Dean Kamen, Renowned Inventor & Engineer: Transforming Care by Doing the Impossible

Dean Kamen, Renowned Inventor & Engineer: Transforming Care by Doing the Impossible

Dean Kamen, a friend with whom I’ve worked on global health issues for two decades, is a world renowned inventor and engineer, whose inventions have literally changed the way we live. In health, he invented the first drug infusion pump, now used and literally every hospital in America. He pioneered water purification systems, to deliver safe drinking water the world over. He holds the patents, which are making portable dialysis machines possible. For those with disabilities, his iBOT wheelchair crosses all terrain, including stair steps.

Dean Kamen:                But we have hundreds of thousands of kids today, that would not be in the kinds of careers they’re in, that we need, had they not been exposed to technology and science via First.

Senator Bill Fr…:           You’re listening to A Second Opinion, your trusted source engaging at the intersection of policy, medicine and innovation and rethinking American health.

Senator Bill Fr…:           Dean Kamen, a friend with whom I’ve worked on global health issues for two decades, is a world renowned inventor and engineer, whose inventions have literally changed the way we live. In health, he invented the first drug infusion pump, now used and literally every hospital in America.

Senator Bill Fr…:           He pioneered water purification systems, to deliver safe drinking water the world over. He holds the patents, which are making portable dialysis machines possible. For those with disabilities, his iBOT wheelchair crosses all terrain, including stairsteps.

Senator Bill Fr…:           You will hear in our conversation, about the invention that he is most proud of, that will change millions of lives, and it’s not what you might expect.

Senator Bill Fr…:           We are broadcasting from the Lake Nona Impact Forum in Lake Nona Medical City, Florida. Welcome to A Second Opinion. This is the second in a three part series on Innovation in Medicine and Health. I’m your host Senator Bill Frist, welcome to A Second Opinion.

Senator Bill Fr…:           Let’s just start with, how your very first company was in the health field. We’ll come back and talk about some of them, but walk us through the role that your interventions have played in health, and health has played in the world of your inventions.

Dean Kamen:                I started my first company when I was in high school. My older brother, a brilliant guy, was going through medical school getting both his MD degree and his PhD, his PhD was pharmacology. He is one of those special people. Back then, it really took a special person, because he specialized in pediatric hematology oncology, babies with leukemia. He was, in his PhD work, coming up with better chemotherapeutic ways to deal with neonates.

Dean Kamen:                But he’d come home on the weekends and complain that these babies, particularly preemies born with cancer, are very sick and very fragile, and they weigh two or three pounds. He’s saying, “Dean, the equipment they give us in a hospital to deliver a drug, you can’t possibly make accurate deliveries of the scale we need in these tiny babies.”

Dean Kamen:                So I’d go down to my parents’ basement, we lived in New York at the time.

Senator Bill Fr…:           And this is what year, roughly?

Dean Kamen:                This is 1970s. I said, “Well, don’t take drug out of the vile and put it in the big bag, and put it on the stand. Put it in a precision little syringe, and I’ll build a little device for you that will move the end of that syringe with great, great, great precision.” These are even before there were microprocessors, I was using digital logic. I was etching circuit boards in my mom’s oven.

Dean Kamen:                I built him these little things about the size of a butter dish, that he could clip a syringe into and program it to do whatever he wanted. Well, it wasn’t really a business, because for one thing, brothers don’t pay you anything. And it’s not going to be a big business there, because fortunately, babies with leukemia is not a big market.

Dean Kamen:                But my brother, as this med student, was very proud of what his little brother was making, so he was showing it to all his professors. He was bouncing up and back, doing guest residencies at both Harvard Med School and at Yale, where he ended up on the faculty.

Dean Kamen:                At Harvard, he shows it to these docs, and they want to use it for delivering chemo to adults that could walk around. And, actually, delivering stuff for kids with thalassemia that had iron overload toxicity. They could give them low dose continuous drugs to chelate the iron out of them. So, they started a study with that.

Dean Kamen:                But at Yale, he lends one to a guy who’s treating people with diabetes. Even in the ’70s, they started to realize that giving a person with diabetes a shot or two a day kept them from dying, but they would have all these long term facts. [crosstalk]

Senator Bill Fr…:           It’s not a physiologic, yeah.

Dean Kamen:                Yeah. I mean microangiography, porphyria disease, retinopathy. That’s why they have all these amputations, they have heart disease and kidney failure.

Dean Kamen:                So this doc takes this thing from my brother and says, “I’m going to ask your brother,” namely me, “To modify it a little for me, so I can let it go continuously, slowly, all day long. Except, give me a button for boluses when people-” [crosstalk]

Senator Bill Fr…:           They need it.

Dean Kamen:                “…. are going to have their meals.” And so, I modified a few for this guy.

Senator Bill Fr…:           What were you doing? How old were you then?

Dean Kamen:                I was probably 17, 18.

Senator Bill Fr…:           And you were doing this in your house?

Dean Kamen:                In my parents’ basement, yeah.

Senator Bill Fr…:           Yeah. Yeah.

Dean Kamen:                But when he lent it to these docs, at very prestigious medical institutions, and the docs ended up publishing papers, both on its use in these kids in Boston, and then the kids in New Haven at Yale, all of a sudden the phone’s ringing off the hook.

Dean Kamen:                My mom, who teaches high school business, would come home after school and take all of these calls, like we were a real business. I’d start making pumps, and unlike my brother, these people would pay for the stuff.

Dean Kamen:                So, I finally had to move out of the basement, rent a little space. As my labor, I used my younger brother, who’s 14, 15. His friends would come over after school and I would teach them how to solder all the components and the circuit boards, do the assembly. Next thing you know, we built a company.

