Podcast appearances and mentions of Richard Miles

How to Support the Rob Skinner Podcast.  If you would like to help support my mission to multiply disciples, leaders and churches, click here:  https://www.buymeacoffee.com/robskinner   Matthew Series Matthew 13:44-58 Sunday, August 25th, 2024 What's the most valuable thing you've ever discovered?    1. Staffordshire Hoard, 2009 In 2009, Terry Herbert, a passionate amateur treasure hunter, was exploring a plowed field near Hammerwich, Staffordshire, England, when his  metal detector signaled a significant discovery. Over five days of diligent excavation, Herbert and the landowner, Fred Johnson, unearthed a staggering 3,500 military artifacts, collectively known as the Staffordshire Hoard. This extraordinary find included over 11 pounds of gold, 3 pounds of silver, and semi-precious garnets, possibly sourced from as far as Sri Lanka or Afghanistan. Dating back to the 6th and 7th centuries, during the Anglo-Saxon kingdom of Mercia, the hoard is believed to have been buried around 875 A.D., when the region was under Viking threat.     2. The Le Catillon II Hoard, 2012 Reg Mead and Richard Miles, metal detection enthusiasts from Jersey, embarked on a decades-long quest after hearing a farmer's tale in the early 1980s. The farmer claimed to have discovered silver coins while plowing his field on the British island of Jersey. Mead and Miles, armed with perseverance, obtained permission to search the field for a mere 10 to 15 hours each year after the harvest. Their dedication bore fruit in 2012 when they unearthed 68,000 coins, along with gold neck torcs and glass beads. These treasures, dating back to 30 B.C. to 40 B.C., were buried by the Coriosolitae tribe of Celts, likely fleeing from a Roman invasion led by Julius Caesar. The Le Catillon II Hoard stands as the largest collection of gold jewelry and Celtic coins ever found.   3. St. Albans Hoard, 2012 In 2012, novice metal detectorist Westley Carrington ventured into a farm field in Berkhamsted, England, armed with a beginner's metal detector. His discovery turned out to be one of the largest hoards of Roman gold coins ever uncovered in Great Britain Jesus Introduction ·         This chapter forms a composite picture of the kingdom of God o   Responses to it o   Rejection of it o   Judgement of all people o   Personal responses to it o   The value of it ·         It can also form a historical outline: o   Planting of the seeds o   Varied responses o   Small beginnings o   Infiltration of the gospel throughout the Roman empire o   Individual responses and value of the kingdom o   Final judgment These parables are only found in Matthew 1.      The Parables of the Hidden Treasure and the Pearl 44 “The kingdom of heaven is like treasure hidden in a field. When a man found it, he hid it again, and then in his joy went and sold all he had and bought that field. 45 “Again, the kingdom of heaven is like a merchant looking for fine pearls. 46 When he found one of great value, he went away and sold everything he had and bought it. These stories build on what Jesus has taught about how things are “hidden” and “secret.”  Some find the gospel, others don't.  The other parables talk about the impact or spread or nature of the gospel, these two talk about the value to individuals.  The treasure ·         People hid valuables in the ground, there were no banks or vaults to provide safety. o   Genghis Khan §  Khan was reported to have given himself a front row seat for the mayhem at Merv. He sat on a golden throne and watched as men were dragged before him and executed. It was said to have been a ‘memorable day for shrieking and weeping and wailing'. The invaders tortured the wealthy citizens of Merv so they'd give up their money and jewels.  One source puts the number of dead in the Merv massacre at 700,000, while a contemporary Persian chronicler estimated the number of corpses at a staggering 1.3 million. Khan apparently ordered each of his soldiers to kill at least 300 people. ·         He stumbles on it ·         He knows he's found something amazing ·         He sells all out of self-interest Feb. 25, 2014, 12:53 PM MST / Updated Feb. 25, 2014, 12:54 PM MST A Northern California couple out walking their dog on their Gold Country property stumbled across a modern-day bonanza: $10 million in rare, mint-condition gold coins buried in the shadow of an old tree.   Nearly all of the 1,427 coins, dating from 1847 to 1894, are in uncirculated, mint condition, said David Hall, co-founder of Professional Coin Grading Service of Santa Ana, which recently authenticated them.   Although the face value of the gold pieces only adds up to about $27,000, some of them are so rare that coin experts say they could fetch nearly $1 million apiece. The pearl ·         This is a person who is seeking actively ·         He is familiar with prices and value ·         He realizes that this is the only one he needs to own ·         Once you have the gospel, you don't need anything else ·         Share:  Silver Coins These stories emphasize that only the wholehearted get to enjoy the treasure.  You have to go all in, sell out and grab hold of what God is offering you.  Jesus specifically says that in Luke 14:33 “In the same way, those of you who do not give up everything you have cannot be my disciples.”   How's your response to the gospel? Whether you've stumbled on it or have been searching for it these stories show that once you discover it, you have to determine the incomparable value of Jesus and then divest of anything necessary to get the treasure. The trouble is we don't value Jesus highly enough.  We want him and a whole lot more. It's time to repent and get baptized.   If you are already a disciple and have the treasure: Ø  Do you gripe and complain how hard it is to follow Jesus? Ø  Do you complain how much you've had to give up to follow him? Ø  Are you considering selling Jesus for something in the world, like Judas?   If you have Jesus, you have everything you need. There once was a fabulously wealthy man who loved his son above all things. To stay close to his son, they began to build an art collection together. Every spare minute, they were out at auctions and sales acquiring rare works of art: everything from Picasso to Raphael. By the time the Vietnam conflict broke out, they built one of the rarest most valuable collections in the world. A letter came one day informing the son he had been drafted. The father offered to pull some strings, but the son felt compelled to serve his country as his father and grandfather did before him.  The son went off to war, but he wrote his dad every day. One day the letters stopped. The father's worst fears were realized when he received a telegram from the war department informing him his son had been killed while attempting to rescue another soldier. About six months later, there was a knock at the door. A young soldier with a large package under his arm said, "Sir, you don't know me, but I am the man your son saved on that faithful day he died deep in the jungles of Viet Nam. He had already saved many lives that day, and as he was carrying me off the battlefield, he was shot through the heart and died instantly. Your son was my friend and we spent many a lonely night "in country talking about you and your love for art." The young soldier held out his package and said, "I know this isn't much and I'm not much of an artist, but I wanted you to have this painting I've done of your son as I last remember him. The father tore open the package and fought back the tears as he gazed at a portrait of his one and only son. He said, "You have captured the essence of my son's smile in this painting and I will cherish it above all others." The father hung the portrait over his mantle. When visitors came to his home, he always drew attention to the portrait of his son before he showed them any of the other masterpieces. When the father died the news went out that the entire collection was being offered at an exclusive private auction. Collectors and art experts from around the world gathered for the chance of purchasing one of them. The first painting on the auction block was the soldier's modest rendering of his son. The auctioneer pounded his gavel and asked someone to start the bidding. The sophisticated crowd scoffed and demanded the Van Gogh's and the Rembrandts be brought forth. The auctioneer persisted. "Who will start the bidding? $200? $100?" The crowd continued to turn up their noses, waiting to see the more serious paintings. Still the auctioneer solicited, "The son! The son! Who will take the son? Finally, a squeaky voice from the back said, "I'll bid $10 for the son." The bidder was none other than the young soldier the son had died saving. He said, "I didn't come to buy anything and all I have is $10 to my name, but I bid it all." The auctioneer continued seeking a higher bid, but the angry crowd began to chant, "Sell it to him and let's get on with the auction." The auctioneer pounded the gavel and sold the painting for the bid of $10. An eager buyer from the second row bellowed, "Finally, on with the auction." And just then the auctioneer said, "The auction is now officially closed." The hostile crowd demanded to know how after coming, all this way could the auction possibly be over? The president of the auctioning company came to the microphone and said, "When I was called to conduct this auction, I was told of a stipulation in the will I could not divulge until now. According to the wishes of the deceased only the painting of the son was to be sold today and whoever takes the son gets it all. So today, for $10 this young man has bought one of the world's most priceless art collections and the entire estate in which it is housed -- auction closed." And with the swing of the gavel, the crowd sat in stunned silence staring at the young soldier. “Whoever takes the son, gets it all” If you have the Son, you have it all.     2.     The Parable of the Net 47 “Once again, the kingdom of heaven is like a net that was let down into the lake and caught all kinds of fish. 48 When it was full, the fishermen pulled it up on the shore. Then they sat down and collected the good fish in baskets, but threw the bad away. 49 This is how it will be at the end of the age. The angels will come and separate the wicked from the righteous 50 and throw them into the blazing furnace, where there will be weeping and gnashing of teeth. ·         This is similar to the parable of the weeds. ·         There will never be a time when you as a disciple will be surrounded only by “righteous” people. ·         It's like a lake where everyone is swimming free. ·         There is a net slowly moving us in one direction, but we all have freedom now. So many people are like the optimist falling from a tenth story window, who called out cheerfully as he passed each story, going down, “All right so far!”   51 “Have you understood all these things?” Jesus asked. “Yes,” they replied. 52 He said to them, “Therefore every teacher of the law who has become a disciple in the kingdom of heaven is like the owner of a house who brings out of his storeroom new treasures as well as old.”   ·         When you become a disciple, you are like a teacher of the law who has access to treasures both old and new. ·         Why wouldn't you want to share those with others? Ø  Share the word study and discipleship study this fall with someone   3.     A Prophet Without Honor 53 When Jesus had finished these parables, he moved on from there. 54 Coming to his hometown, he began teaching the people in their synagogue, and they were amazed. “Where did this man get this wisdom and these miraculous powers?” they asked. 55 “Isn't this the carpenter's son? Isn't his mother's name Mary, and aren't his brothers James, Joseph, Simon and Judas? 56 Aren't all his sisters with us? Where then did this man get all these things?” 57 And they took offense at him. But Jesus said to them, “A prophet is not without honor except in his own town and in his own home.” 58 And he did not do many miracles there because of their lack of faith. ·         This is a variation on the saying, “Familiarity breeds contempt.” ·         I should have read this scripture before I decided to plant a church in my hometown. ·         I somehow missed this ·         Many people became Christians, my family didn't make it. ·         Show picture of my hometown church. You know how many family members responded?  None   Next Steps ·         Pay any price to get Jesus and his kingdom ·         Pull out treasures old and new and teach someone the word and discipleship study this fall ·         Prepare for the judgment.  Make sure you have a real relationship with Christ.  Repent and get baptized immediately.    

Join us for a SPECIAL CADE PRIZE Episode with Phoebe Cade-Miles and Richard Miles from the @CadeMuseum as they discuss everything from how the prize started, to what it was like being the daughter of the inventor of @gatorade Some about Phoebe: "Phoebe Miles is the co-founder of the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum, named after Gatorade inventor (and Miles' father) James Robert Cade, exists to transform communities by inspiring and equipping future inventors, entrepreneurs, and visionaries. Ms. Miles designed the Museum's proprietary education curriculum, Invent Possible, a framework for lifelong STEM learning through the lens of invention. Invent Possible teaching units are tied to Next Generation Science Standards and are available to teachers at all grades. A native of Gainesville, Ms. Miles graduated Phi Beta Kappa and received a B.A. in German, a B.A. in History, and a teacher's certificate from the University of Washington in 1987. She is fluent in German and working on Spanish, Mandarin, and French. From 1988 to 2006, she and her husband spent over a decade living and working overseas in Germany, Barbados, and Argentina. They have lived intermittently in Washington D.C. since 1992 and have three adult children and three grandchildren." Some about Richard: "Richard Miles co-founded the Cade Museum and served as vice president of the Board of Directors until 2019. From 2017 to2021, Miles was a senior fellow and senior associate at the Center for Strategic and International Studies in Washington D.C. He currently serves as chairman of the Trinity Forum and as a board member of Prison Fellowship International. A career Foreign Service officer with the U.S. Department of State from 1993 to 2009, Miles was posted domestically and overseas. His assignments included a provincial reconstruction team in Karbala, Iraq, the staff of the National Security Council at the White House, and postings in Argentina, Germany, and Barbados. During the 2016 presidential campaign, Mr. Miles served as a Latin America policy advisor to Governor Jeb Bush. From 1988 to 1991, Miles was an intelligence officer in the 2nd Armored Cavalry Regiment (ACR) stationed in Nuremberg, Germany. With the 2nd ACR, he participated in Operation Desert Shield in Saudi Arabia and in combat operations in Kuwait and Iraq during Operation Desert Storm. __________________________________ Do you have an idea you want to get off the ground? Reach out to the Making Awesome Podcast through https://3DMusketeers.com/podcast and someone will get you set up to be a guest!

This week on the show, host Richard Miles explores the possibilities of parenting technology with Sarah Ostadabbas, an associate professor of electrical and computer engineering at Northeastern University. Sarah isn’t just talking theory – she’s built a revolutionary baby monitor called AI Wover. Tune in to hear how AI Wover goes beyond simple monitoring, the key distinctions between AI and augmented cognition, and why Sarah believes mentors are crucial for empowering female engineers. Tech enthusiasts and parents won’t want to miss this groundbreaking discussion on AI and child development. “The thing that is very important for me as the lead founder of AI Wover is bringing equity to the hand of everybody, every household with an infant on their day watch. This baby monitoring system, without extra cost, can be equipped with advanced AI and watch out if the babies are going through every milestone on time. And if not, then that concern that they have can be brought up to the pediatrician, and then hopefully the chain of action could happen on time.”                                                                                                                      – Sarah Ostadabbas Our Smart Home series dives deep into the brains behind the innovations, exploring how biometric data, wireless powerless technology, and AI are shaping the homes of tomorrow. Tune in and get ready to reimagine how you live!

I wanted to make this video to once and for all show that Ukrainian soldiers continue to break the laws of armed conflict on a daily basis. Each day, the Ukrainian side releases propaganda videos showing the battlefield murder of Russian soldiers who are hors de combat. This is a French term meaning "out of the fight." It is used in military and international law to describe soldiers or combatants who are no longer able to participate in combat due to injury, surrender, or detention.Such individuals are entitled to certain protections according to the laws of war, meaning they cannot be attacked or targeted as they are no longer considered a threat. Every day, I see videos showing Ukrainian soldiers breaking the Laws of Armed Conflict. Why aren't these people held to the same standards as Western armies? We are funding them and giving them these weapons, yet they continue to break all of the so-called rules that we must abide by. The Australian Defense Minister, Richard Miles, is directly responsible for the ongoing enablement of this murder, and he needs to be held to account.Watch the latest war crime here: https://theunspokentruth.com.au/latest-news/ukrainian-war-crimes

Join host Richard Miles and guest Jordan Sand, CEO of Cold Water Technologies Inc.

Join host Richard Miles and guest Dr. Nancy Gee, Director for the Center for Human Animal Interaction (HAI) at Virginia Commonwealth University and President of the International Society for Anthrozoology, for the first episode of our animal health series: Beyond the Collar! “People come away with smiles. I mean, I can tell you some very impactful stories. I was there. I saw it happen. It gives you chills just thinking about it. But at the same time, I needed to know if there was anything real to it. And that’s what got me started doing this research all those years ago. And it’s real.” — Dr. Nancy Gee  Beyond the Collar is an exploration of animal research and innovations that are making waves in the animal health industry. Listen as our hosts and guests dive into the impact our pet relationships have on us, obstacles and triumphs in pet medicine, and tools for ensuring the safety of our pets.  About Nancy Nancy R. Gee, PhD, is Professor of Psychiatry, Bill Balaban Chair in Human Animal Interaction, and the Director of the Center for Human Animal Interaction at Virginia Commonwealth University in Richmond, Virginia, USA. The Center is uniquely situated in the School of Medicine and in addition to research and educational activities it also houses the “Dogs on Call” therapy dog program, which includes 90+ dog/handler teams who visit patients and staff throughout the VCU health system.  Dr. Gee, President of the International Society for Anthrozoology, has extensive research and teaching experience and has specialized in the area of Human Animal Interaction (HAI) for the past 18 years. She served for five years as the HAI Research Manager for the Waltham Petcare Science Institute, located in Leicestershire, UK. In this role she managed a large portfolio of collaborative university-based research projects spanning multiple countries and topics, including; how companion animals impact the lives of older adults, or help students learn, or reduce the impact of PTSD symptoms in military veterans. Dr. Gee's own program of research has focused primarily on the impact of dogs on aspects of human cognition, including working memory, executive functioning and physiological responses such as heart rate variability to interactions with dogs. Currently she is the primary investigator on three grant funded clinical trials examining the impact of a hospital-based therapy dog visitation program on loneliness, depression and anxiety in vulnerable patient populations such as children, older adults, and people with mental illness.  A recipient of multiple grants and awards, Dr. Gee has 70 peer reviewed publications and has edited and contributed to numerous books. Dr. Gee regularly delivers international presentations on a variety of HAI topics, serves on the editorial review boards of several peer reviewed journals and has actively promoted the field of HAI through participation on the boards of several HAI organizations including the International Society for Anthrozoology and currently as the Chair of Pet Partners' Human-Animal Bond Advisory Board. 

After an enemy Japanese plane crashed into the water besides the USS William D. Porter, it exploded causing the destroyer to partially leave the water and crash down again. Thanks to Lieutenant Richard Miles McCool Jr., the commander of a smaller Landing Craft Support ship (LCS-122), all 300 crew members were evacuated to safety. The next day, on June 11th, 1945, the LCS-122 was subject to its own Kamikaze attack that made a direct hit to its bow. The impact caused an explosion and a serious fire that threatened to ignite the ship's ammunition cache, igniting 120 rockets all at once. Despite his right side being covered in burns and shrapnel, Lt. McCool helped two wounded sailors escape the flaming deckhouse, and directed his crew in order to keep the fire from spreading. His lung then collapsed, but he was able to receive aid and be evacuated to another LCS. Lt. McCool was awarded the Medal of Honor role in saving both the crew of the USS William D. Porter on June 10th, and his own crew on June 11th, 1945.

2023-12-24 - Richard Miles

Join host Richard Miles and guest Serg Albino, Co-founder and CEO of ecoSPEARS, for the third episode of our Blue Economy Series!

“These women had never invented before and they did what women have a tendency, you know, to do what we have to do.” – Edith Tolchin  To celebrate the release of the new book Secrets of Successful Women Inventors by Edith G. Tolchin, from Square One Publishers, the Inventivity Pod has welcomed Edith G. Tolchin, Kenya Adams, and Angelique N. Warner to the show!   Listen as the author and two inventor contributors discuss with host, Richard Miles, their inspiration and journeys. Obstacles like patents, funding and support. And learn what to do when what you want doesn't exist. Create it.   Be sure to purchase Secrets of Successful Women Inventors available now! 

“It’s not all the time, things you love, that you want to do, that you will succeed. It’s figuring out something that you love, or you can love, and someone else really needs it. So when you find this intersection, I think you’re going in the right direction.”  – Rodrigo Griesi Listen as host Richard Miles and Rodrigo Griesi have an engrossing, encompassing conversation. From how winning the 2022 Cade Prize impacted Rodrigo's business, NEPTUNYA, to insights into different business cultures, and what we can do with failure. Join us for the final episode in our Hope for the Future series.   The Hope For the Future series is an innovative look at sustainability. For this limited series, we talk to inventors contributing to the sustainability movement. Listen and see why they provide, Hope for the Future. 

“It’s important to make the most of what’s in front of you at the time.” – Dr. Anthony Engler Join host Richard Miles and guest Dr. Anthony Engler, of Polymer Solutions, as they kick off the first episode of the newly branded Inventivity Pod, with the first episode of our Hope for the Future Series! Listen as they discuss Anthony’s journey from an inquisitive student to CTO of a company he co-founded! The company develops polymers and is focused on energy and material sustainability. The Hope For the Future series is an innovative look at sustainability. For this limited series, we talk to inventors contributing to the sustainability movement. Listen and see why they provide, Hope for the Future.

“Inventivity. What does it mean? The state of being inventive, creating, or designing new things or thoughts” Join hosts Richard Miles and James Di Virgilio as they discuss the future of the podcast! What was once known and loved as Radio Cade will now be known and loved as the Inventivity Pod! Want to find out more? Give this minisode a listen! And stay tuned for all new episodes of, The Inventivity Pod! Brought to you by the Cade Museum for Creativity and Invention, in Gainesville, Florida.

Show Summary Picked vs Chosen In this episode we speak with Richard Miles, again. We just love him as a guest. He's a dear friend and we talk about Mother's Day, current legislation being considered, being picked vs being chosen, and what the one thing is he would change about our legal system, if given cart blanche. Check out Miles of Freedom's website below and check out his full story on episode #2 RESOURCES MENTIONED IN THE SHOW SPONSOR Clarity Roofing and Solar: https://www.clarityroofingandsolar.com/ or Call Joe Today 469-386-9116 Expressions Property: https://expressionsproperty.com/our-charities/ Miles of Freedom's website: https://milesoffreedom.org/ Write Background Check Podcast and Forgiven Felons: PO Box 4283 Cedar Hill, TX 75106 Forgiven Felons website: https://www.forgivenfelons.org/ Watch the Forgiven Felons Documentary: https://therokuchannel.roku.com/details/7abf5e84134e54a394b5b42544c08caa/forgiven-felons/season-1 How to get more involved with Forgiven Felons: Leave a review and subscribe on iTunes: https://podcasts.apple.com/us/podcast/background-check-podcast/id1515831127 BUY MERCHANDISE FOR A CAUSE: https://www.forgivenfelons.org/shop Learn about our Future Plans or to DONATE A BUILDING: https://www.forgivenfelons.org/future-plans Give to our organization: https://www.forgivenfelons.org/support Follow Forgiven Felons on Instagram, Facebook, and Twitter.

The Romans burnt Carthage's books and buildings – but ‘Punic' identity remained influential throughout Antiquity. Read by Leighton Pugh. Image: Print of ancient Carthage. Source: Wiki Creative Commons

Pickleball, Richard Miles on his love of the game

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Serial entrepreneur with several successful exits, seasoned Fortune 500 executive, and non-profit leader. Richard is the author of the "Official US Software Channel Sales Guidebook" and has been a featured speaker at COMDEX, CES, the Art of Product Launches, and many other events. He ran a consulting firm for 14 years and advised startups and multinationals, including Hitachi, IBM, Computer Associates, and many others. He has served as the Executive Director of the American Chamber of Commerce in Tanzania, was CEO of Big Brothers Big Sisters of the San Francisco Bay Area, and is currently CEO of CLOSEM, a SaaS company he co-founded with Laura Betterly. CLOSEM automates the process of sales followup. CLOSEM is now becoming a suite of applications for small businesses and entrepreneurs looking to increase sales, and they have just released LINKEM, with more coming out soon. He has interesting things to share about sales, direct marketing, software startups, and sub-saharan African farming, as well as an avid wildlife and landscape photographer.Connect with Behind Company Lines and HireOtter Website Facebook Twitter LinkedIn:Behind Company LinesHireOtter Instagram Buzzsprout

Stefano Alva, joins host Richard Miles to discuss how Farm to Flame Energy is providing affordable and renewable power in areas across the country. “So, the fuel that we're using to power our generators is really where our patent is around, which is the way that we convert the biomass into a powderized fuel that is very uniform and it behaves in a very predictable way. So, what has been a challenge in the industry is really to be able to overcome the different types of biomass that are available and be able to find the system where you can create a uniform output out of this mixed biomass waste. And that's exactly what our patent focuses on and what our expertise really lies in.” Stefano Alva is Chief Financial Officer of Farm to Flame Energy. Farm to Flame Energy was a Fibonacci Finalists in the 2021 Cade Prize Competition for Innovation. To learn more about Farm to Flame Energy visit their website at ftfenergy.com or visit Wefunder.com/farmtoflameenergy2

Stefano Alva, joins host Richard Miles to discuss how Farm to Flame Energy is providing affordable and renewable power in areas across the country. “So, the fuel that we’re using to power our generators is really where our patent is around, which is the way that we convert the biomass into a powderized fuel that is very uniform and it behaves in a very predictable way. So, what has been a challenge in the industry is really to be able to overcome the different types of biomass that are available and be able to find the system where you can create a uniform output out of this mixed biomass waste. And that’s exactly what our patent focuses on and what our expertise really lies in.” Stefano Alva is Chief Financial Officer of Farm to Flame Energy. Farm to Flame Energy was a Fibonacci Finalists in the 2021 Cade Prize Competition for Innovation. To learn more about Farm to Flame Energy visit their website at ftfenergy.com or visit Wefunder.com/farmtoflameenergy2

Tready Smith, CEO of Bayshore Capital and Chairman of the Board for USA Rare Earth, joins host Richard Miles to discuss rare earth metals, what its like running an investment firm, and what she looks for in potential investment companies. "We believe the team that is trying to bring an idea to market is crucial and having a, we call it a purpose-built team that has been rounded up. Having people on the team who have specific capability and experience in an area makes that team either successful or not successful. So having that purpose-built team where you look at it, you can say, oh, I see why every member of that team is critical to the success of this idea. People drive ideas, people have relationships, people are the critical part of investment success." In this episode, Smith also shares advice for young entrepreneurs and what it was like growing up with an entrepreneur father.

Tready Smith, CEO of Bayshore Capital and Chairman of the Board for USA Rare Earth, joins host Richard Miles to discuss rare earth metals, what its like running an investment firm, and what she looks for in potential investment companies. “We believe the team that is trying to bring an idea to market is crucial and having a, we call it a purpose-built team that has been rounded up. Having people on the team who have specific capability and experience in an area makes that team either successful or not successful. So having that purpose-built team where you look at it, you can say, oh, I see why every member of that team is critical to the success of this idea. People drive ideas, people have relationships, people are the critical part of investment success.” In this episode, Smith also shares advice for young entrepreneurs and what it was like growing up with an entrepreneur father.

Russell Donda, the Entrepreneur in Residence at Great Lakes Innovation and Development Enterprise, joins host Richard Miles to discuss the secrets to startup success. "It is the beginning of an idea, [i]f the startup is going to be successful… that idea should be novel. Secondly, it takes generally a serious plan and then working that plan and working that plan includes the other important component of startups. And that is funding, bringing money in to move that startup along." In this episode, Donda discusses the five fundamentals for startup companies, and his own professional path that brought him to where he is today.

Russell Donda, the Entrepreneur in Residence at Great Lakes Innovation and Development Enterprise, joins host Richard Miles to discuss the secrets to startup success. “It is the beginning of an idea, [i]f the startup is going to be successful… that idea should be novel. Secondly, it takes generally a serious plan and then working that plan and working that plan includes the other important component of startups. And that is funding, bringing money in to move that startup along.” In this episode, Donda discusses the five fundamentals for startup companies, and his own professional path that brought him to where he is today.

Santh Sathya joins host Richard Miles to discuss how his company, LuftCar LLC, is revolutionizing the realm of regional transportation, providing both sustainable and affordable multipurpose mobility vehicles. Sathya and his company are in the process of developing hydrogen powered, modular, autonomous air and road mobility electric vehicles with vertical takeoff and landing: “A lot of people have to travel hundreds of miles to go to a large commercial airport to take an overseas trip or take a long-distance flight. So, what we are doing is promoting an alternative for those people to fly from their little hometowns, from the rural areas, from small cities to these bigger commercial airports and both those sides”. In this episode, Sathya discusses how the movies he saw in his childhood inspired him to find a solution to the problems many face regarding regional transportation—only about 28% of the American population has access to air travel, because it is too tedious or expensive, but Sathya believes it does not have to continue to be this way. He believes inventors should collaborate and solve similar problems together.

Santh Sathya joins host Richard Miles to discuss how his company, LuftCar LLC, is revolutionizing the realm of regional transportation, providing both sustainable and affordable multipurpose mobility vehicles. Sathya and his company are in the process of developing hydrogen powered, modular, autonomous air and road mobility electric vehicles with vertical takeoff and landing: “A lot of people have to travel hundreds of miles to go to a large commercial airport to take an overseas trip or take a long-distance flight. So, what we are doing is promoting an alternative for those people to fly from their little hometowns, from the rural areas, from small cities to these bigger commercial airports and both those sides”. In this episode, Sathya discusses how the movies he saw in his childhood inspired him to find a solution to the problems many face regarding regional transportation—only about 28% of the American population has access to air travel, because it is too tedious or expensive, but Sathya believes it does not have to continue to be this way. He believes inventors should collaborate and solve similar problems together.

Mohit Patil and Parth Shah advise other future entrepreneurs on conceptualizing a company and its products: "Don't come up with a solution looking for a problem, that almost always never works out...what you need is a problem. A problem that the society has, a problem that people are desperate to get solved and then use your engineering mind to think, oh, how can I solve that problem?". Mohit Patil and Parth Shah co-founded Abilitare, a company that provides hands-free access to computers and smartphones for people with hand disabilities. Their products include: the Abili headmouse, a head-wearable sensor that allows the user to control the mouse cursor using head motions instead of hands, an adaptive switch that can be used with feet, fists, or elbows, and Dwell toolbar, a mouse clicking software. In this episode, Patil and Shah share the inspiration behind their ideas with host Richard Miles and recommend always having patience, especially when starting a new business. Click the links below to learn more: Abilitare Products Disability Technology TEDxLSSC by Jeff Paradee

Mohit Patil and Parth Shah advise other future entrepreneurs on conceptualizing a company and its products: “Don’t come up with a solution looking for a problem, that almost always never works out…what you need is a problem. A problem that the society has, a problem that people are desperate to get solved and then use your engineering mind to think, oh, how can I solve that problem?”. Mohit Patil and Parth Shah co-founded Abilitare, a company that provides hands-free access to computers and smartphones for people with hand disabilities. Their products include: the Abili headmouse, a head-wearable sensor that allows the user to control the mouse cursor using head motions instead of hands, an adaptive switch that can be used with feet, fists, or elbows, and Dwell toolbar, a mouse clicking software. In this episode, Patil and Shah share the inspiration behind their ideas with host Richard Miles and recommend always having patience, especially when starting a new business. Click the links below to learn more: Abilitare Products Disability Technology TEDxLSSC by Jeff Paradee

Today on The Jeff Crilley Show, Jeff sits down with Richard Miles, CEO at Miles of Freedom

Dr. Jean-François Rossignol discusses the development behind a class of antiviral drugs, such as Nitazoxanide and Thiazolides, that stimulate immune cells, activating gene pathways that block viral transformation: "You're leading an entire population, and you give them a pill for treating their problems, and you cannot have any side effects, any toxicity, or any kind of things like that. You have to have a safe drug. And that's what we did." Dr. Jean-François Rossignol is the Co-founder and Chief Scientific Officer at Romark Laboratories in Tampa, as well as a professor of Medicine and Infectious Disease at the University of South Florida. He is a scientist, medical chemist, and physician who developed groundbreaking treatments for parasitic diseases. In this episode, Rossignol talks with host Richard Miles about his recent induction into the Florida Inventors Hall of Fame and shares his research on antiviral drug development.

Dr. Jean-François Rossignol discusses the development behind a class of antiviral drugs, such as Nitazoxanide and Thiazolides, that stimulate immune cells, activating gene pathways that block viral transformation: “You’re leading an entire population, and you give them a pill for treating their problems, and you cannot have any side effects, any toxicity, or any kind of things like that. You have to have a safe drug. And that’s what we did.” Dr. Jean-François Rossignol is the Co-founder and Chief Scientific Officer at Romark Laboratories in Tampa, as well as a professor of Medicine and Infectious Disease at the University of South Florida. He is a scientist, medical chemist, and physician who developed groundbreaking treatments for parasitic diseases. In this episode, Rossignol talks with host Richard Miles about his recent induction into the Florida Inventors Hall of Fame and shares his research on antiviral drug development.

Dr. Norma A. Alcantar discusses the mechanisms in cacti ecosystems and the personal inspiration behind her research: “There were many other things that I learned from my mother and my grandmother, very valuable. And so, I think transferring knowledge from one generation, of our parents and our grandparents to our children…I think that’s very valuable. We should not lose that ever.” Dr. Norma A. Alcantar is a Professor of Chemical, Biomedical & Materials Engineering at the University of South Florida. She is internationally known for her breakthroughs using plant-based technology to decontaminate water. Her research and applications are crucial to future global sustainability and advances in biomedical applications for Alzheimer’s and cancer. In this episode, Alcantar reflects on her recent induction into the Florida Inventors Hall of Fame and shares her research on biomaterial from cactus plants with host Richard Miles.

Dr. Norma A. Alcantar discusses the mechanisms in cacti ecosystems and the personal inspiration behind her research: "There were many other things that I learned from my mother and my grandmother, very valuable. And so, I think transferring knowledge from one generation, of our parents and our grandparents to our children...I think that's very valuable. We should not lose that ever." Dr. Norma A. Alcantar is a Professor of Chemical, Biomedical & Materials Engineering at the University of South Florida. She is internationally known for her breakthroughs using plant-based technology to decontaminate water. Her research and applications are crucial to future global sustainability and advances in biomedical applications for Alzheimer’s and cancer. In this episode, Alcantar reflects on her recent induction into the Florida Inventors Hall of Fame and shares her research on biomaterial from cactus plants with host Richard Miles.

Susann Keohane discusses how she uses remote sensing to study behavior patterns in the aging population, a project she hopes will help the elderly thrive: “Overall, I really want us to make older adults feel like technology is for them…and it’s theirs to be used to, and it should be marketed, advertised, and designed for everyone”. Susann Keohane is the IBM Watson Health Innovation Leader for Healthy Aging and Longevity. Her induction into the Florida Inventor’s Hall of Fame in 2021 is amongst one of her achievements; another includes having 137 U.S. patents. She has become an expert in enabling human ability through emerging technologies with a focus on accessibility research, aging-in-place Internet of Things (IoT) technology, and cognitive systems to deliver personalized insights and adaptive interfaces. In this episode, Keohane shares with host Richard Miles the importance of building more intuitive design solutions for the aging population, alongside having them feel comfortable with the technology.

Susann Keohane discusses how she uses remote sensing to study behavior patterns in the aging population, a project she hopes will help the elderly thrive: "Overall, I really want us to make older adults feel like technology is for them...and it's theirs to be used to, and it should be marketed, advertised, and designed for everyone". Susann Keohane is the IBM Watson Health Innovation Leader for Healthy Aging and Longevity. Her induction into the Florida Inventor's Hall of Fame in 2021 is amongst one of her achievements; another includes having 137 U.S. patents. She has become an expert in enabling human ability through emerging technologies with a focus on accessibility research, aging-in-place Internet of Things (IoT) technology, and cognitive systems to deliver personalized insights and adaptive interfaces. In this episode, Keohane shares with host Richard Miles the importance of building more intuitive design solutions for the aging population, alongside having them feel comfortable with the technology.

Once established, Roman exceptionalism and empire needed to be justified and maintained. The practical application of mythology was one way in which this was achieved. Read by Leighton Pugh. 

It began with drinks one Sunday when a woman told Reg Mead a story; her father was ploughing a field when he came across a pot full of ancient silver coins. He scooped up what he could and then ploughed the rest into the field. Reg is a metal detectorist and he was instantly hooked. With his friend Richard Miles they set off on a search that would last for 30 years. Get in touch: outlook@bbc.com Presenter: Jo Fidgen Producer: Andrea Kennedy (Photo: Richard Miles (left) and Reg Mead. Credit: Jamie Graham, JPG Digital Imaging)

