The development of the pacemaker was a byproduct of the medical research conducted at the Banting Institute related to cooling and warming bodies before and after heart surgery (Hopps, 1981). The researchers at the institute were inducing hypothermia prior to conducting heart surgery as it has been previously found this allowed the body to tolerate the lack of blood flow for longer periods than if hypothermia had not been induced. Hopps was an electrical engineer by education and his efforts were related to the application of radio frequency to heating. Before his involvement in the research at Banting related to the application of RF to warming bodies, Hopps was utilizing RF pasteurize beer. Hopps was asked to apply his knowledge of RF warming to subjects of Dr. Calaghan and Dr. Bigelow. It was during this research where it was discovered that electrical stimulation applied to the heart could cause a currently arrested heart to begin beating again (Hopps, 1981). This discovery was the basis upon which the creation of the pacemaker was founded.
Hopps and the researchers were met with many challenges in the development and refinement of the pacemaker. As it was 1950, the transistor was not available, and circuitry was based upon vacuum tubes. The probes and methods to attach the pacemaker to the heart required items which had to be created by a separate team of craftspeople. Materials which the body would not reject such as platinum had to be incorporated into the design. The first commercial pacemaker created in 1951 was approximately the size of a sliced-bread pop-up toaster and required constant power (Hopps, 1981). As with many firsts or cutting-edge innovations, the designs and implementations are often held back by current materials science and technical capabilities with miniaturization advancing based on developments in other fields of science or technology. It was another six years until a battery-powered pacemaker was utilized on a patient in 1957 and a year later an implantable pacemaker was successfully applied to an individual (Chaikhouni, 2010). These rapid advances in capabilities were a result of the fast-paced development of circuitry due to the use of transistors in electronic appliances.
Overcoming the challenges related to immigrating into a new country, Dr. Papanicolaou was hired on to Cornell University’s Medical College Anatomy Department in 1914 (Irish Times, 2011). Dr. Papanicolaou was charting the reproductive cycles of research animals based on examination of vaginal secretions. After success in animals, the research shifted to human subjects in 1920. During the examination of the samples collected, Dr. Papanicolaou was able to distinguish between normal and malignant cervical cells which would indicate that the patient had cancerous cells present. While the first findings were published in 1928, it was not until 1943 that a book covering the topic of uterine cancer diagnosis was published by himself and Dr. Traut. The procedure, which was relatively inexpensive, simple for medical examiners to perform, and generated accurate results was a significant contributor to early identification cervical cancer in a patient.
The development of the Pap Smear as method of cancer detection was the fortunate byproduct of other research. It was due to Dr. Papanicolaou’s previous knowledge and education related to reproductive cycles and anatomy which allowed him to understand the significance of what he was seeing under the microscope. The initial discoveries allowed him and others to continue researching the impact hormones and other factors can impart onto the development of cancerous cells. Dr. Papanicolaou’s collaboration with other leading researchers aided in the rapid growth of research within the field of cancer in not only the reproductive system but other organs as well (Irish Times, 2011).
Comparing the rate of research and knowledge growth between the Pap Smear method and the pacemaker demonstrates quite a difference. In less than ten years the pacemaker transitioned from externally powered prototype to implantable and internally powered unit. The publication of the research conducted by Dr. Papanicolaou took eight years to materialize and another fifteen after that until a more comprehensive text was published. The life-saving implications of the pacemaker were a contributing factor to its rapid development as prototypes were implanted into patients as soon as they were available and deemed acceptable for use (Chaikhouni, 2010). The knowledge and information related to cancers took much longer to develop as cancerous cells and the types of cancer afflicting individuals may appear differently and establishing definitive irrefutable evidence and documentation would take considerably longer due to the number of patients and data which must be collected as part of the research process.
In both instances, the education and knowledge held by the individual in a non-related field had a direct impact on their ability to contribute to research products which generated these ideas as a fortunate accident. Hopps had an educational background in electrical engineering which may have enabled him to consider the problem space from a different perspective than the medical researchers who were also on the team. Dr. Papanicolaou was a trained physician but his PhD in zoology earned from the University of Munich enabled him to participate in the reproductive research on animals which ultimately led to the development of the Pap Smear method (Tan, Tasumura, 2015). While many important and significant discoveries are generated by individuals who devote their life to a particular subject, these examples demonstrate that outside perspectives or simply performing the right research at the right time can also generate longstanding and impactful discoveries and innovation.
As both discoveries were well understood to have a profound and positive impact on public health, they were able to receive support for research universities and government programs to fund additional research and development. Utilizing living beings as the focus of research or evaluation of experimental products or procedures can be next to impossible for those without the appropriate connections and knowledge of the regulations and processes necessary to perform ethically and within the confines of accepted medical practices. Innovation or discoveries in areas which are not related to medical sciences or have a purely commercial applications would have far fewer barriers to development, enhancement, and deployment. The application of the product and how it can be developed is very dependent on its use and it if an individual has ideas for products in these spaces, a collaboration or partnership would be necessary.
Access to tooling, individuals with fabrication skills, or other skills which allow drawings and designs to be converted into physical objects is also vital. As discussed by Hopps, without the availability of the fabrication team in another department, many of the components required for the pacemaker would have been much more difficult to create, taken more time for development, and would have resulted in more costs and delays to the research they were performing in this area. Individuals with an idea or design who are not capable of fabricating the product themselves may face considerable setbacks in the release of their items or unfortunately, the ideas may never materialize and someone else with the means to create may find their product being first to market because of it. While patents and other such design protections may allow for some credit or monetary compensation, there may be requirements for evidence of function or proof of viability which would still necessitate a working protype or physical manifestation of the concepts and ideas presented to a patent office. Innovation is a collaborate process and those who come up with ideas must have a strong network to leverage in order for their thoughts to become known successes.
References
Chaikhouni, A. (2010). The magnificent century of cardiothoracic surgery part 8: Reviving the dead. Heart Views, 11(2), 85-91. http://dx.doi.org/10.4103/1995-705X.73228
Hopps, J. A. (1981). The development of the pacemaker. Pacing and Clinical Electrophysiology : PACE, 4(1), 106–108. https://doi-org.coloradotech.idm.oclc.org/10.1111/j.1540-8159.1981.tb03682.x
Tan, S., & Tatsumura, Y. (2015). George Papanicolaou (1883–1962): Discoverer of the pap smear. Singapore Medical Journal, 56(10), 586-587. https://doi.org/10.11622/smedj.2015155
The pioneers who took on cancer. (2011, Apr 05). Irish Times https://coloradotech.idm.oclc.org/login?url=https://www-proquest-com.coloradotech.idm.oclc.org/newspapers/pioneers-who-took-on-cancer/docview/860014651/se-2?accountid=144789
