Join us for part 2 of the coverage on what it means to be and feels like a fellow in the Cleveland NeuroDesign Innovation Fellowship Program run collaboratively by the Case Western Reserve University and Cleveland Clinic.
Here we are joined by the inaugural cohort comprising: Efstathios Kondylis, Swarna Solanki, Patrick Smith and Nick Couturier with strong recognition for a Case Western Biomedical Engineering Alum, Michael Ackermann.
The next cohort applications are now open: https://www.clevelandneurodesign.org/application
Each of them have a unique story that led them to this point. They walk us through what drove them here, how the process was, their experiences, what they learned, gained and more importantly implement moving forward.
This one is surely one not to miss, as it exposes what it means to be in a program that teaches scientists and engineers how to innovate based on need., a principle well documented by the Stanford Biodesign.
Hey everyone and welcome to Skraps, where Arun and I endeavour to bring you the little known stories behind the science and technology that we find interesting. As always, we appreciate your continued support and we’re not going to be shy about asking for a little more. If you could take a moment and rate Skraps on your favourite podcast platform, your ratings and sharing your favourite episodes on social media, not only stroke our egos, they help us to reach more listeners. That way Arun and I can quit our day jobs and work on Skraps full time for the rest of our lives from an island retreat. If there’s a guest or an idea that you’d like us to feature, shoot us a message and we’ll be happy to check it out. This week, we’re doubling down. Actually, no, we’re gonna quadruple down on our guest count. If you listen to yesterday’s episode, you already know a little bit from Andy Cornwell about the NeuroDesign program through the Cleveland Clinic and Case Western Reserve University. Today we have the inaugural group of fellows to tell us about their journey and what they’re planning for next. If you like what you hear, we encourage you to share or consider the program for yourself. Fellowship applications for the cohort are open. Without further ado, Arun and I would like to welcome Swarna Solanki, Stathis Kondylis, Patrick Smith and Nicholas Couturier. Great, I think if if you guys can just do a quick introduction of who you are and your background and what attracted to you the to the program at the beginning. That would be great.
Yeah, I can start. So my name is Stathis Kondylis. I’m currently a fourth year neurosurgery resident at Cleveland Clinic I have a background in biomedical engineering studied at Arizona State, and then went to medical school at University of Pittsburgh. I also have a background in epilepsy and movement disorders research, mostly in the electrophysiology of those diseases. I was attracted to the program because, well, number one, I’m looking for a way to distinguish myself, you know, in terms of a future job hunt and things. And when I became aware of this program, it seemed like a great avenue to do just that. And the more I thought about it, the more I realised I’m kind of a person who enjoys making things and figuring out new ways to do things. So this programme really lent itself to those interests and, you know, my desire to advance my career as well.
Arun Sridhar: 2:49
So what are your long term ambitions being a neurosurgical resident here?
Sure. So I’m interested in epilepsy and functional neurosurgery. So primarily, I want to work with epilepsy patients, putting in electrodes, doing lobectomy and other surgeries to essentially cure epilepsy. And then on the functional side, I’m interested mostly in movement disorders, putting in electrodes that can treat Parkinson’s and essential tremor and similar diseases. So my ultimate goal would be to get an academic position at a major hospital. So you really got to distance distinguish yourself to get something like that.
Arun Sridhar: 3:29
Patrick, do you want to go
My name is Patrick Smith. I also have a background in biomedical engineering. I did undergrad and grad school both at Ohio State in Columbus. I also received a business minor during undergrad and then for grad school was part of a programme focused on medical product development. So similar to this programme, we were inspired by the bio design process and worked on a project with Ohio health and their trauma surgeons and innovations department to create a new surgical device and essentially go through this process and come up with a working prototype and then implementation plans for how to further commercialise that. So what brought me to this programme was kind of a desire to continue that kind of activity, I really liked the early stage, you know, concept to commercialization activity and the kind of free flowing nature of it all. I kind of realised that I wasn’t necessarily ready to go corporate right after graduation. So this was kind of the perfect opportunity to still flex those creative muscles. And then long term, looking into, you know, positions in which I can kind of continue this and even go further into the process, maybe start a business or, you know, work with businesses as they begin their commercialization efforts. With the ultimate goal. I think it’d be really cool to run a venture studio or startup accelerator kind of deal later down later down the road.
Arun Sridhar: 4:50
Fantastic. Nick, do you want to go next?
Sure. Yeah, so I’m Nicholas Couturier. I have a background in biomedical engineering. We all actually have that in common. So I did my undergraduate in Biomedical Engineering at Case Western. I did my masters in biomedical engineering at Case Western. And I got my PhD in biomedical engineering at Case Western. Surprise.
Arun Sridhar: 5:13
Never really left Cleveland, did you…
No. It’s kind of kind of, I don’t know, it’s like a black hole it kind of sucks you in. But um, so my focus in my research is also epilepsy similar to Stathis. I worked with Dr. Dominic Durand in his lab, studying stimulation and fibre tracks for refractory epilepsy. And I really got into that after a stint working on non invasive methods for treating people with epilepsy, there’s a lot of these patients don’t have the opportunity to in the case of children, for example, at the hospital, I was working with, they did not do deep brain stimulation in those patients. And so we were trying to find something that could be applicable to children. And then, you know, that sort of led me down the track to more invasive stimulation techniques, because the results were kind of more profound. And through my, my PhD, I developed this technique for stimulating the corpus callosum to inhibit seizures or prevent seizures from happening. And I was like, This is great. I love this. I love developing this new technology, when can we take it to the clinic? And then the reality of like, translation set in and I’m like, I don’t even know how to do this. Like, you know, who do I talk to? How do I get buy in from clinicians? Because a lot of them are like, yeah, this is cool, but we’re busy. So it was right around that time, I was finishing up that Andy Cornwell sort of came to me and he was like, so we’ve got this fellowship, that’s, you know, kind of just up and coming. We’re just developing, it’s the first year. I don’t know if you want to take a chance on this because it’s nine months and you’re graduating, you probably want a job. I was like, Yeah, I kind of want a job, but it sounds pretty cool. He’s like, yeah, like, honestly, if I went back in time, I would be jumping on this. And I was like, Okay, all right. That sounds pretty cool. And that was kind of my cue, I just sort of dove headfirst into it, and never looked back. And it’s been great because all the things that I wanted to learn how to do it’s been exactly what we’ve been doing in this programme. You know, going all the way back to before I even started my idea of doing research on epilepsy to like, why do I do research on epilepsy? What’s the unmet need, I’m trying to actually solve here? All the way to implementation, which is the stage I never got to so it’s kind of taken me from this like Limbo in between to both ends of the spectrum of product development. And it’s been great. I’ve really enjoyed it.
