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The Making of the Pacemaker

Student at Cornell - $ 2,000 capital - first pacemakers built in his barn - history changed three times - lithium batteries for pacemakers - the Millennium Project - what is He-3 - let us colonize the Moon (before we go to Mars) - an example for the young generation.

By Consul B. John Zavrel


Dr. Wilson Greatbatch speaking to a group at Borders Bookstore in Buffalo, New York.


'Each worthwhile thing that I have ever done took about ten years to do. It involved living the project all my waking hours, often with no pay for what I did. The doing was the reward. Being paid, asking for success, and peer approval were all insignificant. At the time I thought such an attitude was crazy. I think now that it is the right way. The good Lord doesn't really care whether you succeed or fail. My most abject failure may be a part of some grand success in His sight that may never take place until long after I'm gone. Thus, I shouldn't fear failure or crave success. To ask for a successful experiment, for professional stature, for financial reward, or for peer approval is asking to be paid for what should be an act of love. I do believe He wants me to try and to try hard, but the reward is in the doing, not in the results. So, I'll never get a swelled head over success or shoot myself over failure because I really don't care. I'll be happy however things go, just for the opportunity to try.'

These are the concluding words of the new book written by the American inventor Wilson Greatbatch. His book with the deceptively scientific-sounding title 'The Making of the Pacemaker' and visions of mathematical formulas, complex diagrams and technical vocabulary is actually a very readable and fascinating story of one of the most remarkable Americans of the 20th century.

His story begins with recollections of the early times. 'I have five children. My four sons are all mechanically inclined. They handle metal well, and three of them work beautifully with wood. None of them has the slightest interest in electronics. I have always wondered why. Electricity and electronics have always fascinated me. I think it was the mystery of it. Something was happening that you couldn't see, or feel, or hear. You needed a meter or an oscilloscope or at least a neon bulb to detect it, and then you had to interpret what the reading meant. I know I was thoroughly hooked early in my teens when I built my first two-tube short-wave receiver and listened to London, England, on a coil I had wound myself."

In 1940 the international situation was deteriorating and the navy reserve unit in which he was active was called up for one year of active duty, which however stretched into five years. During this time the young man was repairing electronic equipment on a destroyer tender, "pounding brass" as a navy radio operator on merchant ships in convoys to Iceland, teaching in a navy radar school and finally flying in combat as a rear gunner off the aircraft carrier USS Monterey, where the former President Ford was his deck officer. After the end of World War II, he returned to Buffalo with his new bride Eleanor and worked for a year as an installer-repairman for the New York Telephone Company. Then he decided to register in the School of Electrical Engineering at Cornell University in Ithaca, New York. 'They wouldn't admit me at Cornell. There was room in the school, but no housing for nonresidential students. So I went out to Danby, six miles south of Ithaca, and bought a farm. Then I came back and presented myself as a "resident student." I got in,' he recalls his university beginnings.

'Cornell was wonderful! After all that time in the dive-bombers, it was such a joy to wander around the campus, to go to class and to learn something, to be a part of the great tradition of all that had gone before. I was so grateful. I have repeatedly and vainly tried to imbue my children with the kind of appreciation that I had, just the opportunity to sit, and hear, and learn. I don't think I ever got this across to them. Maybe you have to come straight down two miles with the "ack-ack" of gunfire bursting all around you to appreciate the change.

Cornell has always stressed breadth of background. Thus we got enough math to qualify us as high school teachers, and more physics and chemistry than most other schools ever provide. I still remember and use some of the lectures we heard on patent law and on being an expert witness. My work since then has been mostly outside of my specific training as an electronic circuit designer. The breadth of background Cornell gave me has enabled me to branch out when necessary into nuclear physics, electrochemical polarization of physiological electrodes, battery chemistry, the physics of welding, and the countless other things I have had to do in the past decades to keep our corporate heads above water.'

During the summer of 1951, a pair of New England surgeons spent their summer sabbatical at a research farm doing experimental brain surgery on the hypothalamus of goats. They were investigating the influence of the hypothalamus on behavior. The surgeons carried their lunches in brown bags, as he did, and noontimes they would sit on the grass in the bright Ithaca sun and talk shop. He learned much practical physiology from them. At times the subject of heat block came up. When they described it, Wilson knew he could fix it, but not with the vacuum tubes and storage batteries they had then.

