Oral-History:Earl Bakken

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About Earl Bakken

About the Interview

Earl Bakken: An Interview Conducted by Frederik Nebeker, IEEE History Center, 22 June 2007

Interview #472 for the IEEE History Center, The Institute of Electrical and Electronics Engineers, Inc. and Rutgers, The State University of New Jersey

Copyright Statement

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Request for permission to quote for publication should be addressed to the IEEE History Center Oral History Program, Rutgers - the State University, 39 Union Street, New Brunswick, NJ 08901-8538 USA. It should include identification of the specific passages to be quoted, anticipated use of the passages, and identification of the user.
It is recommended that this oral history be cited as follows:

Earl Bakken, an oral history conducted in 2007 by Frederik Nebeker, IEEE History Center, Rutgers University, New Brunswick, NJ, USA.

Interview

Interview: Earl Bakken
Interviewer: Frederik Nebeker
Date: 22 June 2007
Place: Medtronic, Minneapolis, MN

Medtronic’s Mission

Nebeker:

I think individual cases like that reach people more than the general idea of it; it is good to learn of that kind of success, of the Bakken Library and Museum.

Bakken:

Well, we have an astronomy center on the Big Island. It’s a marvelous center.

Nebeker:

You still have a roll-top.

Bakken:

I have an affinity for roll-top desks.

Bakken:

These are some of the emblems that I give out. For every new employee we do a mission and medallion ceremony with them, and we have 38,000 employees now. I’m doing the same thing at the hospital in Hawaii. But I only have twelve at a time there. When it’s here at Medtronic it’s about 250. I tell the story of how we got started. Of course, we have tapes or DVDs that I use over and over. But then we get into why we developed the mission and we get everybody knowing the mission, and our CEO comes and tells what the board and the Medtronic Leaders think of the mission and how they use it in their work. And then we get everybody at every level of the company to think of the mission and to live by the mission.

Nebeker:

So that it actually means something. There are so many companies that have a mission statement and it doesn’t mean anything.

Bakken:

It doesn’t mean much. But here it means everything. So we want them, at all levels of the company to walk the talk. You know your talk talks and your walk talks, but your walk talks more than your talk talks.

Nebeker:

That’s well put.

Bakken:

Because it’s how you act that people go by, not by what you say.

Nebeker:

As you said down in the studio, when the top management exemplifies that behavior, that does a lot.

Bakken:

Yes. It’s the only way that it really goes through. I normally also wear my hook, my Hawaiian hook that indicates me as an Ali`i Nui, a high chief amongst the Hawaiians. It was given to me by four of the top Hawaiian leaders. I’ve gone so far beyond electronics and electricity. In Hawaii it’s all cultural. I go to the “talk story” that Danny Akaka, the son of Senator Akaka, puts on at the height of the full moon each month at the Mauna Lani Hotel. They tell Hawaiian history and they have musicians from the past. Ladies get up from the audience, kids get up from the audience, and do hulas. It’s really a very fascinating thing.

But badges are important. If I wear my badge nobody else complains about wearing a badge. Everybody in the company carries the mission statement with them, in their billfold or purse. They know that if I test them I want to see them pull out the mission statement. But they get this to have at their home or on their desk.

Association with IEEE

Nebeker:

Yes. Thank you for that. I wanted to ask you, first, about your long association with the IEEE.

Bakken:

We have a lot of members of IEEE here, in the company. There are 7,000 engineers. Do you know how many belong to IEEE?

Nebeker:

I bet a lot of them do. I know the Twin Cities section is active. In fact, David Rhees has had contact with them at the Bakken.

You joined in 1948, you were named a Fellow in 1974, a Life-Fellow in 1990, and I know you’ve had a lot of associationships, have won awards, and your cardiac pacemaker has been named an IEEE Electrical Engineering Milestone. Could you tell us what IEEE has meant to you; its conferences, meetings, publications, standards and so on, through your career?