Arun Sridhar: 7:54
That’s awesome. Thanks, Nick. Swarna? What about you?
Um, hi. I’m Swarna Solanki. I, I got a bachelor’s and a master’s in biomedical engineering. My bachelor’s was from University of North Carolina, masters from Case Western Reserve University, which is what brought me to Cleveland and I never left. So it very much sucks you in. Um, I did research for several years as a biomedical engineer engineer working with Dr. Robert Kirsch. And, you know, during my time as a researcher, I started to get an itch to really build more business acumen. And I don’t think I’m very unique in that, you know, there’s like such cool research questions we were trying to answer but, but fundamentally, we weren’t necessarily focused or rewarded for developing things that were going to end up in patients hands in, in the near term. So I wanted to get a little more experience in that. So I took a pretty hard left turn in my career about at this point five years ago or so. And I decided to be a consultant with McKinsey. So I went there and worked for them as a generalist. And that was a wild ride an incredibly valuable learning experience, just professionally and intellectually, personally. And from there, after getting all that exposure, I found that I really have a passion for kind of the fighting for the underdog, if you will. And so I, I found a new home in entrepreneurial and new venture type activities. I actually co founded a company. We were focusing on developing games that were that were meant to sort of automate health and wellness therapies. So that was pretty cool. And from that, I was introduced to Jumpstart, which is I think it’s the largest startup support organisation in the Cleveland area. And I ended up getting sucked up back into consulting again with them. So I was a consultant again, and that was great. You know, then I was like really focusing on learning what, what it takes for the earliest stage, inventions and ideas to turn into commercially viable ideas. And after consulting for a while, I hit a couple of points where I felt like I was at a fork in the road in the trajectory of my career. One was that I had a baby. And so that was a natural break that I was gonna end up taking. And I decided to use it as a point to think about, you know, do I want to do something different next, and the other was, after being consultant, as long as I had been, I really wanted to kind of do the work myself, like, I was really excited to have an opportunity to be on the ground and start a company myself again. So I, this is kind of a funny story, so I’ll include it in this. I was looking for different opportunities as I was heading into maternity leave. And I was a week away from actually being induced when I was scrolling through LinkedIn and saw this posting that Andy Cornwell had put up, and I knew Andy from grad school, for the fellowship, and I thought, Oh, my God, I have to apply for this, even though the application deadline was like a week away. It was like, ehh you know, and I was like, No, I have to. So I ended up applying for it while I was in the hospital, like getting ready to be induced. And that’s only a funny story now, because I got it. Otherwise, it would just be sad and crazy. And you know, I was so excited about it, because I was actually excited about this kind of fellowship before it ever existed in Cleveland. One of my fellow graduate students, Michael Ackermann, when we were at Case, he went to go do the programme at Stanford, which this programme is modelled after the Stanford biodesign programme. And I remember back then thinking it was so cool. At that time, I described it as bio design for big kids, or I’m sorry, not biodesign. I describe it as senior design for big kids, because that was the perspective I had. And what I meant by that was, you know, sort of a project that you can take forward, but it’s with people who have maybe the skills and expertise and knowledge at that time to really make something that turns into a company that can really be commercialised. So, when I found out it was in Cleveland, I was just over the moon excited and wanted to be a part of it also fits into my hopes to get to start a company for myself. And so that kind of leads into what I’m hoping for going out of the fellowship, or for my future career. I would love to be involved with starting and exiting companies in my future career. Hopefully it comes out of this fellowship, maybe not, but we’re hoping for that, we’re pushing for that. And a lot of my drive to do that is actually I want, I want it to be skilled at this so that I can enable others to do it, I have a lot of passion for this region now. I believe that Cleveland and the greater Northeast Ohio region has a ton of potential. And I’d love to be a part of being a member of the support organisations and like Patrick said, we’ve actually had conversations about.. I told Patrick, I can’t leave Cleveland, I’m settled here. But I was like, you go get awesome experience all over the country and come back and Patrick and I are going to start a venture studio here in Cleveland someday.So yeah, that’s my story.
Arun Sridhar: 13:14
That’s fantastic. Thank you all for sharing that. Because there is one clinician, three engineers, with each of them having a different story, I think I think that’s, that’s fabulous. Can I just put you all on the spot here and just ask one follow up to what you just described, which is, if all of you are very individualistic, I think there is no doubt about that. Right? I think that basically speaks to how the four of you actually complement each other through the programme. But during the programme, as I’ve heard from from others, as well as it’s very clear, and having spoken to you folks a few times now. Can you just describe who … is there one person or a couple of people that you aspire to be? And why?
It’s tough for me to pin down one person. I think my biggest.. the people who motivate me the most are my parents and my grandparents really. Especially on my mom’s side, my grandparents immigrated to this country, they didn’t know the language, they didn’t have anything. And they built a chain of diners, you know, and they worked really hard to make that happen. And I said before that I’m really motivated to build things to make things and I think that might be the source of that, you know, they came with nothing and they built something and made a life made a life for their kids and for me, really. So following off of that my you know, my mom and dad work really hard as well. They got their education, that was the opportunity they got from their parents before them and you know, made a life for themselves as well. So, you know, I aspire to be like them I think. There are lots of you know, I could talk about doctors I could talk about inventors, but those are the those are the the ones that really hit home for me, I think.
And you’re Greek, correct? Just to clarify, I think it’s pretty obvious, but just for clarity. So there’s a pretty, pretty strong Greek network in the neuro tech field, I think you’re gonna find a big extended family there for you.Stathos: 15:18
That’s great. I’ve already started to meet some of them, but I know that it’s a big web.
Great. How about you, Patrick?