Dean Kamen:                By those standards, I was probably in my early 20s. We had started making all sorts of modifications on this, because almost every med school I’d go to, they’d have some other unmet need, and I would just listen. I had no marketing and no sales people, but I would talk to all the docs, like yourself, and I’d ask them the really tricky question, “Hey Doc, what do you need?”

Dean Kamen:                They would typically start thinking about it, say, “Well if it could do this, or do this.” Most of the time, the engineering solution that would put a smile on a doc’s face was relatively straightforward. So I started making all sorts of different, typically, drug delivery systems but sometimes monitors or other things for these docs. And it ended up becoming my business.

Dean Kamen:                I ended up never graduating from college, because it started taking over my life. But I frankly, I love my education. I just hired some of my professors, and said, “Look, it would be more convenient for me if you come to my place, I can learn on the side and you can teach me as we do development.” I ended up, like today, I have 800 engineers and we still do the same kind of thing.

Senator Bill Fr…:           What inspired you then, and we’ll come to all the work that you’re doing nationally and globally on inspiring young people in just a little bit. But as a child, were you always tinkering? Or, did you see things in your mind that other people didn’t see? Or was it the mechanical part of, like to build airplanes or whatever?

Senator Bill Fr…:           Take us back. Now, you were 17, which is remarkable. But what about at 10, and at seven- [crosstalk]

Dean Kamen:                Even at an earlier age, until I was an adult and people asked me questions like that, I never really thought about it. But having been asked many times, and thought about it, I can tell you, there was no moment that I can remember by which I said I want to go and be a “inventor”, or I want to go and start a business or be an… I never had a plan, and to this date I don’t have plans. I just react to opportunities.

Dean Kamen:                But even as a young kid, I had trouble in school trying to keep up with them. I read very, very, very slowly; I have dyslexia. But, if I can read slowly enough, and think about it and read it again, I think I can understand things at a very deep level if I’m given time. But the way school works, you’re going from subject-to-subject, hour-by-hour, day-by-day. They race through things.

Dean Kamen:                I had trouble, and I thought I wasn’t very smart because all my friends could read the stuff, and then they get the question, and they answer the question on the test. I get the question, and think about that question. Is the right answer, A, B, C or D? I’d look, and I was thinking, “I bet there’s a better answer, E. They didn’t put it down here.” I would fall behind, and they would accuse me, I think, of daydreaming. But I was just trying to really understand it.

Dean Kamen:                So, at some point, I realized I’m better off learning at my own pace. Reading stuff, and instead of reading the one paragraph in a textbook on Newton’s laws, I went and got Principia, Newton wrote a whole book and he’s a genius. If it took him a whole book, why am I supposed to understand it in a paragraph?

Dean Kamen:                Then I got interested in reading the original works of Galileo, Two New Sciences. Even Archimedes, and The Elements and Euclid. I started very slowly, but carefully, reading all this stuff until I felt comfortable that I understood it. But you can’t do that in school, and it doesn’t help you get through school very well.

Senator Bill Fr…:           I might be jumping ahead, but was there a point where you realized that you had something that other people didn’t have?

Dean Kamen:                When I realized, and it was about when I started building these things in the basement, I said, “I don’t think it’s that I’m really dumb, and the reason I’m having trouble in school isn’t because I’m dumb.” It’s because they want you to be able to quickly respond, and do well on a test of some very superficial familiarity with whatever they showed you.

Dean Kamen:                I didn’t want superficial familiarity. I wanted an understanding of Archimedes’ principle, of Newton’s laws. It took me a long time to get comfortable with those deep understandings.

Dean Kamen:                So, I finally said to myself, “I will not keep my head down, thinking I’m just dumb. I’ll just take a different path. If the teachers give me Ds or Fs, okay, I’ll agree with them. I’m not good at what they asked me to do, but I don’t care that much about that.

Dean Kamen:                “I’m going to go and start doing things, and I’ll let history answer the question of whether I’m dumb or not. Because if I can solve problems for people, and they’ll pay me for a solution, I’ll do well, I’ll have a career. They’ll do well, because I gave the solution to a problem. History will decide whether I was dumb, or just a little different.” And it worked out just fine.

Senator Bill Fr…:           Yeah. Unbelievable. What a story and inspiration, and again, we’ll touch on how you’re impacting young people around the world today. But the story’s a powerful one.

Senator Bill Fr…:           25 years ago, I called you because I was spending a lot of time around the world looking at child health. It was clear to me, the number one killer in the world, not just to me, but it was a fact, for kids under the age of five was lack of access to clean water. Basically, hard to imagine, we’re sitting here in Orlando, Florida now, that lack of access to clean water is the number one killer.

Senator Bill Fr…:           I called you, through other people. And I say all that, just to say that our connection has been around a while, A. But B, a lot of your inventions have centered on water. Something as basic as the water that we drink every day. It has this great humanitarian impact.

Senator Bill Fr…:           So, share with me and our listeners, a little bit about water and your inventions.

Dean Kamen:                I thank you for a remembering that, because those were very exciting times. But as an example of responding to an opportunity, what happened was, I sold the company that was making all these insulin pumps to Baxter Healthcare. Figuring that they could have a much more efficient reach to all the people that need it around the country and around the world, because they had tens of thousands of people, and they could take products everywhere. I don’t have to be doing it with one little company, that really has a very inefficient process to get my products out.

