Richard Satava

Senior Science Advisor

US Army Medical Research and Materiel Command

Dr. Richard Satava has devoted his four decade career as a surgeon to developing medical technologies that border on the sci-fi. Robotic surgery and medical imaging, he says, are making possible an entirely new kind of operating room: one without a surgeon. Satava, a professor of surgery at the University of Washington, insists that this not-so-futuristic environment actually brings him closer to his patient. “I never see my patient,” he says. “I never touch him. But the images I see by going through computer systems allow me to do things that I can’t do with my own eyes. The systems are more precise. They allow me to scale up and scale down. They magnify an image so I can see much more than if I was standing and looking right at the patient.” The game changer that produced this medical technology, Satava says, was the x-ray, a late 19th-century accident of research that revolutionized medicine. “For the very first time, we didn’t have to look at patients to see what was wrong with them,” he says. “It was a whole new world.” Forever on the hunt for other new worlds, Satava has an unusually progressive vision that evolves from surprisingly conservative roots. Born in Cleveland, Ohio, he grew up in a small Florida town of 2,700 people on the border of the Everglades. He describes his background as “working class” and slightly retrograde. “When I got to Florida, it was like going back in time,” Satava says, “but I was too young to appreciate that. We had no exposure to art. Art was going to the movies or a painting that was in the bank.” The hardest decision he ever had to make was whether he should go out the front door for ‘skin diving’ or out the back door for canoeing in the Everglades. Of the 35 graduates in Satava’s high school class, only four went to college. He went to Johns Hopkins University with plans to become a surgeon. He says the urban culture of Baltimore burst open his world—for the first time, he met people who were Jewish, Muslim and gay. He found out what a musical was. His advisor was a Nobel laureate. And then there were the classes. “It was like being in a candy store for four years,” he says. “There was something called philosophy, something called economics and time-and-motion studies. I was going from knowing virtually nothing to having an extraordinary amount of information in front of me. I opened my mouth wide on the funnel of knowledge and sucked in just about everything I could get, and it just hasn’t stopped.” Satava says he has always been “profoundly affected” by new things. What thrilled him most at Johns Hopkins were the things he didn’t know, and on that score, nothing much has changed. He is still curious, audacious and supremely impatient with obstacles to the kind of productive research that brings novelty into the world. Sometimes those obstacles have to do with human territoriality. But often, they have to do with money. Having worked as a biotechnology project manager at the US Defense Advanced Research Project Agency (DARPA) from 1993 to 2000, Satava saw firsthand what research can produce in the rare instances when money is not an issue. A significant example, he says, occurred in the 1970s when DARPA and the U.S. Air Force allocated $50 million a year for three years to researchers working on low observable technologies in aircraft. Three years later, they were looking at the Stealth Bomber. It was the type of game changer, Satava says, that can only come through “largesse” in research: “Nobody’s willing to lose that kind of money except the government. Nobody’s willing to say, I may not even get one thing, but that one thing may revolutionize the field. But the military doesn’t have any stock holders. It can invest billions of dollars, shut the door and let researchers do what they need to do.” Imagine applying such unbridled freedom to medical research. As Satava sees it, researchers need to satisfy their capacity for wonder if they are to generate meaningful results. It is a question of producing an unfettered state of mind—something akin to the sense of amazement he felt when he stepped onto the Johns Hopkins campus nearly fifty years ago. This year, Satava makes a return trip to BIF to talk about his current fascination: simulation technology and predictive analytics. True to his nature, he is always most intrigued with the one thing in a million that doesn’t behave predictably: “That’s where we get our clue. What is it about this outlier that didn’t fit the pattern? This is how we bring imagination to the scientific method. What doesn’t fit? That’s the beginning.” That’s the game changer.