I’ll start with the serious answer as well. I don’t know if I’ll be able to top statuses story, but um, you know, I’ll also echo, you know, my parents, definitely, you know, my dad has been a big inspiration, you know, going through up into my entire educational journey, and you know, what I aspire to do professionally. He’s a chief of an office, and I don’t know which one I should know, but at NASA, He’s been working there for a long time and doing a lot of really cool, really cool stuff. I was often, you know, I say harassed, but joked that I was gonna follow in his footsteps and be that that rocket space engineer. I always fought very hard against that, but in reality, I mean, it was, it was quite the inspiration to push myself through my education and, you know, be professionally driven. So you know, hoping to continue on with his successes and be effective in my field. And then kind of the, you know, less serious answer, I guess, for lack of a better example, I guess, being someone like Mark Cuban, who is able to just kind of do whatever he wants with investing in companies and working with entrepreneurs and developing their ideas and making them into something real and crazy and great, I think is kind of the ultimate goal of what I want to be able to do within the med tech space.
Mark Cuban might hear this interview.
And if he does, I’d love to chat.
Arun Sridhar: 16:47
So, um, I think I’m going to cut the line off here with the parents. I mean, yeah, I love my parents. But, um, I think that, for me, I sort of have like a, maybe a more of a fictional character, I don’t know, maybe enough people that are specifically the type of person I’m thinking of. So for me, I think I would want to be somebody who can basically pursue their research or get involved with someone else’s research vision, and ultimately be able to be on the front lines of something really big and transformational. And, and that’s something I’ve kind of always envisioned for neurostimulation. And I’ve kind of like over over the years seen glimmers of that, and a different times been like, wouldn’t it be cool, if, you know, we did this or we did that? And, you know, this led to something completely transformational, for example, in a chronic disease state, rather than maybe a small niche market. And someday, I hope to be at the forefront of, for example, neurostimulation for cancer, I was working on a project with my adviser Dominic Durand. And, you know, maybe he is, in some ways, someone that I aspire to be, like, who works on things that are so you know, bizarre that, you know, not many people are really focused on them. So he was taking a stab at, you know, recording from tumours and possibly treating cancer or melanoma with electrical stimulation. And that kind of thing just sort of blows my mind. I’m like, that’s what I want to be involved in. Like, that’s has huge, applicability to so many people, and could completely change the game in terms of the way we think of some of these huge diseases. And I would want to be in the, in the stages of taking that and making it a reality. I’m still in the process of learning how that’s done. But I hope to by the end of this, this programme, sort of have a little bit clearer idea of how I can become that person.
Okay… Um, I hope that this does not come off as cheesy as I anticipate it’s going to but um, I’ve thought about this a lot and my answer pretty consistently for a while, has been I aspire to be like Oprah. Um, and I have been working on like, what I really mean by that for a while and I don’t know if I have a great explanation yet. But I, when I think of Oprah, I think of, you know, somebody who was just so genuine, that was able to be herself and vulnerable, but also really powerful maybe because of that. And, you know, I think of her as someone who is able to create a space where people feel very heard and, and is able to, through that, like really empower people to do things or feel like they can do things that maybe they didn’t always feel like they could. And you know, she has, like incredible like, I think I mentioned you know, listening skills. And then to be able to respond to those things, ask the right questions. And we get to work, all of us have gotten to work with an executive coach, throughout the process of the fellowship, and sort of when I was describing something similar, she, she said, Oh, you want to be the Oprah of entrepreneurship. And she was like, I coined it. That’s it. It’s a thing. And I think I think that is what I’m trying to do. But I’m trying to work out like what that really means, but I am hoping it means something along the lines of, you know, creating a space where people can feel empowered and genuine, maybe something similar to what you all are trying to do with Skraps that you know, this is this is not always the the path, the the simple and clean path that people pose that it is. And you know, to be able to help people make connections and, and find resources to do impossible, incredible things.
Arun Sridhar: 20:57
I’m just saying that she’s incredibly famous right now in the UK, she’s held in very high esteem by the British public right now. So I’ll just throw it in there. Just to date ourselves in terms of the conversation.
It’s true, Oprah is kind of a hot shot, again, in this moment.
So I’m tempted to ask Arun what he wants to be when he grows up. But I don’t I don’t want to take up our time. Because it is limited.
Arun Sridhar: 21:24
I never want to grow up, I just want to be a child. I’m still 12 years old, by the way, in case any of you actually can if you want to date my IQ, I think that’s pretty much it.
Don’t make me go back there. I’m not going. So tell us tell us a bit about I mean, the programme started it was launched, applications were due everything. This is 100% COVID times for your programme. Tell us about how. And I still remember Andy sent me a photo of him on the first day when you guys actually got to meet in person, he was all dressed up and he held up a sign like it was his first day of school. I’m gonna include that in here. By the way. What was your first day of school like? What was the pro? What’s the programme? What’s the direction you’re given? How much rope Are you given to hang yourselves by? what’s a typical day? Like,
I guess I can start with a quick thing about it. Um, it was, I guess very much like a first day of school like we all and we hadn’t met before. I actually didn’t even know the names of the other like Nick, Stathis, and Swarna like didn’t even have any idea of who they were until we met on that first day. You know, masks on kind of that, like, blind day like, Alright, let’s all get to know each other, do some icebreakers. But, you know, it worked out really well. We went through I guess, like a one week boot camp of what the biodesign process is like, kind of did like a case study almost like Crash Course of here’s what your next nine months are going to look like. But condensed into one week and kind of them answering any questions we had explaining the resources that we’re going to be available to us which were and are immense. So it very was much like the first week of school at a new school in a new city.
And you guys are the inaugural group of this programme. And you’re there. The leaders are learning right alongside you. What what … Have there been any hiccups so far?