Weaver Gaines shares his experiences as the CEO of several startup companies in terms of the highs, the lows, the expected, and the unexpected: “So I think you can inculcate a culture from the top, from the beginning, that says, ‘We don’t lie. We don’t cheat. We don’t steal. And we’re not going to tolerate people who do those things.’ You can make that happen throughout your company, regardless of its size. But the other stuff, the commitment to the task, the belief in what you’re doing, all of that stuff, has to be established when the company is small and then you hope it will permeate the company as it grows.” Gaines has served as the CEO of Evren Technologies, OBMedical Company and Ixion Biotechnology. Additionally he has been the chairman of several companies and non-profits, and is a member of the Keck Graduate Institute’s Corporate Relations Board. In this episode, Weaver shares with host Richard Miles the importance of a CEO’s role to encourage teamwork, foster trust in a company, and grow — in a way that’s not just about the money. TRANSCRIPT: Intro: 0:01 Inventors and their inventions. Welcome to Radio Cade, a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. Starting in running your own company — It’s not for everyone. For those who have done it, it can be exhilarating, exhausting, and easily the hardest thing they’ve ever done. We decided to go out and talk to some of those people and find out what they’ve learned, what they’d repeat, what they’ll never do again, or hear stories from their first year, then from the period when they realized they’re going to survive and how they intend to position their companies for the future. We’ll find out what a CEO’s normal day is like, how they build and manage their teams, what it’s done to their personal lives. And finally, when is it time to move on? Join us for CEO 101, a limited series of deep looks at people who are their own boss — for better or for worse. Welcome to another episode of CEO 101, a series of special episodes in which we talk to and about CEOs of startup companies. I’m your host, Richard Miles. Today my guest is Weaver Gaines , the CEO of several companies, including Evren Technologies, OBMedical, both of those are medical device companies, as well as Ixion Biotechnology. He’s also served as a chairman of numerous companies and non-profits, among other things. Welcome to the show, Weaver. Weaver Gaines: 1:18 “Well, thank you for having me here,” I think is the formulaic response to– Richard Miles: 1:22 That’s right, there’s only one right answer. You’re not going to be here. Weaver, you’ve done a lot of stuff in your life and your career. So why don’t we just start with a short overview of your career? Weaver Gaines: 1:31 Okay. Well, one way of thinking about my career is, “here’s a guy who obviously can’t keep a job.” I went to law school primarily because even though I was an ROTC commissioned officer, everybody else was trying to avoid being drafted into the war in Vietnam. And they were all going to law school and they were on the debate team at Dartmouth, so I went to law school too , with about that much forethought about it. And when I graduated from law school, I went on active duty and I spent two years in the army — one year in Europe, in Heidelberg and Berlin. And one year in long been Vietnam — an experience for which I will be always grateful. The whole experience was extraordinary. I’m glad I did it. I can’t talk anybody into doing it now, but I think it’s really one of the formative experiences of my life. And I’m glad I got involved in it. Richard Miles: 2:17 This is being in the military or being in Vietnam, or both? Weaver Gaines: 2:19 Both. Well, the military itself is an extraordinary experience, and being in a world at war where there are people who are actually trying to kill you every day, although you could argue that that was like being in New York, and , um , it was a different circumstance and I’m glad I did it. Richard Miles: 2:35 And you were in an infantry unit in Vietnam, correct? Weaver Gaines: 2:37 No, I was not in an infantry unit in Vietnam. I was a company commander in Berlin, but when I got to Vietnam, the army had just invoked the update to the military justice system, in which for the first time, if the defendant asked for a lawyer, he got a lawyer. Before then, he only got a lawyer if the trial counsel , the army’s prosecutor was a lawyer. Otherwise officers served in that role and the army and its usual degree of incredible forward thinking came up on the day where they had to supply a lawyer to everybody without any lawyers . So a lot of non-JAG lawyers got JAG positions — Judge Advocate General positions. Richard Miles: 3:14 You had a law degree. Weaver Gaines: 3:15 I had a law degree, and by the way, it made the judge advocate guys really mad because they had signed on for four years in order to avoid combat. And here were all these combat arms like me. I only had two years and also avoided combat, but we didn’t avoid people shooting at us or setting– Richard Miles: 3:34 You were in a combat zone. Weaver Gaines: 3:35 We were in a combat zone. And then I went to work for the law firm that I had intended to go to work for. And I worked for them for a bunch of years and decided that being in a law firm wasn’t that interesting. So I went to a corporation and in the middle of that gig, I realized that, really, I wanted to do it more than I wanted to give people advice about how to do it. So I now call myself a recovering lawyer. And while I provided legal services to the companies that I’ve founded, mostly I’m being an executive and mostly in financial or life science businesses. So to get to the crux of CEO 101, I came to Gainesville after I had spent a year on the national reelection campaign for Bush-Quayle in 1992 . And since Bush didn’t get reelected, clearly doing something in Washington, D.C. was not in the cards. I came down to Gainesville where I had a weekend place and a friend said, “Let’s start a biotech company.” And so that’s how I started my first entrepreneurial biotech company. Richard Miles: 4:34 So, Weaver, I’ve got to say that the first parts of our lives eerily track one another. Of course I was in the army as well, got out of the army. And if things had gone right, I’d be in the Jeb Bush administration right now. But things apparently didn’t go that way. So I moved to Gainesville too , but I didn’t start any successful biotech company. So apart from that small asterisk, essentially we’ve lived the same life. Weaver Gaines: 4:55 Well, I can’t say the first one was a successful biotech company. It was named Ixion Biotechnology and I picked its name, a Greek name, very common in science to use Greek. Ixion sounded good. It said that Ixion had been condemned by Zeus to be bound to a burning wheel for eternity. And since the product we were thinking about was going to be used to treat recurrent kidney stones, I thought, well, that sounds like being bound to a burning wheel, that’s not bad. And after the company had been going for two or three years, I asked my very first associate, the first person who joined me, I said, you know, I don’t know anything about this guy, Ixion, whose name, by the way was pronounced ex-eye-on, but I gave up. Everybody called it Ixion. And he comes back to me and he says, “well, do you want to know why he was condemned by Zeus to be bound to a burning wheel for eternity ?” “No. Why?” “Because he attempted to rape Hera. That’s why.” So I named my first company after an attempted rapist. Richard Miles: 5:50 So marketing was not really your strong suit– Weaver Gaines: 5:51 Absolutely not . Nobody knew that except us. And so we never told anybody, and I think this is the first time I’ve ever broadcasted it, for that matter. Richard Miles: 5:58 Anyone owning Ixion stock out there, maybe now’s the time to sell. Weaver Gaines: 6:02 Now’s the time to sell or to put it on 4Chan or something like that, but that was an enlightening experience, Richard. I made, I literally made every mistake a startup entrepreneur could make, although there were some mistakes I couldn’t make because an earlier mistake had sorta foreclosed the possibility of– Richard Miles: 6:19 So we’re going to get into that. But before that, I wanted to ask you. So you get out of the army. This must have been what? Early 70s-ish? Weaver Gaines: 6:25 Yeah, 70s, basically. Richard Miles: 6:26 And you’re an army brat. So what brought you to Gainesville? Did you have a family connection here? Weaver Gaines: 6:32 Okay. So my dad was a graduate at the University of Florida, ROTC graduate — World War II, Korea, Vietnam vet himself, and my sister had gone to the University of Florida, one of my sisters had gone to the University of Florida and her best friend here was my current wife, Mary True. And my sister — I’d been married once before — and she said to me, “Look here, Weaver every time you pick out a girl for yourself, you do a poor job.” That’s not exactly what she said, but that’s what she meant, right ? Yes. “I’d like to pick out your next girl for you.” And I said, “well, I can’t do any worse than that.” So, she was from Gainesville. Mary was from Gainesville. So I got to know her and I got to date her, and then we got married and I told her if she would just keep her apartment in Gainesville and not bring her car to New York for less than the cost of parking the car in New York, we could keep the Gainesville apartment . So that’s how I ended up with a place in Gainesville. Richard Miles: 7:27 This was planned from the very beginning, Weaver Gaines: 7:28 Yes, everything thought out carefully in advance with the primary reason for changing directions, being that I had cracked my shins on something and it hurt. And so I would stop to see where I was going. That wasn’t it. So that’s how I got to Gainesville. And that was in late 1992 after the election with the Bush-Quayle campaign. Richard Miles: 7:46 Okay. Prior to that, you were living in New York? Weaver Gaines: 7:50 Prior to that, I was living in Manhattan, New York, except for one year in Philadelphia, where all I could think of was how to get back to Manhattan. Philadelphia is — sorry, Phillies . So I started the first company, as I said, being completely ignorant. And that’s probably the only reason why anybody would start his first company. Richard Miles: 8:10 Take us back to the first few weeks, even of what that was like, first of all, start with what was the core idea or the core business model insight? And then what were your first steps? Did you just sort of file the papers and rent a space somewhere? Or what was– Weaver Gaines: 8:23 Yeah, basically well, sort of that. I got the idea of starting it from a fellow I’d hired at one of my previous jobs who said, “look, let’s start this biotech company. I have a brother who’s a research scientist, the University of Florida, very smart guy.” And he was a very smart guy. And he’s got some technology, which is really exciting. And he had two completely distinct technologies. One was a stem cell treatment for type 1 diabetes. And the other was a probiotic treatment using a bug called Oxalobacter formigenes, you know how that rolls off the tongue. So the very first thing was to learn to pronounce Oxalobacter formigenes. Richard Miles: 8:59 Now I see why Ixion was a more attractive alternative– Weaver Gaines: 9:01 Yes, right, than “Oxalobacter Formigenes Company.” And so the first thing I told him was, “well, I can get the company started, but really, I don’t know anything about biotech.” And he said, “well, you don’t need to, my brother knows about biotech. You need to know about starting companies.” That turned out to be wrong, by the way. And so I said, “well, the very first thing to do is to kind of get our arms around the intellectual property.” Y ou got nothing if you don’t have that. And the intellectual property was resident at the University of Florida, and the University of Florida had an officer in charge of licensing technology. And on a good year, they would license two or three. They license 90 or 100 now. And on a bad year, they didn’t get much done at all. And so it took about a year to negotiate the license for the technology, but you really couldn’t do much else. I mean, I was running it out o f my house because you really couldn’t do much else, right? Because you didn’t have anything to do i t with. Richard Miles: 9:54 Right. Weaver Gaines: 9:55 And in those days you couldn’t be sure you would live long enough to license it from the university. Richard Miles: 10:00 So there was no point in continuing research or things like that or making an investment because you don’t own anything. Weaver Gaines: 10:05 You don’t own anything. And the research has continued and a guy who’s the research side and he’s going on, doing the research at the university. And there was a fellow named Shelley Schuster who, at that time, was the head of the biotech program here at the University of Florida. He’s now at the Keck Graduate Institute. He’s the president of the Keck Graduate Institute in Claremont, California. And he said, “I have some space in the Progress Center. Why don’t you come out there and have an office in my space while you’re trying to license the technology? And I won’t charge you anything for it.” So yes, I did arrange for an office, but I didn’t pay anything for it. And I went out there and got the office in Progress One, which was, at that time, owned by the university and set up my first computer to demonstrate, yes, we were a company because we had an office– Richard Miles: 10:48 It was a physical, awaiting a computer? Weaver Gaines: 10:50 No, no, it was an IBM. It was an IBM. It had like, I don’t know, 250 bytes of board memory, or so, it’d use the big four-and-a-half-inch floppy disks. But then we got the license. Now you’re going to actually start trying to do something. Richard Miles: 11:06 So after you got done with your bottle of champagne, from getting the license– Weaver Gaines: 11:09 We couldn’t afford champagne. It was a bottle of cold dock , but , um , yeah, we got the license and now we were actually in a position to try and do something. So there’s a whole bunch of things you try and do to get ready to do the thing that you most need to do. So what you most need to do is find money because you can’t do anything without it in the startup world, but you can’t just go say, “give me money; I have an appealing face,” — even worse if you have my face. And so you have to do things like come up with a business plan, think through how exactly you’re going to exploit this technology. What’s feasible? What isn’t? What kinds of research needs to be done? Where are you going to get money to do the research? How far do you have to go in the research before you can make a plausible claim for the money? One of the big mistakes I made was if it’s a really brilliant idea in a magnificent market, they’re going to give you money. No, they’re not. And in this case, it was two, basically, pharmaceutical preparations. And I took a long time to learn that those are decade-long projects — and that’s if they’re ready to be taken out of the university, if they’re developed enough to be taken out of the university, which they said not — another one of my mistakes. And I also didn’t know then, like I know now, that about 90%+ of them will fail. They will not, in fact, ever reach the market — and that’s assuming you can finance it. I’m just talking about the ones that go through the process of bringing a biotechnology, pharmaceutical entity to the point where somebody will buy it or at least be willing to support it to the point where it can be sold, mostly fails. Richard Miles: 12:40 It’s one of those statistics you really don’t need to hear early on. Weaver Gaines: 12:42 No no, well, actually I said, “if you knew, if you knew when you started what you will learn along the way you would go into another line of work,” like, I don’t know, bicycle repair. Richard Miles: 12:50 Something more lucrative, right ? Weaver Gaines: 12:52 Right, plumbing. Richard Miles: 12:53 Plumbing. Yeah . Weaver Gaines: 12:53 So you have to develop a business plan. A lot of people think that you can get somebody to develop a business plan for you, but you can’t. You really have to do it yourself because that’s going to be where you learn about the things you need, but don’t have, and think through how you’re going to get them and then make some guesses about what it’s going to cost you to get from here to there, and with your business plan, and your intellectual property, and some sense of people you might be able to get involved with you that you can talk into working for nothing or nearly nothing, because you’re likely to be working for, not very much money, particularly at the beginning. Quite common for you to go without pay for months at a time, which by the way, Richard, means that if you want to do this sort of game, you can’t be in it for the money because t hat’ll never be good enough. You have to be in it because you think you’re trying to do something that’s worth making some kind of sacrifice for. So when I left the campaign, when Bush lost in 1992, the first thing that happened was I got a job to go to work for a financial service company. And I thought to myself, “well, if we get to the end of the day and they say, ‘okay, Weaver, w hat did you do with your life?’ Say w hat — made a lot of money?” That just didn’t seem very satisfying to me because you can make a lot of money a nd people don’t do that, and there’s nothing wrong with making a lot of money. Good for the people who do. But for me, I thought, you know, my father was a s ervice m an. He spent his life in service and that’s w here I felt a little … smarmy. If that’s all I was going to be able to say, “he made a lot of money,” but if you could say, “well, I tried to cure type 1 diabetes.” Even if it didn’t work, I tried to deal with people who a re suffering from recurrent kidney stones. You ever had a kidney stone? Richard Miles: 14:33 I have not. I’ve seen people who’ve had. Weaver Gaines: 14:35 You don’t want them. Richard Miles: 14:36 Not something I want to do. Weaver Gaines: 14:37 And it turned out, by the way that, that, wasn’t what we ended up trying to get that probiotic to do, because that costs too much money, a long shot, too much money. It ended up being a treatment for a condition called primary hyperoxaluria, which is a genetic condition in which half of the people who have it will die before they’re one year old and the rest will die by the time they’re 12, and there’s no cure. There’s nothing you can do except a kidney-liver transplant. Richard Miles: 15:01 Well, good point that you made there about doing something that you feel makes a difference, and David Brooks, the author, talks about the difference between resume virtues and eulogy virtues, which I think is a nice way of encapsulating ’cause a lot of what we do, certainly as early adults, what we focus on is resume virtues. Weaver Gaines: 15:15 Sure! Richard Miles: 15:16 What’s going to get me my next job? What’s going to get me promoted? What’s going to make me look really good? But if you think about it, when you’re dead and gone, and they’re saying, “Weaver Gaines…” And they just rattle off your qualifications and degrees… Weaver Gaines: 15:29 It’s the same sort of dissatisfaction. And Richard, you and Phoebe have achieved this in your lives with the Cade Museum, and what it represents in terms of contribution to, not just our local community, but to the country and to the world. Richard Miles: 15:42 Well, thank you. Weaver Gaines: 15:44 So you know what I’m talking about. You can only put up with some of this stuff if you’re motivated by something besides the money. Richard Miles: 15:50 But let’s talk about those first few days, because as you well know, from your first few days, it looks really daunting because you wake up and every day your to-do list has a hundred things on it. And all of them are objectively urgent. They all have to be done first, right? Because you get an office. Well, great. Well, your office needs a phone. Well, does it have a phone in it? Maybe it doesn’t. Well, you get a phone and you have to have someone to answer the phone and get the mail, and all of those things were sort of “must-do,” but yet you’ve also got to raise money. So one of the most crucial decisions early on is your first hire, your first couple of hires. Did you have any help in making that decision or was it the first person who walked through the door and needed a job? You said, “go get a phone, go get the mail.” ‘Cause that’s sometimes how it happens, right? Weaver Gaines: 16:30 Well actually I would say what happened in this case was that, because Mary had lived here for a long time, she knew a whole bunch of people: college graduates. Master’s degree in history and he’s helping his wife run a deli, and he became a friend, and he came to me and he said, “either you have to give me a job or I’m going to kill my wife and go to jail. Those are my options. I can’t afford to pay a fine, just as long as I have a job.” And it turned out that one of the critical things, on those first few days, is that there be somebody else there. So while you may have to do everything yourself, sometimes you just can’t do it all today. And even if you could do it tomorrow, even if you could do it tomorrow better than the person that’s working with you, you just can’t bring yourself to do one more thing today after you’ve gotten the mail arranged for the phone, and arrange for the post office to deliver the mail to you the way they said they would, when you put the post office box down and all that sort of stuff … It helps to have somebody there. And somebody you can go in and say, “could you get the phone? Will you answer the phone?” And all that sort of stuff. Richard Miles: 17:33 Right. Weaver Gaines: 17:33 So the very first hire actually was critically important, but did not functionally supply one of the nominal things that we needed, a person who could oversee the science and a person who could handle the legal stuff and all the things that you think of go into a company. But if you’re the only guy on the ground, there’s one person you want to have there that you can turn to and say, “I just, I can’t face this today.” And they’ll do it for you. So that was the very first hire. He was terrific in that role. He later worked for me one other time. In between times, he worked for another one of our local companies that got acquired by SmithKline . Richard Miles: 18:10 And what was his background? Weaver Gaines: 18:11 History major — master’s degree in history. Bright guy, competent, and totally competent and enthusiastic and got caught up in what we were doing. And [he] later took over a lot of things just because he was there, and he was smart, and he could do stuff. And not because he had any background in science or engineering or anything else. Richard Miles: 18:30 This is what we tell people from our limited experience with tech companies is that, people make this assumption, “well, a tech company is just full of engineers and people like that.” It’s like, well, no, every company needs a fairly broad array of talents to just make it to that first milestone. Weaver Gaines: 18:44 Absolutely. Richard Miles: 18:44 Because again, if you don’t have somebody who can help you do all the mundane things that need doing — a room full of 10 engineers that don’t answer the phone or answer the mail is not going to make it. Weaver Gaines: 18:53 And also if you have a company of all engineers and you aren’t, you think you’re speaking their language — it sounds like English — but it’s not. It’s “engineer’s speak.” And it’s hard to communicate with 10 engineers without a translator. Richard Miles: 19:06 So let’s fast forward a little bit, maybe if we’re talking about Ixion or it could be any of the, one of the companies that you started, and I don’t know what the timeline for these companies was, but let’s say you’ve hit your first, maybe, good milestone — whatever that is, and whenever that is. But inevitably, almost every company that succeeds has had at least one, maybe two or more big setbacks. What was, if you’d like to share the details without triggering any lawsuits, what was maybe one of your first big setbacks and how did you recover? Weaver Gaines: 19:32 Okay. Well, I would say that the setbacks tend to come in categories. The one that you’re most conscious of most of the time. So if you’re the CEO of a startup company, you have several jobs and they’re all full-time jobs. And one of them is actually making sure the entity will function, and that it does have telephones and so forth. You don’t have to do it, but you have to make sure of it. And one of them is to make sure that the science is moving forward because it’s never fully developed when you get it. And one of them is raising money. And so basically you’re always raising money. The biggest science setback came when we could not replicate in the company’s labs, the results that were taking place in the scientists’ labs at the university. It was critical that we be able to do the cell culture that he was doing in order to have a product that we could show off to get some more money, right? We couldn’t get it to work. And this is going on for a long time. Now, competent scientists working hand in glove with the people at the university, we can’t get the cells to reproduce? Same refrigerators, same T75 flasks. They won’t grow. “Why not?” A scientist is rolling his eyes. You know, Jesus, he comes out, he can’t get them to grow out there , at the Progress Center either. So the answer to that one was that it turns out that there are two manufacturers of T75 cell culture flasks: Cornell Glass and Phillips . And he was using one and we were using the other — their nominal specifications were identical, but it grew in one, it didn’t grow in the other. And you tell this to people who are cell culture experts, and they say, “Well, yeah, everybody knew that.” I wish they would say, “That’s not possible.” What they say is, “Everybody knows that.” Yeah. Right. No, it made a difference, but that set us back by months. Well, when you’re burning cash every day, whether you’re being set back or not, any one of those kinds of scheduled delays will eventually turn into a financial problem. And the setback comes when you go to people and you say, “We’re not going to be able to make payroll next month. There’s not enough money. We got maybe some coming in, but we’re going to all be working with no money or very little money…” Because some people can’t work with no money. They can’t. Richard Miles: 21:44 Yeah. Weaver Gaines: 21:45 And so you say, “Well, okay,” and one of the ones, this guy I was telling you about, Teddy, said, “Well, I can defer income.” So that was one of them. One of them was, as sometimes happen, you’d get an agreement to make an investment from an angel group or a high-net-worth individual, for example. And you’re very close to closing the agreement, and it falls out of bed for some reason or another. And you’ve made the mistake — one of the many mistakes — you’ve made the mistake of thinking it’s going to close around this day. And then it doesn’t. And now you don’t even know if it’s going to, because the problem that came up is one that isn’t immediately obvious how you’re going to settle it, because it’s a fundamental issue in the deal itself. And those are grim. Richard Miles: 22:25 It’s not in some little insignificant detail. Weaver Gaines: 22:28 No, they’ve thought it over and they need 45% of the company instead of 20% — something major like that, and you can say no, and they say, “Fine, I’ll pack up my bags and wish you the best of luck.” Or you can see if rolling over on your back and exhibiting your unprotected belly will work, or if there’s some other option that might help out. And then there’s the one where you have the fight with the big investor. He’s already invested. He now basically could control the company. He hasn’t yet. You’ve had this conversation that goes, “Well, I invested in you because I believe in the management of this company and I’m going to sit on the board, but I’m going to be influencing as a board member and not as a big investor.” And then you come to a point where you don’t agree with the big investor. And he says, “Well, have you forgotten who owns this amount of money in your company?” And you say, “No, have you forgotten that you said, when you invested, that you were going to rely on the management?” And he says, “No, and I stopped relying on you because I have the money and you’ll either do what I say, or you’re going to quit or get fired.” And “get fired” appeared to be one of the alternatives that turned out was the one that happened. But , uh, all kinds of grace, of course. Richard Miles: 23:35 Right. Weaver Gaines: 23:35 He took over and put one of his young proteges, the Swede — he was a Swedish guy. In fact, he was the only Swedish multi- millionaire I know who was an actual member of the Communist Party. Really interesting, very interesting, cultured man. So that’s an example of an actual death experience. Yeah. Right. Richard Miles: 23:52 Weaver, earlier , we were talking about institutional culture, and it kind of fascinates me and I think it does you as well. And one of the ways in which institutional culture changes is related to the size of the company. And so you’ve been in companies literally where there are a couple of people — that’s the way it starts, two or three people — and you hesitate to even call it a company, right? It seems more like a family or a frat party or something, right? Not an actual company, but then there’s a certain point at which you do have to start resembling an actual company with titles and sort of clear responsibilities and divisions. What does it do from a managerial standpoint? If you’re the leader, what things do you have to consciously do differently? Because you now, instead of two employees, you’ve got 20 or 200 employees. Weaver Gaines: 24:33 Yeah, well first I think, organically, there’s a theory of “span of control.” I’m sure you’ve heard of “span of control.” And some people say, “The most people you can really have usefully reporting to you is somewhere between five and seven, maybe 10.” So early on in a company — when there’s five or seven or eight or nine people in the company — one of the things that’s true is you pretty much all know what the other person’s strengths and weaknesses are. You don’t give a person with a weakness a task that you know plays to the weakness, and you don’t keep a person whose strength from doing that. But you all know what it is. And you, the CEO, can really have a material, substantive effect on all of the major decisions made by your company. And then it goes over that number. And two things happen when it goes over that number — up to about 25 in my experience — one of them is: it’s no longer the case that you really can do everything. And you mustn’t, you have to start relying on people. And sometimes that’s a different person. So the person who could handle lab operations, when there was one person in the lab, can’t handle lab operations when there are 10. It went outside their “Peter principle.” They’re not competent at lab management, as opposed to– Richard Miles: 25:40 Working in the lab. Weaver Gaines: 25:40 Working well in a lab with some scientists. The second thing is: you no longer know all of the strengths and weaknesses of all of the people in your company, although you should still know who’s good and who’s not, and the people who are reporting to you. And as a CEO, you must resist the temptation to meddle in the operations of the people who are now responsible for operations of their own. This is one thing that’s really disabling to people. It’s the sense that two things happen — they’re both bad. One is: you tend to make decisions where you don’t know what’s happening on the ground, like they do. And perhaps the worst aspect is: they start thinking, “Well, he’s going to be the one staying up at night, not me, because he’ll double-check my decisions. And if he doesn’t agree, he’ll tell me to change it.” And if you want a comfortable-running company, you can’t let people think they can move hard decisions to you that is within their area. So I tell people, “Look, there’s three kinds of decisions that affect you,” — and this starts at around 20 people — “One is the kind of decision I expect you to make. And I don’t expect you to tell me, because it’s the kind of decision you should make. And I don’t want to be bothered by being told you did it because it’s your decision. And the second is the kind of decision that I expect you to make, but I do expect you to tell me. It’s something I need to know, but I don’t need to prove it. And I’m not going to disapprove it. And the third: this is the one where you’re about to make a decision that could result in a hole below the water line,” — for all you Navy guys out there — “that one you have to consult with me in advance.” And inevitably, these people say, “Well, how will I know which one’s which?” And I say, “Well, you have to use your judgment.” And by the way, if you get it consistently wrong, you’re in the wrong job. So you have to get this sort of thing right. But I don’t want you to bring Category Two decisions, the kind you need to be making, to me for prior approval. I’ve got all the hard decisions already. You have those. Then, when a company gets to be about 100 or so, you need a lot more bureaucratic structure than you had before. You can get along with a lot of informal arrangements — doesn’t have to all be written down. Yeah, it’s useful to have an organization chart and so forth, but you don’t need it. It’s a bleak day in a company’s existence when it needs a Human Resources department, because that means there will be human resources — people there who are basically spiders or vampires, you pick the name, and that company is a completely different company. And the way you nurture some kind of camaraderie and corporate culture has to come from the top-down and it has to filter through the CEO — so there is no escape from this — to see if you can inculcate that with the janitor in the lab, who’s working for you and whose job is important too , but not at the level that you’re going to go in and pat him on the back and say, “Nice job, Junior, you know, I really appreciate your mopping.” ‘Cause, you know, it’s not gonna work. Richard Miles: 28:26 Right. Weaver Gaines: 28:26 And the other thing you have to do, in my opinion as a CEO, is you cannot rely for your information entirely on the people who are reporting to you. So you actually have to get up and walk down into the lab and say, “So how are things going here?” “We’re completely out of beakers.” “You’re out of beakers! Is that right? Well, does Joe know that?” “I’ve told him several times and we’re still out of beakers.” “Well that’s interesting. Okay. Thank you.” I mean, people will talk to you. Ross Perot, you’ve heard of Ross Perot– Richard Miles: 28:52 Yes, yes. Weaver Gaines: 28:52 Ross Perot ran a company and his cafeteria, you sat at the next seat at whatever table was open — they’re trestle tables — and he would sit down with whoever was at the table and say, “Talk to me.” This did two things. One: he learned what was going on. And the second thing is: the people who reported to him knew he would learn what was going on, which is also useful. So I think you can inculcate a culture from the top, from the beginning, that says, “We don’t lie. We don’t cheat. We don’t steal. And we’re not going to tolerate people who do those things.” You can make that happen throughout your company, regardless of its size. But the other stuff, the commitment to the task, the belief in what you’re doing, all of that stuff, has to be established when the company is small and then you hope it will permeate the company as it grows. Richard Miles: 29:37 Weaver, we were talking about this earlier in a different context: Contrary to popular belief, CEOs are not superhuman. Weaver Gaines: 29:43 Really? That explains a lot. Richard Miles: 29:46 I know, I’m bursting your bubble. Weaver Gaines: 29:47 That explains a great deal. Richard Miles: 29:49 And certainly when you start out and you founded your own company, as we’ve already talked about, there’s no shortage of things and worries to occupy your day. From the minute you get up to the minute you go to bed, you can be working in the company and often you do. At a certain point, that’s not a great personal-life-work-life-balance strategy — particularly if you’re married or you have children and so on. What are some of the things that you have seen, both good and bad? How should CEOs think about their commitments to their company, but then the commitments to the rest of their life? Because they’re just not probably gonna make it very far or, we’ll put it this way, they may have a successful company and ruin the rest of their life. What have you seen, in terms of successful strategies, to avoid that? And then, are there any horror stories you can relate in which people did the exactly wrong thing? Let’s leave out, say, the first 30 days in which, okay, you’re just going to be working 24/7. Everyone gets that. But let’s say you’re a little bit further along. You’ve got some employees, maybe even some revenue, but yet that feeling hasn’t gone away, that you gotta be Johnny-on-the-spot all the time. Weaver Gaines: 30:49 Let me start by saying when I started my career, it was as an associate lawyer at a big law firm on Wall Street. And there was no work-life balance. It was just work. And I think maybe half of the people who started in that law firm with me, including myself, were divorced in the course of six or seven or eight years. You basically communicated through notes on the refrigerator ’cause you were working till 10:00 many nights and almost every weekend. When you’re in a startup company, it’s more than 30 days that it’s like that. And you’re really asking the people who are around you — I don’t have children, so I didn’t have that particular problem, but I do have a wife that I cherish — and you’re basically saying, “Look, you’re signing onto this with me. Are you okay with that? You know what you’re signing on for? Because I can get a job that’s 9:00-5:00 or 9:00-7:30, if it’s a bigger job than that.” But it reminds me of when I was growing up, army wives — they knew what they had signed up for. Foreign service wives knew what they’d signed up for. They’re going to make a sacrifice too, and, in some cases it’ll be a big one, and you can’t do it alone, I don’t think. I mean, maybe for a bachelor, you can, but if you’re married, you have an intimate relationship with somebody or you have a close, personal relationship with somebody. They have to be on board with you too . Or you won’t be able to do what I think needs to be done to be a success in the first couple or three years of a startup company, because it’s going to be that long before you get to the place where you can take a breath and, “Where’s the dog?” “The dog died last month.” You know, I mean it didn’t, you know, we never had a dog. Richard Miles: 32:18 Right. Weaver Gaines: 32:20 I think that the thing that probably engenders more work-life balance is increasing exhaustion in age than it is any kind of conscious stratagem that I know of. And when I look around at the people who are successful CEOs, they may not have dark shadows under their eyes now, but they all went through it. And as I said, you need that team at home who’s willing to back your play and understands what’s involved. I don’t know any other answer to give you, Richard. I mean– Richard Miles: 32:48 No, it’s a good one. I found, just in my very limited experiences, there’s a step of humility and trust, once you start seriously delegating your responsibilities, right? Where when you first start out, you just think, “I’m the only one that really understands this company, this technology. And it’s so important — my understanding of it — that I really can’t ask somebody else to do it.” But at a certain point, you realize you’ve got to make that step. You’ve got to hire that person, mentor them, teach them, because otherwise you are a prisoner of your own creation, right? You will never break free– Weaver Gaines: 33:19 Never. Richard Miles: 33:19 … Until you are able to find and train– Weaver Gaines: 33:23 Community service. Richard Miles: 33:23 … Those people. What I find in many instances, and this is what’s really gratifying, is you find people who can not only do it, they can do it better. And that’s when you realize like, wow, if I really want to build something, first it’s a trust issue because you don’t think they can do it better. And then it turns out they’re really good at it — not always, obviously, there , there are some misfires. And I think that, to me, from what I’ve seen is the secret to building — as we said earlier today — something built to last is a recognition there are talented people out there that can do this job. I’ve got to find them, I’ve got to train them, and so on. And then you’re off to the races. Weaver Gaines: 33:55 All true with this corollary. It took me a while to realize that just because it was different, didn’t mean it was worse. So somebody who did something different from the way I would’ve done it, didn’t mean they were doing it worse. And in fact, my goal in hiring people was to hire people I thought could do it better. But the very first thing I had to get used to doing was the judgment that that was good enough. And then after a while , I got to thinking, “Well, maybe it’s not only good enough. Maybe it’s actually better than the way I would have done it.” But that first step, in which it gets done differently and you think, “Oh my God, you know, we’re doomed! This is not going to — I got to step back in here.” So good enough was the first thing to do. Richard Miles: 34:34 Yeah. Weaver Gaines: 34:35 But sometimes you can’t find somebody that you think is going to be better. You’re happy with somebody fogging a mirror because you have to fill this position. You need a quality person because otherwise you can’t pass the FDA audit. And this is the quality person you could get in Gainesville. This one. And the one thing you know for sure is he knows more about quality than you do, but that’s all you know, and not looking good, right? And recalls are going to be bad — that sort of thing. But even as people take up a bigger share of the burden, the burden itself is growing. So the company is getting bigger. And if you’re lucky enough to actually have a product, which has now been approved by the FDA, well, somebody has to be the manufacturing manager because you got to make sure it’s made. And then somebody else has to be the quality manager to make sure it’s made right. And if you’re dealing with a distributor , somebody has to be in charge of the distribution program in the marketing and sales operation. And you, the CEO, are responsible for all of those things, whereas before you had only the scientists and you and there’s still — notwithstanding Einstein and quantum mechanics — there’s still only 24 hours in the calendar day and you have to spend some of them sleeping, and you really do need to spend some time with the other person or persons in your life, even if they’re taking the short end of the stick for a while. And so sometimes it’s not possible to assemble the dream team right away, as you have to do with what you got. Richard Miles: 36:06 Weaver, one final question and that is: In any of your CEO experiences or leadership positions, have you ever gone in with sort of a personal exit plan? Do you say, “Okay, I’m going to do this, but I’m leaving after 10 years,” or “I’m leaving after we hit this certain milestone,” or is it more, “I’ll play it by ear. I’ll see how it goes. And if it turns out well, I stay.” How has that sorted itself out for you? Weaver Gaines: 36:26 I have never gone in with a personal exit plan, but you remember my planning skills are … defective. Um , more often than not, the exit has been attributed to an exogenous circumstance. Something happens, and it’s appropriate now for you to leave. So, in the first company, Ixion Biotechnology, when the Swedish investor took one of the two technologies and left the other one behind, left the stem cell one behind, and getting together with all of the scientists and everybody, we determined that it was going to take five more years and maybe $20 million to see if it would work. We decided that was not a good play, that we couldn’t justify taking $20 million of somebody’s money, knowing what we now knew. And by the way, that technology has never worked, although, other people have tried it. We could do the stem cell magic — we just couldn’t do it in commercial quantities, couldn’t make enough to sell. So that resulted in leaving. I mean, that’s what we did. In OBMedical Company, the failure of an investment involving one of our local Florida investment groups, — whose name I won’t mention over the air because I can’t mention it without running the risk of a lawsuit… Richard Miles: 37:33 We’re a lawsuit-free podcast here. Weaver Gaines: 37:35 Right . When that was over and it was necessary to go out and now solicit people who had already contributed when you told them, “Okay, we have a term sheet and we’re ready to move forward.” And now you’re going to have to go back and say, “We had a term sheet and we’re not ready to move forward because the other guy’s a jerk.” And everybody’s going to think, “Yeah, well, was he the only jerk in the room?” And my sister was dying of a glioblastoma. I said, “It’s time for a new person to come in — a fresh voice. You’ll put up with what CEOs put up with, which is the new CEO, can blame everything on you for a while ” . And in fact, that’s what happened: A really good guy came in that I recruited, and who pushed the company over the finish line till it was sold. I stayed on as an advisor, so that wasn’t planned. And this current company that we’re doing, I did deliberately promise Blythe Karow, who’s the CEO right now, who’s taken over — I’m the executive chairman, because she’s not quite the complete CEO, and I’m not quite the board chairman, but it’s gradually getting to the point where she’s going to be the standalone CEO. When that happens, when the board says, “Okay, she’s ready. Are you ready?” I’ll be ready. But that will be more planning than I’ve ever done before. And I think she’s probably ready now, but we need to get through this next round of financing and then we’ll see what happens. So, I don’t know, ambiguous answer to that question. Richard Miles: 38:52 Good answer, and well thought out. It’s been a great conversation, Weaver, and I feel charged up and ready to go. I’m going to go out and acquire a company. Weaver Gaines: 38:59 There you go. Richard Miles: 38:59 Now I’m sure that the job offers will flood in, I said — Weaver Gaines: 39:02 Any moment. Richard Miles: 39:03 And that ends our conversation, Weaver Gaines, so you’re ready to go, but I appreciate you coming on the show and look forward to seeing what’s next for you. Weaver Gaines: 39:09 Thank you, Richard. I appreciated being here. It was a lot of fun. Richard Miles: 39:12 Great. Thank you. Outro: 39:14 Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates inventor interviews. Podcasts are recorded at Heartwood Soundstage, and edited and mixed by Bob McPeak . The Radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

