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National Museum of American History Accepts Medical and Personal Artifacts of David, the Boy Who Lived in Bubble like Environment Smithsonian News Release, March 20, 1986 [SI-120-86]

National Museum of American History Accepts Medical and Personal Artifacts of David, the Boy Who Lived in Bubble like Environment

The Smithsonian's National Museum of American History has accepted a mobile support vehicle, space suit, bubble-shaped isolation units, medical literature and personal memorabilia documenting the life of David, the boy who was born with severe combined immune deficiency (SCID), a condition that left his body defenseless against disease and confined him to a sterile, plastic, bubble like environment for nearly all 12 years of his life.

David died on Feb. 22, 1984, following an unsuccessful bone marrow transplant, an attempt to provide his body with the capacity to make its own antibodies and thus free him from the bubble.

The museum's acquisitions come from three sources important to David's life and care. The mobile support vehicle and space suit, developed by the National Aeronautics and Space Administration, were transferred from the Johnson Space Center. Dr. William Shearer, David's physician, arranged for donation of the isolation units from Texas Children's Hospital and Baylor College of Medicine in Houston, Texas. David's parents, Carol Ann and David, have given personal objects, including games, toys and drawings, which illuminate David's lively personality and describe his life in the bubble. David's last name has not been released in deference to the privacy of his family.

Many of these materials were initially assembled as a project for the National History Day competition in 1985 by four students from Nimitz High School in the Aldine Independent School District in greater Houston. The students, David Stevens, Sheri Miller, Jeff Morris and Pam Poynter, developed the project under the supervision of their history teacher, Linda May; it was brought to the museum's attention by Elizabeth Battle, Aldine's social studies coordinator, during the national competition.

These artifacts and documents highlight some crucial issues in late 20th-century medical research, ethics and economics, among them questions about the uses and consequences of sophisticated medical technology. David's responses to treatment provide information especially valuable for the study of immunology, currently at the center of scientific investigations of immune deficiency diseases, aging and cancer. For example, an autopsy revealed that David died of a cancer that developed from latent Epstein-Barr virus (EBV) in the transplanted marrow. These results presented the first direct evidence of a causal link between EBV virus and cancer, an important finding in the history of cancer research.

The donated objects join the earliest CAT scanner, a DNA synthesizer and other examples of medical technology in the collections of the museum's Medical Sciences Division. Those collections document the dramatic changes in the nature and meaning of health care in the United States, changes that have come as new knowledge has increased the possibility of medical intervention, sometimes challenging long-held definitions of life and death. The objects, not currently scheduled for exhibition, will be available for scholarly researchers pursuing relevant topics.

 


Mobile Biological Isolation System, NASA brochure, Lyndon B. Johnson Space Center, Houston, Texas, undated [after 1976]

The Mobile Biological Isolation System was developed by NASA at the Johnson Space Center for use by confined patients who have poor defenses against germs. One of these systems was delivered to the Texas Children's Hospital in 1977 for a boy named David. David is a six year old who suffers from severe combined immune deficiency, a hereditary disease affecting only males. He has been cared for since birth in a series of germ-proof isolators located in the Clinical Research Center at Texas Children's Hospital (TCH) under the care of Baylor College of Medicine (BCM) physicians.

The mobile isolator system will be used by David to broaden his environment and thereby enhance his educational experiences. His experiences in the suit will be designed to meet certain educational, social and psychological needs to afford continued normal development as discerned by family, physicians and child development staff. It will be used for excursions lasting a maximum of four hours. Future trips may include the zoo, a fire station and NASA.

Specialists expect the mobile isolator to be especially valuable in the following areas of David's education: school work, spatial concepts, social interaction, physical education and group play.

System Design and Operation

David's staff has always looked for ways to expand the boundaries of his world. NASA responded to a request by Baylor in 1974 to investigate means for protecting patients like David during outings from their germ resistant isolators.

