Colloquy: A Conversation with Osteoid Creator Deniz Karasahin
For generations, medical advancement has happened at the lab bench. That’s changing, but new developments in product, process and technology are happening in an environment that’s not accustomed to experimentation—or the presences of outsiders. These changes are also taking place in an industry where problems are (rightly) triaged. Comfort and aesthetics take a back seat to life-saving. In 2014, Deniz Karasahin won the prestigious Golden A' Design Award in 3D Printed Forms and Products Design with the Osteoid, a 3D printed cast that combined orthopedics and therapeutics through ultrasound technology that encourages bone healing. In an instant, an industrial designer who previously designed sinks and conceptual bicycle helmets found himself in the public eye—and working in an environment totally foreign to him. Since, Karasahin has been working through the arduous process of turning a great idea into a practical actuality. I recently chatted with him about the experience of throwing himself into healthcare and how design and designers can be best fit into healthcare. The conversation has been lightly edited for length and clarity. So as a relative outsider, when you started looking at the healthcare space, what was your impression of the product design work being done already? The thing about healthcare is... most of the products are very ugly from my point of view, because they were initially designed by doctors and engineers. There is no human touch in the industry in general. Well, of course there is a human touch, but it’s the biomedical touch. There is no touch of an artist. That was lacking from my point of view. When you threw yourself into this, what was your approach? Did you start working directly with physicians? Did you come to this idea from doing background research? How did you immerse yourself in the medical space? It was an accident from my point of view. Because I didn’t do any research, I thought it was just a good idea. I wasn’t aware that it was a discovery or an innovation. It was just an idea that I liked to play with at the time. Once I received the award and got some exposure, that’s when I got into the depths of the medical field. Then I started working with hospitals. With celebrity surgeons and all that. What were some of the problems that you heard repeated most through the research? When I first started work, I reached out to (physicians) and said, we’re combining therapeutics with orthotics. At the time I received so many emails from people with cerebral palsy, or chronic patients — people wearing braces for an extended period of time. It’s very difficult to classify these patients because every manifestation of cerebral palsy is unique in a way. It’s like cancer in that sense. The method for quantifying (orthotic) measurements was a huge problem because all the physical examinations were done by hand. Eventually, I had the idea to put sensors in the splints. There, I had my second idea about the company. We did a case study with Intel in Turkey and did a SmartSplint How did you come to the ultrasound side of things? You have no medical training and that’s not your background. Did that come out of your research? I Googled it (laughs). I didn’t Google “ultrasound” of course. I googled “methods for accelerating bone healing.” I found products and I matched them together. What’s the response been like from the medical community? Unimaginable, from my experience. Especially from someone like me who has no background in anything medical. I found myself in exhibitions, in museums, I found my work in Innovation Nation in CBS America. Crazy stuff. This type of solution, when it becomes more ubiquitous, will require changes in the way that doctors and nurses operate. How do you see design continuing to be incorporated into healthcare? I think it’s about how we communicate with doctors. We want them to think of us as a tool to access this type of technology. In the end, it will need to evolve a platform to allow these doctors to use this technology. (For now) we must act as the bridge between the design world and the world of a doctor. We need to give them the tools to enable them to implement the designs we make. Some doctors are technology-averse. What’s the on-going role of a designer on the clinical team? Medical innovation has happened in a laboratory. For hundreds of years that’s where it happened. How do we change that? Designers should spend much more time in hospitals with patients. For instance, recently I bought myself a doctor’s jacket for when I talk to patients. I still talk to patients (the same way), but I’m wearing a doctor’s jacket. Do people treat you differently? Um… Yes. How so? They listen more. They listen to the jacket (chuckles). The jacket is the metaphor for knowledge and experience. When you work with doctors, doctors are people who who always have the eye of an expert. They always give an expert’s opinion. The role of the designer should be similar—to give the viewpoint of the expert in a related subject. It’s a team, but you should be in the field. A laboratory is so much different than an emergency room. To get that experience you have to be in the field, and if that means wearing a doctor’s jacket, then you wear a doctor’s jacket. Medicine is a field where function has come before form. Your product looks very different from what’s out there now. Yes, it has ultrasound and can increase healing times and all of that, but the most striking difference is the way it looks. What was the response like from patients and even from physicians to the way it looks? I’m going to quote Frank Lloyd Wright, “form and function should be joined in a spiritual union.” Designing a product from a single angle is not correct. If you have to wear a brace, that means you’re already in trouble. You either broke a bone or you have a congenital problem. Basically, these products are built for people that really don’t want to wear them in the first place. So when I was designing the product, I wanted it to be something like an accessory. Something like a handbag. It should be something I like. I may not like the situation I’m in, but at least I have a good looking cast. It’s a psychological aid to survive wearing a brace. You spent a lot of time in hospitals, taking the eye of the artist into the clinical space. What did you notice? It was a huge learning experience for me. I enjoyed learning so much. It was so much fun for me. One of the things it brought to me is how lucky we are to be healthy. It gave me a reminder of that. You don’t get that feedback when you’re designing a turntable or a toilet. It adds something else. I saw huge opportunities because of the fact that everything was designed by non-designers. Traditionally, when you are talking with a doctor, because they see the worst—they are used to amputating arms or giving bad news—if someone is not happy with a cast or someone is having a little itch, the doctor doesn’t care as long as (the arm is) there. That’s the opening I saw. Let’s turn to 3D printing specifically. The technology is still relatively nascent. It’s a new thing. What has to happen to make it more ubiquitous and more accessible to help solve problems on a daily basis? For solving problems on a daily basis, it needs to get out of the lab and be applied. We need some serious software support. It’s a very old tradition, (these problems have) been out there for thousands of years and it’s one of the longest lasting design challenges throughout the history of humanity. New technologies are bringing us new ways of thinking. The advantage I had working in this field, because i’m new to it, i don’t know how to think in the old way. I know how to think in the new way. When I look at the industry with those eyes, i see many opportunities because i’m used to doing things in a nontraditional way. Talk a little about the end vision. What role could 3D printing play in medicine? Everything. Everything. Custom things like orthotics are inevitable. The whole industry is going to evolve into that, first things first. I think it will open the possibilities of constructing hospitals in humanitarian crisis areas or underdeveloped areas. All you’ll need is a couple of printers. We have the huge opportunity to do things like that in Africa. But if you’re talking about the first world or about Europe and America, it will start from the very obvious ones. At a different level you can think about genetic modification, 3D printing DNA. I’m very curious to see what is going to happen because I see the transition in every dimension. What makes you as a designer, with relatively fresh eyes, excited? What are you most looking forward to seeing? Dynamic structures, 4-D printing. They give more opportunity. It’ll provide another level of thinking. It’s another level. It will be more semi-dynamic materials which can be activated with electricity, with heat. For instance, I really seriously admire Neri Oxman’s work. I hope to see in my lifetime those ideas become realities. Has your opinion about your own healthcare, now or in the future, changed at all with your work in the space? Yes. Deep down, I realize the problems are getting more and more sophisticated in every aspect. In printing they get more sophisticated. The challenges are getting more sophisticated. There are layers and layers of different problems. I’m at a point where I am finally finding a good problem for me.