On what it’s like becoming the CEO of a startup and gradually having more and more employees taking over some of the day-to-day responsibilities, guest Ron Tarro says the following: “It’s almost better to view what you’re building as a machine; it’s a machine where, if you actually step back from it, the machine keeps running.” Tarro is the former CEO of a telecommunications software and management services company founded in Boca Raton, Florida. His own experience of developing a startup led him to becoming the Vice President of the Board of Directors at New World Angels, a group of 78 accredited, private investors, operators and entrepreneurs dedicated to providing equity capital and guidance to early-stage entrepreneurial companies with a strong presence in Florida. In this episode, Tarro sits down with host Richard Miles to talk about his own trials of creating a startup, as well as discussing the importance of intellectualizing business as one forges their own path within the marketplace. TRANSCRIPT: Intro (00:01): Starting and running your own company. It’s not for everyone, but for those who have done it, it can be exhilarating, exhausting, and easily the hardest thing they’ve ever done. So we decided to go on and talk to some of those people and find out what they’ve learned, what they’d repeat and what they’ll never do again. We’ll hear stories from their first year, then from the period when they realized they’re going to survive and how they intend to position their companies for the future. We’ll find out what a CEO’s normal day is like, how they build and manage their teams, what it’s done to their personal lives. And finally, when is it time to move on? Join us for CEO 101, a limited series of deep looks at people who are their own boss, for better or for worse. Richard Miles (00:38): Welcome to another episode of CEO 101, a series of special episodes in which we talk to, and about, CEOs of startup companies. I’m your host Richard Miles today. My guest is Ron Tarro, CEO of a number of companies, as well as an advisor and investor in many more. Welcome to the show, Ron. Ron Tarro (00:55): It’s very nice to be here. Thanks for having me. Richard Miles (00:57): So why don’t we start with an overview of your career. You’ve done a lot of things. We just were talking about your role in a number of companies at various stages and levels. So why don’t you give a brief summary of where you started and what you’re doing now? Ron Tarro (01:09): Yeah, so I started as a nerd, software engineer, and I really came through a technical track. My background was in mathematics and the sciences. I ended up getting hired by IBM in IBM labs and so was on product teams, software engineering teams. Went through product marketing and product management jobs there, where I began to focus, not just on making the product, but deciding what should be in the product. I jumped out like a crazy person, one day went I into consulting and joined the industry young, ended up in a leadership position in the management consulting group, which focused on technology companies. So it was basically back to, what should we make? Why should we make it? Who should we sell it to? Those types of things. Did that for a bunch of years. In the meantime, a couple of my pals had started a software company here in Florida, and I was based in Minnesota at the time. I did work at IBM in Boca Raton, if you’re into Florida-centered conversation, and then started a company, I started advising it. I married one of them. My wife was one of the founders of this company and that company is telecommunication software platform. And we took that company, bootstrapping it, with no investment actually, and ended up putting it out into, I think 30, 40 countries. By the time we left, its largest market segment was in hotels and resorts, so we had a pretty big market share. We ultimately sold that company to what is now part of Cisco WebEx actually. And it’s gone through usual chopping up, getting acquired by a public company, where I was a public company, vice president for several years, as part of the arrangement, they went along with the desks and the pencils and that. So since the exiting, all of that, I’ve been an advisor in the incubators here in the state with the university system, in the leadership of a longest standing angel syndicate for investment in startups, so I do a lot of that. And that’s about it. Now, I’ve been a personal angel investor along with my wife, Dana, around the state. So that’s basically it, I mean, nerd turned business person, but still likes to do macros on spreadsheets or something. Richard Miles (03:00): Right, yeah. Nerd turned management consultant turned investor. Ron Tarro (03:03): Yeah, something like that. *laughter*. Richard Miles (03:05): You’re perfect for our show, Ron, perfect. You’ve a great experience in that you are able to both be an outsider and an insider and watching this process unfold of companies starting and then growing and then getting sold from a number of different angles. Why don’t we start with, what’s the biggest difference between watching it from the outside, like as an advisor or something, and actually doing it yourself? When you actually did that yourself with your wife, that company, were there things that you thought like, wow, I thought I knew what this process is like, but this is something nobody told me about? Ron Tarro (03:35): I guess I would look at it this way: in running an early stage company, in whatever form, you are absolutely single-minded. And I would say that what I know today that I didn’t know then is probably, I have more context in seeing some of the moves that we made. So we may have turned left, we should have turned right. And seeing lots of companies making left and right turns, you begin to look at it and say, “hmm, we could have thought about that problem very differently.” Now I would say this, that in our case, I think we made most of the fundamentally right decisions. And we can kind of walk through the life cycle of a company: when to get out of the company and sell it, all that stuff was being driven by stuff. But when you run a company, the thing that you need to be particularly careful, especially as an early one, is you are single-minded in your vision. And as a practical matter, what you don’t know can kill you. And so, I think once you’ve been through this a couple of times, you step back, you begin to see all of those other dangerous–there’s a counter argument, by the way, which would be your ignorance and optimism is the reason you’ll succeed. But I guess I’m a little bit more hardened by some of that. Richard Miles (04:36): Let’s get granular here and talk about the very, very beginning, but from your own experience in companies that you’ve helped start or advise. The first, maybe 30 to 60 days, where you’ve got a founder or a couple of founders, they’re very excited, they’ve got a lot of energy. Why don’t we start with the mistakes? The mistakes are always fun to talk about, right? What are some common mistakes that people make in the first few weeks, did they really come to regret later on? And maybe they don’t even know that they’re mistakes when they’re making them in that first 30 or 60 days? What have you seen? Ron Tarro (05:02): Yeah, no, I’ll start with the very basic one. Should you even bother? Is this a good idea? Because I think one of the things, when you see a founder, is they’re going to walk into this and they believe what they believe. And I’ll actually use the test with New World Angels, which is the angel group that I’m part of and leadership of, is this idea you have is derivative. It’s not better enough from anything else out there. It’s not enough to dislodge the current state. The way to look at that would be: I have a new idea for electronic banking, but can I get everybody to take everything out of this bank, including electronic banking, and move it to that bank? There’s a speed bump. There’s something here: you’re 10% better, but it’s 20% too much hassle to do it. And so one of the big challenges is you see a lot of folks coming into incubators and applying or coming to me for advisory. It is, I don’t know, has this been done before? And if it has, you better have some sort of transformative argument. It was Clayton Christiansen; he’s one of the Harvard guys that wrote a book. Is this sustaining innovation, meaning it’s incrementally improving stuff up, or is it disruptive? It restructures how something’s done fundamentally. Obviously you want a big success, it has to be fundamentally different, not just a flavor. It’s sort of like, there’s Uber and then there’s Uber for pizzas. It’s like, okay, you can make a living at that, and by the way, don’t want to discourage you, but it may not be an investible company, and it may be a company that’s only going to get to be this big because just by the nature of how you defined it in the first place. So part one is, is it even an idea that’s going to be able to, in effect, dislodge what’s already there? And if there is something there or is it clear sailing? And the other is, is it disruptive? Is it just incrementally improving something that already exists? I mean, obviously we want to be disruptive and there’s another great book out there, The Blue Ocean Strategies book that I always talk about, which is as a startup, this whole idea of derivative ideas will repeat. So it’s like, well, if Uber gets into pizzas, you’re dead. You’re, you’re not sailing in open ocean. You’re sailing in the shipping lanes. And so you better have a pretty good argument for why you think you’re gonna be able to stay afloat, new captains, smaller boat, limited gas (meaning financing). So you end up being in a little bit of a challenging spot. So really before you imagine a company, you have to sort of hack your insight, if you will, and say, yeah, I really believe that there’s insight here. There’s an engineer’s disease, and I can make fun of engineers because I used to be one, which is: because I can build it, I should. And that’s not the case. When you look at a lot of products, you see a lot of technology is built by a technical person that is logically and intellectually interesting, and economically kind of is around. For me, it’s like very first thing. Are you onto something here, something transformative? Can we go back a little bit about how you might evaluate that? That’s definitely the very first thing I look at. Yeah. Richard Miles (07:34): So you’ve been, I’m sure pitched a bunch of times. You’ve been to a lot of these pitch competitions, so on. You’ve seen probably thousands of presentations by typically a young-ish or very excited team and probably a bunch of engineers and they’re onto something, they’ve proved it somewhat, and it’s withstood a few proofs of concept. Have you developed, sixth sense is not really what I’m getting at here, but do you have like rules of thumb, five or six things that for you either, you’ll say like, nope, I’m done next? You see right away, apart from what you just talked about, say, is it a derivative idea? And then the other side, when a same team that if they say something, you go, okay, I’m going to go get that guy’s business card or I’m going to call them back because there’s something about their structure. Do you have like a mental checklist or is every presentation sui generis? You just figure it out after you’ve heard the presentation? Ron Tarro (08:22): So actually not only do I have opinions here, actually I’ve written a blog post. If you go to the newworldangels.com blog, there’s a post up there called Back-Testing, why we said no, essentially. So you just layered it right into a whole set of things that could take an hour. So clearly it’s the idea, you haven’t differentiated the idea in the marketplace and that’s a big deal. But at the other one that I look very quickly towards is the structure of the team. Again, I should put some context here. I’m a tech guy, right? So if we’re talking about opening a restaurant and marketing shoelaces, boy, am I the wrong person, right? It’s all a mystery to me, I’m a straight up core software person. But when I look at a team that’s bringing a technology product, if not out of the university, maybe even just an open market, I’m going to go, who are the founders? My favorite founders are one business person that knows the market space, where they think it’s going to apply, and one technology person who can make stuff. Period. If you have a business person who’s hiring out disinterested parties to make stuff, it’s a risk. It doesn’t mean no, but I’m going to worry that if the money runs out, all the cash is running out the door to the consulting firm or wherever it’s going to be. So very much, I look at what that team looks like and what their direct to main knowledge happens to be inside of it. So you have a team that seems logical. I begin to look at the market size, it’s called TAM, people talk about Total Addressable Market or serviceable market. And I always do this in dollars. It’s like, all right, this is great. This is really cool, and there’s 27 people in the world who would use this. So in order for it to be exciting, they each need to pay a hundred million dollars, right? (I’m making numbers up by the way). But it’s this idea that you have a market size that’s way too narrow, and so I’m going to worry about that as an investor. Now, again, you may look at this and you may say, yeah, this is a good product. And it deserves to be in the world. But from an investor standpoint, you’re going to have a ton of uphill battle with what’s being examined. Forming a company is a team sport. I’ll use Florida analogy here, but if the founder gets eaten by an alligator, what happens? And the answer should be well, there’s three more to carry on the journey, right? Richard Miles (10:18): Pre morph the alligator to snack. Ron Tarro (10:20): *Laughter* That’s right, so this whole idea of that is a big deal. And so all of this is back to the design of your company, right? What are you trying to do? Where are you focused? Does it matter? Is it big? Those sorts of things? And by the way, this is the theme you’ll see over and over again with investors, especially. But there’s a reason it’s not just because investors want to make a lot of money. It’s actually very rational. If I go back to running our company, we had lessons learned, but we had a total addressable market for our company, in that we dominated this total addressable market pretty successfully. We made a choice to not change industries, but to go global across one industry, those types of decisions. So in essence, when you look at our company, you would have said, okay, it’s a nichey product except globally, it’s a big niche, right? That kind of idea. And so those are the kind of decisions that you’re forced to make with left and right turns. We think we made the right one because it made us a pure play to be acquired one day. Richard Miles (11:14): I want to follow up on something you said in your ideal team is that you’ve got an inventor and a business person, but I’m sure you’ve seen–we’ve seen it in the Cade Prize competition–particularly coming out of research universities, you have the professor, right? Or you have the scientist or whatever. And they’ve got some grad students with them or whatnot. They love their idea. They’re smart people. and they figure how hard can it be to start and run a company, right? And your heart kind of aches for them because you want to say, you need to stay in the lab. Who has that tough conversation? Is that your job when they bring you along as an advisor or as an investor, for instance? Is one of the first conversations you have and say, look, professor, you need to stick to the, and the development of the idea and the product, and you need somebody who knows how to do this. I’m guessing the successful ones listened to you, and the ones that don’t listen to you, what happens to them? Ron Tarro (12:02): I’ll give you the losing argument, which is, “Hey professor, do you want a hundred percent of zero? Or do you want 50% of a lot?” There’s a question here. It’s hard to succeed in most of these companies; never say never, but aspirationally, there’s always this idea that being the CEO might be cool. However, if you look at the pain in the neck that that job can be, even as a college professor, I’ve been on both sides of the technology versus business fence. Some days I really missed the corny technology story. The reality is that you’re not going to get momentum unaccompanied very easily by being a part-timer, especially a professor. And you see it again and again, where they don’t get funded. The best thing you could do as a college professor would be back to my one maker, one business person that can carry and coordinate. And if you’re a member of the academy of arts and sciences or whatever the case might be, why would you check out of that? Where’s your next idea? What’s your next core research? It’d be better as a professor to have a portfolio of companies that you have a significant interest in that, where you were the founding insight, right? The technology, whatever the case might be. And you let those things grow and nurture because the attention required, you have to choose, you can’t be both. And there are a lot of PhDs who jumped out of academia to run companies, but that’s the choice you must make, I think at the end of the day. So you can rationalize it for a little while, but I know personally a number of folks that just have not been funded because they insist on being CEO as a professor or as a doctor or something like that. And so the funding dries up because nobody wants to fund a hobby, right? Or a side hustle. My money’s at risk and you’re part-timing me, not going to happen. Now maybe again, if you can make it all work without any money up from outside or whatever. But basically go find your best friend’s CEO and found it together, and then you can be chief science officer and you can contribute intellectual property into the business in really interesting ways. You get all the benefit, none of the work, you stay to your passions. And so I think you have to be honest with yourself too. Do you want to be a professor? If that’s where you want, you want the intellectual rigor to an effect, break down new territory. If that’s what energizes you, great. If you have that one idea, you think it’s it, then you got to go all the way in. Richard Miles (14:03): The counter-argument you hear from these researchers is they say, yeah, I recognize I need somebody with a business background, but these people really need to understand the core idea and a core principle here. And sometimes the core principles are fairly sophisticated, like, particularly in the healthcare field or in tech field. So if a business person doesn’t really get the technology, you understand it, right? They’re probably of limited use because they may have trouble visualizing or imagining the applications of that technology, if they don’t really understand how the technology works. Ron Tarro (14:33): Okay, I would argue a little bit differently. All you described was your requirements in recruiting for a CEO. You’re not going to get a CEO who did real estate management, no offense to real estate managers. That’s an entire industry that has a focus. If indeed, and we’ve done a series of investments in med tech, so basically what you need is somebody who understands the marketplace for these technologies. Here’s the problem with investing in research. Science is not the thing that adds value, it’s the application of the science in the marketplace. So you need somebody who knows the marketplace. So you have to go to a professor and you have to say, “Hey, you know the science, now you need somebody who needs to know the application space for the science.” And that’s different. They don’t have to be you, but they have to be somebody who is in effect, creating value through the application of the technology. That’s a different thought process. That’s a quite different thought process, because at some point it has to be commercialized. Now, if you’re just busy selling patents, if you will, you can do that. But then hire a patent troll, they’ll know how to do all that stuff too. So you still have somebody who’s going to spend all their time thinking about that. So there’s an intellectual foundation for a business and there’s an application foundation, if you want to think of it that way, maybe. So you still really haven’t defeated the argument. My two-person model is still the best model and that’s what should be pursued to create value. You know, I’ve been in the consulting world, which is sort of the intellectualization of business, right, which is all about strategies and frameworks and methods. And I worked at a think tank, for a number of years, doing this kind of published work. I get the academic-business divide. The reality is, is putting something in the marketplace takes balls. Period. Yeah. Richard Miles (16:05): So it sounds like important advice. Number one is it’s not enough to get somebody with a generic business background or business skills. You really need to have somebody who understands that particular market in which you’re trying to enter with your technology. Ron Tarro (16:17): And came out of networks, and networks and telecommunication. And there’s some young motivated types that can come up those learning curves, and that’s all great. But listen, if you want a CEO, you probably want somebody who knows how telecom works. All the better, right? We’re going to get back to, what you don’t know can kill you, right? So they bring actually wisdom that an academic probably wouldn’t bring to the business. Richard Miles (16:36): So let’s talk about the strategy and the frameworks. Now let’s imagine a company and I’m sure you’ve got real-world examples of, let’s say they’ve gone through their first year. They’ve launched, they’re getting revenue. They’re doing pretty well. They’re starting to grow, but then they face some serious choices, right? Do we grow in this direction or that direction? You start having to make significant trade-offs in terms of hires or just start hiring like crazy. What are some of the pitfalls, let’s say after a successful year one, that companies make in terms of a strategic direction after that first 365 days? Ron Tarro (17:05): So I’ll change your 365 days, cause I’ll let that flex, and I’m going to look for certain milestones. So I carve up a company lifestyle this way, is somebody is in the phase of hacking value. It’s the idea that I have a technology and I am busy refining potential uses for it and testing that. A good program in that startup type of stuff, iCore, I think most of the academic world has seen the iCore program. If you want NSF funding, et cetera, there’s iCore, is certainly a help to that process. But this is the idea of, before I build it, should I, right? Or, and what should it do? So this is the idea of hacking your insight, right? Getting that really polished, such a way that you have an insight and you know how it’s going to be applied, then build a prototype. So I’m gonna look at a company first and say, where are you at with that, and have you established that as a phase? Second thing I’m gonna look at is, okay, let’s hack product market fit. Product market fit is this idea that somehow it’s the right set of features and it’s the right price, and you’ve demonstrated that by a bunch of things like, maybe selling it to a few people. And so hacking product market fit to me is you’re done with that based on basically a quick check. Are you having to force customers to take this product or are they excited to take it? And we can talk about how to do that. And you’re going to test your different ways to sell it and your messages and stuff like that. And then third, you’re going to hack growth, and hack growth is another way of saying, you’re going to hire more salespeople and you’re going to begin to accelerate because things start to get repeatable, right? Here’s the problem, if you haven’t properly hacked your product market fit, and now you start hiring salespeople, guess what happens? They work really, really hard and they don’t sell a lot. Or worse yet, they do sell something, customer doesn’t like it and is always yelling at you, and maybe they stop using it. So what’s going on? The ones who went through and did this in steps. It’s not a calendar step. It’s sort of like a testing thing almost to say, I have insight. I have fit. Now I’m going to chase growth. And then you start hiring salespeople and evolving your messages, and you decide whether you’re going to use in-house people or whatever, and that lots of different things can go on. But that’s how I look at it. And you can see more often than not, that’s how companies get stuck, is they actually didn’t do the first two steps. The other interesting thing that you see with companies is you can look at the marketplace, crossing the chasm, that guy, this idea that you’ve got innovators and early adopters. And when you’re a new company, brand new product, and this idea that you have, these innovators and early adopters, and when you’re first starting a company, you have a brand new product. The tendency is to take the product out there and convince everybody how great it is. And if you did your insight right, what you really want to do is just look for all the people who are desperate to have it. Ron Tarro (19:40): There are certain people that a narrow range of people who will be fast adopters to this; it could be people with a huge problem and they don’t care about the wrong or risk it takes on a new company, somebody who’s the perfect fit for the product. So you’re looking for people with perfect fit, not trying to convince the rest of the world that you have the next big thing. You’ll see a lot of folks doing a lot of presenting, and what they haven’t done is they haven’t narrowed everything down into a nice tight message to a very tight group of people. And so they burn weeks and months, even a year or two, break their picking because they’re tackling the wrong folks. The other side of that is you want the risk takers, the people who have such a big problem that take a risk on you, right? And what you’re going to have is the big corporates. Everyone says, I want to sell this. I want so-and-so to buy it, big NASDAQ, New York stock exchange company. The reality is is those folks more often than not are managing risk of technology acquisition, along with innovation. You need somebody who needs the innovation because they’re desperate for it. So, I watch where people are on the cycle of early stage, and what you find is that some people rush it and fail late, after they’ve collected a lot of money by the way, from investors or worse yet, from their mom. So now you’re sitting there going, well, what happened here? Well, you weren’t quite defined in what your product was. It’s interesting, the story of our company really was similar to this, which was, we built a piece of software that was essentially a middleware, to use software terms. And we put that software into very select companies that were very innovative and had very sophisticated requirements that only we could do. And so we’ve found that one and then this one and picked our way individually through the group until we said, okay, this is a story that’s turning out to be repeatable with everybody else, and we refined it. So it happens that way in real life. If you try to circumvent that, you lose. Richard Miles (21:26): Let’s talk some about CEO’s as managers. You referred earlier to the life cycle of an early stage company, and you start out say with four or five people on your team, and it’s more like a family or a basketball team than it is a company, right? Because everyone knows each other. It’s very close. And then you get a little bit bigger. Maybe now you’re 25 or 30 employees. And then one day you’re 150 to 200 employees, and that obviously requires a different management structure, a different management style as you start growing the company in size and scope. How many CEOs are able to successfully make that transition from five people working for them to 200 people working for them? And how often is the case where somebody says, you know, “All I ever want to do is manage startups, I don’t want to manage a big company. It’s not fun. It’s too bureaucratic. Blah, blah, blah.” What is the range of outcomes that you’ve seen? Ron Tarro (22:13): Well, actually you described it. Let me just put it this way, maybe. Let’s just talk about growth of a CEO. So I started a company, it’s getting bigger. How do I have to change personally, right? Now I came into a small company from a large, so I had some visibility on what it’s like to manage a more complex environment, I suppose. You go as a founder and a CEO to, in effect, managing a product and customers, right, and building a product, if you will, to, in effect, building an organization. So it’s almost better to view what you’re building as a machine. It’s a machine where, if you actually step back from it, the machine keeps running, right? So you see a lot of CEOs who, and they’re right in the short term, they could probably do everybody’s job better than the person they hired. This becomes untrue as time goes on or less true, anyway. It’s probably even untrue. And so, they hold on to stuff too long. If you show me an overwhelmed manager, the first thing I look for is a delegation problem where they’re not viewing your organization as an organism that care and feeding, if you will, and they haven’t spread things out. And the real telling thing happens when you become a manager of managers, that’s the break point where it forces you down this road. So if you’re reaching into your managers or over your managers, then you’re just in the wrong head space. So to me, the growth thing is you have to then begin to say, okay, “how do I set up structures and communication so that everybody knows what I know believes, what I believe is seeking what I seek, KPIs to use fancy terms, Key Performance Indicators, to design the organization a little bit, so everybody’s a believer?” Ron Tarro (23:38): Listen, Elon Musk is great. He knows how to do this intuitively, which is our mission is to get to the moon, right? Who believes that we should be on the moon? So he’s got a whole organization, absolutely energized to this big idea and lining everything up to it. Here’s all the steps. And that’s the big thing is that basic transition away from being the best at everything and the person who’s best at moving the chess pieces around, if you want to think of it that way or best at designing ways that everybody can get stuff done faster. You don’t give up everything, you know, you choose. So for me, an example of how we sold early on; I sold, because we’re not venture backed, so I was selling the product, if you will. Ended up then having a sales group. In the sales group, they would in effect do some selling, but I would focus on various strategic things like this customer right over here has to be the one that we get next, Marriott or something. And so, I’m actively involved in that, because it had a material impact. But once we got Marriott corporate on board, getting every Marriott hotel to in effect use our product, an entire team that could drive that. So you begin to move yourself into something and then back out. You look at the messaging, all your positioning. So in our case, it was strategic impact sales, and then also the product roadmap. What are we making and why? One of the most telling things, cause I obsess on Musk probably too much is he’s not the CEO he was. But if you look at where he spent his time, he spent it as chief product officer, chief engineers. He’s very focused, because the product is what makes the business as a foundation and then its application and alignment to the marketplace the second. Those are the two things. If you have a CFO, the CFO makes sure that the mine is not running out the door wrong or something, but those are not the core things for a CEO. The CEO is what do we make and who are we making it for and why does it matter, et cetera. And that’s until you go public. And even then, still that. Richard Miles (25:24): Do you see that often where a founder, the idea person says, I just want to stick with product, developing products because that’s what I love? Is that fairly common? Ron Tarro (25:33): One of the reasons I came into our company was our CTO and COO were like, “we really don’t want to run this,” our CTO just really wanted to stay on the product side, it’s all he wanted to do. And by the way, that’s a very honest self-assessment, just to say this is not something I want to do. You can still own a huge percentage equity of a company and do profoundly well, but you just don’t want to go through the brain damage to that other job over there. And by the way, since you are a founder, is you get to pick your job. So why shouldn’t you? I actually have a lot of respect for that. The idea that, especially with technical co-founders is I say, “I want to be on the technical track. I don’t want to be a CEO. I don’t want to be dealing with every HR issue and financial and market, this and blah, blah, blah. I want to design and make products.” That’s hugely valid and maybe even desirable if I were to go back. Richard Miles (26:17): Ron, why don’t we conclude with something you said at the very beginning. You mentioned, if you could give yourself advice, young Ron Tarro advice from the older Ron Tarro, what would it be in terms of lessons learned? Let’s say you’ve got the young idealistic tech guy at 22, 23, or tech woman, and they’re going to go conquer the world, start the next Facebook, whatever. What do you think their older selves would be telling them in 20 years? Ron Tarro (26:40): At the end of the day, I end up getting rather tactical. I’ve been asked this before and I end up getting, “I would’ve made this decision differently,” but in general, if I were looking at all of it, I would have much more peripheral vision than I did. In some sense, we were pretty good at this, but not good enough. So the idea that we could have gone into other verticals faster, that we could have accelerated faster, that we were a little bit too conservative in what we were up to. Now, the reality is it turned out okay. But I would say that there’s an element of luck to that, that is significantly large, so we beat the odds. In some sense it was our success, but it was also probably a limiting factor of the company. So in a lot of ways, there’s a tendency to try to make what you’re doing today better, more efficient, more whatever. And sometimes there’s a breakout idea that you should be focused on to really grow the company. You could reasonably argue that we didn’t have enough peripheral vision to make a bunch of decisions or even see the decisions to be made. And so the advice to myself would be to get wider faster on what’s going on with mega trends, et cetera. I’m like 75% convinced of what I just told you. Now we pivoted different products in different markets. And the other was a strictly technical one and maybe more tactical too. It was really fundamental. There’s this thing called technical debt in software, and technical debt is this idea that you designed a product that has an architecture, but as you grow, your architecture is not so cool. It doesn’t support the growth or better yet, it sort of turns into a hair ball and you’d be adding this and adding that. Customer A wants this and customer B, and you lose control of the core product, and I would say that you suffered from a technical debt issue, because as an early company in our segment, we said yes to everybody. Sure, we’ll do that. Sure, we’ll do that. And we did not take a step back and abstract, what we’re doing, get back to peripheral vision, why are we doing this, right? What’s the larger context. And so we literally had to take a year pause on our product to say, it’s time to remodel the house. We should have been remodeling the hallway and then also abstracting. And so this is very much a software technology CEO problem, very specific to my world, but this idea that you sort of lost control of your code base. And so now every time you wanted to do an update, it took you 47 horses and a mule to get a new release out, when it should’ve just been a horse. You end up with a slower and slower product cycle. And so, one of the big lessons on the technical side was to really approach, I think, the software engineering story differently, but we survived. Richard Miles (28:58): I actually have one final question, both from your personal experience and what you’ve seen. What does being a CEO do to somebody’s personal life? Because everyone thinks like I want to be my own boss, that’s the best thing in the world. But then once you are, you realize that you’ve exchanged some freedom for responsibility, right? Part of being your own boss is you have to worry literally for a time, at least, about just about everything. You don’t really get to go home at 5:00 PM or 6:00 PM and check out and then show up at work the next day. You are the person. What was that like for you? And what has it been like for others that you’ve seen in that position? Ron Tarro (29:28): Well, I thought about my business every day of the week and pretty much all day. So let me give you the motivation. There’s a moral case for a CEO, especially startups, with deep respect to startups. What you have is you’re changing the world in a positive way. You’re creating something that will improve something for somebody somewhere. And so, if you have a passion for that, that’s pretty cool. And that is a motivation. I find that CEOs that care about money, it’s a crappy and soul-deadening way to approach life. Money’s a by-product of changing the world in a cool way. And so if you’re chasing money, then you’re just chasing money, and there’s no excitement. Then work is work, a slave to a dollar rather than a slave to change. I think one of the things I heard, I always sort of kept in the back of my mind is if you’re a CEO in these companies, what you’re trying to do is, it’s not about you making a product. It’s about you solving a problem in the world for somebody. And so, stay focused on the product or the problem. And with that focus, everything else takes care of itself. It’s its own joy. You made this industry better. You made this customer better. You made the world better. Something to that effect. That’s a huge personal motivation and something worth chasing. Back to, are you in the business of making profitable rockets or are we trying to get to Mars? And what’s the big calling here? And so I think as a CEO, if you have that, then everything else kind of gets easy, and you start blending work, play, and purpose all together in one thing. And that’s much better than being a slave to a dollar. Richard Miles (30:47): Ron, thank you very much for joining me today on CEO 101. Lots of good advice. I hope all of your clients and your companies are doing well and do well, and look forward to having you back on the show at some point. Ron Tarro (30:58): Cool. Hey, it was very nice meeting you. Outro (31:01): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates inventor interviews. Podcasts are recorded at Heartwood, Soundstage, and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

Before the age of digital downloads, SaaS and streaming there were these huge boxes filled with disks and these boxes were sold at retail stores and via mail order shops - lol - no, really they were. Then it all changed and we used email and other web-based forms of communication to drive sales. The sage veteran of these marketing battles for the customer's attention were forged by the likes of my old friend Richard Miles. Richard was not only a leading marketing consultant in this era but also an innovator and builder of astute marketing practices. And then his next journey began and then his next and next. We cover several of the key steps in the latest edition of The Look Back.

When Rick Carlson founded SharpSpring in 2012, he didn’t think of himself as a CEO. “My co-founder and I were doing whatever it took to survive,” Carlson says, and they were responsible for everything from software development to buying office supplies. In the early days of the automated marketing software company, “there were so many failures it was hard to name them all,” according to Carlson. “There was an immense amount of wasted effort in figuring out what customers wanted. Over the years we think we’ve gotten smarter about how we make those decisions.” The company went public in 2014, after being acquired by SMTP, and is currently listed on the NASDAQ. TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade, a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work, and how their ideas get from the laboratory to the marketplace. Starting and running your own company: it’s not for everyone, but for those who have done it, it can be exhilarating, exhausting, and easily the hardest thing they’ve ever done. So we decided to go out and talk to some of those people and find out what they’ve learned, what they’d repeat, and what they’ll never do again. We’ll hear stories from their first year, then from the period when they realized they’re going to survive, and how they intend to position their companies for the future. We’ll find out what a CEO’s normal day’s like, how they build and manage their teams, what it’s done to their personal lives. And finally, when is the time to move on? Join us for CEO 101, a limited series of deep looks at people who are their own boss for better or for worse. This episode’s guest is Rick Carlson, CEO of SharpSpring, a comprehensive sales and marketing automation platform. Richard Miles (01:25): Rick, welcome to the show. Glad to have you on to get your experiences as CEO of SharpSpring. We’re going to start by talking about the very beginning. So if you could take us back literally to your first year, really your first few days as CEO, and let’s get a snapshot for people who’ve never done this before, what that is like. And obviously, you put in work before you probably became a CEO into the company, the idea, but let’s start with the first 30 days. You’ve got your company, it started, maybe it’s just you, maybe you have a handful of employees. What was that experience like? Rick Carlson (01:56): First off, thanks so much for having me, appreciate the opportunity and I’m glad to be here. So when I heard you pose the question, your first day as CEO, actually what immediately came to mind is during that first year or even two years, or maybe three years, I certainly did not think of myself as a CEO. CEO is what I am now managing a very large team with managers and a couple of hundred people. When I think about that first year, I think about struggling with a fledgling team where I am just another team member, and that’s exactly what it was like. I was a founder of a business, much more than a CEO, what somebody thinks of as a CEO today, and that means everything that you think it means. My co-founder and I, Travis, who was really the technical side (he remains our CTO today), we’re doing anything and everything that it took to survive, from raising money to making the coffee, to go buying the office supplies fortuitously. Just a week ago, Travis celebrated his ninth year with us and dug up one of his first emails to me about buying office supplies as he moved over from his previous company to start things. So very literally in that first year, it’s about being a team member and forming a team and doing whatever it takes to survive. Richard Miles (03:17): So at this stage, you can afford to tell great anecdotes about the early days, including maybe some early failures or things that didn’t work out, right? Do you have any stories–again, go back, limit yourself to maybe the first month or first few weeks–of something that you look back and smile now, but at the time you considered it a disaster or failure, or just a really bad day? Rick Carlson (03:37): Depending on which lens you think about SharpSpring, my business, in some senses, it feels like we had a straight line to success. Like we did not have to pivot our business model. Once we got to market, we started selling and I think it’s even more common that a business pivots once or twice before it really finds its footing. Through that lens, SharpSpring was pretty straightforward, but being more on track to the question that you asked, there are so many failures that it’s too hard to name one in every sort of micro way. There are more failures than you can count. It’s a winding road. So I have put our development teams and the early days through so many useless development features projects that never took off and meant anything to any one of our customers. And over the years, we think we’ve gotten a little bit smarter about how we make those decisions, but an immense amount of wasted effort on this sort of winding road to figure out what customers want and how our business is supposed to work. Again, though, if you backed up, it would look like a straight line for us. So I hope that paradox makes sense to your listeners. Richard Miles (04:51): So all the management books, or most of them, focus on one of the most important things you do as a founder, CEO, is who you hire. So again, going back to this first few weeks, did you have sort of a template in mind already of like, this is the person that my co-founder and I want to work at this company? Did you have, literally, a list of qualifications, or did you just sort of figure it out as you went along? What constituted a good employee for SharpSpring and a bad employee for SharpSpring? Rick Carlson (05:18): Yeah, great question. Like everything in a startup, my vision of what I wanted was almost immediately thrown out the window, and we were left with reality. But the specific story there is that I left a great job in internet security to start SharpSpring and intended to found it with somebody different than the person I ended up founding it with. So I quit the job. I moved back to Gainesville, I’m in it, up to my neck, and I get a call from the original co-founder who said, “Guess what? I can’t do this. My wife is having twins and I just can’t take the risk with you. I’m so sorry, Rick.” So yeah, I had exactly the right guy in mind and before we could even really get started, the best laid plans as they were, right? I think that there’s a lesson there though, which is press forward, and I found a lot of luck involved in this. So pressing forward is not always enough to be very clear, but it is required. And so I press forward and was lucky enough to find Travis Whitten, who founded the company with me ultimately. And we found a third person in the early days. And between the three of us, we had a super complimentary skillset. Travis backend architecture, fantastic developer, could really build anything we imagined. I sort of brought the business model and product vision to the company. And then we had another gentleman, Joe Kelly, who came from Grooveshark. Some of your listeners probably are very familiar with Grooveshark. Between the three of us, we were able to build a product and get to market. And so it was a super powerful team. And I’ve read a lot about this, a lot of companies are founded with three. That’s, sort of a magic number. It feels rare that two people can cover all the ground to make things work out of the gates, and four starts to become a crowd if you will, and in essence, three doesn’t appear to be a crowd when it comes to starting a business. Richard Miles (07:16): Good answer. Okay, final question on the early days: I’m sure you’re at the stage in your career, having succeeded as you are, that you’re probably asked for advice a lot by people wanting to do something similar. What sort of advice do you give to people who say, “Okay, I’m ready to jump out the window. I’m quitting my good job, and I’m going to go out on my own, start my company.” Or what wisdom would you have given yourself now, looking back, talking about everything from the completely mundane to the inspirational. So like, “hey, make sure you buy a fire extinguisher” or “believe in yourself,” whatever. What are a key piece of advice you would give to somebody, let’s say tomorrow, that was about to start their own company? Rick Carlson (07:52): Yeah, so, I think that answer depends on the experience of the person who’s wanting to start the business. So yes, you’re right. I do get people, different experience levels, asking, “Hey, I’m thinking about doing this.” In my mind, there’s a magic window, and that window is bigger for some people than others. That the magic window I’m talking about is where you have enough experience. You have enough knowledge of the market that you’re trying to get into, or problem that you’re trying to solve for your customers, that’s a whole other conversation. Incidentally, being able to solve a customer’s problem is not enough to start a business. But, anyway, you’ve got enough experience, and yet at the same time, you haven’t gotten bogged down with life, family, children, mortgages, all the things that mean you’ve got to find security and so forth. And so there’s a window there that it feels like gives you the best chance to succeed with the experience, and yet allows you to take the risks that you need to take. And sometimes, people wait too long and they realize it’s just impractical to start a business. I mentioned my original co-founder all of a sudden having twins. It’s a perfect example of that. And then I see people who are maybe starting a business a little bit too early, before they’ve gotten into the market that they’re trying to attack and participate in. It’s not to say that they can’t succeed. People succeed all the time, but we’re talking about giving yourself the best chance and having that experience to put to bare, I think is a really important thing. So that’s the framework I like to think about these things. Also, you should have a fire extinguisher. Richard Miles (09:26): No, it was good advice, right? So Rick, I’m literally going to go off script here. I’m going to ask you a question we hadn’t thought about, but something you said triggered it when you decided, okay, I’m going to do this. I’m going to go try to start my own company. What was the most common reaction from friends and family? Did they go, “All right, Rick, go get them!” Or were they like, “Whoa, uh, what are you doing?” What sort of reactions did you get from those who knew you best? Rick Carlson (09:50): For most people, it wasn’t a surprise at all. For me, and anybody who is listening to this that knows me, knows this to be true, very difficult for me to work underneath somebody else. It was almost a requirement that I go and start my own thing, because working for 40 years for somebody else, with my personality, probably not going to work. Richard Miles (10:10): So this sounds like it was part of a plea deal, right? Rick Carlson (10:14): [Laughter] Well put, well put, exactly right. I think it was just a foregone conclusion. But even before I figured that out, when I was a teen, I knew that I had no idea what business–I mean, it could have been a restaurant at the time, but I just knew I wanted to start my own business. And so, I don’t think it surprised anybody. I still think people, parents and so forth, it’s not to say they weren’t worried. They weren’t surprised, but not to say they weren’t worried at the same time. Richard Miles (10:43): I’m sure you did no complaining whatsoever, so they probably didn’t even know if you’d had a bad day, right? Rick Carlson (10:48): Yeah, that’s right. Well, just in terms of generational changes, my father was somebody who worked for an electric company for his entire career. And what you sought at the time was security and a pension. And so even before I started a business, what’s commonplace today, switching jobs every couple years and trying different things was just foreign to them. And so, yeah, there was a complete lack of understanding. And it’s only just in the last few years where people go, “okay, you knew what you were doing,” so. Richard Miles (11:20): Let’s talk a little bit about the middle years, and I know that’s a relative term, depending on what company we’re talking about, but let’s start as a discussion point. Let’s say a year or two. So you’ve been doing this for a year, and presumably at that point you had more than three employees, your personal priorities in terms of how you spent your day as the founder slash CEO were probably starting to change. Maybe the original team was starting to change. You’re beyond the, “okay, we may fail tomorrow stage,” but you haven’t quite hit the big time yet either. Was it a surprise in terms of the new challenges or did it just seem like this is day 366, it’s not really any different than day five? Rick Carlson (11:54): There are absolutely stages to the thing, where everything felt different. For me, again, I was the guy that the first year and a half, two years, pretty fantastic for me. I raised some money. I knew how to do that–again, I had some experience–and so I was able to raise some money, and a lot of the burden was on Travis and the dev team to actually build the product. And I remember distinctly, it took us a couple of years, even though we were building an MVP product and trying to get to market quickly, because our product category in many ways had already been defined by the market, took us a while to build our version of it and the layering on the new things. And I remember distinctly, after two years of hard work from my teammates, not to say that I wasn’t working hard during that time doing my thing, but the burden shifted over to me. I promised these guys we can sell, I promised these guys we could market, and all of a sudden we had to go and do that. And I remember the first month we went to market, we sold exactly nothing, and that was because we had unrealistic expectations of the sales cycle. And thankfully in the second month we started to do some things, but I definitely remember a stressful period during that time. Then I remember a third phase, in what I would call those middle or teenage years, where all of a sudden we had enough customers and gosh, it became even harder. So first it was like raising money, which is actually sort of the easy part, then it’s your initial sales, and then you’ve got this customer base. Now you’ve got to keep selling, you probably have to keep raising money, and now you’ve got to support customers. So it just layers on these incremental obligations and complexities and difficulties as time goes on, which doesn’t paint a very beautiful picture. But I think running a business can be pretty messy. It’s not to say it’s also not fun and rewarding and that you learn things, but that’s how I remember the years, two and three and those earlier years. Richard Miles (13:55): It’s almost more of a challenge to grow and succeed, right, than to decline and fail because decline and fail, your world keeps getting smaller, but the growing and succeeding you’re now, like you said, adding layers of complexity that somebody’s got to manage, and somebody’s got to think about it. Rick Carlson (14:10): That’s a fantastic way to put it. I think that’s exactly right. Mentally, clearly the opposite is true when you’re not succeeding. And sometimes even when you are and when you’re marginally successful, it can take a real mental toll on you. It’s really tough to work that hard and not succeed, which is the case with a lot of businesses. And if you’re in that situation, you have to remember that that’s okay, and that’s part of the thing and that most businesses don’t succeed. But I think that’s exactly right on the operational side of things; you get to the next level, and there’s a whole new set of complexity that you’ve got to figure out how to manage. And I could keep going into stage four and five. I think I described three of them so far, but I’ll stop there. Richard Miles (14:48): That’s a perfect segue into the next topic. Now, we’re bringing you up to the present day. So if this were a movie, the flashback would be over, the characters back in the present day. So I can only imagine that your duties may be significantly different than they were when you first started. Maybe you’re further detached from the actual production of the product, so to speak and even sales. So what are you spending most of your time on now in the company? And then, describe some of those additional challenges that you have to take on at this level. I imagine dealing with the media, dealing with public opinion, dealing with a lot more employees is a bit more of a challenge. So what is that like today? Rick Carlson (15:27): I think I left off where we’re all of a sudden, we were selling and then we had all these customers to manage and so forth. Along the way you hire a bunch of people, and there’s a phase when we first started our conversation today, I said, I didn’t feel like a CEO. I felt like a member of a team, a founder, a part of a team. Somewhere along the line, you become a CEO, and there’s a difference, and what was striking to me was when people started to treat me–when we had enough employees–where people started to treat me as a CEO, and I struggled with it, actually. There were things that I could say to a teammate in even an abrasive way, because that person knew that we were on the same team and they knew what I meant, and they knew we were all going in the same direction. And it was no big deal because, you know, we’re just onto the next thing, and we’re all pressured. But as a CEO, saying exactly the same thing to somebody who doesn’t know you as well, who thinks of you as a, not a teammate or a founder, but as a CEO, even the smallest things you say could really ruin someone’s day. So there’s this transition that takes place. I can’t pinpoint it, but it’s part of the detachment that you mentioned. You’re right. Like I used to know everybody on the team, and I used to be able to spot talent personally and see somebody who’s making a mark. And now, you are separated by a layer or sometimes even two layers of management, and you’re not intimately involved in really any process. You try to dabble in everything, but you’re not as deep in any process. And I think you know this, but we’re actually public, and so there’s a strange story to how we became public, but we’re a public company. So a lot of my time now is dealing with analysts and banks in New York and everywhere, and key investors, and new potential investors, and our public company board. And that carves out a big chunk of time that would, in the early days, be a hundred percent focused on the business. So it’s a pyramid with your customers sort of at the bottom of the pyramid, and the bigger the organization gets, the taller the pyramid, the further you are away from those customers and what’s happening sort of at the ground level, if you will. I think I just described a multilevel marketing company. I hope, I hope I didn’t do that. Richard Miles (17:47): That’s what, that’s how I will describe in the show notes, exactly [laughter]. I think the transition comes when everyone starts laughing at all your jokes and you win all your golf games, then you know, you’re really the CEO, right? Rick Carlson (17:57): That is required from day one, Richard, that was day one where we just, everybody knew that about me. You got to laugh at the jokes. It’s the uncomfortable laugh. Richard Miles (18:06): And they laugh when you know the joke wasn’t funny. But it’s interesting what you say, just the limited experience I’ve had with running the Cade Museum and starting it, is in a way, you have to keep reinventing yourself, right? Because you keep having to redefine, how do I add value? And it’s not the same way as you did in week one or year one, when, as you said, you may be down there with the floor level programmers and workers and you no longer really add value to the company doing that anymore. You’ve got to do, like you said, talk to the Wall Street analysts and talk to the media and that’s how you add value. But in a sense, it’s a shifting target, right? As a company gets bigger and bigger, and as you said, you have other layers of management, even those things, eventually, maybe somebody else will do, right? Rick Carlson (18:46): Yeah, you are a hundred percent spot on, that you have to reinvent yourself. You can cause more harm than good actually by, by not doing that, not evolving, which isn’t to say as I sit here and proudly declare that I’ve figured that out. It’s not to say. I know it to be true, and yet it’s a work in progress for me, constantly trying to evolve and figure out how I can be the least disruptive and add the most value, right? I would actually go further since we’re on the topic, that is true of every person in the company and every process, every process in the company. So one of the things that I’ve talked about with the nucleus of people that have worked together 5, 6, 7 years now, and we have constantly built up processes, they’ve worked and then somehow 12 or 18 months later, because of the size of the company, because of other changes in the company, they no longer work. So there’s a process of tearing down the processes that worked yesterday and rebuilding them. The obvious examples, when you’re 20 employees and you need to communicate something, you yell it out because you’re all in the same room, right? There’s that sort of thing. When all of a sudden you’ve got departments, it’s a totally different communication style. When you’ve got enough departments of enough size where the interaction between departments and coordinating two, three departments, almost like they’re people. Each department has a personality, it has their own needs and goals and ambitions, and trying to coordinate that, it requires different processes. And so going back to the original question you posed, it’s absolutely, as a CEO, tearing down my idea of the value that I create and rebuilding it, but it’s also true of, I think every process in the business, by my estimation. Richard Miles (20:44): I like the way you put it. It almost gives you a sneaking sympathy for large bureaucracies, right? Because you can understand how bureaucratic processes get put in place to coordinate ever larger and larger companies or government agencies and so on. But then of course, you’ve got to be careful because that also tends to sort of throttle creativity and make people risk averse and all those things. So it’s a real challenge, right? How to get bigger, stay coordinated yet without killing the dream with all your employees, so to speak. Rick Carlson (21:09): Yeah, that’s exactly right. I could talk about that one point for a while, frankly. I remember with a certain amount of hubris and this is true today, by the way we, this is part of our corporate culture. We’re extremely proud of how nimble we are versus our competition. But I remember almost laughing about it and thinking about these much larger companies and how slow and cumbersome they were. In reality, we’ve taken a couple steps closer to those companies out of necessity. And guess what? Turns out when you’ve got 10,000 businesses using your software, you darn sure better have better QA than you had in the early days, right? And so there are definitely things that necessitate slowing down and communication and so many things. So it’s just one of the many things that, that changes over time with a business Richard Miles (21:57): Yeah, and when you’re publicly traded, best not to talk to the press after three martinis, right? Rick Carlson (22:01): Ah, a lesson, I’m still trying to learn [laughter]. No, that’s not true. Richard Miles (22:04): So let’s talk about, a little bit philosophical here, and I understand since you’re publicly traded, you can’t give me any secrets, and we don’t want any of our listeners to be indicted for insider trading here. But tell us a little bit about the model and strategy that maybe you had from day one or maybe you developed it. What was your strategic true north? Did you know, from the very beginning, okay, this model, this strategy we think is going to position us so that we beat our competitors. And if so, has that model and strategy changed or you just had to maybe tweak it? Is it still essentially, the model and business strategy that you have, is essentially the same as when you began with modifications? Rick Carlson (22:41): So, what I would say is the mission has been consistent, and the strategy has shifted once. And now we’re at an interesting stage forth with our business where the strategy isn’t shifting, but we’re layering on other concepts. So let me bring some of that to life. For our business, we’ve always had a mission of bringing what we call today, a revenue growth platform. Our product is traditionally known as marketing automation, but has grown well beyond that set of functionality now to basically being anything in, an SMB needs to manage their sales and marketing processes, s,o CRM and social media management and marketing automation and email. So that was always our mission to bring an affordable, easy to use solution to SMBs, of which there are millions of them. And as we spent all that time building our first version of the product, when we started the business, we saw it as greenfields because everything was up at the enterprise. Large businesses were using this and maybe medium-sized businesses, but SMBs were not. And over those years that we were feverously building, we saw other competition enter that space, and they were better brands with at the time better products and more well-funded, and by the way, really sophisticated marketers. So one of the strategic decisions we made and it’s less important to think about the decision itself and more about the impetus for the decision we had to figure out a way not to compete. And so often you hear people talk about figuring out ways to compete. Well, the thing to do is to figure out how not to compete. If you can find a place not to compete, it’s a much easier path to go down. And so early on, we decided to work with digital marketing agencies because we found that they were the path to get to these SMB businesses. And when we looked around, nobody was focused on them, and so that has been something we’ve done since we launched the business six years ago. Now we’ve got a brand that is becoming nationally known, that people are aware of. And we can potentially, in addition to working with agencies, approach businesses directly and so forth as we move forward. But I think for the listeners, for us, it was staying true to our mission of going after SMBs while figuring out that space in which we could avoid competition for as long as possible. That’s what I think we did successfully. Richard Miles (25:14): I read or heard, or maybe I just made it up, this idea of embrace your weaknesses in so far as the earlier, you understand what you’re not good at–and I’m not saying that your company wasn’t good at theirs–but it allows you to focus on their strengths and reach out and find somebody else to help you do this stuff that maybe you’re not as good at or interested in or whatnot. And I’ve always thought that’s pretty good advice, that the people or the companies that decide they’re going to be everything a to Z soup to nuts. Usually they’re just a can’t be, right. There are going to be certain aspects that they do better than others. And sometimes it just makes sense to think, like you said, choose not to compete in a certain area. Rick Carlson (25:47): Yeah, no, I think that’s right. Look, at least metaphorically, companies are a lot like people, and they’re going to have their strengths and weaknesses in their products and their people. I’m never going to be a weightlifter. Richard Miles (25:58): That was my next question, Rick. Rick Carlson (26:01): Yeah [laughter]. Anyway, there are things I’m not going to do. And there are things that our business is not going to do and being realistic about those things and working with what you have, applying your skills efficiently, is the key to everything. Richard Miles (26:14): So Rick, one final question, and I know you may have to plead the fifth amendment on this one, but coming back to you as a CEO, Rick Carlson, do you have an internal endpoint where you think, or, you know, you’ve accomplished pretty much everything you set out to do with this company and you know, it’s time to move on or have you not even thought about that? Rick Carlson (26:31): Well, the question is a multi-part question. First off, when you’re starting a business, like I was, which is hard to believe, but nine years ago now, we’ve been in the market roughly seven, but nine years ago, we chose to start the business. I’ve far surpassed what I set out to do back then. We thought we’d build something with a few million dollars of revenue and sell. It was the idea, and that would be the end of it. Maybe we go to another startup, that sort of thing. So by that measure, I have far surpassed it, but what I would say is still a lot of fun, still a lot of challenges. We’re lucky to be in a market that there’s no ticking time bomb in terms of we’re missing a wave or something where the market’s going to disappear. And it’s constantly, there’s new things that are coming out of the product to make it even more valuable to customers. And there’s new lessons to learn with how to manage an ever growing business. And so our folks know I’m prone to say, I’m always going to keep it interesting. Being in SharpSpring is always interesting. Sometimes it’s fun. Sometimes it’s not fun. Sometimes it’s challenging, but always interesting. And that I think has got me amped up for the next couple of years, for sure. Richard Miles (27:39): Isn’t that what Don Corleone said in the Godfather too, right? The mafia is always interesting, right? Rick Carlson (27:44): I actually don’t remember that quote. I think it keeps sucking me back in, right, or something like that. That’s exactly right, Richard Miles (27:51): Rick, that was great. I really appreciate having you on the show. You’re doing tremendous work, keep doing it. It’s inspirational on all sorts of different levels and wish you the best. Rick Carlson (27:59): Thanks so much for having me. Outro (28:00): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates inventor interviews. Podcasts are recorded at Heartwood, soundstage and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

