Things are picking up for the bionic boy
At 13, Patrick is the youngest patient in the world to be fitted with a pioneering prosthetic arm. His father, Frank Kane, describes how it has changed his life
By Frank Kane
Published: 7:00AM BST 06 Sep 2010
On July 22 my 13-year-old son, Patrick, tied his shoelaces. It was a moving occasion. For the first time in his life he had performed this routine but intricate task, on his own and unaided.
He went on to cut up his own steak at dinner, lift a glass of orange juice to his lips, and pick up a grape between forefinger and thumb. Each new achievement was a cause for pride and satisfaction.
We had just spent five days with Touch Bionics, a medical technology company based in Livingstone in Scotland. The company had manufactured and fitted him with an ectro-mechanical hand that responds to muscle activity in the arm, transforming it into movement in the powered fingers and thumb.
Patrick had become the youngest of the small number of people round the world – some 1,400 or so – fitted with the Touch Bionic prosthetic. He was the "bionic boy".
When he was nine months old, my son fell victim to a vicious strain of meningitis. He also developed septicaemia (blood poisoning) and was on the edge of death for many days, unconscious in intensive care for three weeks, and spent three months in St Mary's Hospital in Paddington, London.
He beat the disease, thanks to his fighting spirit and the skill of the staff at St Mary's. But it took a terrible toll. His right leg was amputated below the knee, as was most of his left hand. His shortened left arm ended as a stump of scar tissue, with the growth plates between the bones of his arm permanently damaged.
Even allowing for the fact that he's my son, it's fair to say Patrick is a remarkably resilient, independent and resourceful boy. He learned to walk with a prosthesis, and goes to a "normal" school, where his lower limb disability has not prevented him taking part in all aspects of school life, both academic and sporting. His hard-wearing carbon fibre leg won him a reputation as a fearsome tackler on the football pitch.
But that left arm was increasingly problematic. It was visibly shorter than his right and almost useless. He could use it to hold objects against his body – to open a bottle top or a crisp packet with his right hand – but without a hand he had no grip, no functionality.
He, and others, were also becoming more conscious of it. People would stare in restaurants as he struggled to cut his food; trips to the beach or swimming pool were fraught with potential confrontation. It's surprising how ready you are to snap: "So what are you looking at?" at a startled youngster after you've spotted the 20th obtrusive stare of the day.
Last spring, Patrick's stepfather, Ian, saw a news item about Touch Bionics and the innovative work the company was doing in the field of bionic prosthetics. Potentially, it was a life-changer for Patrick, as it has been for the many (mainly American) servicemen who lost arms or fingers in Iraq and Afghanistan, and victims of industrial accidents, who form the majority of their patients.
But these were all adults who had once had full and active use of their limb. Would it be suitable for a young teenager who had never properly used his arm? An initial consultation in London suggested that it could be, and a week-long session of fitting, training and therapy was arranged in Scotland.
Touch Bionics evolved from the thalidomide scandal in the Sixties, which left hundreds of young children disabled at birth after their expectant mothers were prescribed an apparently harmless "cure" for morning sickness.
Princess Margaret Rose Hospital in Edinburgh led the way in research into the effects of long-term disability, and this programme formed the core of the Touch Bionics project. In 2003, with increasing pressure on Scottish NHS finances and an eye on the commercial potential, the unit was spun off into a separate company, backed by private investors.
Despite this Scots pedigree, Touch Bionics business comes overwhelmingly from America, from where 75 per cent of patients originate. Of the 1,400 fitted since 2007, only 15 have come from Britain, and just six have been fitted on the NHS. At £20,000 a time, the equipment has been considered beyond most NHS trust budgets.
In modest premises on the outskirts of Livingstone, Patrick had his first close-up encounter with the i-Limb Pulse prosthetic. A hard-cased sleeve was fitted over his stump, with two sensors inside touching his skin to detect muscular movement in the lower part of his arm. This was then transformed into electro-mechanical power for the fingers and thumb of the "bionic" hand. By flexing and relaxing the muscles in a set of co-ordinated movements, he could open and close the fist of the limb, and move the fingers in the fashion of a real hand. The proper term for the system is "myo-electric multi-articulating prosthesis".
But for a teenage boy hooked on the Terminator movies, it was science fiction become reality. With a little practice, he could work the limb effectively in a convincing imitation of Arnold Schwarzenegger's humanoid robot, with soft clicks and whirrs providing sound-effects. And there was no question for Patrick of a cosmetic replica skin hand (though this is available and convincing) – he wanted jet black, just like Arnie.
Power for the limb is provided by batteries inside the arm covering, recharged via a mobile-phone type socket plug. This turned into quite a challenge for the technicians in Livingstone. They had to provide Patrick with enough battery power to keep it functioning all day, but without making the arm too heavy or bulky for a young boy.
Over five days, the Touch Bionics team improvised and refined the limb, and Patrick worked hard learning how to use it. The degree of muscle control necessary to work the fingers and thumb, while maintaining control of his upper arm while lifting or manipulating, was demanding.
There were a few accidents while trying to pour fluids or raise a cup to his lips, but he picked it up surprisingly quickly. The prosthetic therapists, Alison and Rebecca, said he was the fastest learner they had dealt with.
The Pulse bionic prosthesis is not a perfect replica of a hand, and it will take a lot more research before it approaches that level of sophistication. But it can already significantly enhance the quality of life of anyone who has lost a hand. It can lift up to 90 kilos, perform intricate tasks (such as shoelace tying, holding spherical objects, using a keyboard), and provide a level of digital functionality previously impossible.
At the clinic we met Donald McKillop, a former panel-beater who lost his right hand in an industrial accident 30 years ago. He has had a Touch Bionics prosthetic hand since 2006 and uses it like a normal limb in all everyday domestic activities, as well as for work and handicrafts. "I couldn't be without it now," said McKillop, as he casually scratched his nose with a prosthetic finger.
For Patrick, the benefits are two-fold: he now has a functioning limb where before there was a pretty useless stump; and when people stare now, they are simply being curious about a state-of-the-art piece of equipment that he is proud to own. He is at the cutting edge of medical technology, and cannot wait for the beginning of the school term.
