Of arms and men: losing a limb in Iraq leads a Durham
industrial designer on a quest to help amputees get a better grip on
things.
by Boykin, Sam^Maley, Frank
Capt. Jonathan Kuniholm crouches, low and quiet, as he and three
dozen other Marines advance through a thick palm grove along the
Euphrates River. The platoon is looking for Iraqi insurgents who a few
hours earlier had fired at a boat patrolling near Haditha Dam. As they
close in on the suspected hot spot, a homemade bomb hidden in an olive
oil can explodes. Shrapnel rips through the squadron, knocking Kuniholm
off his feet. When he regains his senses a few minutes later, he sees
his right arm is nearly severed just below the elbow. His M-16 rifle is
blown in half. Amid a raging firefight, Kuniholm pulls himself out of
danger and is airlifted to the al-Asad air base hospital, near Baghdad.
Surgeons have to amputate the lower part of his ravaged arm. It's
Jan. 1, 2005. Happy New Year.
A week later, he undergoes surgery at Duke University Hospital in
Durham to prepare the injured arm for a prosthesis. A few months later
at Walter Reed Army Medical Center in Washington, D.C., doctors outfit
him with several artificial limbs, including one with a split-hook
gripping device, which operates via a harness and cable system activated
by arm movements. He's also given a more cosmetically appealing
myoelectric prosthesis, which uses electrodes to translate nerve signals
produced by muscle tension in the upper arm into hand movements. Flexing
his upper arm causes the hand to grip; relaxing causes it to release.
He finds both frustrating. The myoelectric limb is heavy and
slow-operating. The wrist motor isn't strong enough to turn a
doorknob. The piratical split hook works better, but it's a poor
replacement for a hand, and the basic design hasn't changed much
since World War I. "This sucks," Kuniholm thinks. "I
could come up with way better ideas than this." He has reasons to
believe that. His tour in Iraq has interrupted his quest for a doctorate
in biomedical engineering, and he and some guys from his master's
program had started an industrial-design consultancy in Durham--Tackle
Design Inc. But he quickly discovers that lack of ideas isn't why
progress on prosthetic hands has been so slow. Patent literature is full
of promising ideas that never become products.
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The problem, it turned out, lay in the market. It's too small
for companies to justify spending much on research and development.
About 2 million Americans--less than 1% of the population--have lost a
limb to illness or trauma, and only a fraction of them need hands.
"There are like 75,000 potential customers for our prosthetics in
the entire United States--less than half of Durham," Kuniholm says.
"Probably half of them are right[-handed] and half of them are
left, and there are all different levels and all different preferences.
By the time you segment that down to a single product, you're
talking about a roomful of people."
Tackle Design had never focused on making lots of money. It started
with a client base consisting largely of what Kuniholm calls "crazy
inventors," who were long on dreams and short on cash. The partners
operated more like a confederation of contractors than a buttoned-down
business. Doing interesting work mattered more than raking in revenue.
Marginally profitable, the company grossed less than $1 million a year.
His partners helped Kuniholm develop a strategy for making better
artificial hands with meager financial resources, and the company is
close to bringing products to market. The quest has brought
publicity--always a struggle for a small company--but he admits it has
diverted manpower and other resources. He's enough of a realist to
know that people who try to make the world a better place don't
always get rich doing it. If they're not careful, they can go
broke. "The real question that I and everybody else here is asking
is, 'Is there some way to turn this bullshit into money or
not?' And I don't know if there is."
As if there weren't enough centrifugal forces tugging at
Tackle Design, the departure of the de facto manager and two other
partners means Kuniholm, 36, must take on more executive duties. That
means more attention to building profitable, long-term client
relationships and less time spent improving artificial hands. "I am
doing everything I can to keep our pursuit of this and similar projects
from destroying our fledgling company."
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He was working on his second bachelor's degree when he joined
the Marines in 1997. The Durham native already had a bachelor's in
English from Dartmouth and had settled in at N.C. State to pursue one in
mechanical engineering. Just a year into his studies, Kuniholm felt the
pull of family tradition. His paternal grandfather, who had gone to West
Point, was a foreign-service officer whose wife had been career CIA. His
dad had been an infantry officer in Vietnam.
