Challenge Conventional Wisdom
As a society we are spoiled. Thanks to smart-phones we have the internet at our fingertips, thanks to GPS we never get lost anymore, and we have an infinite choice of flavoured coffees to enjoy during down time. Would it surprise you to know that all these ingenious inventions that are now a part of every day life were close to not even happening.
Furthermore some of the creations we take for granted today were mocked or wildly unpopular when they were first introduced, forcing some inventors to push on despite the backlash and the headaches.
Challenging conventional wisdom is an essential part of innovation because by the very nature of what you are improving there is always somebody who regards the existing technology as their own or as I learned, there were people who had trained for years to use the technology that I was about to make obsolete.
Assume that everyone knows something that you don’t.
Whenever I meet someone my ears are always open, I have a genuine interest in what that person has to say. It’s something I developed from being a child, the old adage that ‘children should be seen but not heard’ meant that I would listen to visitors to our household, and my thirst for knowledge meant that I acquired knowledge from these interactions. In later life I realised that by listening to people with genuine interest, you gain their respect and quite frequently you learn something you didn’t know ...... occasionally that’s a nugget which is life-changing.
In 2001 I was heavily involved in the commercialisation of Electrogastrography, an amazing tool for the diagnosis of gastrointestinal diseases. By analysing the myoelectric activity of the smooth muscles of the stomach it is possible to identify irregularities, and I had developed software that is able to turn that data into a diagnosis for gastrointestinal disorders. Around this time I was listening to a colleague who told me about a research paper that had just been published in a medical journal regarding endometriosis. At this time endometriosis was still relatively unknown by the wider population despite effecting over 10% of the global female population and it was widely becoming accepted that it was the cause of infertility in 30% of cases. The research paper highlighted the relationship between endometriosis and neuromuscular disease of the gastrointestinal tract.
I suppose you could say that was my eureka moment, if I could identify the presence of gastrointestinal tract diseases then I was sure I could detect the disease related to endometriosis.
If you don’t believe in yourself, others won’t believe in you.
From an early age I had self belief in abundance, a good family upbringing had ensured my moral and intellectual compass were functioning perfectly. I displayed good judgement in the decisions I made through adolescence and if I ever decided to champion a cause then it was worthwhile and I can’t think of an instance where I was wrong.
When it comes to the introduction of new technology it’s essential that at the earliest opportunity you gain the support of others, the more influential the better. When it comes to ‘selling’ that idea to others you need to have the courage of your conviction that it’s going to work and be worthwhile then your task is effectively selling yourself, or rather your belief in the proposition.
Luck is where opportunity meets preparation
With success comes a degree of scrutiny and observation, some of that will be positive and some negative, on more than one occasion my success was a result of luck, or literally being the proverbial right person in the right place at the right time.
I had just returned from my therapeutic endoscopy fellowship in the department of surgery at the University of Hamburg in Hamburg Germany. It was interesting to me was that not only was it an opportunity to master new advanced techniques that very few people in the world could perform, but with it came the responsibility of being able to teach those same techniques to others in my own country. I had been preoccupied by this thought while away, and had often mused that it would be incredible to be able to have a simulator-type product for these highly specialized endoscopic procedures, that would teach both the manual and the cognitive skills separately and then unite them together in a simulator format. In fact, in this way it would be possible to actually program in the procedural style and methods of any of the worlds’ most accomplished surgeons for anyone to learn without having to travel or spend extensive amounts of time in on-site training.
These concepts stemmed from an early childhood experience where a friend of the Family and accomplished science fiction author Isaac Asimov came to know my early thirst for knowledge, created a short story just for me as a young child. It was in that short story a young student was sent to school to study in the traditional way while his friends were instead taught skills on simulators. The young man quickly realized that the knowledge and skills obtained by working on simulators ended up being a limitation to his friends who did not have the most recent models or software. When the protagonist in the story questioned why he was learning in a more traditional way, he was informed that he was selected to be one of those who would teach beyond what a simulator could provide.
Shortly after my return from Germany, I was introduced to a remarkable innovator whose name was David Hon who had created a company called Ixion. Somehow, David had learned of my skill as well as my encounter with our family’s friend. In what was an amazing stroke of luck, he invited me to join him in developing simulators for medicine that would teach upper endoscopy, colonoscopy, and the more advanced skills of ERCP including selective cannulation of both the bile duct and pancreatic duct as well as sphincterotomy and stent placement, and ultimately laparoscopic surgery. It was at that moment I realized that forces that have been set in motion when I was a young child had come together at that moment in time and that it was my preordained destiny. It was only up to me to seize the moment.
Thus began an exciting journey that led to an intense period of learning during which I could use my learned engineering skills combined with new skills of software development and hardware integration to develop the simulators. At the time we were writing programming using artificial intelligence before the existence of artificial intelligence was recognized. If you will, imagine having to program and coordinate live images that would match with manual maneuvers of an endoscope for every millimeter of possible direction during a procedure.
Even more interesting was to witness the birth of a new field known as medical simulation and to play a prominent role in its creation. True to the protagonist in the science fiction story, I witnessed the creation of simulators that would teach the maneuvers of various experts in the field. However, I also recognized the limitations and began deconstructing the process and publishing concepts like “visual feel” and the importance of mastering manual skills apart from visual skills, and then bringing them together that resulted in even greater learning capabilities. In this manner it was possible to take the teaching skills and combine them with the device building skill to not only shorten the learning curve, but potentially prevent complications and even death…. as physicians would learn on simulators instead of new patients as part of their training process.
Since that time, there is not a month that does not go by when I am not approached by a physician, either young or older, who trained on one of the simulators I helped to develop or was influenced by the textbook chapters or other publications that came out of our simulation work.
Now, I am a firm believer in both destiny and that you make your own luck in life and it’s my contention that if you are prepared when an opportunity arises then you are well placed to exploit it. My thirst for knowledge and my desire for continuous improvement is at the heart of my personality and this leaves me fully prepared as well as minded to grasp any opportunity.
Nothing trumps the thanks of a cured patient
During my career spanning over forty years I spent 30+ years as a gastroenterologist and I see medicine as a vocation I was drawn to with a desire to cure people. In terms of global impact some of my inventions far out weigh the outcome of my medical practice, however the ability to make people better is a wonderful driving force and when you receive the thanks from a patient who has been cured there is no better feeling.
It’s noble to teach oneself but still nobler to teach other
That’s a famous quote from Mark Twain I would change that quote and replace noble with rewarding. I was at a recent conference in Mexico when I bumped into one of my past students, Herrera He made a comment at dinner that really touched my heart. He said that until he heard my explanation of reflux he didn’t understand the disease and at that moment in time what I was teaching to him just exploded his mind and he achieved complete understanding that has helped him be a better doctor.
“Being attacked is a sign that you are important enough to be a target. You should relish the attention and the chance to prove yourself.”
When it was first suggested to me that I should create this website the overriding motivation was the fact that the innovators in this world are some of the most criticised. In my life I have witnessed brilliant people be deterred because they couldn’t understand or cope with having a target on their back. To somebody minded as an innovator it is counter intuitive; the basis of innovation is improvement, and so the last thing you’d expect is to be greeted with anything less than enthusiasm. Sadly that’s not how society is structured and over the years I started to gain an understanding why people react in this way. More beneficial is working out when this is likely to happen and what strategies you can employ to prevent it.
If all else fails and should you ever find yourself the victim of other people’s bitterness, smallness, or insecurities. Remember things could be worse ... you could be them!