Robert Fischell says matter-of-factly that what he does is simple, pragmatic stuff, although one of his inventions may have saved more than 65,000 lives. That contrast is evident everywhere in his life: He can sit back and sip ice tea on a quiet summer afternoon, but he is also driven to change the world. At 74, retired from his position as a principal staff physicist and chief of technology transfer at the Johns Hopkins University’s Applied Physics Laboratory, Fischell still puts in 60-hour workweeks, cranking out innovative ideas. “Every day I wake up wanting to invent,” he says.
Photograph by Amanda Friedman | Fischell trained as a physicist, and for 15 years at Johns Hopkins he worked with NASA on developing and improving the reliability of space satellites. But he found his calling in the late 1960s as he began to identify and build bridges between the world of satellites and the world of medical devices. As an inventor, Fischell sees connections and analogies that most people do not see. He looked at the idea of an implantable heart defibrillator and saw something like a satellite in space-a remote mechanism that needed to be controlled from afar while it gathered, stored, and transmitted information about an interesting phenomenon—in this case, the heart. |
His career as a medical inventor was launched the day he spotted an advertisement for pacemakers with batteries that had to be replaced every two years. He told a cardiologist friend at Hopkins that he could build a smaller unit, one that would run, as satellites did then, on a rechargeable nickel-cadmium battery that could last almost indefinitely. Three days later, he and his colleagues at the lab had built an effective prototype that changed the way pacemakers were built. “I became enthralled,” he says now. “Satellites were great fun, but the prospect of saving lives felt more important.”
Fischell now holds 117 licensed medical patents, including a radio-controlled rechargeable pacemaker, an implantable insulin pump, and a wide variety of stents designed to hold obstructed arteries open. But for sheer dramatic impact on humankind, the development and refinement of the implantable cardiac defibrillator leads the list.
Ventricular fibrillation, whether brought on by myocardial infarction or as the result of chronic instability of the heart’s rhythm, is a killer. Instead of beating with a steady, controlled synchronous beat, the heart quivers. It gets no oxygen, pumps no blood, and unless the pattern is reversed, the patient dies. The implantable defibrillator is a lifesaver. The device consists of a tiny computer that monitors the electrical signal of the heart’s rhythm, leads that are attached to the heart, and a battery to power the whole operation. When the computer detects that the signal has stopped or gone awry, the device sends out a corrective jolt, forcing the heart to return to its normal rhythm.
The idea for the defibrillator first came to Michel Mirowski, a physician in Israel whose mentor, Harry Heller, died in 1966 of a heart attack brought on by malignant ventricular arrhythmias. Grieving for Heller, Mirowski asked whether his death might not have been preventable. He reasoned that a miniaturized, automated defibrillator could have saved Heller and might save others. He moved to the United States and began working on a device with Morton Mower, a cardiologist, at Sinai Hospital in Baltimore in 1969. Their prototype was insufficiently reliable and so bulky that doctors would have had to implant it in the abdomen. However, in animal testing, it worked.