Dean Kamen:                But after I sold that company to them, I used the resources to just build out my development team, and I wanted to do even bigger projects. One of the first projects that I had after I sold that company to Baxter, was Baxter came back to me and said, “We’ve created this new opportunity, to let people get dialysis at home instead of being in centers. The way we do it, is something called peritoneal dialysis.”

Dean Kamen:                Instead of pulling their blood out of their body, which at the time was the only way they did it, and run it through an artificial kidney and then put the blood back in their body. They said, “We’ll fill up essentially, the peritoneal space.” I know you know, as a surgeon. But to your listeners, all the organs in your stomach, well, your stomach and your liver and your kidney, they’re all like in a big pouch in your belly.

Dean Kamen:                If you could put an extra Naval into somebody, and just fill that pouch up around all those organs with nice clean water, with actually, a little bit of saline and glucose in it. Then the membranes of all those organs in this big peritoneal space would diffuse the bad stuff out.

Dean Kamen:                Then if you flushed it, and you continually flushed it with a few liters at a time, Baxter’s physicians and their internal people realized, instead of pulling blood out, you could just flush this cavity. It wasn’t as efficient as the blood, but they said, “It’s safe. So, we could do it at home. And if we do it at home, they could do it every night. And they could do it for five or six or seven hours while they sleep, instead of just a few hours in a center.”

Dean Kamen:                Anyway, they came to me and said, the kludgy system they had for putting the fluid in and getting it out, without ever overpressure or under pressure, was a problem. They had to do it aseptically so people don’t get peritonitis. They asked, could I help? It was another example of moving, and measuring, and controlling and valving fluids, which I had been doing for years. But it was just on a much larger scale, namely gallons of this stuff overnight.

Dean Kamen:                Well, I built him a system to do that. And a really neat little cartridge that could be used, so that a patient could easily do it by themselves with a machine that looked, in those days, like a small computer that would sit by your bed. It turned out to be a huge success for them.

Senator Bill Fr…:           How long from the time that first phone call was made to you, to a product that would work and could be used in a person?

Dean Kamen:                That development was probably a couple of years. We got the product out for them, and I’m happy to say today, many years later they’ve shipped well over half a billion of those cartridges, there’s hundreds of thousands of those machines out there.

Dean Kamen:                Within a year of when we started shipping them, when we got the FDA approval back, just saw a huge success with the program. So, I was very excited. Then I went back to them, and said, “Now that you’ve put this machine at the bedside, you send out bags,” IV bags, great big bags, like half a gallon bags, maybe five or six of them they need per day, to flush through this thing.

Dean Kamen:                I said, “It’s not practical to ship them a day’s supply.” So, the Baxter trucks would back up to your house and deliver half a garage bay full of these things, every couple of weeks.

Dean Kamen:                I said to them, “That’s, now, the long pole in the tent, the gating item. Instead of you shipping these big heavy bags of water, and you need lots of it, why don’t we make another little machine that would look like a nightstand under this home peritoneal dialysis machine, that would just filter the water for these patients. So, they only need a bag or two a night, and when the fluid came out of the patient, we’d filter it and put it back, and save this massive problem.”

Dean Kamen:                They said, kind of dismissively, “Dean, because we’re not filtering big stuff out. It’s ammonia and ammonium, it’s NH4 molecules. It’s smaller than the way…” They said, “There is no practical way to filter that stuff. You can’t do it.”

Dean Kamen:                I thought about it a little and said, okay, “If you can’t filter out the bad stuff and put back the good stuff,” because the bad stuff is smaller than the glucose and the metal molecules.”

Senator Bill Fr…:           Sodium molecules.

Dean Kamen:                I said, “I got a better idea. When this stuff comes out of the patient, we’ll just turn it into absolutely pure water. Then just add back the stuff you wished you didn’t take out, from a concentrate.”

Dean Kamen:                So I went back to them, and said, “Let’s do that.” And they weren’t enthusiastic about that idea either. But I liked it, so I just started working on it myself. I found that there were no practical ways to make that water so pure you could do this, by any kind of filtration.

Dean Kamen:                Then I said, “Well, how does nature do it?” Well, nature distills the water. You look up in a cloud, I fly, and you can fly across a very salty ocean and the water in those clouds that’s coming down as the pure rain, there’s no osmosis membranes up there. I fly over toxic waste sites, and there’s no activated charcoal filters up there. I fly over places where this cryptosporidia and Giardia in the surface water, and they don’t have chlorine tablets up there.

Dean Kamen:                All the water that comes down to this earth as pure water, didn’t need any of those complicated engineering interventions. Nature just says, “I’m going to do it by brute force. I’m going to boil all that water.” Well, fortunately, we got a nuclear plant out there 93 million miles away, it’s called the sun. It just, whether the water is in an open waste site and it’s, and it’s full of chemical waste or industrial waste, or whether it’s in the ocean, it doesn’t matter.

Dean Kamen:                So I said, “What if I could make a miniature device, that would distill any water that comes through it. And whether it has cryptosporidia, or Giardia, or heavy metals or anything in it, I’ll turn it into pure distilled water and then reconstitute the stuff they need.” I was doing it in the context of the dialysis machine.

Dean Kamen:                Well, soon after, I realized that the reason you can’t do that is, distillation takes so much energy to make a few hundred liters of water a day, you’d need more power coming out of your outlet than the whole house needs. Then I realized the second law of thermodynamics, it’s subtle but it’s not cruel.

Dean Kamen:                What if I boil a little bit of that water right up front? But then run it through a counterflow heat exchanger, after I compress it a little bit. Because if you compress the water, you heated it. [inaudible] is work.

