The inside story: Biotech pioneer revolutionized ultrasound

When Donald Baker was 13 years old, he wanted to build a railroad on his family’s nine-acre property in Rochester, Wash., to carry the trees he helped his father cut down.

Every weekend during his childhood, Baker’s father, a civil engineer, gave Don and his siblings heavy-duty projects, like helping log trees from their land. The Baker kids also helped landscape their yard, lay the foundation for their home, build their own toys, milk their own cows, raise their own meat, grow their own vegetables, even winch out tree stumps.

“And we did everything by hand,” Baker recalls of his years growing up in the 1940s in the tiny southwestern Washington town. “I thought having a railroad would be a good solution.”

If anyone knows a thing or two about finding solutions, it’s Baker (pictured at top along with his prototype Doppler ultrasound unit). At the age of 22, shortly before he graduated with a degree in electrical engineering from the University of Washington, he took a part-time job in the UW’s bioengineering research lab. His task: employing engineering methods to assess the cardiovascular workings of animals.

Baker, who as a kid wanted to be an architect before falling in love with electrical engineering, knew absolutely nothing about bioengineering. In fact, “I had never even heard of it,” he recalls.

But engineers were put on earth to find answers. And over the course of the next 30 years, Baker, armed with an insatiable curiosity, ravenous desire to learn, and problem-solving smarts he learned as a kid, turned his assignment into a lifetime quest that revolutionized the field of medicine. By refining ultrasound into the most vital, cost-effective diagnostic tool available today, Baker—and legions of followers, many in the bioengineering lab at the UW—developed the tools that can do everything from take a first look at a fetus in the womb of an expectant mom to search for the cause of mysterious abdominal pain to measure the speed blood travels through the heart in order to detect damage and disease in the heart.

Ultrasound first appeared on the medical front in 1953, when a Swedish cardiologist and nuclear physics grad student used an industrial ultrasound machine to see if it would improve the ways to diagnose heart disease, but it was only a start. Early ultrasound provided small, fuzzy, black and white images. It wasn’t until Baker came up with the idea of adding Doppler technology that medical ultrasound became the diagnostic and commercial marvel it is today.

The Doppler effect, first explained in 1842 by Christian Doppler, is the shift in frequency and wavelength of waves that results from a source moving with respect to the medium, a receiver moving with respect to the medium or even a moving medium. We experience it when we hear a horn change its pitch as a car passes by on the street, or in the pitch of a boom box on the sidewalk as you drive by in your car. By taking advantage of the Doppler effect, Baker was able to achieve unheard-of, high-resolution, crystal-clear, real-time imaging that showed anatomical structures and delivered precise information about the inside of the body.

Don Baker (left) and Vern Simmons, a colleague of Baker’s in the UW bioengineering lab, display an early pulsed Doppler unit, built in 1967. Simmons built the unit based on a design by Baker. Photo courtesy Don Baker.

But Baker’s quest didn’t stop with the ingenuity he used in the lab of the late pioneering UW bioengineering professor, Robert Rushmer. Employing a natural entrepreneurial zeal, Baker also transformed the field of technology transfer, commercializing his breakthrough in medical imaging to the great benefit of millions of people worldwide.

His work, first published in 1967, led directly to the booming success of a Bothell company called Advanced Technology Laboratories (ATL), one of the world’s main suppliers of ultrasound equipment. His innate knack for medical marketing made ATL (sales: $1 billion annually)—and five spin-off companies—a major player in the healthcare industry. Soon the quiet Puget Sound region became an international healthcare technology powerhouse. This was long before the age of venture capital and over the objections of academic purists.

“The implications of Don’s development are huge and international,” states Indiana University Professor Harvey Feigenbaum, one of the world’s foremost cardiologists. “Not only in developing the technique, but in demonstrating how useful the technique would be. This is a rare accomplishment.”

In recognition of his accomplishment, the University of Washington and the UW Alumni Association have bestowed upon Baker their highest honor: the 2002 Alumnus Summa Laude Dignatus Award. He joins a distinguished list of alumni who have been honored as the alumnus of the year. Started in 1938, the award is the most prestigious honor the UW bestows upon its graduates.

