Oral-History:Dov Jaron

About Dov Jaron

After obtaining Ph.Ds from both the University of Pennsylvania in Biomedical Engineering and from the Medical school of the University of Colorado (1967), Dov Jaron collaborated on the development of the intra-aortic balloon pump with heart surgeon Adrian Konforwitz. This device, which improves the circulation of those who have suffered from a heart attack or who have problems coming off the oxygenator used during surgery, is now owned by nearly every hospital. Computer modeling was central to his development of the intra-aortic balloon pump and he continued to design an engineering model that predicts various properties of the cardiovascular system and he made simulation packages for others. Jaron initiated the Biomedical Engineering program at the University of Rhode Island (1973) and built up the education program at the Biomedical and Engineering Science Institute at Drexel University as its Director(1980). He directed the division of Biological and Critical Positions and the Engineering Director to the National Science Center (1991) and was in charge of the Biomedical Technology program at the NIH (1996), where he organized a conference convincing the NIH of the importance of biomedical engineering to research in biology and medicine. Jaron also served as President of the IEEE EMBS. Subsequently, he returned to Drexel, which was now the school of Biomedical Engineering, Science, and Health Systems, as the Calhoun distinguished professor of engineering and medicine. He is currently working on a Navy-funded protective suit for pilots, in which he simulates the effect of G stress on gas transport and recirculation in the microcirculation to integrate with his hemodynamic model. Jaron foresees the incorporation of the chemical effects of drug therapy in the computer modeling of the cardiovascular system.

About the Interview

DOV JARON: An Interview Conducted by Frederik Nebeker, IEEE History Center, 12 October 1999

Interview # 371 for the IEEE History Center, The Institute of Electrical and Electronics Engineering, Inc., and Rutgers, The State University of New Jersey

Copyright Statement

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It is recommended that this oral history be cited as follows:
Dov Jaron, an oral history conducted in 1999 by Frederik Nebeker, IEEE History Center, Rutgers University, New Brunswick, NJ, USA.

Interview

Interview: Dov Jaron
Interviewer: Frederik Nebeker
Date: 12 October 1999
Place: Atlanta, Georgia

Childhood, family, and educational background

Nebeker:

Can you tell me where and when you were born, and a little about your family?

Jaron:

My family immigrated to Israel from Lithuania in Europe in the late twenties. They came as part of the pioneers’ movement to work the land and to settle the country. We settled the country. I was born in Tel Aviv, Israel. It was Palestine in 1935. I went to school in Israel, and went to the army and did my service.

Nebeker:

It was rather unsettled times there after the war.

Jaron:

Yes, they were.

Nebeker:

How did that affect you personally?

Jaron:

The British army had what they called a Jewish Brigade, and my father volunteered to fight in the War, and he went to Europe to Italy with the Allied forces. He was away for almost five years during the war.

Nebeker:

Can you remember the war itself?

Jaron:

I can remember it very well. I remember when Rommel was advancing in Northern Africa and getting closer to Egypt.

Nebeker:

He got into Egypt, or very close anyway.

Jaron:

Yes. Clearly we were very, very concerned because we started hearing what was happening in Europe.

Nebeker:

Did you have brothers and sisters?

Jaron:

Yes, I had one brother. Those were very tough times. Then of course in 1948 the country got its independence. I was thirteen at the time, living in Tel Aviv.

Nebeker:

Was there any fighting there in 1948?

Jaron:

Yes, as a matter of fact. We actually lived in a suburb of the city, and I remember there was an armament factory within a half of a mile from our house. I remember attacks on that factory and planes diving right over our house to hit the factory. It was not very pleasant. You never knew whether the bombs were actually going to fall where they were supposed to fall. But I was fairly young at that time.

Nebeker:

Your father came through World War II fine?

Jaron:

Yes, he returned from the War. Not very many people returned, but he did.

Nebeker:

Did your education get disrupted?

Jaron:

Actually it was not disrupted. Schools went on and they functioned normally. There were some disruptions, but not very serious.

Nebeker:

Was Hebrew the language of the schools?

Jaron:

Yes. After I finished school, just like any other male and female citizen, I went into the armed services.

Military service; agricultural settlement

Nebeker:

What year was that?

Jaron:

I was eighteen, so that would have been in 1953. I spent two years in the military. My service in the military was not very difficult because I was in a special branch of the military, which was divided into groups of about thirty or forty and sent to settlements along the border. In those days the country tried to settle the border, and those were locations that guarded the border. We were sent to one of those settlements, and I spent basically three years there.

Nebeker:

What was your position in the army?

Jaron:

I was a Private. I guess it was infantry. In those days you really did not distinguish, except that we had a very small Air Force, but that was it.

Nebeker:

Your MOS (military occupation specialty), the job that they are trained for, could be a technician or infantry.

Jaron:

Private First Class.

Nebeker:

An all-purpose soldier. But you were not into technical—radar or anything?

Jaron:

No, just regular service, regular infantry. Some of my friends lost their lives during that period.

Nebeker:

There was fighting?

Jaron:

There was fighting in 1956, and some of my best friends never came back from the fighting. Then I decided I had had enough of rural life. The settlements basically were agricultural settlements. They were kibbutzim.

Nebeker:

You served what was required, and then went to the University?

Jaron:

I served what was required, and then I stayed on past that for a couple of extra years. It was not in the army; I had just become a member of that settlement.

Nebeker:

Was it a kibbutz that you were born on?

Jaron:

No, I was born in the city.

