Kate Serralde is building a 3D printing medical program for one of the largest universities in the state of Texas, Texas Tech University Health Sciences Center (TTHHSC) . They currently have 11 3D printers and offer a 3D printing course for the TTUHSC School of Medicine that focuses on the relationship between aesthetics and medical imaging as a way to generate ideas for new technology. Kate’s work focuses on the process of segmentation which extracts volumetric data from medical imaging.
It seemed like a good opportunity when I accepted a position to oversee the daily operations of a learning resource center within a university medical library. With a grant funded 3D printer collecting dust, they needed someone to run it and I needed an out. Eleven years had passed when I returned to my alma mater. And I returned not triumphant but defeated. My marriage was failing, my vision was failing and this return was my attempt to fix things. I have thought a great deal about why I returned to Texas, Lubbock specifically. My conclusion? What do you do when you get lost? You retrace the path that brought you to that particular place to begin with.
The place that I found myself? Standing in front of a large black 3D printer about to press print. I suppose you are still wondering what prepared me to press print? What is among one of my many artistic dabblings was the experience of film editing. In college, I made a series of art films to bore people with. I spent hours in the university library’s digital media center learning how to use Final Cut Pro. In addition to that, as a research manager at the University of Denver, I oversaw a longitudinal study that had a film archive. I implemented the study’s transition from analog into digital media. My ability to build things along with the technical similarities between film conversion and 3D modeling seemed to be the right recipe for walking into 3D-printing cold.
Another part of that recipe was the fact that two weeks after I started my new position, I fell ill and was hospitalized. When I returned to work, I remember thinking: ‘I better figure out how to use this, if I want to keep my job.’ So, I pressed print. I started printing things. Even so, I knew that chess pieces and vape-stands were not going to be enough, I needed to make this printer relevant to the medical community. I needed to define the point of it all. I found an open-source software, 3D Slicer, that extracts volumetric data from medical imaging through a process called segmentation.
From there it went. As I asked the question of what’s the point of a 3D-printed model within medicine, I began to find a new viewpoint for my life. As I taught myself how to use the segmentation software and the process of converting medical imaging data into 3D printable models, I filed for divorce. When I was learning how to interpret and convert CT and MRI scans, I underwent a series of eye injections to preserve my vision. While I began writing a course on Additive Manufacturing and medical imaging, I went back to school to pursue a graduate degree in philosophy. In my first two years, I went from one to eleven printers, updated what was a 1990s computer lab. In addition, I began teaching, after my 3D-printing course was approved and added to the 4th year medical curriculum. Currently, I have started presenting my work at medical education conferences: World Ultrasound Conference, South West Medical Librarians Association, John Hopkins and the National Medical Library Association.
Four years ago, I started on a path with an intent to ‘keep my job,’ little did I know that the 3D printer I was standing in front of, would be a pivotal point in redefining my place in life.
You kept working hard and taught yourself into it no matter what. What kept you going?
I found a voice in 3D-printing. In the creative process of making things, I was able to express a part of myself that had been silenced. A silence that arose from a constant stream of messages and relationships that screamed ‘I had no value and I didn’t matter.
The daily challenges of working with the 3D printer became a set of transformative applications and experiences.
There was a moment when I realized that even if it was true that “I didn’t matter”- nothing about myself would be different. Through my work, I could see that I retained the ability to problem solve and make changes. I finally recognized that this external message, ‘That I didn’t matter,’ had no bearing on my ability to think, create, or make changes. Early on, I came across the following quote from Virgil’s Aeneid:
Flectere si nequeo superos, Acheronta movebo” (If I cannot bend the will of heaven, then I shall move the river Acheron in Hell.)
In utter defeat, the goddess Juno is standing by the river Acheron. She has lost everything and even, the gods are against her. It seems her destiny is set. In an act of defiance, she voices her intention to stand her ground at any cost. The literal translation refers to the rerouting of the river. How do you move a river? You move one rock at a time.
Like Juno, I was faced with relationships and situations that were indomitable. The continual decline in my eyesight and the constant harassment during my divorce are some of the times when I felt completely defeated and backed into a corner. But Juno was able to see that through her actions even a river can be moved. In all the obstacles and failure, I found a power in the act of making things that allowed me to reroute the river of my life. By making stuff, I could see the actualization of my thought process. The problems I solved and things I constructed became concrete markers that my value existed within me – unchanged by the very real consequences of pending vision loss and the surrounding messages of disregard. I could make things different –- I was capable of change. And it was here, that I found the ability to keep going or ‘reroute my own river Acheron.’ One rock at a time, I faced each challenge, found the solution, and moved on to the next until I had finally moved the river out of hell.
