Nikolay Amosov’s Bio-cybernetics
Nikolay Mikhailovich Amosov is primarily remembered as one of the best surgeons in the world. It’s a little-known fact that he was also the founder of bio-cybernetics in Ukraine. Thanks to his talent as an engineer, Amosov constructed the first cardiopulmonary bypass (CPB) mechanism in Ukraine, researched artificial intelligence, and once even managed to cut a tricuspid heart valve out of a nylon shirt (due to a lack of necessary materials for an operation). Amosov’s pursuit of a comprehensive understanding of man defined another, equally important area of his interest – modeling human physiology, thinking, psyche, and social behavior.
In 1960, with the support of V.M. Glushkov, the Institute of Cybernetics at the Ukrainian SST Academy of Sciencesopened a bio-cybernetics department. Nikolay Amasov was its irreplaceable supervisor and ideological inspiration for over 30 years.
According to Amosov’s account in his book, “Voices of the Times”, for him cybernetics began when he met Ekaterina Shkabara, S.A. Lebedev’s student. He wrote, “I still remember the new character, which appeared on our stage, with monumental consequences. With Ekaterina Alekseevna Shkabara began my interest in cybernetics: she enlightened me, gave me a book by Ashby, then by Wiener, and then introduced me to Academician V.M. Glushkov. She’s a very smart woman, but a leader, almost to a fault. That was the primary reason we drifted apart; she tried to command too much. Still, it was she who created the Bio-cybernetics department for me.”
Bio-cybernetics began in Ukraine with the creation of computer programs for medical diagnosis. According to Amosov’s recollections, “We began cybernetics with diagnostic machines. Katya (Shkabara) explained punched cards; I created a clinical record matrix with symptoms, so you could punch the symptoms onto the card, insert it into the machine, and receive the diagnosis. Naturally, this also required statistics, i.e. what symptoms correspond to which diseases. This is where Ozar Mintser helped by furnishing the mechanical processing of the punched cards. I have to say though, this medical direction in cybernetics was rather useless; the machine diagnosed poorly. Some good did come out of it, however; the “formalized” clinical record system made doctors’ work much easier, and is still being used.”
During its years of operation, the Bio-cybernetics department worked on a project to mathematically model physiological organs and systems, accounting for human capabilities, employing computing technologies and control theory. Under Amosov’s supervision, the department conducted fundamental research on heart autoregulation systems. This research allowed them to create several original CPB devices. However, the initial idea of creating a self-learning diagnosis and treatment machine was of paramount importance. It was precisely this idea which gave birth to medical cybernetics as an independent branch of science.
The creation of the first Ukrainian CPB device marked the start of a new stage of surgical practice in Amosov’s clinic. It all began in October 1957, when Amosov, as part of a Soviet delegation, visited a surgeon convention in Mexico. Amosov extracted several professional and general lessons from the visit. First of all, according to him, “surgeons are the best companions during a trip abroad. They aren’t stingy, they freely chat about politics; take turns reading “seditious” literature, without hiding. They also visit strip joints and drink vodka.” Secondly, despite the pomp of the Soviet leaders, American technologies allowed Amosov to identify significant gaps in Soviet science. Most importantly, Amosov witnessed a unique surgery, which dramatically influenced the rest of his life. The great surgeon wrote in his memoirs, “The most important event on the trip to Mexico was the surgery using a CPB pump, which I saw for the first time in my life. The three of us, B.V. Petrovskiy, A.A Vishnevskiy, and I watched the operation. I still clearly remember the large building, the good operating room, the typical middle-aged Mexican doctor. He operated on a 12-year-old boy’s Fallot's tetralogy using the very first model of CPB. I’ve read about it in the journals. The doctor opened the chest with a transverse incision, separated the heart, injected heparin, and connected the CPB. The pump was started, and the artificial circulation began. In short, the surgeon successfully completed the operation, sewed up the cardiac wall hole, and expanded the pulmonary artery entrance. Very impressive. Easy as pie, we had to acquire a CPB and begin operating! But we didn’t have any. I heard rumors that the Moscow Institute of instruments worked on CPBs, but they were not available in Kyiv. This meant that we had to make one ourselves. The design was not that difficult, I’m an engineer after all. We did lack the necessary tubes, and, most importantly, heparin to prevent blood coagulation. But I still had 15 dollars! So I took the initiative to find a medical shop and purchase the materials. The trip ended, but the results – anesthesiology and artificial blood circulation – remained.”