Nebeker:

You must have felt some attachment to that kibbutz?

Jaron:

There was a lot of pain in experience in those days. People felt the need to contribute to the settlement of the country. People were very idealistic then. Not so much now.

Nebeker:

You were there for three or four years?

Jaron:

I was there almost four years.

Undergraduate studies, electrical engineering

Nebeker:

Then you went to the University?

Jaron:

Then I went to the Technion. I went to Technion and spent only one year there, and then came to this country.

Nebeker:

How did that come about?

Jaron:

I just wanted to see the world.

Nebeker:

Without an intention to immigrate?

Jaron:

No, not at all. I stayed here, and I got my first degree, my Bachelor’s Degree, at the University of Denver in Electrical Engineering.

Nebeker:

How did you choose electrical engineering?

Jaron:

I thought it was a very interesting profession.

Nebeker:

Some people were ham radio operators or had a father who was an engineer.

Jaron:

Actually I was studying music as a hobby in those days before I went to the University. Now that you ask me, actually the reason I chose engineering was because in high school we had a teacher who taught us physics and mathematics, and he was absolutely the most fantastic teacher I ever had.

Nebeker:

What was his name? Do you remember? Sometimes with these inspirational teachers it is nice to give them the recognition they deserve.

Jaron:

His last name was Mr. Shamir. I do not remember his first name. He was very inspiring, and I really loved the subjects. Everybody who took classes with him felt the same way. He was a very unusual teacher. That is sort of what got me interested.

Nebeker:

How did you end up at the University of Denver?

Jaron:

I had some distant family there. That is a sad story because the University of Denver closed its Engineering College about four, five, or six years after I graduated, then they reopened it about ten years ago.

Nebeker:

How was your education at the University of Denver?

Jaron:

It was good. Some of the teachers were very good there, and some of them were not. It was not a high-powered research university, particularly not in engineering. From there I went to the University of Pennsylvania. While I was an undergraduate student I worked as an electronics technician at the Medical Center of the University of Colorado in Denver. I worked for a psychiatrist named Sidney Margolin, who was actually trained under Freud, and did what was called psychophysiology. He lived in New York for many years and treated some of the most famous movie stars as a psychiatrist, then he decided he had enough of the city life and moved to Denver to be on the faculty. He was an electronics nut. He had the first electronics system to measure psychological responses. Dr. Offner built it for him.

Nebeker:

Do you know what sort of psychological responses?

Jaron:

Yes. ECG, EKG, galvanic response—any electrical response that is measured today, he had the first unit that did that. I maintained this unit for him. It was built with tubes and all done by hand.

Nebeker:

That is interesting. Thelma Estrin got her start in the field by maintaining the ECG machine. This seems to be your entry into biomedical engineering, working on such a machine.

Graduate studies, biomedical engineering

Jaron:

This was what got me interested. When I graduated with my Bachelor’s Degree, NIH just funded three universities that started biomedical engineering programs: Johns Hopkins, The University of Pennsylvania, and the University of Rochester. The program at Rochester was directed by one of Herman Schwan’s students, Ed Carstensen. Talbott was at Johns Hopkins, he also was one of the pioneers in biomedical engineering, but he died very young. I do not know if his name was ever mentioned, or if Schwan has ever mentioned him.

Nebeker:

Yes, I know the name.

Jaron:

I found out that NIH funded those three training programs, so I applied to all three of them and was accepted at all three institutions with fellowship offers.

Nebeker:

So how did you choose Pennsylvania?

Jaron:

I looked at what each university offered, and felt that the University of Pennsylvania would give me the best variety, the broadest possible education. Talbot, who ran Johns Hopkins program, was in charge of the student seminars at Penn. He came every two weeks to Pennsylvania and gave the most thought-provoking seminars that I ever experienced. Each student had to do a project, had to read papers. There was a lot of preparation for those seminars.

Nebeker:

He was conducting this seminar at Penn on a regular basis?

Jaron:

Basically what he did was to assign us papers, and then he would write up a set of questions that we should think about while reading the papers. Then we would make presentations and have discussions at those seminars. It was very interesting. Some of the luminaries in the field were there. Schwan was there and David Geselowitz was there, and some other people who are no longer there.

Nebeker:

Jack Reid may have been there when you were there?

Jaron:

Yes. Jack Reid was a student back then. I hired Jack Reid when I was director of the Institute at Drexel. I finished my Ph.D. at the University of Pennsylvania.

Nebeker:

What was your thesis work?

Jaron:

My thesis was on cardiac pacemaker electrodes.

Nebeker:

What years were you a graduate student?

Jaron:

Before I went to the University of Pennsylvania, I received a special fellowship to the University of Colorado Medical School—not as a medical student but to the graduate school. I studied biophysics and biochemistry there for one year.

Nebeker:

Was that a degree program or just course work?

Jaron:

Just course work. I just felt I needed some biological background before I went into biomedical engineering.

Nebeker:

Your undergraduate Bachelor’s of Engineering was strictly general?

Jaron:

Strictly general.

Nebeker:

But you got interested in biomedical applications.

Jaron:

Because I was an electronics technician, I felt that I needed a year of extra training, which I did. Then I applied to those universities.

Nebeker:

So it does not surprise me then to hear that you were accepted at all three places because you had the engineering degree plus training.

Jaron:

Plus I graduated with honors with my Bachelor’s degree. I think that is why I was accepted at all the institutions.

Nebeker:

What years were you were a graduate?

