Why Are Prosthetics So Expensive and Inaccessible?

Two overworked-looking physical therapists started their presentation on what they called “challenging” patients. Photos of patients with missing limbs and dysfunctional appendages covered the screen. Most were athletes who required specialized sports equipment; some were heart-wrenching depictions of children with rare congenital conditions who needed custom braces.

The last patient was described as “particularly challenging” — a 20-something Black mother from a low-income, highly segregated neighborhood. Unfortunately, when the mother felt ill and had pain, she was unable to call in sick from work for fear of being fired. And, although she worked more than 40 hours per week, her time was divided among multiple part-time jobs, none of which offered health insurance as a benefit.

Unable to take time off or pay for care, she continued to work despite worsening symptoms. The woman had unknowingly experienced a miscarriage without delivering the fetus, which remained inside her body.

As weeks passed, the infection worsened to sepsis, which occurs when the body’s response to an infection damages its own tissues. By then, the infection had spread to her limbs, causing gangrene (when body tissue breaks down and dies). She ultimately collapsed. An ambulance took her to the hospital, where she arrived in critical condition. To save her life, the doctors amputated both her arms and legs.

The therapists described her as “difficult” because she wouldn’t stop crying after these life-altering procedures. They noted, in conclusion, that they had convinced her to relearn to feed herself by reminding her that she would still need to care for her child, who waited with relatives for her return. They considered this woman to be a health care success. Appalled, I considered this woman’s story to be a health care system catastrophe.

Hearing about her experience left me grieving. I cried for this woman and her family and the millions more similarly suffering. And I realized my efforts to build better body parts were insufficient to deliver the help I envisioned. At first, I became passive, rejecting good job offers and fully funded PhD programs. Soon, though, I reached a new stage of mourning: anger. I grew furious at the injustice of it all. If this was the best the US system could do, I would leave it and not return until I could engineer a better system.

I packed two suitcases and put my entire savings toward a flat in Milan to pursue a degree in health policy and economics that I thought would help me get to the root of this problem, and hopefully give me tools to do something about it. When the program was finished, my classmates and I were each tasked with spending six months in an internship, job, or project.

As companies lured students with promising jobs at places like the World Health Organization or with high-paying pharmaceutical positions in Paris, Geneva, and Dubai, I sought an opportunity to figure out why it was so hard to get quality prosthetic technology to the patients who needed it most.

I discovered an extraordinary professor at the Massachusetts Institute of Technology (MIT), Dr. Hugh Herr, who, as a person with amputation himself, shares this passion of mine. I begged him to let me work on an experimental project to transform the field. I swore to do the work under any conditions, I even told him that I would work for free. He must have sensed that I had about $27 to my name and insisted on paying me. Finally, after taking up residence in an affordable (but gross) fraternity-house apartment, I tried to figure out what the hell is going wrong in the world of prosthetics.

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