Medicine that talks to you. Eric Buffkin of eTectRx developed an “edible radio” powered by the chemicals in your stomach that tracks when you take every dose of your medication. Eric’s colleague, pharmacist Susan Baumgartner, says about 50% of people that are prescribed medication do not take it when they are supposed to. Over the last decade, the company has extensively tested the ID-Cap System and In December 2019 received FDA approval. The company has had several “near-death” experiences, but Buffkin said the real problem of tracking medication usage wasn’t going away, and therefore the opportunity for the company wouldn’t go away either. Susan said at each pivot point or setback the team and investors said: “let’s go forward.” *This episode is a re-release.* TRANSCRIPT: Intro (00:01): Inventors and their inventions Radio Cade, and podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida, the museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work, and how their ideas get from the laboratory to the marketplace. James Di Virgilio (00:40): Medicine that talks to you, or at least talks to your smartphone. That’s no longer the stuff of science fiction. It will soon be available for patients everywhere. Welcome to another episode of Radio Cade, I’m your host, James Di Virgilio. And today my guests are Eric Buffkin and Susan Baumgartner the developers of a system called ID Cap and the co-founder of a company called eTectRx. Welcome to the show, Eric and Susan. Eric Buffkin (01:03): Thanks very much. James Di Virgilio (01:04): So let’s dive right into your story. I spent a lot of time pre-show talking with you, Eric, about what you developed. It’s very fascinating. I’m sitting here looking at it right now, in its simplest form you developed a medical breakthrough, this something that doesn’t exist in its form. Tell us about what you’ve done, what you’ve created. Eric Buffkin (01:19): Probably the most important thing we invented James, is a way to communicate in an edible radio. And when you get right down to it, it’s a tiny little radio that’s small enough that you can swallow it and it can take power off of the chemicals in your stomach. And so you don’t need a battery. You don’t need much of anything. You can see it there it’s really tiny. And once you swallow it, it essentially starts transmitting. There are a lot of folks that have tried to do different things like this. You can get ingestible cameras for doing endoscopy’s and different things, but they’re typically fairly large, fairly expensive and not something you want to use to track when somebody takes every dose of their medication, which is what we’re trying to do. James Di Virgilio (01:56): Now, Susan, as a pharmacist, I have friends who are pharmacists, I know that one of the most important things is for patients to actually take their drugs. How often is it that patients are not taking their drugs on time or even taking them at all during a course of drug therapy? Susan Baumgartner (02:11): In terms of long term therapy, the numbers about 50%. So 50% of medicine is not taken as it’s prescribed or as it’s needed in patients. So that’s pretty big number and that’s the one that we’re trying to help solve for. James Di Virgilio (02:24): And that’s what creates a significant need, is if I’m the physician and I prescribe the medication, it’s not taken, my patient may not get better. And I can’t for sure say why I might prescribe another medication, which may be the wrong course of therapy. So in comes this solution, we understood and learned, you know, really recently that you’ve gotten FDA approval. Tell us about the process of getting FDA approval, because it’s not simple and for what you’re doing, it was essential. Eric Buffkin (02:47): So that would be Susan’s core area of expertise. She is the one responsible for wrestling the FDA to the ground and making them cry uncle. And in that regard. Susan Baumgartner (02:56): So we have extensively tested the product. So after Eric and his team developed an incredible product with amazing technology, we had to put it into a usable form so that patients could use it on a day to day basis. And physicians could take that and other healthcare professionals could take that information and really use that to improve health outcomes. And so the process for getting clearance takes several years. It actually was a period of about four to five years that we did the required testing for the product and that included putting it into humans and seeing how long it took for the battery to send a signal and how long it took for the reader that’s worn to detect that signal. And also how the communication flowed from the body to the patient, to the healthcare provider who might be using that information. So we did clinical testing. We did a series of making sure that what was swallowed was actually very safe and it moved through the system the way it was supposed to move through and did a number of bench tests that also made sure that it worked the way it needed to, and it produced the results that it needed to. James Di Virgilio (04:04): So I’m looking at the pill here in front of me, it’s a normal capsule size. The drug manufacturer would be able to put their drug into this, along with the ID cap. Right? I take that. And then within 30 minutes, a signal is sent to a reader which is going to collect the data of the medication that I’ve taken. So therefore the physician, myself, maybe even the drug company, potentially I can know that I’ve taken this drug. Now that’s the base level thought of what’s going on. Right? Eric Buffkin (04:29): Right. Exactly. It’s really a measuring stick so that you can measure how often and how frequently and how regularly somebody takes their medicine. And the big difference between this approach. You didn’t notice a confirmed ingestion. There are hundreds of other products out on the market. You can go on to the app store for iOS and probably find 20 different medication reminder apps. All of those will allow you to separate minders to remind you to take your medicine, but not one of those or confirm anything, same thing with little pill bottles or other organizers, you can get reminded, but there’s no way for the physician to know other than the report by the patient saying, doc, I took my medicine and there’s many cases where that’s simply not sufficient for the care or for the patient’s wellbeing. James Di Virgilio (05:11): Now, as you mentioned, Eric, this problem has been around for a long time. We’ve talked about this, right? 50% of patients are not taking their drugs or taking them correctly. This idea that you had was not a brand new one, it’s been attempted to have been solved before we understood. There’s a competitor that exists, that does something similar and you yourself and this company has been around for more than 10 years. It’s obviously been a journey. Oh yes. And with any entrepreneurial story, there’s some conflict points where we would call it. Maybe some drama points in a movie. Tell us about a few of those experiences that got you to where you were today, but were maybe unknown as you walk through them. Eric Buffkin (05:44): Oh jeepers, how long we have? James Di Virgilio (05:46): Hours. Eric Buffkin (05:47): Okay. We’ll try and narrow it down. So first of all, I was one of the co-founders of the company. I had Dr. Neil Yoliana a local PhD, brilliant man who was actually the aha guy, the guy who originally thought of the, hey why don’t we put a radio on a pill and be able to detect when somebody takes their medicine. And he and I met several years ago, I had some chip and radio background and he has a lot of biomedical engineering background. And so we started exploring this. He had actually had some funding from the NSF to work with some UF professors to do some early development. And so we took that development, started the company we’re moving down the path a couple of years into it. We were getting interesting experimental results thing. Wasn’t quite behave in the way we wanted it to behave. And we ended up hiring a new engineer out of St. Pete named Judd Sheets. Brilliant guy. Also, one of the things I have discovered is make sure all the guys you hire are a lot smarter than you are. That’s certainly the case in our company. And one of the first days Judd came in and he started looking at this system and say, wow, this is really cool stuff, but you know, it’ll never work the way you’ve got it designed. And that was kind of one of those aha moments of are you serious? And to his credit, he was absolutely right. And to his further credit, he allowed us to fix it, which is a big part of it. So that was a big drama point, especially for being about three years into the company. At that time, James, enough of your background in the investment community, you’ve dealt with a lot of folks that are entrepreneurs and startups. They say, you can tell you’re a pioneer by the arrows in your back. We had a few of those three or four years ago. We actually had to shut the company down for a period of time. The short story is we weren’t able to raise the investment we needed. We had to shut it down, tell everybody go home. And we were fortunate in that. We around it up a new set of investors who basically said, okay, everybody come back and recapitalize and we got restarted and we’ve been better capitalized and resourced since that time. And that’s, what’s really allowed us to get over the hump of this FDA clearance. So that near death experience will give you a few gray hairs. James Di Virgilio (07:38): You’ve mentioned so much in your story that resonates with so many other success stories, which wouldn’t feel like a success. If you stop that a lot of points along the way, what kept you believing in your vision of this idea, becoming a reality, despite financial issues, a decade of time going through having to deal with FDA approval, you had a lot of hurdles. What kept you going? Why didn’t you just pull the plug and say, you know what? This isn’t worth it. Eric Buffkin (08:02): And we still thought it was the right thing to do. I want to play off one thing Susan said, and also want Susan to share one of the other interesting conflict points, but drama points, maybe. The problem’s not going away. 50% of people are still not taking the medicine for all you hear and in the press about how high drug prices are pharmaceuticals are still one of the least expensive ways to treat somebody, compare it, to go into emergency room or go into the hospital. Still much less expensive. And 50% of people that don’t take their medicine results in hundreds of billions of dollars of completely avoidable costs to the healthcare system here in the U.S. that’s money that our taxes have to pay and that we have to pay and drives our insurance premiums and drives a lot of stuff. So the problem was still there. The need was still there. We felt like the opportunity was still there. So we kept kicking the can down the road, kept trying to move ahead. James Di Virgilio (08:47): Now, Susan, tell us about this drama points that Eric’s mentioning. Susan Baumgartner (08:50): I was just in a play off one thing that you said in terms of the adherence side of things, the current way that adherence is measured is through a self report by the patient. The patient tells their provider how they’ve been taking the medicine, and that’s not as objective as it needs to be when you’re looking at high cost therapy or you’re looking at the outcomes that you’re really trying to drive in a patient and in a care situation. And so our device ends up giving real time, look at medication use that has not been seen before. It gives the time that they’ve taken the medication. It gives medication patterns, really essential information when someone’s being discharged from a hospital or when they’re starting on a new therapy or they have a complex regimen or a very expensive regimen that is designed to produce a certain outcome in that patient. And so it helps to inform that and provide evidence to be able to make the best decisions for that patient and their care. James Di Virgilio (09:46): Yeah, you’re hitting the nail on the head. I follow nutrition very closely, and it’s almost impossible to do a really good academic study in nutrition because it’s all self-reported and you get all sorts of weird results because people say why this many calories this week, or this much protein, and certainly in medicine, it’s the same thing. Only. It’s a lot more serious when it comes to drug therapy. And so when you were telling your story about it, because it’s important because it needed to be done. I think that’s the neatest thing. I think in our modern times, there’s oftentimes a misconception about why entrepreneurs start businesses, why creativity maybe even occurs in almost every time it’s to solve a real problem that exists. And that’s what I’m hearing in your stories. There’s a real problem that patients are not taking their drugs correctly, which is leading to a lower result for their own health. And this is an elegant solution that can hopefully improve the outcomes for patients. Susan Baumgartner (10:34): Yes. You asked about the persistence of this idea and the company over time. And as Eric said, we were fortunate to have an infusion of funding and people who trusted that this was the right solution. And there was a large market opportunity. And fortunately at each of those critical pivot points where we could have said, it’s not going to work, or it’s going to be too long of a road, or the regulatory hurdles are just too much for a small company like ours, the team that developed it, the group that was working on implementing it, and the investors all stood behind and said, we’ve got to bring this to the market to improve care and to improve adherence monitoring. And that’s one of the points that I think Eric was bringing up was when we stood at the end of a very long, very expensive clinical trial and had results that didn’t look quite what we expected them to be. And it took a large and laborious investigation from all of our technical folks and the entire team to dissect that and try to figure out why is it that we know this product can deliver at this high level? And why did we not achieve that in this study? And fortunately through the hard work of the engineers and the development team, we were able to pinpoint exactly what it was correct it very quickly and move forward with additional clinical studies, to be able to demonstrate that we were performing at that high level. Just one of many examples of the incredible persistence of a team and the investment group to make things happen. James Di Virgilio (12:01): And today we’re sitting here and there’s a bottle of champagne on the table in front of the three of us. And Eric You were the first to do the living adventure series at the Cade Museum, and you are now the first recipient of the Cade’s gift to you and to your company for receiving FDA approval. So we go through these dramatic points in your story, you survive some tumultuous points. Now you have FDA approval. What’s next. Eric Buffkin (12:23): Boy, that’s a good question. Sell like crazy. The FDA clearance is essentially the permission by the regulatory authority to go take money for this thing. We’ve been developing for a long time and it is now of something we are going to do with great enthusiasm. We’re working on building collaborations with a lot of people in the ecosystem around how pharmaceuticals are delivered to patients. There’s a lot of important partnerships delivery for development, data flow reimbursement. So one thing that was another kind of, one of these ahas, I come out of the chip business, primary building microchips for consumer electronics and, and that business, once you get at work, you go sell it. And the person who buys it is the person who uses it. The healthcare market’s not quite so simple because the person who uses it, it’s not the person who’s paying for it. And the person who’s prescribing it. It’s a lot of intertwined things that have to be sorted out. And the whole machine has to be running before the business starts to ramp up. So, um, we’re hopefully going to be taking advantage of this clearance to help get that ramp going. James Di Virgilio (13:22): And so taking what you said into consideration, how long do you think it will be before I could take a capsule like this one and have data transmitted to it? Are we months away, years away, maybe? Hard to say? Eric Buffkin (13:33): I’m going to give you two answers. The first one I’m gonna give you the second one. I’m give Susan to answer. If you’re willing to sign up for one of the clinical studies, we have run in with multiple people around the country, you can do it tomorrow. It’s a matter of fact, I may have some informed consent forms in that truck, James, so we can walk you out there and sign you up. But on the commercial side, do you want to talk about the commercial a little bit better as to what the companies have to go through to actually introduce a commercial product? Susan Baumgartner (13:54): Yes, the product will actually be available by prescription only. So as Eric said, there are clinical studies right now in place where the product is being used and you could get access to it. If you are eligible for those studies in terms of bringing a product to market within our capsule and with the ingestible sensor in it, there is a pathway that is allowed for that through the FDA. And so we can provide a combination drug device product very soon, but more than likely in partnership with other companies and other payers and pharmaceutical companies will be able to take approved products, combine them with that sensor that’s available and have those available for clinical applications and clinical use very soon. Eric Buffkin (14:36): One thing probably should clarify, James is that eTectRx does not handle drugs. We don’t make drugs. We don’t distribute drugs. We’re not a pharmacy. We created this device to help feed into that chain of pharmaceutical manufacturers, our pharmacies, to do exactly what described there. So we’re providing an enabling component to make that happen. James Di Virgilio (14:55): Well, Eric and Susan, this has been wonderful. We definitely need to bring you back for a second session so we can dive further into there’s so much more we can talk about including your own backgrounds, which I know oftentimes play into our stories as entrepreneurs. I know Eric, you like the beach. I know there’s other things you’d like to fishing, boating, right? I see that you have, in fact, a fishing shirt, I feel like it’s Friday. Maybe you’re going to head out and hit the open water this weekend, but regardless, there’s so much to cover. This is so exciting. I think it’s really neat whenever you get to look at a solution that doesn’t exist, there’s nothing right now that exists like what you have. And it’s been great to talk about it. We should dive further into it. And for James Di Virgilio and Radio Cade, thanks for joining us. Eric Buffkin (15:33): Thanks very much for having us James. Outro (15:35): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. This podcast episodes host was James Di Virgilio and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood Soundstage, and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinist, Jacob Lawson.

Diabetes sometimes leads to loss of vision. What if there were a simple screening device to find out who is at risk? Dr. Lloyd Hildebrand, a Canadian ophthalmologist and founder of two start-up companies, invented a hand-held device that in minutes measures the eye’s electrical waves to detect patients who may be suffering from diabetic retinopathy. Hildebrand talks about the challenges in moving from academia to the start-up world. “It was hard to get somebody that understood what we were doing to fund the company and run it,” Hildebrand said, “so I drew the short straw.” *This episode is a re-release.* TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. Richard Miles (00:40): An EKG for the eye is helping people with diabetes to keep their eyesight. Welcome to radio Cade, I’m your host, Richard Miles. And today I’m talking to Dr. Lloyd Hildebrand and ophthalmologist and founder of two startup companies. Welcome to Radio Cade, Lloyd. Dr. Lloyd Hildebrand (00:53): Thank you very much. It’s good to be here. Richard Miles (00:55): So Lloyd, I got to say you’re the second Canadian I’ve interviewed in the last three days. And our listeners may begin to think I’ve fled to Manitoba, Saskatchewan or somewhere, but I promise from the beginning, no hockey jokes, no references to Molson or any of that nonsense. Dr. Lloyd Hildebrand (01:08): Okay. At least it’s not February and 40 below zero. Richard Miles (01:12): Exactly. But I did want to comment on that. Actually, you were born in Canada and you grew up in Brazil. You came back to Canada for medical school, you practice in Iowa for a few years as a physician, then some training in Oklahoma, you worked in Portland, Oregon for a while. And now you’re either in New York or Las Vegas. I can’t remember where you are at the moment. Dr. Lloyd Hildebrand (01:30): I’m in Las Vegas now. Richard Miles (01:31): So the obvious question is, are you on the run from the law or sort of what explains your trajectory, give us a snapshot of Lloyd Hildebrand and why it is you in so many different places? Dr. Lloyd Hildebrand (01:39): Sure. I was born in Canada and at age four, my family moved to Brazil, Southern Brazil. All my parents were missionaries there. And I lived there till I was age 16. I came back to Canada and finished high school and went to do my undergraduate work in my medical school in Winnipeg at the University of Manitoba. I then went into primary care and was a primary care physician for almost a decade one year in Canada, and then move to council Bluffs, Iowa, where I joined two of the Canadian physicians there in a primary care setting, doing family medicine there, obstetrics. I then went back to training in ophthalmology at the University of Oklahoma in Oklahoma city at the Dean McGee eye Institute, which is a large regional well known academic center and did a fellowship at a family plastic and reconstructive surgery in Portland, Oregon. That was a one year program. And I was recruited back to the University of Oklahoma at that time. And I spent 22 years there on faculty and went through the full academic career there. I retired in 2016 to go to New York and work on an artificial intelligence project. I worked a couple of companies that were working with IBM Watson at the time. And after that project is completed, now I’ve decided to come to Las Vegas, Nevada and I start work on Monday, two days from now. Richard Miles (02:55): You’re quite the traveler. I did note that you’ve actually hit both coasts and the dead center of the United States, Canada and Brazil. So you’ve got the hemisphere pretty well covered. Lloyd, let’s talk about your core idea that you’ve been working on for a while, but I think is fascinating. I think that what we’d like to spend most of our time today talking about, and then later the company or the companies that you have founded to spread those ideas. So let’s start talking about diabetes, which isn’t obviously connected to eyesight for a lot of people, but tell us what is the connection to vision? And then what is the problem that you are trying to solve? Dr. Lloyd Hildebrand (03:29): Sure, well, diabetes is the largest growing problem and growing very rapidly at epidemic proportions, diabetes really does a lot of its damage in terms of damaging the end organs, The eye being one of them, the kidney, the heart, and the brain are also organs that can be damaged. It’s usually damaged to the small blood vessel of the eye and that’s called diabetic retinopathy and diabetic retinopathy is actually the leading cause of preventable blindness in working aged Americans. So it’s a major cause of vision loss. The real challenge in diabetic retinopathy is that it’s easily treated. They’re very effective treatments and there’s very, very good research, probably one of the best research diseases in our scientific literature. And yet at the same time, it’s best treated when patients are asymptomatic. So therefore patients with diabetes, there’s a guideline recommendations for them to have an annual examination or evaluation of their retina to see if they have treatable disease. And if you treat the disease, you can prevent the blindness. If they start having symptoms, you can prevent the progression, but it’s very difficult to reverse the vision that they’ve already lost. So therefore the real challenge becomes how do you treat people in a timely way? And the way to do that is to evaluate them regularly and have a reliable test for doing that. The result of the healthcare system though is that only about 40 to 50% of people have that test done on a regular basis. And as a result, a lot of disease go detected until it becomes symptomatic. And they’re behind the eight ball in terms of treatment at that point in time. Richard Miles (05:05): Can you give us a sense of the magnitude of the problem and do you know, what is the percentage say of people who are going to develop diabetic retinopathy? If they’re not checked? I mean, reminds me a little bit of skin cancer or certain forms of skin cancer, right? Where if you detected easy to treat, if you don’t detect it, it’s highly lethal. What are we talking about in terms of those folks who don’t get checked? Are they in big, big trouble? Dr. Lloyd Hildebrand (05:27): 80% of people will develop diabetic retinopathy at some point in their lifetime of the disease. And there are certain risk factors that are associated with it. How long you’ve had diabetes, how poorly controlled it is. So the hemoglobin a one C level or the level of blood sugar that you have also it’s associated with a higher risk of patients with high blood pressure and high cholesterol and triglyceride levels. So high lipid levels. So all three of those states combined to increase the risk of the patient in doing this. So the relative risk of people developing vision from this, there were about 40,000 people a year that go blind from diabetic retinopathy. So it’s significant and there’s a much larger group of people that then have what we call moderate vision loss and moderate vision loss. Wouldn’t be so moderate to you and I. It’s the loss of the ability to read newsprint and loss of the ability to drive. So they’re very, very significant impacts in terms of people’s lifestyle and activities of daily living. Richard Miles (06:24): It sounds like if you have diabetes or if one has diabetes, you should at least be aware of the problem. But if I understand it correctly, from what I’ve read, the key is you may get this recommendation from your primary care physician and then you get a referral to a specialist and it’s in that scene, right? That a lot of people just don’t get around to doing it, or they don’t want to do it or whatnot. And so a lot of people who are actually told are aware that this may be a problem, don’t do the critical follow-up and there for, they go largely undiagnosed. Do I have that right? Dr. Lloyd Hildebrand (06:53): That’s correct. So the big challenge in the healthcare system is what I call people falling off the wagon. And you fall off the wagon from the primary care setting to the eye care environment where the eye exam needs to be done. Part of that is because it’s asymptomatic people, don’t perceive the importance of it. Part of it is it takes time. It costs money to do that. Part of it is that there’s some resistance on the eyecare environment in terms of getting appointments in a timely way. So there’s some inconvenience factor in that as well. And some of it is just that people aren’t even referred for it because again, it’s the asymptomatic disease. Richard Miles (07:27): So tell me then about the technology that you’ve developed to make this more efficient. I assume a primary care physician can do this in his or her office or pretty rapidly, so you no longer have to refer them to a specialist. Dr. Lloyd Hildebrand (07:40): Yes. So again, drawing back from my experience as a primary care physician, diabetes has exploded since I last practiced as a primary care physician, but nonetheless, it was an important part of our treatment as well. And so one of the things that primary care physicians do very well is tests people find out when they hit a threshold of disease that needs a specialist and then send them onto a specialist. So our idea is if we could provide a test for a primary care physician to do that was reliable and accurate and convenient for them to do. And generally you have to consider also the economic aspects of it so that they can actually make some revenue from doing this. But that would be something that could help us address this issue because it would avoid patients having to move from the primary care setting to the eye care setting until they had what we call threshold disease or disease severe enough to need treatment. So the initial application that we did is we use the photographic technique to do this. There was a photographic technique developed by the national institutes of health that was used for all clinical trials that were done for the FDA, for the new treatments, for new therapies and for epidemiologic studies. And that technique was developed on film, very similar to the view master film reels of cartoons that we used to watch as kids, little view masters. And it used that ability to create stereo by creating these two different views, our initial solution for doing that in the first company, I started took photographs and converted that process from a film based process to a digital process, created a reading center. So the photographs could be done in the primary care setting sent to the reading center and a report sent back to the primary care physician with a red and green label on it, a lot more detail if they wanted to, but they knew that if it was ramped, they needed to send the patient onto the ophthalmologist for treatments. So what we’re using now instead of imaging technology is we’re using a different form of imaging electrophysiologic imaging, where we actually measure the electrical activity of the eye to determine whether or not there is disease present there. And so that’s where the EKG of the eye analogy comes from. So it’s simpler to do doesn’t require the challenges of imaging, particularly in patients with cataract, because it doesn’t require us to image through the eye to get the data and it can be done much quicker and the reimbursement model is better. So there are several different advantages to the techniques of doing that currently. So part of that then was developing the service in such a way so that it could be delivered in the primary care setting. The workflow would not interfere with how the primary care physician does his or her work, and then setting up a reading center to be able to interpret the data and then report it back and doing this all through a cloud based architecture for doing it, and then important to the primary care physicians that we be able to integrate this into their existing healthcare infrastructure, their EMR systems, and that isn’t such a trivial thing to do either. So once we got all of that established, we were actually rolling out our pilot site and then our pilot site was very successful. And once we were successful with that, we were really working on commercial deployment and that’s when COVID hit. So we have to shut down for awhile. And now we’re reopening at this point and time. Richard Miles (10:42): So that makes it sound like this idea should spread like wildfire, right? Because it sounds like a quite superior way of handling it. And probably it’s going to save if not lives, at least people’s vision. Let’s talk now about the companies that you founded, not just the origin story, sort of like the day, but also a little bit about the experience of doing so, because you’re not the first one that we’ve had on the show. They come from primarily an academic background. They hit upon a great idea through their research, or they are collaborators on somebody else’s original insight. And most of them find it a very challenging transition to go from the academic world in which you do research and you publish and you then move on to the next research and you don’t have to worry about who’s paying for the little lights over your head or air conditioning or any of that. When they go into this world, in which your idea doesn’t sell itself, it has to be developed it has to be tested. It has to be marketed, it has to be distributed. How did you get, first of all, the idea that you wanted to do this to be involved yourself, right? Cause there’s another path and simply you could license the technology. And a lot of people do that and you move on to whatever else you want to do in life, but you decided to take the hard road and actually get involved in not one but two companies. So tell us what was the impetus for doing that? And describe for us maybe your first, I dunno, six months, what was it like and what did you learn in those early days? Dr. Lloyd Hildebrand (12:01): A little bit of this is the story of necessity is the mother of invention. So a lot of this was stimulated by a need. I had to do something to do that, to keep the idea alive. We developed the technology in our labs and we had actually continued to grow and develop the idea. We’re validating the idea through research grants and doing it through the traditional academic settings. We had a very large national trial that was going to be done, which is going to be the largest clinical trial ever done through the VA system. It was funded. We got the highest scores ever granted the program. And then for some unknown reason, it was rescinded. Again, I’m still not clear on why that happened. It was an almost $10 million grant, which at the time was the largest grant ever granted the University of Oklahoma health sciences center. So when that happened, the university said, look, either you have to abandon the idea or what you need to do is commercialize this idea and license it out. So we said, fine, we’ll do that. And we had obtained a patent for it at the time. So we thought we had some very tangible intellectual property license it out, but again, those things are a little bit challenging to do. And it was hard to get somebody that understood what we were doing to fund the company and then to run the company as well. There were two other co-inventors with me and they asked one of us to step out. And so I actually took the short straw and stepped out of the academic environment on a leave of absence from the university, just as I was about to hit tenure, my tenure promotion. It was a bit of a challenge and it was something that I hadn’t done before. And I remember the driving force behind my initial business plan was the Ernst & Young book, How to Write a Business Plan. And I literally followed that line by line chapter by chapter and develop a business plan for doing that. And I started marketing the business plan locally in Oklahoma, at the time it was hard to do that because a lot of people didn’t really understand what we were doing and the.com was booming at the time. So I packed everything up and I went to California and I started cold calling people on Sandhill Road. Richard Miles (13:59): Did you have any mentors at all that you turned to, or that offered you advice or was it just the Ernst & Young book and trial and error? You know, their whole bunch of small steps when you start a company that you don’t even think about filing for registration and finding an office and getting office furniture, all those sort of things that in other circumstances just appear out of nowhere as you do your work, did you have a roadmap or did you just day by day figure out, well, I guess I’ve got to do this and I guess I got to do that. Dr. Lloyd Hildebrand (14:25): So it’s not that there weren’t mentors, but at that point in time, especially in our academic environment, we were fairly immature at this concept of commercializing technology. So I was a little bit of a pioneer in all of that. And I think I suffered a lot of the arrows that pioneers have in their backs as a result of that as well, but still I did have good mentorship from some business people in the community, some people inside the university and then some of foundations that supported research at the university and these people were early investors in the idea, if nothing else, they provided me with encouragement. But much of what I had to do is really learn on the job OJT for sure, on the job training for the largest part of it. And the most frustrating part about it was that we really had an investor community in the Southwest in Oklahoma and in the region that really didn’t understand the digital world and the digital technology. And that changed dramatically when I went to California, didn’t move there. But when I went there to visit with investors there. Richard Miles (15:23): Primary care physicians are your principle market. I take it right. I mean, they’re the ones who you really expect this, or at least their hospitals will buy it for them. Once you had the product up and going or something to offer, was it a struggle at all? Or was it difficult to sell them on this idea? I mean, having been one yourself, you knew the language, at least that wasn’t a hurdle, but were there cost considerations or ease of use consideration? Did they said like, yeah. Okay. It looks great, but you know, we’re just going to stick with what we do and that’s fine with us. What did you encounter that at all? Or was it an easy sell? Dr. Lloyd Hildebrand (15:52): It was not an easy sell, as you can imagine. Medical systems are very resistant to change. First of all. So innovation is difficult to get implemented in medical systems. And there’s plenty of doors in terms of how long that takes somewhere between 7 to 14 years to really get that kind of adopted change. That was one of the points of resistance. So one of the main concerns that they had is the reimbursement issues and the reimbursement issues were complex because of the regulatory events around reimbursement. So Medicare and CMS had certain regulations that we had to follow. There were anti kickback rules that had to be followed as well because of self referral issues. And there were some telemedicine laws that were also pretty antiquated at that point of time, particularly anything that was done out of state. And when that happened, then we also have to follow other new rules in terms of licensure to be able to do this in other States. So there were significant complications to doing that. And then there was the natural resistance of the medical system to changing anything that they’re doing. There was some resistance from organized ophthalmology as well, which seemed to think that this was a threat because the ophthalmologist perspective of the problem is I see every diabetic that comes in and I examine them. What they don’t realize is that 60% of them aren’t making it in. Right? And so that was also one of the burdens that we had to overcome in order to do this. Richard Miles (17:13): I think you pointed out an under-appreciated problem or problems in the medical device or healthcare industry, and that this is classic third payer problem, right? Where even if the physicians themselves love the product or love the technology very often, they’re not the ones paying for it, nor do they have to deal with the regulatory hurdles necessarily in getting to use it. So did you find yourself having to spend a lot of time at Medicare offices in Washington or with regulators and insurance companies convincing them, this was a good thing for the field? Or how did you negotiate those hurdles? Dr. Lloyd Hildebrand (17:48): So we actually had to develop a strategy who we call coverage and reimbursement. So first of all, we had to change the policies and make this acceptable in order to do that, we went to the accreditation body. First of all, MCQA that this would meet the quality regulations that were part of the heat it’s report card, which is the report card, measuring the quality of a health plan performance on all of this. So that’s the first thing we had to do. Then we had to go to individual payers in each marketplace in order to get them to provide coverage and the reimbursement for this. So part of that is that we did a technical assessment. There are these organizations that the Hayes group does technical assessments of new technologies that come out, get that done. They review the literature and then provide a judgment on whether or not this is a qualified test to be done. We then went into individual marketplaces and we, first of all, tried to get Medicare coverage for that region. And we did that by visiting with people at CMS central office in Baltimore first, and then with the local carriers and the local carriers each made their own decisions. There’s an interesting story about our initial visit to CMS. It was actually on 9/11 and it was at nine o’clock on 9/11. So you can imagine what that was like. As I was walking into the building, the building was streaming out and we were meeting with the director of CMS at the time Dr. Sean Tunis. And he asked us and said, do you want to stay for the meeting or not? And we said, well, if you’re willing to meet, we’ll still meet, but we understand if you don’t want to do that. And we met and then lights were all grounded by them. And so we rented the last car at the airport and drove 24 hours, back to Oklahoma city. So it’s a very memorable day when we got that, but it was also a very good meeting with Dr. Tunis. Richard Miles (19:29): Wow. You probably carried out one of the only previously scheduled meetings and actually finished it on 9/11. I was in Washington at the state department and it was quite chaotic and, um, yeah. Dr. Lloyd Hildebrand (19:38): It was very, very tense and we had just driven from DC to Baltimore. So during that time, it was a very interesting time and very chaotic time. Richard Miles (19:47): Let’s go back a bit now about the company. So you have two companies, right? The current one is Trinoveon did I pronounce that correctly or how you did, but then the first one was called Inoveon, right? Correct. Okay. What’s the meaning behind those words? And what’s the difference between the two companies? Dr. Lloyd Hildebrand (20:02): Well, Inoveon was the initial company that we did and really the name was an aggregation of the word innovation and eon, the age of innovation. And so that was really the concept behind it. And our mission really was the prevention of diabetic blindness, because that was our whole mission in doing that. And so we set that up and we developed the technology. We developed all of the protocols with the protocols, the workflow, the business model, the regulatory model, and then the competency reimbursement and coverage decisions with all the health plans. We went through some ups and downs. We had several investors cycles and all of that. And ultimately, we sold that company to a German company that was a health IT company based in Germany, focused in, on the ophthalmology space and the largest provider of EMR systems for ophthalmology in the world. That company was then acquired in the sharks and minnows game by Topcon, which is a large Japanese ophthalmic company. And they were very interested because they were developing the devices that we were using to do the imaging. And so this was a natural fit for what they wanted to do. However, they also had an internal team that was working on their own solution for this. And so when they acquired the company, they basically mothballed the company. But the residual of all of that was that we had one of the largest datasets for annotated data that had very high quality data and evaluations in it that were commensurate with the research quality data that the NIH trials had done. So we had about 3 million images in that dataset. So as a result that became valuable to some of the artificial intelligence groups that were out there, the Googles of the world, and some of the large pharmaceutical companies that were developing and some of them are device companies. And so that data set has become the core of some of the big data analytics that has gone into some of the automated image reading systems that are out there. The challenge with imaging system and reading is that there are some significant operational challenges doing that. Diabetics have a large incidence of cataract. So when you have a cataract, it’s difficult to get a good image. And when you don’t get a good image, you can’t get a good test result. There are other workflow issues and the cost of the equipment and the operation of the equipment is also complex. So we thought that might be a better way to do this. So after that company was sold and spun out and was doing all of those things, we continued to work on other new innovative technologies to solve the same problem. And that’s the origin of trying to Trinoveon. Richard Miles (22:26): So the difference in, let me see if I have this straight part of what the challenge was. You’ve got all this data, but the ability to interpret the data and is that where the AI comes in, it just makes it more efficient and more accurate. Is that correct? Dr. Lloyd Hildebrand (22:37): That’s part of it. We still haven’t validated that it’s more accurate. We had human readers doing it. We had a very, very high quality system doing it. In fact, in daily routine operations, we actually matched or out performed research, trial quality data in our reading centers. So that was still difficult to do. The second part of it is that what’s happened in the retinal imaging. It’s become more of a screening technology rather than a diagnostic technology. And so what they’ve done is dummy down some of the questions that they have, and trying to just basically find people that have some disease and just get those people over. And so they can eliminate about 50% of the population that way. Richard Miles (23:15): I see. I hadn’t thought about that key difference between screening and diagnostic. One is just kind of bare minimum to do with a triage sort. Right. And then the other one is to really try to understand the disease Lloyd, tell me, how do you spend your days now in terms of the life cycle of the company? Are you still primarily on the research and development end or strategic management or.. Dr. Lloyd Hildebrand (23:36): So the answer is yes, to all of those as you do at small companies, there is a difference with Trinoveon, so first of all, the technology is different instead of technology we’re using electrophysiologic imaging. Richard Miles (23:49): So it’s the electrical activity, not actual photos that makes this so much simpler or relatively less complicated than the systems that are in place now. Dr. Lloyd Hildebrand (23:58): Yeah. So the technology of the device is actually quite complex, but what we’re trying to do is we’re trying to simplify all of the workflow for the primary care physician. So it can be done simply by a medical technician and can be done in less than five minutes. That was really the goal of what we were trying to do. So we’ve systematically operationalized all of those aspects with a device that used to be a desktop device that you put your head into now its a handheld device, much like an ice cream scooper has a little cup on it like that, that you put over the eye and the electrode that goes onto the lower eyelid and attaches to the device. And then a series of flashing lights that trigger the electrical activity in the eye and auto correct any errors in it, getting a valid test. And once a valid test is done, it notifies the user of that. And they put it into a little holster and that holster sends it over the internet to our reading center. And then we send the report back to them. Richard Miles (24:52): Is something that if you went to your doctor, it would only be done if you were diabetic or is this potentially something you would do as a normal battery things that physician’s assistant will do before you see your primary care physician or is that over kill? Dr. Lloyd Hildebrand (25:05): So one of the critical elements of everything that we do is we try and make sure that there’s a very solid, scientific and clinical foundation behind it. So what we’ve done is we’ve only validated this approach for diabetic retinopathy at this point, electrophysiology of the eye is done for other conditions, such as glaucoma. Hypertension can also make some changes in the eye, but we haven’t validated that clinically, but those are some future applications that we had anticipated will happen. Richard Miles (25:31): Wow that sounds exciting. So usually what I’d like to do is give everyone on the show, a chance to dispense the many nuggets of wisdom that they’ve accumulated in their scientific and entrepreneurial journeys. And so I’m guessing that from time to time, you were asked for advice maybe from other startups or even other physicians who might be thinking of something similar, have you accumulated a short list of things that you wouldn’t do again, knowing what you know now or pitfalls you definitely stay away from if you were say, asked to serve as a consultant to somebody else’s business. Dr. Lloyd Hildebrand (26:00): Yeah. I think one of the real lessons that I’ve learned is that perseverance is probably as important as brilliance or intelligence in this game. Is that really persevering with the idea believing in it? And then when the naysayers come, it’s much easier to say no to something than to say, Oh yes, that’s wonderful. That was work. So I think you have to have perseverance and you have to be a little bit immune to some of the critique and criticism that are out there. Even from environments like the academic environment. Some of the harshest critique we took was actually from our research and development group at the university that was supposed to be supporting us for doing this. We had to work through constitutional amendment to the state constitution, which prohibited faculty from participating in equity positions in company. And so we have to work through a lot of these different issues in order to be able to even achieve it. Now, fortunately, we paved the path for other people to do it, and it’s a leisure to doing it, but they’re facing other challenges as a result. But I think perseverance is one of the key things. And I think the other one is really having a solid foundation for what you’re doing. That’s based in scientific merit, particularly in medical applications that has the validation to it always gives you the high road. And so when you face those challenges, knowing that you have that behind you, I think it’s a very, very powerful tool. Ultimately, sometimes it’s harder to sell people on that because they don’t believe you can do it, but once you can prove that you can do it, then I think it becomes a real selling point. Richard Miles (27:29): Right, because there’s nothing like confidence in your product. If you know it works, then it’s that much easier to go out and tell other people, I guess in many cases it’s a chicken and egg thing, right. You know that a certain trial probably will confirm or make confirm, but you need money to do that trial. And so how do you split the difference? Like, you know, I’m very, very confident, but I’m not certain and get somebody to fund that. Dr. Lloyd Hildebrand (27:49): The other lesson that you learn is that leadership in a company like this is lonely, it’s lonely at the top because ultimately somebody has to make the call. What’s your priority and spending, are you doing it on marketing? Are you doing it on research? Research people are pulling for more data, the marketing people just want more money, so they can go out and tell the message, right? And so you have to make all of these decisions, how much to invest in technology. And so when you’re making that final decision, I think you really have to think about what are the basic principles that you’re going for. What are the metrics that you’re using to assure that your decision is a good decision, then how do you implement that decision and not lose your organization. Richard Miles (28:25): The other comment I was going to make Lloyd is when you said that you didn’t get the support, maybe you’re expecting from the academic community. I was gonna say, I’m shocked, shocked to hear that that would take place pettiness in academia. And it reminds me of that famous. I think it’s a Henry Kitchener quote in which he said the fights in academia are so vicious because the stakes are so small. Dr. Lloyd Hildebrand (28:43): Well, that’s right in academics. And in a lot of ways is a very individual sport too, right? It’s a lot about how do I develop my own career and how do I prosper in that career? And so each individual achievement has to be allocated to somebody. And so that is one of the challenges. The second one is that entrepreneurship wasn’t typically viewed as part of the academic journey. And now I think a lot of those things have changed in some of the academic settings and entrepreneurship actually does count for some of that. So I think those are good changes. Richard Miles (29:13): Yes. And you’ve made a very impressive and rare transition, most academics. In fact, most academic adventures at some point say, you know, this is just not worth it. And I’m going to either get bought or let this go to somebody else. Although I guess you had the best of both worlds you got bought and you kept going, so that’s even better, but I commend you for sticking with it Because it is a tough road, lots of very bright, energetic, committed people who don’t ultimately succeed through a combination of circumstances. So congratulate you on doing it. Not once, but twice. Dr. Lloyd Hildebrand (29:40): I tell my children find something you do in life that makes it easy to get up in the morning. And usually that means that you find something significant. And when you experience a blind person and particularly somebody that’s blinded from something that was avoidable preventable or treatable, then you really realize the pain and suffering that you can prevent by doing something significant is really relevant to the world. And it’s meaningful. And I think that’s the main thing that drives me. I work in other blindness prevention programs internationally as well, cataract blindness that’s for example, and all of these activities I think are centered on this focus that I’ve tried to put into my career, which is how do we leverage information technology to give us better clinical tool. We have a lot of administrative tools in medicine that really encumber us more than they help us. So I’m really focused much more on the clinical side. It’s how do we get good tool to help us do this? And that was part of the work in AI that I’m very interested in continuing to foster as well. Richard Miles (30:35): Lloyd, thank you very much. These have been very inspiring, encouraging words. My takeaway from this is I need to start booking more Canadians clearly. Dr. Lloyd Hildebrand (30:43): That’s probably a good thing to do. Richard Miles (30:46): Right, thanks very much for being on Radio Cade and hope to have you back at some point. Dr. Lloyd Hildebrand (30:49): Absolutely. Thank you very much for the opportunity. It was a pleasure. Outro (30:53): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates inventor interviews, podcasts are recorded at Heartwood Soundstage and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinists, Jacob Lawson.