After completion of his studies at Cornell, he went into aerospace work at Cornell Aeronautical Laboratory in Buffalo. In 1953 he saw the first transistors and he built some amplifiers with them. In 1956, the first really commercial silicon transistors became available and he began using them. In Buffalo he belonged to the first local chapter in the world of the 'Institute of Radio Engineers, Professional Group in Medical Electronics' -- a group of doctors and engineers that met for a technical program every month. They had a standing offer to send an engineering team to assist any doctor who had an instrumentation problem. He went with one team to visit Dr. Chardack on a problem dealing with a blood oximeter. He recalls, 'imagine my surprise to find that his assistant was my old high school classmate, Dr. Andrew Gage. We couldn't help Dr. Chardack much with his oximeter problem, but when I broached my pacemaker idea to him, he walked up and down the lab a couple of times, looked at me strangely, and said, "If you can do that, you can save ten thousand lives a year." Three weeks later we had our first model implanted in a dog.'

50 pacemakers built for $ 2,000 in a barn

And his story continues; 'I had $ 2,000 in cash and enough set aside to feed my family for two years. I put it to the Lord in prayer and felt led to quit my jobs and devote my time to the pacemaker. I gave the family money to my wife. I then took the $ 2,000 and went into my wood-heated barn workshop. In two years I build fifty pacemakers, forty of which went into animals and ten into patients. We had no grant funding and asked for none. The program was successful. We got fifty pacemakers for $ 2,000. Today, you can't buy one for that.'

In 1961 he worked out a license agreement with Medtronic from Minneapolis to let them produce the Chardack-Greatbatch implantable cardiac pacemaker, which dominated the field for the next decade. The license agreement was a very tight one. He assumed design control for all Medtronic implantable pacemakers. He signed every drawing, every change, and had to approve every procurement document. Medtronic had been in a precarious financial situation in 1960, but substantially recovered within two years and became number one in pacemakers. Today, in 2000, Medtronic is still number one.

About these early days the inventor likes to tell the following anecdote: 'Many of the early Medtronic programs were first worked out in Clarence, New York, and then taken to Minneapolis. I had two ovens set up in my bedroom. My wife did much of the testing. The shock test consisted of striking the transistor with a wooden pencil while measuring beta (current gain). We found that a metal pencil could wreck the transistor, but a wooden pencil could not. Many mornings I would awake to the cadence of my wife Eleanor tap, tap, tapping the transistors with her calibrated pencil. For some months every transistor that was used worldwide in Medtronic pacemakers got tapped in my bedroom.'

In 1958, they foresaw an optimistic annual usage of about 10,000 pacemakers per year. In a remarkably shot time, the implantable pacemaker became the treatment of choice for complete heart block with Stokes-Adams syndrome. Today, more than forty years later, pacemakers have assumed forms and functions that were never dreamed of, and the world pacemaker market is well over 600,000 units per year.

This was the first of the three instances when the work of Bill Greatbatch changed history.

Lithium batteries for pacemakers

The second history-changing invention was the development of clinically implantable lithium battery for pacemakers. Nearly all of the early implantable pacemakers were powered by zinc mercury batteries. However, by 1970 the average life of the pulse generator was only two years, with about 80 percent of the removals necessitated by failed batteries. In 1968, he began a search for an improved power source.

After several years of experimenting with various kinds of batteries, including nuclear batteries and rechargeable batteries, and finally developing the lithium batteries. The first lithium battery to appear in pacemakers and by far the most used today is the lithium iodine system, invented by James Moser and first introduced into pacemaker work by Greatbatch. The new battery had a life of ten years compared to only two years of the old mercury-zinc battery; this further greatly advanced the use and acceptance of the implantable pacemakers.

The Millennium Project

The third history-changing project of Wilson Greatbatch is the one he is currently working on: he calls it the 'Millennium Project.' This is how he explains it:

'The twentieth century was the century of aviation and the century of globalization. The next century will be the century of space, and in the next millennium globalization will explode into the far reaches of our galaxy. For this I coin the word "Galaxian," with apologies and due credit to Isaac Asimov.

We will be driven by the need for new energy sources. By the year 2050 we will have run out of all the economically recoverable fossil fuels like oil, coal, and natural gas. We will also have run out of places to put the toxic residues of our present nuclear fission reactors. Worse yet, in 2050 all the alternate sources of energy, like hydroelectric, wind, wood, tidal, geothermal, and solar, will not supply even 25 percent of the energy we will need to feed the 10 billion people that will populate Earth by that time. We will have no place to go but nuclear fusion.

