lost a
limb, that is in some ways

our minimum bar, and that was

the energy in the room that day,
it was Jim feeling whole again.

And that was kind of
a spiritual experience.

I've chosen a special song
for this. (chuckles)

("Walk this Way"
by Aerosmith playing)

You know this song, right?

JIM EWING:
Yeah, of course.

♪ ♪

CLITES:
Okay, I am recording now.

Go ahead, Jim.

HERR (voiceover):
There's a debate within the
bionics world as to...

Okay, and stop.

HERR (voiceover):
how good the neural
connection would have to be

for things to just be
completely intuitive.

CLITES:
Jim, you can step.

Wow.

HERR (voiceover):
So, what we just saw there was
Jim step down a step

and not even think anything
consciously.

The foot did the right thing.

When he went up the step,
toes went toes up, dorsiflex,

and when he went down,
it reached down.

So those spinal-level circuits
are still active.

He feels enough feedback
to the spinal cord

that everything triggers
naturally.

CLITES:
Hugh, did you put
on cologne today?

No.

You smell very...
Did you?

It's very nice.

Somebody's got a nice
fragrance smell going.

You know I have to sign
your thesis?

(chuckles)

HERR (voiceover):
What we observed with the
emergent reflexive biomechanics

mediated through
the mechatronic device

is what we thought would occur,

but didn't quite believe
that it would occur.

(chuckles)

So when I saw it, it supported
the really intellectual idea

that if you give
the nervous system

enough sensory information
via nerves,

that the brain knows exactly

how to control
the mechatronic device.

All right, give me a lift.

CLITES (voiceover):
With everything we do,
there's always a desire

to explore not only how
these systems work

in the confines
of the laboratory,

but also out in the real world,

and that's a challenge because
all of our measuring equipment

is confined to the lab space.

So knowing full well that Jim
was an avid climber,

the decision was made to design

a robotic leg specifically
for rock climbing

that Jim could use in the field.

And a series of studies
could be run on Jim

while he's climbing on a wall
using this new robotic limb.

JIM EWING:
It's really kind of
futuristic looking.

Adequately futuristic looking.

CLITES (voiceover):
Emily Rogers
is a graduate student

who kind of took point
on that project,

and she designed this phenomenal
system that is field ready.

Height is good.

ROGERS (voiceover):
It will allow the wearer
to plantarflex and dorsiflex,

and also will provide
inversion and eversion.

The power requirements are going
to be fairly low

compared to a powered prosthesis
that you would use for walking.

They'll be able to manipulate
their foot in free space

and position their ankle to
whatever location they want it.

And then when they place it
back on the wall,

the ankle will lock
in that position.

JIM EWING:
This is going to be fun
on the wall.

CLITES (voiceover):
As we're brainstorming different
ways to do this,

Hugh had the idea to go back
to the Cayman Islands,

to enable Jim

to climb in the same place
where he was injured.

♪ ♪

JIM EWING (voiceover):
I always knew that I would
go back,

so going back now with
this cutting edge technology

is kind of fitting.

It's showing that
the human spirit, let's say,

and ingenuity can overcome
a lot of things.

♪ ♪

Do you notice that
the Cayman Airways logo

is a turtle with
a prosthetic leg?
(chuckles)

I hadn't noticed that before.

I think I'm offended.

♪ ♪

The hard part
is always finding, like,

where the trail is in here.

The route goes up through
those tufas,

so I fell from, basically, where
the tufas are and landed...

There's one actual stalactite
coming down.

Yeah, so to the right of it.

To the right of that,
in that area.

Yes.
Holy cow.

I guess it is like 40
or 50 feet.

(chuckles)

So, anyway.
How did you survive that?

This sucks, right?

Like, it sucks that
this happened.
Yeah.

Um, but to see where
all that started has been...

It's come full circle now.

Like, you know, we're back here
climbing with a robot foot.

I mean...
Yeah, it's crazy.

How incredible is that?

♪ ♪

HERR (voiceover):
I am, I would say,

green with envy of Jim,

because I don't have that level
of neural implant yet.

I've met with Dr. Carty
as a patient

and the next step
is to image my legs

and look at my nerves,
and neuromas,

and muscles, and see,
see what can be done surgically.

Even I have no idea

what my physicality will be
a decade from now.

I'm sure it'll be very
spectacular.

(waves crashing)

♪ ♪

CLITES (voiceover):
We're moving to a place
where it no longer matters

what your body parts
are made out of.

Whether they're muscle and bone

or whether they're metal
and carbon fiber,

It's this beautiful merging

of the synthetic
and biological into a body.

♪ ♪

(crowd applauding)

HERR:
Ladies and gentleman, Jim Ewing,
the first cyborg rock climber.

(cheers and applause)

NEWS ANCHOR:
Remember that bionic arm
that Luke Skywalker got

in one of the
"Star Wars" movies?

Well, modern medicine
is getting closer

and closer to making sci-fi
a reality.

NEWS ANCHOR:
These smart limbs being
developed at MIT are possible

because of the Ewing amputation.

CARTY (voiceover):
We were able

to obtain a pretty significant
grant

from the Department of Defense.

So we're gonna have a total
of 20 patients

who are undergoing
the Ewing amputation,

or it's above-knee analog,
and be able to compare those

to a group of 20 patients who
undergo a standard amputation.