Dean Kamen:                Then I’ll turn it back into a liquid, because it went to high pressure. I’ll turn it back into a liquid at a higher temperature than it boiled, it’ll come out of the machine by going through counterflow heat exchanger at a little over room temperature. All of the energy I extracted in that heat exchange, will boil the next water.

Dean Kamen:                Well after a few years, I made it a little machine that was so efficient, that once you started it up with a little bit of a heater to get the first stuff going, you turn off the heater. The thing would run all day long, taking in water from anywhere and just using and reusing the heat that it used in compressing it, to instantly flash boil the incoming water and give you distilled water at the output, with essentially one moving part. This compressive component, that I was levitating magnetically.

Dean Kamen:                I was all excited to make this, essentially, nightstand size device that would sit under this home machine. When I realized, well, I could make dialysis a little bit more convenient for a few tens of thousands of people. Where, since this machine is so robust and it doesn’t care what the water was. It didn’t have to be the pure water coming out of you, going back into you.

Dean Kamen:                I could take water, literally, out of an open cesspool, or a latrine or the ocean, and turn it into absolutely pure medical grade water. Now, to drink it, you don’t need medical grade, but the medical grade was coming free. You don’t need to add chlorine, you don’t need to pretest the water.

Dean Kamen:                I realized, as you pointed out, that since the number one killer of human humans, kids, in this world, below five years old, is no access to drinkable water. I said, “If I make this little machine, and I can get them to scale, I can get the cost down, we could just put them all over. Put them in schools, and put them in clinics and put them in villages around the world, where kids don’t have clean water.”

Dean Kamen:                I could make a machine about the size of a dorm room refrigerated, that would make a thousand liters of water a day. Each machine would serve 100 people, the purest water they’ll ever see. It doesn’t need all of these continuing support of chemicals and filters and membranes. And so, I got excited to do that. That’s about when I got that call from you.

Dean Kamen:                I convinced then, the Coca Cola Company, that they should help me do a demonstration of these things. Because you know, my medical clients don’t go to… there’s 200 countries in the world, there’s about 100 of them that are rich enough, that they all get as much medical products as they can get, complain about the high cost of it, but buy as much as they can get, because it’s the most important thing that we all have, is our health.

Dean Kamen:                There’s about another 100 countries out there, that never complains of the price of health care, because they don’t did any of it. I said, “They’re not going to be able to suddenly start getting these really expensive exotic pharmaceutical products, or medical interventions.”

Dean Kamen:                But in that other 100 countries, if there was just a distribution channel that could efficiently put these machines there, we would empty half the hospital beds in the world by just giving kids clean water. I realized that none of my medical company clients, by then, were the ones with efficient access to those 100 countries.

Dean Kamen:                But if there’s one product you can buy anywhere in the world, it’s Coke. In any little village you can buy Coke. So, I went to see the chairman of Coke.

Senator Bill Fr…:           You went to see them, they didn’t call you.

Dean Kamen:                Yeah, I went to see them, and I said, “Look, I know you don’t consider yourselves a medical products company, but you do go into every country in the world. You even bottle your products in every country in the world. Not just sell them, but you have the biggest logistic reach of any company, any organization on the planet. If you’ll just help me get these machines to the places that you have machines, you have distribution partners, let’s do a demonstration.”

Dean Kamen:                Well, the chairman of the Coca Cola Company grew up in parts of the world, but he knew how bad this problem is. Muhtar Kent was just a fantastic human being. He said, “Dean, we want to help you. You’re right, we have the logistics to do this. But, Dean, we have a problem of our own.

Dean Kamen:                “We want to make our next generation of,” essentially, a machine that instead of bottles and cans, which by then they had 100 different skews. Because you can have a real Coke or Diet Coke, a Coke with caffeine and not caffeine. A Coke with sugar, not sugar. A Coke with cherry or vanilla. Well, you start doing the permutations of that, there’s 100 different kinds.

Dean Kamen:                He said, “We sell all those different kinds in bottles and cans, but when you go look at our fountain business, it’s still a couple of buttons. Or you go to a machine,” he said, “We want to make our next generation of, essentially, a beverage machine, that you could walk up to it and say, ‘I want Coke, with or without sugar, with or without caffeine, with or without cherry.’

Dean Kamen:                “You hit the buttons, and it will make it in real time. But we want it with the same quality and same precision of mixing, as if it was done at one of our bottling companies.” He said, “Since you’ve been moving, and measuring and controlling precision fluid your whole career, could you help us do that?”

Dean Kamen:                I said, “Mr. Kent, I could probably build you a machine that would meet your expectations. But if I exceed your expectations, would you be willing to commit to me, that you’ll go take, let’s say, 100 of the machines that I’m now talking about, that make water, and put them out around the world?”

Dean Kamen:                We literally shook hands on that aspect. So, we made a business deal with Coke, by which we ended up making a machine they call Freestyle, is now tens of thousands of those machines all over the place. He’s such a gracious, and a man of his word, that he said, “Dean, you did exceed our expectation. We’re going to follow through and do a demonstration program with you..”

Dean Kamen:                They supported and paid the cost of building over 100 of these demonstration machines. We put them in Ghana, and South Africa and Paraguay. We demonstrated, wherever we put those machines, we were giving kids clean water.

Senator Bill Fr…:           I’ve, Dean, forgotten what country that I met you in. [crosstalk]

Dean Kamen:                We went to China. You and I-

Senator Bill Fr…:           Is that when… yeah, yeah.

Dean Kamen:                You were on your way to Africa, when you asked me that. And I said, “I can’t believe Senator, that you’re asking me. Because the days you’re going, I’ve got to be in China with these folks.”