Can I just go back to your last question, actually, you asked what a typical day is like. And one of the things I love most about this programme is almost every day is whatever we want to make out of it. Right. So there was a phase when we were going to operating rooms and you know, going to various clinical engagements and it was really anything we wanted. One day we would go see, you know, a brain tumour resection. The next day, we would go see physical therapy. And it was really just, you know, us chasing what we thought were the best leads. And as we’ve gone into the invent phase, which we’re concluding now. Every day is just however, we think we can come up with a creative solution. So for example, a couple days ago, we printed a 3d, we 3d printed a replica of a patient’s mouth, just so that we would have something we could prototype on. That’s something I could have never imagined doing. But you know, we came up with a problem. The problem was how do we test these things, and we came up with a solution. And we had the tools we just made it happen. So I think that’s the best part about the programme is that our executive team and the Cleveland Clinic and Case Western everybody has made it so that really all the resources we need are at our fingertips. And all we have to do is imagine what the next step is and when we can make it happen. You asked if there have been any hiccups? You know, COVID has been a hiccup for sure. So we were lucky we were able to get access to the hospital. But certainly there were some restrictions. I don’t know that there were real restrictions like you cannot go here. But there was a sense that we wanted to be safe so we spent a large period of time with working mostly remotely. And you know, we found tools to help us do that, you know, we use tools like air table and zoom and Microsoft Teams and sort of some of the standard things everybody’s aware of, but we tried to find creative solutions to be able to work collaboratively remotely. So you know, that’s something that other cohorts maybe maybe they will have to learn. Maybe they won’t if things are fully in person in the future, but yeah we may do.
I’m going to take umbrage with you calling COVID a hiccup I’m gonna call it a shit show. But how does the the chain of accountability work? How do you stay on track? Are you giving them milestones that you have to reach along the ways? How much of the programme Do you go by the seat of your pants? And how much is prescribed?
Um, yeah, that’s a great question. We, we have found that, you know, the, the Stanford biodesign process is very well laid out. And our exec team is helping us sort of learn that process. And with it come a lot of these milestones. So you know, it’s in the realm of commercialization, where we’re at, we’re trying to operate at a really fast pace, like I would say, like two times three times the pace, maybe that would happen normally. And exec team has given us milestones, but at the same time, like, and this is, this is maybe the more negative version of what Stathis was highlighting when you think about the day to day and he said very positively and poetically, that it’s, you know, what we want to make of it. There’s also the the Mondays that we have, where we’re banging our heads against the wall and having like, pretty hard discussions on like, what should our strategy be for the week, and it occurs weekly, because it’s moving so quickly, every week has like some significant milestone that is, like, like I mentioned, suggested by the exec team, we also ourselves vet it to see does it make sense to us? Do we want to pose something different and have a discussion about a different sort of milestone, and then how are we going to use this week to get there, what should the strategy be. And that starts over again, the next Monday, and the next Monday, so. So it’s great that we can define it, but it also means we have to do the hard work of defining it. And I think, in some ways, I mean, you’ll you’ll get to talk to our exec board members too, but I think they’ve, they’ve been sort of very pleasantly surprised that we’ve taken this very seriously. Like, we don’t necessarily talk about this, just like an educational programme, we’ve, we’ve taken a lot of ownership about how this should go. And, and, and have taken the onus on ourselves to really define, like the pace and the milestones.
Arun Sridhar: 27:39
Yeah, and just describe what that early. So you describe the three stages of what you’re doing. And in terms of how the programme is kind of defined. So just walk us through how you went through the process of, of understanding the various potential needs, and ultimately filtering it down. And then defining what was important, what was in etc. So I think all of that was, I mean, you had a lot of help you kind of did it as a group, etc, etc. All of that is granted, but just walk us through that process so that people can actually understand how you go from a blank sheet of paper, for lack of a better phrase to actually having something that you would want to then invent on, which is basically what it actually is. So start with describing the three areas, just naming it and then go through the first stage for us.
Well, there are three phases of the fellowship. And the first phase is called, I think, identify where we were identifying different clinical needs. The second phase is called invent, where we were inventing solutions, or potential solutions for those needs, and the last one is implement. And that’s where you really come up with an implementation plan for, let’s say, said clinical need with awesome solution. So we just finished the second phase, and are moving into the hardcore developing a business plan phase.
Sure. Go ahead, Nick.
Okay. I was just gonna say. So for the first phase for the identification phase, the first thing that we did was.. It was very clear, I think we didn’t really have a whole lot of doubt about what the first phase was going to look like, you know, in terms of observation, we knew we had to physically go to an operating room, we had to go to an ICU, we had to go to a clinic. This was very clear, like this is part of what makes the Stanford biodesign programme so unique and I feel like gets a lot of attention. So we did that we went to these places. And we just went there day in day out over and over and over again. And we just started taking notes on everything. And I think that was probably the part that was a little less clear at first, like what’s relevant, why, you know, this person over here is struggling with, you know, this tool, is that, is that a problem? Do we need to you know, think about that as something we could possibly solve. So, we just started completely open minded, and wrote everything down that we saw. And we just had tonnes and tonnes, you know, over 500 different observations in the course of a month. And what we do is we debrief at the end of the day and sort of go through some of these and be like, Okay, what do we think was really important? What do we think was not so important? And can we rank these in some ways? You know, a little bit, not too much, but a little bit. And then, you know, by the end of the week, we should have some ability to create some need statements, like, Who’s the population that this is a problem for? What is the problem isn’t even really a problem? And, you know, what do we think we can we can do in the end to make this better? And is that a big deal? So we spent, we spent way more…
Arun Sridhar: 30:47
And you were solving for whom, Nick? you’re solving for the patients you’re solving for the physicians, or you’re solving for the composite?
I would say, it’s, it’s different in every, every, every one of these needs, has a different person or stakeholder who this is a problem for. And that was part of the educational element of this was, we had the opportunity to really identify who is the person that this affects the most, and who maybe perhaps this is also a problem for but who is the person or group of people, that’s really, you know,
Arun Sridhar: 31:24
It’s not It’s not the only reason why I’m asking is basically from my own personal experience. Example, if you go to an ICU, the first priority for all the healthcare people that are there, nurses, doctors, etc, is to do the right thing for the patient. And everything else comes secondary. So therefore, when you enter the place like that, you are barraged with a tsunami of information all the way from the most minute, just minor thing to actually some of the probably some form of a major crisis that’s actually happening right in front of your eyes. So which is exactly where that question came from is like, how do you rank them? But yeah,
it’s interesting that you mentioned the like tsunami of information that was one of kind of the biggest things we really were dealing with in that first phase was, we come out of everyday having spent eight hours you know, in an OR, and whatever scenario we were in, and we’d have all of our individual observations lists of like up to 50 each. And do we have, we don’t have time to talk through all of these. Are all of them worth it? Are all of them valid? Do we overlap? So initially, you know, before we even started narrowing down from this big list to a small one to go forward with prototyping, a lot of that really early stuff was figuring out just how to manage all the information we were gathering, because it was all important in one way or another. But the reality is, there’s only so much time in a day, so much time we can work together, that, you know, we kind of had to start prioritising some stuff right out the gate in terms of what were what do we want to talk about what the rest of the team, what did I see today that I really want to talk to talk about the rest of the to the rest of the team, and figure out if if there’s really a clinical need here, if we should move this forward. So then through that, at the end of that six weeks, we did have a list of about I think it was like 500 need state… observations, and then about 280 actual need statements that came out of that, that then we started developing a more formal process to go through, look at specific criteria and aspects of them, rank them against each other, see where things were important, which weren’t as important things of that nature.
