Within Reach

Ethan Brown uses a 3-D printed hand provided by e-NABLE. Photo by Kevin Liles

Jon Schull ’75 engineers a new solution for prosthetic hands

By William Abernathy ’88

Ethan Brown is like any other 9-year-old boy. At times strikingly poised, often taciturn, and always active, Ethan lives in Opelika, a not-too-large town in Alabama about 80 miles southwest of Atlanta. His mother, Melina, talks about the kids with every mom’s mix of awe and pride. One’s in college at Auburn, another just graduated. Cole’s the comedian, and Emily attracts butterflies like Snow White. “Ethan,” she says, “is full speed ahead.” He skates, rides a bike, plays basketball, is on the football team, and just started horse-riding lessons. “His trainer had the whip out—making the horse go faster,” she recounts of a recent lesson, “and all you see are teeth and smiles. Everything he does is as fast as possible.”

But Ethan is different in one respect. For some reason, his left hand came out all wrong. His thumb is normal, but his index finger twists across his hand at a right angle, taking up the space where the tiny nubs of his middle and ring fingers ought to have grown. His pinky is fused into a stiff digit with a rigid middle knuckle. “He’s never actually been diagnosed,” Melina says, “syn-brachy-something that I can’t pronounce... It doesn’t really matter.”

Growing up with a visible physical difference, of course, is no cakewalk. Faced with teasing and bullying in school, Ethan was, by age 7, beginning to withdraw. One night, he asked his mom, “Are there other people like me?” Melina hopped onto Facebook to show him a support group for people with upper-limb deformity. She was scrolling through the comments when she stumbled across a post by a man named Jon Schull, who had an idea that would change Ethan’s life.

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Mechanical hands have a long and fascinating history. One of the earliest models was built for the medieval German mercenary and poet Gottfried von Berlichingen, known as “Götz of the Iron Hand,” who lost his right arm during the siege of Landshut in 1504. His mailed hand boasted articulated fingers that allowed him, it is said, to hold a shield and write with a feather pen. In 1845, an Australian dental surgeon named Dr. Robert Norman used whalebone and pulleys to fashion a mechanical hand for a Corporal John Coles of Adelaide, who lost several fingers in a gunpowder accident. Norman’s design featured an innovative pulley system that allowed Coles to flex the fingers by moving his thumb. 

Upper-limb prosthetics have improved since then, but they are by no means perfect. Children pose a special problem, because they can grow out of a device in the time it takes to fit one. A conventional upper-limb prosthesis, built and fitted by a trained, certified professional, starts at around $6,000. Even with insurance, most parents can’t afford to fit multiple hands as a child continually grows out of them. Also, not every kid with an upper-limb difference lives in the same city—or country—as a trained prosthetist. 

Which brings us to Schull, who stands at the crest of a new wave in prosthetics that harnesses the power of crowdsourcing to solve the problem of building mechanical hands. With the help of a South African carpenter, a Bellingham prop maker, and a Reedie in North Carolina, he has launched e-NABLE, a global movement matching an army of DIY fabricators with kids who need a hand.

Schull started at Reed with an interest in animal behavior, which, after a brief flirtation with biology, led him to the psychology department. “I had been interested in biology because of Darwin,” he says, “and then I learned about reinforcement theory, which was all about rewards’ variations on behavior, which is very similar to the reproductive consequence of variations on the behavior of genes.” The analogy between the evolutionary fitness of genes and of behaviors became a source of an abiding fascination. 

Schull’s interest in this parallel was heightened his senior year in History and Systems of Psychology, taught by Prof. Allen Neuringer [psychology 1970–2008]. “We read a few chapters by William James, the 19th-century philosopher, who went to Harvard at around the same time Darwinism swept across the world,” he remembers. “James thought about natural selection as it relates to behavior and learning, as it relates to consciousness, as it relates to social evolution, and as it relates to the evolution of all sorts of complexity.”

Under Prof. Neuringer’s guidance, Schull delivered papers at Western Psychological Association conferences in both his junior and senior years at Reed. After graduating from Reed, he went to Penn to earn his PhD and taught biological psychology for 13 years at Haverford.

