Real Me

Before you believe what others say about me, you should read my confession below to know the REAL ME!

Binseng Wang was born in Taiwan after his parents fled mainland China during the civil war.  From there they moved to Singapore, Malaysia and eventually to Brazil.  So he attended elementary school in English, Chinese, and Portuguese.  With such a chaotic educational foundation, no wonder he is such a confused and rebellious person.  😂

He thinks he is fluent enough in several languages to give lectures, but the reality is that his accent is so thick, most audiences cannot understand what he is saying but are too courteous to complain. He was often “politely” praised as having a very "rich" vocabulary, because he constantly invents words that does not exist in those languages. He also writes a lot but his publications are mostly incomprehensible, and his books are not useful as doorstops because they are not heavy enough! ☹️

While in the first year of high school, he competed for and won a scholarship for the college entrance exam prep school at night.  After finishing the prep school (along with the second year of high school during the day), he took the entrance exam and got the 13th place among >1,500 candidates for the Engineering school (Escola Politécnica, University of São Paulo, Brazil), as well as passing the Physics baccalaureate entrance exam.  When he tried to register for college, he was told that he couldn’t do it because he did not have a high-school diploma!  Undaunted, he said he will take the General Educational Development (GED) and bring the GED certificate later.  Luckily, he passed the GED, so he did not have to return and finish high school.  He finally shook off his bad luck of 13th-placed freshman by graduating at the top of his class. ✌️

Unsure whether he want to be the next Einstein or Faraday, he double majored in physics and electronics engineering.  He only discovered his true passion when he attended some classes in Medical Physics and learned that Physiology is quite interesting and the nervous system actually uses electrical impulses to transmit and process information.  So, he applied to a graduate EE program focused on biomedical applications at the State University of Campinas (UNICAMP), Brazil. 

His dream was crashed on the first day of school when he learned that his advisor’s husband was in coma after an auto accident and, thus, unable to guide him.  Since it was too late to transfer to another school >500 miles away, he accepted the alternative of being supervised by his co-advisor, the Chief of Neurosurgery.  Not having prior experience with engineers, the Chief told him to join the neurosurgery interns’ team.  Thus, Binseng became a “surgical intern” for six months.  Donning a white coat, he attended surgeries, observed ICU patients, made morning rounds and listened to case reviews.  Only many years later he realized that this was the best introduction to biomedical and clinical engineering that he could have ever wished for because he learned how the doctors and nurses think and deploy technology.  He highly recommends anyone who wants to be a successful biomedical or clinical engineer to shadow clinicians to learn their reasoning process and empathy for patients.  For his MSc thesis he designed, built and tested on patients a transcutaneous electrical pain-relief stimulator.  Unfortunately, other researches and manufacturers in the US were faster than him to commercialize the new technology (known as TENS), so he missed the opportunity to become rich and famous ☹.

Undaunted, he applied for the doctoral program at that little technical school in Massachusetts known as MIT—because he thought himself not smart enough to attend an Ivy League school 😢—to study Bioelectrical Engineering, wishing to find ways to understand how the brain works. After spending dozens of 30+ hours "nights" working with cats at the Eaton-Peabody Lab for Auditory Physiology of the Massachusetts Eye & Ear Infirmary trying to decipher what the auditory nerve's electrical response to sound can tell us about the underlying activities of individual nerve fiber activities, he finally earned a doctor of science (ScD) degree in bio-electrical engineering.  His thesis provided the foundation of what is known today as the electrocochleography (ECoG), but no money or fame for him ☹️.