Bakken:

The IEEE has meant a lot to me over the years. From the time I was young I wanted to be the member of the Institute of Electronics and Electrical Engineers. If nothing else, it’s a thrill to have made it into engineering and to be a member of a national organization of electrical and electronic engineers. That’s a big pleasure in itself. I love the publications. I used to read them; now I transfer them to others a lot. But I think it’s so important that the electrical engineers are represented well and that they retain a history of their profession. It’s important that young engineers and doctors don’t start out on a new project without reading the history, looking up the past. Because they start out and they do something that’s been done thirty or forty years ago, probably better, and they get socked at the next show where they give a paper and someone says, “Oh, we did that twenty years ago and we got different results.” I know that one of Otto Schmidt’s great pleasures was to ask a newcomer a question about what they were talking about, because he knew more about it than they did. He could always buffalo them into being embarrassed by the fact that they didn’t look at history. They didn’t look at the past and learn from the past. I keep thinking, it’s so important for a new engineer, working with a doctor, to look at the past and build on the past, not to ignore the past.

Nebeker:

Within IEEE, the society that is most concerned with your area of work is the Engineering and Medicine Biology Society, which began as a Professional Group on Medical Electronics. You’ve been a member for a long time. Can you say anything about that organization, EMBS?

Early Interest in Medical Equipment

Bakken:

I’m very interested in the organization of medical engineering, medical electronics, because that’s what I got into. When I was in school at the University of Minnesota, my wife was a medical technologist at Abbott Northwestern Hospital. That was in 1948 and 1949. It was just after World War II and electronics had started to move into hospital equipment. Hospital people didn’t have engineers that could prepare colorimeters or flame photometers, or some of the more complicated vacuum tube equipment. I used to pick her up after work, and they would say, “Earl, could you fix this device for us?”.

Nebeker:

And that was because your wife was involved.

Bakken:

Because my wife was involved. I worked on blood shakers and centrifuges and all sorts of electronic or electrical devices. That’s what got me interested in that. I went to graduate school and I got into Advanced Thermodynamics, against a lot of students from the Physics Department. I was a poor little electrical engineer. I didn’t know anything about thermodynamics. I said, “boy, I’d better do something different.” So, one evening at a birthday party, a brother-in-law and I said maybe there’s a business in repairing medical electronic equipment. At that time, hospitals were bringing this equipment to radio shops to try to get it repaired. Radio shops were not much good at doing quality work on medical equipment, on EKG machines and amplifiers, and so forth. So we decided to start a business in repairing medical electronic equipment.

Medtronic

Nebeker:

I was impressed with the name—Medtronic--that you and your partner came up with at the very beginning. Do you remember a discussion about what the company should be named?

Bakken:

Yes. I remember about the name Medtronic. It was interesting. Most of my thoughts come just before I go to sleep and I keep a pad by my bed and I carry an astronaut’s pen so I can write over my head without getting awakened too much. I was thinking of a name for our company. We were working in the medical field and they were electronic devices. The med, from medical and tronic from the electronic, and I said, gee, that would be an interesting name, just to call it Medtronic. That was in 1949. We tried to register that name, but a company in California that had registered their name, Meditron, in 1948, prevented us from registering ours. They said it would be too much competition with what they were trying to do. They were making electroencephalographs. We argued with them in the courts for several years and finally, we grew and they didn’t grow particularly. Finally, we bought that company in California, closed them up, and registered our name. Now we have to fight our name legally time after time when someone comes up with using med and then putting the tronic in slanted letters or something. We want to protect it. It’s a good name in the field so we have to protect it in every way we can.

Origins of the Pacemaker

Nebeker:

As you say, you started out as a repairer of medical electronics. Can you tell us how you got into designing the pacemaker.

Bakken:

We just set up a repair service and we were repairing every kind of thing that was brought to us. And it began that so often, someone would ask, “Isn’t there some way we could modify this piece of equipment to do a little different process?” We started in 1949, and in 1950 we started selling for the Sanborn Company. You certainly remember the Sanborn Company that sold out to Hewlett-Packard. We were selling single-channel recorders and dual-channel recorders and their four-channel recorder. That’s what made our connections to various organizations. They would want a piece of Sanborn recording equipment, but they’d want an amplifier that did something different. Then instead of being just an amplifier, they’d like an integrator. Back then it took a whole row of vacuum tubes to do integration. Now you can do it in a chip. We built integrators and things that were special, or modifications, so that they could do special kinds of research work. We would get involved with the physicians, and the physicians would like that we understood electronics, to help them.