Am I going stump nude?

SRINIVASAN:
Yes, please.

Stump nude.

SRINIVASAN (voiceover):
So far, the data

has been really encouraging.

These patients have seen
an incredible transformation

in their general quality
of life,

before and after the amputation.

(prosthesis whirring)

When you see a patient move
their robotic prostheses

for the first time.

I can do ballet with my foot.

SRINIVASAN (voiceover):
The smile on their face

is just incredible.

I don't know, it just feels
like it makes sense.

We've also had three patients

who have had an above-knee
or transfemoral amputation.

For the first time, you know,

some of them have been able to
actually move their ankle joint.

It's like a weird connection
because it's, like,

I know it's a foot,
you know, it's not...

it doesn't look like my foot.
Mm-hmm.

But it's, like, I'm moving it,
so it's my foot.

If that makes sense.
Yeah, no, that's good.

Foot in, and relax.

PATIENT (voiceover):
You run into these same patients
throughout the study,

or going to, you know,
check in with Dr. Carty.

And you come in and, "Oh, look
at this, you're missing a leg.

Are you one?"

"Oh, I'm number this,
I'm number that."

And so, now we're like Facebook
friends, it's kind of nice.

It's a little community.

♪ ♪

JIM EWING (voiceover):
Here it is almost two years
later

since my surgery

and coming back
to where it all started

in support of patient
number nine.

(indistinct chatter)

(voiceover):
I know what the patients
are going through,

it's a difficult decision.

And once you make the decision,

it's quite the emotional
roller coaster

while you're waiting
for the surgery.

They bring in heated blankets?

CARTY (voiceover):
We believe that
the amputation by itself

is just a better amputation,

and that that has certain
intrinsic advantages,

even if those patients never
had access to a high-fidelity

next-generation prosthesis.

But when you combine
the modified amputation

with the next generation
prosthesis,

that's when really magical
things start to happen.

The amputation we call
the agonist-antagonist

myoneural interface,
or AMI for short,

we refer to it as
the Ewing amputation

when it's below the knee.

Since those early days,

we've applied the AMI amputation
above the knee,

below the elbow,
and above the elbow.

Over 30 people have now received
the AMI amputation.

So, we've amassed a tremendous
amount of scientific data

to more deeply understand
the impact

and the clinical efficacy
of the technique.

We have further evidence that
it improves bionic limb control.

We've also measured
reductions in pain.

And furthermore, with fMRI
imaging of the central brain,

we've shown with direct evidence

that the amount of
proprioception

as a person's moving their
phantom limb,

in the case of an AMI
amputation,

is the same level,
statistically,

than a person with intact
biological limbs,

which is truly remarkable.

♪ ♪

I think in 20 years,

limb amputation will not be
a disability,

and there will be several

dimensions that are actual
augmentation.

That is to say, people with limb
amputation can do

certain things that people
with innate,

natural bodies are not
able to do.

To run faster, to jump higher,

to do all kinds of things that
we can't even imagine today.

If I don't want to alter
my body, but I see that

altered people are getting
the rewards

and the spoils of the world,
they're getting the money,

they're getting the fame, right,
they're getting the fortune,

then I might say,

"If that's what it takes to get
those things, then I will."

So, whenever we attach

things that are of great
consequence to people

to their abilities,

that's when we have to start
thinking about,

is it coercive

to attach goods
to the abilities of the body?

I think we really have
to educate people.

We have to educate people

in the same way that we had
to educate them

about racism and sexism,

is the same way we'll have
to educate people

about able bodies
and disabled bodies,

and enhanced bodies, right?

Because we really are creating
another category of person.

And when you create another
category of person,

that's going to really tug at
people's sense of self,

but also how people operate
in the world.

How they hire people,

how they put people in the
classrooms, that kind of thing.

So, we really have to make sure
that people are understanding

of what it means to be
this enhanced body,

and what it means to be
an enhanced body

among other unenhanced bodies.

CEREMONY HOST:
Since 1849, there have been
over 150 casualties

in and around Mount Washington

in the presidential range.

None of them have been
insignificant.

We're here today to honor
and pay tribute

to Albert Dow by dedicating
this sudden weather exhibit.

CEREMONY HOST:
So, the plaque you're about
to see

says, "Albert H. Dow III,

climber, rescuer, friend."

(cheers and applause)

HERR:
After we were pulled
from the mountain,

I was profoundly confused
as to why

I was alive and
Albert had perished,

and I still don't understand.

But I... the only thing
I could control was to...

how I, how I live my life,

and Albert put forth tremendous
service in his life,

and I thought it would be
a disgrace to his memory

to give up.

So, thank you, Albert,

for all your inspiration to me,
and to so many other people.

And thank you so much
for venturing out

in the young winter of 1982,
in search of two lost boys.

Thank you.

(cheers and applause)

(voiceover):
My goal was to not give up,

to not succumb to pity,

to use every cell in my body

to try to do something
worthwhile with my life

because of Albert's ultimate
sacrifice.

I'm certainly still on
that journey.

I really feel that we're,
we're just getting started.

♪ ♪

♪ ♪

♪ ♪

♪ ♪

♪ ♪

♪ ♪

ANNOUNCER:
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on Amazon Prime Video.

♪ ♪