While invited to remain in the US, he returned to Brazil to honor his pledge of paying back for the fellowship he received while attending MIT.  At UNICAMP, he helped to create its Department of Biomedical Engineering, teaching and doing research with undergraduate and graduate students.  Although some of the equipment designs were transferred to the native industry, all the royalties and recognition went to the university and he remained penniless. ☹️

Suddenly, one day he was summoned to the UNICAMP’s president’s office.  Filled with trepidation, he went to see the president who got his name from an officer at the Pan-American Health Organization (PAHO) in Washington DC as someone who could help manage a stockpile of imported equipment worth ~US$15 M (~$100 M today) that has been rotting away for about a decade while waiting for the hospital’s construction to be finished.  With his back pinned against the wall, Binseng struck a deal with the president: in exchange for creating a clinical engineering (CE) team for the university hospital, he would get resources to build laboratories.  Initially he was allowed to hire only one engineer and one technician and set up shop in semi-finished patient rooms. The technician left immediately upon realizing that it was an impossible mission, but fortunately the engineer stayed (until his retirement).  This is how the Center for Biomedical Engineering (CEB) started in 1982. Every month he provided a detailed report on savings achieved with equipment recovered or repaired and service contracts cancelled, and the president would increase the CEB budget by the amount saved.  Four years later, CEB had 80 staff members and a 3-story, 10,000 square-feet building, supporting not only the university hospital but also a new women’s hospital.  However, he never quite understood why the World Health Organization (WHO) waited for him to leave Brazil to designate CEB as a WHO collaborating center... ☹️.

Just when he thought he could continue his academic career, he was summoned by his former boss (UNCAMP president) who had become the new Secretary of Health of São Paulo state to manage healthcare technology for the entire state.  Starting from scratch again, he created an Office of the Special Advisor for Equipment and recruited nurses, physicians, nutritionists, and administrators in addition to engineers and architects.  This office was responsible for establishing a statewide policy for technology acquisition, distribution, management, and maintenance, covering 550 hospitals and thousands of clinics.  The Office team specified and procured equipment for 5 brand new community hospitals in the greater São Paulo metropolitan area financed by the World Bank.  Knowing the inherent instability of political institutions in developing countries, instead of creating a centralized CE facility, he “lent” an engineer to each major public hospital with the stipulation that at the end of 12 months he will take the engineer back unless the hospital agrees to put the engineer on its own budget.  This “proof of concept” strategy worked so well that not a single hospital returned those engineers and later all major public hospitals—and private ones too—had their own CE department.

The biggest challenge at the Secretariat of Health was however not equipment maintenance and management but the distribution of major capital equipment acquired through loans totaling >US$150 M (~$500 M today), including those financed by the American and European governments.  Not only the public hospitals but also the not-for-profit hospitals clamored for the equipment.  To manage this process rationally, he created an equipment requisition process which required detailed justification based on epidemiology and sustainability (adequate infrastructure and competent staff).  Unsurprisingly, this became a political “hot potato” that made him a "persona non-grata" almost everywhere, forcing him to leave the country in a hurry under the disguise of a research sabbatical.  Curiously, despite all the complaints, the following Administration turned the Office his created into a permanent Department of Health Equipment that still exists today. ✌️

His research sabbatical was spent at the National Institutes of Health (NIH) in Bethesda MD, as a visiting scientist.  There he tried to merge EEG and MEG signals and TMS data, with brain images collected through CT, MRI and PET.  This project—code named alphabet soup—proved that it is possible and useful to correlate accurately electrophysiological data with anatomical and functional images of the brain, thus paving the way for major manufacturers to introduce later imaging equipment that combines CT with PET and MRI with PET.  Furthermore, transcranial magnetic stimulation (TMS) became a widely accepted clinical tool.  Again, he never got a penny for it! ☹️

Just when he was packing to return to Brazil, he received a call from an old friend inviting him to work for an equipment rental company called MEDIQ/PRN that had just become a nationwide resource.  Thinking such an equipment sharing idea was intriguing and potentially useful in Brazil and other countries, he decided to give it a shot, especially because his prior experience was limited to the public sector, so it was a good opportunity to "taste the greener pasture on the other side of the fence."  The grass (not weed!) turned out to be very addictive and he stayed there for almost twelve years!