Senator Bill Fr…:           Yeah. That’s where it was, yeah.

Dean Kamen:                And you said, “Well, when you’re done there, can we stop on the way back,” and I think you were going to Darfur. Somebody said, “Dean, that senator’s either very brave, or senators get a lot of protection. But Dean, that’s an open war zone. People are killing each other over there.”

Dean Kamen:                I remember calling you, and saying, “Senator/Doc, I know you go there, I can get a machine to you there. I’ve been told, I better not go there.”

Senator Bill Fr…:           Oh, that’s right. That’s exactly, that’s what my family would tell me. They’d say, “You shouldn’t be going there.” But, that’s the story. I’d forgotten that.

Dean Kamen:                So, you and I went to China together. We put the machine in Tiananmen Square. We had the mayor drinking water out of it, that they brought in from the river that looked so bad, it was unbelievable. But the water came out of the machine, and everybody loved it. That was a very fun trip, Senator.

Senator Bill Fr…:           Going back on that storyline, it’s unbelievable. I know that our listeners now, are saying, “That’s incredible.” It prefaced it all, saying, it does change the course of humanity.

Senator Bill Fr…:           Today, there is a huge wave converting the traditional hemodialysis, for people with end-stage kidney disease, to peritoneal dialysis. That’s 20 years later, after you invented the machine to do that. Do you ever step back, and think about that impact that it has on humanity itself?

Senator Bill Fr…:           My impression is, that you come and you solve, and these are huge things. This hasn’t been getting an easier way, just to do a little thing. Then these devices, whether it’s the syringes that are in every single hospital in America, to the tune of hundreds of these machines, 7,000 hospitals, and to doctor’s offices.

Senator Bill Fr…:           To peritoneal dialysis, which is right now, because of that work, is going to affect millions of people around the world. But it’s much later, than when you’re sitting there figuring the problem. Did you ever sit back, and think about it?

Dean Kamen:                Well, I have an update for you now. It turns out, as I said, from the date we launched that machine with Baxter Healthcare, it’s continued to grow, meet the needs of more and more people that are medically amenable to that kind of dialysis. Even though their kidneys don’t work, they can be kept alive and healthy with that.

Dean Kamen:                But it’s turned out, over this more than 20 years now, the overwhelming population, for various medical reasons, that you would know better than I do, are simply not amenable to taking advantage of peritoneal dialysis. So the overwhelming majority of end-stage renal failure patients still go to a center for hemodialysis.

Dean Kamen:                Once we realized, after maybe five, or six or seven years, that anybody that was amenable to peritoneal was changing to it, and their lives improved, they could do it at home, they could do it with dignity. But these other patients still had to go there. I went back and said to Baxter, “Let’s go do the same thing for the other 90% of all end-stage renal failure patients.”

Dean Kamen:                They said, “Well, you really can’t, because it’s a much more dangerous procedure. What if the line comes out? And besides, you don’t just need five or 10 bags of water for doing hemodialysis, you need hundreds of liters of medical grade water every day. And in a center that’s easy to come by, hospitals make it. But in a home, where are you going to make hundreds of liters?”

Dean Kamen:                I went back to them, and said, “Well remember, even before I thought about this, I thought even just for the smaller quantities,” because you have to ship weeks of it at a time. So it does get to be hundreds of liters, “Make this little machine. But if I could make a machine that could make every day, hundreds of liters of medical grade water, and then on top of that machine, instead of putting a peritoneal machine, we’ll put a hemo machine.

Dean Kamen:                “We just have to do all the other inventing of systems, to make it so safe, that you could do hemodialysis alone at home, while you sleep, because the machine’s going to have all these safety systems. If a line comes out, you won’t bleed.” They basically said, “That’s a really big one.”

Dean Kamen:                Anyway, we, they did support the effort for a while. In the end, after many years of development with them, for various reasons, I think, everything from: how long it would take to get through the Food and Drug Administration, to their marketing situation, where their customers are all based in these centers for hemo, they decided to discontinue the effort.

Dean Kamen:                But, I knew it could work. I had done all the “inventing”. The water machine works, the safety systems work. So, when they said they’re not going to do it, I just couldn’t give up. So, I kept working on it for the next couple of years, on my own. And then, again, as I said a few times I seize opportunities. I don’t have plans.

Dean Kamen:                It turns out, that a couple of years has gone by. I think I really have a nice solution. But like the Coke thing, who am I going to get to help me? Because I don’t sell products. I certainly don’t do clinical work. I happened to meet a very senior person at a company called CVS, which most people would think as the corner drugstore.

Dean Kamen:                But the chairman and CEO of Dartmouth Hitchcock Medical Center, Dr. Jim Weinstein, a renowned surgeon, and head of it. On his board of trustees, were senior people from CVS. He brought them to see me about something else, that they wanted to do.

Dean Kamen:                They said, this is only a few years ago, “We, CVS realized that hospitals are shifting only to become acute care. The old days of the family physician are going away.” That’s why you see all over the country, the minute clinic and the doc in the box. They said, “We’ve got to find a way to take care of patients in their home. We’re thinking of doing home infusion. We are going to have nurses that can visit homes.”

Dean Kamen:                They finish explaining this to me, and they want pumps for that, because they know I make pumps. I said, “Guys, I’m happy to talk to you about that. I’ll design pumps, if you like. But home infusion, a little bit of antibiotics for a few weeks, or chemotherapy for a few weeks, we can do that with you. But that’s sort of like swatting at the flies, while we’re getting trampled by the elephants.