Jaron:

I got my Ph.D. in 1967.

Ph.D. thesis on cardiac pacemaker electrodes; surface potentials research

Nebeker:

This was very early for pacemakers.

Jaron:

Very early for pacemakers. The electronics was fairly straightforward; not necessarily miniaturized the way it is right now. It was a fixed rate pacemaker.

Nebeker:

Were these implantable pacemakers you were working on?

Jaron:

Yes. What people did not know was the reaction of the electrodes with tissues and how that affects the pacemakers.

Nebeker:

Were you concerned with the long-term interaction of tissue and electrodes?

Jaron:

Yes, that is right. But I was looking basically at the electrical properties of the interface between pacemakers and the electrodes.

Nebeker:

The physics of what is going on with the tissue and electrodes?

Jaron:

Exactly. Actually Banu Onaral continued some of that work, but she worked on electrodes in general, not necessarily pacemaker electrodes. She was looking at lower frequency responses. I was looking at higher frequency properties of the interface.

Nebeker:

How did you study that interface? Did you have some system?

Jaron:

I studied using frequency domain and time domain studies.

Nebeker:

With what tissue? How did you actually get measurement?

Jaron:

I did bench and theoretical studies, then I did patient studies.

Nebeker:

What kind of tissue was available for the bench studies?

Jaron:

Just saline for the bench studies. I do not remember whether I did any actual tissue studies. I do not think we did. That would have been fairly complicated, short of using animals. We did not have animal facilities in the department. We would have had to go to the vet school. We just went directly to patients and I studied them.

Nebeker:

You developed a theoretical explanation of what is going on, and then measured this in the lab and with patients?

Jaron:

Yes, precisely.

Nebeker:

How do you feel, looking back on that work?

Jaron:

It was better work than many of my students are doing these days. I think the quality of the work that is done right now in graduate school is somewhat lower than it used to be.

Nebeker:

Did you work closely with Schwan?

Jaron:

Yes. I worked basically with three people. I worked with Schwan, David Geselowitz and I worked with a cardiologist by the name of Stanley Brilles.

Nebeker:

Jack Reid mentioned a cardiologist.

Jaron:

No, he mentioned somebody else.

Nebeker:

Claude Joyner?

Jaron:

No, not Claude Joyner. The reason Geselowitz was interested is because Geselowitz did a lot of modeling of the heart as an electrical generator, and trying to figure out the electrical properties of the heart from surface potentials.

Nebeker:

You mean the surface of the body?

Jaron:

Yes, from measurement on the surface of the body. If you have a generator inside the body, it generates potentials on the surface. You can measure the potential on the surface of the body. The question is, from the surface of the body, can you deduce what happens to the generator representing the heart. That is done to a certain extent with electrocardiography—that is what electrocardiography is all about. But electrocardiography has serious limitations. He was trying to figure out whether there is a better way of getting more information about the generator. With a pacemaker, we knew exactly the properties of those generators. We knew exactly what the current of the pacemaker is, what the voltage is, so we tried to measure surface potentials and relate those surface potentials to the pacemaker as a generator.

Nebeker:

That sounds like a completely different problem from the electrodes.

Jaron:

Yes. I worked on both.

Nebeker:

I see. But your thesis was the electrodes?

Jaron:

I wrote up both projects.

Nebeker:

Both. How self-directed was this work? Were you deciding what problems to attack?

Jaron:

The general problem was given to me, but the approach was pretty much self-directed. It was my own approach.

Nebeker:

Were your results much noticed?

Jaron:

Yes, in regular written literature. That was a long time ago. There have been many other advances since then.

Nebeker:

I remember being told how important it was to understand electrodes in these systems. I’m sure those results were valuable.

Jaron:

Yes.

Intra-aortic balloon pump development

Collaboration with Adrian Kantrowitz, Maimonides Hospital

Nebeker:

You got your Ph.D. in 1967. What did you do then?

Jaron:

I then went to work with a heart surgeon by the name of Adrian Kantrowitz at Intra-aortic balloon pump development, Maimonides Hospital in Brooklyn, New York. The reason I went to work with him was that he had just received a very large grant from the NIH to build and test heart assist devices. The pacemaker is an electrical generator, not a heart assist device. A heart assist device is a mechanical device. Together we developed the intra-aortic balloon pump. The intra-aortic balloon pump is a plastic balloon, maybe 20 centimeters long, mounted at the end of a hollow catheter, which is introduced through the femoral artery all the way through the descending thoracic aorta. That is the vessel where all the blood is pumped from the left ventricle. The balloon is inflated and deflated in synchrony with the heart. When the heart begins to pump blood, to eject blood, you deflate the balloon, thereby creating a lower lobe low resistance, making it easier for the heart to pump the blood. When the ejection period of the heart is finished and the aortic valve closes, the balloon is inflated, which displaces the blood to the periphery, but more importantly towards the heart. The coronary vessels get all their blood supply during the time when the heart is relaxed, which is the time that the balloon is inflating. You are prefusing the heart itself as well as the periphery. What you are achieving by that is increasing the blood supply to the heart, which in the case of a heart attack is a problem; and also increasing the blood supply to the periphery; and reducing the workload on the heart, making it easier for the heart to recover.

Nebeker:

This is for people with weak hearts for some reason?

Jaron:

Yes, after a severe heart attack. Or people who cannot come off the heart-lung oxygenator, used during surgery, to improve circulation. This is now used clinically throughout the world.