A big problem for most prosthetics is they don’t send sensory information back to the brain. Until now. Dr. Ranu Jung and her team at Florida International University (FIU) have developed a device that restores the sense of touch and hand grasp when someone is using their prosthetic hands. This technology could eventually be applied to other non-functioning parts of the body. A finalist for the 2020 Cade Prize for Innovation, Dr. Jung is head of the Biomedical Engineering Department at FIU, and the holder of multiple patents. Dr. Jung, who immigrated to the U.S. from India in 1983, credits the “can-do” spirit of her parents for her persistence and sense of discovery. *This episode is a re-release.* TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from The Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them. We’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. Richard Miles (00:40): A neural enabled prosthesis. That is a hand that actually feels like a hand for people who have lost them. Welcome to Radio Cade, I’m your host Richard Miles. Today I’ll be talking to Dr. Ranu Jung professor and chair of the biomedical engineering department at Florida International University. The holder of multiple patents and a finalist for this year’s Cade Prize for Innovation. Congratulations and welcome to Radio Cade, Dr. Jung. Dr. Ranu Jung (01:04): Thank you, Richard, for giving me this opportunity to be on Radio Cade. I’m excited about talking to you. Richard Miles (01:10): So Ranu, if it’s okay. If I call you Ranu, you’ve been at Florida International University for about 10 years now, but you’ve also spent time at Arizona State University, University of Kentucky and Case Western University in Cleveland. But you started life in New Delhi, India and came to the United States in 1983. So the first thing I’d like to ask, you’ve had a very illustrious career in academia, but I’m very curious about what was your first impression of the United States? What did you think when you stepped off the plane, were you excited to, do you think you’d made a really big mistake? Dr. Ranu Jung (01:42): That’s a long time ago, but I was excited because I was going to be able to follow a dream and I had come specifically to follow biomedical engineering. So I came into New York and I actually drove with a family friend from New York to Cleveland. And so what a way to get welcomed to the United States going across the whole of the East coast to the Midwest. It was just absolutely, absolutely fantastic. The whole, the whole beginning, as, as I recollect, it’s been a long time ago now. And the other thing in Cleveland was the welcoming nature of us Americans, because another graduate student who was starting in the program had already reached out to me and sent a letter to me saying, would you be interested in being my roommate? So I was really looking forward to meet Ruth tan Bracey who was going to be this new roommate for me. So it was a very, very exciting trip. Richard Miles (02:35): That’s a great experience. And you probably know this by now, but that is exact route. A lot of early settlers took as we sort of open up the frontier is going from New York through Ohio and further. And that was the frontier at the time. So what a great way to get introduced to the United States? Dr. Ranu Jung (02:50): Absolutely. Richard Miles (02:51): Let’s talk about your current work and this is what you are in the finalist for the Cade Prize for Innovation, but it’s obviously you’ve been doing this for awhile and I understand it correctly. You and your team at FIU, Florida International University have developed a prosthetic hand that can actually transmit neural signals to the brain so that a person without a hand can actually feel and control the prosthetic far better than a normal one. That sounds really complicated to me. I don’t know if I described it correctly, but tell us how it works and how did you come up with the idea? Dr. Ranu Jung (03:20): Yeah. So think about when you touch something, right? You’re, you’re what you feel, or you’ve touched somebody’s face. How do you feel about it? Or you grasp something you don’t really think about it much, right? You just pick up and you automatically know it’s hard, it’s soft, you don’t crush it. And if you touch somebody, you have all the sensations associated with it. Now, if somebody loses their hand for many reasons, often it’s because of trauma. Then what are their choices? The choices for them are to get a prosthetic hand. And currently there are prosthetic hands that are available, to, what we call upper limb amputees. Who have lost their hand, that the person can already control. So the way it works is that when we use our own hand, the muscles in our forearms contract and relax, and when they contract and relax, your hand opens or closes, or your fingers will open and close into the whole mechanism that happens. When you have an amputation, the muscles that are above the level of the amputation, that person can still control them. So if you can record the activity of those muscles and that is done with electrodes that are placed on the skin, one of the examples that’s the most common is like an EKG system, right? So putting the sensor is on there, those signals are picked up and they can be used to drive motors in the prosthetic hand. This is commercially available and there are different levels of prosthetic hands that are available that are simple to close, or there may be now new better prosthetic hands. So there are many that are available like that, but what is missing is how do you get sensation back. So there has been some attempt of saying, let’s take some information back and put a vibratory signal on this pin. So there’s approaches like that, that have been done. But what we went about saying is how could we give a better sensorial experience that would interface this information when somebody is touching something or grasping? So basically what our system is, it’s not designing the prosthetic hand. It is designing this whole interface with the nervous system to restore, hopefully this whole sensory experience. So in this case, what we have done is we have said, all right, let’s look at the prosthetic hand. If the prosthetic hand had sensors in it, can we tap into the sensory information? We process this sensor information to make sense of what is coming out from different parts of the sensors. And then we take that information and pass it on as commands through a wireless link, to a small neurostimulator that is implanted under the skin in the upper arm of the amputee. So what do I mean by a wireless link? You know, when you listen to the radio, there is somewhere a radio station that is sending out radio waves. So there’s a transmitting and an antenna and in your radio, and you’re now in your phone, there is some kind of receiving antenna. So these radio waves are going back, taking the information and passing it from the transmitting system, long distance into this antenna embedded inside some radio or a device, and it’s picking it up and it’s being coded. And you do hear the sound now, step into our system. You’re not sending radio waves all along very far distance, but we have a transmitting antenna that’s connected to the outside of the skin. And that’s what is connected to a little box that is inside the prosthetic, where all the processing has happened. And the receiving antenna is right underneath the skin below. There are no wires going back and forth. So it’s a wireless connection. Now this receiving antenna is connected to a neurostimulator. What’s a neurostimulator is like a pacemaker, but now your similator is connected to very, very fine wires like human hair. And these fine wires are threaded through the nerves in the upper arm. So again, reminding you, it’s an amputee who has a forearm that is gone, the hand is gone. They can control their muscles in the leftover arm, open and close the prosthesis as they close, the prosthesis back and forth. Signals are going to come back in. We are going to process them. We you’re going to communicate those through this wireless link to the implanted antenna. And that implanted antenna connected to a stimulator connected to fine wires inside nerves. So we give little charges of electrical pulses. When these pulses are delivered, the nerves get activated more precisely the nerve fibers that are inside the nerves get activated. And these nerve fibers would have originally carried sensor information from your hand or some of the nerve fibers are going the other way and are controlling the muscles. So when these nerve fibers get activated, then now this biological neural signal goes into the spinal cord and from the spinal cord to the brain and right there in the brain, there is where a person perceives. So the whole point here is, as we do a task, as you reach out, as you touched something with your prosthetic hand, you hold it, you squeeze something, but you’re not looking at it and your eyes are closed. Or maybe you can’t even hear it. You get a sense of touch or you understand what you’re grasping and how strong you are grasping it. So with this ability, we can do this. It might even embody that prosthetic hand into the person’s body. And if that happens, then perhaps this will become really much more a part of the person with the sensory loop factor. They may improve their control and that’s one aspect, but the richer sensorial experience may also embody the prosthetic hand better. And that might make people use the prosthetic hands more. And that has many other benefits. For example, they may be compensating with their other hand to do things, but now they may use this prosthetic hand, for example, or a plastic bottle with water in it. If you don’t know how much you’re squeezing out the water. So usually you would not use that prosthetic hand to do it. You’ll use your other hand. You would use compensatory methods. So our system is to restore the sensation through this neural interface. Richard Miles (09:23): That’s a great explanation. And this happens to me every year when we run the Cade Prize. I read the application. I think I understand the technology, but it’s not until talking to the inventor that I finally understand what the real breakthrough is, because it sounds like, as you said, the current state of the art is essentially one way communication only, right? You’re sending to the hand, the hand can open, close and so on, but it’s that feedback loop that is missing. And because there’s no feedback loop, you have somebody who doesn’t really feel like this is a part of them and not really delivering what they want it to and they end up not using it. Dr. Ranu Jung (09:56): Yeah. So we are really closing the loop. There is some feedback, obviously, if you have models in the system and people are very adapt, we are very, very good at doing things and they learn how much I open and close my hand. So they have learned a lot of that aspect they have learned. So it’s not like there is zero feedback and vision is a huge feedback. So if you’re looking at things that you can do a lot of stuff just by looking at it and seeing how much repetitive training you can do that, but it’s paying attention, not having to second guess yourself. It is having the confidence to reach out to things. All of those things are not there when the loop is not closed. Richard Miles (10:34): So a couple of questions come to mind, would this, in theory, at least as you develop the technology and improve, it, would it enable people who’ve lost a hand for instance, to engage in finer motor skills because they have the feedback or does that not really make a difference? Dr. Ranu Jung (10:47): Well, we hope that that is going to make a difference to be able to do finer motor skills. There’ll be many things to take into account how dextrous is the prosthetic camp. That will be one of the things, but that’s the technology that then, and that’s part of the scientific question. What is that information? That one can process when it’s coming from this effectively, to some extent an artificial sensor system, right? Do we really need a lot, or do we only need a few things about the cochlear system for hearing, right? They’re not people who have lost hearing. It’s not like every single sound and every single nerve is being stimulated, but they are interpreting sound. They are reading music. It is become part of the life. When you read, you don’t read each letter, you read words, you fill the gap, you put the whole thing together. We don’t know how many gaps you could effectively have in the sensor information and the person we are fantastic brains. So what we will do to put all of that together, but yes, it might help us with finer motor control. It might also help with things like picking up lighter weight objects. If it’s a heavy thing, something heavy, you are picking up, you know, rest of your arm is going to feel heavy and you will get information back. But what if people are picking up small things, like a towel at home, and you are pulling it, folding that light towel and pulling it. Yeah. The person would contract their muscles really hard and squeeze it really hard and pull it. But if they have the courage, they will know I already touched it. I already have it. I don’t have to squeeze. My muscles really had to clamp system. So over time fatigue, short term to make a difference. Long term use will impact the muscles. So all of these will be questions to ask. So you need the system first, you need the technology first. And then you can start to ask these questions and start to ask just pure science questions. How does our brain interpret information? What happens when you have, for a long time use of compensatory strategies, things have changed in the brain, perhaps. How do you pull all of this stuff together? So it opens up Pandora’s box. Richard Miles (12:48): I imagine, as soon as you solve one question, it just raises probably five more questions. In theory, could this also be applied to feet into legs? Or is there something about this technology that lends itself only to doing hands Dr. Ranu Jung (13:00): You are absolutely right. This can be extended to many different levels. So right now our indication is for somebody who has lost their forearm and their hand, but you wouldn’t think of it first portions of the upper arm, right? Then you can think about it as people who have lost their lower limbs. Actually what we have, what our technology is, is really think. We can take a signal and based on the signals, we can do targeted, focused stimulation inside the nerves. That’s what the technology is. This application is sensor information to go to our nerves that are going to communicate with the brain to give some information for prosthetic hand, but that’s not necessarily the only application. So in the very long run, you could think about saying, Oh, I’m going to stimulate another nerve. That’s a control system, right? And now are based on a signal that I’m going to get that says, there’s a problem with the stomach or the spleen. For example, in the diabetes situation, I will use that signal to stimulate those nerves because we are inside the nerve. We can do very focused stimulation. And so maybe that would be the application that is going to be the killer application. So to speak that you can do a very targeted stimulation of nerves going to organs within the body that would move us into the bioelectronic medicine, right? So pure thinking comes up at the bigger expanse in which the system could work. There are many pathways could be there, but our first application, our focus right now is to restore sensation to people who have lost their hands. Richard Miles (14:36): That’s really exciting. That would be huge. If that could be developed for other areas of the body. This targeted neurostimulation. Tell us where you are in terms of testing. I know that in the case of the hand, the prosthetic, you want to test this sort of in as much of a real world environment as possible. Tell how that’s going. And then what sort of path to market does it look like for you? Are we talking about years away from something that could be widely available for amputees? Or is this something that we’re going to see fairly soon? Dr. Ranu Jung (15:03): So this is what is called a class, it would fall under, what’s called a class three medical device. It’s because of the implanted neurostimulator that that is there. So the first step that we had to do was to go to the FDA to get approval for what is called an investigational device exemption in order to be able to run a clinical trial. So we did that. Not many academic labs will take technology such as this all the way through the pathway, to the FDA while companies often do it. And of course, large companies are doing the Medtronic and Boston Scientific is doing this all the time, but it’s not usual for an academic lab to have taken it from the scratch, something to the FDA. So we got the investigational device exemption. And so now we are in the process of running a feasibility clinical trial. And what that means is that we will be doing a small sample size of people who have a translatable amputation at first. And putting them through use of the system the way we have it. This is a longterm take home study. So you would do things for about three months in the lab. So after you get the implant, you would come into the lab, it’s a person I speak to you. So we would make sure you’re fit. And of course we want to collect additional data about how you are doing control of things. You will find some for a large, bigger control. Can you close your eyes and say it’s soft or hard or big or small things like that? What do you feel like when you open zip things up or squeeze water bottles? So we do that in the lab and then after three months, the person will take it home and then they will come back for the next three months, a little more often. And then they’ll come back for some data collection in the lab for up to two years. So we want to collect the data, but the system is then there’s to keep. You know, the implant is hopefully the way we have designed it, it’s for life. So the internal part doesn’t change. There’s no battery inside. So you don’t have to undergo another surgery to replace depleted batteries, all the powers with both from outside. And as we’re coming up with new algorithms outside, we have smarter prosthetic hands that may come in place. Then the outside can all be upgrade. So that’s also a throught through modular design aspect of it. So we are currently in this clinical trial. One person has completed 28 months of use more than 24 at home. And we are currently recruiting people. Once we recruit these people for one site, we also have received funding from the Army to move it to a second site, which would be the Walter Reed National Military Medical Center. We have to go back to their VA and we’ll back to the IRB to get approvals for increasing the number of people in the disability file and for the second site. And in case we will also try to see approvals for somebody who has amputations on both sides of bilateral amputee. We believe that this sensory feedback step is going to be really much more important for people who have lost both hands, even more so than somebody who has lost one of them. So once that happens, then we can go to the next step. We have just been accepted, absolutely delighted that we have just been accepted by the NIH in a program, which is called clinic to commercialization CPI program. And that program, our team was just accepted into that part. And that will take us for about 24 months to put a whole business framework in place. So we are expecting that by next year, we will have transcends, we have ideas of how we are thinking about our business framework, but we would start to strengthen that and we’ll start putting that in place. And while the feasibility trial is going on, and of course the feasibility trial has to go well for all of that to put it together. And so probably the first place we would have people in the Army, that’s where we would probably look to think the first deployment, but the clinical trial is funded by the National Institutes of Health and then new, additional monies from the US Army. So it would be open to all the civilians and it will be opened later to also people through the world to reach. So in a few years, we hope that this is going to be getting ready to be real commercialized. Richard Miles (19:17): So Ranu, I have to ask you, how do you spend your average day? Cause what you just listed in terms of your, to do list, I think would require about five or six people. So I’m guessing you’re not the one that’s doing all of this. You have people around you helping you, giving you advice. What do you focus on? Are you continuing to do a line share of the actual research? Or are you thinking about how do we actually get this into the hands of the people that need it? Dr. Ranu Jung (19:40): This is a partnership, as you said, this is not a one person job. This is a partnership. It’s an epidemic in this preclinical partnership. A lot of it has been so far in academia. I have the best team I can talk about. It is a long term partnership. It’s not two years. One year, three years. It’s about 10 years or more. I was talking to James Abbas at Arizona State who has been from the initial concept is research scientists who came same time. I came here, who used to be here. He was my doctoral student, but decided to become an engineer. And then now he’s actually going back to do his PhD another one, my old, old grad students have come back as well. I recently graduated grad student who works on the project is spending doing a post doc and is actually taking this commercialization pathway for what it’s a team. So what do I do in this team? Because we have cross-training so it’s not one person for one thing, but we do the regulatory work in high school. The implant was done right here in Miami, by doctor Aaron Burglar from the Nicholas Children’s Hospital. And obviously we have industry partners to make the implants. If we can make them think of like the computer manufacturers who have to buy things from different places, right. We can tell them the design, but it has to be somebody who can make medical products to be able to put an implant in there. And bof course we partnered with prosthetic manufacturers for making the prosthetic hand. So what do I do? I am like the orchestra manager for all of it, but I am officially the sponsor of the trial and the principal investigator of the trial. So I take the responsibility for all of that, all of the negotiations, the legal negotiations and all of that part. I discuss those, all the FDA submissions. I will read them and I will update them and I will review them, but I’m not writing from scratch. And it’s over years that has happened. I’m also not writing the program level details. The research scientists are doing, we will discuss, this is what we need to do. This is what we need support, but they are the ones writing the framework and putting all of that code in there. So to speak, what algorithms, what should they capture? So you can think of it as I’m putting the book in place, the chapter organization in place. But the exact words of how you are going to put in that paragraph are written by the engineers and scientists and graduate students that are involved and undergraduate students are involved, Richard Miles (22:03): Ranu, one of the questions we asked normally if inventors and entrepreneurs and we’re fascinated by it at the Cade Museum is well, what was the inspiration behind their story? And you’ve said that you were inspired by your parents and their can do spirit. Your father was a metallurgical engineer. Your mother was a school teacher taught English in India. How did they influence your decision to go into engineering? Dr. Ranu Jung (22:23): Not in a direct manner to say you should go into engineering because they themselves were doing what they wanted to do. They were pursuing new things. So right from early childhood, it was, you can do whatever you want to do. So it wasn’t that, Oh, you should do this or you should do that. So I think them taking that risk, and as I mentioned earlier to you, this was post India independence and a new industrialization happening to be coming in place. So my father who is going to be close to 19 and one of the first engineers and they were all doing this every day and you watch them do it. So you saw him come back and say, we broke this record of the blast furnaces. We melted this much iron ore today. So you saw that kind of atmosphere, you know, this allowed you to think and say, Oh yeah, what could I do? What would I want to do? And so that was the inspiration. And it was an interesting time to be in India. At that time in Indira Gandhi was the prime minister. I still remember going to a rally and listening to this woman, giving a speech. And I think that whole ecosystem was encouraging the children to dream and no boundaries that you need to stay here. You need to stay with the family. So they left their parents and their families to go to this new city and build that up. And for their children, they said, you have the world. You can go wherever you want to go to a very special time in history and a special city be raised in with a group of young entrepreneurial parents we were like a cohort, but then that’s what it was. You know, Richard Miles (23:52): What I find fascinating too is I know is that you actually consider going into medicine instead of engineering, and then you chose engineering, but now sort of the peak of your career, you’re in bioengineering, right? And ultimately you’ve got to have both things you wanted. Dr. Ranu Jung (24:04): And I have to say, undergraduate students going into research lab, they really should explore. And that’s how I found out about that. There is a potential possibility. There was a professor who had a lab called problem oriented research lab. And he had actually just spent maybe a semester in the US I don’t know exactly how long and come back. And he started this lab where they would bring medical instrumentation for an electronic blood pressure cuff. Oh, I could have a combination of all this electronic stuff. My major was electronics and communications and things. I could have been doing radar. And instead I said, Oh, there’s a place I could combine it. But there was nothing in biomedical engineering in India. I even interviewed to sell x-ray machines for a company, so I could get into the medical field, but then getting this opportunity to do grad school at Case Western it really, really a fantastic graduate program. That was the opportunity that helped me solidify my passion and this, I found a place that would be good. Richard Miles (25:03): I asked you earlier about what would your advice be to other researchers and entrepreneurs? And you wrote that one piece of advice would be don’t cross out ideas too fast because ideas are too early. So why don’t we explore that a little bit? How do you keep a good idea alive? Let’s say as a researcher, for which there may not be funding right away, or there may not be a commercial application right away, but you know, it’s a good idea. How do you keep those going? Dr. Ranu Jung (25:28): So let me tell you this idea of interfacing with the nervous system and think of it as out what we call a bio hybrid system, a bionic system, and this together, this idea of pulling this together and interfacing was way back when I was just graduated from my postdoc. And I worked with a professor named Davis Cohain and we were studying lamprey eels. They are like eels. And we looked at the spinal cord and how the spinal cord works and what helps to do the movement and was like, what if we could do a combination of a electronic circuit that mimics part of the spinal cord and interface it with this, I could do the simulations. I could do the experimental prep. I could not make the actual chip hardware, because that was not my background. I went to a summer course. I learned about it. And I came back and said, I gotta find it. Electrical engineering friend who is faculty member who will be willing to put this into hardware, found one practice with her for a few years. She went and did the course came back and we actually then put it into a physical thing. And we interfaced it with this grant. We’ve got a grant from NIH, which was called the a21. A futuristic grant to say, we can take an electronic chip and you’re hearing the word neuro morphic. Now this is now in there talking about in early 1990s, pick up the spinal cord from the lamprey. You can put it into a fluid bag and you can maintain it. And the spinal cord will be activated. We then connected it to this chip and close the loop. And we could show that the electronic chip and the spinal cord activity can go next to each other. I had a very tough time position that who would ever interface these pains, but the living system, what a crazy idea. Okay. So we got into a journal. I was thinking, this should go into science. It never did, but we did get there 10, 15 years later, somebody in the Army saw this paper. This was in the Iraq war. So I founded a small company because who needed a company for this. And we got funding where we basically said, if you’re focused injured, you will be stabilized in a false boot underneath it. We will put a small fall spot this spot would we be controlled with a circuit? Hey, what was that stuff like? The spinal cord circuits that we had done way back there. And this spinal cord circuit will be driven by sensors that pick up when the person starts to move. So if your upper leg is okay, as you start to move, there is make movement that will drive that file for circuit, that electronics that moves the food, that is the boot. And so the person can stick their foot into the stabilized park, the false foot, and you can wear this boot and you could walk out of there. And we actually demonstrated that on a person in the lab. So what forward even further, a few years, and this happened around the same time as I got funding for this neural interface thing to me. So I’m thinking all of this and saying, how are we combining electronic interfaces? So it has changed pace, but I idea has moved that you can link artificial systems with living systems and close the loop so that you’ve got, this merger, this bio hybrid system, where one is impacting the other, where will we go. Will we have adaptive engineered systems because our engineered systems that’s feeling not adapted enough. Where will it go? I think they will. Now you’d hear about neuromorphic word. Major companies are doing it, everybody’s doing it. So who knows where this is going to go? Where will this organic inorganic link happen? I’m talking about early 1990s. And we were the first people to show that you can interface an electronic circuit in a living spinal cord. It isn’t a bat. It’s not in the person walking or animal walking per se, but it was a living system. And today we are looking at saying, how can we interface? What are we doing with interfacing in electronic system with a real person and putting them into this room and hoping that this is going to actually improve their whole self, their ability to do different tasks. But most importantly to have is some [inaudible]. Richard Miles (29:35): I’m pretty sure I never heard the term neuromorphic until probably 2012, 2013, right around there. And I’d never heard of the term before. I thought it was brand new. I had no idea. It had been around since early nineties. Dr. Ranu Jung (29:47): Our paper is published with saying your morphic army grant is neuromorphic something. So it was way in the infancy of when that stuff was being talked about. Carver Mead from Caltech had been talking about it. I was very, very fortunate to have is Cohen and worked with her. I met her at the summer course at Woods Hole, Massachusetts on competition neuroscience. You never know where it can get you. So my PhD advisor, Peter Catona who I call him my academic father, who always gave me this type of saying, explore, explore. There was no idea, too crazy to be taken up. There was not this whole, we don’t do this, or you can’t do this. Richard Miles (30:25): Ranu, clearly our judges have done a great job in advancing you to our finals this year. I’m very excited to learn about what you’re doing. I hope it succeeds. I hope we can have you back at some point on the show to talk about updates. Again, want to congratulate you on making finals, but also just more broadly on the work that you have done currently at Florida International University, really enjoyed talking to you. So thank you for coming on the show today. Dr. Ranu Jung (30:46): Thank you Richard look forward to returning. Outro (30:49): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood Soundstage, and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

“I remember early in my career,” says Gary Miller, “attending orthopedic conferences just listening to the surgeons talking to each other. You build a vocabulary of what they’re talking about.” Miller is the co-founder of Exactech, a Florida company which develops and manufactures orthopedic implants, and the holder of 14 US patents. He talks with James Di Virgilio about his first invention, the innovative process, and the need for inventors and end-users to speak a common language. *This episode is a re-release.* TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. James Di Virgilio (00:39): Innovation. Does it follow a specific path? Is it spontaneous? Is it something that we can plan for ahead of time? My guest today is Gary Miller, the co founder, and executive VP of research and development at Exactech. Gary, you’ve done so many things in your career. Your first let’s call official, right? Patented innovation was called the cemented hip. Yes? Gary Miller (01:05): No. James Di Virgilio (01:06): Not your first? Gary Miller (01:07): No, no. That was years later, but it did involve cement. My first invention, I was actually, by that time on the faculty, in the college of medicine, I was a researcher there as an engineer working in orthopedics and at the time, and still today, they have a very active bone tumor group. It’s really one of the foundational elements of that department. And we treated a lot of folks with metastatic disease. And when you have tumors in your bone, it’s very, very painful. And one of the things that we were trying to figure out is how to reduce the pain. And it turns out if you could reinforce that bone, it didn’t hurt as much. And my first invention was taking a metal rod, which was used for trauma or fractures and perforating the sides of that rod and using it as a long cannula to inject cement through. And that’s cement. So very liquidy viscous kind of material that hardens inside the body and leave the rod with the cement there, take the nozzle off and remove it. And that was the first foray for me into seeking an invention. I hadn’t even thought about patenting it and somebody suggested that’s a good idea. Why don’t you think about patenting it? And that led to that first patent for me. James Di Virgilio (02:21): Now, patents are often talked about, but are also very confusing. Did you find that to be true? The first patent you had to apply for like, what’s it like, how long does this take, what am I even patenting? Gary Miller (02:31): Absolutely. That patent world, the words, the phrases all mean something. And I think for an inventor, you know what the picture of it looks like, but in the patent world, it’s about the written claims. In fact, the pictures don’t matter. So that was very much new for me in my career. I was new in what I was doing and had that the good news was the university had patent attorneys on call that helped us do all that. And I really enjoyed that of the engineering and the law and continue to spend a lot of time to this day. I still do a lot of that kind of work because it’s a lot of fun to do. It can be very disappointing for the creative person. Oh, this is great. Nobody could have ever thought about that. Again. It used to be hard to find out whether it had ever been done because it was before the internet. Now in seconds you can find out by searching the internet and the US patent and trademark office, all the international offices now have online services. You can do basically a Google search. There’s Google patent is actually one of their products and get right into it very quickly. And you’ll find out well, half a dozen people have variations on this theme. And then if you do really want to pursue that patent, you’ve got to figure out what is in fact, new and inventive that somebody that skilled in the art of what you’re doing, wouldn’t have thought of it. And there’s an obviousness test that you have to perform. I’m not an attorney, but it’s a lot of fun being there because it really does help. You fine tune what you’re doing. Find out what’s really important about it. James Di Virgilio (04:04): Imagining that we’re in an operating room and we’ve got a surgeon and we have a patient, and then we have you. And then there’s me as an observer. And you’re watching the surgeon work. You’re seeing a medical device go in, it’s a hip or a knee, or it’s something that’s going to help the patient. You have two people you’re really serving there. You’re serving both the surgeon and the patient. And if it just works for the surgeon, but the patient’s like, Hey doctor, this is really painful. This is not working. I’m not feeling good and the surgeon thinking, but this is wonderful. Like how efficient this is. I can put this right in. It’s not successful. So you have two, and what you’re doing in this example, you have two end users two people that this matters the most to you, and you have to find a solution that works for both. That seems incredibly sensical. However, I think what you said is true. Oftentimes if you look at businesses or service models that don’t work, there’s so many layers between the person creating the solution and the person using the solution that the solution no longer works. How is it that you learn, as you’ve talked about off air to speak the language of the surgeon and the patient to find the proper solution, that’s an art and a science. I feel like. Gary Miller (05:08): It is. It’s an art and the sciences that takes a long time. And I liked the way you couched it. I don’t know that I was as efficient at it. Then as I like to think, I have become as you as an interview or no there’s good ways and not so good ways of trying to elicit responses, answers from people, being able to be conversant talking their language helps a lot. And I remember very distinctly first years of my career, attending orthopedic conferences, just listening to the surgeons, talking to each other, you build a vocabulary, you build an understanding of what they’re talking about. They use a different lingo than the engineer uses. The most effective teams are an engineer working with a surgeon who has a background or has learned the lingo of the engineer. So when I give out an engineering term, I don’t have to translate it for that person. So we can be talking about a design and a solution. And I’ll say, well, the stresses are going to be too high here. And they know what a stress is. And it doesn’t mean that you’re nervous about something. We’re talking about an engineering principle that resonates with them. So you get rid of the translator in the middle, if you will. So it can be very rapid fire. Most of the inventive work that I’ve done, I’ve always been surprised how, again, a little bit serendipitous, you’ll be working on a problem, working on a problem. All of a sudden this answer pops out for me. It’s usually not a solitary event. You’ll notice on my patents. I may have one or two that are just my invention, but I’ve shared ideas with people. Who’ve shared their ideas with me. And so I’m a co-inventor with folks and that’s the way patents are. That’s the way it should be. That all the people that created that inventive step should be included in the patent application and the eventual patent that efficiency can bubble. And they’re good folks to work with. And that’s so good folks to work with. And you’ll find that some people are very dogged in the solution that they brought to you. So what they’re really looking for is somebody to render their idea. That’s a very different kind of concept for me. I’ve been very lucky in my career that I haven’t been faced with that very often or when faced with it. I’ve usually been able to walk the person back to, I understand you have this answer, but could we talk about the question for a minute? Can we look at what the need is? And either work with me as a helper and translator to work with some of the brilliant minds that I’ve been able to work with. They’re people that design, that’s what they do. Engineering design in specific areas like medical devices. I’ve been really lucky and enjoyed immensely working with those kinds of creative minds. But when we talk to each other about, well, when did you finally figure that out? It’s the old adage? Oh, well I was taking out the garbage or I was in the shower. It’s when you stop thinking about something that you sometimes come up with your most creative ideas, I’d never been good at saying, okay, I’ve got this problem to solve. I’m going to sit down this morning and I’m going to spend the next hour. I blocked out the time to be creative or to be invented for me that doesn’t work. My mind doesn’t work that way. I have a bunch of stuff rumbling around in it. And every once in awhile at births an idea, and sometimes you could go for a long time. It’s the equivalent, I guess, to writer’s block when it just, it’s not there. It’s not there. James Di Virgilio (08:34): Is there pressure once you’ve innovated and created at a certain level to have to keep creating new things, you get to five, six, seven, eight patents, and it’s sort of like, Hey, Gary’s the guy. He can create stuff. He’s a visionary, he’s a creative. Do you feel that pressure build as you do more and more? Or is it just a thought where, Hey, if I have a good idea, I’m going to do it. And if I don’t, I don’t feel any pressure. Gary Miller (08:56): Two answers to your question. I don’t judge a person’s creativity or ability to solve unmet needs. I keep going back to that theme because I really believe in it to improve patient outcomes is another way to say it. It doesn’t have to result in a patent. Being the first in the market could be very valuable. Let’s just get it out there. Let’s just do it. If you look at the number of things that I’ve had, the opportunity to work on, the patents, don’t speak for the number of different things that we’ve done on the teams that I’ve worked on over the years, that’s sort of icing on the cake for me. I would be not telling you the truth. If I said that, getting that first one, which I still have, it’s all coffee spilled on it and everything else, but getting that first one and seeing it and seeing your name on it, it’s a validation of your inventiveness, if you will. But for me, it’s really about in the area I work in it’s about improving patient outcomes. There’ve been a lot of ideas that I and my colleagues have come up with that I would call me to, or people will come to you and say, well, three other companies had this, we need this one. We should make it. In some cases, you need to have that full bag. I go kicking and screaming in that direction sometimes. But finding that thing that hasn’t been solved out of that myriad of stuff and be able to come up with an answer to it that advances the art or the science that you’re in is what makes me tick. It’s what I love to do. So it’s a long way of answering your question, but there’s always stuff that I think we can improve. You know, I’ve been in this area of medical devices for over 40 years. Now that I think about it and still working on hips, one of the first implants that I developed, you mentioned it earlier, when I corrected it was a cemented hip and there were a lot of them on the market at the time. And working with an orthopedic surgeon who became my partner, Bill Petty, working together, the idea was, well, there’s all this stuff about cemented hips that work, but they don’t last for the lifetime of a patient. Could you get just one and be done those kinds of things. And we’re still advancing that art. And there are improvements it’s much faster to put them in, the instrumentation has improved, all of those kind of innovations contribute to that improvement in the patient outcome, because we all know it’s pretty obvious to a lot of people, the faster and better you can do something with the least amount of insult. In this case to the body, usually the better the outcome is going to be. And thinking back historically, when we used to judge, whether an implant was going to work very well, we thought about the 65 to 70 year old person that weighed 157 pounds. That was the standard that the first Food Drug Administration standards, had, imagine that today we all know people that are in their fifties or sixties that have arthritis that would benefit from a total joint replacement, for whatever reason. Sure. It would be better to get it later in life, but wouldn’t it be great if you then have a solution to that that lasts the patient’s lifetime and they’re in and out of the hospital the same day, it used to be a seven day hospital, stay in a very old population of folks. Now you hear about it and you see it on the news. You see it in your friends and family around a person. Well, I had my surgery one day and I was out the next day or two days later, walking around. Think about those improvements in four decades. Those are the kinds of things that you hear. That that’s what gets me excited. That’s, what’s nice about what we do. And I think there’s still a lot out there to improve and improve the experience for the patients and for the surgeons. It’s a lot of work doing a lot of these cases, standing there all day long and here, again, improving the instrumentation, working with surgeons to do what they think will work best. And time is a measure of that. Used to be years ago, you did two cases or three cases in a day, and now you could do five or six or more. And I say that primarily because you can double the number of patients that you can treat with the same resources for all intents and purposes, which is something that we as baby boomers get out there. We need to be able to do more cases. James Di Virgilio (13:14): What kind of environment do you need to be able to create and improve the world around you? We’ve talked on previous podcasts that the United States is significantly the leader in medical, technological improvements. It’s not even remotely close. It’s the US way ahead of Germany and everyone else. Why it’s a question that gets asked a lot you’re directly working in it? Why or what is the environment that allows companies like yours brains like yours and the US to innovate at a way higher level than what we see across the world? Gary Miller (13:45): Well, I think if I knew that that’s the $64,000 question, I don’t know that I have a great answer for you. I think one answer is we want, and in some ways, demand being healthy. And I put healthy in quotes, short on pain threshold, want to be able at age 55 to be able to play singles tennis and all those kinds of things. You don’t want to see yourself degrading if you will, and all those things you want to do. And I always joke if you lived your life backwards, you finally get the time when you can be out there playing and doing whatever and traveling, and you find your body giving out on you before you can do it. But back to your question, I’ve traveled to a lot of places outside the world had been really lucky to be able to lecture and be in those environments around the world. You know, it’s not fair to generalize probably, but you see people that have more deformity, they endure more pain before they get treatment, whether it’s because it’s not available. And it’s a vicious cycle. In some ways in the United States, we apply a lot of resources to creating an environment so that we can solve those problems as you were talking about. But I think that’s one of the answers. I don’t have a perfect answer for you. There are a lot of countries that do have niches though, within what we would now call the medical community, whether it’s drug development, the pharma industry, a lot of that happens outside of the United States, as you know, and a lot of computer assisted kinds of stuff happen in various places around the world as well. One of our divisions is in France that we’re works a lot on our computer assisted surgery happens to be an area in the South of France that does a lot of that kind of stuff. And it breeds itself. You have people that are working together, I think to do it well. It is a team sport and the United States creates a good playing field to use that analogy for engineers to both be trained and to be able to create careers in this area and do well at it. James Di Virgilio (15:48): Do you have a favorite project that you’ve worked on or creation or innovation, something that sticks out as like that one was really special. Gary Miller (15:57): You know I really don’t. I talk about that rod that I worked on at the very beginning, that was very, very rewarding for me. Let me twist it a little bit for you. One of the nicest things that I see, one of the most rewarding things for me as an engineer working in medicine is you get that feedback of how you’ve done. It was amazing to me with that first experience as a person that was debilitated on heavy drugs, couldn’t really walk. And it’s an end of life experience. It’s metastatic bone cancer, but their quality of life was really awful because of pain. And after doing the procedure that we had created, the orthopedic surgeons and I at the hospital would get up the next day, even though they had had a surgical procedure and say, Oh, wow, this is great. They were ready to go. Similarly, a person with really bad arthritis. They can’t get in and out of a chair to have to use the arms of a chair. One of the things I always kid around with some people is try getting up from a chair with no use of your hands. You have to have good knees to do that. And your hips have to be functioning really well. One of the nice things that we get to do in biomechanics in the field that I’ve spent my career in is seeing that patient walk out of the hospital or getting up that first day and say, well, I know it hurts because I had surgery, but it doesn’t hurt like it did before my surgery. That’s the measure that we have. There’s other areas of engineering that it’s much harder to get a read on the success of what you’ve done. I think that one of the things I’ve enjoyed so much working in medical devices and working in biomechanics over the years and being in a clinical situation, their research areas are all those things and not to dismiss those that I need as a person, you need the tools and the toolbox to be able to do all the things that we do. We need the materials. We need some of the understanding of design that are done in a laboratory setting. I’ve worked my career in applied biomechanics, if you will, or applied biomaterials where I get to use some of those early inventive steps to create a product or a device, if you will, that goes into a patient or is used to put something in a patient. And it’s been tremendously rewarding for me because as I said, if we can give a surgeon the opportunity to do that extra case, that’s one more patient. That’s gonna not have to endure pain for an extra day. It’s all about that patient outcome thing resonates with me. And I’ve been lucky to be able to spend so many years just being in that sandbox. James Di Virgilio (18:29): I’m hearing so much passion and excitement and joy for what you do. And I’m wondering after a full career of doing all these things, when you wake up each day, are you just as excited about solving problems today as you were 10, 15, 20, 30 years ago? Gary Miller (18:44): Yeah. I am. I don’t know if I can get there as fast and do it as quickly, but yes, it’s a terrifically rewarding area to be, and it’s what keeps me going for sure. James Di Virgilio (18:55): I think that’s true of people in general. You know, my belief and philosophy in life is that we’re here. We’re created to be here. We’re created to attempt to improve the world around us and your energy. As I’m sitting 10 feet away from you is palpable. You can feel the satisfaction and the drive that you have to improve the world around you. And that’s what creativity and innovation does. Let’s bring this down to the listener, whether they’re 15 or they’re 50, and talk about this idea of problem solving, how do you teach somebody to have not the same passion you do? Cause we’re all created differently in that regard, but to maybe view the world that way, Hey, maybe you too can see some problems and begin to think about solving them. Can this be taught? Are you born with this? What is this? Like? Gary Miller (19:35): Yes. And yes, the folks that are successful, I do think bring that intellectual curiosity with them. They don’t take things for granted about how’s it working, what it’s doing. And so I think that is innate. I think because there are people that are frustrated that they can’t sometimes I wish it was totally teachable because we could use more people inventing, right? If you use my basic thesis of improving life, however, to answer your question more specifically, very structured ways of looking at things that if you learn those techniques, that you can be better at it. I’ve been asked this by students before when I lecture. And one of the things I love to do is mentor at this stage. If somebody is willing to listen to you about your experiences and how you solved it, you end up transferring both the passion and the technique. So yours is a very good question. There’s structured ways of doing it and being creative there’s skills that you can learn. You look at a solution and say, what happens if you turn it upside down? What happens if it’s backwards? They’re ways of brainstorming is a catch phrase that some people use where you put every which way, think you could do it down on paper without judging whether it would work or not. And then manipulating those images of what you thought about. It works really good in a group setting that people throw stuff out on the table, if you will, and you’re not allowed to critique whether it would work or not. The whole idea is to generate the most ideas. So there are techniques. There have been a lot of books written about it. There have been a lot of books written about a lot of things. And how many books have been written about how to become a millionaire? How many people read the book and become a millionaire? I think the same applies here. I have been impressed though that the tools have gotten more powerful for us. I remember 40 years ago, it was a drafting table and a pencil and scale and compass and drawing stuff. And if you wanted to make four sizes, you had to make four different drawings and you sat there with your slide rule and or a tablet of paper and added all the numbers up fast forward to today. When there’s three D rendering of computer assisted design, and you can look at it on the screen and you can make it larger and smaller and you can take four pieces like their fourth five pieces in a given joint replacement, put them all together, see how they move together. Those are incredibly powerful tools. And then you decide, well, I want the smallest one to be this size and I want the largest one to be this size. And then you can do the scaling if you will. And the system, the computer helps you. I have to tell you, I have yet to be able to be good at computer assisted design, but I work with people that are just, they blow your mind away. You’ll say something about this idea you have, and they’ll walk in and say, how about looking at this on my tablet used to be a desk size computer. Now it’s on a tablet if you will. So we’ve gotten really good and powerful tools. Testing has matured dramatically. We can’t use the person as the experiment here, and you’ve gotta be able to do a lot of simulation testing. A lot of those kinds of things, which were very hard to do in the past now because of the computing power we have, we’re able to make simulators that run an implant for 50 million, 20 million to look for the endurance. How’s it behaving all those kinds of things. And you can do a lot of things simultaneously. So between CAD simulation and all those things, it’s a far cry from what it was many years ago, when you had to build a prototype and try to test it in some way in a laboratory. And then honestly, in those days, once we thought we had it pretty close, we’d start using it. And it would be used in patients that needed it the most so that the risk reward was there. Now we can do a lot more and we can do it much more quickly. We talked about earlier about the length of time that it takes to do a design when everything works well, 18 months is not out of the question sometimes because of the regulatory overhead that we have. It takes longer than that. But in years past, it could take five years, seven, eight years, and then you weren’t anywhere near as sure about what the outcome was going to be. As I think we are now, they’re less small steps, James Di Virgilio (24:01): Words of wisdom. So here you are decades of experience. I want you to imagine going back in time and having a conversation with your 20 something self, what are two things you would tell yourself back then? Here’s what I want you to anchor to. As you go forward and you have this career doing all these things, remember these two things, Gary Miller (24:20): Be sure to listen and to watch what’s going on. That would be number one for me. And number two would be, I know you’re going to be asked to learn a lot of things that you don’t think you’re going to need to learn. And all I can tell you is I’ve used almost everything that I was taught, except for super higher math. I’ve never liked partial differential equations, and I’ve never had to use them, but I’d mentioned the tools in the toolbox to you earlier. I would tell a person earlier in their career, learn as much as you can keep learning it, keep learning new things, because you’ll never know when you might need to use it. And I could cite examples over and over again of things. I never thought I would be in business. That engineering economics class looked like a waste of time to me. And it’s helped me those on the finance side that say, I still don’t know how to read a balance sheet. What can I tell you, James? But at least I know what I don’t know. And sometimes you need to know what you don’t know. James Di Virgilio (25:22): There’s a lot of wisdom there, especially if you look at being a lifelong learner, having no idea where your life will take you. And then as you mentioned, maybe one of the most important things that I hope listeners pull from. This is what we’ve talked about. Indirectly sometimes directly about this concept of communication language, if you will, and if you’ve traveled at all, you can relate to what it’s like to drop yourself. I went to Asia many years back and you drop in the middle of China or Japan, and no one speaks a word of your language and you don’t speak a word of their language and you both could be brilliant people. And you’re reduced to hand signals, right? And as you mentioned, you want to go from hand signals to fluency in whatever language you have, and you have no idea what language is you’ll pick up throughout your time, whether yours is a mixture of engineering and finance and classes you’ve taken or life experiences you have and how they will cross over down the road. That’s very wise. Gary Miller (26:13): Yeah. I have examples of that in my own life and career. What I love to tell traveling in Spain, I speak minimal Spanish. And at the time I spoke absolutely no Spanish and went to dinner with one of those creative orthopedic surgeons like I was telling you about. And both of us were so frustrated trying to speak through the one person at the table who spoke English and Spanish. And after about 10 minutes, we both had our pens out and you’re going to laugh at me, but we kept moving the glasses and the plates out of the way. And we started drawing on the tablecloth. And so the visual became our medium for communication. And you were teasing me about cemented hips there earlier. We went through his idea of a hip design on that tablecloth and two napkins, as I recall, and we got to the end and we understood what each of us was trying to say. And it came to a pretty nice solution in design that we were able to move forward on. The only embarrassing thing was in this very nice restaurant in Spain, we had to have them take the tablecloth and the napkins off the table and wrap them up and give them to us because it was before cell phones and the only way to transport all this work we had done for two and a half hours at a classic Spanish dinner was to take the table with us. So it’s a fond memory. Obviously for me, I bet a wonderful group of people all over the world. And it comes down yes to hand signals and drawing, drawing. The visual is really without language usually. James Di Virgilio (27:45): And that’s one of the greatest things about doing this podcast, talking with you today is that it’s people, it’s people like you. If you’re listening and it’s people like Gary, it’s people that have ideas and get together with other people that have ideas and those ideas become a reality, right? The things you’ve created, those were humans, creating the ideas and putting them into play. It wasn’t some magical process. It didn’t happen on its own. What you’ve learned what’s in your brain is valuable. Working with others valuable. One of my favorite economic examples is Milton Friedman. You can find this on the internet does like a two minute video on the pencil, the humble pencil, but the pencil comes from so many different places all over the world, which is what allows it to be so cheap nowadays. Right? But at one point in time, it wasn’t so cheap, even just getting led was difficult. And we’ve talked a lot about a lot of these things today. I always find it very encouraging when we’re talking to someone who’s created as many things as you have to hear that it really does come back to what do you know, what do other people know? How can you get together, work together, find solutions to problems that exist. It’s been absolutely great to have you. My guest today, Gary Miller, the co founder of Exactech, also a man of many other things. We can’t just label you as that. And also on the board for the Cade Museum. I would remiss, if I didn’t say that. So thank you for all of your support and also for your time today, we certainly loved having you on Radio Cade. Gary Miller (28:55): Well, thank you. It’s been an absolute pleasure. James Di Virgilio (28:58): For Radio Cade, I’m James Di Virgilio. Outro (29:01): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. This podcast episodes host was James Di Virgilio and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood Soundstage, and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinists, Jacob Lawson.

