Engineering the future of health

"Steve Austin, astronaut. A man barely alive. Gentleman, we can rebuild him. We have the technology. We have the capability to build the world’s first bionic man. Steve Austin will be that man, better than he was before. Better, stronger, faster."
— THE INTRODUCTION TO EACH EPISODE OF THE 1970s SCIENCE FICTION TV SERIES "THE SIX MILLION DOLLAR MAN"

For Ed Berbari, what once must have seemed like a fanciful line from science fiction is remarkably close to scientific fact-just three decades later.

But the director of IUPUI's fledgling biomedical engineering (BME) program in the Purdue School of Engineering and Technology isn't surprised. In fact, his own career-which saw him start as a BME intern at Carnegie Mellon University in Pittsburgh about the time the TV docs were repairing Steve Austin-has been built on the same set of assumptions.

The program he helped launch in 2004 blurs the lines between the engineering school and the IU School of Medicine, marrying the two disciplines in new and inventive ways that have opened the eyes of research funding organizations-and just as importantly, begun attracting a new breed of students eager for the challenges of a program that's diving into an undefined future instead of being bound by traditions.

High-quality students

Berbari, who has been at IUPUI since 1994 and holds dual academic appointments in both E&T and Medicine, isn't at all surprised by the high caliber of students who have enrolled in the BME program. "High achievers like our kids love to test themselves," he says.

"They get to immerse themselves in research projects from the start, and thanks to our partnership with medicine, they get to work in hospital settings-something a lot of them would like to do-and also to get published in a new and exciting field."

The four most prominent research areas in BME are orthopaedics, cardiovascular science, medical imaging and the neurosciences, Berbari says. The field is all about finding ways to help people adapt when their bodies have somehow failed.

"We think in engineering terms and use engineering's tools to study and solve medical problems," Berbari says. "And as medicine has moved into research on the molecular level, we've begun work on the cellular level, through fields like nanotechnology or tissue engineering."

The BME chairman expects some of his grads will migrate into medical school. Others may work in research and related fields. And he hopes all will build their careers around shaping the future. One former IUPUI student who would have loved to be part of the BME program-and whose career revolves around biomedical engineering on a daily basis-is U.S. astronaut David Wolf (view article), who shares Berbari's unbridled enthusiasm.

"Traditionally, biology has been so complex that it has been as much an art as a science," says Wolf, an Indianapolis native. "But because of our technological advances, we're on the verge of a significantly greater understanding of our biological systems. And that allows us to use engineering principles to build our knowledge about human performance, disease and many other fields of medical care."

Breathtaking possibilities

"Already, our (BME) tissue engineers are working on engineered bone, which opens up a new world of hope for people with nonhealing bone fractures. We're just scratching the surface of what is possible," says Berbari, who admits that even after decades in the field, he still finds himself amazed by the possibilities his profession could offer.

"We're asking ourselves questions like 'can we grow ligaments, tendons, even bones that match what our bodies now do?' he adds. "Can we grow an entirely new kidney from a few cells? If that's possible, it dramatically reduces the problems of rejection!" The field may completely revamp one of it's own greatest success stories: the cardiac pacemaker.

"They've been reduced in size, but the power source still takes up more space than we'd like," Berbari explains. "But what if we used a tissue-engineering approach, implanting cells which replace or alter the non-functioning diseased cells in the heart. Then its not a question of if, but when, we make pacemakers out of a set of cells from the person being treated!"

The ongoing partnership between biomedical engineering and the schools of Medicine, Dentistry, Science and others has been a vital part of BME's growth from a collection of courses in the engineering school to a full-sized department, complete with bachelor's, master's and Ph.D. degrees.

"Those relationships are vital to our growth, but they also strengthen our partners, too," Berbari says. "Look at the work already underway and the quality of students we're attracting and one thing's clear: we have the potential to rank among the top 20 to 25 percent of biomedical engineering programs nationwide. And that's incredible for a program as young as ours!"

Reshaping two fields

One of the biggest challenges of building a strong program has been "finding worthwhile textbooks," sighs Berbari, who headed the University of Oklahoma's BME program in the early 1990s. The flip side of that coin? Berbari and his staff can unleash their creative juices and teach their students the principles-and wonders-of a field that could reshape both its parents: medicine and engineering.

"Because the medical school has been so receptive to us, our students have gotten a chance to see the human side of health care, and have had the chance to imagine how their work could make things better for others," says Berbari. "In engineering, we tend to think in terms of objects and systems. Working with medicine so closely makes things more real for our students."

Those advantages affect the outlook of BME's students-and, Berbari admits, the faculty, too.

"There is an energy, an excitement, in our program," he says. "Our kids have always been high achievers, good at pretty much everything they do. But here, they're exposed to challenges that require them to go further, to use their skills in several fields and do it all at the same time!"

It was that same "humanistic" motivation that pulled Berbari himself into a field that barely had a name and virtually no heritage when he started at Carnegie Mellon in 1971.

"Mostly, they thought I was there to fix the hospital's electrical systems," the BME director laughs. "But I was a library rat; I read anything I could find on ways to use engineering in health care. I even made some of my own instruments to study electrical safety in the catheterization labs and intensive care units, to find ways to make things work better."

His experiences have made Berbari an unapologetic cheerleader for BME.

"I think biomedical engineering will help us apply the lessons we're learning from human genomic studies and put them into practice, helping people stay healthier, be stronger and live longer," he says.

He calls the concept "individualized medicine."

"In the 1970s, an IBM executive said that in a year or so, we'd have maybe 300 computers in the world, and that'd be all we'd ever need," Berbari laughs. "Of course, that's when one computer filled a room. But things change. The care we get now and what we have in years to come could be just as different as those old room-sized computers were from the ones we wear on our wrists or hold in our hands.

"Those changes are coming, and it's kids like those in our program now that will make them happen," Berbari says. "It's a thrill to be part of that!"