Back then, the doctors weren’t computer nuts like they are now and they didn’t know much about electronics, so they wanted someone to help them. Dr. Lillehei, at the University of Minnesota, was one of those doctors who wanted help. He had purchased some four-channel Sanborn recorders and he wanted them to run correctly. He wanted the pressure gage he was using for monitoring patients’ blood flow, or blood pressure, to be accurately calibrated. He wanted someone in electronics to be in the lab with him. He tried getting the engineer at the University of Minnesota to come into the lab and that didn’t work. He knew of me, and asked if I would come into the lab or go into surgery and keep these machines going. I said, sure, I’ll do that. I was the only engineer who would go into all this blood and mess. But I was trying to keep enough money coming in to keep the company going. So we just did that. I would go into surgery with him. In 1954 he came up with the idea of doing open-heart surgery on blue babies, babies who have an interventricular septal defect, some of them at birth. When they get the blood flowing between the ventricles the blood that gets pumped around the baby is bluish, it has a bluish tinge to it, and so they were called “blue babies”. They would all die before they’d reach their teen age years. His thought was to open up the right ventricle and go in through the right ventricle and sew a plastic patch over the hole, the septum, and then close it up and start blood flowing again.

But back then they didn’t have oxygenators, so they had to use a parent or an older brother or sister that had the same blood type as the infant that we were working on, and would flow the blood through the parent and the parent would become the pump oxygenator. Lillehei pointed out that there was a chance of 200% mortality if things didn’t go right. So he had everything very carefully controlled to keep bubbles out of the system and keep measuring both the mother or father and the child.

Nebeker:

It was all your monitoring equipment?

Bakken:

All our monitoring equipment that we had sold them, the Sanborn equipment. And we sold them paper and pens, so it was good business. And then they found that when they sewed a patch over this hole, the heart’s conductive system ran right along the edge of the hole. They would often traumatize the conduction system and—in at least 20% of the patients--the system conducting the signal from the atrium to the ventricle would stop working, at least temporarily. The baby would come out of surgery with a good mechanical repair but would have heart block, and would usually die within a day or two because their heart rate was 40 or 50 instead of 120. Lillehei wanted to do something about this. At one of their surgical meetings there was a Dr. Johnson from the Physiology Department. In Physiology they used a lot of Grass Stimulators. A Grass Stimulator has three knobs; one for duration, one for amplitude, one for frequency; it is an AC operated stimulator. Dr. Johnson said he had used this on animals and it triggered the heart. He said, “Why don’t you try it on the babies?” So they tried it on the babies and it worked. It kept the heart beating at 100 or 120 and the kids recovered in a few days and could be weaned from the pacemaker. But the Grass Stimulator is AC-powered. You have to keep it plugged into an AC system. Then Dr. Lillehei asked us if we could make a portable pacemaker.

Nebeker:

Was it called a pacemaker then?

Bakken:

Yes it was. Pacemakers had been constructed before. We have some at the museum from 1850 when they’d use a simple system. In 1930 a doctor came up with a method of using a 78-RPM turntable, and every time it passed a magnet it put out a stimulus. So you’d get 78 pulses per minute, which became a nice rate for pacemakers. But everybody thought he was a nut and condemned him for doing this to the human heart. But we did it. My thinking for Walt Lillehei was that we would put an electrodyne external pacemaker, which put out 150 volts, on the top shelf of a cart. On the lower shelf of the cart we would have a battery—they were six-volt batteries back then—with an inverter to change it to 115 volts. We would also have a charger there to keep the battery charged. I said we can do this in a week--just buy these pieces and put it together. He was concerned about getting it separate from the AC system because there was a major power failure in 1957 and one baby on an AC-powered stimulator died. And the electrodyne was AC-powered.