But the seed Neuringer planted had taken root. Schull’s sabbatical years are marked by papers that return to James’s work, a focal intrigue being how far Darwin’s insights could be pushed. Do ideas evolve? Can they meaningfully be thought to have a life? How do they propagate? How are bad ideas selected out?

These musings proved far from idle. In the early ’90s his attempt to sell laboratory software he’d developed resulted in several patents concerning software distribution and digital-rights management. “I ended up writing … a solution to the Napster problem 10 years before Napster existed,” he says. Knowing a fit idea when he saw one, he left Haverford to found SoftLock.com, which lasted nine years until collapsing in the 2001 dot-com bust. By this time, he confesses, “I was no longer qualified to teach biological psychology.”

Adapting, he found a new niche at the Rochester Institute of Technology, where his nominal focus changed to information technology and innovation. “I started teaching a course called Innovation and Invention,” Schull says, “which was all about what I’d come to decide was my great interest ... how new ideas can come into being—and this is the hard part—how they spread.”

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In 2011—some 13,000 miles away from Rochester—Johannesburg carpenter Richard Van As hustled to finish a job. Table-saw accidents happen with unfathomable speed, and he doesn’t recall what happened, just the smell of blood filling the room. He found two of his fingers on the saw table. His ring finger was hung up in the dust collector, and neither he nor his wife could find his pinky. What they found, doctors could not reattach. Before leaving the the hospital, he vowed to build something to replace his missing fingers. In the months that followed, Van As found and partnered with Ivan Owen, a theatrical prop maker in Bellingham, Washington, with experience building giant mechanical hands, to help him replace the fingers he had lost. 

Two years and a day after the accident, a YouTube video announced the fruit of their collaboration: the Robohand, a do-it-yourself prosthetic designed and built for 3-D printers. Significantly, Van As and Owen released their design as an open-source plan: anyone with a 3-D printer can take their plans and build their own. For free.

The video sparked an online discussion, and Schull weighed in with a practical (and fateful) challenge: 

OK Makerbotters

If you’re willing to receive inquiries from people who need a robohand, put yourself on the map! I’ve put a user-editable map on Robohand’s facebook and thingiverse pages.

Spread the word.

“It took off.” Schull says, “And it has now entirely taken over my life.”

E-NABLE, a Google+ virtual community that started with this post, now has more than 7,000 members around the world engaged in a massive online collaboration to design, build, and improve artificial hands, and to make them freely available to anyone who needs one. 3-D printers, like the MakerBot referenced in Schull’s post, are computer-controlled extruders that lay down a thin layer of thermoplastic (like the ABS used to make Lego bricks) that gradually builds up, layer by layer, into a complex three-dimensional shape. Once expensive and exotic, 3-D printing is becoming cheaper and more ubiquitous daily. 

As important as the 3-D printing technology is, it was social media that gave e-NABLE wings. Van As and Owen’s open-source licensing of the Robohand plan encouraged others to share and improve on their original design. A designer sitting at a laptop in Rochester, for example, can make an improvement or an adjustment to a part and instantaneously propagate it to anyone with a printer and an internet connection—be they in Berlin, Taipei, or Timbuktu. Starting with Van As and Owen’s Robohand design, the e-NABLE community has adapted and improved the basic concept with new designs, hands with names like Raptor, Osprey, and Cyborg Beast. Designers share ideas on new approaches and new materials as they become available.

hand

In September 2014, over 125 unassembled 3-D printed hand kits were created by volunteers from all over the world and shipped to Baltimore for the first e-NABLE community conference, “Prosthetists Meet Printers.”

Jon Schull

Jon Schull ’ 75 demonstrates a 3-D printed hand at Johns Hopkins medical center.
Photos by Jen Owen of enablingthefuture.org

E-NABLE’s hands fit around the wearer’s palm and use simple mechanical actuation—such as pulleys, levers, or elastic bands—to translate wrist motions to finger movement. Schull describes it to kids more concisely: “When you bend your wrist, it makes a fist.” The fingers and much of the supporting structures are plastic, usually pivoting on joints made of Chicago screws, available in most hardware stores.

