The Graeme Clark Legacy
Laureate Professor Graeme Clark AC – Pioneer of the Multi-channel Cochlear Implant /Bionic Ear
Graeme Clark AC Laureate Professor at the University of Melbourne led the team that invented Australia's cochlear implant which was developed by Cochlear Limited. And he founded the Bionic Ear Institute which became the Bionics Institute.
Professor Clark and his team achieved an incredible breakthrough with the cochlear implant, which is regarded by many as the greatest advance in the treatment of hearing loss.
The cochlear implant is one of Australia’s most important innovations and has given the ability to hear and understand speech to nearly a million children and adults.
By allowing deaf people to hear and understand speech, the cochlear implant created the field of medical bionics - the combination of biology and electronics for new treatments and diagnostic tools.
Professor Clark’s legacy has continued at The University of Melbourne’s Graeme Clark Institute for Biomedical Engineering, as well as the Bionics Institute. It is supported by the Graeme Clark Professor of Audiology and Speech Science, and though the Graeme Clark Foundation. His multidisciplinary approach has resulted in world leaders in engineering, research and clinical specialities emerging and their coming together to find innovative solutions to unmet medical needs.
Professor Clark’s Initial Journey Developing the Multi-channel Cochlear Implant / Bionic Ear
Professor Graeme Clark AC was born in Camden, New South Wales in 1935 and boarded at Scots College in Sydney (1).
He graduated in Medicine in 1957 from the University of Sydney with first place in his final year and honours over the course.
Professor Clark was inspired by his father's struggle with deafness and specialised in otolaryngology (ear, nose and throat).
He gained experience at the Royal Prince Alfred and North Shore Hospitals before moving to England to train.
He returned to Melbourne in 1963 to be a consultant at the Royal Victorian Eye and Ear, Alfred, Austin and Repatriation General Hospitals.
Professor Clark felt that more could be done to treat nerve deafness and for that reason, he left private practice in Melbourne at the end of 1966 to study at the University of Sydney in auditory brain science and obtained a Doctor of Philosophy (PhD) degree on the subject of “Middle Ear and Neural Mechanisms in Hearing and in the Management of Deafness” (1969).
Professor Clark’s auditory brain research demonstrated why a single-channel cochlear implant, which was being promoted at the time would not lead to adequate speech understanding. He hypothesized that the place coding of frequency would be required. He also postulated that for meaningful speech it would have to be analysed into its important components and these used for electrical stimulation (Clark 1969).
Professor Clark’s Research at the University of Melbourne (1970-)
After completing his PhD Professor Clark’s only chance to continue his research occurred when the University of Melbourne appointed him in October 1969 to the first Chair of Otolaryngology in Australasia at the Royal Victorian Eye & Ear Hospital. Although Clark’s research was seen by many in the scientific community as high risk and unlikely to be successful the University of Melbourne had carefully reviewed it and found it to be well-grounded.
He created an interdisciplinary team to ensure that multi-channel implants would be safe and effective before implanting his first deaf patients. This also meant collaboration with Dr David Dewhurst and his students from the University of Melbourne’s Department of Electrical Engineering. For Professor Clark to determine whether multi-channel stimulation could achieve speech understanding he had to implant the most complex package of electronics ever inserted in a patient.
But one of the pressing biological / surgical problems that required a solution was creating an electrode bundle that would pass around the tightening spiral of the tiny cochlea so the different speech frequencies could be stimulated on a place coding basis. Inspiration came on Minnamurra beach NSW in the Christmas holidays 1966-67 when Professor Clark saw a shell resembling the cochlea. By inserting grass blades that were flexible at the tip and stiffer at the base they would pass the required distance.
In 1978 on 1st August Professor Clark implanted totally deaf Rod Saunders ably assisted by A/Professor Brian Pyman. Some weeks later Professor Clark had a “Eureka" moment when Rod heard vowels when different frequency sites were simulated. The frequencies corresponded to the formant frequencies of the vowels. This research led to the creation of the first electrical stimulus code to enable a severely deaf person to understand speech in their daily life and without lipreading.