Nebeker:

It seems like an auxiliary heart that is pumping.

Jaron:

That is exactly what it is. It is like an auxiliary heart. It is like a third chamber. The way you synchronize it to the heart is you pick up the electrocardiogram and use it to time the balloon. With every heartbeat, when the heart pumps the balloon is inflated and when the heart relaxes the balloon is deflated.

Nebeker:

With the cardiac surgeon that you were working with, your job was the electronics of the synchronizing?

Jaron:

I had a theory to get the optimized effects from the balloon. I did a lot of simulation.

Nebeker:

I see, of exactly how and when you would inflate.

Jaron:

That’s right. And how much. So I had to study the cardiovascular system.

Computer modeling

Nebeker:

Did you actually make a mathematical model of what was going on?

Jaron:

I sure did, absolutely.

Nebeker:

Was this before the days when you would simulate on the computer?

Jaron:

No, we used a computer. It was just a different computer—a much slower computer.

Nebeker:

Maybe with punched cards or something like that.

Jaron:

Actually it was. I am trying to remember the first machine we had. I remember we bought a PDP-15, DEC PDP-15. It was the machine that came after the PDP-9, and it did not last very long. It was not a very good machine.

Nebeker:

I think it was in the mid ‘60s that the first of the mini computers came out.

Jaron:

Right, the Link 8.

Nebeker:

That made a big difference to a lot of the scientists and engineers. For the first time they could have their own computer.

Jaron:

The PDP-15 was not a personal computer. It occupied a room this big.

Nebeker:

Right. But still in the laboratory as opposed to the mainframe that the university would have.

Jaron:

That’s right.

Sinai Hospital, Detroit

Nebeker:

How long did you work with Kontrowitz?

Jaron:

I worked with him from 1967 until the end of 1972. In 1970 we moved the whole laboratory to Detroit.

Nebeker:

Why was that?

Jaron:

He was not getting the support he needed where he was. The hospital was not really research oriented enough. We moved the whole thing to the Sinai Hospital in Detroit. I was in Detroit for three years.

Testing, human trials

Nebeker:

Had anything like the intra-aortic balloon been done before?

Jaron:

No.

Nebeker:

This was completely new?

Jaron:

Actually, the concept was first proposed by a man named Mollopolus. He was not in Greece at that time; he was doing work in the United States. He didn’t really develop it. It is interesting, because Kantrowitz has a brother by the name of Arthur Kantrowitz, who is a very famous physicist. He worked at AVCO at the time. They had both been discussing the idea, and he had tried to develop the same device through AVCO. Adrian Kontrowitz, whom I worked for, developed it in his own laboratory. Adrian Kontrowitz did the first test on patients.

Nebeker:

You worked with him in actually building this device?

Jaron:

That is right, exactly. We actually made the balloons. We made everything, tested it on animals extensively, and then used it on patients.

Nebeker:

How did this development process go? How did it go when you first tested it in animals? Did it work initially?

Jaron:

It worked from the beginning. The theory behind it was very sound. We just had to make sure that it was as effective as we wanted it to be. We were concerned about any interactions with the blood.

Nebeker:

Also, it sounds like a very difficult placement.

Jaron:

No, it was not very difficult.

Nebeker:

There is quite a distance there between where you are inserting it and where it is residing, right?

Jaron:

Yes.

Nebeker:

You have a catheter that is carrying the airflow to inflate the balloons?

Jaron:

Helium. Because we had to move the gas flow very fast, so we had to use the lowest density gas as possible, so we used helium. The problem with animals was that at first we started using normal animals. When you have a normal heart, it is not very effective. We realized that the heart had to be in failure. We induced failure in the animals, and that is when it started being effective.

Nebeker:

Do you remember the first human trial?

Jaron:

I do remember the first human trials because I spent a lot of nights at the hospital.

Nebeker:

Were there major problems initially?

Jaron:

The real problem was the control unit that we used was basically an oscilloscope. We had to synchronize the valves, which controlled the inflation and deflation cycles using an oscilloscope. Everything was very big and all custom made.

Nebeker:

Was it hand-synchronization?

Jaron:

No. We picked up the signal on the oscilloscope, and then we synchronized the balloon from output of the oscilloscope.

Nebeker:

Are you turning the dials or is somebody turning the dials?

Jaron:

We had to turn dials to time it correctly, absolutely.

Nebeker:

It was not an automatic system picking it up?

Jaron:

No, even now it is not automatic. It is much more sophisticated now, but it is not completely automatic. If you have a regular heartbeat, it is fine. But those patients do not have a regular heartbeat.

Nebeker:

It takes an eye to see where you should…

Jaron:

That is right. One of the problems was to try and find a way so that it can operate automatically, so you do not need the human intervention. If you inflate a balloon while the aortic valve is too open, that actually could do much more damage because now you are all of a sudden increasing the load immensely on the heart.

Nebeker:

Was it possible to detect the opening and closing of that valve?

Jaron:

Only through the EKG.

Nebeker:

What year was this that you were first using the device?

