Many of today’s prosthetic design concepts have their roots in World War I. A major museum exhibit connects the dots.
By Larry Borowsky
In its day, the Carnes arm represented the absolute pinnacle of prosthetic technology. Commercially introduced in 1910 by the Carnes Artificial Limb Company, the device paired mechanical sophistication with cosmetic elegance. “We manufacture the only artificial arm in the world that you can do all kinds of work with,” the firm’s promotional literature asserted. Because it articulated with the muscles in the residual limb, the prosthesis supposedly enabled wearers to tie a necktie, use a knife and fork, grip a bicycle’s handlebars, and retrieve individual bills from a wallet.
The Western world’s top surgeons were duly impressed when the Carnes arm was presented at a European conference in 1913. Two years later, the marvelous innovation won the top prize at the Panama-Pacific Exposition (a world’s fair held in San Francisco). And in the early years of World War I, before the United States entered the conflict, the German government licensed Carnes’ technology and began mass-producing knockoffs for the legions of soldiers who were coming home as amputees.
There’s quite a bit more to that story, and it’s just one of the fascinating narratives woven into “Bespoke Bodies,” which opens next month at the National World War I Museum in Kansas City, Missouri. This sprawling exhibition traces the evolution of prosthetic design over the last five or six centuries, spotlighting dozens of artifacts. It may be the largest collection of prosthetic relics ever displayed. And it uniquely positions amputees as active agents—not merely passive beneficiaries—of technological innovation.
“We’re talking about more than functionality,” curator Amanda Hawkins said in a 2018 interview. “[Prosthetics meet] a social and emotional need. We’re listening to the people who use them and design them, many of whom are amputees. We’re seeing things that we didn’t know were a possibility, and that are now celebrated.”
Developed by the Boston-based Design Museum Everywhere, “Bespoke Bodies” debuted in 2018 and was meant to tour the country as a traveling exhibition. The pandemic derailed those intentions, however. The show has only been on display in a handful of cities, never for more than a few weeks at any given stop. The Kansas City exhibition is scheduled to run for 11 months, stretching well into the spring of 2024, so it offers the first really good chance for the public to experience this unique set of perspectives on limb loss.
And because it’s being staged in a museum that commemorates World War I, this particular iteration of “Bespoke Bodies” carries an extra layer of meaning: the critical role wounded warriors have played in pushing prosthetic technology to meet every kind of human need.
Past as Prologue
“We’re excited to host this exhibition, because it sheds light on one of the lesser-known stories about World War I,” says Christopher Warren, the National WWI Museum’s senior curator and vice president of collections. A Congressionally authorized facility that serves as the nation’s official memorial to and repository of World War I history, the museum documents that conflict’s extensive, largely overlooked influence on the present. It has hosted exhibitions connecting the dots between the Great War and many aspects of 21st-century life, including such diverse areas as beer, entertainment, fashion, politics, architecture, and religion.
“World War I was the first time in human history where there was an intentional effort not only to develop medical treatments for amputee soldiers, but also to reintegrate them back into society,” Warren says. “It went beyond advanced prosthetics; it included mental health treatment and workforce training. People demanded that their governments had an obligation not only to give these men a pension, but actually help them go back to their jobs and their family lives. It didn’t always work, but that was the goal.”
Those objectives lay behind the German government’s pursuit of the Carnes arm and other advanced prosthetic technology. An estimated 65,000 German soldiers lost limbs during the war, or roughly one amputee for every thousand German citizens. Among men of working age, the percentage was closer to one in 200. The entire society was deeply affected by limb loss, and existing prosthetic options were completely inadequate to restore wounded veterans’ independence, productivity, and sense of purpose.
To complicate matters, existing production methods couldn’t scale up to meet the overwhelming demand. The solution to that problem gave rise to one of today’s most recognizable global brands. Otto Bock, a prosthetist from Berlin, launched his company in 1919 with a radically original approach to prosthetic design and manufacture. Instead of building complete limbs one by one in sprawling workshops teeming with individual craftsmen, Bock conceived a new paradigm of prosthetic limbs consisting of integrated components. The parts could be mass produced, addressing the need for high-volume production; they also could be mixed and matched in flexible configurations, making Ottobock limbs compatible with a wide variety of bodies.
The Great War spurred similar innovations in the United States, which welcomed home about 4,000 amputee veterans—a population roughly three times as large as the amputee cohort that emerged from this century’s Iraq and Afghanistan wars. The US Patent Office approved hundreds of applications for newfangled prosthetic technology in the war’s aftermath. Military doctors developed specialized expertise in amputee care and built stand-alone hospital units for this purpose. Adaptive sports programs became a regular feature of post-limb-loss rehabilitation, helping lay the groundwork for the Paralympic movement that emerged after World War II. And device designers, seeking to professionalize and standardize limb care and technology, established the Artificial Limb Manufacturers and Brace Association, a direct ancestor of today’s American Orthotics and Prosthetics Association (AOPA).
“We want to put the story of World War I prosthetics into the overall timeline of history,” says Stacie Peterson, the National WWI Museum’s director of exhibitions. “Everything that’s occurring today [in prosthetics] has roots that can be traced back 100 years, and likely more. So anyone who uses a prosthesis will be able to see themselves in this exhibition, not only in the history of technology, but also in how their current device was influenced by historical action over time.”
People Over Prostheses
“Bespoke Bodies” traces the history of prosthetics back long before World War I. The timeline begins in the 1500s and carries forward into the 21st century. You’ll see handcrafted wooden limbs of the preindustrial era, 3D-printed devices outfitted with microchip sensors, and outlandishly decorative limbs that unite advanced function with imaginative form. There are interactive stations where all visitors (with and without limb difference) can try out VR goggles, mind-controlled devices, and 3D-printed prototypes.