When Carolyn Yarina, today’s guest, walked into her university’s Center for Entrepreneurship one day as an undergraduate, she was convinced that she would never become an entrepreneur herself. “I remember tapping my foot, being impatient,” she recalls, laughing, “I couldn’t wait to get out of there, thinking that entrepreneurship wasn’t for me.” Fast forward to a few years later, and she is now the co-founder and CEO of Sisu Global, a company that is committed to providing medical technology which enables healthcare for each person in their own community. In this episode, host Richard Miles sits down with Yarina to learn more about Sisu Global and more specifically, Hemafuse, the company’s handheld, mechanical device for intraoperative autotransfusions, designed to replace or augment donor blood in emergency situations. TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. James Di Virgilio (00:39): Innovation. Does it follow a specific path? Is it spontaneous? Is it something that we can plan for ahead of time? My guest today is Gary Miller, the co founder, and executive VP of research and development at Exactech. Gary, you’ve done so many things in your career. Your first let’s call official, right? Patented innovation was called the cemented hip. Yes? Gary Miller (01:05): No. James Di Virgilio (01:06): Not your first? Gary Miller (01:07): No, no. That was years later, but it did involve cement. My first invention, I was actually, by that time on the faculty, in the college of medicine, I was a researcher there as an engineer working in orthopedics and at the time, and still today, they have a very active bone tumor group. It’s really one of the foundational elements of that department. And we treated a lot of folks with metastatic disease. And when you have tumors in your bone, it’s very, very painful. And one of the things that we were trying to figure out is how to reduce the pain. And it turns out if you could reinforce that bone, it didn’t hurt as much. And my first invention was taking a metal rod, which was used for trauma or fractures and perforating the sides of that rod and using it as a long cannula to inject cement through. And that’s cement. So very liquidy viscous kind of material that hardens inside the body and leave the rod with the cement there, take the nozzle off and remove it. And that was the first foray for me into seeking an invention. I hadn’t even thought about patenting it and somebody suggested that’s a good idea. Why don’t you think about patenting it? And that led to that first patent for me. James Di Virgilio (02:21): Now, patents are often talked about, but are also very confusing. Did you find that to be true? The first patent you had to apply for like, what’s it like, how long does this take, what am I even patenting? Gary Miller (02:31): Absolutely. That patent world, the words, the phrases all mean something. And I think for an inventor, you know what the picture of it looks like, but in the patent world, it’s about the written claims. In fact, the pictures don’t matter. So that was very much new for me in my career. I was new in what I was doing and had that the good news was the university had patent attorneys on call that helped us do all that. And I really enjoyed that of the engineering and the law and continue to spend a lot of time to this day. I still do a lot of that kind of work because it’s a lot of fun to do. It can be very disappointing for the creative person. Oh, this is great. Nobody could have ever thought about that. Again. It used to be hard to find out whether it had ever been done because it was before the internet. Now in seconds you can find out by searching the internet and the US patent and trademark office, all the international offices now have online services. You can do basically a Google search. There’s Google patent is actually one of their products and get right into it very quickly. And you’ll find out well, half a dozen people have variations on this theme. And then if you do really want to pursue that patent, you’ve got to figure out what is in fact, new and inventive that somebody that skilled in the art of what you’re doing, wouldn’t have thought of it. And there’s an obviousness test that you have to perform. I’m not an attorney, but it’s a lot of fun being there because it really does help. You fine tune what you’re doing. Find out what’s really important about it. James Di Virgilio (04:04): Imagining that we’re in an operating room and we’ve got a surgeon and we have a patient, and then we have you. And then there’s me as an observer. And you’re watching the surgeon work. You’re seeing a medical device go in, it’s a hip or a knee, or it’s something that’s going to help the patient. You have two people you’re really serving there. You’re serving both the surgeon and the patient. And if it just works for the surgeon, but the patient’s like, Hey doctor, this is really painful. This is not working. I’m not feeling good and the surgeon thinking, but this is wonderful. Like how efficient this is. I can put this right in. It’s not successful. So you have two, and what you’re doing in this example, you have two end users two people that this matters the most to you, and you have to find a solution that works for both. That seems incredibly sensical. However, I think what you said is true. Oftentimes if you look at businesses or service models that don’t work, there’s so many layers between the person creating the solution and the person using the solution that the solution no longer works. How is it that you learn, as you’ve talked about off air to speak the language of the surgeon and the patient to find the proper solution, that’s an art and a science. I feel like. Gary Miller (05:08): It is. It’s an art and the sciences that takes a long time. And I liked the way you couched it. I don’t know that I was as efficient at it. Then as I like to think, I have become as you as an interview or no there’s good ways and not so good ways of trying to elicit responses, answers from people, being able to be conversant talking their language helps a lot. And I remember very distinctly first years of my career, attending orthopedic conferences, just listening to the surgeons, talking to each other, you build a vocabulary, you build an understanding of what they’re talking about. They use a different lingo than the engineer uses. The most effective teams are an engineer working with a surgeon who has a background or has learned the lingo of the engineer. So when I give out an engineering term, I don’t have to translate it for that person. So we can be talking about a design and a solution. And I’ll say, well, the stresses are going to be too high here. And they know what a stress is. And it doesn’t mean that you’re nervous about something. We’re talking about an engineering principle that resonates with them. So you get rid of the translator in the middle, if you will. So it can be very rapid fire. Most of the inventive work that I’ve done, I’ve always been surprised how, again, a little bit serendipitous, you’ll be working on a problem, working on a problem. All of a sudden this answer pops out for me. It’s usually not a solitary event. You’ll notice on my patents. I may have one or two that are just my invention, but I’ve shared ideas with people. Who’ve shared their ideas with me. And so I’m a co-inventor with folks and that’s the way patents are. That’s the way it should be. That all the people that created that inventive step should be included in the patent application and the eventual patent that efficiency can bubble. And they’re good folks to work with. And that’s so good folks to work with. And you’ll find that some people are very dogged in the solution that they brought to you. So what they’re really looking for is somebody to render their idea. That’s a very different kind of concept for me. I’ve been very lucky in my career that I haven’t been faced with that very often or when faced with it. I’ve usually been able to walk the person back to, I understand you have this answer, but could we talk about the question for a minute? Can we look at what the need is? And either work with me as a helper and translator to work with some of the brilliant minds that I’ve been able to work with. They’re people that design, that’s what they do. Engineering design in specific areas like medical devices. I’ve been really lucky and enjoyed immensely working with those kinds of creative minds. But when we talk to each other about, well, when did you finally figure that out? It’s the old adage? Oh, well I was taking out the garbage or I was in the shower. It’s when you stop thinking about something that you sometimes come up with your most creative ideas, I’d never been good at saying, okay, I’ve got this problem to solve. I’m going to sit down this morning and I’m going to spend the next hour. I blocked out the time to be creative or to be invented for me that doesn’t work. My mind doesn’t work that way. I have a bunch of stuff rumbling around in it. And every once in awhile at births an idea, and sometimes you could go for a long time. It’s the equivalent, I guess, to writer’s block when it just, it’s not there. It’s not there. James Di Virgilio (08:34): Is there pressure once you’ve innovated and created at a certain level to have to keep creating new things, you get to five, six, seven, eight patents, and it’s sort of like, Hey, Gary’s the guy. He can create stuff. He’s a visionary, he’s a creative. Do you feel that pressure build as you do more and more? Or is it just a thought where, Hey, if I have a good idea, I’m going to do it. And if I don’t, I don’t feel any pressure. Gary Miller (08:56): Two answers to your question. I don’t judge a person’s creativity or ability to solve unmet needs. I keep going back to that theme because I really believe in it to improve patient outcomes is another way to say it. It doesn’t have to result in a patent. Being the first in the market could be very valuable. Let’s just get it out there. Let’s just do it. If you look at the number of things that I’ve had, the opportunity to work on, the patents, don’t speak for the number of different things that we’ve done on the teams that I’ve worked on over the years, that’s sort of icing on the cake for me. I would be not telling you the truth. If I said that, getting that first one, which I still have, it’s all coffee spilled on it and everything else, but getting that first one and seeing it and seeing your name on it, it’s a validation of your inventiveness, if you will. But for me, it’s really about in the area I work in it’s about improving patient outcomes. There’ve been a lot of ideas that I and my colleagues have come up with that I would call me to, or people will come to you and say, well, three other companies had this, we need this one. We should make it. In some cases, you need to have that full bag. I go kicking and screaming in that direction sometimes. But finding that thing that hasn’t been solved out of that myriad of stuff and be able to come up with an answer to it that advances the art or the science that you’re in is what makes me tick. It’s what I love to do. So it’s a long way of answering your question, but there’s always stuff that I think we can improve. You know, I’ve been in this area of medical devices for over 40 years. Now that I think about it and still working on hips, one of the first implants that I developed, you mentioned it earlier, when I corrected it was a cemented hip and there were a lot of them on the market at the time. And working with an orthopedic surgeon who became my partner, Bill Petty, working together, the idea was, well, there’s all this stuff about cemented hips that work, but they don’t last for the lifetime of a patient. Could you get just one and be done those kinds of things. And we’re still advancing that art. And there are improvements it’s much faster to put them in, the instrumentation has improved, all of those kind of innovations contribute to that improvement in the patient outcome, because we all know it’s pretty obvious to a lot of people, the faster and better you can do something with the least amount of insult. In this case to the body, usually the better the outcome is going to be. And thinking back historically, when we used to judge, whether an implant was going to work very well, we thought about the 65 to 70 year old person that weighed 157 pounds. That was the standard that the first Food Drug Administration standards, had, imagine that today we all know people that are in their fifties or sixties that have arthritis that would benefit from a total joint replacement, for whatever reason. Sure. It would be better to get it later in life, but wouldn’t it be great if you then have a solution to that that lasts the patient’s lifetime and they’re in and out of the hospital the same day, it used to be a seven day hospital, stay in a very old population of folks. Now you hear about it and you see it on the news. You see it in your friends and family around a person. Well, I had my surgery one day and I was out the next day or two days later, walking around. Think about those improvements in four decades. Those are the kinds of things that you hear. That that’s what gets me excited. That’s, what’s nice about what we do. And I think there’s still a lot out there to improve and improve the experience for the patients and for the surgeons. It’s a lot of work doing a lot of these cases, standing there all day long and here, again, improving the instrumentation, working with surgeons to do what they think will work best. And time is a measure of that. Used to be years ago, you did two cases or three cases in a day, and now you could do five or six or more. And I say that primarily because you can double the number of patients that you can treat with the same resources for all intents and purposes, which is something that we as baby boomers get out there. We need to be able to do more cases. James Di Virgilio (13:14): What kind of environment do you need to be able to create and improve the world around you? We’ve talked on previous podcasts that the United States is significantly the leader in medical, technological improvements. It’s not even remotely close. It’s the US way ahead of Germany and everyone else. Why it’s a question that gets asked a lot you’re directly working in it? Why or what is the environment that allows companies like yours brains like yours and the US to innovate at a way higher level than what we see across the world? Gary Miller (13:45): Well, I think if I knew that that’s the $64,000 question, I don’t know that I have a great answer for you. I think one answer is we want, and in some ways, demand being healthy. And I put healthy in quotes, short on pain threshold, want to be able at age 55 to be able to play singles tennis and all those kinds of things. You don’t want to see yourself degrading if you will, and all those things you want to do. And I always joke if you lived your life backwards, you finally get the time when you can be out there playing and doing whatever and traveling, and you find your body giving out on you before you can do it. But back to your question, I’ve traveled to a lot of places outside the world had been really lucky to be able to lecture and be in those environments around the world. You know, it’s not fair to generalize probably, but you see people that have more deformity, they endure more pain before they get treatment, whether it’s because it’s not available. And it’s a vicious cycle. In some ways in the United States, we apply a lot of resources to creating an environment so that we can solve those problems as you were talking about. But I think that’s one of the answers. I don’t have a perfect answer for you. There are a lot of countries that do have niches though, within what we would now call the medical community, whether it’s drug development, the pharma industry, a lot of that happens outside of the United States, as you know, and a lot of computer assisted kinds of stuff happen in various places around the world as well. One of our divisions is in France that we’re works a lot on our computer assisted surgery happens to be an area in the South of France that does a lot of that kind of stuff. And it breeds itself. You have people that are working together, I think to do it well. It is a team sport and the United States creates a good playing field to use that analogy for engineers to both be trained and to be able to create careers in this area and do well at it. James Di Virgilio (15:48): Do you have a favorite project that you’ve worked on or creation or innovation, something that sticks out as like that one was really special. Gary Miller (15:57): You know I really don’t. I talk about that rod that I worked on at the very beginning, that was very, very rewarding for me. Let me twist it a little bit for you. One of the nicest things that I see, one of the most rewarding things for me as an engineer working in medicine is you get that feedback of how you’ve done. It was amazing to me with that first experience as a person that was debilitated on heavy drugs, couldn’t really walk. And it’s an end of life experience. It’s metastatic bone cancer, but their quality of life was really awful because of pain. And after doing the procedure that we had created, the orthopedic surgeons and I at the hospital would get up the next day, even though they had had a surgical procedure and say, Oh, wow, this is great. They were ready to go. Similarly, a person with really bad arthritis. They can’t get in and out of a chair to have to use the arms of a chair. One of the things I always kid around with some people is try getting up from a chair with no use of your hands. You have to have good knees to do that. And your hips have to be functioning really well. One of the nice things that we get to do in biomechanics in the field that I’ve spent my career in is seeing that patient walk out of the hospital or getting up that first day and say, well, I know it hurts because I had surgery, but it doesn’t hurt like it did before my surgery. That’s the measure that we have. There’s other areas of engineering that it’s much harder to get a read on the success of what you’ve done. I think that one of the things I’ve enjoyed so much working in medical devices and working in biomechanics over the years and being in a clinical situation, their research areas are all those things and not to dismiss those that I need as a person, you need the tools and the toolbox to be able to do all the things that we do. We need the materials. We need some of the understanding of design that are done in a laboratory setting. I’ve worked my career in applied biomechanics, if you will, or applied biomaterials where I get to use some of those early inventive steps to create a product or a device, if you will, that goes into a patient or is used to put something in a patient. And it’s been tremendously rewarding for me because as I said, if we can give a surgeon the opportunity to do that extra case, that’s one more patient. That’s gonna not have to endure pain for an extra day. It’s all about that patient outcome thing resonates with me. And I’ve been lucky to be able to spend so many years just being in that sandbox. James Di Virgilio (18:29): I’m hearing so much passion and excitement and joy for what you do. And I’m wondering after a full career of doing all these things, when you wake up each day, are you just as excited about solving problems today as you were 10, 15, 20, 30 years ago? Gary Miller (18:44): Yeah. I am. I don’t know if I can get there as fast and do it as quickly, but yes, it’s a terrifically rewarding area to be, and it’s what keeps me going for sure. James Di Virgilio (18:55): I think that’s true of people in general. You know, my belief and philosophy in life is that we’re here. We’re created to be here. We’re created to attempt to improve the world around us and your energy. As I’m sitting 10 feet away from you is palpable. You can feel the satisfaction and the drive that you have to improve the world around you. And that’s what creativity and innovation does. Let’s bring this down to the listener, whether they’re 15 or they’re 50, and talk about this idea of problem solving, how do you teach somebody to have not the same passion you do? Cause we’re all created differently in that regard, but to maybe view the world that way, Hey, maybe you too can see some problems and begin to think about solving them. Can this be taught? Are you born with this? What is this? Like? Gary Miller (19:35): Yes. And yes, the folks that are successful, I do think bring that intellectual curiosity with them. They don’t take things for granted about how’s it working, what it’s doing. And so I think that is innate. I think because there are people that are frustrated that they can’t sometimes I wish it was totally teachable because we could use more people inventing, right? If you use my basic thesis of improving life, however, to answer your question more specifically, very structured ways of looking at things that if you learn those techniques, that you can be better at it. I’ve been asked this by students before when I lecture. And one of the things I love to do is mentor at this stage. If somebody is willing to listen to you about your experiences and how you solved it, you end up transferring both the passion and the technique. So yours is a very good question. There’s structured ways of doing it and being creative there’s skills that you can learn. You look at a solution and say, what happens if you turn it upside down? What happens if it’s backwards? They’re ways of brainstorming is a catch phrase that some people use where you put every which way, think you could do it down on paper without judging whether it would work or not. And then manipulating those images of what you thought about. It works really good in a group setting that people throw stuff out on the table, if you will, and you’re not allowed to critique whether it would work or not. The whole idea is to generate the most ideas. So there are techniques. There have been a lot of books written about it. There have been a lot of books written about a lot of things. And how many books have been written about how to become a millionaire? How many people read the book and become a millionaire? I think the same applies here. I have been impressed though that the tools have gotten more powerful for us. I remember 40 years ago, it was a drafting table and a pencil and scale and compass and drawing stuff. And if you wanted to make four sizes, you had to make four different drawings and you sat there with your slide rule and or a tablet of paper and added all the numbers up fast forward to today. When there’s three D rendering of computer assisted design, and you can look at it on the screen and you can make it larger and smaller and you can take four pieces like their fourth five pieces in a given joint replacement, put them all together, see how they move together. Those are incredibly powerful tools. And then you decide, well, I want the smallest one to be this size and I want the largest one to be this size. And then you can do the scaling if you will. And the system, the computer helps you. I have to tell you, I have yet to be able to be good at computer assisted design, but I work with people that are just, they blow your mind away. You’ll say something about this idea you have, and they’ll walk in and say, how about looking at this on my tablet used to be a desk size computer. Now it’s on a tablet if you will. So we’ve gotten really good and powerful tools. Testing has matured dramatically. We can’t use the person as the experiment here, and you’ve gotta be able to do a lot of simulation testing. A lot of those kinds of things, which were very hard to do in the past now because of the computing power we have, we’re able to make simulators that run an implant for 50 million, 20 million to look for the endurance. How’s it behaving all those kinds of things. And you can do a lot of things simultaneously. So between CAD simulation and all those things, it’s a far cry from what it was many years ago, when you had to build a prototype and try to test it in some way in a laboratory. And then honestly, in those days, once we thought we had it pretty close, we’d start using it. And it would be used in patients that needed it the most so that the risk reward was there. Now we can do a lot more and we can do it much more quickly. We talked about earlier about the length of time that it takes to do a design when everything works well, 18 months is not out of the question sometimes because of the regulatory overhead that we have. It takes longer than that. But in years past, it could take five years, seven, eight years, and then you weren’t anywhere near as sure about what the outcome was going to be. As I think we are now, they’re less small steps, James Di Virgilio (24:01): Words of wisdom. So here you are decades of experience. I want you to imagine going back in time and having a conversation with your 20 something self, what are two things you would tell yourself back then? Here’s what I want you to anchor to. As you go forward and you have this career doing all these things, remember these two things, Gary Miller (24:20): Be sure to listen and to watch what’s going on. That would be number one for me. And number two would be, I know you’re going to be asked to learn a lot of things that you don’t think you’re going to need to learn. And all I can tell you is I’ve used almost everything that I was taught, except for super higher math. I’ve never liked partial differential equations, and I’ve never had to use them, but I’d mentioned the tools in the toolbox to you earlier. I would tell a person earlier in their career, learn as much as you can keep learning it, keep learning new things, because you’ll never know when you might need to use it. And I could cite examples over and over again of things. I never thought I would be in business. That engineering economics class looked like a waste of time to me. And it’s helped me those on the finance side that say, I still don’t know how to read a balance sheet. What can I tell you, James? But at least I know what I don’t know. And sometimes you need to know what you don’t know. James Di Virgilio (25:22): There’s a lot of wisdom there, especially if you look at being a lifelong learner, having no idea where your life will take you. And then as you mentioned, maybe one of the most important things that I hope listeners pull from. This is what we’ve talked about. Indirectly sometimes directly about this concept of communication language, if you will, and if you’ve traveled at all, you can relate to what it’s like to drop yourself. I went to Asia many years back and you drop in the middle of China or Japan, and no one speaks a word of your language and you don’t speak a word of their language and you both could be brilliant people. And you’re reduced to hand signals, right? And as you mentioned, you want to go from hand signals to fluency in whatever language you have, and you have no idea what language is you’ll pick up throughout your time, whether yours is a mixture of engineering and finance and classes you’ve taken or life experiences you have and how they will cross over down the road. That’s very wise. Gary Miller (26:13): Yeah. I have examples of that in my own life and career. What I love to tell traveling in Spain, I speak minimal Spanish. And at the time I spoke absolutely no Spanish and went to dinner with one of those creative orthopedic surgeons like I was telling you about. And both of us were so frustrated trying to speak through the one person at the table who spoke English and Spanish. And after about 10 minutes, we both had our pens out and you’re going to laugh at me, but we kept moving the glasses and the plates out of the way. And we started drawing on the tablecloth. And so the visual became our medium for communication. And you were teasing me about cemented hips there earlier. We went through his idea of a hip design on that tablecloth and two napkins, as I recall, and we got to the end and we understood what each of us was trying to say. And it came to a pretty nice solution in design that we were able to move forward on. The only embarrassing thing was in this very nice restaurant in Spain, we had to have them take the tablecloth and the napkins off the table and wrap them up and give them to us because it was before cell phones and the only way to transport all this work we had done for two and a half hours at a classic Spanish dinner was to take the table with us. So it’s a fond memory. Obviously for me, I bet a wonderful group of people all over the world. And it comes down yes to hand signals and drawing, drawing. The visual is really without language usually. James Di Virgilio (27:45): And that’s one of the greatest things about doing this podcast, talking with you today is that it’s people, it’s people like you. If you’re listening and it’s people like Gary, it’s people that have ideas and get together with other people that have ideas and those ideas become a reality, right? The things you’ve created, those were humans, creating the ideas and putting them into play. It wasn’t some magical process. It didn’t happen on its own. What you’ve learned what’s in your brain is valuable. Working with others valuable. One of my favorite economic examples is Milton Friedman. You can find this on the internet does like a two minute video on the pencil, the humble pencil, but the pencil comes from so many different places all over the world, which is what allows it to be so cheap nowadays. Right? But at one point in time, it wasn’t so cheap, even just getting led was difficult. And we’ve talked a lot about a lot of these things today. I always find it very encouraging when we’re talking to someone who’s created as many things as you have to hear that it really does come back to what do you know, what do other people know? How can you get together, work together, find solutions to problems that exist. It’s been absolutely great to have you. My guest today, Gary Miller, the co founder of Exactech, also a man of many other things. We can’t just label you as that. And also on the board for the Cade Museum. I would remiss, if I didn’t say that. So thank you for all of your support and also for your time today, we certainly loved having you on Radio Cade. Gary Miller (28:55): Well, thank you. It’s been an absolute pleasure. James Di Virgilio (28:58): For Radio Cade, I’m James Di Virgilio. Outro (29:01): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. This podcast episodes host was James Di Virgilio and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood Soundstage, and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinists, Jacob Lawson.

The fight for a cure to Parkinson’s Disease has been a decades-long battle, with several treatments evolving alongside the evolution of medicine as a practice. In this episode, host Richard Miles sits down with Dr. Michael Okun, the Chair of Neurology, and Professor and Executive Director of the Norman Fixel Institute for Neurological Diseases at the University of Florida College of Medicine. He is an expert on deep brain stimulation, and author of over 400 peer reviewed articles as well as the book Parkinson’s Treatment: 10 Secrets to a Happier Life. Here, Dr. Okun dispels myths surrounding Parkinson’s, talks about his research and clinical work, and discusses his involvement with several non-profits raising awareness on other conditions and diseases. “Every day that I practice medicine, I know less,” says Dr. Okun. “It’s a profession where you have to have a lot of humility. You have to have an open mind and things change over time.” TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade, a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. Parkinson’s Disease. What do we know about it? Why does it seem to be more common and how do we treat it? Welcome to Radio Cade. I’m your host Richard Miles today. I’m pleased to welcome Dr. Michael Okun the Chair of Neurology and Professor and Executive Director of the Norman Fixel Institute for Neurological Diseases at the University of Florida College of Medicine. Dr. Okun’s also an expert on deep brain stimulation and author of over 400 peer-reviewed articles, as well as the book “Parkinson’s Treatment: 10 Secrets to a Happier Life.” Welcome to Radio Cade, Dr. Okun. Dr. Michael Okun (01:11): My pleasure to be here, Richard. Richard Miles (01:12): So before we start, I have to mention you’re also a poet and that caught my eye mostly because I find myself in middle age becoming very interested in poetry, but only as a reader, not an actual poet. So I have to start, is this something you’ve always done or is it because being a brain doctor wasn’t challenging enough for you? What got you into poetry? Dr. Michael Okun (01:28): My original bent was in humanities, and I have a degree in history. And so, I love to write, and I love to try to express myself in different ways. I love poetry, because there’s a new precision towards, and I think that through poetry, you can express concepts using emotions and other modalities to reach your readers. And so, over the years I’ve done a number of poems, and I have an old book called “Lessons From the Bedside” and have done some writings in said time as well. Richard Miles (02:01): I love that analogy too, to the work that you do. Cause one of the things I have noticed in my very limited foray into studying poetry is precisely what you said, that the precision of the use of certain words versus not other words. And that reveals a lot of the thinking and so on. And I imagine studying medicine, there is some similarities there. Dr. Michael Okun (02:18): That’s right, and really keeping an open mind. And I am also a neurologist by training. And so I practice medicine and I say often that every day that I practice medicine, I know less. It’s a profession where you have to have a lot of humility. You have to have an open mind and things change over time. And we’re really like cabinet advisors to people. We’re here to help with the best information that we can, but we really shouldn’t be so prescriptive, and so sure of ourselves. And I think anybody, whether you’re an inventor, you’re a scientist, you’re a clinician or all of the above, will look back and say what I did five years ago, versus what I’m doing now, is different. And it might seem subtle because you lived it, but if you think in those terms, that’s, I think what I would term as wisdom and you realize that practice of medicine and the understanding of diseases evolves and that there’s not one solution for everyone. Richard Miles (03:15): That’s a great way of looking at it. And that really helps, I think, for what we’re about to talk about now, and that is you have developed, or you’re known as really one of the world’s experts on a technique to treat Parkinson’s. But before we get into the details of what that is and how it works, I’d like to talk more broadly about Parkinson’s itself, which is a disease that most people probably have heard of or know somebody with Parkinson’s, but they may not know exactly how it works and what are some of the underlying causes. And I noticed that a few years ago, you wrote a paper called “The Emerging Evidence of the Parkinson Pandemic,” which caught my eye, obviously because we’re in the midst of another pandemic. And so pandemics in general, I think are of higher interest to everyone. But in that paper, you said that neurological disorders are now the leading source of disability globally, and the fastest growing neurological disorder in the world is Parkinson’s disease. And you said that from 1990 to 2015, so about a quarter century time period, the number of people with Parkinson’s disease doubled to over 6 million. And finally your quote, “for most of human history, Parkinson has been a rare disorder, but various factors have now created” what you call Parkinson’s pandemic. There’s a lot there, but why don’t we start by briefly describing for listeners who are maybe not exactly sure how Parkinson’s differs from other types of neurological diseases. Define it for us. And then why don’t we spend some time talking about those various factors that have caused it apparently to go from a rare condition to pandemic-level proportions. Dr. Michael Okun (04:40): So first Parkinson’s Disease, it’s a neurological syndrome, and it comes with symptoms that people can readily detect. Oftentimes when you’re in a crowd, you see somebody might be shaking, they might be shuffling their feet, their handwriting might be small when they’re at the bank, and they may be struggling with some of these, what we call motor features and also what we call non-motor features. So it’s a brain disease that affect depression, anxiety, and quality of life. And it turns out that Parkinson’s Disease is not just a disease of dopamine. And so a lot of people believe that you lose dopamine in the brain and you get Parkinson’s, it’s actually degeneration of multiple circuits. I’ve spent my career studying the circuits and Parkinson and in other diseases. And when we think of Parkinson, I remember when I was at the White House in 2015, I was quoted as saying, “Parkinson is,” and I’m not the first person that said this and won’t be the last, “the most complex medical disorder period,” because there’s over 20 motor features and non-motor features. So tremor, stiffness, slowness, (and not everybody gets tremors and not everybody gets stiff necessarily, it could be different varieties) in depression, anxiety, sexual dysfunction, other issues too. And then you throw in dopamine replacement therapies, you throw in deep brain stimulation ,what you mentioned, and it’s something that we’ve been researching now for a few decades here at University of Florida with one of my partners, Kelly Foote, and Mendez and many other people in the laboratory. And so Parkinson’s Disease is a neurological disorder. It is rapidly expanding. And about eight years ago in the book, 10 Secrets to a Happier Life, in the prologue, I said: “Parkinson has all the same characteristics of a pandemic.” And that was very controversial at the time. That’s eight years ago. And our most recent book that just came out from Hatchette publishing, “Ending Parkinson’s Disease,” it was originally titled the Parkinson’s pandemic. The publisher changed the title, and they wished they could have that back because it came out in March, 2020. So, “pan” means “all” in Greek, “demos” means “people.” And when you apply the concepts of a pandemic, they can apply to other diseases. Although, I was just on a call with the World Health Organization last week, and I think it’s fair to keep the term pandemic reserved for infectious diseases. Although people should know that the rapid expansion, the geography, the people not being immune to it, it all applies to other diseases like Parkinson’s. Richard Miles (07:06): So tell us, what are some of the factors that researchers have uncovered, or maybe that you hypothesized are at work here that are causing it to grow, I’m guessing, dramatically on a per capita basis? Are there geographic differences, for instance, in range between different countries or different demographic groups? What is going on here, and what do you think is behind it? Dr. Michael Okun (07:25): So we just had a conference with our colleagues in Geneva, Switzerland at the World Health Organization that have taken this on. And there’s a working group of us from all different countries, from rich countries, from poor countries, from countries somewhere in the middle…Parkinson occurs in all of the above. Now, one of the myths of Parkinson is that it’s all due to aging. And so as you get older, you get a higher prevalence of Parkinson and that’s true. Now, many people might be surprised when I tell you in our waiting room, I see people in their teens, and twenties and thirties with Parkinson’s, and it becomes more of a common as you get older, but it doesn’t mean it can’t occur in young people, as well as people–I don’t say old people–I say more seasoned people. And it turns out that age, it’s a myth. Age is not the only thing that’s driving this increase. There is going to be a doubling of Parkinson between 1990 and 2015. That’s already happened. It’s going to double again from 2015 to 2040 and could collapse healthcare systems, cause lots of suffering if we don’t get out in front of it. And so there are other factors that are driving this. And one of the ones that we talked about in the latest book is about pesticides and chemicals and environmental factors, and how those factors and the industrialization of society and how that’s changed the game. Richard Miles (08:47): That’s fascinating. So let’s move on to, what are some of the treatments that are available? You mentioned deep brain stimulation that you and Dr. Foote and others have been working on for a couple of decades. What led you to that I guess, and tell us how it works and what sort of improvements that you see? Dr. Michael Okun (09:02): Back in the 1930s and 40s, there weren’t treatments for Parkinson’s and for other diseases of movement. Some of the early attempts were actually making holes in people’s minds and disrupting these abnormal conversations. So if we think of the brain as a group of islands and the islands are all talking to each other, if you disrupt the conversation, people discovered that this is a potential way to treat specific symptoms, depending on which circuit you disrupt that conversation. And as time evolved, we were able to modulate conversations by using medicines. And the first major medicine was introduced by George Cotzias in the 1960s, and that was dopamine replacement therapy. And that actually modulates, it changes the way the brain’s oscillations are moving, and everybody, whether you’re awake or you’re asleep, your brain is always oscillating. And when you have a disease, particularly in neurological disease, that oscillates in different ways. So surgeries came back; when we have better technology to get to very specific sub millimeter zones of the brain, we started burning out pieces of the brain and that’s what I did during my training. And then as we moved along, we began to understand how the different areas were talking to each other, and we develop what’s called neuromodulation, so sticking straws in, introducing electricity into those circuits, I’m trying to change the way that they would talk to each other. And so my mentor and one of Kelly Foote’s mentors who I work with is a man named Mahlon DeLong at Emory University. He’s retired now, but a tremendous human being, and he was the one that really spent years and years at the National Institute of Health, and then at Hopkins, and at Emory decoding what the circuits are. And in 2015, he received the Lasker Award, which is one of the highest awards in medicine, just under the Nobel, for this work. Richard Miles (10:50): Doctor, now that this is becoming more common and will become more common, walk us through what happens when, let’s say someone’s parent they’re 60, 65, 70 years old, they’re brought in to a doctor like you or a clinic somewhere, and they’re diagnosed with Parkinson’s. What are some of the first steps of treatment? And coming back to deep brain stimulation, is this a one and done type of treatment, or is this a continuous regimen of treatments over time? And then what does the outcome look like for, say, someone in their mid-fifties or early sixties? Dr. Michael Okun (11:20): So when we think about Parkinson’s Disease, the first thing we think about is when somebody comes in, we need to understand when you say those words, “you have Parkinson’s Disease,” it’s not the end of the world. Okay? There are a lot of different forms of Parkinson’s Disease. And I have folks in my practice I’ve taken care of for 20, 30, 40 years. Okay? So it’s important for us to dispel that myth. And as we dispel the myth and begin to deliver treatment, we recently wrote in the Lancer last week, a seminar on Parkinson’s Disease, 20 page-seminars, get your coffee if you want to read it. But we talk about, in that seminar, there’s a picture of when we started here at University of Florida, we had this concept of model for caring for the Parkinson person. And we said, the person’s the sun, and we should all orbit around the person and the family, because this is such a complex condition. And there are so many, you know, specialists; you need an archeologist, a neurosurgeon, neuropsychologist, PT, OT, and speech, or maybe you need a nutritionist, access to clinical trials… We have over a hundred clinical trials, it becomes confusing. And so, we need to integrate the care, and if we integrate the care into what we call a multidisciplinary team, we’ve learned that it isn’t just–I call myself the drug dealer as a neurologist. It isn’t just the drug dealer or the device dealer, where we take people to the operating room and put a device in that provides the best possible care. It’s this model of interdisciplinary care, and it continuously changes over time, and you have to actually listen to the people, so it’s a different specialty, and to actually listen to the clues that they give you on how they’re living in order to change timing and change doses. There’s over a dozen different medications, there’s all sorts of infusions, there’s deep brain stimulation. And I like to teach, and we have fellows here who, after they’re done with their neurology residency, spend two years with us to train in this, and we’ve trained about 70 of these were all over the world. And what I like to tell people is Parkinson is like a lifetime disease. Think of all these different therapies, and you need to understand how the disease evolves and when is the right window to apply each one. So deep brain stimulation isn’t for everyone at all times, but there are points in the treatment where it can provide extremely beneficial effects on things like just suppressing tremor or movements we call dyskinesia. And so knowing the disease and knowing the person, and then creating the right multidisciplinary plan is important. And the last point is, we wrote something for the Journal of the American Medical Association last year with Melissa Armstrong here at UF. And we, as experts said, a first-line therapy now is exercise. We now recognize that exercise is so beneficial for this disease, that it’s now considered a first-line therapy, right along with the medications. And so that should tell you something about the humility of treating this disease for so many years and us understanding what’s good for folks and what’s not. Richard Miles (14:18): If we compare this to a disease like cancer, is Parkinson’s something that could actually be put into remission, or is this a steadily degenerative disease? All the treatments are just slowing down or resting that trajectory, but essentially it’s going down, or can you stabilize somebody for a decade, for instance, with no decline? How does that compare to something like cancer? Dr. Michael Okun (14:37): Parkinson’s is a progressive neurodegenerative disorder. Now there are multiple what we call phenotypes. So we have what some people call benign Parkinson, because it progresses so slowly. And then there are other forms that progress faster. We’re just beginning–it’s like Genesis of the Bible–we’re just the in first couple of days in understanding actually the differences between some of these entities, but it is progressive. Now people might say, well, tell me, how did Pope John Paul get anointed as a Saint, right? Didn’t he cure a nun of Parkinson disease, and that’s how he achieved sainthood. Well, we’d like to leave that story alone because it turns out that many people who are presumed to have Parkinson’s disease do not. And so if you get better then you may not have Parkinson’s, and then there’s a group of people who have tremors and other symptoms that look like Parkinson’s. About 10%, about one in 10, very early on, when you first see them, then never progress. And a lot of times people don’t go back and realize, wait, this person’s not progressing at all — hey actually don’t have Parkinson, they have something else that’s more benign. And we realized that, and we gave this crazy name to that called scans without evidence of dopaminergic denervation. I would never call a person a sweat, that’s what it stands for. But, if you’re not progressing, you may not have Parkinson’s. And sometimes early on the diagnosis can be made in the wrong direction as well. And so it’s very important, but when you do have Parkinson right now, it’s progressive. Now we are searching for things that will slow the disease down and, or provide precision medicine or other treatments for it, but we haven’t gotten there yet. Richard Miles (16:15): So let me come back to something you just said about perhaps a faulty diagnosis. It sounds like the ideal treatment or regimen of treatment is this interdisciplinary approach, which you’ve got multiple people looking at it and working on it from different angles for a patient, but I’m guessing that that level of complexity of care is not available to everyone. Do you have to be next to, say a major research hospital, like University of Florida, or some major metropolitan area to get that kind of care? And if you’re not, and you’re in a rural area or in a very poor country, for instance, what is the outlook for somebody in their mid-sixties? Dr. Michael Okun (16:44): So in general, if you can get access to one of these multidisciplinary teams, it’s better. We know from Medicare data done by Allison Willis, who is at the University of Pennsylvania, that if you have access to even a neurologist, and most people don’t actually see a neurologist, if you have access to a neurologist, your morbidity and mortality, your nursing home placement, all of those things that are super important, those numbers get better. Just having access. If you have access to multidisciplinary care, the data is beginning to point that this is also better. There are centers of excellence that have been set up through foundations, ike I work as a medical advisor and former medical director for the Parkinson Foundation. We have 47 centers all over the globe, but these aren’t widely available to people. What we do at the University of Florida is we see people from all over the world, we always have, and we try to construct plans for them, so these plans can be carried out by people within local zip codes, whether your local zip code is in Australia or Asia, or you have flown in to be seen, you know, from there where we set the plans, and then we ask the therapists to follow them out. Beause a lot of therapists and other members of a multidisciplinary team, they may be giving you the wrong therapy. And sometimes the wrong therapy, Richard, is worse than no therapy in a disease like this. And so setting the right plans, communicating and creating public health value is important. And one of the three things, we just had a campaign it’s still ongoing called the Give a Dime for Parkinson’s Disease campaign, and our first goal was to get to 10,000 red cards to the White House. We’ve now reached 25,000. One of the three points, while we asked for three things– because if you ask for too many people get distracted–we’re asking the White House and congressional members to consider as one of the three things is to maintain telehealth access for people in the United States. That didn’t happen before COVID-19, and many people don’t realize that that’s not permanent. That has to be made permanent, and then we have to develop these types of interdisciplinary models, so that people who don’t have access or don’t live right next door can still get access and the right advice, and then put the right team together, so they can have the best outcomes. The best outcomes mean less falls, less fractures, billions of dollars in healthcare savings, happier people. And so I think it’s in everybody’s best interest, particularly as the disease has exploded. Richard Miles (19:06): And Dr. Okun, In addition to your research and your clinical work, I know you are involved in at least several nonprofits that I know of, probably more. Tell us a little bit about what you’re doing in those areas, like Tyler’s Hope and so on, and what has been the response as you’re trying to raise awareness on some of these conditions or diseases that are not as well known. Dr. Michael Okun (19:23): Yeah. So I think when you look at other diseases and what they’ve done to change the trajectory, the story of polio, the story of HIV, and in HIV, it took what we call four pillars to do that. So you have to develop a system with any of these nonprofits for any of these really important diseases that are going to affect society. P is for prevent, A is for advocate, C is for care, and T is for developing new treatments through research. We call it the PACT. So when we went and we researched, we said, what do you need to do? So we need to get all of our non-for-profits together and we need to organize and sum our voices, and reach that inflection point where we can become loud enough. We can advocate with enough force to actually push change. And that’s what happened in HIV. For example, they went from a few hundred million in funding to 3 billion, a year in funding. And now HIV, when I was an intern, my first year out of medical school, 25 years ago, this was a bad word to be on. If you have HIV, it was kind of the death word, and it was really not great. And now, it’s a chronic livable condition, the trajectory has changed for literally tens of thousands, if not more people, worldwide. And there’s a reason why that happened: prevent, advocate, care, and treat them. And advocacy was huge. And so I’m a big believer in non-for-profits and even more than opening the checkbook and writing the check, getting involved. And I’m a believer that when you sum voices together, if you can get to a certain level–and nobody knows exactly what that is, maybe we can ask them out loud while our tipping point lives through these things. But there is a moment where things tip. And so one of the things in Perkinson, for example, we’re trying to tip, one of the three things we’re asking for us increase the funding from 200 million to 2 billion a year, by 10 times, because we know that if you increase it by two times, you’re going to get twice as much research, twice as many young researchers. And so this is going to have a multiplicative effect. When it comes for Tyler’s Hope for just only a cure, here, this is a disease where we know the deletion. We know where it lives. We know quite a bit about it. We have a lot of technology, we just need to, sum our voices, push more money into this, and that’s what Tyler’s Hope is doing, push the advocacy, and we can create a precision medicine treatment. And I think we’re on our way and that disease as well, there’s still a way to go, but the same for Tourette. So I’ve been in the tourette world with a non-for-profit called the Tourette Association of America. So I think the story is the same, but I think part of the formula to reach impact is you have to bring together globally voices. And when we were speaking with World Health Organization, there were representatives from all countries talking about Parkinson and creating that grassroots movement. And we have a grassroots movement called the PD Avengers on Twitter. Now there’s 3000, like really loud, obnoxious people on one of them that are really making a lot of noise. And that’s what we need. We don’t need to be polite anymore. We need to be aggressive and charismatic and a bit obnoxious for these diseases. Richard Miles (22:26): I like how you put that and, as a comment, as an aside, I spent a good portion of my career overseas. And one thing that non-Americans are amazed by is the level for nonprofit activity that we have in the United States, directed towards all sorts of things, but in particular medicine or health, and the vibrancy of that sector really is something almost distinctly American. They obviously exist in other countries, but not nearly at the level and scope of what you see all over the place in small towns, big towns, and so on. Dr. Michael Okun (22:53): It’s a very special thing. And you’re absolutely right. I’ve done outreach to other countries. And I, I won’t say which country I was in, we actually brought some devices in and probably could have been arrested for doing that. And we were helping the doctors with some devices and some implants. And we were out seeing people all over, who just needed help. And it struck me in that experience, and I’ve seen it in other countries as well, that we helped a woman, and then they invited us to dinner, and we realized that, Oh my God, this woman that we helped is the mother of somebody huge in the country that has these huge business interests all over the country. And we said, why don’t you give a whole bunch of money to Parkinson’s disease? And they said, “give money to Parkinson disease? We don’t give money. This is an American thing.” You know, too, we’re having this discussion. “You all give away your money. We don’t do that. We don’t do charity.” And I thought, wow, it is really something special. And, and then I think they felt a little bit embarrassed. And then they said, well, we do give charity. But the charity we give is we support our sports teams. And so we explained to them, well, that’s not exactly charity. And so I do think that it is a uniquely American thing. It’s one of the things that differentiates us, makes us stronger and gives us the potential to mobilize and galvanize against diseases and other issues that face society. Richard Miles (24:12): And it’s also a perfect way to mediate between the individual who alone can’t do much, and the government, which often has a lot of resources, but is not terribly efficient in how it distributes them, so it creates this whole layer between small groups and very large governments. Dr. Okun, one final question or a couple of questions actually. At the Cade Museum, we like to not just tell a story of inventions, but the inventors, and not just the story of technology, but the researchers behind the technology. So tell us a little bit about pre-professional Michael Okun: what were you like as a kid? Did you know, early on you wanted to be a doctor or a researcher? What were some of your early influences? Dr. Michael Okun (24:48): Yeah, so I had it pretty good as a kid. I grew up with a good house. I had two parents. My father was a dentist, my mother was teacher. And so I kind of got left brain, right brain. They had very different ways of looking at the world. I was always memorizing things like the backs of baseball cards, statistics, things like that. And my life I’ve always had a joy. I’ve always been a person that’s had pure joy to be part of things. And so for me, a lot of my joy was in reading history and humanities and things like that. And so I saw myself more as a teacher and a teacher of history and even going into medicine for me, I saw myself as a black bag family practice doc. But what happened to me was life as a journey. And it’s like a lot of Chinese philosophers say, Lu Zhen is a famous Chinese philosopher who talks about roads, and there are no roads, and when there are no roads, a road is formed because people walk on that road. And so you walk your journey and you take your opportunities. And sometimes you don’t know exactly what you’re interested in or not interested in. And so even when I ended up saying, I want to go to medical school now and try to help people in underserved communities, I couldn’t tell you the difference between a neurologist and neurosurgeon you know, at that point in my life, and you just keep walking the road, and it turns out I’ve always been fascinated by people with tremors and movements and saying why. And I said, I would never do research. I’m a teacher. I would never do research. And then I realized that the government will give you a whole bunch of money to study things that you’re super passionate about that can help people. And so I was super passionate about figuring out where in the brain ticks came from. And so I’ve spent 20 years working on that problem, and we’ve developed devices, systems and things to try to address that problem, same with Parkinson and tremors and certain movements and funny walks. And so I’ve always been fascinated by that. I think the secret is, you find your passion, you spend as many minutes as you can doing your passion. And if you can get somebody to actually pay you to do it, then that’s the bonus, but the bonus doesn’t always happen. And I think in my life, all of those things have aligned and I have great joy every day that I come to work ,every day that we go to the operating room, Kelly and I, I have great joy. We’re always thinking, we’re always innovating. And we consider our labs a continuous beta test. We’re always writing papers. We’re always thinking about stuff. Now, one thing we’re not for people that are listening to this podcast, we’re not like business entrepreneurs. So we patented a whole bunch of different things: how you do a cap on this, how you do reporting on that, how a device would do this, how one side might turn this side on. And, we get involved with all of these things–vaccines–but our job is we just keep innovating, and then we hand that over to someone else and innovations square and let other people run with it, because our passion and our impact is trying to help as many people as we can. And so there are various different aspects to the creativity process, to the invention and the innovation process. And we have kind of a human laboratory, you know, in the operating room and in the clinics and in seeing people and they tell us what the problems are and we try to innovate for them. And the next steps happen as we try to create that, we try to write it down. Remember I like to write poetry and other things. We try to write it down and tell people what we did, and then the next steps will happen. So there is this beautiful process of innovation that happens, and there are a lot of people that quietly do that in the background like Kelly Foote and groups here that are just quietly doing their jobs, writing down what they’re doing, and then letting other people take it to the next level and commercialize these things and make sure that they get out there to help people. And there’s a great quote, I think it was Jonas Salk who they said, are you going to patent polio vaccine? And he said, well, that would be like patenting the sun. And so we’re all into patents and innovations and everything. But at the end of the day, we have a certain amount of minutes on the planet, and if we can come up with innovations that are going to help and impact people’s lives, I think that’s what most of the people, at least on the medical disease side of innovation, are interested in. And so you asked me what my message would be for kids or young people would just be follow your road, spend as many minutes doing the passion that you can, impact as many lives as you can. Don’t worry about the money. Don’t worry about that. Just worry about how much joy you have in your heart. That’s all you need to do. Richard Miles (29:14): That’s a great answer. And whether intentionally or not, you summarized also a good chunk of the origin story of the Cade Museum and Dr. Robert Cade, who invented as you know, Gatorade, because he didn’t have any idea how to take that product to market. He liked to write poetry. He had just a real joy in life for helping others and to his final day, he and his co-inventors, the number one thing they were proudest about, about Gatorade, was the fact that it became the cheapest and most widely available treatment for infant diarrhea in the third world. Wasn’t intended to do that, but that’s what they are really the proudest to have, not that it became a culture or a sports icon. And so it’s nice to hear you say that, but just in different words. Dr. Michael Okun (29:50): I think it’s a great story, and one I hope kids are listening to, but so many people will give you advice about your career and everything, and I think they make it more complicated than it needs to be. Richard Miles (30:01): You precluded my last question, was what would your career advice be? And you just gave it to me anyway, but it’s great advice and really appreciate having you on the show. You’re doing tremendous work, keep doing it. It’s inspiration on all sorts of different levels and wish you the best of luck. Dr. Michael Okun (30:13): It’s my pleasure, and we love the Cade Museum. We talked about being involved in non-for-profits, my wife and I are involved in, and we think it’s just a great thing for not only this community, but for the world. So thanks for all you do. Outro (30:25): Thank you. Radio Cade is produced by the Cade museum for creativity and invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie, Tom coordinates, inventor interviews, podcasts are recorded at Heartwood, soundstage and edited and mixed by Bob McPeak. The radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