But I said that making it portable so it didn’t have to be plugged in would make it easier going on elevators. We wouldn’t have to drop an extension cord down the elevator, or have cords down the hall, and pull it out on one end and plug it in, immediately, at the other end. But he wanted something that would work that way and we said it was very possible. I went back to my garage but I didn’t know anything about transistors because my training was all during vacuum tubes. I knew how to design anything with vacuum tubes—but I couldn’t make something really small or efficient. I’d heard of these transistors that had been invented just a couple of years before, and that you could make something small, but I didn’t know how to design a transistor circuit. So I looked in a Popular Electronics magazine, which had just come out in 1956, and there was a circuit in there for a metronome, a two-transistor circuit, a blocking oscillator, and amplifier. I looked up that circuit and plagiarized it, because a metronome is exactly the same as heart rate, and it’s putting out pulses. It was just the perfect circuit for a pacemaker. I put it all in a box and brought it over. This is a copy of the original pacemaker that was made in December of 1957. It’s now fifty years since this was taken and I built it just as a test instrument. I wanted it used on dogs to see how it would work. I brought it over to the hospital one day, and the next day they were using this pacemaker attached to a child.

Nebeker:

How did you feel?

Bakken:

You have strange emotions. I thought, what a wonderful thing we’ve done. We’ve built this thing with our hands; we’re keeping this child alive. Then you ask, well is it good enough to keep the child alive, is it reliable? So you immediately have a lot of reaction. But the idea of keeping a child alive for two days or more, until their conduction system recovers, felt good. So I said let’s stick with that, do that with our company, and start manufacturing.

Nebeker:

Would this have been possible before transistors?

Bakken:

I don’t think the vacuum tubes were small enough and they had a filament, so you had to heat the filament in some way and you just couldn’t make them small enough or reliable enough. So we were lucky to use the transistors and we had to start trying to learn how transistor circuits work. Now, the copy of this circuit is on a wall over at the University of Minnesota, but I’m sorry the circuit came out of Popular Electronics, not an IEEE journal. But they had all sorts of simple circuits in there. That was about two years after Texas Instruments had shown the first transistor radios.

Nebeker:

I know the transistor was just getting manufactured in the early mid 1950s—so a very early transistorized device.

Bakken:

Yes. And this of course didn’t work too well with kids because the kids would start playing with the knobs or they’d turn it off. We had to quickly change it to something that had the knobs recessed so that little fingers couldn’t get in there and change the settings. And then we had to make it difficult to turn on or off. A nurse could push in the off button--to see if the person was pacing on their own--and just release it to start pacing again. They could then slide a slide over it to hold it off. Then in St. Paul in 1958 a doctor by the name of Sam Hunter used one on an adult patient who had heart block. That was really the beginning of pacing, and it’s fifty years ago.

Nebeker:

Did you realize at the beginning that this might be a very widely used device?

Bakken:

No.

Nebeker:

You thought it was this special purpose for these blue babies?

Bakken:

Yes. We thought it was pretty limited because it was just another special we had made for the university to do something they weren’t capable of doing. And that’s all we thought it was--a special. But by 1960 we started to sell quite a few of them for temporary use post-surgically on patients because others began to repeat Walt Lillehei’s work. And we got deeper and deeper into debt and that’s when the board said you’ve got to put down on paper exactly what you want to do in your business, and we think we can raise a little bit more money to keep you afloat. So that’s when I wrote the mission for the company. Back in 1960 missions weren’t a big thing. Companies didn’t write missions for their work. But we wrote the mission statement and that’s what stuck with us, ever since 1960.

Spread of Pacemaker Use

Nebeker:

You said it was in 1958 that this doctor in St. Paul used it for adult heart block?

Bakken:

Yes.

Nebeker:

How quickly did the pacemaker move into more general medical use?

Bakken:

Well it moved pretty fast because there were so many in heart block and Dr. Hyman in 1929 and 1930 had been condemned for producing his pacemaker with a phonograph motor. And yet, in 1960 we were able to sell more. It wasn’t condemned in such a way because it wasn’t a big apparatus like Hyman had. We began to sell quite a few but it cost us more to make them. We had priced them before and didn’t know much about pricing and so forth.

Nebeker:

How big was the company at that point?

Bakken:

Well, we were up to probably $200,000 or $300,000 a year.

Nebeker:

And how many employees?