The basic design and makeup of David's suit was already available to NASA scientists from the "spin-off" technology of Apollo lunar missions. David's suit most resembles the biological isolator garments (BIG) worn by the astronauts during quarantine after their return to earth. The suit's body is made from rubberized nonporous fabric similar to that used in life rafts. For added protection, it is covered with a white silky material, Nomex, identical to that used on the outer garments worn by astronauts during EVA on the early Gemini flights. A soft transparent helmet, rubber gloves and boots are integral with the suit.

David enters and exits the suit through an eight-foot long tunnel permanently attached to the back of the suit. This tunnel, made of the same fabric as the suit, has a metal ring at its end which mates to another ring on David's isolator. Within these rings two doors separate David's isolator from the suit. After sterilization of the space between these doors, a process which takes about 30 minutes, the doors are removed internally and temporarily stored in the fixed isolator while David enters or exits the suit. After David has entered the suit, the doors are reinstalled in the ring assembly and the tunnel is collapsed and covered with a protective sheath. The tunnel ring may then be separated from the ring on the isolator and stored in the pushcart.

The equipment pushcart, built from a lawnmower chassis, also serves as a transporter for the patient during excursions lasting up to four hours. The patient may ride on a seat at the front of the pushcart or walk within the limits of the 10-foot life support umbilical. The pushcart can be moved with a suited patient and attendants in a station wagon or van.

In normal operations, the suit is inflated to less than 1/10 of a pound per square inch (psi) by a blower in the equipment pushcart. A single blower moves approximately seven cubic feet of air per minute through a twelve foot plastic hose to the suit, but the flow rate can be increased to above 10 cubic feet per minute with a second redundant blower in an emergency. Air enters the suit at the helmet and passes over the patient's body for cooling before exiting at ankle exhaust ports. Filters in the air circulation system catch particles larger than 0.3 micron--about one-millionth of an inch.

The filter system is powered by one 12-volt battery. There are two mounted on the pushcart capable of operating the system for eight hours each. The system is also capable of running off of a battery charger plugged into an ordinary electrical outlet or through a car cigarette lighter. Should the batter power system fail to operate properly, an emergency blower and power supply are available. David will normally be transported in the suit by van, but it is possible to carry him in this fashion in a station wagon.

After wearing, the suit is sterilized with ethylene oxide gas in special containers manufactured to NASA's specifications. It is then retested for air tightness. An extra suit is also at David's disposal. The suit and its filtering system have undergone certification and acceptance testing by NASA.

Error-avoiding checklists, much like those used aboard spacecraft, are used in operating the mobile isolator system. His parents are among the four people (other than NASA engineers) trained to assist David. Three people skilled in the suit's operation must be present during all excursions.

Other Applications

NASA has completed a second mobile isolator system for clinical evaluation by the Children's Hospital of Los Angeles on young cancer patients whose body immunity has been temporarily impaired by chemotherapy. With support from microbiologists at the Jet Propulsion Laboratory in Pasadena medical personnel at the hospital will perform studies of the effects and benefits offered by a mobile isolator system to patients being treated for solid tumors.

It is for this type of patient, those undergoing chemical therapy for diseases or for organ transplant, that equipment such as NASA's Mobile Biological Isolation System may eventually receive its widest use. In time, with successful results from these clinical evaluations, hospitals and medical centers may likely consider these or similar systems a necessary part of their inventory.

[Brochure also includes illustrations of Suit Exit/Entry and Equipment Pushcart, contact address, and excerpt from National Aeronautics and Space Act of 1958.]

 

Related Images

David's suit attached to the mobile support vehicle.
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David's suit attached to the mobile support vehicle.
NASA diagram of the tunnel used to enter and exit the space suit
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NASA diagram of the tunnel used to enter and exit the space suit
NASA tested the suit with a child David's size.
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NASA tested the suit with a child David's size.
The Mobile Biological Isolation System was developed by NASA at the Johnson Space Center.
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The Mobile Biological Isolation System was developed by NASA at the Johnson Space Center.


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