Jaron:

It was 1968. We had done maybe five or six or seven patients, and the word began to spread around and people started calling us. We got a call from the family of President Eisenhower to come with our device because he was hospitalized with a bad heart. His physician vetoed it; he did not want us to come. In an even more interesting instance, a physician on a trip to Sicily was hospitalized with a heart attack there, and he was deteriorating very quickly. His son, who was also a physician, knew of our work, and he called us and asked us to fly over to Sicily with our equipment and assist the heart. That was over Memorial weekend or something like that. At that time I did not have my American citizenship yet; I just did not see any reason to get it. What we did was to organize basically a small hospital and ship it to Sicily. I pulled out my Israeli passport and realized it had expired. So on Memorial Day, I flew to Chicago and I knocked on the door of the Embassy in the middle of a holiday and told them what was happening, and they renewed my passport. I flew back to Detroit and we packed everything. The son had a lot of influence with the Air Force, so he had the Air Force fly compressed helium to Sicily by special jet. We got on a plane in Detroit and flew to New York where he was meeting us and was taking us from there to Italy.

Nebeker:

Were you traveling with your equipment?

Jaron:

We were traveling with our equipment. I was the engineer and Kantrowitz was the physician. The son met us in New York, and he said, “You know something, my father is improving. So I am going to save the money.” So we turned around and flew back to Detroit. When we landed in Detroit, we got a telephone call that his father had died. It may have been a day later. Had we been there, we might have been able to save him.

Patents and commercialization

Nebeker:

How did the technique then spread? Did some company take up manufacturing?

Jaron:

That is right.

Nebeker:

Were you involved in that?

Jaron:

Actually, we tried to commercialize it through one company, and that company failed miserably in marketing it. There was another competitor who picked it up. The company that is selling most of the balloons right now is called Datascope in New Jersey.

Nebeker:

Did you and Kantrowitz have patents on it?

Jaron:

We had patents, but it is very easy to get around a patent.

Nebeker:

Did several companies develop it once it had been shown that this was an effective technique?

Jaron:

Several companies tried. Then various other companies bought them. It was sort of a chain reaction. But Datascope is really the major manufacturer of intra-aortic balloon pumps.

Nebeker:

This is widely used now?

Jaron:

Widely used, yes. Almost every hospital now has it.

Nebeker:

It must have been gratifying right out of your Ph.D. to do very important work like that.

Jaron:

It was very gratifying. I moved to Detroit in 1971 and then left in 1973. I went to the University of Rhode Island. I felt that I really wanted to go back to academia. I went to the University of Rhode Island where I joined the Electrical Engineering Department there.

University of Rhode Island

Biomedical engineering program, cardiovascular research

Nebeker:

Did they have a program in biomedical engineering?

Jaron:

They did not. I started the program. Basically they brought me in to start a program there that was an option of the electrical engineering program. They do not have a medical school there, so I started collaborating with medical schools and hospitals. The program started growing very substantially. I continued my research. I still worked together with Kantrowitz while I was there doing some simulation work.

Nebeker:

Still on the intra-aortic pump?

Jaron:

Yes. I was sort of switching my work, changing gradually to look at the cardiovascular system in general, trying to simulate the cardiovascular system, looking at how it functions in normal state and in disease.

Nebeker:

Sort of an engineering model of the cardiovascular system?

Jaron:

Yes. That is right. How blood flows and how the vessels react. I spent seven years there at the University of Rhode Island.

Nebeker:

Were there other faculty members who got into biomedical engineering?

Jaron:

Yes. We brought some faculty members in, and there were other faculty members there. The university was very supportive for a long time.

Nebeker:

You got quite a few students?

Jaron:

Yes, I had quite a few students.

Nebeker:

Your work in this period was the cardiovascular system?

Jaron:

Yes that is right, and has remained that way pretty much.

Nebeker:

How do you go about that work? Is it largely theoretical?

Jaron:

A lot of it is theoretical, and it was combined with animal experiments. I worked with Rhode Island Hospital, where we did tests on animals.

Nebeker:

Did you get some mathematical model that would allow you to predict what would happen under certain conditions?

Jaron:

Yes. We studied the various properties, but you cannot really study in a living system because of so many variables. If you can validate the model under certain conditions, you have the expectations that it would also work under other conditions, but you cannot really duplicate them in the laboratory. So you could predict various properties of the system.

Simulations

Nebeker:

You were trying to model healthy systems?

Jaron:

Healthy systems at the beginning, and then later on I started simulations. I am still working on that. This is not something that you do in a day or a year.

Nebeker:

Right. Is this something that was developed into some standard piece of software, some simulation package that others could look at?

Jaron:

I have quite a few simulation packages, and other people have used it. I will tell you in a second about it. I left the University of Rhode Island because I was offered to direct the Biomedical and Engineering and Science Institute, and I have been there since 1980. So I left the University of Rhode Island and I moved to Philadelphia and started working at Drexel University. I built up a very strong educational program there.

Drexel University

Biomedical engineering program growth

Nebeker:

What was at Drexel before you arrived?

Jaron:

Drexel had an institute before I arrived, and they had one of the earliest biomedical engineering programs in the country. It started in 1958 with a grant from the NIH. The purpose of that program was to take physicians and convert them into engineers. If I remember correctly, the first one was Dr. Dowd. It was not very successful because it is very difficult to take somebody who was not brought up in the engineering culture and try to get the person to think in that way. It really did not continue for very long as that kind of a program. It sort of limped along until 1980 when I came, and I really rebuilt that program.

Nebeker:

They had a couple of faculty members in biomedical engineering?

Jaron:

Until the early ‘70s, it was an option in electrical engineering. It was actually a program initially; it was not an institute. Then it was established as an interdisciplinary institute. I am not exactly sure what year that happened but it was sometime in the early ‘70s. Hun Sun was director of the program for a while, then Dick Beard was director for just a couple of years. Then it sort of went without a head for a couple of years until they recruited me.

