Making Hearts Beat
by John Adam
people seemed destined for success. Maybe they are always at the top of
their class. Maybe they are from wealthy or from well-connected families.
Or perhaps they work superhuman hours. Wilson Greatbatch, the 1996 honoree
of the Lemelson-MIT Lifetime Achievement Award, fits none of those criteria.
This is the story of how a very average person developed into one of the country's greatest inventors with more than 140 patents. His most famous invention, called the cardiac pacemaker, keeps the rhythm of millions of heartbeats and helps people live longer and better. The pacemaker was the first electronic device ever surgically implanted inside human bodies. In October 1996, Greatbatch shared his experiences with middle school students in one of the Lemelson Center's Innovative Lives programs.
When he was five Wilson Greatbatch picked up a harmonica and began to make screeching noises. He stuck with it. No one taught him, yet eventually melodies started to flow like a songbird's. He did not realize then that he learned the greatest lesson of his life: don't fear mistakes, learn by them. Music always fascinated Greatbatch. He grew up in the 1920s, when "wireless" radio amazed people. These invisible waves silently carried music and voices through fog, through cement, and into people's homes. Receivers captured these signals and made sense of them, reconstituting the sounds.
"I think it was the mystery of it that attracted me" to radio electronics. "Something was happening that you couldn't see or feel," he recalled. An only child, in his teens he found he could expand his world with radio. In his early teens he built his own short wave radio receiver. Cockney accents from London, England proved he was reaching far away. He wanted to talk back. Around 16, Greatbatch passed the test for an amateur radio license and joined the Sea Scouts (a type of Boy Scouts) because they had a radio station.
World War II changed everything. Radio was no longer just fun. It became critical to war communications between ships and airplanes. Greatbatch, packing his trusty harmonica, joined the Navy. He repaired electronics on a destroyer, served as radioman on convoys to Iceland, and crewed aboard the USS Monterrey aircraft carrier in the Pacific. Greatbatch tuned the aircraft's electronics and ensured they were reliable. If an aircraft's radar and communications failed, the plane might be lost at sea. He also flew combat missions. In six months of combat, a third of the squadron crew perished. Amid all that seemingly random death, Greatbatch became religious and began carrying a Bible in his pants leg for each mission.
Asked if he himself killed people, he simply replies, "Probably. During bombing runs I just held down the machine gun trigger." When the war ended, Greatbatch returned to Buffalo with his new bride and longtime girlfriend Eleanor, a home economics teacher. He thought about teaching industrial arts. He worked a year as a telephone repairman. Then he enrolled at Cornell University. Under the G.I. Bill, the government paid for part of his expenses in appreciation for his military service. "After all that time in the dive-bombers with the ack-ack [anti-aircraft fire] bursting all around, you appreciate the change," he said. "I was so grateful. I have repeatedly and vainly tried to imbue my children with the kind of appreciation that I had, just for the opportunity to sit, and hear, and learn," he said. "I don't think I ever got this across to them."
At Cornell, he took math, physics, and chemistry. He tested poorly -- maybe because so many jobs kept him busy. To support his family, he maintained the local radio station. He also built receivers for what became the Cornell radio telescope at Arecibo, Puerto Rico. Eventually Greatbatch joined the Psychology Department's animal behavior farm. He attached instruments to about 100 sheep and goats to monitor blood pressure, heart rate, and brain waves in science experiments.
During 1951 on this animal farm, Greatbatch shared brown bag lunches with two surgeons visiting from New England. They described an ailment called heart block that occurs when natural electrical impulses from the heart's upper chambers (atria) fail to reach the heart's lower chambers or ventricles. The result is irregular heartbeats that can cause shortness of breath and, in extreme cases, loss of consciousness and even death.
"When they described it, I knew I could fix it," Greatbatch recalled. It was basically a problem of communications. To put it in radio terms, the signal was not getting through. Unknown to Greatbatch, Paul Zoll in Boston had made the first practical external pacemaker in 1952. About the size of a table radio, it could be plugged into household current. Its repeated electrical shocks were painful and damaged the skin, but the device could save lives. Several years later, Earl Bakken, the founder of Medtronic Inc., developed a hand-held external pacemaker that was powered by batteries.
In the meantime, Greatbatch had returned to Buffalo to teach as an assistant professor of electrical engineering at the University of Buffalo while he earned his master's degree. He also worked for the nearby Chronic Disease Research Institute. By that time, around 1956, commercial silicon transistors had become available for US $90 each, and Greatbatch, working for a doctor at the institute, was designing a circuit to help record fast heart sounds.
By mistake, he grabbed the wrong resistor from a box and plugged it into the circuit he was making. The curcuit pulsed for 1.8 milliseconds and then stopped for 1 second and then repeated. Greatbatch recognized the lub-dub rhythm.
"I stared at the thing in disbelief," he said. This was exactly what was needed to drive a sick human heart! For the next five years, most of the world's pacemakers used that simple blocking oscillator design -- just because of Greatbatch's accident.
Greatbatch met William C. Chardack, chief of surgery at Buffalo's Veterans Administration Hospital. Chardack predicted such an implantable pacemaker would save 10,000 lives a year.