Nearly all of our existing power sources are generators that use a heat cycle. This includes our coal, oil, and gas-fired utilities, our automobiles, trucks, and trains, and even our nuclear fission utility power plants. All are "heat engines" and thus are confined to a theoretical efficiency of about 40 percent. Did you know that when you buy a gallon of gas, over 60 percent of the energy you pay for goes out the radiator in the form of waste heat? In fact, that's why you have a radiator in your car in the first place. This is a basic law of physics and there is absolutely nothing you can do about it. This is also why our fossil-fueled power utility plants are built by rivers.

But He-3 nuclear fusion reactors are not heat engines. They generate electricity directly and are not limited by the "Carnot cycle" efficiency. More importantly, the He-3 nuclear fusion reactor doesn't generate carbon dioxide or any of the other "greenhouse" gasses. By going to future global He-3 power generation, we can wipe out much of global warming in one fell swoop.'

And he continues: 'Does this sound too good to be true? Yes, there are a couple of caveats. The first is that the reaction takes place at a temperature much hotter than the surface of the Sun. But we engineers can handle that. The other is that there is practically no He-3 on Earth. But I tell my engineering students that these are just minor engineering challenges. He-3 comes to us from the Sun in an ionized form on the solar wind. The ions hit the Earth's magnetic field and get diverted sway. They cannot land on Earth, so they drift around and eventually land on the Moon. They have been landing there for four billion years. There is more He-3 energy on the Moon that we have ever had in the from of fossil fuels on Earth. All we have to do is go there and get it.

The cost of He-3, including the shuttle, the Moon colony, and the ilmenite refinery, amortized over a suitable number of decades, has been calculated to be equivalent to an oil cost of about $ 8 per barrel of oil. We now pay about $ 22. The whole project is not only technically feasible, it is economically feasible. In fact, in the opinion of many, including me, it is inevitable. There is no reasonable alternative. But if we want to get there by 2050, we had better start now.

Let America colonize the Moon - then on to Mars!

So, the challenge of the Moon is clear. The rewards are manifest. But, who should do it?

Only one nation has the equipment, the know-how, and the need for energy to drive this idea forward. That nation is obviously the United States. It needs the same kind of unwavering dedication and the kinds of people that got us the first nuclear submarine and the first man on the moon. We need the kind of leadership exemplified by President Kennedy who ignored the negatives relating to a "man-on-the-moon" and convinced us to "just do it." But we must do it as good stewards, aggressively (but not forcefully) exerting control over the Moon. We can best do this by going there. We are the only nation that has the capability to do it. However, we must exert our stewardship in a generous and altruistic way, making the completed facilities available to all comers, especially including the have-nots nations, on an equitable basis compatible with their economies. Also, we must do it soon, while we still have the technological lead to accomplish it, and while the energy shortage is not yet so severe as to encourage terrorist elements (and even out friends) to take extreme steps to block us. Our objective must be not only to alleviate our own energy needs, but also a strong altruism that recognizes that helping to alleviate the world's needs would deter them from extreme and desperate acts if they find themselves with the immediate prospect of no energy. In the coming years we must get used to evaluating national and business (and Galaxial) options on a one-hundred year basis, rather than on a quarterly basis. Procrastination on this item will prove prohibitively expensive in the long run.

It is clear that the nation that assumes stewardship of the Moon now will inherit stewardship of the galaxy in the coming millennium. I think the United States is ready for that challenge. I know I am,' concludes the 81-year old inventor.

The book is much more than a history of the making of the pacemaker. It is a story which will inspire the young people to follow the example of a man whose genius, perseverance, dedicated work, humility, strength of character and service to mankind are an ideal for which we all can strive. A copy of this book should be in all school libraries in America.


(The Making of the Pacemaker by Wilson Greatbatch. Published by Prometheus Books, ISBN 1-57392-806-2. Hard cover, 260 pages, with photo of the author with a young pacemaker patient at Royal Children's Hospital in Melbourne, Australia. Price $ 26.40).


Clarence, New York

January 8, 2001

Great Honor for Wilson Greatbatch

May we recommend some books?

A World Transformed, by George Bush

Ronald Reagan: An American Story

Primer for Those Who Would Govern, by Hermann Oberth

Alexander the Great, by Robin Lane Fox

The Making of the Pacemaker by Wilson Greatbatch.


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