Arun Sridhar: 33:42
And just as a thing, all four of you were in the same or, or the same ICU, etc, you all were splitting up or were all of you in the same place? Because that I mean, that basically speaks to the wide range of information that you’re probably collected in the early stage, right? So were you all together or were you all separate for the entire day, and then you aggregated towards at different points in the day to look at your notes, etc.
I think the answer is both. So especially at the very, very beginning, I was sort of the guy who knew the way around the hospital and knew everybody. So one of the first things we did was try to introduce the team to everyone who who would be important. And as they became familiar with the operating rooms and the nursing floors and all the different locations, we started splitting off, like you said, to cover the most ground and then especially as we I think one of the best things we did was get away from the hospital a little bit. We had observation opportunities, like I said before that physical therapy, you know, outpatient physical therapy, you know, things like that, and really at that point, we were splitting off trying to cover a lot of ground. So we started all together and then all went our separate ways
Arun Sridhar: 34:54
and how which means that when you folks went in and asked for the information from whoever whichever department or the the place that you that you were rotating in on a given day, you also needed people to engage with you. So what was your overall experience because being a first batch of of group means that they are not exposed to this type of people badgering them for information on a daily basis. So, I’m sure you had some interesting stories, but I think let’s, but overall, did you did you get the support that you required, and that you needed to be able to gather all the information?
I think the overall theme is that we had incredible support. So Dr. Machado is head of the Neurological Institute at Cleveland Clinic. Before we even started, he sent out an email describing who we were what we were going to be doing. So everybody kind of knew what to expect with us. And everywhere we went, we just kind of had to say, you know, we’re the neuro design team, we’re here to try to figure stuff out. And it’s unbelievable how many times people would come up to us with their own ideas, hoping that, you know, we would champion some of the things they’d already thought of. So everybody has seen problems in the hospital, everybody has made a mental note of them. And almost everybody was more than happy to share their space and ideas with us. So we really didn’t run into any problems at all there.
Yeah, one of the kind of surprising things was, you know, how many times you know, we’re sitting in the operating room, essentially, you you try to be a fly on the wall, stay out of everyone’s way. But there were a lot of times where the surgeon or whoever would kind of, you know, look at us and be like, hey, come take a look at this, like, come up look in the microscope, or Hey, come like, I want to talk to you about this. During this break or something. It wasn’t just us kind of standing there, silently gathering information and not talking to anybody, we really got a lot of buy in from the clinical staff across the board, which was, you know, immensely valuable to us.
Arun Sridhar: 36:53
Yeah, I mean, the biggest learning experience is when you actually stand quietly in the room, nothing’s happening. And people will actually talk to you. It’s, it’s not like what it’s shown on on ER, or, or Grey’s Anatomy, unfortunately. But it’s it’s fantastically engaging with the right people and the right teachers there.
I was just going to add one thing, like one of the big lessons that I learned from this process, and how to how to maybe explain to somebody, how do you go through something like this, and maybe going back to what you’re saying Arun. You have.. how do you go from the blank paper to clinical needs that you actually want to focus on for innovation. The, the biggest lesson, I feel like I learned was to very deliberately be divergent and then convergent. And it’s something that they tout a lot in this process. But I found it to be very real in hindsight, and, you know, the rest of my teammates elaborated on it really well. But just high level, the the important thing was that there were in that first phase, which was the identify phase, there were about six weeks where the whole point was to do these observations day in and day out, like we talked about. And then we sort of deliberately stopped and said, okay, that that divergent, high volume collection phase is over, there were a lot of things that needed to happen then. And now it’s time to switch gears and start to think convergently. And think about how to take this mass of information that we’ve collected and start to whittle it down. And then there was six weeks where we went through the process of sifting through hundreds of these needs, and in a strategic manner, landing on four that we then took over to innovation. So that was like a big, I think, educational experience.
So in in whittling that list down from 500, to two, whatever 100 down to four, are there are there projects or needs that you sort of became emotionally attached to you or thought that or just really spoke to you individually without any, I mean, one more so than another for? And for what reason?
I’ll take a stab at answering this first. And I don’t want to speak for everybody. But I think we all did talk about this a lot at that time. And it surprisingly, wasn’t that much of a problem. Because one thing that we did all align on really early on was that we wanted to make a big clinical impact, we wanted to treat this as the start of a real company that we you know, all wanted it to be successful, successful, commercially viable. So because we were all so deeply rooted in those goals, the the individual interests of like various different needs, kind of fell, like below that. And I think another thing that helped with that, too, is we still went through this process and have our whole careers ahead of us. So everybody still remembers the needs like that didn’t end up in the top four. And there could be a time where they come back up in our careers and we’re able to take them forward. So when we had to whittle them down, I’m not sure that we felt a tonne of heartache as much as just excitement for the ones that were still in the running. I don’t know if anyone wants to add to that.
Yeah, that that was a problem we anticipated and spent a lot of time trying to prepare for. And ultimate, maybe because of the preparation, but ultimately, it never really reared its ugly head. You know, I think one of the best things we did, as Swarna said was to outline what are the goals of the programme for each of us. And then we establish criteria for you know, what are the good needs in order to good ideas. And at that point, it really became a question of like, okay, you like this idea? Does it meet the criteria? Does it meet the goals? And if not, you know, it’s gone, we don’t have time to linger. So fortunately, it never became a big problem.
Arun Sridhar: 40:55
That’s fantastic. Moving on, from identifying to the next stage, which is invent. Nick, do you want to start us off here, kind of talking about what were the critical processes that that went behind, or steps that went behind the invent process there, what what the team do?
