PREPRINT NO. 836 (C-6)

THE ROLE OF THE AUDIO ENGINEER IN MEDICINE

ByDean A. DeMarre, ScD.Technical Education Research CenterNortheastern UniversityBoston, Massachusetts

PRESENTED AT THE

41st CONVENTION

OCTOBER 5-B, 1971

AN AUDIO ENGINEERING SOCIETY PREPRINT

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The Role of The Audio Engineer in Medicine

Dean A. DeMarre, ScD.

A new era in medicine and engineering is slowly being brought

forth under the guidance of farsighted physicians and engi-

neers. New techniques born of medicine are reinforced by

technology not thought possible even ten years ago. Whereit will lead no one will forecast.

This progress, however, requires a cooperative spiritbetween medicine and engineers. A spirit never attained

in the past, that will be difficult to maintain in thefuture.

Complicating this marriage of medical science and engineer-ing technology is a mutual, if separate, history of dif-ficult challenges overcome at great personal and profes-

sional costs. Let us briefly consider who the players arein the future of medicine.

The Role of the Physician

The physician is shaded by the color of viewpoint of theobserver. To some he is God, to others the demigod --

literal holder of life and death over his fellow men.

Like all characterizations, this one is false. A doctor

is a man who, having completed a prescribed program and

passed prerequisite exams, is authorized by his state and

fellow practitioners to treat the sick and heal the wounded.

But essentially he is a man, another human being, with hisown set of skills, knowledge and talent, albeit specialized,

that with experience is honed to an awareness, a sensitivity,

a compassion of and for his fellow man, unequaled by any

other profession. While at the time it seems that thisman, the physician, is cold, demanding and withdrawn, we

must consider the pressures that he works under.

The medical profession is possibly the most disciplined

of all of our professions. The physician is regulated by

his fellow professionals, state boards, and specialty

boards. On top of this sets the patient, in some instances,the most ruthless of all his judges.

A slip, a thoughtless moment, or unforeseen circumstance andall that the doctor has worked for lies about him in ruins.

Malpractice, or implied malpractice, has driven up the cost

of medicine over the last ten years more than any otherfactor. A malpractice suit, won or lost by the claimant is

always lost by the physician. For even if he wins, he loses

patients and his insurance skyrockets. If he loses once,the judgments against him can be so large that he will never

recover. It takes only one $100,000 suit to wipe out anyone.

On top of the medical legal problem rests the position the

medical man holds within our community.

Whipped by the self-righteous and pompous, censored by poli-

ticians and ignored by the population the physician cannotraise his voice in defense or denial.

Thus, while we expect the physician to work wonders in our

behalf, we in our misunderstanding strike out in denial of

the very tools required for these cures.

In the final analysis the physician is the commander of the

health delivery team, be it large or small. All of the

nurses, paramedical and allied health technicians work in

support of his treatment of patients. When the engineer

enters the hospital his knowledge, skill and talents must

be directed toward the intensification of the physician's

ability to heal.

The Role of the Engineer

The physician, even though misunderstood, is at least recog-nized for what he is -- a healer. The doctor is never confused

with the nurse. The engineer, however, is another story.

In time of great need the engineer is a genius to be pamperedand protected. When his services are not needed he is just

a technician. Fortunately, no matter what, the engineer

survives, for a technically based society cannot survive with-out them.

The image of the engineer held by the majority of our popula-

tion is that of an automan. An individual who is superiorin mathematics and technique, yet is somehow deficient in

human attributes. The old logic still persists that if a

boy is poor in English and History he must be good in Mathand Mechanics.

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The average individual never quite gets the concept that

our technical people are somewhat more than literate. The

average engineer also has an image of himself. This self

image can be in many ways as false as the popular view.In the best of time he sees himself as a builder, semi-

scientist and leader of his fellow man. A more recent

new self-appraisal brought about by economics, is less

flattering. It is an image of a man cheated of his just

rewards -- somehow left to drift by his fickle society.

None of these three views are valid. They, like the images

cast for the physician, are based in ignorance of the nature,

practice and personality of engineers.

Engineers, are like physicians -- men. Men who have passed

through a course of study and endured a structured, if in-

formal, apprenticeship, who finally reach a professional

maturity allowing them to practice both one of the oldest

and newest professions.

The engineer is a builder ',a communicator and, in many res-

pects, a guider of our destiny. It is his lot to transform

dreams from his mind, or the minds of others into real,

tangible products. It makes no difference if the concept

is microminiature as in integrated circuit design or

colossal as in building skyscrapers. Engineers use care-

fully thought-out procedures and practices to achieve

the stated goal -- construction of a product.

Engineers often confuse themselves with scientists because

they use many of the same tools as the scientist uses.

In many instances engineering research is quite like scienti-

fic research. In other cases, it is quite different.

At the same time,an engineer can be a pure scientist and in

fact and intent not actually be performing as an engineer.

The distinction lays more in intent than in procedure.

The engineer practicing his specialty within the medical com-

munity is not in total control of his environment. His judg-

ment and expertise must be supportive and responsive to thedemands of health care delivery.

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The Audio Engineer and Medicine

The audio engineer has a unique position in the medical

engineering community.

Basic problems in acoustics, audiometrics and instrumentationare yet to be resolved and will remain unsolved until the

appropriate skills and knowledge are brought to bear on them.

As an example consider audiometrics. A simple concept of

measurement of hearing ability. If you take ten audiometers

at random you are likely to get ten different hearing profilesfor a single test subject. Not only are they not calibrated

to a single, reproduceable standard, they drift radically,

not being able to hold the adjustment they do have.

Hospitals, like most sites of intense human activity, are

noisy. Acoustical studies and design are major areas ofconcern for hospital designers. New materials, devices

and techniques need to be integrated into the medical sys-

tem to reduce noise for increased hospital worker efficiencyas well as improved patient care.

Medical instrumentation is almost universally limited to a

narrow bandwidth of from DC to 1,000 Hertz. In effect,the lower audio spectrum. The audio designer can be ef-

fective in improving and implementing instrument design.This is especially true today and over the near future as

the latest solid state-integrated technology is moved from

communications and instrumentation technology to medicaldevices.

A great latitude of work can be performed by the audio engi-

neer in medicine today. What of the future of audio engineersin health care?

The forecast is anything but bleak. Audio engineering promises

to be one of the most exciting areas of development in medi-

cal instrumentation over the next two decades. The pointsof interest range from sonication, molecular disintegration

utilizing sound energy, to diagnostic and therapeutic pro-cedures based upon audio and ultrasonic devices.

Audio engineering, while being one of the basic engineeringfields, has become extremely important to the practice of

medicine and to the future of health care delivery. _ile

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from outside the hospital this role for the audio engineer

may be difficult to discern, it is there in reality.

Employment for the audio engineer is not limited to the 8,000

hospitals in the United States. There are over 1,000 manu-

facturers of medical instrumentation and nearly 300 researchinstitutions related to medicine or health care delivery.

The present and future of dedicated audio engineers parti-

cipating as part of the health care team is both excitingand personally rewarding.

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