Mechanical body parts could someday
make disabilities irrelevant in the workplace

Getting a makeover is about to take on a whole new meaning. In the not-too-distant future, doctors will be able to do as much under the skin as beauticians now do on top. For the many people with disabilities or chronic diseases, technology is on the verge of unlocking a whole new world.

Scattered across the globe, dozens of research teams are working on computer chips that will be implanted in the brain or spinal cord to give artificial vision to the blind, hearing to the deaf, and speech to the victims of stroke. Other laboratories and companies are developing products that will regulate bladder function for the incontinent, restore movement to the paralyzed, and give back muscle control to people with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). Artificial kidneys and blood vessels are being tested in several labs, including the McGowan Center for Artificial Organ Development at the University of Pittsburgh. At the University of New Mexico's Artificial Muscle Research Institute, scientists are developing polymer-metal composites that could serve as replacement muscles for patients suffering such afflictions as muscular dystrophy.

SILICON RETINAS. Name almost any disability, and there's probably research under way to overcome it. Most magical of all, though, is the drive to restore vision in the blind. Already, Dr. Mark S. Humayun, a researcher at Johns Hopkins University Medical Institutions in Baltimore, has implanted light-sensitive chips in the eyes of some 15 patients. These tiny silicon retinas provide a very crude, 15-pixel image. A somewhat better, 64-pixel image is provided by an artificial-vision system that relays scenes from a miniature video camera to a small electronic-circuit card inside the skull of Jerry, the blind man wearing the strange-looking eye glasses in the picture above. (He asks that his last name not be used.) Jerry's vision system was developed over four decades by William H. Dobelle, CEO of Dobelle Institute Inc. in Commack, N.Y. ''My next version will be better still,'' he says--with 512 pixels. Still, that's a far cry from the hundreds of thousands of pixels on a TV screen or computer monitor.

Image quality will keep getting better as semiconductor technology continues to pack silicon chips with more power. In 10 years it might be good enough that users will blend into the crowd. In 20 years, the acuity of artificial vision might rival that of a biological eye, says Dr. William J. Heetderks, head of a National Institutes of Health program focused on developing electronic implants. In fact, fully functioning artificial eyes should be ready by 2024, predicts Ian D. Pearson, a researcher at British Telecommunications PLC's BT Laboratories in England.

Long before then, other manmade body parts will be helping people to overcome disabilities. Artificial hearing implants, offering better sound than today's cochlear implants, may arrive sooner--perhaps within a year. Electronic implants to stimulate the muscles in paralyzed limbs should be ready by 2002, says Pearson of BT Labs. Artificial lungs and kidneys may follow by 2015, although some researchers optimistically predict 2010, when a permanent artificial heart may be ready.

Advanced prototypes of all these spare body parts already exist in research labs. The history of such efforts, after all, goes back almost six decades to the kidney dialysis machine, which was invented in 1943 in the Netherlands by Dr. Willem J. Kolff. Known today as the father of artificial organs, he came to the U.S. in 1950, developed an artificial heart at the Cleveland Clinic in the mid-1950s, and in the 1960s formed an artificial-organ research program at the University of Utah. Many others followed; Dobelle, for one, started his artificial vision work under Kolff's tutelage.

Probably the Utah group's most famous product was the Jarvik heart, named after Robert K. Jarvik, who developed the original design in the late 1970s while he was an engineering student at Utah--building on the work of at least 147 of Kolff's students. Since then, mechanical-heart designs have leaped into the Space Age. Several of the latest versions have tiny turbines for pumping blood--borrowed from the turbines that pump fuel in the Space Shuttle. Supercomputer simulations at NASA and the Pittsburgh Supercomputing Center honed the turbine designs to make them superhumanly efficient. For now, these pumps are used only as ''bridge'' devices to sustain a patient until a human heart is available for transplant. But researchers are confident they'll eventually be permanent replacements.

Moreover, artificial organs no longer need a connection through the skin to an outside power source. In 1991, researchers at the University of Ottawa Heart Institute developed a so-called inductive system that ''broadcasts'' electrical power through the skin. Patients can move about freely using a battery pack. A similar system also transmitted signals through the skin, activating an artificial-vision brain implant. So blind people may not need a hole in their head like Jerry has.

Americans who want Dobelle's system may have to fly to Zurich, where he has a clinic. Stringent U.S. Food & Drug Administration safety rules make it uneconomical to introduce artificial-organ technology at home, he says. That's why Dr. Bartley P. Griffith, director of Pittsburgh's McGowan Center for Artificial Organ Development, will head to Israel to perform the first human implant of a new turbine heart. ''The U.S. standard is that we're not going to use devices that might do harm, no matter how gravely ill the patient is,'' he says. To Kolff, who's now 89, that doesn't make sense, and he has been lobbying Washington for a change. Some 95,000 people will die this year ''without a chance,'' he laments, because only a couple thousand donor hearts will probably be available. Dr. Steven J. Phillips, an assistant research director at the National Institutes of Health, also believes the FDA could ease up. ''Europe's safety record with our new devices is actually better than our own--and they're saving more lives,'' he notes. He also worries about so much of the research migrating to Europe because of its encouraging climate.

Yet ultimately, most of these gadgets may be replaced. Biotech engineers will figure out how to tinker with genes and prevent or cure blindness, heart disease, and other afflictions. But it won't happen for at least 20 years, says Griffith. That leaves a big gap for mechanical body parts to fill. Soon, ''making a new you'' could take on a whole new meaning.

By Otis Port in New York