Dean Kamen:                “If you really want to help people in their home. I’ve got a piece of technology, that I don’t know how to deliver right now. But it could be a much bigger system, than just a small infusion pump for those antibiotics for a few days or a few weeks. And by the way, these patients are going to need this pretty much every day for the rest of their life, or until they get a transplant,” which I’m also working on doing.

Dean Kamen:                But I showed them this machine, and they ended up saying, “Dean, there’s a few hundred thousand patients that are going to these centers every day. And you’re right, this would be a huge opportunity.” It turns out, CVS is something like the fourth largest company in the United States. They have hundreds of thousands of trained clinical people and pharmacists, and they got 11,000 locations.

Dean Kamen:                Well, they very quickly said, “Let’s do this together.” So I started tooling up to do a clinical trial with this machine, with the support of my partner, CVS. I’m happy to tell you, that last year we got the FDA approval to do a clinical trial. I now have four patients already at home on these machines, being supported by a whole clinical staff being put together by CVS.

Dean Kamen:                I think by this time next year, if things go well, they will be launching this, to really make a huge impact on people all over this country. And by the way, it’s one of the most expensive line items in all of healthcare in the United States, because these patients need such intensive, chronic care.

Dean Kamen:                It’s tens of billions of dollars a year, and we’re going to give them a better quality of life, because they can do it more often, they can do it while they sleep, they can do it at home. We’re going to give them better outcomes. We’re going to save the government loads of money, and it’s going to be a win-win. While we figure out how to grow replacement organs for them, so they’ll never need dialysis at all. [crosstalk]

Senator Bill Fr…:           Exactly. The storyline, and it’s your mind that carries you that way, which I love just sitting here listing to it, as I know our listeners do. Because, the storyline is one continuous thread. You don’t know where the thread’s going to go, because it depends on now, where you’ve been and then who comes to you.

Senator Bill Fr…:           But, I had no idea, really when I was going to open with water, it really does kind of go throughout. And water, and, you say, starting with pumps, and flows, and valves and all. And it’s all a variation of that.

Senator Bill Fr…:           As I listen to the story, especially where we started, it also leads me to what you do better than anything that you’ve told me so far, and that is inspiring young kids today. I say that honestly, because there’ll be other Dean Kamen build for us, there’ll be a lot of other. But where are they going to come from? It’s from that younger generation.

Senator Bill Fr…:           I know it, but tell me a little bit, so our listeners want to know the magnitude of the inspiration and the dreams, that you plant in little kids’ minds.

Dean Kamen:                Well, about 30 years ago now, we just had a 30th anniversary, I started a little not for profit. I had sold my first company, and made a little bit of money. As soon as you have a little money, I think you’ve got to start giving back. I was pretty young, but I was lucky, I was in a position.

Dean Kamen:                I had moved to New Hampshire, and I said, “I’m going to build them a hands-on science center, because that’s the stuff I know and love and I want to get kids to see how cool tech is.” I started a little organization, and I built a little hands-on science center in one of my old mills. But I quickly realized, that it was the grandparents and parents, of the kids that needed it least.

Dean Kamen:                On a weekend, you go into this place, and it’s the kids who have two professional parents that were taking them to see this. It was almost like, I’m giving advantage to the advantage. The self-selection process of the parents and grandparents that bring their kids to a science center instead of something else, they’re probably not the kids at risk.

Dean Kamen:                It was at a time, which hasn’t changed much in the dialogue in this country, it was at a time when everybody was saying, “We have an education crisis. We’re not making enough scientists and engineers. We’re not going to be competitive with Japan, and China and Europe.” Everybody in government, everybody in business back then, and today, was worried that America’s losing its edge.

Dean Kamen:                Then you’d looked at the data, and you’d say… particularly among women, girls and minorities, none of them go into math, and science and engineering. I’m looking at my little science center, and sure enough, it’s not the broad base cross-section of kids.

Dean Kamen:                Well, I’m an inventor, right? What do inventors do? Inventors look at the same problem everybody else will look at it, and see it differently. In fact, as Henry Ford said, “A problem well-defined, or I’d say redefined, “Is half solved.”

Dean Kamen:                I looked at it and said, “We don’t have an education crisis at all in this country.” Everybody I know remembers some great teacher they had. We spend more money on public education than the rest of the world combined, on a per student basis. I said, “It can’t be, that suddenly teachers have become bad.”

Dean Kamen:                So, I know it’s happened. We don’t have an education problem, we have a culture problem. We have a culture, because we’re a rich country now. We have the Super Bowl, we have the World Series, we have the Academy Awards and the Grammy. What we have a culture that’s obsessed with two things, sports and entertainment.

Dean Kamen:                Then, particularly, if you’re a girl or a minority, every young adult you see that’s happy and successful, they come from the NBA, the NFL or Hollywood

Senator Bill Fr…:           That’s right. Yeah.

Dean Kamen:                I said, “In a free country, where you get the best of what you celebrate, if we now have kids, they don’t celebrate Edison and Madame Curie, and they don’t celebrate the Wright brothers. They celebrate LeBron James, or the Kardashians.

Dean Kamen:                So I said to myself, as I was standing in that little center, “I’m doing the wrong thing here, by showing these little booths for electricity and magnetism. I got to make a sport. It’s got to be sports and entertainment, so the kids will think it’s cool and fun and they can participate.”

Dean Kamen:                I walk out of there, went up to my office and said, “Well, I know how to get kids inspired. The road map’s there.” You don’t make it in the classroom, where you get the red marks. And it’s not that that teachers are bad, they’re required to be judgmental. That’s what they’re there to do. But that same teacher from 9:00 to 3:00, that has to be judgmental, turns his or her head around, becomes the coach after school.