Nebeker:

There were a couple of people on the faculty in that area when you arrived?

Jaron:

Yes, on the faculty of electrical engineering.

Nebeker:

So the institute was within the Electrical Engineering Department?

Jaron:

The program sort of followed Electrical Engineering, then it became an interdisciplinary institute and it was moved above or out of the Electrical Engineering Department and added other faculty members who were interested in it. Although there were really almost no other faculty members that participated in the teaching program, except from Electrical Engineering and Mechanical Engineering. When I came I started recruiting more faculty members. We did not have our own tenure slots. I was the only person who was appointed full time, but my tenure still resided in Electrical Engineering. We had a dozen or so faculty members who had either taught a little bit in the program or had some research interests in the program. I started building the graduate program. We did not have any undergraduate program. Within a fairly short time, maybe six or seven years, the number of our graduate students rose from the teens to about 120. The research funding that we were getting when I came was like $200,000 or $300,000 total for the institute, and we built it up to about two or three million dollars a year. It went very, very well.

Nebeker:

How long did you direct the institute?

Jaron:

In 1991 I decided I needed a sabbatical, and I went to the National Science Foundation for two years on leave. One of the first things that I did when I became director was hire two professors. We received a very large endowment called The Calhoun Endowment, named after Ernest Calhoun, that allowed us to hire one individual, and that was Jack Reid. I brought Jack Reid to the Institute. When we were searching for the individual, we came up with two final candidates, both of them were very good: Jack Reid and Vernon Newhouse. We went to the president and asked what should we do. The president said, “Bring them both aboard.” He came up with a named position for Vernon Newhouse, and Jack Reid became the Calhoun professor. After eleven years as director, in 1991 I went to the National Science Foundation, where I was the Director of the Division of Biological and Critical Systems in the Engineering Directorate. Jack Reid became the Acting Director while I was away.

Administrative roles; National Science Foundation sabbatical

Nebeker:

At NSF were you a program officer overseeing grants?

Jaron:

Division Director. I had ten programs under me. I was Division Director, not a program officer. Some of the programs that were under my direction were the Biomedical Engineering program, technology program, Biochemical Engineering program, Research to Aid Persons with Disability program, and I also had the Earthquake Engineering Research programs and the Environmental programs. Before I left, I convinced the Assistant Director for Engineering to create a new division, which became the Bioengineering in Environmental Systems, and all the earthquake programs moved to another division, because I just did not see how those were related to the rest of the division.

Nebeker:

Why did you want such a job? It sounds like full time administration.

Jaron:

It was.

Nebeker:

You were a researcher?

Jaron:

I was both a researcher and an administrator.

Nebeker:

I guess you had become more of an administrator at Drexel?

Jaron:

Yes, I did a lot of administration at Drexel. It was a major responsibility to manage the Institute. I just wanted to have some reprieve from the Drexel environment for a while, and I found it very, very interesting. It was very rewarding and I learned a great deal. I did a lot of good, too, at NSF. I had a lot of accomplishments there, not the least of them was to change the division which became Bioengineering and Environmental Systems, elevating bioengineering and making it much better known within the NSF.

Sabbatical at National Institutes of Health Biomedical Technology Program

Jaron:

I returned to Drexel in 1993 as head of the Institute again. Four years later, in 1996, I decided I needed another sabbatical, so I went on leave to the NIH. At the NIH I was in charge of the Biomedical Technology program at the National Center for Research Resources and Associate Director of the Center.

Nebeker:

Is this a very similar job to the NSF one?

Jaron:

No, it was quite different. It was also administrative.

Nebeker:

You are administering grants, is that right?

Jaron:

No. I was managing the overall program.

Nebeker:

You were managing the research at NIH ?

Jaron:

No, I did not do any research. Neither did I do any research at NSF. But at NIH, I also had people working for me who managed the grants that they awarded. It was similar in the terms of the responsibilities, but in terms of funding the program was five times as large as the NSF program. When I was Division Director at NSF, my whole division had maybe $40 or $45 million, but the Biomedical Engineering part of it had only like $20 million. At NIH, I was in charge of over $100 million, which was a lot more.

Nebeker:

And that is biomedical engineering?

Jaron:

It was called biomedical technology, but a lot of what we funded was biomedical engineering.

Biomedical engineering funding

Nebeker:

Give me some sense of where the funding is coming from in biomedical engineering generally. NIH must be one of the main players in this. NSF…

Jaron:

NSF is a very small player in biomedical engineering. The total funding of biomedical engineering by NSF is probably on the order of $25 million today.

Nebeker:

And NIH today?

Jaron:

NIH is very, very difficult to estimate. As a matter of fact, a study was done before I came there and we did another study again. If you take the definition of NIH for biomedical engineering, then NIH funded biomedical engineering research to the tune of about $400 million, roughly. But that may be a little bit exaggerated because of the way they count the money and the way they define what is biomedical engineering. Maybe if we could cut it by about 40% or so, I think a better figure may be about $250 to $300 million.

Nebeker:

Is there any estimate of how much industry is putting into biomedical engineering?

Jaron:

That is very, very difficult to estimate.

Nebeker:

What about the Whitaker Foundation?

Jaron:

The Whitaker Foundation is putting in a lot of money.

Nebeker:

Any estimate of how much?

Jaron:

I think this year they are talking about making grants in the amount of $60 or $70 million. That is a lot of money.

Nebeker:

I am just trying to get some rough idea. Are there any other major players or funders in biomedical engineering?