These momentous results were repeated on other patients, and this led to the creation of Cochlear Limited. In 1985 it became the first multi-channel device to be approved by the US Food & Drug Administration (FDA) for adults who had hearing before going deaf.
To provide adequate patient care and with funding from the Victorian Government in 1985 Professor Clark helped establish the first public hospital cochlear implant clinic in the world at the Royal Victorian Eye & Ear Hospital.
Professor Clark also became the first to insert cochlear implants in each ear and an implant in an ear opposite to one with a hearing aid to improve hearing in noise.
However, Professor Clark’s greatest passion, one that had driven him through many years of struggle, was the desire to give hearing, and especially speech perception and spoken language, to deaf children.
After an international trial in 1990 it became the first cochlear implant of any type to be approved by the US FDA or any world regulatory body for deaf children older than two years of age. It thus became the first device to help severely to profoundly deaf children communicate in the last 250 years since Sign Language of the Deaf was developed at the Paris Deaf School.
Cochlear Limited has been the leading cochlear implant company for the last 40 years with the greatest share of the one million deaf people now implanted in over 150 countries.
The Bionic Ear Institute (1986-2008)
Following the success of the University of Melbourne/ Cochlear Limited’s Nucleus cochlear implant (1978-1985), Professor Graeme Clark founded the Bionic Ear Institute in 1986 to facilitate the further development of the cochlear implant and to house his university’s ARC Special Human Communication Research Centre. He did so as both the Professor of Otolaryngology at the University of Melbourne and Director of the Bionic Ear Institute, two positions he held for the next 20 years.
During that time the integration of the University Department and Bionic Ear Institute was an effective model and allowed the cochlear implant research to expand and other research areas to develop.
The Bionics Program in the ARC Centre of Excellence for Electromaterials Science (2005-2012)
However, in 2005 aged 70 years Professor Clark had to retire and was uncertain how to continue his research. He was fortunate to have been appointed to head the Bionics program of the Australian Research Council’s (ARC) Centre of Excellence in Electromaterials Science at the University of Wollongong being led by Professor Gordon Wallace. He was also grateful that St Vincent’s Hospital appointed him as a Principal Scientist. Professor Clark and team in the ARC program produced significant advances in understanding how polymers (plastics) which conduct electricity could be used to improve cochlear implants and restore spinal cord function in people who had paraplegia or quadriplegia.
Professor Clark Appointed to the Graeme Clark Hearing and Neurosensory Unit at Latrobe University (2009-2011)
In addition, Professor Clark was able to discover how best to code high fidelity sound so that music could be appreciated, and speech heard in the presence of background noise. He was able to do this with A/Professor Antonio Paolini through the newly created Graeme Clark Hearing and Neurosensory Unit at Latrobe University where he was honoured to be appointed as the University’s first Distinguished Professor.
The Bionics Institute (2009-)
In 2009 the Bionic Ear Institute changed its name to the Bionics Institute with the aim of creating a wider discipline than the cochlear implant. At its inception under the leadership of Professor Robert Shepherd the Bionics Institute placed an emphasis on developing a bionic eye.
Now at the Bionics Institute under CEO Mr Robert Klupacs it is expanding its research goals to transform the lives of people with a range of conditions, including, Crohnʼs disease, Parkinsonʼs disease, Alzheimer’s disease, epilepsy, stroke, arthritis, and diabetes. It is undertaking this research with a multidisciplinary team of world-class scientists, engineers and researchers, with laboratories located at St Vincent’s Hospital Melbourne, close to clinical collaborators.
The University of Melbourne’s Graeme Clark Institute for Biomedical Engineering (2017-)
The cochlear implant has especially helped pave the way for many advances in biomedical engineering, now supported through creating the Graeme Clark Institute (GCI) for Biomedical Engineering at the University of Melbourne in 2016.
The Graeme Clark Institute is located centrally in the Melbourne Biomedical Precinct with over 25 collaborators from health services, research and academic partners. The Institute has unparalleled access to the clinical and research opportunities available across this entire network. By creating a community of engineers, scientists and clinicians in the healthcare system, relevant clinical problems are being identified and strategies for new approaches developed in partnership with industry.
