For burn victims, VR can ease the pain

When you’re talking about pain, nothing comes close to the excruciating intensity of burning alive. Survivors of severe burns report trying anything—anything—to stop the pain, sometimes resigning themselves to death and hoping they won’t be on fire much longer before the end.

And that’s just during the event. Those who are lucky enough to live through the experience have another nightmare to look forward to: recovery. Burn wounds are especially susceptible to infection, and have to be cleaned daily. For the victim, this amounts to reliving the torture of being burned over and over again. The pain is nearly as severe, and the drugs to alleviate it are woefully inadequate. Morphine and other opioids are effective when patients are resting, but during treatment, they just don’t cut it: invented to relieve pain in 1804, morphine hasn’t changed since. For all intents and purposes, pain management’s been stuck in the 19^th century.

Until recently, that is. Beginning in late 2006, caregivers received a new tool for fighting pain, one that doesn’t require a prescription and has no risk of dependency. It’s a videogame called SnowWorld, and it’s the first immersive virtual world designed specifically for reducing pain.

The environment of SnowWorld is as far from hot as you can get: icy, snow-covered, and populated with penguins, snowmen, and woolly mammoths. Patients undergoing treatment for severe burns don a VR headset or look through a pair of goggles, and find themselves transported into this world where they can run around and toss snowballs at the inhabitants for as long as the PT session lasts. And, believe it or not, it gets results. Says University of Washington researcher Hunter Hoffman, who worked with combat veterans from Iraq and Afghanistan,

What was encouraging was the ones that needed it the most showed the most pain reduction, so the patients that were in the most pain showed the most pain reduction from SnowWorld.”

The idea behind SnowWorld predates the game by a decade. It’s called immersive VR distraction, and it was co-developed in 1996 by Hoffman and Dr. David Patterson, head of the Division of Psychology of the University of Washington’s Department of Rehabilitation Medicine. Dr. Patterson also works with patients at the university’s Harborview Burn Center, studying psychological techniques for reducing severe burn pain. According to Patterson, the concept is simple:

It takes a certain amount of attention to process pain. If you are able to put that attention elsewhere, there is less attention to process pain, and consequently, people will feel less pain.”

This is born out not only in interviews with patients, who universally report drastic pain reduction, but in MRI scans that clearly show less activity in the brain’s pain centers when physical rehab is combined with immersion into SnowWorld.

GQ Magazine just reported the case of First Lieutenant Sam Brown, horribly burned after his Humvee rolled over an IED in Iraq. His full story is here, but some of the descriptions are a bit gruesome, so those of a more delicate constitution might want to read the NPR story here.

Sergeant Oscar Libretto experienced a similar event in 2009, and you can find his story here.

These are only two of the hundreds of veterans from Iraq and Afghanistan who’ve returned after surviving one of the most horrific experiences a human being can endure. But survival is only the beginning of their struggle. Wound care and rehab is taxing and painful, both physically and mentally—on the servicemen and women, the caregivers, and their families. For all of them, the immersive distraction of videogames like SnowWorld is a nothing less than a godsend, improving recovery, providing relief from unimaginable suffering, and offering a glimpse—however fleeting—of a future beyond pain.

To learn more about the Harborview Burn Center, click here.

You can read about immersive VR for pain control here.

And you can watch a video of SnowWorld in action here.

Welcome to the V-Army

As any William Gibson fan will tell you, it was only a matter of time.

Just yesterday, the Department of Defense announced that it’s developing virtual reality contact lenses to enhance the intelligence, surveillance and reconnaissance (ISR) abilities of soldiers on the battlefield. The lenses, which fit over the eye exactly like standard contact lenses, contain miniature, full-color displays, on which digital images can be directly projected. Unlike a laptop, PDA or other handheld device, which places a screen between the user and his or her environment, wearers could watch these images and still have an unobstructed view of their surroundings, allowing them to react to events on the ground while receiving potentially critical intel through the lenses. According to DARPA, who’s working with Innovega iOptiks to create the lenses, they would

operate hands-free, provide similar or better magnification on-demand, while providing FOV [field-of-view] equal to that of the unaided eye.”

They would also cost less than existing equipment used for ISR activities, and would provide soldiers with a freedom of movement not possible with binoculars, night-vision goggles, and other traditional ISR gear. There’s an image of the lenses here.

Of course, this is hardly the U.S. military’s first foray into the realm of VR technology. In 2008, the U.S. Air Force built a simulated base in Second Life; in 2010, the Army posted details for a complex virtual world similar to Second Life’s massively multiplayer environment, and began courting a systems integrator to build it (InformationWeek reported the article here).

2011, though, saw a flurry of activity, with both the Army and the Navy exploring the potential of virtual worlds to train their personnel for a variety of battle exercises, from firing torpedoes to preparing for encounters with IEDs and other explosive devices—right down to the nature and damage of an explosion, including haptic (tactile) feedback systems that would simulate being hit with debris.

But what does this all mean, really? What are the larger implications?

Last year, I spoke with Rob Lindeman, a game design and technology professor in Worcester Polytechnic Institute’s Department of Computer Science, and I asked him how far VR technology could go. Would it ever be possible to create a fully-immersive virtual world? Here’s what he had to say:

I think the answer is yes, and I think it’s going to be more Matrix-like than anything else. What I’ve found is that technology seems to be moving closer to the brain and bypassing more and more systems. So for instance there are these displays that draw images on the retina, so instead of showing you a display, it actually draws directly on your retina. So it bypasses the optics and it’s perfect resolution. There’s no pixelation, there’s actually no display, it’s literally drawing on it, so you have perfect resolution. And that’s one step closer to the brain. At some point, we’ll just be tapping into the optic nerve, tapping into the auditory nerve and just stimulating… sending nerve impulses to the brain. And then at some point we’ll start just tapping right into the area of the brain that we know and can tap into. And I think that’ll happen. I don’t know when it will happen. I don’t know what the motivation will be for it to happen, but I think it will happen.”

What seemed far-fetched and confined to the realms of science fiction less than 30 years ago is all but upon us. In another 30 years, we may be able to live much of our lives in a completely virtual world that’s indistinguishable from reality. Whether this turns out to be a boon or a curse will debated long after its inauguration. We can turn away in fear or face the future and embrace the possibilities. However, the history of technological progress has taught us that there’s no turning back: Once we have the means to create something, it’s a virtual certainty that we will. How we use it is up to us.

To read more about virtual reality contact lenses, click here.

This article talks about some of the next generation training tools being investigated by the DOD.

Here’s another article regarding the DOD and virtual worlds.

A similar article regarding the U.S. Navy’s virtual reality exploration is here.

The DOD has a special report with several articles about military virtual worlds here.