So the invent phase, unfortunately, I mean, in some ways, I’m glad we got the identify phase out of the way early on before COVID was really, you know, wiping the floor with, you know, the entire community. So it was difficult around that time, we switched to going back to fully remote. And, like I said, That’s not as big of a deal as it would have been for going to the OR because we needed to do that there was no way of doing that remotely. So, um, so our first thing that we knew we had to do was brainstorming, like, that’s, that’s kind of sold is like, this is the fun part. This is the part where you guys get to, like, sit there and think about the craziest ideas. You know, whatever comes to your mind, were divergent, as Swarna said, again, so we very quickly had to identify a way to do that remotely. And we came up with, you know, using jamboard.
Arun Sridhar: 42:14
But those divergent, inventive ideas were for the few bullets that you actually had that were left with at the end of the identify phase, correct?
Yeah, yeah. So we only took four of those needs after the identify phase. And from those four needs, we had separate brainstorming sessions for each one of those four. Yeah, we were never going to do that with 500, that would have taken forever. So, so those top four needs, we said, okay, what’s that brainstorming sessions for each of them and do it multiple times, not just one session. And we sat around, and we really, you know, put our minds to not being judgmental in any way. Because we had some pretty crazy ideas, I think at one point, Magic School Bus type, you know, little pill thing you could swallow would, you know, solve a problem or something like that. But, you know, some advice that we got, I think, in the book or from someone was behind the curtain, just behind the craziest ideas, or, you know, some of the most inventive and powerful. So we went through this, and we went, we really dove into brainstorming. And that probably took us several weeks just doing that. And that was that was it was honestly the most fun because it forced us to think completely out of the box, and not be judgmental, and not worry about what other people were going to and not worry about what anybody else is gonna say, regardless of how ridiculous our ideas were. And you know, there were plenty of times where we’ve just, you know, we’re busting a gut laughing because it was hilarious, but it’s pretty good ideas behind some of those crazy getting that down, what
Arun Sridhar: 43:55
Were there different considerations in that so you had a bunch of ideas, but then you had to then filter down those ideas. So let’s go from diversion to convergent again, what were the considerations that you actually had to employ to converge that?
Patrick Do you want to you want to take that? He was the driver of that.
Like you mentioned, it was another kind of round of divergence and convergence, this one was actually kind of two of those. So we treated the first brainstorming session as like the heavy duty mass, divergent, you know, all the ideas and then took a look at what came out of those, kind of tried to group them see what we had see what areas we had really focused on and maybe come up with some new approaches to solving the problem for a second brainstorming session. And then again, kind of came had the ideas that came out of that and tried to organise them see any patterns. And then we also had developed criteria for each of the needs. So we you know, labelled those as must haves and nice to haves for you know, what is the solution have to have, in order to adequately address this need, what would be nice to Have on it but isn’t necessarily vital to its success. And that wasn’t really our initial filter was looking at, you know, okay of these somewhat crazy solutions, which ones meet the criteria? And which ones really just missed the mark? Or are, you know, we don’t really see a way to actually make it happen. You know, just because we live in reality. That was our kind of initial check. And then after that, we went into more of an individual brainstorming area and concept generation, which the brainstorming sessions has left us with a lot of fragments of ideas and different kind of overarching approaches, we really wanted to nail down alright, what are these actual concepts look like draw it out on paper, we treated almost like a thesis that we defended to the rest of the team, in order to kind of land on a solid list of real ideas and real actionable concepts that we were ready to take forward,
Arun Sridhar: 45:54
Coming from somebody who did not go through this type of bio-design process. But probably having had a hand in doing this, I think the key things that I always when I go through some of the inventive ideas, and then filter it down. The considerations always, for me, is really, I was always I always taught myself to think of the three P’s, which is patients, physicians, and the payers. And ultimately, if your idea doesn’t fit into each of those three buckets, then it possibly is not a good way. So now that was my approach. And I want you guys to challenge me on that and say, was that something similar to you took you took in your programme? Or was it something different? And if so, what was it that was different?
God Arun, rpysician starts with an F .Everybody knows that?
Yeah. Know what, we took very much a similar approach, we had several phases. In the early phases, like right after brainstorming, we really had a lot of ideas to go through. And we had to take an approach that lent itself to dealing with that sort of volume, just as we had to do at the beginning of the identify phase. So you know, we use sort of numerical systems, outline criteria, who does this help? You know, does it help patients? Does it help physicians? What’s the magnitude of the impact? Is it something that makes things more convenient? Or is it something that saves lives, and we attach numbers to things like this, and in that way, we had sort of a numerical method, where we could set a cutoff threshold, right? If, you know, on one of our charts, there was a maximum of 30 points, let’s say that these ideas could get, and we knew the 50th percentile was around 18 points, you know, we could set a threshold like that. And immediately, you know, which were the ideas that on the better half of things and cut the rest, essentially. And as we got down towards fewer and fewer ideas, we took the approach, I think Patrick was alluding to a little bit before where, you know, each of us would champion some of the ideas. And that allowed us to get into a lot more of the nuance of these ideas. is no more was it you know, a one to three scale, it was really presenting and defending an idea to the group, and all the nuance that goes with it, you know, yes, this helps physicians, but it can also save lives and 20% of patients, things like that. And that was my favourite part of the process, actually, because these ideas are not simple and straightforward, a lot of them. So having the opportunity to really get into things and understand, you know, the payers, the physicians, that things you said before, but also the dynamics of how the operating room works, and specifically how this can help various people, the nurses, the physicians, there was something I really enjoyed getting into in detail.
So now you’ve whittled it down to four, you’re prototyping, you’re you’re looking at business cases, what’s the next step for you guys?
So we have basically narrowed down to, and I don’t think we’re super unique in this. Sometimes teams take one invention forward, sometimes they take like, two, we are, we’re taking forward three inventions. Two, for one need one for another need. And the next steps are really to figure out, we’re going to be looking into what are the activities that are required to really implement those inventions? And of those activities? What are sort of the high risk ones and create plans and or, like get answers to significant questions that really mitigate some of those risks, to figure out which ones really have legs post the fellowship. So and those kind of implementation activities include figuring out what is the regulatory path for these, what are potential reimbursement strategies? What is the IP strategy to protect the intellectual property? Those are the kind of plans that we need to lay out, figure out How much they cost? And where would that funding come from post the fellowship.