Dean Kamen:                And you know what? They’re teaching you how to play football this season, or basketball. There’s no quizzes, there’s no test, there’s no final exam. You work together, you learn teamwork. You bring the school band, you bring the cheerleaders, you bring the mascots. No wonder they love sports. And they love the coach. They don’t like them from 9:00 to 3:00. And in the classroom, if you work together, they don’t call it teamwork. They call it cheating.

Dean Kamen:                So I realized, no wonder kids end up the way they are. All I got to do, is make the after school thing the place where they learn the math and the science and the physics, and I’m going to put it in the format of the other sports where they learn how to bounce a ball. Not a very useful skill to most people, unless you’re going to be seven feet tall, and one of the best ball bounces in the world.

Dean Kamen:                But if you play a sport, I’ll put you in. It’ll be the only sport where every kid can turn pro. Because it’ll be just as fun and exciting, there’ll be no quizzes and tests, there’ll be no finals. There’ll be a double elimination tournament, there’ll be champions, there’ll be letters and trophies. We’ll just turn a sport that develops the muscle hanging between your ears, into part of the culture of kids.

Dean Kamen:                I realized one problem, if you make a sport and you don’t have superstars, it would be as attractive to kids in this country is cricket. Well, if you don’t have superstars, like you having football or basketball, they’re not going to play your sport. At the time, I was lucky. I knew a lot of people in the medical industry. I have a lot of engineers. I was building helicopters, so I knew people in the aerospace industry.

Dean Kamen:                So I called some CEOs of the companies that I know, and they know I’m a little bit of a noodge, and they could help me. I said, “I’m going to make a sport. I need each of your companies to lend a couple of you engineers, and hopefully there’ll be young women engineers, and break the stereotype of what an engineer is. Or, they’ll be Latino, African American.

Dean Kamen:                “And we’re going to show kids, that there are people just as proud of what they do in their profession, as the people who are proud that they can sing, or dance or bounce a ball. We’re going to show kids all over the parts of this country, where kids are in schools, where they’ve never seen a professional scientist or engineer. They don’t even know what they do.

Dean Kamen:                “We’re going to introduce your people to these kid, in an afterschool fun environment. We’re not going to ask your professionals to teach, let the teachers teach. We’re going to ask them to be the superstars, to show them the power of tech. They’re going to have a fun experience for a short, intense season. Just like six or eight weeks of the basketball season, or the baseball season or the football season. It’ll end with a big celebration.”

Dean Kamen:                I got 23 companies to lend me a few engineers. I built the kits, we gave them out in January of 1992. Eight weeks later, in a high school gym, all these 20 some odd companies sent a couple of their engineers, with the teachers, the parents, the kids for that team, and we had the celebration. The playing field was eight feet by eight feet, and the robot’s weighed 10 pounds, I made them kits with parts and the playing things for points with tennis balls.

Dean Kamen:                The next year I gave them a 20 pound kit, and doubled the size of the field, and we had about 50 teams. Because I went to the companies at the end of the season, said, “What do think?”

Dean Kamen:                Every one of them said, “Dean, we couldn’t believe, A, how energized our own engineers were to be the heroes. And we couldn’t believe how the schools embraced us, because we weren’t there to complain about the education crisis. We were there to create demand. And the kids…”

Dean Kamen:                Basically, at that first celebration in that high school gym, at the end of that first experiment, everybody that touched it, the parents, the teachers, the corporations, they loved it.

Dean Kamen:                I said to them, “All right, I’m going to build bigger kits next year. Make it a bigger game. It’ll be a different game. So the kids that played this, you don’t have an advantage over the new schools. But, you all have to bring a friend. You’re all big companies, you’re on the boards of other big companies, bring your friends.”

Dean Kamen:                So, I went from 20 to 40, and you might say that’s not a lot of companies. But when the company’s are like IBM, Boeing and United Technologies. So, by the next year we had 100 teams. By the next year, 200 teams. Then we had to move, there was no venue in the state of New Hampshire to do it.

Dean Kamen:                I convinced a little company down here in Orlando, called Disney, to put us on stage at Epcot. And then, for the next seven years, we kept growing at Epcot. And then, finally, we started doing regional events.

Dean Kamen:                By the 10th year, I told all the big companies, “Look, I’ve run out of fortune 500 giants, that can afford to take parents and kids engineers, and put them on planes and fly them to this. That’s like saying kids will all love baseball, after you show them the World Series. But in order to ever touch a baseball, you got to put them on a plane and fly him to it.

Dean Kamen:                “So, you big guys have to do the equivalent of giving kids access like little league. After we inspire them with the World Series, or we inspire them at the Super Bowl, you’ve got to find local ways.” And all the big companies said, “All right.” J&J told us, “We’ll do one here at Rutgers.” Baxter said, “We’ll do one here.”

Senator Bill Fr…:           I got it right here.

Dean Kamen:                Yeah?

Senator Bill Fr…:           Now, look at them just, again, because we’ve got listers here. In my hand. It says First Robotics Competition, 2020 Spectacular Schedule. And, what’s in this little book here?

Dean Kamen:                So now, it went from one page and it said, “First,” on the front, to, “Come to Manchester,” on the back. Now you open it up, and it’s 12 pages. That March Madness of 2020. March Madness starts next weekend, and there will be 180 cities holding events throughout March, for over a million kids. We have 200,000 volunteer mentors, working with these teams.