The Institute’s research programs involve various disciplines: Neuro-electronics therapy and bionics, Personalized implants; Robotic neuro-prostheses; Computational modelling for cardiovascular disease; Drug-screening technologies and Mechano-pharmacology; Nanomaterials and drug-delivery systems; Polymeric drugs for combating anti-microbial resistance; Fluid dynamic modelling for pharmaceutical manufacturing; Synthetic biology approaches to designer-stem-cell -based therapies; Systems biology; and Biomaterials, bio-fabrication and regenerative medicine.
The GCI was led from 2016 by founding director Professor Mark Cook. His research has led to the creation of Epiminder for the early detection of epileptic seizures and based on the cochlear implant development.
In 2021 David Nisbet was appointed as Professor of Translational engineering at the University of Melbourne and Head of its Graeme Clark Institute for Biomedical Engineering. Professor Nisbet brings to the Institute a passion for developing materials that can be used clinically in patients. They integrate with the body tissues and enable cells to cause regeneration of diseased tissue and organs. It is one of the exciting frontiers for the future of health care.
The University of Melbourne’s Graeme Clark Chair of Audiology and Speech Science
In November 2013 the University of Melbourne established the Graeme Clark Chair of Audiology and Speech Science. Richard Dowell was appointed as the inaugural Professor as he had contributed greatly to the clinical outcomes of the multi-channel cochlear implant.
Professor Dowell and team showed the importance of cochlear implantation in young children, the perception and production of tone in children who speak Mandarin and Cantonese, and the preservation of hearing in people who have a cochlear implant.
The position is now held by Professor Gary Rance who has made seminal contributions to our understanding of the electrical activity in the brain and how we can use this knowledge to give people normal spoken language.
The Graeme Clark Foundation
The Graeme Clark Foundation grew from the private earnings of Professor Graeme Clark and A/Professor Brian Pyman.
The Foundation has given funds to the University of Melbourne to support the Graeme Clark Chair of Audiology and Speech Science, to support research to reduce the terrible incidence of middle ear infections in aboriginal children, to St Vincent’s Hospital for research to repair damaged spinal cords which have led to paraplegia, and to provide assistance to the severely disadvantaged children needing hearing assistance in India, other southeast Asian countries and Africa.
Professor Graeme Clark’s Notable Honours
Through his pioneering work, Professor Graeme Clark has had a distinguished career with significant awards to his name. These awards reflect the great variety of disciplines he had to lead to develop the cochlear implant and their success is acknowledged by the prestigious Australian and International bodies listed below.
In 1983, Graeme was made an Officer of the Order of Australia, and in 2004, was elevated to a Companion of the Order of Australia (AC), the country’s highest civil honour, for services to medicine and to science through innovative research to further the development of cochlear implant technology for worldwide benefit.
Other significant Australian awards include:
The James Cook Medal from the Royal Society of New South Wales (1991) (for outstanding contributions to science and human welfare in the southern hemisphere);
The Clunies Ross National Science and Technology Award (1992), (for application of science and technology for the benefit of Australia)
Sir William Upjohn Medal from the University of Melbourne (1997) (Awarded every 5 years for outstanding contributions to medicine).
Fellow of the Australian Academy of Science (1998); (for outstanding contributions to science).
Fellow of the Australian Academy of Technological Sciences and Engineering (1998); (for outstanding contributions to science and technology).
Victoria Prize (1999) (a celebration of outstanding achievements in science, engineering and technology).
Cavalcade of Science Award from Australian Institute Political Science (2000) (one of eleven most outstanding Australian scientists of the 20th century).
Senior Australian of the Year (2001), (for outstanding contribution to the welfare of Australians and international commitment).
The Prime Minister’s Prize for Science (2004); (in recognition of outstanding achievement by Australians in science and technology which promotes human welfare-Australia’s premier award in science).
Fellow of the Australian Acoustical Society (2004) (for notable contribution to the science and practice of acoustics).
Excellence in Surgery Award, Royal Australasian College of Surgeons (2005) (recognising the highest level of surgical achievement by world standards, advanced innovation in the field, continued quality and worth of the innovation, and the highest standard of ethics).