And speaking as a clinical person, that’s definitely been. The implementation phase, which one is talking about is something I’m not very familiar with. And it’s been pretty difficult. And I think we’re all kind of cognizant of that. We’ve actually cut down to two needs that we’re tackling right now to clinical needs. And we have three solutions. So from hundreds of needs and hundreds of solutions, we whittled down to two needs and three solutions that we’re working on at this point.
So all right, you’re getting close. Now. It’s the programme that end is in sight. What what is what have each of you individually gotten out of the programme and what we missed most?
Arun Sridhar: 50:45
Especially compared to the goalposts, that you set yourself at the very beginning? Because that was a reason why we asked you that question as to what were your ambitions. And now, I want to see in line with your ambitions. Did you get enough out of the programme,
go in reverse order? This time? How about Swarna?
What we’ve gotten out of this programme is it’s so hard to describe. It’s so much and it’s embarrassing, when I hesitate, to answer it. We actually just went through this exercise in one of our teamwork seminars that we do weekly. And it’s like, I just feel like I get jammed up on how to answer it. But I think largely, it’s the biggest lesson learned for me is that there was a long period of my, like career up to this point that I spent thinking like Who am I to think that I can invent something or start a company? You know, that’s for Steve Jobs. And I’m not that and, and one of the major things they drove home with this is that this is a process, this is a skill that can be learned. And I very much feel that way. Another major lesson is, is an I honestly think I always felt this way and this really drove at home is any one of these ventures are the kind of make or break with the people that are involved. And there was a lot of effort, I think, put into matchmaking the four of us together. And through the time that we’ve spent, I can see why they put us together both for like our technical skills, experiences, and also our personalities. team dynamics is often a deal breaker for many startups. And we have been very fortunate, like even even the hiccups or hurdles that we face in our team dynamics. I think relatively we’re very lucky. We’re all good people. I respect these guys a lot. And I’m going to miss them the most for sure. At the end of this that’s that that answer is simple for me. And I think I think moving forward in my career, what I learned and what I’ll be able to take forward is, you know, this really taught me that the the feeling that I can’t do something because only like, special famous people do it is a fallacy. And I’m looking forward to kind of like being more empowered myself moving forward, Nick.
Yeah, I would, you know, I guess I’ll just start off with echoing what Swarna said, probably the thing that I’ll miss most about this programme is being able to work in such a high functioning team. You know, we, I was really kind of surprised, you know, walking into this that everything would run so smoothly. Because you know, I’m sure most people have experiences working with teams, there are very few times where you can think of, at least personally with teams just run perfectly. And I’m not saying we’ve run perfectly, but we’ve we’ve been very effective at getting things done, even when we didn’t know exactly what those things should be. And maybe that’s part of what some of the thing that I’ve valued the most of this programme is figuring out how to do very complicated things. With a bunch of people with different skill sets, who you know, you haven’t known your whole life, you’ve just sort of been introduced to how do you structure all of that all that chaos? How do you bring it together to to achieve your ultimate goal at the end, which is to make some product or have some idea of what the product looks like, and then sell it to an investor? And how do you how do you do that? How do you navigate that, especially when you’ve never done it before. So in a way, at a high level, there’s been a lot of educational value to this. Coming from a background in graduate school where you’re, you know, you have very complicated problems you’re trying to solve. You do it on your own, and you can set the pace for what you want to do. You can make the decisions when you’re going to do them how you’re going to do them. You don’t really have to consult with anyone outside of maybe your advisor from time to time but you know, when You have to have a whole team on your shoulders or, you know, together. You know, you move as a unit, you don’t move individually. And that’s been a huge learning experience for me. And I think it’s been enormously valuable as I move into the next phase of my career, learning how to do this in the real world with other people and not being an island. In terms of your skill set,
Arun Sridhar: 55:24
So yeah, I really, I really like what Nick said about being able to structure chaos. I think that’s also a big takeaway that I’ve gotten through this, you know, we’ve talked a lot about the divergent and convergent kind of cyclical nature of this process we’ve gone through and it’s taken, you know, a lot to get a grasp on how to look at, you know, on a Monday, what are our tasks for the week? What do we need to achieve, what’s this five day goal. And then at the same time, understanding that what you’re doing during that week is also actively pushing you towards a longer term goal and being able to manage and understand that zooming in and zooming out perspective on, you know, a big project like this, I think has been incredibly, you know, useful to understand how to do and it’s been great to, you know, with our structure of, you know, there’s not really one single person on this team telling everyone what to do, it’s been very collaborative, and figuring out how to do that and figuring out the best ways that work. So that’s been great as well, I think that’s probably what I’ll miss the most is, you know, not necessarily having someone looking over our shoulder telling us what to do. There’s a lot of freedom to what we’re doing, and a lot that we have control over. And you know how this goes. And I know that that’s not necessarily the case on a lot of projects. And I say the real world as if this isn’t, but you know what I mean. And so I think that’s what I missed the most. But I’m very grateful to have gone through and kind of develop a lot of these, I guess, project management skills, and understanding of how to control the chaos father’s
Yeah. So at the beginning of this fellowship, we did a really cool team building activity where we all listed out or dreams and ambitions and put them on post it notes and stuck them on the wall. And the point was to show and it did show that a lot of us had many of those in common. But one of the ones I put down was to fundamentally change some aspect of medical care in something. And I think that one, at least one of our ideas that we’re moving with has the potential to do that. And the best takeaway from, from this, this programme would be for all of us to be able to kind of check off that box, I think that’s what we all hope and dream for. But I think the more realistic takeaway that that I expect to get is learning a lot of the skills to you know, perhaps be able to make that happen in the future. So, you know, I’ve, I’ve been going into the operating room a while now. And not everything runs perfectly smoothly, there are lots of problems. And not only the surgeons, but the the other people who work in the operating room are amazing at finding creative solutions to those problems. And I think we’ve had the opportunity to learn a lot of the skills to make those creative solutions, and, you know, products that, you know, can can change medicine and can be sold to other people. So what I’m hopeful for is that, you know, in the future, when I notice a problem, I have the skills and the tools to be able to develop a marketable solution to that kind of a problem. And I would love for that to be part of what I do in the future, in addition to being a clinician,
Arun Sridhar: 58:25
Fantastic, thank you, in terms of the programme finishing, and let’s talk about what the next one year is going to look like for each one of you. So what’s next? What have you guys have have planned
We mentioned a lot during this, that we, while this, you know, is at some level and educational opportunity for all of us and has been we have been taking it very seriously with that kind of startup mentality. And we really do fully intend, you know, to do everything we can to make one if not all of these inventions and you know, commercialization plans a reality. So, you know, that’s definitely on the forefront of all of our minds. I think we all in one way or another want to be involved in whatever that looks like beyond the fellowship. On the realistic side, though, you know, we we are facing kind of the imminent end of employment essentially. So, I know next one on I have been, you know, in the in the area, searching for jobs, looking at new opportunities and ways we can translate these skills, you know, beyond the fellowship and figuring out what, what the the path look like for each of us. And I there, I think there are somewhat different but all exciting,
Arun Sridhar: 59:38
so Stathos, I assume you’re going back to your neurosurgical training to complete all of that. (Stathos Nods). Okay, so I think
Just keep that up, you know, you haven’t invested much time in it, just let it slide.
