3D printing as a thinking tool for surgery


My latest Wired column came out — and this one is about a new trend in 3D printers: Using them as thinking tools. It’s online here, and a copy is below …

Meet the neurosurgeon who uses a 3D printer before operating
by Clive Thompson

Ed Smith does some fiendishly difficult surgeries. A paediatric neurosurgeon at Boston Children’s Hospital, he often removes tumours and blood vessels that have grown in gnarled, tangled shapes. “It’s defusing-a-bomb-type surgery,” he says.

So these days, Smith prepares for his work by using an unusual tool: a 3D printer. Days in advance, hospital technicians use standard imaging to print a high-resolution copy of the child’s brain, tumour and all. Smith will examine it for hours, slowly developing a nuanced, tactile feel for the challenge. “I can hold the problem in my hand,” Smith says. “I can rehearse the surgery as many times as I want.” During the operation, Smith keeps the printed brain next to him for reference. As a visualisation tool, it’s so powerful that it has reduced the length of his surgeries by an average of 12 per cent.

Smith’s work will make you look at 3D printers in a new way. Most of the time, they’re pitched as tiny artisanal factories, useful for cranking out one-off products and niche objects: a desktop-sized industrial revolution. But what if it’s more? What if the 3D printers are going to be equally useful — or even more so — as thinking tools?

The 3D printer’s intellectual impact is going to be like that of the inkjet printer. We (correctly) do not regard printers as replacements for industrial presses. Few people print a whole newspaper or book. We use printers as cognitive aids. We print documents so we can array them on our desks, ponder them and show them to other people. That’s exactly how Smith uses his 3D printer. He doesn’t print the brain so he can have a product. He prints the way you’d print an email — as a document, yes, but more as a way to understand data and solve problems.

Doctors have long used MRIs and CT scans to help visualise tumours. But when the visualisation is physical, it has a haptic impact that screens do not. That’s why architects build scale models of their buildings: only by peering around a structure do you “get” what’s going on. “You see these spatial relations and depth of field that aren’t possible on-screen,” Smith says.

It works for more than brains. Last winter, Nasa astronomers printed a model of a binary-star system to help visualise its solar winds. “We discovered a number of things we hadn’t fully appreciated,” says Thomas Madura, a Nasa visiting scientist. 3D prints are also great for accessibility, giving the blind a new way to grasp astronomy. (Maths, too: an enterprising San Diego father printed fractions so his blind daughter could learn them.)

To really unlock the power of 3D printers, the tech will have to improve. If we’re going to use physical “documents” the way we use paper ones – glancing at them for a moment, then tossing them aside – we’ll need material to be recyclable, even biodegradable. Imagine the 3D printing equivalent of a Post-it note. What’s more, we need our intellectual culture to evolve. We don’t value or teach spatial reasoning enough; “literacy” generally only means writing and reading.
There can be all sorts of uses for 3D data. Courts could print forensic evidence that juries could handle. You could render a sales report as a sculpture. 3D printers aren’t just factories for products — they’re factories for thought.

moretti quote big citiesIt is the big city that protects what is unusual, writes a sociologist at the turn of the century, and that makes it more unusual still: The city is the spectroscope of society; it analyses and sifts the population, separating and classifying the diverse elements. The entire progress of civilization is a process of differentiation, and the city is the greatest differentiator. The mediocrity of the country is transformed by the city into the highest talent or the lowest criminal. Genius is often born in the country, but it is brought to light and developed by the city [just as] the boy thief of the village becomes the daring bank robber of the metropolis.

The history of “Ipsum Lorem”

When you design a new web site, a design convention is to put in blocks of Latin text called Lorem Ipsum. This, the theory goes, lets you visually assess the aesthetics of the design without being distracted by the meaning of the text. I’ve always found this concept a little sort of, I dunno, aesthetically sociopathic — I mean, isn’t form supposed to follow function? But it got me interested in the origins of Lorem Ipsum.

Hello, Wikipedia! According to the hivemind over there …

A variation of the ordinary lorem ipsum text has been used in typesetting since the 1960s or earlier, when it was popularized by advertisements for Letraset transfer sheets. It was introduced to the Information Age in the mid-1980s by Aldus Corporation, which employed it in graphics and word processing templates for its desktop publishing program, PageMaker, for the Apple Macintosh.

Better yet is the what Lorem Ipsum means. It’s from a text by Cicero called “On the Ends of Goods and Evils”, and …

The original passage began: Neque porro quisquam est qui dolorem ipsum quia dolor sit amet consectetur adipisci velit (translation: “Neither is there anyone who loves, pursues or desires pain itself because it is pain”).

I hunted down this free online translation and found the passage in which this extract occurs. It’s pretty interesting:

No one rejects, dislikes or avoids pleasure itself, because it is pleasure, but because those who do not know how to pursue pleasure rationally encounter consequences that are extremely painful. Nor again is there anyone who loves or pursues or desires to obtain pain of itself, because it is pain, but because occasionally circumstances occur in which toil and pain can procure him some great pleasure. To take a trivial example, which of us ever undertakes laborious physical exercise, except to obtain some advantage from it? But who has any right to find fault with a man who chooses to enjoy a pleasure that has no annoying consequences, or one who avoids a pain that produces no resultant pleasure? On the other hand, we denounce with righteous indignation and dislike men who are so beguiled and demoralized by the charms of the pleasure of the moment, so blinded by desire, that they cannot foresee the pain and trouble that are bound to ensue; and equal blame belongs to those who fail in their duty through weakness of will, which is the same as saying through shrinking from toil and pain. These cases are perfectly simple and easy to distinguish. In a free hour, when our power of choice is untrammelled and when nothing prevents our being able to do what we like best, every pleasure is to be welcomed and every pain avoided. But in certain emergencies and owing to the claims of duty or the obligations of business it will frequently occur that pleasures have to be repudiated and annoyances accepted. The wise man therefore always holds in these matters to this principle of selection: he rejects pleasures to secure other greater pleasures, or else he endures pains to avoid worse pains.

Cool, but how precisely did designers pick this text to use? Why Cicero? And why this Cicero text?

According to a speculation at the Pricenomics blog, the original folks at Letraset may have picked it simply because Cicero was/is an extremely popular writer … and if you were sitting around looking for a long chunk of non-English text to work with, the odds were good you’d reach over to your shelf and find a copy of Cicero. As they quote the Latin professor Richard McClintock saying …

At some point, likely in the middle ages, a typesetter had to make a type specimen book, to demo different fonts, and he got the idea that if the text should be insensible, so as not to distract from the page’s graphical features. So he took a handy page of non-Biblical Latin — Cicero — and scrambled it into mostly gibberish. “Lorem” isn’t even a Latin word — it’s the second half of “dolorem,” meaning “pain” or “sorrow”. Thus Lorem Ipsum was born, and began its long journey to ubiquity.

I must say I’m charmed by the image of thousands of art directors out there, today, working into the wee hours as they attempt to design their textbooks and web sites and pamphlets and corporate reports, all gazing down at a Latin text that encourages them to embrace necessary pain.