Dean Kamen:                We have 200 universities, that are scouting for these kids. That this year, at the championship, which has been broken into two weekends in the end of April, one at the Astrodome in Houston, one at Tiger Stadium in Detroit.

Dean Kamen:                But at the end of April, at those two events, if you walked down what we call Scholarship Row, you will watch these universities hand to these first competitors, $80 million in scholarships. 3,700 corporate sponsors, and everybody loves it. The entire operation, all these events, these two championships are run by a staff now, in Manchester, in New Hampshire, of less than 200 people.

Senator Bill Fr…:           Unbelievable. And that investment, that happens over the period, how long has is one of these?

Dean Kamen:                So, the typical season is set six, seven, eight weeks long, but they can go to regionals throughout March. But we now have enough history, you remember, you walk through the pits now and you’ll see young people there, that they’re too old to be the high school kids. You talk to them, “Oh, I’m an engineer at such and such a company. I’m mentoring the school I went to.”

Dean Kamen:                Then you’ll see older people there, and they’re clearly… “Are you the parent, are you the teacher?” “Dean, I was the vice president of engineering at,” blank, some fortune 50 giant, “I started 15 years ago, when my daughter was 12. Well, she’s off. She’s even at a college, she’s working on a competitive team now, because she’s an engineer, because of you. But I can’t give up, this is my team.”

Dean Kamen:                We have people that have retired from giant technology companies, whose own kids are now sponsoring teams. But we never lose our mentors, because they love the program. They love the kids. They love the fact that we’re transforming the lives of a generation.

Senator Bill Fr…:           So, which of your inventions, which we touched on six or seven today, and there are another 100 equal to that. Our listeners know that, but it’s hugely just unbelievable, in terms of size and scope. Or, this investment in kids. And, it’s a rhetorical question.

Senator Bill Fr…:           But over the long haul, 100 years from now, I’ll bet you is this little pamphlet, where you’re inspiring hundreds of thousands of kids, the Dean Kamens of the future, that that’s going to be the investment. All hugely important. But I say that, the first one changed the course of humanity. This is really, we’re investing in the future change in the course of humanity.

Dean Kamen:                So, Doc, people ask me, What invention are you most proud of?” I always have two answers to that. “What project that we did, I’m most proud of? I don’t know, because it hasn’t happened yet.” I don’t look back, I look forward. And we have more resources, more engineers, more people. There’s more technology out there. So I’d like to think our new projects, like now, manufacturing replacement human organs, will always be a bigger and better solution than the ones of the past.

Dean Kamen:                But if they ask, “Well, what’s the most significant project or invention you’ve ever did?” That one’s easy. It’s First. Because, if you believe that innovation itself is the critical resource to move humanity forward, well if innovation is the most critical resource, then the best thing you could ever invent is innovators. An army of them.

Dean Kamen:                I think, and it’s already been shown now, because all the years we’ve had, that we’ve transformed what kids aspire to do, and where they put their time, and why they go to school and what they study.

Dean Kamen:                But Doc, I will bet you anything, just the laws of large numbers, with the army of kids that have now come through First, that you are going to start seeing more and more, when the news puts a microphone up to some doc, who’s mid-career doc and says, “Wow, you just won the Nobel Prize for Generative Medicine. What made you do this?”

Dean Kamen:                That person will look up, and, “Well, you never really know. But I remember when I was in junior high school, for the first time I saw the power to,” and they’ll tell some story about how they got involved in First, and never looked back.

Dean Kamen:                But we have hundreds of thousands of kids today, that would not be in the kinds of careers they’re in, that we need, had they not been exposed to technology and science via First.

Senator Bill Fr…:           The First Robotics Competition is the entire name. But listen, Dean, you teased me a little bit, since my clinical life is spent in transplanting the human heart, transplanting the human lung, and the combined heart-lung. Then you tell me, all of a sudden, “If you were still in that business, I may put you out of business. Because I’m, I’m out working on the organs of the future.” [crosstalk]

Dean Kamen:                We’re going to support you, because once we give you the organ, somebody’s got to put them in the people.

Senator Bill Fr…:           Okay, good. Still have a job, still have a job.

Dean Kamen:                You’ll have a job.

Senator Bill Fr…:           We’ll look forward… in fact, let’s do this same show, and I promise to come up to New Hampshire. We’ve talked about it a lot.

Dean Kamen:                Please.

Senator Bill Fr…:           I’d love to come up, and see the operation. But, thank you for taking time today. It’s really inspiring. I mean, I really do leave this conversation inspired, and say, “I got to go get to work. I got to go out and inspire some people, just like Dean Kamen.” Thank you so much, for being with us today.

Dean Kamen:                Thank you for what you’ve done. You inspire us, and I will hold you to a visit. We’ll make it worth your while.

Senator Bill Fr…:           We’ll do it. Good. Thank you Dean, appreciate it.

Dean Kamen:                Thank you.

Senator Bill Fr…:           Bye.

Senator Bill Fr…:           This episode of A Second Opinion was produced by Todd Schlosser, Modus Creative Group and SnapShot Interactive.

Senator Bill Fr…:           You can subscribe to A Second Opinion on Apple podcast, Spotify, or wherever you are listening right now. You can also watch our interviews on YouTube and on our website. Be sure to rate and review A Second Opinion, so we can continue to bring you great content.

Senator Bill Fr…:           You can get more information about the show, it’s guests and sponsors at That’s,

Senator Bill Fr…:           A Second Opinion broadcast from Nashville, Tennessee, the nation’s Silicon Valley of health services, where we engage at the intersection of policy, medicine and innovation.