To date, what would you say is your greatest achievement in Additive Manufacturing?
My greatest achievement? Sometimes, I think it is simply making the printer work. In all seriousness, I am extremely honored that my course ‘Thinking in 3D: An Introduction to Medical Imaging and 3D-Printing’ is part of the medical school curriculum. I am grateful for the freedom to design a course that is not only technical, but also anchored in philosophy and art. In terms of achievement, I am proud of the connections that I have made between aesthetics and 3D-printing and how accurately that reflects who I am and what I think.
Additive manufacturing is not a one-man show — it is interdisciplinary.
And my course delves into this interdisciplinary nature. As an underscore to the process of segmentation and additive manufacturing, we examine how a creative process can help us to generate applications for new technologies like 3D printers. In addition, we explore the philosophy of aesthetics by asking the question: ‘How can our aesthetic preferences offer us insight into the integration of 3D-printing into every day medical practice.’
Do you have any (fun or not) story about your career to share with us?
One of the earliest prints I completed was a 3D-print of a rat skeleton. The first time I printed it – the bones broke apart. I printed the skeleton a second time, when the woman was picking it up the leg fell off. I stood there speechless helping her pick up the pieces. She was clearly irritated and I was puzzled. In the tension of this awkward moment, I asked myself: ‘Why did model keep breaking?’ I realized that the rat skeleton was created from a medical scan and was a model of only bones. The skeleton was breaking, because there were no ligaments holding the bones together. Reality is truth!
Have you run into any challenges from being a woman 3D-printing?
I am an artist and a woman working not only in the medical, but also in the technological and engineering fields. I have underscored my work upon a creative process with the merging of art and science. My greatest challenge is redefining conventional notions that assume creativity is not anchored in an heuristic process.
I am frequently confronted by a subtle stream of assumptions that an artistic person lacks technical rigor because of an unstructured mindset.
Here, creativity has no relevance. This assumption relies on stereotypical examples of artistic or scientific practices. In other words, people presume that creative process applies to only painting pictures while scientific method applies only to conducting experiments. The dictionary definition of creativity states that creativity is a way of thinking not an action:
Creativity: the ability to transcend traditional ideas, rules, patterns, relationships, or the like, and to create meaningful new ideas, forms, methods, interpretations, etc.; originality, progressiveness, or imagination.
Here, we see that creativity draws from a wide range of experiences and associations. My creative approach is a tool that allows me to see infinite solutions to problems. For example, when I was asked to make a knee model with removable ligaments: We first tried to print ligament with flexible filament. When doctors found that texture unacceptable, I had to find another solution. I knew about 3D printers that can print with silicone, but there was not enough time to purchase one. I bought bathroom caulking and made a set of knee ligaments. From that project, I have gone on to apply this same technique to a foot model with removable ligaments, working heart valves, and suturing models. Even with these innovative solutions, there still is a lack of acknowledgement. In fact, when 3D-printing groups were being formed to create protective equipment for the COVID-19 healthcare workers, I was included as an afterthought. Seemingly to the university administration, my eleven 3D printers or myself was not seen as a useful resource. And you have to wonder if the fact that I am an artist and woman is what contributed to that oversight.
What makes the 3D-printing industry particularly interesting for you?
I find the process of segmentation fascinating, because of the potential applications that can be derived from using a CT scan or MRI to isolate and print a patient’s anatomy. It seems like segmentation has the potential to create a new future for healthcare. Segmentation has allowed me to create customized heart models to help students learn cardiac ultrasound skills, head trauma models to be used in court cases, and spinal deformity models to assist in complex surgical procedures. However, these projects are just the beginning. The implications are so far reaching that I have made segmentation the main focus of my work.
What is the most impressive or impactful use of 3D-printing you’ve seen so far?
The most impactful use of Additive Manufacturing was my printing of a toddler’s skull fracture for a child abuse court case. The model represents a new way of presenting medical imaging as legal evidence. The 3D model serves as tangible documentation of the injuries that resulted from physical violence.
This type of model is a powerful example of how we can help a person without a medical background to fully comprehend the extent of the inflicted injuries.