Upon returning to Kyiv, Amosov immediately set out to make sketches of the CPB pump. A week later, he completed a detailed engineering blueprint of the machine. He borrowed the basic principle of the blood pump from Crafford, and oxygenator design from Lilikhey. The machine turned out to be simple enough, but required precision. Several engineers volunteered to help, but they still needed about 1,000 rubles, which were eventually found. Within two months, the device was complete, and in 1957 it began to be tested. At first, Amosov met with some difficulty, but eventually, on March 10, 1960, a boy with a severe cardiac defect survived an operation that used a CPB. Nikolay Amosov was not the first surgeon in the USSR to perform this operation. A. Vishnevskiy was first; he used the CPB designed by the Moscow Institute of instruments. Bakulev Institute was second; they invited a team over from England, who performed 5 operations (4 successful), and gave the device to the Institute. While Amosov was only the third, his Institute was way ahead in number of operations performed as well as the success ratio.
Later that year, Amosov’s assistants V. Lishchuk and O. Lisova created a real experimental laboratory for heart research fitted out with a complete set of engineering equipment. They tested the heart as a pump, recorded its “performance characteristics” relative to changing venous pressure. At first, they used this laboratory to perfect CPB surgery techniques; later, engineers and physicists joined in to turn the project into a full-blown physiological study of the heart. Eventually, surgeons lead by Amosov used this very laboratory to learn heart valve surgery techniques, and much later about heart transplant surgery.
The situation with artificial heart valves in the Soviet Union was as difficult as with the CPB. Amosov reasoned, “We have already succeeded with treating the most significant in-born heart defects in children over the age of six, but any attempts to treat acquired defects were a complete failure. When valves are saturated with calcium, we need to replace them. What can we do? I do not have American artificial valves, and never will, because they are unavailable for import. The patients are doomed to die within 2-5 years. This justifies the risk of a human experiment. Trust me, it is very difficult to find the resolve to perform a new, untested surgery using only self-made equipment. It would be much easier to step aside and only save those we can save. I did not like such a stance. I deemed it reasonable to risk the lives of one or two terminally ill patients.”
The first tricuspid heart valve was cut out of a nylon shirt Amosov bought in Italy, because the USSR did not produce nylon at the time. The Institute performed 11 surgeries, but had to repeat them within half a year, because the material unexpectedly lost its flexibility. In 1963, Dr. Starr, an American surgeon, published an article proposing a new design for artificial heart valves. This design, perfected by Amosov and his engineers, was used for all the following operations at the Institute, and eventually all around the Soviet Union for more than 20 years.
In 1964, Amosov put forward a hypothesis describing the mechanisms by which human brains processed information. Within the framework of this hypothesis, Amosov described and systematized the knowledge about the structure and mechanisms of the brain, which initiate the psychic functions of man. Particularly important to the hypothesis was the fact that it modeled not just separate structures or mechanisms of the brain (for example memory, perception, learning and so on), but the brain of a human as a social creature, the brain of Homo sapiens as a whole. This made the paper by Amosov groundbreaking. After being published in 1965 as a treatise “Modeling cogitation and pshyche”, it became the “Bible” for several generations of researchers in this area. According to the scientist himself, “Modeling is all there is to my cybernetics. Modeling cells, organisms, mind, society.” He developed the ideas presented in this treatise further in his later works, like “Modeling complex systems”, “Artificial Intelligence”, “Mind algorithms”, “The nature of man”.
Amosov’s theory about the mechanisms of information processing by the brain and principles of complex psychic function creation were applied practically during the creation of a neuronlike network dubbed “M-net”. M-net was presented by A. Kasatkin and L. Kasatkina in 1966 as a device for modeling information processing mechanisms. The computer models they produced, “REM” (1965-1967) and “MOD” (1968-1971) showed that it was, in principle, possible to create neuronlike networks mimicking complex psychic functions. Most notably, they modeled mechanisms of emotion, creation and influence of behavioral acts. REM and MOD were created as prototypes for integral robots with the ability to analyze their own condition and the environment, plan their behavior, and make necessary decisions for the execution or correction of the plan. The models were the first serious attempt to use a neuronlike network to represent psychological aspects of higher animal and human behavior. They were also the first attempt to model Amosov’s theory in practice.