Ian Wark Medal and Lecture, Australian Academy of Science (2006) (for contributions to Australian science and industry).
Lifetime Achievement Award, the Faculty of Medicine, Nursing and Health Sciences, Monash University (2007) (the highest award made by the faculty).
The CSL-Florey medal (2011) (In recognition of outstanding achievement by Australians in science and technology which promotes human welfare-Australia’s premier award in science).
Notable international academic honours include:
Honorary Doctor of Medicine, Medizinische Hochschule, Hannover, Germany (1988).
Honorary Fellow of The Royal Society of Medicine, London (2003) (for exceptional distinction, and recipients drawn from across the world and from a wide range of endeavour, particularly from, the medical sciences – notable fellows include Charles Darwin, Louis Pasteur and Sigmund Freud).
Fellow of the Royal Society, London (2004) (founded in 1660 it is the world’s oldest national scientific academy- Fellows include Isaac Newton, Charles Darwin, and Albert Einstein).
Honorary Fellow of the Royal College of Surgeons, England (2004) (The supreme single award of the College for outstanding achievement in medicine).
International Speech Communication Association-ISCA-Medal (2005) (for an individual who has made extraordinary contributions to the field of speech communication science and technology).
Royal College of Surgeons of Edinburgh Medal, awarded at the Quincentenary Celebrations of the College (2005) (for outstanding contributions to medicine).
A. Charles Holland Foundation International Prize (2005) (for fundamental contribution to the progress of knowledge in the audiological/otological field).
K-J Zulch prize, Max Planck Institute (2007) (Germany’s highest award in neuroscience).
Fellow of the American Institute of Medical and Biological Engineering (2007) (for an outstanding achievement in biomedical engineering).
Otto Schmitt Award, from The International Federation of Medical and Biological Engineering (2009) (for exceptional contributions to the advancement of the field of medical and biological engineering presented every three years at the World Congress on Medical Physics and Biomedical Engineering).
Doctor Honoris Causa, University of Zaragoza, Spain (2010) (for the development of the cochlear implant).
Lister Medal, awarded by the Royal College of Surgeons of England, and Ireland, the Royal Society and the Universities of Edinburgh and Glasgow (2010) (One of the world’s most prestigious awards in the surgical sciences).
Zotterman Medal, Nobel Institute for Neurophysiology, Karolinska Institutet, Stockholm (2011) (Professor Clark in a pioneering effort, has developed cochlear implants, an achievement not thought possible, over several decades it has allowed children born deaf to be able to perceive speech in a practically normal way and for adults to regain hearing).
Lasker-DeBakey Award from the Lasker Foundation (2013) (honours investigators whose contributions have improved the clinical treatment of patients -one of the most prestigious prizes in science in the world).
Fellow National Academy of Inventors (NAI) (2014) (in recognition of exceptional accomplishments in innovation and invention to benefit society).
The Fritz J. and Dolores H. Russ Prize, awarded biennially by the National Academy of Engineering and Ohio University (2015) (Recognizing a bioengineering achievement in widespread use that improves the human condition).
Medal from Paul Sabatier University (2015) (for the development of the multi-channel cochlear implant).
The Shambaugh Prize, awarded by the Collegium Oto-Rhino-Laryngologicum Amictae Sacrum (2018) (Conferred every second year for a member who has accomplished a remarkable work in the fields of Otology and related basic sciences- the only Australian to have received this award).
Professor Clark and Visiting Dignitaries
Queen Beatrix and Prince Klaus of the Netherlands in 1988.
Prince and Princess Akishino of Japan in 1995.
President of China, Jiang Zemin in 1999.
Queen Elizabeth II and the Duke of Edinburgh in 2000.
The Legacy of Professor Graeme Clark
Professor Graeme Clark’s legacy is to inspire a multidisciplinary approach to solving challenging medical conditions.
He understood that it required a team of leading clinicians, researchers and engineers to create the cochlear implant, and this multidisciplinary approach continues today.
His vision has been to lead the world in the development and translation of biomedical engineering health care solutions.
His wish is to see organizations working collegially to advance human communication and to use technology to improve disabilities in all peoples.