And we can see here, how Additive Manufacturing can be used as a way to bridge the communication gap so often found in the challenge of understanding medical terminology.
What do you consider game-changing technologies in Additive Manufacturing?
The bio-printing of organs and tissue will have a huge impact on people’s lives and healthcare practices. However, it is only when Additive Manufacturing is integrated into our everyday lives that we will start to see a major paradigm shift. The mass adoption of 3D-printing will increase the ways in which the printers will and can be used. The game-changer will be innovation resulting from 3D-printing becoming a household product. Additive manufacturing processes like stereolithography is a type of 3D printer that I can see being part of this mass adoption. SLA printers are dependable and produce high quality prints. Moreover, some SLA printers are under $1,000 which make it affordable. The affordability and ease of use makes SLA a strong candidate for use in offices and homes.
Where do you think the industry will move to in the next 10 years?
Within the next ten years, we will see an integration of additive manufacturing into most educational curriculums. The development of 3D-printing classes will be a key resource to the next generation of thinkers. ‘Making stuff matters,’ because it is a way to actualize and connect to an idea. The ability to create, promotes self-sufficiency and this self-reliance promotes critical thinking skills and problem solving which ultimately leads to innovation. We can see this relationship played out especially now, during this time of COVID-19. 3D-printing has become a way for hospitals to maintain a self-sustaining inventory of protective equipment. Thus, having a curriculum that will create a workforce trained to think in these terms will be vital to socio-economic stability
What advice do you have for women looking to get started in 3D-printing?
My advice for women is three-fold.
First, start making stuff and get good at it. Learn how to use the technology and experiment with the materials. If you don’t have access to a 3D-printing lab, buy a cheap 3D printer kit and put a printer together.
Just the experience of assembling the printer will give you insight into the relationship between the basic mechanics, slicing software, and material.
After you have assembled the printer: experiment, experiment, and experiment. Did I mention experimentation? One of the best ways to gain mastery over a technology is to push the limits of what it can do. And when it gets difficult and it seems like there is no viable solution – work harder.
Second, learn to fail and get good at it. Failure allows you to see things from a different perspective. That perspective will push you to redefine what you believe to be true and how you understand causal relationships. Even more, try starting with the obvious wrong answer, sometimes this constraint can be a scaffolding to a solution.
Third, learn to be vulnerable at the right times and get good at it. Let people see ‘you’ – all of you: your successes, your failures, and your history. Who you are matters not only in your personal life, but also in your professional career. Your authenticity is your greatest asset in the generation of ideas and learning to be innovative. And know that being authentic can make people uncomfortable, because they will not be able to define the role you should be playing. Do not blindly accept the role your family, friends, or society ascribes to you, rather trust your instincts and follow your passions to define the roles that you play on your terms. And if you cannot ‘bend the will of heaven…’, then find another way.
In your opinion, how could we encourage more women to become involved with Additive Manufacturing?
The best way to encourage women to become involved in Additive Manufacturing is to offer workshops to women where they can work directly with the equipment. I have thought about creating a fellowship that brings women from different academic areas together. For example, engaging artists, doctors, and engineers to work and collaborate on finding new ways to integrate 3D-printing into everyday medical practices. So having at theme or goal that requires a diverse range of experience will bring more women into the AM world. Nonetheless, the biggest hurdle in accessing 3D-printing is overcoming the technical intimidation factor.
In my personal experience having direct access to a printer without anyone looking over my shoulder judging me, allowed me the freedom to make as many mistakes as I needed to master the technology.
Giving women a supportive, non-judgmental environment to work will increase interest as well. In addition, support the creation of spaces for women to create and offer consulting to help schools develop their own programs.
Favorite 3D tool?
My favorite 3D tool is my segmentation software: 3D Slicer, a software that extracts volumetric data from medical imaging, because I love seeing the human form actualized in three dimensions from the black and white slices of the CT scan.
Favorite moment in your day job?
Seeing a finish print the next morning and of course the instant gratification that derives from removing a print from the build plate, chipping off the supports, hand sanding it, and creating a functional and beautiful object.
What’s on your 3D-printing wish list for the next 5 years?
I would love to have a 3D-printing lab with a broader range of AM processes: SLA, Binder Jetting Material Jetting and Selective Laser Sintering. It would be great to have a filament recycler to reduce the material waste with FDM printers. Moreover, I would love to have a range of bio-printers to teach an intro-bioprinting course for the medical students.