Jaron:

There are some other foundations that have funded a little bit. The Kellogg Foundation funded some biomedical engineering from time to time.

Nebeker:

There is certainly a good deal of university support for all these faculty positions. But the research typically is funded from outside.

Jaron:

Right. I suppose there are some hospitals that have funded biomedical engineering from the in clinical income, but this is diminishing because of the reimbursement system. The hospitals are pressed to make ends meet as it is, let alone to fund additional research.

NIH biomedical engineering conference

Nebeker:

Were you living in Washington or that area?

Jaron:

I commuted. I came back to Philadelphia on weekends. I had an apartment in Washington.

Nebeker:

How long did you work at NIH?

Jaron:

A little over two years. Again, I had some very major accomplishments, not the least one of them was to put together a major conference in biomedical engineering that really, I think, changed NIH’s view of biomedical engineering. Most of the people at NIH had never thought of biomedical engineering as a serious contributor to basic research in biology and medicine. They look at biomedical engineering sort of as a service profession—you tell biomedical engineering what you want to build and they build it for you. I think that having that major symposium in 1998 was really a major step for NIH.

Nebeker:

Was that in the Washington area?

Jaron:

It was in Bethesda.

Nebeker:

Did you bring in top people from around the world?

Jaron:

Top people. Some were from around the world but mostly from the United States. We ran all kinds of special sessions.

Nebeker:

To interest other people at NIH in this work?

Jaron:

To interest other people at NIH, and to make recommendations to NIH as to what needs to be done. As a result, NIH started looking at how applications are reviewed at NIH, and the fact that it is really difficult for biomedical engineering applications to get funded. They are changing that now, which is a very major change.

Debates on a proposed Institute for Bioimaging and Bioengineering

Jaron:

Of course, there is now legislation on the Hill to start a new institute. I do not think that legislation will make it, but this is the second year now in a row, and there is much more support in Congress for it right now.

Nebeker:

An institute for biomedical engineering?

Jaron:

It is called the Institute for Bioimaging and Bioengineering. The previous year there were two bills in Congress, one for an imaging institute and the other one for a biomedical engineering center.

Nebeker:

Did you advocate that there would be such an institute when you were at NIH?

Jaron:

Working for the government, you are not allowed to advocate anything like that. It is illegal. Once you are out of the government, you can advocate all you want. I was opposed to the Center because I think the Center is really not going to do very much. The way the name of the institute is being proposed is flawed because imaging is really part of biomedical engineering. The reason it was done that way is because imaging research has been advocated by the radiology community. The radiology community feels that they are not getting their fair share of grant support, and they are very, very strong and have a lot of money. Bioengineers are not very rich, so they do not have the same lobbying power that radiologists do. So the two committees agreed at least for a compromise, which generated much more support in Congress, but I still do not think it is going to fly because Varmus is opposed to this. But of course, Varmus is leaving NIH at the end of the year, so that may change things all together - who knows.

Radiology and biomedical engineering; professional societies

Nebeker:

Radiology is a well-established branch of medicine, and as you say, very large. What have been the relations between the two fields of radiology and biomedical engineering, academically and otherwise? Professionally are they completely separate?

Jaron:

I can tell you that you work very closely with radiology departments. It depends. In many institutions there is a close synergy between biomedical engineering and radiology—the two communities work very closely together and they benefit from each other. In some institutions that is not the case at all. You cannot make any generalizations.

Nebeker:

Radiology goes back to the turn of the century.

Jaron:

You have to think of it in terms of those who do research in radiology and those who just provide clinical service. The ones who just provide clinical service do not care where all the innovations come from, they do not care who thought of those ideas, they don’t care who first proposed the MRI or developed ultrasound, etc. This is all done by biomedical engineers. But as a clinician, you use the equipment and that is it. As a researcher, if you want to make advances in the field, you have to work together with engineers.

Nebeker:

Have the people who have been making advances in radiology technique been members of the IEEE EMBS for example?

Jaron:

Some of them, but not all of them. Ever since I was president of the EMBS I have pointed out the very serious problem that the EMBS focuses only on those professionals whose roots are in electrical engineering. Biomedical engineering has become much more than electrical engineering oriented. As a matter of fact, the majority of biomedical engineers right now do not even know what an electrical engineering circuit is, probably. There are many more mechanical, chemical, information, computer, materials… I predicted it ever since I became president of the society, and I have urged the society to move more and more in that direction. But it is very difficult to do. I think that there is some attempt to do something along these lines, but I just do not know how successful it is.

Nebeker:

It seems some of these areas like radiology, maybe ultrasound is another example, are so large that it is a little bit hard to keep those professionals in a more general society like the EMBS, when there are plenty of people in that more specific field to fill journals and conferences and so on.

Jaron:

Since you are talking about radiology, The Radiological Society of North America (RSNA) has probably 60,000 or 70,000 members, maybe not quite that many, but that is certainly the order of magnitude of participants in the RSNA meeting which takes place in Chicago every year. Within radiology, some of them specialize in ultrasound, some of them specialize in MRI. The ultrasound people have their own Society and the MRI have their own. But they all come to the RSNA meeting because that is where they see all the new things that are happening. I do not know why it is, but in general in engineering you do not see that. People look at their very narrow area and do not try to look at the bigger picture.