Bakken:

Probably about five or six, maybe seven employees, building pacemakers and doing repair work. But we had to stop doing a lot of the repair work because we were losing more money. Our idea was--when this is external, you have a wire in through the wall to the heart, and you have oozing around the wire, and you worry about infection. Even though several thousand were used it was always a problem. Every thirty days or so they’d have to change the battery; so you’d begin to think, isn’t there some way of putting it in the body? Isn’t that possible? And then we heard from Greatbatch in Buffalo.

Nebeker:

Wilson Greatbatch?

Bakken:

He said he would like to use our leads which we had developed for use with this pacemaker because they seemed to last for a while. It was the way that Hunter put it in, to run it in at the top of the heart and down the heart, so that the flexing wasn’t very much on the wire. So we got together with Greatbatch and Dr. Chardack, whom he was connected with, and we signed a contract in the airport during a snowstorm, that we would work together on developing the implantable. I have one of the implantables here. This is one of the first implantable Chardack-Greatbatch pacemakers. We had a pigtail on it that was buried separately. You could get at the two wires that went to the heart to measure the output of the pacemaker, and you could measure cardiac impedance and the current that was sent; there’s a resistor in here to use. You could measure the current going to the heart and you could short out the resistor to increase the output. So this was a programmer, not a very complex programmer, but you could shut it off by shorting the wires together if it was running away. So you had a lot of programming you could do separately and not get the infection into the pocket where the main pacemaker was.

Nebeker:

And you signed an agreement with Chardack-Greatbatch to manufacture the implantable?

Bakken:

Yes. This has their name on it, Chardack-Greatbatch.

Nebeker:

How did that business grow?

Bakken:

Well, it grew rapidly. Chardack was kind of a bashful person but he was very loud about talking about the pacemaker and what he was doing. He gave ideas to other people and there were a lot of objections to putting something in the body. Some of the major religious groups said it was not proper to put something in God’s temple and you shouldn’t do that. But people started ordering them and the market started growing. And we still were not being very successful, financially. The Mallory Battery Company offered to buy us. We had issued some stock at a $1.50 a share and they offered $3.00 a share to buy us. We were willing to sell because we wanted to get out of the problem we were in. They had a study done by the I.D. Little Company, and they said there would never be much market for pacemakers, that 10,000 would be the all-time world market. So the Mallory Battery Company backed out of the deal.

Nebeker:

Can you tell us what the world market turned out to be for pacemakers?

Bakken:

It’s now well over 10,000 a month and growing. It’s interesting that the pacing market has been there fifty years and it’s still growing. You can hardly think any other device that has a market—but then pacemakers are getting more complicated.

Nebeker:

And getting more sophisticated.

Bakken:

And getting more sophisticated, and smaller, and they’re super-computers now. I think I’ve got a little one here, someplace. I’ve got a little one that the engineers made a good deal on. It has the mission statement engraved on the back. And this is now used in kids, the Minix. We were just at a party last night where they were talking about how one of their children had been paced since she was born. She was heart blocked before being born. She’s a year-and-a-half old now and just going wild, just very excited, but living on a pacemaker.

I don’t know whether you can see that, but on the back here, they engraved the mission statement.

Nebeker:

Yes. Remarkable.

Bakken:

Engineers know how to get my attention by putting the mission statement on something. They know how to get my positive feeling about what they’re doing.

Neural Engineering Conference

Nebeker:

Yes. I know you attended part of the EMBS Neural Engineering Conference, in Hawaii. What was it that interested you there?

Bakken:

Well of course, I’m interested in anything connected with the brain or heart. I’m trying to promote blended medicine, which is another invention, but I’m not sure you’d call it an electrical invention. It’s a different kind of medicine that combines high technology and high touch with human caring, and acupuncture, and massage therapy, and guided imagery, and chiropractic and all of that. And then the environment has to be a healing environment. Most hospitals are warehouses for sick bodies. So what I’ve promoted there that’s starting to move around the world is blended medicine. One hospital in South Minneapolis and another in Woodbury use blended medicine. Some of the bigger hospitals are coming along. We’re trying to get Cleveland Clinic into blended medicine because we have a Bakken Heart-Brain Center at the Cleveland Clinic. If you can imagine-our little hospital out in the Pacific is connected to Cleveland Clinic, the top clinic in the country for heart disease. But we have a lot of good times working with them in the Heart-Brain Institute there.