How do you measure the performance of people whose achievements are hard to measure? Building on the work of Harold Fethe, Jeff Lyons founded MindSolve, a company that developed a technology which made employee evaluations more accurate and more reliable. The company did well and was sold, and Jeff made the challenging transition from founder to employee. A self-described “nerd,” Jeff as a kid used to secretly reprogram Tandy computers at the Radio Shack in the Jacksonville mall. He said “not a lot of planning was involved” in his career, “it was more “just being open to stuff and people who say, ‘come solve this problem for me.” *This episode was originally released on August 14, 2019.* TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida, the museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. Richard Miles (00:38): I’m going to call HR if you work for any size company, that sentence has the appeal of I’m going to tell your mom, but it turns out HR has a fun, sexy side. I’m your host, Richard Miles and today we will be talking about how much fun it is with Jeff Lyons, founder of a company called MindSolve and currently the Senior Vice President of Global Professional Services at Sum Total, welcome to the show, Jeff. Jeff Lyons (01:00): Thanks, Richard. Excited to be here. Richard Miles (01:02): So Jeff, when I look up fun and sexy in the dictionary, there’s a picture of you, right? Jeff Lyons (01:05): Definitely. And HR as well. Richard Miles (01:08): I also forgot to mention actually the pinnacle of your professional career has been serving as a board member on the Cade Museum, right? It’s pretty much downhill from here. Jeff Lyons (01:16): Yes, thank you. Richard Miles (01:17): And normally we’re talking about topics that are unfamiliar to a lot of people, advanced medical technologies, engineering marvels, that sort of stuff. Today, we’ll be talking about something that actually most people understand pretty well, performance evaluations, training skills management, but let’s talk about first of all, how those things in an organization can be a problem or at least what was the problem you saw in organizational process and what was the solution that you came up with? Jeff Lyons (01:43): So the first thing I should say is that the core technology that MindSolve took to market was not something that I came up with or, or that the folks at MindSolve really came up with. It was the brainchild of a guy named Harold Fethy who ran the HR function at a pharmaceutical research firm in Palo Alto. And so what was interesting was the problem, there was a unique, because he’s trying to do performance assessment with a company full of PhDs that are going to argue with any kind of measurement model or metric or calculation you can put in front of them. Richard Miles (02:12): What year are we talking about Jeff roughly? Jeff Lyons (02:14): This was 95, 96. Um, so sort of just prior to the founding of MindSolve, and so it was an idea that Harold had, and then we help develop the technology and then licensed to take that to market. Richard Miles (02:25): So what is the problem in principle that you were trying to solve? Jeff Lyons (02:29): So the main problem is how do we evaluate employee performance in a way that’s relevant and in a way that has a lot of quality in the data where you can make solid decisions on it, but in a way that’s also easy. Performance appraisal, as you said, everybody’s familiar with it, universally, everybody hates it. It doesn’t matter what you do. You’re never the popular guy walking into the building when it’s performance, appraisal time. But I think we actually did come up with a way to make it pretty sexy and pretty easy and at Aliza because they had a very high bar for data quality and for a robust measurement metric behind everything that was challenging to do in a way that was fun and easy. And Harold had an idea of doing a visual ranking. And I hope talking with my hands on the podcast that comes through, you could describe this to our listeners, but a way of doing just a very simple drag and drop stack ranking on a screen and took Aliza from a process that had very high data quality and was well-respected, but was miserable and onerous and people would do over the weekend with a case of beer and complain about it to something that people were finishing very quickly on time. Not only felt good about the validity, but it was easy to do, and that helped also make it well received. And so that translated very well to a broader audience, that wasn’t a company full of PhDs. And that’s what helped grow the company. Richard Miles (03:45): Instead of a long series of questions, for instance, like, is this employee good at X, Y, and Z, it would be more of a graphical interface or? Jeff Lyons (03:53): Exactly. So what else it was coming from was an idea called paired comparison, which has a lot of data validity. And you build up a data model by comparing A to B and then B to C and then C to A, and kind of making these one by one paired comparisons. And so the psychometrics behind that are great, but people are pretty skeptical and it’s a hugely painful exercise. Normal performance appraisal looks at every employee one at a time. And you just do like a one to five ranking on a bunch of questions and people try to make it better by asking more questions. And there’s a lot of counterintuitive stuff. You get better data up until about eight or nine factors or questions after that, your data quality drops way, way off. The more questions you ask because people get tired of it and they just start Christmas treeing. So this was a way, instead of doing each employee one at a time, we would take your whole team, put them on screen and say, let’s talk about communication skill, put your best communicator at the top, worst communicater at the bottom, kind of rank people in there. And then we’ll look at decision making and self management. And we ended up with about five criteria for most employees. And I think we added two or three extra for managers. So it was very simple, very fast, but we did a lot of work to look at the data quality and we ended up with very, very good decision quality coming out of the exercise. Richard Miles (05:05): That’s fascinating. I wish they had had that when I was in the federal government, which is probably the worst possible example for performance evaluations. But I remember in the army, they had a problem with the officer evaluations and that there were really only two types of officer evaluations. One, your the next Dwight D. Eisenhower and you should be promoted immediately. And the other one is you’re basically a trader to your country and you should be taken out shot. There’s nothing in between. And then the way the army saw that problem is it sounds like something similar. What they started doing is they started putting, I think they called it a diamond and it was after you’d gone through all this verbiage of how wonderful this person was. You were forced to say, well, this person is among the top 5% of officers I’ve ever commanded and so on. And the second and third tier, but then they would add a reality check and that you could then check what your average was. So you kind of knew that this raider was full of it because he gave everybody top diamond or whatever. It’s something like that. Is this something similar in principle to where you’re sort of forcing an accountability so that you can’t just go on and on about somebody’s qualities without comparing them to something? That that kind of it in principle? Jeff Lyons (06:10): You’ve hit on a lot of really, really dense stuff. There’s a lot of psychometrics wrapped up in what you just said. So the first is, yeah, if you evaluate people on a 10 point scale, you might have one person who rates his employees, all eights, nines, and tens, and then you have another person, especially in a room full of PhDs. Who’s just much more critical. Nobody’s perfect. And he rates all his employees five, six, seven, right? So the best guys getting a seven versus the best guy getting a nine. And when you want to make a decision across a broad organization, that’s not really fair. So the first thing that we did was we had to normalize that data. So, you essentially come up with a percentile. So what’s my number one compared to your number one. And we were doing multi-raider assessments. So it wasn’t just a manager evaluation.There were peer evaluations, direct reports would evaluate managers. And so you ended up with a lot of different perspectives about a single person’s performance and backing up for a second. When we took the data, we worked with a couple of really great people on the data model. And one of them, they had the advantage of being in Palo Alto is one of Harold’s close friends is a guy named Brad Ephron who was head of Stanford statistics department at the time, and a MacArthur fellow studying small datasets statistics, which is exactly what we had, right? So we’ve got not classic statistics, but five or six or seven ratings about an individual from a lot of different people. So he worked with us to say first normalize the data average that, and what we found was the absolute rating matters, right? A 3 out of 10 is not as good as a 9 out of 10, but the relative does as well. And what, having multiple people on screen at the same time does use your thinking, not just about what is decision making, but you’re thinking, how does Richard make decisions? And I can benchmark that against how does Jeff make decisions? And it helps me as a evaluator ground, something in reality and make better decisions. And there’s also an element of fairness to it. And then you mentioned kind of this idea that we would call like a forced distribution. Like if everybody fits into a bell curve, you can’t have all tens, you can’t have all ones. Where we ended up after lots of trial and error and back and forth and working with people is that it would be invalid to look at a large group of folks and not make decisions about who you’re starting five are, and who’s going to be cut from the team, right? You’ve got to be able to make those hard decisions in any organization. And it’s difficult because people say, well, we only hire A’s, everybody’s an A, but then you can’t get anything done if you’re not able to make those decisions, but we would not force a ranking. You could tie people, you didn’t necessarily have to fit percentages into those sections of the diamond, but you also couldn’t be flat. And what we would do is provide reports back to show where there wasn’t good differentiation in the ratings and go ask the question and you will get situations where we put our starting five all with this manager. So they’re all going to get high ratings or vice versa, but it was pretty rare. And you could look at the data and at least ask the question of, are we making a good, valid decision? Richard Miles (08:57): So you started out trying to solve the problem, or at least make more efficient performance evaluations, but then the company MindSolve that you originally founded, started doing other things, right? Like skills training and other types of management process. Can you describe, or the evolution from going to the performance evaluations to the other function. Jeff Lyons (09:14): Yeah, absolutely. What got us into more things was that we licensed that technology back from the company we built it for and started selling it to other companies. And what happens, I think this is true of almost any startup situation is if you go in and you help someone solve problems, they turn out to have a lot of problems and are struggled to solve them. And so they end up giving you more work. So if you look in HR, there’s a bunch of different functions. There’s performance, appraisal, there’s compensation, succession planning, learning, and development. And so you do good work here and they say, well, now we want to push that data into our comp process. For example, we use Excel spreadsheets, it’s miserable. We need to automate it. Can you help us automate that and just tie it right in that was the first sort of adjacent space we went into and then kind of worked our way around the wheel of HR. As customers started asking us to do more stuff. So we really grew in a direction dictated by our customers or requested by our customers. Richard Miles (10:07): Is there an optimal size of company that’s sort of like your ideal client for whom this is the most useful? Is it relatively small companies that for them you’re taking a huge burden in terms of HR off of their shoulders, or is this ideal for our company of say a thousand employees or more? Jeff Lyons (10:24): I think there’s a better ROI larger. And we used to talk about, if you’ve got 10 employees, you can kind of sit around a table and do this. Richard Miles (10:31): And rank them one through 10. Jeff Lyons (10:32): Yeah, it’s pretty straight forward, and everybody knows everybody. And the value of automation is greater when there, the data gets so big, you just can’t manage it. Compensation is a great example. People would send Excel spreadsheets out to every manager in the company, pull those back together, copy paste. It was a huge just labor problem. If you only have a few dozen employees, anything about maybe a hundred and fewer, is pretty easy to do, above that it gets very difficult. Richard Miles (10:58): And so some guy or gal spend their entire day just trying to figure out what everyone should get paid. Jeff Lyons (11:02): Yes. Every case that they’re tested around for everybody versus real time, everybody’s kind of in the same data. Richard Miles (11:10): Now, you have had as an entrepreneur being in that field, sort of one of those experiences that is both, I guess, a Mark of success, but also a challenge. And that is a company that you helped found, MindSolve became acquired by another company or sold. And then you became an employee for that company. So you’re making the transition from being the top guy to being a guy who probably has to fix a lot more your own coffee and that sort of stuff, right? So tell us, what’s that like mentally or professionally, how do you make that transition from being the person who started something to being the person who is at work. Jeff Lyons (11:41): I feel like I should lay down on a couch for this part of this session, that you’re, there’s a lot of scar tissue, your brain, Richard Miles (11:47): I just started my clock. I am billing you for this job. Jeff Lyons (11:51): Well, first I’ll correct. You going a bigger organization was nice because then you actually had people who would help with administrative stuff. At a small startup we were making our own coffee, we would draw straws on who got to clean the bathroom. You know, the biggest thing though, was the change in the level of control that you have. That was hard. But I think as we got closer to our acquisition, I was really becoming aware of our limitations, which is a really polished way of saying I had no clue what I was doing. And so we had kind of maxed out what we could do with the organization. We needed more funding. We had bootstrapped the organization, meaning just grown out of revenue. We weren’t burning through a ton of VC money, but we also a couple of guys straight out of college who had no idea about enterprise software. And so we really didn’t know how to sell well. And we had kind of maxed out the organic growth model. So I was actually very excited about talking to people who I thought knew how to run an air quotes, real company. There were definitely a lot of frustrations. Things move so much slower. I was not very politically astute at MindSolve our, our decision making model was yell at each other until somebody gave up and that did not serve me well as part of a bigger organization. And then I came to find out that, Richard Miles (12:58): So you’re really a consultant is what you’re telling me. You just tell other people to yell at you. And it sounds like a title of a great book or, you know, yell until you win right? Jeff Lyons (13:06): It’s probably a best seller, but it’s not a very good model. I’ve gotten definitely better models since then. But no, I think we definitely learned a lot post acquisition about the corporate world, how to sell to that world. Surprisingly, there were a lot of things we lucked into doing better at MindSolve. Then we’re done at the big publicly traded company that we went into. And we found that after a few years, that company was acquired by a private equity firm who was extremely focused on operational efficiency. And we looked at massive changes to how we approached management. So that was a big learning curve. Richard Miles (13:39): One thing that a lot of people talk about is AI, artificial intelligence and it’s going to take everyone’s job, right? Is this a sector loosely described as you, you weren’t consultants, but basically you are helping businesses do their business better, and by making the HR process across the board more efficient, is this something that you could write into a code, right? Where basically you’ve now got an automated way to swart and judge employees and give them training and so on. So is this in any way going to be, or is it already being affected by AI? Jeff Lyons (14:10): It is, at some total and it’s Skillsoft we have AI built into our code now and I think it’s an amazing tool. I think it can help you, but I don’t see it really replacing management judgment strategy, things like that. A good example is we use AI to look at, what do I know about you? What do I know about folks who are similar? And we can recommend, for example, developmental training, that’s better for you than if you just did a random search and found 200 courses on management communication. We’ll find the one that’s most relevant to you, almost like an Amazon matching, but there’s limits to that. As you know, you go into Amazon and you’ve bought a bathtub. Amazon thinks you want to buy five more bathtubs in the next week. It makes no sense, right? So there are those kinds limitations. Richard Miles (14:52): I stop at three bathtubs. I never buy that forth bathtub.So we’re not at a point where you ask Alexa what the weather is and she says, Jeff you’re fired, right? We’re not there yet right? Jeff Lyons (15:02): I don’t think so. And I think there’s cultural hurdles to that as well. People want a human safety net on that stuff. I think the technology can get you closer to a small set of decisions with good data to help you make a decision. But I think unless it’s just sort of a repeatable cookie cutter, kind of a problem, I don’t see AI solving a what’s best for the company. Richard Miles (15:23): And it seems to be the consensus on AI is that it will take away some jobs, but it really just helps people do their existing job better because it cuts out some of that mundane data gathering, I guess, or sorting. Right? Jeff Lyons (15:34): You know, I think people never ask the question of what new jobs is AI going to create. Right. And people think, Oh, well it’s just coding AI. It’s not that at all. What we saw with our technology is HR is spending 90% of their time on tactical logistical, moving data around not really adding value stuff. And when we can automate that, it frees up their time to do interesting things right? Drive the strategy of the business, which then creates more work and more growth and all of that. We never really downsized HR because we automated part of what they did. We freed up their time to add more value, to do more things. Richard Miles (16:06): So Jeff, now we sort of shift to the best part of the show and the one most likely to get subpoenaed in a few years. And that is what were you like as a kid, where you smart, curious, are you just someone whose parents drop them off at the mall as fast as they could, you know? And your a Jacksonville boy as well, so tell us a little bit about growing up in Jacksonville. What were you like? What did you do? That sort of thing? Jeff Lyons (16:25): I was a nerd that kind of sums up most of it. Richard Miles (16:28): It’s amazing how many Radio Cade guests describe themselves as nerds, it’s gotta be over 90%. So we’re doing something wrong here. I don’t know. Jeff Lyons (16:33): You’re definitely hiring to a profile. Look that just cuts out about 20 minutes of description right? Um, I was not at all athletic, I was super uncoordinated. I liked to do a lot of different creative stuff, all the normal nerd things in terms of reading and movies and watching Star Trek and I never really got big into the Star Trek versus Star Wars debate. I was more of, we can like everybody, Richard Miles (16:58): We can all get along here, we can. Jeff Lyons (17:00): Yeah, exactly, always did well in school to spite myself. I never applied myself at all until I got to college. Richard Miles (17:07): So you’re a little bit younger than I am. What was the cutting edge technology when you were say in ninth grade, what was the thing that everyone was talking about? Can you remember, or that you just had to have. Jeff Lyons (17:17): This is horrible. What we used to do was go to the Radio Shack in the mall and they would have their Tandy computer sitting out there and you could walk up and immediately just interrupt it and write little basic programs to scroll words at random, across the screen and do stupid stuff like that. Richard Miles (17:30): So Radio Shack, Tandy computers, maybe you are as old as I am. You just look, younger. Jeff Lyons (17:36): Keyboard built right into the monitor. You know, that kind of thing. I mean, that was just when Atari was coming out and Kaliko Vision and, and television and all that stuff. So that was kind of the hot stuff we wanted with just the home video games. We would spend all our time at the mall, arcade, Richard Miles (17:52): Re-programming. Okay. Was there a certain point in your childhood or later in high school where the idea of going into business of some sort of, kind of entrepreneur appealed to you? Or did you think about it? Did you have your own business? Did you know lawn business or whatever in high school, or did that come later? Jeff Lyons (18:07): I always worked. I was cutting yards when I was young. I worked through high school at a shoe store. That’s a nice embarrassing podcast we can save for later time. But I was never, I need to go start a business or dream of being an entrepreneur. It was more, I needed money. Richard Miles (18:22): So it’s a fine motivator. It works for a lot of people. Jeff Lyons (18:27): It went from, you know, wanting to be able to play video games at the mall to wanting to buy beer. There are always staples of life that I needed. No, it was more about that. And I think that’s one thing that served me well, it’s always had a decent work ethic. I was never afraid of working late. Richard Miles (18:41): Now you come from a family of engineers. Correct? Your father is a civil engineer. Right? And you have a couple of siblings that are engineers? Jeff Lyons (18:47): I have an older brother who yeah designs subdivisions. Richard Miles (18:51): Alright. But your degree was in, what? Was it software engineering? Jeff Lyons (18:55): No, my degree was in mechanical engineering. So back to your question of wanting to start a business, now, I thought I’d go into engineering and I used that approximately zero days after graduation. Richard Miles (19:07): So you graduate your mechanical engineering degree and what did you do? Jeff Lyons (19:09): Well, I was working part time for some folks in Gainesville doing software development. That’s what got me into software and then when, Richard Miles (19:15): Again, what year are we talking about here? Jeff Lyons (19:17): I started working with them in 90 and I graduated in 94. Richard Miles (19:22): So software was still kind of in its infancy in terms of, Jeff Lyons (19:25): Very much so.Yeah. I mean, we were writing really rudimentary code, but also doing really neat stuff. We doing three dimensional models and walkthroughs of, of hotel ballrooms, really, really neat stuff. And when I graduated, we had been developing some software that we decided to take to market. So that was kind of the first startup pre MindSolve, which was a big failure, but fun. And so I had this offer to come be employee number two, working out of a defunct dentist office in Gainesville. And my other offer was a company that was in the fortune one at the time. And so, uh, those were the two ends of the bell curve. And I said, well, I’ll go give this a shot. And if it doesn’t work out after a year, I can go back to being an engineer. And I did that these little one year, i’ll just give it one more year for quite a while and that led to today, basically. Yeah, so that was the last time I got a job was straight out of college. Richard Miles (20:17): Okay. Well, I hope you’ve worked on your resume recently. Jeff Lyons (20:21): Yeah. There was not a lot of planning involved or this was not a, this is what I want to do with my life. There was a lot of being open to stuff and working really hard and people going, Hey, come solve this problem for me. Richard Miles (20:31): Well, so that’s kind of a nice segue into my next question is asking you your words of wisdom and maybe you don’t have any words of wisdom, Jeff, I don’t know, but most people do or they make it up on the spot, but let’s say you magically encounter that the 22 year old version of Jeff Lyons, probably in the arcade at the video games, what would you say? What would you tell him aside from always wipe off the fingerprints, what would you say to that person? Jeff Lyons (20:53): You know, it’s really funny, I’m really of two minds of it because I think I’ve had a really fun life. I think it’s been really rewarding and I’ve liked the journey, but there’s a big part of me saying, don’t do what I did. I mean, we made like every mistake you can make. I was very lucky to have great mentors and advisors early on, right? Even though one of my co-founders, Dan and I were sort of straight out of college. Our third co-founder was a guy who had been an entrepreneur for a long time, was able to give us great advice was a very calming influence on, on a couple idiots, straight out of school. So I did have that, but I still think, just get more advice of people who had done it. There was no real startup community. And in Gainesville, um, as you said, software and the technology, Richard Miles (21:32): There wasn’t a startup community until like 2006 or 2007? You waited a long while. Jeff Lyons (21:35): This was before the.com boom. I mean, there was no model. And so we were just kinda making it up as we went along and our story is great and it sounds fun and everything until you realize that we had a competitor of similar size that we had better technology, but they knew how to sell things and were connected and invested. Right? And that company later sold to SAP for $4 billion. So I probably would have preferred to run that company. Um, all things being equal so, Richard Miles (22:05): Well then you wouldn’t be in a booth with me, it’d be on your private jet somewhere. So lets just be honest here right. Jeff Lyons (22:10): So we probably tried to do things too much on a shoe string. I think being well-funded especially now is even more important. So that’s a pretty easy lesson to share is don’t be afraid to give up a little bit of control to people. You’d benefit from them having a little bit of control and who can bring a lot of funding and not suffocate the business. Richard Miles (22:28): Well, it’s interesting because you hear a lot from other people saying, give up control, any control at your peril and don’t take any money because they’ll take over and so on. But it’s interesting counterpoint that that may limit a lot of what you can actually do. You don’t have the resources. Jeff Lyons (22:43): Yeah. Very much. And I’ve seen the downside of that as well. The other thing I’d say is more on a personal level versus a professional for me coming out of engineering school and just being a very technical oriented type of a person we joked around before about kind of the communication style and the debate style that decisions got made. But in reality, it took me about 10 years to realize that other people have feelings and that most people don’t enjoy vigorous debate as much as I do. And that I think held me back from being an effective leader for a long time. So to somebody who can recognize that handicap in themselves, paying more attention to the people side versus the technical side will serve you very well. Richard Miles (23:25): Well, Jeff, my invoice for counseling is already hit probably about a thousand dollars here. So I’m going to have to wrap this up, but Jeff Lyons author of the soon to be written book yell until you get what you want. Jeff, thanks very much for coming on to Radio Cade, wish you all the best in your professional career. And I look forward to having you back on the show. Jeff Lyons (23:43): Richard, it was a lot of fun. Thank you. Richard Miles (23:45): I’m Richard Miles. Outro (23:46): Radio Cade would like to thank the following people for their help and support Liz Gist of the Cade Museum for coordinating and vendor interviews. Bob McPeak of Heartwood Soundstage in downtown Gainesville, Florida for recording, editing and production of the podcasts and music theme. Tracy Collins for the composition and performance of the Radio Cade theme song featuring violinist, Jacob Lawson and special thanks to the Cade Museum for Creativity and Invention located in Gainesville, Florida.