Nebeker:

I suppose that people who are in one type of imaging are more likely to be interested in other types of medical imaging, and therefore would be interested in going to a radiology conference that presents these different types. Whereas, biomedical engineering in general is so diverse that it may be difficult to attract people who do not care at all about prosthesis or wheelchairs, or these very different areas

Jaron:

I do not know; it is hard to say. I know radiologists who use only imaging technique. They converge on that one meeting even though at that meeting they will go into sessions in their particular imaging area. The meeting is so global and is so broad in nature that people want to come there.

Nebeker:

I suppose the rationale for having a society with a broader range is that the techniques can be transferred to some extent. There is some benefit to being a member, and seeing that in cardiology they are using ultrasound for this or they are using this sensor for that and maybe we can do a similar thing in neurology. A rationale is that there is transfer of techniques, and if you are an electrical engineer you can see how in this other area of biomedicine techniques are being used, and maybe that can be transferred into something that you are interested in.

Jaron:

I think that the same thing is true in engineering. You can listen to talks which are not necessarily in your area and get ideas that may be applicable to your own area.

Nebeker:

Right, so that is the rationale for having a large meeting.

Jaron:

Sure it is a rationale.

Nebeker:

As someone who has been president of EMBS, you must feel that there are things to be gained from being a member of a more general society rather than a very narrow specialty.

Jaron:

Yes. I think that you learn a great deal from what other people do and you come up with ideas you never thought could be applicable to your own specialty.

Professorship and research at Drexel

Nebeker:

We are well into the 1990s because we talked about your NIH tenure. And then you returned to Drexel after that. Are you head of the institute?

Jaron:

No. Banu Onoral is now. The Institute was converted into a school. The Institute was called the Biomedical Engineering and Science Institute, and the new school is called The School of Biomedical Engineering, Science, and Health Systems. Calhoun distinguished professor of engineering and medicine, so I am a professor now.

Nebeker:

Are you still doing research in cardiovascular science?

Jaron:

Yes, I am beginning to build up my research again. When I was with NIH I was able to do very little research. I had my last Ph.D. student finish just when I came back. During the years, in addition to looking at the cardiovascular system I did some research on cardiovascular responses to acceleration stress—G stress with pilots. I was working on developing a special protective suit that would give pilots more protection than the standard G suit that exists today. I have been expanding my research to look at gas transport in the recirculation and to integrate this information with my hemodynamic model.

Nebeker:

Where is the gas?

Jaron:

In the microcirculation. This is all done by simulation, modeling, and comparison with experiments.

Nebeker:

Is NASA or the Air Force interested in that?

Jaron:

The Navy funded it. The Navy has more airplanes that the Air Force. I did not know that until I started getting funding from them.

Changes in biomedical engineering as a field

Nebeker:

Any comments you care to make about biomedical engineering in general in this country?

Jaron:

Biomedical engineering in general is changing very rapidly and dramatically. It started as an extension of electrical engineering, but that is no longer the case. It is a discipline that has grown and has matured. It includes areas which relate to chemical engineering, mechanical engineering, and materials, and now it is looking not only at the overall system but more and more at the micro level and how to integrate the knowledge that we find at the micro level to the properties of the entire system. In the past we were looking just at what we could measure in a very gross fashion and try to understand it from that point of view. Right now we are looking at the molecular and cellular levels and trying to understand the whole system based on what is happening at these levels.

Nebeker:

There are also the new capabilities of acting at that level using implantable devices and microelectronics.

Jaron:

Correct. We are entering a new era. When we finish sequencing the genome, we will begin to understand how the genes relate to proteins and how they relate to cell function, how the cells behave, how tissues behave, and finally how whole organs and the organism behaves. I think the only people that will really be able to piece that picture together are biomedical engineers. The way scientists study something is by what is called the reductionist approach. They break a system down into its smallest components and concentrate on the very small components. Engineers try to integrate. Biomedical engineers who understand the living system should be able to integrate all those functions and begin to understand how the whole system works.

Nebeker:

Right. The engineer is typically concerned with an overall performance and how that is achieved.

Jaron:

Up to now we did not know how the components behaved. We are now beginning to understand how some of the components of the system behave. Knowing how the components behave is not necessarily going to tell you how the whole system behaves because of nonlinearities, because of chaos, because of other factors that enter into play. Scientists, biologists, or chemists, or what have you, are not really trained to be able to put all of those components together into a coherent system.

The future of cardiovascular modeling

Nebeker:

What is the prospect right now in your own area of cardiovascular modeling of getting a satisfactory model of it that works under a wide range of conditions?

Jaron:

The prospects are very good. There are some people who are actually now putting together a mechanical and electrical model of the heart, and they are able to explain a great deal and predict behavior, and then suggest drug therapy.

Nebeker:

These models actually incorporate how chemical effects occur?

Jaron:

That is right, exactly.

Nebeker:

In the history of physics, there have been certain areas where physics adequately explained what was going on. One could take billiard balls or something like that and predict if you have a ball moving at this speed and this arrangement what is going to happen. Do you think that with cardiovascular modeling we are getting close to that kind of understanding?

Jaron:

At a certain level. But I think that in order to make sense of all the information that we are gaining right now from biological research, we will have to have much more extensive modeling and simulation.

Nebeker:

It is the integration of all these many components and effects and so on in a very complex system that the engineers are particularly good at.

Jaron:

Precisely. I think that is where the engineering is going to play an even more important role than it has played in the past.

Nebeker:

Anything else that you would care to comment on?

Jaron:

I had lots of things to say, but I am sort of running out of steam.

Nebeker:

Thank you for the interview.