Nebeker:

That may relate to another thing I wanted to ask you about. The EMBS will hold its 31st annual conference here in Minneapolis in 2009. What do you think will be important topics at that conference?

Bakken:

I think we will be further along in developing the role of the mind, not the brain, but the role of the mind. The mind is only partially in the brain, and is partially in the heart, and it’s partially in the gut and it surrounds our body. The mind is also in the cosmos, that’s how we connect together on some of these energy medicines. I have ten points that I am trying to get doctors to go into beyond blended medicine. It’s ten points of chronobiology of frequency that we go through--circadian rhythms, weekly rhythms, 28-day rhythms, annual rhythms, 1.3-year rhythms--and then all of the Reiki and extra ways of healing the body for blended medicine. So I’m only trying to change the medical profession again. I changed it in going into devices, implantable devices. Now we implant a device at Medtronic every five seconds; someplace in the world, one is being used. But they’re for pain, for depression, for brain implants. We have something like 70,000 or 80,000 Parkinson’s patients that have been relieved of their tremor. We have tons of patients who receive pain relief. And then we have an implantable pump so that we can pump in fluids that need to be used slowly, like for dystonia or contractions of cerebral palsy. We can release all those in so many ways because the body is an electrical machine and most of the problems are defects in electronic systems, so they can be substituted for by implantable devices. Right now nobody thinks anything of putting something in the body. I have a pacemaker and I have an insulin pump and I often wear an automatic recorder of insulin, and then I have two stents in my heart. That’s why I’m on Plavix, to keep the blood flowing through. It’s amazing what we can do now in implanting in the body, but it started with the pacemaker.

Early Inspirations

Nebeker:

How was the story of Frankenstein an inspiration to get into the field that you’re in?

Bakken:

Well, Frankenstein was what really turned me on as a nine-year-old--all the flashing of lightning. But the story of restoring life to a body out of stolen body parts was very fascinating. So as I went through the years afterwards, I said I wanted to be an electrical engineer; I want to play with lightning like that. And of course I have. When I went to school, high-voltage electricity was my worse subject. I got Ds on transformers, big transformers. But I did great on electronics and micro-miniatures. But the Frankenstein story stuck with me. Before I went through Confirmation I made things like a taser, to keep the bullies away because I was a nerd. It had a Ford spark coil and got 20,000 volts out of it. I made a robot that wielded a knife and smoked cigarettes and all sorts of things that were not the healthiest things. My minister said, “You shouldn’t be doing some of those things. You should somehow find a way of using electricity to help people.” So that’s what stuck with me since Confirmation--to use electricity to help people in some definite way. And that fit in so well with what we did with pacemakers and then every other electronic device that we now make; using electricity to restore health to millions of people.

Just a couple of evenings ago I was talking to a group, and a man in a wheelchair came up and he said, “Your company helped me get through college.” He said he had legs that were twisted, and that he had a pump put in to put fluid into his system, mainly into the brain, to stop the deformity of his legs. He said he never would have gone through college if it hadn’t been for our pump. He had tears in his eyes. The other people there in the company had never heard that story before--that Medtronic had helped him. But we help a lot of people that have contractions or distortions of their body, dystonia, of course, depression. We now are putting in brain stimulators for depression and it’s interesting, you can control the depression and their memory comes back. Every memory they’d lost suddenly comes back. It’s just amazing and we’re understanding better and better, how we stimulate single cells and what the reactions are going to be.

Nebeker:

I think you’ve eloquently argued why young people might want to get into engineering, not because the technology is exciting, per se, but because it could mean so much to everyone.

Bakken:

Yes. It’s so fulfilling. Everyday someone is coming up to me and thanking me for saving their life or their uncle or their grandparent or their child. I didn’t do it, you know, it’s the employees that did that, and 7,000 engineers that we have working here. So it’s a very fulfilling career to be in. I can’t think of any better.

Nebeker:

Thank you for your time to do this interview.