Healing Designs—Makeshift
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Healing Designs

Editor’s Note: This article originally appeared as the Footnote essay in Healing (Issue 13). We’re bringing it to the digital realm for the Jan. 28 launch of Invent Health, a new initiative by HHS Idea Lab to empower inventors — both inside and outside government — to create tools for better living and clinical care.

We think of the Wright Brothers as soaring. They launched their airplane almost as soon as they finished tinkering. The reality is more complicated. Wilbur and Orville borrowed ideas from kite design, gliders, and flying toys. In all, they went through 200 airfoil designs before landing on the world’s first flyer. Their neighbors dismissed them as fanciful; the brothers lacked the engineering credentials to counter such critiques.

The history of medical technology is full of Wrights: individuals with a relentless drive not to fly, but to create the devices that heal us. And not always through the biggest and shiniest inventions.

U.S. regulators approved 42 new medical devices last year. At least three times that number are created every year by underground nurses, doctors, and patients. We see it in Andreas Greuntzig’s kitchen table experiments to generate the first balloon heart catheter. Or in the flywheels of Dr. Yombo Awojobi’s bicycle centrifuge in his hospital-tinkering lab outside Lagos. We see it in the contours of the handmade UV protection shades cut by a Nicaraguan nurse for her jaundiced neonatal patient.

The medical device industrial complex runs on black-box technologies to impress a sense of design and engineering wonder. Yet obscurity by complication is not how we advance as a society. Medicine and health thrive on a transparent process of sharing methods and their challenges. You’d be hard-pressed to create a more transparent machine than the Wright Flyer — with every mechanism exposed and self-explained, allowing others to learn from their work.  

Our Little Devices Lab focuses on the user-innovators who manage the risk and reward of medical making. We don’t just create the medical device invention, we try create the tools that allow someone else to invent their own. Our lab creates construction kits so that everyone who wants can strive to make their own devices. We do medical technology teardowns. Did you know that while the average USD 20 digital rapid test has 30 parts, you only need three to make it work and on just a dollar? It’s not exactly open source, but it’s gentle shift toward transparent design.

It will not be the frugalistas who advance the agenda. DIY medical technology and the tinkerers behind them do not thrive by creating sandboxes of necessity. When someone else is at the other end of your creation, it fosters a drive to make it work. To reinvent. To try again and to experiment. As improved health care has bumped average lifespan in the U.S. from 48 to 79 in 100 years, we have learned that medicine requires patience. It’s a long game.

So when the assay fails, when the prototype breaks, and your patients basically tell you go back to the drawing board, let’s bet on what will keep on surprising us: You, as a health maker. For us, the process is about making tools that could launch a thousand Wrights in medicine. Whether they solve n=1 studies, long tail disease challenges, or make a dent at reducing digital health inequality is up to them. It’s up to us to make sure that the health revolution will be tinkered by the experimentalistas. They make the things that we hold in our hands. The ones we can share. The things that can heal.

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