Three weeks later, on May 7, 1958, Greatbatch brought what would become the world's first implantable cardiac pacemaker, made with two Texas Instrument transistors, to Chardack's hospital. There Chardack and another surgeon, Andrew Gage, exposed the heart of a dog, to which Greatbatch touched the two pacemaker wires. The device took control of the heartbeat. The team stared in near disbelief.
"I seriously doubt if anything I ever do will ever give me the elation I felt that day when my own two cubic inch piece of electronic design controlled a living heart," Greatbatch scribbled in his lab diary in 1959. "We were pretty naive about early pacemaker designs," Greatbatch recalled. "We thought that wrapping the module in electric tape would seal it." But body fluid found its way through any holes to short out the circuit. That first implant lasted only 4 hours. Switching tactics, they began to cast the unit in a solid block of epoxy. Within a year, devices could last four months. It was time now, they felt, to look for a suitable human patient. Greatbatch's then employer, Taber Instrument Corp., was unwilling to risk a million-dollar company on a perilous item like the pacemaker, so Greatbatch left. He got into a race.
Like so many other inventions, an implantable pacemaker was the goal of several groups during the late 1950s-from General Electric Co. to Swedish researchers. In Sweden, Ake Senning had attempted the first human implant late in 1958. The unit failed after 3 hours. A second unit worked for eight days before failing, and the patient had to wait for three years before receiving a satisfactory unit.
Perhaps Greatbatch succeeded because of his deadline: he'd saved $2000 and enough extra so he could devote himself full-time to the pacemaker. He figured the savings could feed his wife and four kids for two years. (His wife is very resourceful and he raised a big garden.)
"I put it to the Lord in prayer and felt led to quit all my jobs," Greatbatch said. He retreated to his backyard workshop, a barn heated by a wood-burning stove. There he made 50 pacemakers by hand that would launch Medtronics, the biggest medical device company in the world. Forty of his units would go into animals.
Just like harmonica-playing as a boy, Greatbatch, now in his late thirties, learned along the way. Improvements were made at each step. He tried different materials. He experimented with designs with three, six, eight and ten batteries.
At the same time, he was developing reliability procedures. As in World War II airplane maintenance, lives critically depended on his electronic professionalism. In his bedroom, he set up two ovens to bake transistors in a temperature test. His wife, Eleanor, administered shock tests. "Many mornings," he said, "I would awake to the cadence of Eleanor 'tap, tap, tapping' the transistors" with a pencil. Only the best transistors made it through these tortuous hurdles.
During 1960, starting on April 15, Chardack and his associates implanted pacemakers in 10 patients, most over 60 years of age. Two were children. All had complete heart blocks, so that without pacemakers they had perhaps a 50-percent chance of living more than a year. The first patient lived 18 months. Another of the initial group was a young man who had collapsed on his job at a local rubber factory . After receiving a pacemaker, he retrained as a hairdresser and lived for 30 years.
Administering tiny painless shocks like clockwork, the pacemaker controlled the heart beat from within the body. It allowed a normal rate of invigorating fresh blood to circulate from the scalp to the tips of the toes. Patients with bad hearts could now shower and swim without worry. One of Greatbatch's most gratifying moments came from watching grandparents interact with grandchildren. "With the pacemaker," Greatbatch said, "grandpa could be in the mainstream again."
Greatbatch admits that "if I didn't do it [invent the implantable pacemaker], someone else would have. Most new developments are like that -- not somebody getting a Eureka flash." What distinguishes Greatbatch perhaps is a persistant committment to improving his invention.
Greatbatch kept learning from mistakes. Soon the biggest problem became the battery. Patients had to undergo surgery every two years just to change batteries. Greatbatch devised a special lithium battery that now often lasts 10 years or more. He created a company to make the special batteries. They now power most of the world's estimated 3 million pacemaker patients.
Most of the millions that Greatbatch has earned he has plowed back into research or donated to education and charities. He lives very simply near a dairy farm outside Buffalo where he was born. One would never guess by his manner that he is a great inventor. "He's just a learner," said his wife Eleanor. "If something is new, it doesn't bother him a bit."
For the last decade Greatbatch has been investigating the human immunodeficiency virus of AIDS. With John Sanford of Cornell Universitiy, he was able to inhibit a similar viral replication in cats. The two were recently awarded U.S. Patent 5 324 643 for this work. To help his studies, he recently bought a new computer and modem to access the Internet from his home.
He also enjoys talking to students. Invariably, he repeats passages from his favorite two-minute speech, first given in 1987 at Clarkson University in Potsdam, N.Y. He urges listeners, "Don't fear failure. Don't crave success. The reward is not in the results, but rather in the doing."
If the crowd is especially lucky, this persistent inventor might even take out his trusty harmonica and play.
Winner of the National Magazine Award, John Adam writes about people and technology from Washington, D.C. His forthcoming book, Silicon Souls, profiles our future through creators such as Wilson Greatbatch.
All text and images © Smithsonian Institution. Updated 5 February 1999.