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Of course, like most success stories, this one has a twist. Baker, now 70, semi-retired and living with his wife, Joan, in a Kirkland home he designed and built, had no intention of revolutionizing medicine when he started out.

After graduating from Raymond High School, where he was senior class president, Baker attended Grays Harbor College on a football scholarship for two years. Injuries ended the left tackle’s promising athletic career, but he loved studying automobile design. However, he interrupted his studies in 1951 to enlist in the Air Force, since the Korean War was brewing and he didn’t want to be drafted. Although he had no electronics background, an aptitude test said he would do great in the field. He was told to enroll in radar training and later served as an electronics troubleshooter for an air base in Fairbanks, Alaska.

After his stint in the military, he was assigned to a Boston-area lab to do research on an airborne Doppler radar project (to see if low-flying aircraft could be detected). He thought he would finish college at MIT but decided at the last minute that he wanted to return home to the Pacific Northwest. He came back to Raymond but didn’t go to school right away, working for three months in a sawmill. It was memorable for one reason: it destroyed his hearing.

While a UW student in the late ’50s, Baker had to work his way through school (his GI bill paid only $135 a month). He worked the swing shift until 1 a.m. as an instrument technician in the Boeing Wind Tunnel before heading off to class at 8 a.m. He also worked full time in the summers for John Fluke Sr. on a project involving the nuclear reactor in the basement of the civil engineering building on the UW campus.

In 1958, Baker bumped into Wayne Quinton, who ran the medical instrument shop at the UW medical school. Quinton—who helped the UW devise the world’s first successful artificial kidney as well as one of the first treadmills—suggested that Baker apply for a job with Rushmer, the founder of the UW bioengineering department. “This was a path I never expected to take,” Baker says. He signed on as an electronics technician and joined a team of former military electronics experts who were helping Rushmer develop ways to measure things like blood pressure, volume and flow.

But there was one problem. “No tools for that existed,” Baker recalls. “We had to create them. We were the living embodiment of the collaboration of medicine and engineering. It was a very exciting time.”

Trying out a continuous wave Doppler ultrasound machine on a male subject, Baker discovered it had severe limitations. “We could not determine the depth of the blood vessels,” he says. “We could not find where a blockage in an artery would be. The whole idea was to find a way so a physician could find exactly where that was and then figure out a treatment.”

This was an important approach because back then diagnosing heart problems almost always required an invasive catheterization procedure.

Early black and white echocardiography images (top) didn’t provide much information. Today’s color Doppler echocardiography scans (bottom) show not only biological structures, but blood flow, giving physicians much more information when they diagnose heart problems. Images courtesy Dr. J. Geoffrey Stevenson

While struggling with the problem, Baker had his “a-ha moment.” He remembered hearing of meteorologists who were trying to track the presence of rain and snow in cloud formations. Continuous Doppler waves wouldn’t work for that, either. “Sending pulsed sound waves would work,” he thought.

So he tried it. And the “pulsed ultrasonic Doppler velocimeter” was born. Physicians could now track vital, real-time information on blood flow, volume and other characteristics. It was a stunning breakthrough.

But it was only half the battle. Getting the word out was the next step. Not content with letting its research sit on a shelf in a library, the UW bioengineering department held “show and tell” meetings with local industry and banks.

These meetings were not regarded very well by many in the academic community. “Contact with industry was a dirty word,” Baker recalls, adding that it is still the subject of ethical debate in academic circles today. “It was as if commercial applications tainted your work.”

But Rushmer, a world-renowned researcher himself, had the philosophy that you hadn’t achieved anything until it benefited people.

The big break for the Doppler ultrasound project came in the early 1970s when two officials from ATL, then a fledgling four-person company based in Bellevue, came to a show-and-tell and asked Baker to consult on an ultrasound emulsifier to treat cataracts. Although that project never went anywhere, the ATL folks were extremely interested in Baker’s Doppler imaging project.

They joined forces and ATL began manufacturing Doppler machines in a garage in Bellevue. At the time, there were no rules governing technology transfer—developing ideas at a university, then having local industry produce and sell the products. Baker was “completely open” about his relationship with the new company (in which he owned a significant amount of founder’s stock), and he made sure everything about his involvement—from scientific information to marketing strategy and compensation—was listed on paper, for all to see.