But at its core, the exhibit is about people, not prostheses. Each object knits together a tapestry of human stories, contextualizing limb loss within broader narratives about medicine, technology, artistry, body image, self-expression, cultural conformity, and equal rights. The cast of characters includes well-known amputees such as fashion model Kelly Knox, who helped shatter conventional definitions of beauty, and philanthropist Lauren Scruggs Kennedy, whose near-fatal experience of limb loss gave her a new sense of purpose in serving others. You’ll also meet everyday people like Wafa LaVelle, who quietly struggled with congenital limb difference for many years before she discovered her voice, took charge of her own prosthetic care, and became a mentor to other people with limb difference.
Prosthetists, doctors, engineers, and other nonamputees also appear in “Bespoke Bodies,” largely playing secondary parts. Then there’s the singular figure of William T. Carnes, the namesake inventor of the Carnes arm. A factory machinist from Pittsburgh, he is perhaps the bespokest body in the exhibition: an amputee test subject, design engineer, industrial innovator/disruptor, and hero to World War I’s wounded, all rolled into one.
After losing his right arm above the elbow in a 1902 milling accident, Carnes went shopping for a device that would enable him to return to work. The available models, he discovered, “were more ornamental than useful, and very little of either.” Unable to find a prosthesis that met his needs, Carnes set about building one for himself. The result was unquestionably more appealing to the eye than anything else on the market, and its impressive technical capabilities included full-finger motion, a bending wrist and elbow, and a locking-joint option. The body-powered device attached via a shoulder harness and, in the words of one early customer, “is comfortable to wear and feels like a part of me.”
In 1910, Carnes teamed up with JP Prescott, an amputee businessman from Kansas City who’d purchased a Carnes arm and started seeing dollar signs. Within a few years, Carnes Artificial Limb had customers all over the country. By the time doughboys started coming back from the trenches as amputees, the device was firmly established as the industry standard. The Army issued more than a thousand of them.
You can see one of those devices at “Bespoke Bodies.” It belonged to an infantry lieutenant named Henry G. Botjer, who lost his right arm below the elbow in 1918 when a grenade blew up in his hand. The artifact didn’t appear in Design Museum Everywhere’s original lineup, but it makes perfect sense at the National WWI Museum show. In addition to the historical and geographical connections, the Carnes limb reinforces one of the exhibition’s central themes: A well-designed prosthetic limb can’t merely address physical function. It has to account for mental and emotional needs, too.
The Carnes apparently didn’t, for whatever reason.
Designing for the Whole Human
“Most of the soldiers who were provided with these prosthetics ended up not using them,” says Warren. “Even though they were much more advanced than a Civil War-era device, and surgeons knew how to make these things fit better, and the soldiers were given some rehabilitation and training in how to use it, they just didn’t fully accept them.”
That was Henry Botjer’s experience. “I never saw him wear that arm,” his daughter told the Kansas City Star when she donated the arm to the National WWI Museum in 2013. “It always hung from the kitchen stairs.”
Same as it ever was; today’s most sophisticated prosthetics are also abandoned at high rates, even though they’re supported by far greater surgical knowledge and clinical rehab techniques than the devices of 1920 were. In both eras, even the best prosthetic limbs carried design flaws that impeded full acceptance. The Carnes arm, for example, depended on an intricate mesh of nearly 150 cogwheels, springs, and screws. Not surprisingly, it broke down easily and cost a pretty penny to repair. By the late 1920s, the device—acclaimed as the future of the industry for the entire 1910s—had become a dead-end on the evolutionary tree of prosthetics.
But some of the factors that caused WWI veterans to ditch their government-issued prostheses may have had nothing to do with the technology itself, and everything to do with challenges that couldn’t be solved through sheer mechanical wizardry.
“Doctors were just starting to understand that you can’t simply give someone an artificial limb and throw them back into society,” Warren says. “Some of the men who suffered these types of wounds in the war didn’t even want to come home. They simply wanted to die. Army doctors were only beginning to recognize that a wound of this type is not just a physical injury. It’s a mental trauma as well. World War I was the first time in the history of warfare that these issues were even identified. They were just starting to learn how to deal with it.”
Prosthetic technology has come a long way in the century-plus since World War I ended. For that matter, it has made significant progress in just the five years since the debut of “Bespoke Bodies.” Important developments have occurred in socket design, neuroprosthetics, osseointegration, and consumer choice. These recent updates aren’t well represented in the exhibition.
But the omissions don’t meaningfully weaken the telling of “Bespoke Bodies”’ core historical narrative: the centuries-old quest to design prosthetic solutions that restore heart and mind as well as body. The key to future breakthroughs, the exhibition suggests, may not be anything that’s engineered in a lab. It might depend on the continued education of the able-bodied world, until it learns to look beyond the whiz-bang limb and recognize the whole human being attached to it.
How to Experience “Bespoke Bodies”
AT THE MUSEUM
“Bespoke Bodies” opens in June at the National World War I Museum in Kansas City, Missouri. Tickets are $10 adult, $8 seniors/military, $6 youth, free for children age 6 and under. For dates, directions, and ticket info, visit the museum online at theworldwar.org.
Lectures, discussion panels, and other special programming related to “Bespoke Bodies” will take place throughout the show’s 11-month residence in Kansas City. Many events will be available online, either via live videostream or after-event recording. Get updates at theworldwar.org/events.
In 2020, Design Museum Everywhere commemorated the exhibition in a 200-page coffeetable book. Order a copy at designmuseumfoundation.org/publication/bespoke-bodies.