After MEDIQ/PRN was absorbed by another company, he was recruited by Aramark Healthcare Technologies, which at the time was the largest independent service organization (ISO) in the US.  There he was responsible for quality and regulatory compliance, guiding—and often aggravating—almost 2,000 CE professionals scattered in over 450 facilities around the country managing ~1.2 million pieces of medical equipment.  In the meanwhile, he openly criticized and challenged accreditation organizations and government agencies whenever he believed their requirements were unreasonable and/or not beneficial to the clinicians and patients.  Such audacity almost got him fired, but he managed to provide evidence to convince the Centers for Medicare & Medicaid Services (CMS)—through The Joint Commission’s Director of Engineering, George Mills—to reverse its original demand for strictly following manufacturers’ maintenance recommendations and to allow the Alternate Equipment Management (AEM) program.  

In 2014 he left Aramark to venture into the "dark side," i.e., joining device manufacturers.  The first company, called Sundance Solutions, was manufacturing pressure-ulcer prevention devices and needed someone to improve its quality and regulatory compliance program while being considered for a merger with a major manufacturer.  Although the merger was successful, he did not get the big bucks to retire comfortably as he had hoped ☹, so he went to work in another, smaller producer of orthoses and medical-grade pillows.  Meanwhile, he provided consulting services to manufacturers, ISOs, hospitals, governments and anyone willing to pay him for questionable advice 😊

He drifted back to clinical engineering when he was to manage quality and regulatory compliance for the third largest ISO in the US, Sodexo HTM with >100 hospital clients and ~650,000 pieces of equipment around the country.  His expertise and flexibility were promptly tested by the COVID‑19 pandemic.  He join his colleagues nationwide to convince CMS to issue a blanket waiver that allowed postponing of equipment maintenance during the pandemic.  Despite of interruptions caused by the pandemic, he was also able to establish a Quality Management System (QMS) that earned the ISO 13485 registration after a series of rigorous audits by a global certification body. 

When he saw an almost unrecognized face full of white hair in the mirror, he decided to retire from Sodexo, knowing that black shoe polish is no longer able to help him look and feel younger… ☹️  So now he is back to writing articles, making presentations, and providing occasional consulting services and, whenever possible, take some lessons from Yoda... 😇

While still in Brazil, he had the privilege to perform numerous consulting engagements for PAHO and its member countries, e.g. Cuba, Mexico, and Peru. After migrating to the US, he participated in the founding of the American College of Clinical Engineering (ACCE) and was involved in some of its educational workshops in the US and foreign countries.  Due to his international background and interest, he was invited to join the ACCE’s International Committee and was named its chair in 2018.  In this capacity, he helped ACCE to establish collaboration and mutual assistance agreements with a dozen of similar associations in other countries, thus adding >20,000 foreign collaborating members to ACCE’s membership.

He thinks that if you mistreat young people, they are strong and can come after you, whereas the older folks are usually weaker and, thus, less dangerous.  So he has adopted the strategy of helping and encouraging young CE professionals while picking on the famous and well-established colleagues.  😜 Apparently, he was so successful in aggravating his colleagues, they decided to bestow him the inaugural AAMI-TRIMEDX John D. Hughes Iconoclast Award.  While he was very appreciative of the award, he became very concerned that he would be target of some uninformed authorities and religious zealots who could believe his is one of those who destroy religious symbols.  So he rushed to renew his Brazilian passport, because it has a very limited extradition treaty with the US for its citizens.  Unfortunately, the situation got even worse when TechNation decided to give him their ICON-Lifetime achievement award.  Now that he is at the same time an icon and an iconoclast, he is unsure whether he should consider returning both awards or just blow himself up… 😰

Finally, before you think that he has accomplished much, please be remind what a physicist “slightly more famous” than him said a long time ago:

If I have seen further than others, it is by standing upon the shoulders of giants.

Isaac Newton (1642 - 1727)