David W. Smith MD, ACP, BS (Chemistry), Board Certified (Internal Medicine Specialist), recognized as a visiting scientist for both the Division of Sports Medicine at Cincinnati Children’s Hospital Medical Center and the North Shore Division of Neurosurgery, Chicago Illinois. Over his 30-year medical career, he served as Chief of Medicine at Reid Hospital and Healthcare Services. In addition, he founded commercial companies for developing his innovative product concepts – Xennovate Medical LLC, TBI Innovations LLC, and Delta Chase LLC. As Chief Science Officer, he was a consultant to GENTEX Corp, the largest manufacturer of USAF helmets, and Materials Modification Inc., nano–materials and coating pioneer to the military complex.
Dr. Smith has 40+ patents and 20+ peer-reviewed publications in diverse fields of science, providing him with a unique perspective in overcoming a broad spectrum of significant medical paradigms. As a consultant, he presented several novel battlefield dressings to the Department of the Army Research Lab (DARPA) at the Aberdeen Proving Grounds, Aberdeen, MD. Dr. Smith discovered and then pioneered “SLOSH Theory,” which represents the basis of first and only FDA-Cleared device for claims against Traumatic Brain Injury, The Q-Collar which is also the basis of his new book “When heads Come Together.”
Tell us about your new book, When Heads Come Together.
When Heads Come Together shines a light on the journey to overcome many longstanding scientific mysteries, including the elusive scourge of Traumatic Brain Injury (TBI), potentially saving contact sports and the brains of our warfighters. “Why don’t clever people solve Traumatic Brain Injury?” a member of the 2008 Army Research Lab presented to me. Fifteen years, 40 patents, and 25 journal publications later, I had pioneered “SLOSH Theory™” which explains how Nature’s highly g-tolerant creatures such as woodpeckers, giraffes and head-ramming sheep can tolerate, and even thrive, in the setting of innumerable head impacts. This theory discloses the different ways that the natural world has given animals to raise the volume of the cranial vault to create a “tighter fit” not unlike bubble wrap, which results in reduced energy absorption from impacts and explosions. My tagline may say it all... Nature is my mentor™ and you can witness how this mantra plays out through the book’s pages.
My background in chemistry, physics, and medicine helped me uncover and understand these clever physiological and anatomical adaptations in the animal kingdom, which led to the creation of many novel principles and medical devices which alleviate human suffering.” Much of the early chapters of the book revolve around the creation of the First and Only medical device, the Q-Collar™, authorized by the FDA in 2021, as being safe and effective against Traumatic Brain Injury (TBI). Within a year of launch and at the time of this writing, more than 20 NFL professionals have adopted this device, and given the continued struggles the league has had with TBI, more are sure to come.
Why did you decide to write this book?
I have been fortunate to have presented the above discoveries and technologies to hundreds of venues including universities, concussion clinics, national athletic trainers’ associations, to even having been one of just seven presenters to the Army’s 3-Star Lieutenant General Laura A. Potters, Deputy Chief of Staff of the US ARMY at a symposium titled “What Cincinnati has done to protect the Warfighter’s Brain.”
In the above role, I am usually given 10-30 minutes for my talk, yet questions seem to abound...for hours. Humans are instinctively creative and inquisitive. Never has this been more evident than when people are shown that persistence and cleverness are still being rewarded with revolutionary understanding and novel technologies that can help mankind. Time and time again, I had been asked, “where can I find more information about your work?” This book now answers that question.
Much of the book goes into how the whole innovative process works. For example, I showed how we framed the problem, conceived an answer, vetted the ideas academically, followed by bench studies, and right through to animal and human trials. There are so many out there that want to capitalize on a creative thought or invention, When Heads Comes Together serves to illustrate a path forward. Imagine having a treasure map that no one even knows you have and now, for the first time, you get to tell everyone all about it!
How do woodpeckers, sheep and giraffes figure into your book?
When the Army Research Lab joking asked for clever people to “solve Traumatic Brain Injury,” a brilliant PhD chemist in the audience piped in, “I think if someone could just figure out how woodpeckers can slam their heads into trees 80-million times and fly away unharmed, wouldn’t this whole thing become obvious.” Now, I am sure you can imagine, all the people in the room started laughing, except me. You see, as a practicing internal medicine physician, thousands of people came to me over the years expecting answers to their health concerns - and I never knew for sure if there even was an answer. But his statement was stone cold proof that there WAS an answer to the scourge of TBI, and Nature (I always capitalize Nature in reverence) was in possession of it.