Modifications made to the M-net (or just weights of certain links) allowed the scientists to create different “personality types” for the REM, e.g. aggressive, calm, cowardly. The structure of the M-net remained intact throughout the experiment. The number of completed tests was formidable, which was very difficult to accomplish at the time, as M-220 was the only “big” computing machine at the Institute of Cybernetics, and scheduling machine time was not an easy task. Still, REM proved that one can use Amosov’s hypothesis to create neuron-like networks, which will exhibit intelligent behavior, and more importantly intelligent motivation of that behavior. The next model (MOD) was built using a more powerful and high-performance computer, BESM-6.
The initial focus of the Amosov school on ‘complex modeling of psychic functions’ largely defined the future “robotic” direction of the research at the Bio-cybernetics department. It’s worth noting that initially Amosov was staunchly opposed to this “mechanization” of his ideas. His staff, however, eventually persuaded him to allow them to design and study a whole line of such robots. E.M. Kussul was the initiator and supervisor of these projects. In 1972-1975, they developed the first Soviet autonomous transport robot “TAIR”. The robot exhibited task-oriented movement in a natural environment, avoiding obstacles for example. “TAIR” was a three-wheel automotive cart outfitted with a sensor system (including range finder and tactile sensors), which was operated by a hardwired neuronlike network.
The study and improvement of robot control algorithms continued in 1984-1986 using the «MAVR» model. This project was contracted by the USSR Ministry of Defense; its goal was the creation of an autonomous robot able to move directionally in a complex cross-country environment. Sensors received information about the environment and sent it for processing to the software-based (on-board computer) neuronlike network. Based on the data, the system made a decision about the direction of movement or other operations included in the decision-making sector. The decisions activated the relevant actuators.
By mid-80s, a new term appeared in brain modeling - the so-called “neurocomputer”. All the hopes associated with the early projects on creating artificial intelligence were now placed on the neurocomputers, which were basically viewed as prototypes of an “artificial brain” - an intelligent system that was built like, and functioned like, the human brain. The first neurocomputer was created using Soviet hardware and implemented as an attachment to a personal computer, whereas later prototypes used more advanced hardware. In 1992, in a joint project with the Japanese WACOM firm, the scientists created the last version of the neurocomputer.
Amosov also exhibited considerable interest toward societal organization and the interaction between man and society. He used modeling in his attempts to answer questions about societal structure. What are the advantages and disadvantages of capitalism and socialism? What is a “perfect society”? These and other questions were the focus of Amosov’s research in this sphere.
Amosov proposed to use generalized personality models, which reflected prominent features of various social groups as vehicles for the psychological qualities of man in the model.
He and his team developed a functional formula of the generalized personality model, which demonstrated the interaction of emotions, labour effort, and labour “reward”. All of the basic psychological qualities of a personality and the societal responses were presented as saturated nonlinear functions, accounting for humans’ limited physical ability as well as society’s limited resources. Model adjustment consisted of balancing labour and “reward”, circuited through motives. The influence of ideology was presented using special scales, like labour-reward, labour-exhaustion, level of aspiration (“reward-emotion” curves) and so forth.
In 1982, tired of the successful surgeries, and even more frustrated by the unsuccessful ones, Amosov decided to focus completely on cybernetics. He halted medical practice and moved to his cottage. A meeting with B.E. Paton, however, brought him out of his solitude. In early October, the two were on a Moscow-bound train when Amosov shared his thoughts about giving up medical “practice” for bio-cybernetic “theory”. Paton exclaimed, “Are you out of your mind? How can you give up surgeries? What good is cybernetics? It's all talk and little use.” The great surgeon thought, as he wrote in his memoirs, “Nobody needs societal models. A.I. as I envision it, is currently but a dream. My assistants constantly try to ground the idea, focusing on robots and artificial perception. So I returned to the clinic, never to come back to cybernetics and models. Can one compare them to human lives?”
Despite huge success in bio-cybernetics, surgery always remained Amosov’s primary focus. His student and the current director of the Institute of Cardiovascular Surgery, Gennadiy Knyshov, wrote about him, “Amosov made it through the Great Patriotic War with his field hospital, and came out even more resolute and ready to contribute to medicine than before. He was an innovator and an extraordinary man. He tried his hand and succeeded in many undertakings; in medicine, he became a remarkable surgeon; in cybernetics he worked on designing artificial intelligence; in literature he gained worldwide acclaim with his novel, “The Thoughts and Heart”. Not to mention, he created the best laboratory for heart and lung research in the USSR, served as a deputy of the Supreme Soviet for 18 years, and created the Institute of Cardiovascular Surgery. Like all people, Amosov had his highs and lows. However, he always came back to heart surgery, without which he could not imagine his life.”