PREPRINT

THE

ROLE

OF THE AUDIO

ENGINEER

By
Dean A. DeMarre,
ScD.
Technical
Education
Research
Northeastern
University
Boston,
Massachusetts

PRESENTED
41st

AT

NO. 836

(C-6)

IN MEDICINE

Center

THE

CONVENTION

OCTOBER

5-B,

1971

AN AUDIO

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ENGINEERING

SOCIETY

PREPRINT

This preprint has been reproduced

from the author's
advance manuscript, without editing or corrections. For
this reason there may be changes should this paper be
published in the Audio Engineering Society Journal.
Additional preprints may be obtained by sending request and remittance to lhe Audio Engineering
Society
Room 929, 60 East 42nd Street, New York, N.Y. 10017.
C Copyright

1971 by the Audio

All

rights

Engineering

reserved

Society

The

Role

of

The Audio

Dean

A new

era

in medicine

forth under
neers.
New

and

A.

Engineer

DeMarre,

engineering

in Medicine

ScD.

is slowly

being

brought

the guidance
of farsighted
physicians
and
techniques
born of medicine
are reinforced

technology
not thought possible
even
it will lead no one will forecast.
This progress,
however,
requires
between
medicine
and engineers.
in the past,
future.

that

will

be

ten years

ago.

engiby
Where

a cooperative
spirit
A spirit never attained

difficult

to maintain

in

the

Complicating
this marriage
of medical
science
and engineering technology
is a mutual,
if separate,
history
of difficult
challenges
overcome
at great
personal
and professional costs.
Let us briefly
consider who the players
are
in the future of medicine.
The

Role

of

the

Physician

The physician
is shaded by the color of viewpoint
of the
observer.
To some he is God, to others the demigod -literal holder
of life and death over his fellow men.
Like all characterizations,
this one is false.
A doctor
is a man who, having
completed
a prescribed
program
and
passed prerequisite
exams,
is authorized
by his state and
fellow practitioners
to treat the sick and heal
the wounded.
But essentially
he is a man, another human being,
with his
own set of skills,
knowledge
and talent,
albeit
specialized,
that with experience
is honed
to an awareness,
a sensitivity,
a compassion
of and for his fellow man, unequaled
by any
other profession.
While at the time it seems that this
man, the physician,
is cold, demanding
and withdrawn,
we
must

consider

the pressures

that

he

works

under.

The medical
profession
is possibly
the most disciplined
of all of our professions.
The physician
is regulated
by
his fellow professionals,
state boards,
and specialty
boards.
On top of this sets the patient,
in some instances,
the most ruthless
of all his judges.

A slip, a thoughtless
moment,
or unforeseen
circumstance
and
all that the doctor has worked
for lies about him in ruins.
Malpractice,
or implied malpractice,
of medicine
over the last ten years
factor.
A malpractice
suit, won or

has
more
lost

driven
up the cost
than any other
by the claimant
is

always lost by the physician.

For even if he wins, he loses
patients
and his insurance
skyrockets.
If he loses once,
the judgments
against him can be so large that he will never
recover.

It

takes

only

one

$100,000

suit

to wipe

out

On top of the medical

legal problem
rests
medical
man holds within
our community.

the position

Whipped
by the self-righteous
and pompous,
ticians
and ignored
by the population
the
raise his voice in defense
or denial.

censored
physician

anyone.
the

by policannot

Thus, while we expect the physician

to work wonders
in our
behalf,
we in our misunderstanding
strike out in denial
of
the very tools required
for these cures.
In the final analysis
the physician
is the commander
of the
health delivery
team, be it large or small.
All of the
nurses,
paramedical
and allied health
technicians
work
in
support
of his treatment
of patients.
When the engineer
enters the hospital
his knowledge,
skill and talents must
be directed
toward
the intensification
of the physician's
ability
to heal.
The Role

of

the Engineer

The physician,
nized for what
with

the nurse.

even though misunderstood,

is at least recoghe is -- a healer.
The doctor is never confused
The engineer,

however,

is another

story.