But sales of the first pulsed Doppler flow meter didn’t go that well, which was very puzzling for such a momentous technological achievement. After scratching their heads, Baker and his partners realized that clinical physicians didn’t know what good there was in measuring blood flow.

“We were taught that there was no need for blood flow information at that time,” recalls Dr. J. Geoffrey Stevenson, a pediatric cardiologist at Children’s Hospital in Seattle. “Clinical medicine had to be convinced why it was necessary.”

So Baker retreated to develop a new business strategy. At the time, Smith Kline had the best echocardiography instrument on the market. “We decided to get a hold on the market by building a better instrument,” Baker recalls. “That way, people would listen to us.”

It worked.

By the mid-1970s, the number of fields interested in pulsed Doppler ultrasound grew like crazy. First developed for cardiology, ultrasound now drew serious interest from obstetrics, vascular surgery, gastroenterology, orthopedics, you name it.

Fred Silverstein, a gastroenterologist who is a clinical professor at the UW and a partner in Frazier and Company, a Seattle biotechnical firm, remembers the time in 1976 when he saw a demonstration of Baker’s new pulsed Duplex Doppler machine.

“It blew my socks off,” he recalls. “I had never seen anything like that. No one had. These were not vague images, but high-resolution, high-frequency, real-time images—and the best part was that the diagnosis could be made in a non-invasive manner. You didn’t have to give a patient an injection of a contrasting agent. It was totally safe. We never had anything like that before.”

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Doppler ultrasound was off and running, and so was Baker. He developed a worldwide network of researchers and clinicians who could go out to teach physicians about this new diagnostic tool that was effective and not that expensive. “I was like an evangelist,” he says.

By the late 1970s, Baker had created a bioengineering juggernaut. As a research professor at the UW (he joined the faculty soon after he graduated in 1960), he was one of the UW’s superstars in receiving federal research funds, and had a staff of 40 working in his lab, which consumed half of the electrical engineering building’s basement. In 1979, he asked for and received a $1.3 million grant from the National Institutes of Health—an astonishing figure back then.

Then everything came to a screeching halt. When Ronald Reagan was elected president, he promptly shut down many federally funded medical research projects. Baker lost his funding, so he shut down his lab, lock stock and barrel, and left to join ATL as a full-time consultant.

“I was sorry the funding came to an end, but I have been always self-sufficient,” he says. “It’s like a genetic trait with my family. We always worked for ourselves, so it was not a big deal to shift gears and go into private industry.”

He spent the next five years at ATL, traveling the world, lecturing and spreading the word about his ultrasound creation. But he tired of the corporate world and decided to retire. It didn’t hurt that ATL was later gobbled up by medical research giant Squibb for $60 million.

The legacy he created reaches into every nook and cranny of medicine.

“There is no other diagnostic imaging modality that provides so much vital diagnostic information, is so cost effective compared to other more invasive procedures and is so readily available to all parts of the medical community in all parts of the world,” says Donald Milburn, manager of customer education programs at General Electric Medical Systems.

In addition, Baker helped establish the Seattle area as one of the world’s preeminent spots for training in ultrasound. Seattle University, Bellevue Community College and a Spokane school offer programs in sonography, a new field of health professionals who have special training to do ultrasound diagnosis. (In fact, Baker’s wife, Joan, is one of the world’s leaders in sonography training.)

Even though he is semi-retired, Baker, who was honored with the Joseph Homes Pioneer Award of the American Institute of Ultrasound, isn’t sitting still. Soon, his early inventions will be headed to the Smithsonian Institution’s National Museum of American History, where they will go on permanent display sometime this fall in preparation of the 40th anniversary of medical ultrasound.

Finding solutions has been his life. Looking back at his career, he sits at the dining table in his home, where the future of ATL and Doppler ultrasound was debated over thousands of dinners. “It was very exciting to be involved in a project like that,” he says. “It was like being an explorer in the mountains, looking for that mountain pass. And you are the first one there. But you know exactly what to do.”

Jon Marmor, '94, is associate editor of Columns.