So, my research had been compelled by these amazing woodpeckers, and then, I went on to include so many of Nature’s g-force tolerant creature. Head-ramming sheep and giraffes both repeatedly crash their skulls at 500 x g, when you and I tend to get a brain injury at one-fifth of that force (and often with just one blow)? This book shows the reader how natural selection went on to facilitate simple mechanisms to protect these animals and how a touch of clever mimicry could offer these same protections to our human world.
Tell us about the Q-Collar.
Much of the early chapters of the book revolve around the inspiration for, and creation of, the Q-Collar™, the First and Only medical device to be authorized by the FDA as being safe and effective against Traumatic Brain Injury (TBI). Within a year of launch and at the time of this writing, more than 20 NFL professionals have adopted this device, and given the continued struggles the league has had with TBI, more are sure to come. Further adoption has been seen by the Premier Lacrosse League, the International Bobsledding and Skelton community and even the US Army. Illustrating the world’s anticipation of this technology, within 48 hours of the above FDA’s press release, the Q-Collar received more than 350 million media hits.
The device itself is fashioned after the physiological mechanism found within the woodpecker’s neck, the omo-hyoid apparatus. In all mammals, including humans, we all have omo-hyoid muscles that are actually attached to both jugular veins and prior to our work, mankind did not know their function. As it turns out, when we yawn, we occlude our jugulars in four places—seriously. After connecting the dots, this inspired me to invent the Q-Collar, a “C” shaped device which comes around from the back of the neck to apply gentle pressure to areas above the jugulars to mimic what the highly g-force tolerant creatures of the forest seemed to be doing. When we tested this jugular compression concept in animal studies, we blocked 83% of the signature injury pattern of TBI, quite a fete when you would be hard pressed to find any other technologies that could block even one percent. Recent advancements include the addition of a 4-way stretch, moisture-wicking, machine washable “sleeve” that goes snugly over the Q-Collar. It’s softer, cooler (temperature), and adds color customization to your collar. The military and first responders requested this device be fire-retardant and that is soon to be offered through this sleeve as well.
Besides athletes, who is it ideal for?
More than ONE MILLION head impacts (with and without the Q-Collar) have been meticulously studied by many of the most prestigious academic institutions in the world. Q30 Innovations has just been awarded a $2.8 million contract by the United States Army Medical Research and Development Command (USAMRDC) in an effort to evaluate the effectiveness, and field suitability of the Q-Collar to help prevent or reduce TBI in soldiers in their operational environment. We actually studied 30 SWAT officers in Cincinnati, OH while they were performing Breacher Simulation Practices blowing up the walls of a condemned bank with C-4 explosives (You could find me hiding far away in the parking lot). Half of the officers were outfitted with the Q-Collar and “high tech” tensor MRI analysis of their brains were taken before and after a day of blast explosion exposure. As hoped, the positive results of the protection afforded by the Q-Collar was vetted and published in prestigious journal articles and furthered the interest of the military.
The medical world is also finding an amazing place for the Q-Collar. A little-known condition of balance and fatigue call Postural Orthostatic Tachycardia Syndrome (POTS) has been showing much promise in utilizing this device. Although the data has yet to be published, and with no submission yet for FDA claims, one patient after another seems to see their symptoms abate immediately upon placement of the Q-Collar.
Tell us about the SAGE Rebreather.
So, the first protective physiology found in woodpeckers was not jugular compression (the basis of the Q-Collar). It was, in fact, the exposure to, or modulation of, the animal’s own carbon dioxide levels. You see, woodpeckers are “cavity nesting birds.” I had never heard of that classification before trying to decipher their bewildering tolerance to head impacts. Inside these cavities you find only 16% oxygen (normal being 21%) and get this, 5% CO2 levels (125-times the ambient level of CO2). What is that mamma woodpecker thinking when placing her babies in this caustic environment? Cavity nesters include the likes of peregrine falcons, owls, fly catchers and they’re all predator strafing birds, pulling as much as 50 x g or more when swooping down at their prey at 220 mph (as is the falcon’s case) and yet when they pull up suddenly, they don’t pass out. Could the g-force tolerance be due to the higher levels of CO2 to which they were exposing themselves?
Every cell of your body produces CO2 and it is not toxic in any way, however it can produce unfavorable effects at very high levels. So, we set out to mimic what Nature has been doing for millions of years, safely and precisely raising one’s CO2 level to afford the miracles of mild hypercapnia (raised CO2). We then set out to see if the protective benefit that many animals like head ramming sheep and giraffe was in fact due to their raised CO2 levels. We published our vetted CO2 studies showing a 65% reduction in TBI markers using just 5% CO2.