The resultant device is by no means a perfect replacement for a well-formed hand. The wearer can’t generally move individual fingers (a motion called “gross grip”), and the grip strength doesn’t enable jar-opening or walnut-cracking. But users can pick up cups and other lightweight objects and stabilize objects for the opposing hand. The advantages in cost, appearance, availability, and customizability make e-NABLE designs popular  with kids and their parents. 

Even with free, globally distributed volunteer labor, the e-NABLE community has rapidly grown to the point that it has become several full-time jobs’ worth of effort to keep it going. Having headed a company already, Schull knew his limitations and sought help to provide support for the burgeoning project. Attorneys working pro bono had already set up a 501(c)(3) to establish the Enable Community Foundation when Schull reached out to Grace Mastalli ’73. 

“Originally I was going to meet with him, have lunch, see a friend, and leave on a return flight at four in the afternoon,” Mastalli says of their first face-to-face meeting. “What I thought was our one-on-one involved a bunch of other people, all of whom were fascinating, and he was sort of multitasking, trying to form relationships and get engagements with multiple people simultaneously… The day ended up ending at 4 a.m. instead of 4 p.m. I decided he really needed someone like me to work with him to make his vision and dreams a reality.”

Mastalli initially signed on to help for a three-month mini-sabbatical but has since taken the helm as CEO of the foundation, a nonprofit that supports the efforts of the online community. Schull, Mastalli says, “is the quintessential visionary. He’s creative, he’s spontaneous, he’s opportunistic. He’s sometimes inconsistent. He’s a man that you want to have in a room, generating ideas for a thousand people to work on executing.” 

While Schull can inspire an audience by drawing insights from evolutionary psychology, the legally trained Mastalli quietly wields organizational psychology to make e-NABLE sustainable. As Schull ponders how to help ideas evolve, Mastalli, a veteran of the US Departments of Justice and Homeland Security with multiple startups under her belt, builds the ecosystem that e-NABLE’s ideas require to survive. “Where our thinking came together was networks and societies,” she says. “The difference is that he is very much interested in the evolution of collaborative networks, and I want to manage and design collaborative problem solving.”

The idea has caught on so fast that the organization’s ability to gather data has yet to catch up. “There’s been at least one hand delivered to more than 50 countries,” Schull says, “Our big push next year is collecting reliable and useful data to inform and understand what we do.” The foundation estimates that 1,800 hands have been delivered so far, but because their designs are open and free, they suspect that as many hands have been produced without their direct knowledge. Google, Autodesk, and several charitable organizations have contributed funds, and they’ve had visits from CNN, the New York Times, and other national media.  

The foundation’s first full-time employee was Ethan’s mom, Melina, whom the foundation now calls “the heart of the organization” for her tireless advocacy for recipients. To hear her describe it, the hand isn’t about grip strength or dexterity at all. It’s about self-respect. 

The biggest changes the e-NABLE hand has made in Ethan’s life, she says, are psychosocial. He’s more outgoing now, less withdrawn, and more able to engage with friends. “His self-confidence now is huge,” Melina says. “If we’re at an event, he takes off his hand and he’s like, ‘This is what it looked like. This is what I was born with.’ Never would he have done that when he was younger.” Ethan’s classmates’ attitudes changed with the new hand as well. “One day you’re the weird kid,” Ethan says, “and the next day, you’re suddenly the cool kid, because you have an Iron Man hand.” 

Melina’s getting Ethan ready for his first public-speaking engagement. To hear him talk, he’s not the least bit nervous, looking forward instead to his 10th birthday, only four months away. Adult concerns aren’t holding his interest. It’s a sunny winter day in Opelika, and he’s playing basketball in the driveway. He steadies the ball with his thermoplastic fingers, squares up, and takes the shot.

—Author info: William Abernathy ’88 lives in Berkeley, writes for a living, and makes things for fun.