In time of great need the engineer

is a genius
to be pampered
and protected.
When his services
are not needed
he is just
a technician.
Fortunately,
no matter what,
the engineer
survives, for a technically
based
society
cannot
survive
without them.
The image of the engineer held by the majority
of our population is that of an automan.
An individual
who is superior
in mathematics
and technique,
yet is somehow
deficient
in
human attributes.
The
boy is poor in English
and Mechanics.

old
and

logic still persists

that if a
History he must be good in Math

--2--

The average
individual
never quite gets the concept
that
our technical
people
are somewhat
more than literate.
The
average
engineer
also has an image of himself.
This self
image can be in many ways as false as the popular
view.
In the best of time he sees himself
as a builder,
semiscientist
and leader of his fellow man.
A more recent
new self-appraisal
brought
about by economics,
is less
flattering.
It is an image of a man cheated
of his just
rewards
-- somehow left to drift by his fickle society.
None

of

these

three

views

cast for the physician,

practice
and personality

are

are
of

valid.

They,

like

based in ignorance
engineers.

of

the
the

images
nature,

Engineers,
are like physicians
-- men.
Men who have passed
through a course
of study and endured
a structured,
if informal,
apprenticeship,
who finally
reach a professional
maturity
allowing
them to practice
both one of the oldest
and newest
professions.
The engineer
is a builder ', a communicator
and, in many respects, a guider of our destiny.
It is his lot to transform
dreams from his mind, or the minds of others
into real,
tangible
products.
It makes no difference
if the concept
is microminiature
as in integrated
circuit
design or
colossal
as in building
skyscrapers.
Engineers
use carefully
thought-out
procedures
and practices
to achieve
the stated goal -- construction
of a product.
Engineers
often confuse
themselves
with scientists
because
they use many of the same tools as the scientist
uses.
In many instances
engineering
research
is quite like scientific research.
In other cases,
it is quite different.
At the same time,an
fact and intent not
The distinction

lays

engineer
actually
more

in

can be a pure
be performing
intent

than

The engineer
practicing
his specialty
munity
is not in total control
of his
ment and expertise
must be supportive
demands
of health
care delivery.

-3-

scientist
and in
as an engineer.

in procedure.

within
the medical
comenvironment.
His judgand responsive
to the

The

Audio

Engineer

and

Medicine

The audio engineer

has
engineering
community.
Basic
problems
are yet to be
appropriate

a unique

position

in the medical

in acoustics,
audiometrics
and instrumentation
resolved
and will remain unsolved
until
the

skills

and knowledge

As an example
consider
measurement
of hearing

are brought

to bear

on

them.

audiometrics.
A simple
concept
of
ability.
If you take ten audiometers

at random you are likely

to get ten different
hearing
profiles
for a single test subject.
Not only are they not calibrated
to a single,
reproduceable
standard,
they drift
radically,
not being able to hold the adjustment
they do have.
Hospitals,
like most sites of intense human activity,
are
noisy.
Acoustical
studies
and design
are major areas of
concern
for hospital
designers.
New materials,
devices
and techniques
need
tem to reduce noise
as well as improved
Medical

to be integrated
into
for increased
hospital
patient
care.

instrumentation

is almost

narrow bandwidth
of from DC to
the lower audio spectrum.
The

the medical sysworker

efficiency

universally

1,000
audio

limited

to a

Hertz.
In effect,
designer
can be ef-

fective
in improving
and implementing
instrument
design.
This is especially
true today and over the near future
as
the latest solid state-integrated
technology
is moved from
communications
and instrumentation
technology
to medical
devices.
A great latitude
neer in medicine
in health
care?
The forecast
to be one of

of work
today.

can be performed
by the audio engiWhat of the future of audio engineers

is anything
but bleak.
the most exciting
areas

cal instrumentation
of interest
range

over the next

from sonication,

Audio engineering
promises
of development
in medi-

two decades.
The points
molecular
disintegration

utilizing
sound
energy,
to diagnostic
and therapeutic
cedures
based
upon audio and ultrasonic
devices.

pro-

Audio
engineering,
while being one of the basic engineering
fields, has become
extremely
important
to the practice
of
medicine
and to the future of health
care delivery.
_ile

-4-

from outside
the hospital
this role for the audio engineer
may be difficult
to discern,
it is there in reality.
Employment
for the audio engineer
is not limited
to the 8,000
hospitals
in the United
States.
There are over 1,000 manufacturers
of medical
instrumentation
and nearly
300 research
institutions
related
to medicine
or health
care delivery.
The present
and future of dedicated
cipating
as part of the health
care
and personally
rewarding.

-5-

audio engineers
partiteam is both exciting