We weren’t done. Next, we showed that precise delivery of CO2 levels could be accomplished by rebreathing your own exhaled breath and in doing so, we have made massive strides against obstructive and central sleep apnea, POTS, Altitude Illness and we will now be studying it in restless leg syndrome, fibromyalgia, and long COVID. We believe we might even be able to reverse brain injury by bringing elevated CO2 levels to the post-impact battlefield or sporting field. We are coining this technology, “CPR for the Brain.”
What is the main message you want people to take away from reading your book?
Why don’t people just keep asking “why?” Yes, I do carry several letters after my name, but honestly, it often just takes cleverness, perseverance and the willingness to keep failing over and over yet never giving up. Admittedly, I was given a peek into the realization that Nature had found an answer, so I had a general idea of what field to start looking for rabbit holes.
What I might take credit for is that once I thought I had found the right rabbit hole, I didn’t stop there, I just kept looking for others. I call this obsession, immersion. I did not stop at the anatomy of the woodpecker, giraffe, or the head ramming sheep, I went on to familiarize myself with what these creatures ate, where they lived, their migration patterns and the reasons why?
Academia tends to get lost in data. Perhaps a good thing if wanting to publish a paper. But sadly, many of my researcher colleague’s hair starts on fire when I mention “overwhelming circumstantial evidence.” An oxymoron to most of them. But, if you want to delve into a deeper meaning, you have to step back from your teacup and really look to see if the leaves are telling you something? Answers are out there to many of life’s conundrums. “Conventional Wisdom” just may be that oxymoron.
You have such an extensive background - medicine, chemistry, physics, writing - and a big family (5 kids!), how did you find time to add "author" to your resume?
Well, I admit to a bit of obsessive compulsiveness, but in reality, I owe so much of this to my parents. My early years were quite full with being a national level competitive swimmer (complete with early morning practices) and often, I had been encouraged to play other sports, like tennis, for my high school team ... at the same time. You see, at age 8 to 15 years-old, my parents were somewhat concerned about the neighborhood kids I was hanging around with and thought if they just kept me wildly busy, yet demanded good grades, maybe I wouldn’t find time to get into trouble.
The concept was brilliant on their part, but yet, all this did was fertilize an already overly inquisitive mind ... and that meant I was always into something. I am not saying I had trouble with the law or anything, but self-driving to swim practices at 4:30 am, did afford us the opportunity to put 200 rolls of toilette paper on an opposing high school the night before the big Friday football game.
I have learned that family is everything. I truly cannot think of a single one of my kids’ athletic or musical events that I missed when they were growing up. Admittedly, it wasn’t easy as a practicing Internal Medicine physician whereby I could be on-call and up continuously the whole night before. I could always find sleep sometime later; you can’t always make up missed shared experiences.
Authoring has been a much greater challenge for me. My formal training prepared me well to do technical writing, whether that be journal articles, patents or grant writing. But finding a way to not put readers to sleep...now that is frighteningly difficult. To make it worse, the ideas and concepts I hoped to write about have often been steeped in very complex and boring physiology and mathematics. When presenting my theories or concepts visually, I could get away with using one video or graphic after another, you know, “a picture paints a thousand words” and all. But when you have to paint word pictures when so many of these words are completely foreign to your reader – that gets dicey.
What can we expect from you next?
I have started a website (DavidSmithMD.com) to chronical the research into what may be the crowning achievement. It appears that both jugular compression and CO2 rebreathing, both facilitate the Glymphatic Circulatory System. Yes, that is a mouthful, but let me explain. The brain is THE most metabolically active organ of our bodies, yet until 2014, we could not figure out how it “took out the trash.” Maiken Nedergaard, a Danish neuroscientist, and her team described a newly discovered physiological pathway that explains how the brain rejuvenates itself, and as it turns out, our technologies just may be able to potentiate this mechanism. If it proves true, this could herald a new way to treat neurodegenerative disorders like Alzheimer’s, Parkinson’s Disease, Chronic Traumatic Encephalopathy and the like. Ideally, our most recent patent pending technology could even repair brain injuries or even protect our astronauts from Spaceflight-Associated Neuro-Ocular Syndrome (SANS). This strange condition appears to be happening in our astronauts when they stay in space for prolonged periods of time. Research suggests this could be the result of altered pressures and volumes of Cerebral Spinal fluid in or around the eyeball and we just might be able to help!
The discoveries are coming in rapid fire and writing about them in book format seems to be the perfect venue to get the word out. Stay tuned for more innovation and storytelling – this is really getting fun!
For more information, visit https://davidsmithmd.com/.