Nina Kraus, a professor of communication sciences, neurobiology, and physiology at Northwestern University in Chicago, has done a lot of research on the effect of playing music on processing sound, learning, and brain development. She explains the “musician’s advantage,” which includes better reading skills, and how music training can be a tool to improve the performance of students from low socio-economic backgrounds. *This episode was originally released on June 10, 2020.* Intro (00:01): Inventors and their inventions. Welcome to Radio Cade, a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them. We’ll learn about their personal stories, how their inventions work, and how their ideas get from the laboratory to the marketplace. Richard Miles (00:39): The sound of music, not just a movie about seeing Austrians, but also a fertile field of research, specifically the effect of playing music on processing sound, learning, and brain development. I’m your host Richard Miles. Today my guest is Nina Kraus, a professor of communication, sciences, neurobiology, and physiology at Northwestern University in Chicago. Welcome to Radio Cade, Nina. Nina Kraus (01:02): I’m so glad to be here. Richard Miles (01:03): So Nina, you’re one of those difficult guests that you have done so much, and we could talk a lot, but then this would not be a 30 minute podcast, it would be like a 30 hour podcast, but I have heard you speak before, and I know you were actually quite good about summarizing your research so I know you’re up to the challenge, but I’d like to start out by focusing on one particular area of your work. You’ve done a lot in sound processing and how the brain processes sound, but why don’t we start with some basic definitions for our listeners. So from a scientific perspective or researchers perspective, what is the relationship or the difference, I guess, between music, noise, and language. What’s the relationship between those three things? Nina Kraus (01:41): What a great starting question. So sound is the common denominator for all the things that you mentioned and sound is a very under-recognized force in our society. It is very, very powerful, and yet we don’t pay very much attention to it because it’s invisible, first of all, like a lot of powerful forces like gravity. So you don’t think about it. And we live in a very visually biased world. And even scientifically there was a National Institute for Vision 13 years before there was one for hearing. And that was the National Institute for Deafness and Communication. We share that with smell and taste, but all of the things that you mentioned, language, and, music, and noise, these are all sounds. And I’m a biologist and I am interested in sound and the brain. And so really the overall umbrella over everything that we study is sound and brain. How do we make sense of sound? How is sound processed in the brain and how does our experience with sound shape how we perceive the world? Richard Miles (02:52): I saw on one of your papers, you have a specific way or methodology that you can actually look at brain as it is interpreting sound, right? Nina Kraus (03:01): Yeah. Let me tell you a little bit about that. Initially, as a biologist, I came into science studying single neurons, actually, single neurons with scalp electrodes and animal models and one of my first experiments was to play sound to an animal while I was recording the brain’s response, the one cell’s response, to that sound. This was a rabbit, a bunny rabbit, and we taught the rabbit that the sound had a meaning that every time the sound happened, he’d get some food. So the same sound, same neuron, but the neurons response to that sound changed. And so we could see firsthand learning, the biology of learning, and that’s something that I’m deeply interested in. My lab, which we call Brain Volts has been looking at how our experience with sound shapes our nervous system, but I was coming from the specificity of recording from individual cells. And so these are signals. These are tangible signals that you can really define, and that felt good. And so the question was, well, how can we get a way of measuring sound processing in the brain in humans when we can’t go sticking needles into individual cells? You know, there are many ways of recording the brain’s response to sound with scalp electrodes. And of course, as I’m talking to you, now, the nerves in your brain that respond to sound are producing electricity. And so with the scalp electrodes, we can pick up that electricity and that’s been done for a long, long time, but most of the measures that we can obtain from the scalp are rather blunt with respect to what I’m interested in, which is the different ingredients of sound. So sound consists, again let me make a visual object comparison. So with vision, everybody knows that a given object has a shape, a size, a color, a texture, that’s all very obvious, but people don’t realize, first of all, that there is sound and secondly, that sound also consists of ingredients like pitch, how high or low a tambour, a violin and a tuba sound different when they’re playing the same note, that’s tambour. The harmonics that differentiate one speech sound from another. There’s phase that tells us where objects are in space, based on the time of arrival of the sound to your two ears. And there’s a huge timing. So the auditory system is our fastest sense, even though light is faster than sound processing sound happens on the order of microseconds because there’s so much timing information in sound. That’s how sound works, it’s fleeting. And so, what I was interested, what I am interested in is how do we figure out how the brain makes sense of these different ingredients? And we figured out a way of doing this because most of the methods that were available to us in the past, you could just see is the response large, is the response fast to sound, but I want to know how does your brain respond specifically to pitch and timing and tambour and phase all these different ingredients. And so one of the metaphors that I like to use is a mixing board. So if you think about the faders on a mixing board and you think of all the different ingredients and sound, when they are transduced into the signals of the brain, which is electricity, it doesn’t work like a volume knob. People, even musicians, are not good at processing all the sounds like a volume knob. They have specific strengths and weaknesses like the faders on a mixing board and I wanted a biological approach that would be able to look at that, would be very, very precise, and not only be able to tell us well, what is the effect of playing a musical instrument for many years? What is the effect of speaking another language, but not only looking at these group differences, but what about individuals? I mean, my auditory brain is different from your auditory brain, we’re all individuals. And so would it be possible to actually have a physiologic response that reflected these ingredients, A-of-all, and B-of-all would not only reflect what happens with experience in groups of people, but even on an individual basis. And we have really figured this out. So this is a response called the ‘frequency following response’ the FFR, which we have adapted to our use and we are able to use very complex, sounds like speech and music and analyze the responses in a way to see how an individual processes these different ingredients. And we’ve spent a lot of time on the methodology. So we have two tutorials on the frequency following response, which really speaks about these responses in a lot of detail. We have a number of patents on what we’ve discovered in terms of how to measure these responses. So this is really something that has kept us busy. So on the one hand, it was really a quest to search for a biological approach, which I’m really happy with now. And then it is a matter of applying that biological approach. Partly it was synergistic because we wanted to see, well, is this approach actually yielding the kind of information we want through research. And so we’ve done a lot of research and now we can really have confidence that a person’s response to sound really does reflect how their brain processes the different ingredients, how it might’ve been affected by the songs we sing, the languages we speak, and even your brain health, because making sense of sound is one of the hardest jobs that we ask our brains to do. So you can imagine that if you get hit in the head, it will disrupt this very, very fine microsecond level processing, which is one of the areas that we’re interested in looking at is, is what happens with head injury, especially with concussion, sports induced concussion. And so again, we can do that as well. Richard Miles (08:56): So on your website, I think you have this great graphical representation of the frequency following response, right? Where you will play a snippet of almost anything, but let’s say a piece of music and in the brain of the person listening to it, you have almost a mirror image right, of that same frequency. And you can see differences in the ability of the person to process what they’re hearing. And so you found, and again, I may have this wrong, you found that musicians had several advantages in the way that you will play for them something say Beethoven’s Fifth Symphony and a musician will hear it differently than when you say musician, it’s someone who actually plays an instrument, right? Not just a music appreciator, or someone who plays an instrument. Those people process the sound differently than those people who are not trained in playing music. Is that correct? Nina Kraus (09:55): That’s exactly right. Because what is so beautiful about this biological approach is that the response we get from the brain, the electricity actually physically resembles the sound that was used to evoke it. This hardly ever happens in biological systems. I mean, usually you’re looking at something very abstract, like lipid levels, cholesterol levels, to give you some index of cardiovascular health. Then, to actually be able to say, Oh, well, people process sounds in a way that we can actually see with a certain transparency. So the transparency is, as you said, is such that we play a sound wave and you can see the sound wave and you can then deliver that sound, wave to a person and pick up the electricity that the sound wave generates. And then, you know, we’re all familiar with taking a sound wave and feeding it through a microphone, and then you can play it through a speaker. And then the same way, you can take an electrical response that you have recorded from the brain, it’s just an electrical response, and you can deliver that to a speaker and play it so we can both see and hear a person’s response to sound. And yes, in fact, we can see the people who regularly play an instrument, so I’m not talking about professional musicians. I’m just talking about people who regularly play a musical instrument, you know, as little as half an hour, twice a week on a regular basis. And one of the things that we’ve been able to find is that there really is a neural signature for the musician. So remember I said, that sound consisted of these ingredients like pitch and timing and tambour. And what we see as the musician strength is a strengthening of the harmonics in sound and of various timing ingredients. And it turns out that both the harmonics and the timing are not only important in music, but they also overlap with what you need for language. So you can imagine how if you are doing an activity that is strengthening your brain’s response to the harmonics, which not only are important for playing a musical instrument, the harmonics are what distinguish B’s and P’s, and D’s, and G’s from each other. So these are the same signals. They’re the same ingredients. They’re these beautiful signals outside the head and inside the head that we can see, how does experience shape how we perceive the world. So the musician signature really has a strengthening of harmonics and timing, which it turns out transfers to language abilities and language abilities, including things like reading and being able to hear speech in a noisy place like a classroom, being able to figure out what’s going on in a complex soundscape. So these are advantages that seem to come along with the brains increased stability, strengthened ability to process these particular ingredients of harmonics and timing and what we call FM sweeps, which are basically the simplest FM suites. It’s a change of frequency over time. It’s like a cat call, right? It’s a sweep up and down. And it turns out that speech sounds have very, very, very fast FM sweeps that distinguishes one consonant from another, that happened in a very, very short period of time. And so the brain’s ability to process these FM sweeps is something that we see as a strength in musicians, and is very much an important ingredient in language. Richard Miles (13:32): I find all of this fascinating Nina. I remember the one example that you gave you tested musician’s ability to, as you said, pick out a particular sound in a crowded room, and you compare that to non-musicians and that the musicians had this definitive ability to recognize a sound pattern and all that. And then of course, different types of syllables or consonant, they also had that ability. The only time I can ever do this, I’m not a musician is if we’re at a party, I can hear Phoebe’s voice in a crowded room, and then she said, well, yes, that’s because research has found that men interpret women’s voices like music. So finally, I have a researcher. You tell me, is that true or not? Nina Kraus (14:08): Well, I would say that you have had a lot of experience with Phoebe’s voice and so you’re sonic brain is tuned to that voice. And we say this, when, you know, you pick up the phone, your son calls you and you say, “Oh, it’s so good to hear the sound of your voice”, the years of the sound to meaning, sound to emotion connections that you’ve made with that voice even before you hear the particular words, you have this very strong connection to what you’ve learned. And so I think that’s why you can hear Phoebe so well. Richard Miles (14:41): Let’s talk some more about work that you have done, very interesting work, with something called The Harmony Project in Los Angeles. This is something, I think in 2014 was the research, and essentially you worked with an organization in Los Angeles, it was giving music lessons, I think mostly stringed instruments, right? They’re giving them lessons for a substantial amount of time and then you started tracking them doing assessments to see if there were other advantages, right, that translated not just the ability to play a given instrument, but also the ability to do other cognitive skills. Tell us a little bit more about that. Nina Kraus (15:14): So, we’re really fortunate as scientists, and also if you read about Brain Volts and what we care about in our lab. We really are interested in sound in the world and we’re less interested in creating an experiment in the lab where people come in and they are given a certain amount of training with sound. We’re really interested in what is the impact of playing a musical instrument in actual music programs that live in the world? Also, one of the questions that one often asks is, well, is it that the brains strengthened response in musicians is just something they were born with so that if you have a strength in a certain domain, you might be encouraged to pursue that activity. A way of, of trying to understand what the effect of experiences is to do a so-called longitudinal study. Let me tell you the long in longitudinal is no joke, because that means tracking the same individuals year after year after year. So, we had the opportunity to do this in Los Angeles in the gang reduction zones of LA. And also we had a companion project at the same time in the Chicago Public Schools, where we basically had the same experimental design, which consisted of you take two groups of people and you match them at the beginning of training, or before training has started, and you match them on age and sex and reading scores and IQ and everything that you can think of, and then one group gets music and another group gets something else and you track them over time. So you track them year after year. And we were able to do this in LA with elementary school kids, second, third, and fourth graders. So we did this over three years and then the project in Chicago was adolescents also in low income areas. We’ve tracked the adolescents from freshman year until they graduated as seniors. And what was important is that the individuals in the different groups were in the same classroom, same teachers, same socioeconomic areas. And we could see, well, what happens if one group gets music and another group gets something else? So what we were able to find was, first of all, we were very interested in, well, we already knew from cross sectional studies across the, about this musician signature that I told you about that musicians had strengthened responses to FM sweeps, to harmonics, to timing in speech. The musicians had these stronger responses, but we wanted to know, well, is this something that develops over time? And in both studies after a year of regular music making in LA, these were after-school programs five times a week. If you also include Saturday and in the Chicago public schools, it was actually within the school day so that they had an hour every day of music, just like you had an hour of English and Math and History. We’d measure sound processing in the brain using our biological approach at the beginning of the year. And then at again at the end of the year, and after a year in both studies, we found no change in the brain’s response to sound. And that’s what the data showed but we kept going. And so in both of the studies, what we found was that it takes a while to change the brain. And that’s a good thing. If your brain was changing in a fundamental way, every second, you’d be really confused, but you speak a certain language that has certain sound ingredients after a while. And it’s really after years of speaking of particular language, your brain automatically changes and changes in a way fundamental or your default experience of the world. I mean, even if you’re asleep and I’m measuring your brain’s response to sound, you will have this heightened response to certain sound ingredients, because it has just become a fundamental way of how you perceive the world. But this takes, while it really did take two years to see these changes. And at the same time, of course, we were interested well, are these kids doing better in school in various ways, in terms of literacy, for example, and being able to hear speech and noise. And in fact, again, we were able to, to track the changes in the brain with these gains in literacy, and in being able to hear, for example, speech in noise, Richard Miles (19:52): So Nina, it’s fairly common observation that the younger you are the easier it seems to do things like learn languages, foreign language, play instruments, and so on. Is there anything in your research or other people’s research that indicates are there definitive windows of neuroplasticity past which it’s not really worth it or the returns are so diminishing that every 10 hours of effort you put into it is really not going to get you much. Do you find that there’s a cutoff? Does it happen in elementary school or middle school? Or can you go on up through your twenties and still reasonably hope to take up an instrument or learn a foreign language and accomplish a very high degree of proficiency with it. Nina Kraus (20:28): Great question, the answer is no, there is no limit. Certainly the way that a young brain learns is different from an older brain, but we continue to learn until the day we die. And in fact, there’ve been very beautiful experiments in auditory learning in animal models where you can very easily and in a very precise way, regulate an animal’s experience at different ages and see how their brain responds to learning an auditory task. And there have been experiments showing that certainly animals will learn differently when they’re younger and when they’re older, but they will continue to learn until the end of their lives. And this is born out in human studies as well, specifically with music. So in our own experience, in the harmony project, the kids were elementary school kids, in high school, the kids just began their music instruction as freshmen. So what was kind of a tragedy for these kids? The fact that they really had had no music instruction of any kind before they were freshmen in high school, turned out to be from a scientific standpoint, very important, because we could see that certainly the kids who began their music training as adolescents had the same kinds of brain changes that we saw in the younger kids. Moreover, the number of labs have looked at learning in older people. And even if you’ve never played a musical instrument, your brain can change and you can continue to learn music, to learn new languages. And we have this very, very dynamic system, and I think we should embrace the differences in the way we learn at different ages, because as we’re older, we bring wisdom with us and we bring an understanding of what we’re doing that is very different from the way a child might approach learning, for example, a musical instrument. But the fact is that the benefits of playing a musical instrument, which are profound, really in terms of memory and attention and emotion, sociability, these are gifts from music that you want to experience throughout your life. Richard Miles (22:41): If we could just stay on that just a little bit more Nina, one of the fascinating things I saw in one of your papers was the connection of musical ability or music training to reading, and that you expected to find obviously, a connection to speaking, cause that’s sort of an auditory sound function, right? But reading, and I didn’t realize the extent to which a solid understanding of how a word sounds, how are phoning sounds is essential to reading a written word. So comment on that, but there’s a second part of my question. Let me put it in right now, what are the other cognitive things that you have found that improve? I mean, is there a link with math, for instance, do you increase math abilities among musicians? Are there any other cognitive things that appear to be improved or beneficial as a result of music training? Nina Kraus (23:24): So your first question is what does sound have to do with reading? And we learned to speak first and what we need to do when we read is we have to associate the sound of the letters with a symbol on the page. And so, we’ve known from decades of research that kids who have difficulty processing sounds have difficulty reading. So there is a very, very strong connection there. Also there’s a part of speech. When you think of music, you know that there’s rhythm in music, right? Rhythm is a part of music, but you don’t necessarily think about rhythm as being a part of speech. But it is. I mean, think of the difference between the word rebel and rebel. It’s the same word, but I have a different rhythm. And even though the rhythm isn’t as regular, we have tremendous rhythmic ability in speaking. So every Martin Luther King day, my husband and I listened to the, I have a dream speech and listening to Dr. King speak, it has this wonderful rhythm and cadence to it. And if I was saying those same words to you, you’d be looking at your watch, you’d be, when is this going to be over? But so much of the communication is rhythmic. If you want to have fun, do some YouTube searches for rhythm and music. And you’ll find there’s a guy who plays drums along with while people are speaking, it really pulls out what is not so inherently obvious. But after awhile you realize, Oh, this is really rhythmic. So this is another thing that gets strengthened. If you make music, you really make abilities get better. And the reason that we know that this is tied to reading is that again, for decades now, people have demonstrated that kids who have difficulty reading have difficulty with rhythm. Rhythm is one part of what gets strengthened with music. And I would say that it’s the rhythm, and it is the tuning, if you will, of important sound ingredients that together help achieve the gains, which is now the second part of your question, which is why do we care? And well we care because we want to know what to pay attention to. And in order to learn, we have to be able to pay attention to sounds. So, for example, my husband’s a real musician. And one day I was trying to learn a dire straits lead on the guitar and he came by and he said, Nina, if you just listen, you would realize that Mark Knopfler is not using his pick on the string each time. He’s not going to Dee Dee Dee Dee. The reason that he’s playing those notes so fast is because he’s actually pulling off the string with the fingers of his left hand, it’s called a pull off. And it has a very special sound to it, that I was deaf to. But now I know what that sounds like. And so when I hear it again, I have learned what to pay attention to. And it’s kind of automatic like, Oh yeah, I know what this is. And so there are so many associations with sound and our ability to pay attention and to then be able to pay attention to other sounds in the world that might be important, like a teacher’s voice or Phoebe’s voice across the room. So that’s one thing. The other is auditory working memory, in order for you to make sense of what I’m saying right now, you need to remember what I just said. So a typical auditory working memory test language is I’ll give you a list of words and then ask you to repeat back only the words that were names of cars that started with M. And so you think, okay, so what did she say? Which ones are cars, which ones start with M. And this is your auditory working memory that is kind of helping you make sense of what you hear constantly. So it’s very, very important. So on the test like this people who are musicians, someone who regularly plays a musical instrument, by the way, singing counts, then across the lifespan, people who are musicians have stronger auditory working memory skills and stronger attention skills, and any teacher will tell you. And one of the reasons this was interesting to me is that teachers will tell me all the time that the kids who play music are the ones who do better in school. Richard Miles (27:33): Nina, you alluded to this earlier, you talked about Brain Volts, which is essentially, you’re looking at ways to take this research that you’re doing or the findings, and basically help others in other fields. And if I understand it correctly, you can use this in addition to research, but also as a diagnostic tool, right? If you find somebody and it appears to be their audio processing capabilities off, that may be an indicator of something else, such as a concussion or maybe dementia or something like that. I’m not entirely sure about that. So I’m waiting for you to correct me, but is that what it is? And then how’s it gone in terms of setting up something to try to commercialize the technology. And this is something we talk on this podcast, a lot, a lot of people like you, researchers have something that they know has a value outside of the research arena, and they want to take that technology to market. And it’s very difficult. So it’s kind of hit or miss. And we know for the genesis of this particular podcast, the museum project was Gatorade, a research project with great success, but isn’t a tiny minority of what happens to typical research. So first of all, correct me, or affirm me that I have that description of your business model, correct. And then how’s it going in terms of going to market? Nina Kraus (28:43): So I think the two areas that we have been focusing on, one is language and literacy. And yes, the idea is to use this biomarker, if you will, as a way to provide additional information about a kid who might be having difficulty in school or is having various problems with language and learning. And the question is, is this coming from the fact that his brain is not processing sounds in a typical way? And to be able to at any age, just deliver sounds and just use some scalp electrodes to get this piece of information is very valuable. And people talk about diagnosis. I wouldn’t say that this would be the only thing that you would look at. Any clinician wants to have an armamentarium of clinical results. You go to your physician and he’s looking at all of your various test results, and hopefully he can put together this constellation of findings and be well-informed. Well, I think at being well-informed, if you have a kid with a learning problem, when a language delay, if it was my kid, I would want to know, is there a bottleneck? Is there a problem here with sound processing? I would also want to know is my kid at risk? So I can envision this as now they have newborn hearing screenings where every child gets a hearing test to make sure that they can actually detect the sounds. I could envision the kind of technology that we’ve developed as being something that would be side by side with that. And you would also be able to see is my child at risk for struggling to learn language or struggling to learn, to read way before he actually begins to struggle in school. Wouldn’t it be great to just know that this is a child who is at risk. And so there are various things that can be done, especially if you are aware of a potential problem early on Richard Miles (30:39): Nina, just to clarify, going back to your analogy of the sound volume knob versus the mixing board the tests are doing now, essentially just measuring the sound knob, right? Can they hear or not? And your test would give the ability to say, well specifically, are there things going on at the auditory processing level that bear watching or concern? Is that? Nina Kraus (30:58): Yeah, I mean the typical hearing test now is really, can you hear, there’s a range of pitches that language consists of, and can you hear very, very quiet sounds and your ears ability to hear what I am measuring more is the brain’s ability to understand what you hear. And so the sounds that we deliver, aren’t very quiet, they’re conversational level. So we already know that they can hear their ears are working fine. They’ve passed the hearing test from an ear perspective, but we want to know now, if I’m speaking conversationally, I know that you can hear me, does your brain process these different ingredients properly or not? And what are the strengths and what are the bottlenecks? And we know that there are certain signatures, and this is again, one of the things that we have patents on is that we know that there is a certain signature that’s associated with a language delay and literacy problems. And so you would want to look for that particular signature in a child that you were wondering about in terms of their current or their future language potential. Richard Miles (32:02): Could you use it to detect mild concussions? For instance, if there is neurological damage and traditional tests, weren’t willing indicating one way or another, is this another tool that you could use to figure out something is wrong here? Nina Kraus (32:14): Absolutely. Because most concussions, unless you have a cerebral bleed, you’re not going to see them on imaging. You need a very sensitive measure and sound processing. The brain does provide that. It’s also noninvasive. It takes 15 minutes to obtain and we have found again and again, we have papers and patents that describe that we’ve established this effect in youngsters who are elementary and high school aged kids. And right now we have a big study looking at division one athletes or northwestern athletes and NIH study, it’s a five year project. That was won on the strength of the original work that we did describing what is now a different neural signature. It doesn’t look anything like the language signature. There are other ingredients that are especially sensitive to head injury. And we can see this right now. I know that the whole issue of diagnosing concussion is a tricky one. And again, historically, people have been looking at vision. They’ve been looking at balance, but looking at hearing is fairly new. And one of the things that we have done in a couple of our studies is we followed our North Side Football League. These are our kids, and we gave them the vision test, the balance tests and the hearing tests. And you could see that they each tell us different things. So they’re not redundant. So you know how wonderful my vision is for a clinician, a trainer, a coach, position, to be able to look at balance, look at vision, look at hearing, and to have this biological marker that would inform the diagnosis of the injury and also inform return to play, because we know that concussions often occur in the same person shortly after they’ve had a concussion. And so, it might be that with the current measures that we have available, it looks as though the athlete is ready to return to play. But maybe if you had a more sensitive measure and objective measure, because again, the athletes are very motivated to do whatever they can to get back on the field. But if you have an objective measure that doesn’t require any kind of an overt response, wouldn’t it be great to know? Let’s just wait another week. His brain isn’t quite ready, just to wait a week or two. I mean, we see that the changes in the brain change very rapidly, usually as individuals, athletes, recover from their concussions. Richard Miles (34:44): Nina, I know you have a lab there where you can assess people with that method. Is this something that could be done with a medical device? It could be done in a doctor’s office or even in a trainer’s room? Nina Kraus (34:54): That’s what we do. When we went out to LA, we did this testing in instrument closets, and wherever we could find a spot, it’s very portable right now. It’s the size of a laptop. Richard Miles (35:04): Nina, this has been fascinating. And like I said, this could be episode one of a thirty podcast series on just sounds. I could listen to this all day and I’ll go meta for just one second here. We’re actually doing this in the medium of podcasting, right, that has made a huge resurgence as people like to listen now. And I don’t know what that says about humans or our society in general, but it is a throwback to the days of the thirties and forties, right? When people consumed a lot of their entertainment from radio shows. Right? And what I like about it forced a little bit of your imagination, and play, because it’s not laid out for you visually, you’re listening to somebody sound or a sound clip of a particular event. And anyway, I thought I’d throw that in there. We’re talking about sound on a medium that is only sound. Nina Kraus (35:44): I love that. I love that. And actually I have to say for myself, I do a lot of my reading, listening to audio books. I think we all spend probably too much time looking at screens. And it’s just wonderful to kind of give your eyes a rest and listen. Of course I love radio and podcasts and I consume books that way. Sound is awesome. Richard Miles (36:05): Nina, thank you very much today for being on Radio Cade, hope to have you back maybe with an update on Brain Volts or your new research. Thank you very much for joining us today. Nina Kraus (36:13): Thank you for having me take care of Richard. Bye. Outro (36:18): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. Richard Miles is the podcast host and Ellie Thom coordinates inventor interviews, podcasts are recorded at Heartwood Soundstage and edited and mixed by Bob McPeek. The Radio Cade theme song was produced and performed by Tracy Collins and features violinist Jacob Lawson.

Is Bitcoin a store of value during a financial crisis? What role does it play in a portfolio? Scott Melker, a successful trader and one of the leading voices of Cryptos discusses the origins of bitcoin, its uses, and what the future may look like. *This episode was originally released on March 25, 2020.* TRANSCRIPT: Intro (00:01): Inventors and their inventions. Welcome to Radio Cade the podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida, the museum is named after James Robert Cade, who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work and how their ideas get from the laboratory to the marketplace. James Di Virgilio (00:38): Today, we are joined by Scott Melker. He is a leading voice in cryptocurrency. He’s a trader he’s an advisor. He formerly was a DJ and at times like these discussing cryptocurrency is more than just whether or not Bitcoin is an investment. It’s actually an indictment on where we are as a society, monetarily, fiscally. What does all of this mean? Scott, welcome to the program. It’s great to have you. Scott Melker (01:04): Thank you so much for having me. I’m truly honored. James Di Virgilio (01:06): Now, Scott, I know your background really for the first 15, 20 years of your career was as a DJ. In fact, you gained a significant amount of fame doing that. Then at some point in time, you got into dealing with the cryptos. Tell us about that transition and how that happened. Scott Melker (01:20): As you said, it was about two decades of DJ and music with a million other projects. On the side, I was always superficially interested in trading and investing. My parents gave me a pretty good base and understanding of money and finances and how to save. But as a trader, I was pretty much an amateur and actually pretty terrible at it, especially riding through the recession of 2008 and all of those things. But as I began to feel like I was aging out of music, I’m in my forties. Now I was deejaying to kids that were twenty, just became very awkward. I started to look for other things, but at the time when, if you were trading anything, crypto became just absolutely huge. You couldn’t stop hearing about it. It was at the end of 2016, beginning of 2017 and so I put a little money into it. I started trading it and just by virtue of being in the right place at the right time, it quickly became something that could sustain and become a career. So I sort of fell into it to some degree. And then interestingly, at the same time, my daughter who’s now five was born and alongside, already feeling like I was too old for a music production and deejaying having her really took me off the road and put me back in front of my screens to trading. So she was born and I had to go to South by Southwest to play a concert literally the next day and going away and having that feeling. I knew that that was just not going to be my future path. And so I decided to pack it in and focus on trading crypto. James Di Virgilio (02:39): Now learning is a large part of this podcast. We’ve had chances to talk to so many different innovators, entrepreneurs, creativity, leaders, you jumped into a field that was entirely different from what you did, how difficult was it to learn the concepts behind how to trade, how to trade correctly, how not to lose your money, how to invest. And then how did you learn? What was your primary tool for learning? Scott Melker (03:02): Like I said, I’ve had a level of base knowledge. I at least understood the basics of technical analysis and charts and had a bit of an understanding of chart patterns and things like that. And I think I also had a generally good understanding of how to balance a portfolio, not trade with all your money and basically just be responsible as a whole. But to some degree it was a trial by fire. Like I think it was for anyone else. Trading crypto is very different than trading stocks or any other assets. It is primarily technical being that almost everyone is using charts as opposed to fundamentals. There’s no PNL or quarterly earnings report for Bitcoin. There’s no CEO to call and see what your expectations are for the next year. So you’re really trading based on charts, which is effectively just trying to guess, where are the big players in the market are likely to inflict the most pain on retail traders, where they’re likely to sell and where they’re likely to buy and try to be on their team. So that’s something you can do by gaging sentiment and looking at a chart. But as I said, it was somewhat of a trial by fire. Luckily I found a friend who became a mentor who is an exceptional trader for over 20 years. His name’s Christopher Inks of Texas West Capitol and to some degree I forced myself under his wing. And when 2017, I really learned even more by multiples of what I knew before. And at that time, I really think I honed it in and became a pretty exceptional trader. James Di Virgilio (04:22): So as a voice for crypto, as someone who’s living this and breathing this every day, we’re going through a financial crisis right now, due to coronavirus. There’s a lot of thought that something like Bitcoin or maybe another coin, but cryptos in general could serve as the antithesis of what we see with central banks around the world here in the US we’re printing trillions of dollars to bail out the country. And obviously the idea for something like Bitcoin is if you can have a stable currency that maintains its value, you’re not going to have a Fiat currency, right. A currency that can be manipulated by a government that can be inflated. That can be cheapened. Do you see that as a narrative for Bitcoin in the long run? Or is that an idea that was nice and novel, but not reality? Scott Melker (05:06): Uh, honestly, it’s a bit of both. So I think that the notion that people would rush to Bitcoin when they’re losing their money in a risk off environment is somewhat absurd. Never in history have people when they’re losing their money in the market, run into something that’s perceived as riskier, they run to cash, right? And so at presence, even though a dollar is inflationary, it’s behaving somewhat deflationary in that the entire world is trying to rush into dollars. So I don’t know if you’ve seen lately, but for example, recently against the Australian dollar, the dollar rose 20% in value in a matter of hours. So right now people want dollars. And so I don’t think that notion is correct at the moment, but when you look at Bitcoin as a whole, it’s not a hedge against your portfolio dropping what it is a hedge against is that inflationary environment of Fiat because Bitcoin itself is deflationary. So I think there’s a differentiation between what the given price of Bitcoin is at any moment and what its actual true value is to look at a society like Venezuela country, like Venezuela, where they have hyperinflation a suitcase of money. It doesn’t even buy you a loaf of bread. There are people who, regardless of what the price is on Coinbase or an American crypto exchange, are there are people who are surviving strictly because they’re mining or trading or transacting in Bitcoin. So it has real life use cases in a lot of countries and a lot of the situations around the world, but that’s just never been seen on a macro level. So I don’t believe it’s a store of value like gold or something like that. I’ve never really subscribed to the digital gold or store value narrative. But I do think that in certain environments, when it really goes somewhat madmax on the planet, unfortunately, which could be a future that we’re somewhat headed towards. I think that it has tremendous value. So I believe that everyone should have at least minimal exposure to Bitcoin, just in case of the worst case scenario. Not because they believe that next week it’ll necessarily be priced higher or lower. James Di Virgilio (06:59): Well, the Venezuela example is interesting because as you mentioned, if we live in a Keynesian and if you’re not an economist, John Maynard Keynes, a leading economist in the 1920s and thirties, you could say is largely responsible for how most of the world manages debt and fiscal responsibility, monetary policy. Nowadays, you can certainly make, as you mentioned, this longterm argument that Bitcoin, if you lose your currency, right, runaway inflation becomes something you may go to because now you and I need to exchange goods and services in Venezuela. The last thing we want to do is do that in the Venezuelan currency, because that is wildly losing value every single day. So we choose to use something like Bitcoin, obviously gold function this way, really, for most of human history, the idea is Bitcoin of course could function that way. I think you’re articulating very nice that it’s nowhere near that yet. And the reason for that, it’s very simple to be a usable, consistent currency. It needs to be stable. And that’s why the U S dollar, despite I think a lot of real fundamental issues that we could bring up and spend an hour talking about today is still that safe haven is right now. As far as history goes, that’s your most proven safe asset. Scott Melker (08:01): The only true safe haven in my eyes. But I do think that we’re going to see that change likely very soon not to be alarmist, but the fact that the value of the dollar is rising so fast is not actually a particularly good thing. But like you said that’s a conversation for another day. James Di Virgilio (08:16): Right? And that is certainly an interesting one. I mean, like we said, fundamentally where we are as a world and what we’re doing with monetary policy matters a lot. In fact, that’s something I talk about in my profession. Maybe more frequently than anything is to learn about monetary policy study. What’s good or bad. That’s going to change the world significantly. And that could certainly in the future be an opportunity for something like Bitcoin. Now I think a big hurdle for most people on Bitcoin is understanding why it’s possibly even theoretically, a stable currency. Let’s assume the best case scenario in this becomes stable. What is a Bitcoin? How do we get a Bitcoin? It’s easy to understand gold it’s in the ground. I mine it, people think it’s valuable. Explain to us how Bitcoin has any value or how it’s stable or what it really is. Cause I know that loses most people right here in this part of the conversation. Scott Melker (09:02): Well, it’s certainly not stable and I don’t necessarily believe that it will be. And actually as a trader, the volatility is what draws so many people to trading Bitcoin and their interest in it. But a Bitcoin it’s a protocol it’s math. And the computer has to effectively at the most basic level, computers around the world are competing to solve a complicated math problem. And when they solve it, that creates Bitcoin. It’s a ledger that keeps these transactions on the blockchain. And once an individual block is locked, it’s effectively unhackable. And so the idea is that you’re not on a centralized server somewhere. You know, it’s decentralized, it’s spread all over the planet and the miners are creating Bitcoin. And like I said, you have these unhackable blockchain decentralized it’s trustless. You don’t have to trust a government or a central party. And that’s really the appeal to a lot of people because you want to use PayPal or your bank or whoever it is. There’s a third party involved in you transacting with someone else. And this eliminates that third party in a manner where you’re at much less risk. But that said as an average person to understand that, you have to understand that you are now your own bank, nobody is going to bail you out. If you get hacked or if you get your Bitcoins stolen, you’re not insured. So for the average person, I think it’s actually terrifying. Most of them don’t even understand that. I think they just buy it on an exchange and they leave it there. When you buy Bitcoin on an exchange and you leave it there, it’s not really yours. There’s a saying in crypto, uh, not your Bitcoin If you don’t have the private T’s basically. So unless you put it on your own hardware wallet or move it somewhere offline, I mean, there’s a conversation that could go for hours. And, and it’s funny because I actually was recently the victim of a pretty major hack attempt by some famous hackers in Europe. They swapped my SIM card. They attacked my exchange accounts, but because I have my proper security in place, I didn’t actually lose any money. They made my life really miserable for a couple of weeks. But stories like that are going to drive your average retail person away from Bitcoin. And let’s be honest, in 2017, when everyone was interested in Bitcoin, they were not interested in it because it was a hedge against inflation or because it could protect them from their government. They were buying it because someone told them that they make a ton of money selling it later. That’s not a use case. That’s just FOMO, fear of missing out. So at the end of the day, you can’t explain all of that to a five-year-old effectively. And I think that’s been one of the greatest impediments to Bitcoin because people just don’t want to learn and they don’t want to deal with that. They don’t want to go buy a private hardware wallet and understand their seed phrases and private T’s, and that they got to put one on a safe and one of the safe deposit box. It’s really crazy. I mean, you really are your own bank. James Di Virgilio (11:32): Yeah. And everything you just said there, I think is exactly the reason why Bitcoin is nowhere near a currency adoption, despite in a theoretical world, how nice it does sound on a macro level. Look at what it can do. Look at the hedge against currencies. Those are all nice thoughts. But the function as that kind of store of value, one of the things is it really needs to be simple and easy to understand. You mentioned something that obviously a significant hurdle for Bitcoin, and this is this idea of safety, your digital wallet being safe every single day. We know of people getting robbed or mugged or their money being stolen, their dollars being stolen. Right? But it’s rather unlikely that someone’s going to get into your bank account and pull your money out without stealing your credit card or something of that nature. But even when that happens, Scott, the banks will usually cover you, right? But if somebody comes and takes my digital wallet, what happens? Scott Melker (12:21): If they’re not taking your digital wallet, per se, what they’re basically doing is they transfer your Bitcoin through many ways of hacking, but they’re sending their Bitcoin from your wallet into theirs and becomes untraceable. They spread it around and it’s gone and there’s no way to go get it back. So yes, you’re at tremendous risk, but there’s a flip side to that, which is that if you’re carrying cash, say you’re leading an African country right now, or you’re a refugee, or you’re running away from this virus and you get to the border, we’ve all heard the stories you want to come into the country, give us everything you’ve got. Your cash, your gold, your everything. So physical goods are still far easier to steal and in an environment like that, going back to it, yes, we’re not talking about going into your bank and stealing your money. Scott Melker (13:02): But if you’re really in a desperate situation and you have physical goods, those are more likely to be taken from you. If you have your seed phrases in your head, you don’t even need to have a physical hardware wallet, all that is the place to store your private keys. Well, your Bitcoin goes with you wherever you go, and nobody can steal it from you in that regard. So as a hedge against bad actors, as a hedge against dishonest government or the hedge against all of these bad things that could be coming for us in the future, and I’m not trying to be alarmist, I don’t think we’re going on mad max or anything, but it happens in other places in the world and Bitcoin or some digital currency can save your life. In that scenario, you will be able to trim back when you cross that border. James Di Virgilio (13:40): And this is not historically unprecedented. If you think back on the history of gold and monetary value in general, that same problem that you just illustrated was the original problem that led to winding up with a dollar in your pocket, right? That was the issue. Hey, I’m carrying all of this value from the goods that I have just transacted with. And now I’m at risk of being robbed or mugged, or my train is going to get stolen. And so how do we find a way to deposit money now in the city I’m in. Travel to the next one with effectively, nothing but still have access to that money. And that was a very, a nice example. I think of something that does become appealing in a frontier situation. If you will, now let’s focus back in on trading it. You mentioned it’s very speculative in a lot of ways and an overly simplified version trading Bitcoin, it sort of feels like tulip mania and that it’s largely people driven. That’s kind of what you’re talking about. When you’re looking at sentiment and charts, no one has any idea what Bitcoin is worth, right? And you couldn’t tell me what it’s worth, but it’s fundamentally worth what you’re looking at is what people think that it’s worth. Talk a little bit about the human behavior impact on cryptos. Scott Melker (14:41): So it’s my opinion and on chain metrics, somewhat support this, but everybody has their own opinion. I believe if you look at the way that Bitcoin transacts, the it moves between exchanges and the ways that it trades is that it’s still a highly manipulated asset. And by the way, I believe everything is a highly manipulated asset. So that’s not necessarily a point against, but it’s a highly manipulated asset. That’s traded by a few huge players. That’s in our industry. We like to call whales and effectively in markets in general, they just players like compound operator or whatever you want to call them. Their general goal is to inflict as much pain on retail as possible. They want to take advantage of where your stop loss might be or where you might be interested in buying and selling. And they want to just basically abuse you. And that’s the way that markets work. And so it’s a very frictionless environment with Bitcoin trading. One person with a whole lot of Bitcoin can move the books, 30, 40, 50% in a matter of hours, but that offers a tremendous amount of opportunity. If you’re a trader and you can get on the right side of those moves, which is basically what I mentioned earlier, that you think about it. Everybody I think is somewhat, at least superficially aware of what happened to Bitcoin two weeks ago. And it dropped 50% in one day. But if you look at the on chain metrics, 70% of all Bitcoin basically has not moved in ages, right? It’s the people who mine it, the original holders, whatever they’re holding onto it for dear life, it’s going nowhere. So when you look at the way that Bitcoin moved around and also there’s a huge percentage that’s been lost, and obviously there’s a finite amount of Bitcoin that’s going to ever be mined. So you’re really talking about 20, 25% of the Bitcoin that exists in the world is what’s being traded and moved around and affecting the price of the market. So it’s very strange in that regard, but if you look at what was happening, it’s basically a few people likely got together and decided, Hey, we’re just going to dump all this Bitcoin on the market, on the exchanges. And we’re going to absolutely destroy the price. Why would they do that? There’s a million reasons to speculate. Maybe they had a margin call because the market was crashing and they had to sell Bitcoin for a margin call. Maybe they’ve mined so much Bitcoin since 2009 or 2010, that they have so much supply to dump on the market. That for them, it doesn’t matter if they sell it at 20,000 or 2000, it’s just profit. They did it for a dollar who cares if they sell it for 2000 or 10,000, maybe they want to move into cash. It doesn’t really matter the reason. We just know that it’s a few people who are doing it, but when you look at the price of Bitcoin, as we speak in the mid six thousands, it dropped basically from 8,000 to 3,600, that’s a humongous move, but it’s already back to 6,600. And from 3,600, it bounced to almost 6,000 in a matter of 12 hours. So as a trader theres far more money to be made by longing catching the bottom, buying somewhere between 3,640-4500 and just selling it 12 hours later at 6,000 than there even was in being short or selling during that entire move down. James Di Virgilio (17:34): So right. I mean, absolutely. Is there any element of catching a falling knife there? Did you just time that based upon, Hey, I caught the falling knife correctly, it didn’t cut me. Or is there a level of predictability, like you said, you’re telling story of really low volume, significant price trades that you feel like, Hey, there is a floor here, right? Basically cryptocurrencies, aren’t going to zero. Bitcoin’s not going to zero. Scott Melker (17:58): Right. It’s not, but there’s a leverage exchange. That’s the biggest in the world that almost took Bitcoin to zero during that move because of an inefficient exchange. So Bitcoin on that exchange could have touched zero that day. If it had not turned the exchange off, which is somewhat astounding and shows you how much the market is affected by traders and those being high leverage traders, which is effectively worse odds than throwing craps in Vegas, at least you get free drinks there. I think there’s always an element of touching a falling knife. I generally, as a trader and this becomes a technical thing, but I look for when a level that seems key is recaptured as support, as opposed to just trying to catch it on the way down. But I’ll tell you, I got very lucky on that move. I had orders at 4,000 that had been sitting there for I mean months and it happened in the middle of the night. I woke up, I looked at my phone, the price of Bitcoin was $5,800. And I had bought it at $4,000, three hours before, while I was sleeping. I sold it immediately for an almost 50% profit. James Di Virgilio (18:54): Yeah. Those are the moments as a trader, right? That keep you coming back now, how do we apply this? What’s your advice for the average family out there? They’re investing in their 401k. They’ve got some real estate they’re doing the very normal things. How do they employ or should they employ Bitcoin or a crypto in their portfolio? Scott Melker (19:12): I’m certainly not a financial advisor. I guess I should put that disclaimer out there. As I mentioned before, I believe that everybody should have at least minimal exposure to it. 1%, 2%, for me, I’m comfortable more 5% to 10%, but how do you do that? I think that the best way, like any market might invest in your 401k is to start small and dollar cost average until you have a full position. I mean, it’s such a volatile asset that one week you can be buying it at $8,000 in the next week at $3000 and then a week later at $14,000. So trying to catch a price that you’re comfortable with for most people, if they’re not traders is an extremely uncomfortable thing. So set up an automatic buy and buy $500 worth of Bitcoin every Monday until you’ve bought the $10,000 allotment that you have for yourself or do it once a month or whatever that is. I think that’s safer for more mentally stable people than traders, the safer and smarter way probably to acquire a position. James Di Virgilio (20:06): So Bitcoin is a tremendously creative and innovative idea. If this podcast could interview the founder of Bitcoin, of course, no one really knows exactly who this person is. Right. We would certainly do it because of creativity. I often find that fields overlap in life, whether you’re an artist or a musician or a trader, you can find commonalities. What commonalities have you found between your life as a musician and your life as a crypto guru? Scott Melker (20:31): The obvious ones, which is that I’ve forged the path where I never had to have a boss, which is always very important to me. It’s funny you guys had my dad on the show recently, definitely got the best of what the Melker had to offer in that case. You know, my parents and I was very fortunate. They sent me to an Ivy League University. They were able to leave me without student debt. And then one day I called them and said, I’m going to be a DJ. When I graduated with my Ivy League degree, I could have gone at that time. It was very easy to get investment banking job and go to the wall street route, like all of my friends, but I was just never the kind of person. I don’t know if it’s an acceptance of authority or that I’m a bit of an ADHD case and I’m scattered. And I don’t fit into those environments, but I was always someone who was trying to forge my own path. So I’d say the most common theme obviously is that I make my own schedule. I work when I want to work and I worked as hard as I want to work, which usually is very hard, honestly, when you’re doing it yourself. So that’s one I can tell you on a creative level, it’s very funny. I produced music for forever and using all of these different DWS, you have all your workstations, Ableton, Logic, Pro Tools. To me, it almost feels the same to sit in front of a naked chart and draw the patterns and lines. Even the shortcuts that you use on the keyboard are very familiar. So to me it’s actually very interesting, I almost feel like I’m making music when I’m drawing and identifying levels on a chart. And that’s something that other musicians have actually mentioned to me as well. So there is some creativity and kind of a big game, but I would say that those are the biggest similarities. Really. I think that transition was more of retaining the same sort of lifestyle of being a self starter and not having to really answer to someone James Di Virgilio (22:05): Let’s go to that moment where you told your parents that you were going to be a DJ after graduating from an Ivy League school. What was that moment like for them and for you? Were they supportive? Were they frustrated? Tell me about that. Scott Melker (22:18): My parents have never been, even for one second of my life, anything other than supportive, it’s more nuanced than that. So first I want to see a music business while also deejaying. So I got a job in New York with a music agent moved to New York. And the first day that I showed up for my job, he told me that he had given the job to his nephew instead. So it was a somewhat forced exit from the music business very early in that regard, but deejaying and making music was always at the core of what I wanted to do. My parents were extremely supportive. I think they always believed that I would find success one way or another. And I didn’t always, I mean, I’ve failed more than I exceeded to some degree. JingingThat’s definitely stumbled forward through certain portions of my life. And I have needed help. There was a time when I was an Ivy League graduate five years out of college and I was deejaying once or twice a week in New York at night for some somewhat of a pittance. And I was delivering packages during the day while all my friends were on wall street. It definitely, wasn’t always easy, but my parents never batted an eye for a second. I have an older brother who’s a very successful physician. So I think that I can’t speak to their mentality about it, but I guess it’s good that they had one who was on the right path out of the way all right for their creative lunatics son kind of came through. But yeah, I’ve never had a conversation with my parents that I felt was uncomfortable about my future, because I always knew that they would talk it through with me, provide good advice and then get behind me. James Di Virgilio (23:37): So they gave you a lot of independence and what that independence, you find yourself in New York, you’re deejaying a couple of gigs. You’re delivering packages. What was your mindset at that time? And how’d you get through it? How’d you stick with following your passion, pursuing the path you were on? Scott Melker (23:53): It was hard. I was broke and there wasn’t really that much hope, I guess. I mean, I always had hope, but there was no really a major light at the end of the tunnel. At that point, musically, I was playing local bars and clubs every once in a while. I get a big club gig, but you’re talking about sustaining yourself without health insurance. You know, you have to pay for your own health insurance or without any guarantee that that gig will be there next week. So great. You made $500 tonight, but maybe next Friday the club’s going to close or nobody’s going to show up and you’re not going to have a job the next week. So it was always a constant grind and hustle for the next gig or the next thing. And then eventually like an actor or any musician, you kind of catch your break for me, it was in 2006, a friend called me in and said, listen, they’re auditioning DJs for this big tour in Japan, they audition 50 DJs. I got the job for an artist named Toshi Kubota, who is effectively, you know, they call them the Michael Jackson in Japan. It was his 20th anniversary tour. I had no idea what a big deal it was. I was just trying to get a job. I happened to bond with the drummer who was doing the auditions and we kind of jammed out. And so I spent the next two months rehearsing. And then five months after that, traveling in Japan, playing stadiums in 30,000 to 50,000 person shows as the DJ and opening act and percussionist in a 14 person band for this huge Japanese artists that not only offered some financial help because I got paid well for it. But it also gave me a lot of confidence in the platform to jump from there and do other things. James Di Virgilio (25:18): So you mentioned that you’ve failed quite a bit, right? Like anyone who’s done anything successfully, especially somebody who’s blazed a trail on their own. How did you keep learning from the failure without letting it beat you down to the point where you would just quit? Scott Melker (25:32): I dunno. I think it becomes routine to some degree, not to say that you become negative about it, but hope for the best, but prepare for the worst. I started a print publication in Philadelphia after I moved back from New York to Philadelphia, where I went to school and it launched and it was really like great success, well received. And two months later, 9/11 happened and all the businesses that were my advertisers started to go out of business. And so that was interesting experience and kind of lighten it probably to a lot. What’s going to happen to people now, but I think I’ve always had a positive support system for better or for worse. I would say that I knew that if something really went bad, I would have a soft landing. I never feared being homeless. I could have always gone back to my parents. I never did, but I guess mentally, you know that. And so I’m very fortunate to have a good support system in that regard as well, but I really never cared so much when I failed. I always just looked on the bright side and enjoyed what I was doing. I absolutely absolutely loved music from the earliest age. I started playing piano at five. I was a singer and saxophone player and everything. So it was just, music was always what I wanted to do. So at any point, regardless of what my financial situation was or how much I was working, I was just really excited be making music and to be a part of that scene, my passion for what I was actually doing, carried me through largely the rough times. James Di Virgilio (26:50): And this is interesting because given your background as a musician, what would you say to people that are inspiring to follow their passion, but maybe there’s no money in it or there’s inability to make a career out of it at the moment, do you have a view on the balance between continuing to drive for your passion, but also maybe providing for yourself and your future and your family. It’s a delicate dance to make. What’s your counsel on that? Having done that successfully kind of in several arenas. Scott Melker (27:16): I think it’s largely dependent on the individual, their financial situation, where they are in their life. And again, like how much of, I guess a support system they have. I think that at a certain age, you probably have to give up and become realistic. If you have a family, if you have kids, but if you’re a single person in this world with a true passion, I think that you should give it everything you possibly have until you can’t anymore. I know that if I had quit in 2005, I would have never known what was coming for me. But I really think that I would have a lot of regret not try my best and most passions that people have are things that they could probably do part time to some degree, go to your job and then come home and sacrifice your sleep and sleep four hours a night and make music and get it out there. I mean, it’s never been a time in history where it’s been easier with social media and all of these platforms, the SoundCloud and Spotify to get your work out there. When I was making music, I was one of those guys, on Canal St in New York City with CDs trying to get stores to sell my CDs and handing them out to strangers and stuff. So it is much easier now I think, I mean, you have to cut through the noise, but if you’re truly talented and you truly believe and you work hard enough, listen, the important thing to understand is you can be passionate about something, but if you’re bad at it, it’s not going to happen. I hate to say that, but if you have a discernible talent and you try your hardest, I do believe that the career that you dreamed of probably won’t happen. But I do think that you can probably make a living pursuing your passion. James Di Virgilio (28:40): Yeah. I think that’s really good advice. You balanced a lot of things there. One is balancing responsibility. Where are you in life? Who are you responsible for, is what you’re doing, going to cause others to have to pick up the slack for you towards significantly alters their life. And then secondarily, if you are actually really good at something and you continue to do it, if you live in a society that’s free and able to invest in that sort of talent, I totally agree with you. It could be longer than you wanted it to be, but at some point in time, if you are good, if you are skilled, you will find a way to be able to craft something out of that. Now, who knows how much you’ll get out of that. But that’s a good feedback mechanism. And often failure, Scott is obviously feedback. It tells us whether or not we should continue or whether we should keep going as a trader. You know, the failure is really a part of every single day, practically in your life. Uh, because traders traders are seeking to make very small wins, right? 52%, 53%, 54% of your trades are wins. You’re a hero. You’re a legend. So failure is something you learned to live with. I think it’s very helpful. I read on your Twitter about how you said really emotionally. You’re not that involved in what happens if you lose a lot, you can take it. You have a high pain tolerance, and it makes sense, given what you’ve just said in your life, there’s a lot of dots connecting there to the foundational floor. You’ve built what you view as success, which you view as failure. And one thing I’m not hearing a lot in your story is a prideful angle. I’m hearing a lot of humility with, Hey, I’m going after what I like and what I enjoy. And if I fail, it doesn’t mean I, myself am a failure as a person. It’s a chance for me to respond to what I’m learning. Scott Melker (30:06): I’ve never heard it put that way, but I do think humility was another thing that was deeply ingrained from my parents. I just feel like unless you become the biggest artist in the world or the biggest, this and that, where your ego is being fed 24/7. And I think that most people probably maintain that humility because especially as an artist, you know, that it can all be taken away from you in a second. I mean, how many, one hit wonders are there who bought their Ferrari and then returned it for half or had it repoed six months later? It’s just the reality of being a creative is that it’s not the 1950s. You don’t have a job your entire life. You don’t have a pension. Eventually you probably are not going to be at the top of your game and it’s somewhat a cycle. So I think that you just have to accept that whether you want to skin it as failure or whether it’s just the downturn or whether it’s that slow, steep descent from popularity into oblivion, that it’s coming for. Almost all of us who are not, like I said, just add a job and working for a boss who is able that boring and, and you know that you’ll have your job. So I don’t see how you can really be too prideful. You know, I’m proud of the things I’ve accomplished, but I also recognize that it was not all my doing. I had a lot of support and that it was very hard along the way. James Di Virgilio (31:13): Scott, it’s been excellent talking with you today. Kind of getting your background, hearing your stories, talking about cryptocurrency, music, trading. So many things you can follow Scott and find a lot of his insights on his Twitter feed the Wolf of all streets. Very interesting stuff there. He is Scott Melker. Scott, thank you for joining us today. Scott Melker (31:31): Well, thank you so much. It was really my pleasure. James Di Virgilio (31:33): And for Radio Cade, I’m James Di Virgilio Outro (31:37): Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida. This podcast episodes host was James Di Virgilio and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood Soundstage and edited and mixed by Bob McPeak. The Radio Cade theme song was produced and performed by Tracy Collins and features violinists, Jacob Lawson.