Arun Sridhar: 59:51
(Laughs) So I think I think the important message that we want to put across to everybody who’s listening to this is the fact that you four people who have been incredibly well trained by experts in the area who have both been fertilised, you know, fertilise themselves into in terms of the excellent ecosystem for neurotechnology who are in the market, we’re actively seeking opportunities. I think people should seriously start thinking about figuring out ways in which they can engage with each one of you. So I think that is one message or one request from myself and Jojo. And that is one of the big reasons why we’re actually doing this because having worked in the area, especially of of neuromodulation, while there are lots of, of kind of traditional companies and startups who are focused on in, in either coast, etc, especially the West Coast. I think there is paucity of really good talent that you can hire, and, and mould and mend and really kind of develop them and give them the opportunities to do so during the course of their usually people will have to move jobs, but I think to ultimately get to the next stage, but I think what this actually means is that you are assimilated a multitude of capabilities that you can ultimately employ, no matter which company you go to, or who you work for, etc, you can have a lot of lateral movements, in that based on the capabilities that you have actually gained in the last few months here with the neuro design programme. So
Arun, if we can, we let’s just let each one of them pitch themselves individually. And then because this is, you know, a marketable opportunity. And then if it’s okay with you, we’ll include in the show notes, your LinkedIn connections, and then if you want us to include your CVS, just make sure and send those to us. Because, you know, we’re happy to help you guys out. So if that’s cool, I know we’re on a time crunch. But Nick, if you could go and then just want to say those.
So my next step is to basically kind of bridge the gap of what I did before this fellowship and what I did during this fellowship. And to me, as I mentioned earlier, my goal is to have an impact through neuro modulation on patient care in a significant way. And so my goal is, is to take my years of experience in DBS and electrophysiology. And, you know, designing experiments and thinking strategically about how to really figure out what’s going to work and what’s not going to work. And couple that with all this experience that I’ve gotten in the fellowship, sort of de risking things, looking at the market, and figuring out how to take something and make it a reality in terms of a product and, and apply that to neuromodulation. So any company, that’s, you know, hiring at this point, or has the potential to fill that role, I’m looking forward to pursuing where I can actually play that role of developing a neuro modulation technology, and making it a reality taking it from, you know, some some experiments to something that’s actually marketable and can be implemented. Whether that means clinical testing, research and development, or just really working with different stakeholders to really flesh out how do we make this a reality?
Alright. So nothing, nothing is more awkward than pitching yourself. So thanks, thanks. No advance notice on that, um, but given what my experiences have been, and you know, I’m really trying to head to a place where I can really add value in, like I’ve mentioned, you know, this greater Cleveland, kind of Northeast Ohio region, specifically in like health care entrepreneurial activity. I am really hoping that in the near term, I’m able to gain more experience either with startups directly or in startups, support type organisations, where I get to sort of push my envelope and be at a stage where I’m able to really work out deals and establish strategic partnerships and just get a better understanding of what does that really look like, I feel like I’ve got an experience. I’m at this point, I’m a strategist, I’m a generalist, I’ve done the very early stages of companies, but sort of when it gets right to where we’re going to be ending this fellowship, you know, where we’ve got this great idea. We have all these plans for it, but now it’s going to take people outside of our team to really make this happen. How do you really create those deals and and what do they even look like? And how are people incentivized to do that? I’m really excited to To gain experience in exactly those kind of activities, and I feel like after that, what I would really like is to be able to take that beginning to end and and empower others to do the same
Oh, yeah. So things are a little bit simpler for me going forward than for the other members of my team, I’m going to go back to clinical training, which I will continue for at least four years, probably some clinical fellowship training as well after that. But I think you know, one of the big takeaways from from this fellowships and they have discovered myself about myself is that I have the energy, passion and bandwidth to engage these kinds of projects, making things making things that help people, it’s something I’ve really enjoyed doing and something I want to continue doing in the future. So like I said, before, I’m going to be looking for one day looking for a position at an academic institution. And in addition to clinical research activities, that these are the kinds of activities I’m hoping I’ll be engaging as well. So I’ll be looking forward to that.
Arun Sridhar: 1:05:58
Patrick, over to you.
So I’m actually quite similar to Swarna. And some near term goals, you know, this is my second time going through a process like this, and a project like this kind of developing some early stage technologies, and really trying to put a plan together to get them off the ground. And really looking forward to you know, in my next role, taking that next step and understanding you know, what it takes once you start getting funding, making these, you know, strategic partnerships, and really getting what you invented into clinicians hands and in a position to impact patient lives. So, no, I’ve looked into areas that involve consulting, startup support organisations, innovation, arms, at different companies, all kinds of sort of things, just trying to figure out, you know, what, what would be the best fit and where I can really gain some more knowledge and that later stage, the later stage of the early stage, if you will. So really looking forward to exploring that in the near future.
So now with that, I think we have we have a cohort of four pretty amazing people to present to you as possible candidates. Three more, more immediately, and the fourth coming soon to operating theatre near you. But these folks seem to have will come to you with an exceptional experience with leadership skills, real world applications of neuro technology and business case use with a little bit of B school thrown into their technical background. So we’re gonna include their LinkedIn profiles in the show notes, as well as possibly some CVS or so for you too, so that you can connect and hire this next round of really amazing talent. Thank you all for being here. We really appreciate it.
Arun Sridhar: 1:07:47
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