At Camp Lejeune, he served as a logistics officer, reaching the
rank of first lieutenant. Managing maintenance, supply chains and
transportation of men and equipment gave him skills that might have been
a good fit at a place like Wal-Mart or FedEx. "But not only would I
have had to move somewhere else, I would have been doing something I
didn't enjoy. It needs to be somebody's job to figure out how
many port-a-potties they need at the state fair, but I don't want
to be that guy."
He returned to State in 2000 and finished his bachelor's in
mechanical engineering in 2002. The following year, he earned
master's degrees in that and in industrial design. In early 2003,
he worked on a class project with Chuck Messer, Jesse Crossen and Jason
Stevens. They decided that instead of trying to land jobs with
established companies, they would start their own. Kevin Webb, a
childhood friend of Crossen, joined them. Each put in $50 to get it
going, and Kuniholm filed the incorporation papers. Setting up shop in
the Raleigh house Messer, Webb and Crossen rented helped save money.
Stevens soon dropped out, and Kuniholm began work on his doctorate at
Duke. He did what he could on nights and weekends for the business,
which Messer ended up running.
It provided some interesting projects. One client came up with a
plastic lock for keeping shoestrings tied. Tackle Design also built
prototypes, on a fee-for-service basis, of a light-emitting-diode
bicycle light and a fishing lure with an LED inside. But the partners
quickly learned the perils of working with "crazy inventors."
"We got stiffed on a few of those," Kuniholm says. "And
you expend so much time talking to them on the phone just trying to get
a contract set up that it's almost not worth it for a $3,000 to
$5,000 job."
The company also did work for larger clients, including conceiving
and making prototypes for researchers at State who were developing tools
for minimally invasive robotic surgery. But what it needed was a
well-heeled client who could provide an ongoing revenue stream. "We
haven't been able to establish a relationship like that,"
Kuniholm says. "The ones that we've had have sort of been on
and off again."
The makeup of the partnership had a lot to do with Tackle
Design's financial woes, Messer admits. "We're kind of
crazy-idea guys, and we like to brainstorm, and we get kind of
fantastical about things we might do. And that kind of stuff is more fun
than managing books and looking at profit-loss statements." Those
tendencies frustrated him as a manager, but he succumbed to them, too,
and got sidetracked on unprofitable jobs. He spent considerable time
doing pro bono work with researchers at Duke on a low-cost phototherapy
light to treat Third World infants afflicted with jaundice. Saving
babies inspired him in a way that thoughts of commercial success
couldn't.
But projects like that strained relationships. "Some of the
things that some of the other partners went off and explored ended up
making money, and some of the things that were explored did not. In the
end, you can't help but feel some tension among partners when
somebody else is making money and supporting something that you're
doing or when you're supporting somebody else."
In 2004, Tackle Design moved to its current office, a former diner
with a concrete floor and glass-and-brick facade facing the Durham
County Courthouse. Its workshop is filled with tubes, wires, tools, bits
of wood and metal and countless gadgets. That summer, with the Iraq war
raging, Kuniholm again felt the call of duty and joined a Marine reserve
unit. It was activated less than 48 hours later, and he was deployed to
Anbar Province as a platoon leader in the 4th Combat Engineer Battalion.
On the morning of Jan. 1, 2005, Kuniholm met with a platoon commander
who had received word one of his boats had taken enemy fire on the
Euphrates. He was about to send out a team to investigate. "He
asked me if I wanted to go, so I grabbed my stuff."
When word of the injury reached his partners, they started trolling
the Web to learn all they could about prosthetics. "Initially it
was kind of exciting," Webb says. "We had done a lot of work
in robotics, and we just assumed prosthetics had the same kind of
innovation. But we found out differently." Wounded warriors often
have had to push the boundaries of prosthetics by demanding more
functional and capable devices. Kuniholm figured that, as an amputee and
an engineer, he was uniquely poised to do that, whether it made money or
not. With a disability pension of more than $3,000 a month, a working
wife and Messer running things--sort of--at Tackle Design, he could
afford to pursue his passion.
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