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Luxury Week

The 'Maserati of Microprocessor Prosthetics' Costs $120,000

The luxury of being whole.

Ian Birnbaum

Image: Ottobock.

"Every neighborhood has a kid who gets hurt doing something stupid, and I was that kid," Andrew Carter said. Carter, who is now a music attorney for major film studio in Los Angeles, was 14 when he snuck into an abandoned steel mill. For Pittsburgh kids in the '80s, the rusting corpses of industrial sites were everywhere. The opportunity and danger of a little trespassing was irresistible.

Carter climbed an electrical tower and ended up touching a live wire. "It should have killed me, but didn't. I got off fairly easy," he said. Carter lost his left hand about three inches above the wrist and suffered various burns. He started wearing prosthetic hands as a teenager.

Prosthetic technology has come a long way since hooked hands and peg-legs, but prosthetics have always advanced in fits and starts. Prosthetic technology enjoys a grim boom following a war, and the decade-long conflict in Iraq and Afghanistan are no exception. Modern military forces enjoy better armor and medical care than any other army in history, so more critically injured soldiers are surviving and coming home as amputees.

Image: Ottobock.

One of the largest creators of prosthetic technology is Ottobock, a German company originally founded in 1919 to care for World War 1 veterans. Even the simplest modern prosthetic costs north of $10,000—not including the price of custom fitting and physical therapy patients need to learn or relearn how to use their newly augmented bodies. Rod McCrimmon, the director of marketing for Ottobock North America, said that prices vary wildly between models, makers, and insurance policies.

"The least expensive thing to do is to do nothing, and many people do," McCrimmon said. For upper-limb amputees, this means pinning up shirt-sleeves and learning to dress, cook, and drive one-handed. For lower-limb amputees, the cheapest answer is a wheelchair and a sedentary existence. "It really affects their quality of life."

After a mechanical or pneumatic limb, prices jump when electronics and operating systems get involved. For prices between $40,000 and $60,000, popular prosthetics like the C-Leg are the closest thing to a human leg amputees have ever had access to.

Image: Ottobock.

"If you're able to walk more safely and move about more easily, you're going to be safer," McCrimmon says. "Less falls, less injuries." What a patient gets out of a higher-end prosthetic depends on their goals and their previous health. Sometimes people just want freedom of movement and independence. Sometimes they go further. "It's can be a wake-up call or a second chance at life. We see folks doing things they never would have done before, like wakeboarding, you know—extreme sports."

The highest of high-end prosthetics right now is the Genium X3 knee, "the Maserati of microprocessor prosthetics," according to McCrimmon. Ottobock developed the X3 with the Department of Defense, hoping to let soldiers with lower-limb amputations return to active duty. It's waterproof, dust proof, saltwater resistant, and it runs silently. The X3's estimated cost is around $120,000.

When I asked McCrimmon if a $120,000 computer-controlled leg could be a luxury, he seemed to balk: these devices are necessities, not luxuries. "There were some policy makers commenting on the pricing," McCrimmon recalled. "The person being interviewed said, 'It's my leg! What price do you put on your leg?' It was a sobering conversation. It provides people a shot at returning to the life they want to live. How do you put a price on that?"


For upper-limb amputees, the Michelangelo electronic hand is as good as it gets. For a ballpark price in the neighborhood of $60,000, the Michelangelo features a lightweight main drive, natural gripping patterns, and a soft-touch outer skin. Carter was the first person on the West Coast to get one.

"On the drive home with it, I was blown away with how fast and strong it was," Carter says. He stopped at a Babies R Us and bought stacking cups and plastic gripping toys. For a few minutes every hour, he taught himself how to use his new state-of-the-art hand. "It's the closest thing to a second hand I've experienced since I had two hands."

The Michelangelo is useful, but it also looks more realistic than older prosthetics. Ottobock has a team of artists who paint prosthetics using high-res images and scans of patients' bodies. More than anything, many amputees want to blend in, to avoid what Carter calls "the second look."

"The market is bifurcating," McCrimmon says. "There are still a lot of people who want the realistic look and want to fit in... Then there are some—men, in particular—who are interested in the Terminator look. They show off the machinery."

Image: Ottobock.

A cottage industry of prosthetic decorators offer carbon fiber prosthetic covers, and tattoo artists will switch from needle to brush to permanently ink up an amputee's new limb. Refusing to blend in and look "normal" is a defiant statement, a self-expressive luxury that amputees revel in.

"Oh, yeah," Carter says. "I definitely get it. This isn't an industry where I can go and collect prosthetics like Billy Gibbons from ZZ Top collects guitars. It would be nice to have one with a carbon fiber, Terminator look. I could wear it when I go out to a Slayer concert. That would be fantastic. I think that is a very empowering thing."

Carter is a big fan of body art, but he always stopped his tattoos at the elbow. After getting the Michelangelo, Carter decided to extend his ink down to the end of his residual limb. He got the tattoos, then had the prosthesis and socket handpainted to match exactly with the tattoos.

"I have a long-standing obsession with symmetry," Carter laughs. "Not quite to the level that Stanley Kubrick does, but still… I've gone through gates at the airport, I've had TSA guys look straight at my arm and compliment my tattoos—and then they realize that it's a prosthetic. It's pretty seamless."

Image: Ottobock.

When I ask Carter if his new hand could be luxurious, he seems more open to the idea than McCrimmon had been. "Not in the same way," Carter says. "A luxury sports car is a really nice thing, but I'd be using it to drive back and forth to work and nothing else. This is far more vital to my day-to-day existence. It is certainly a luxury—if you were to line up every other upper-limb amputee on the planet and compare it to the prosthesis they have, if any…" he trails off.

"I think that luxury isn't even the right word at this point. It's the best device that is commercially available, but it's become something that I rely on so heavily that I can't see it those terms. In some ways it is [a luxury], I just have a hard time seeing that."

There's a kind of luxury that means diamond-studded eye-glasses, private jets, and $50,000 handbags. Then there's the other kind: the privilege of taking something for granted when less fortunate people would kill for a chance at what you call "normal." In developed economies, luxury is air conditioning, clean water, and supermarkets. For the able-bodied, luxury is waking up every day with two hands, two feet, and enough fingers to hold a pen.

"I work at a place that has excellent health care for its employees," Carter says. "I have an excellent doctor who works with the insurance company. I have excellent prosthetists. I have all of that back-up." Over the phone, I hear an electric motor whir and a servo click. Carter is moving his hand. "It's easy for me to sit here in Los Angeles and say I have a hard time thinking of it as a luxury, but I'll tell you what: the vast majority of the world would."

Luxury Week is a series about our evolving views of what constitutes luxury. Follow along here.

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