Medsider: Learn from Medtech and Healthtech Founders and CEOs - Is Your Medtech Idea Worth Pursuing?: Interview with BrainSpace CEO Caitlin Morse

Episode Date: March 19, 2025

In this episode of Medsider Radio, we sat down with Caitlin Morse, CEO and co-founder of BrainSpace, who has a decade of experience spanning medtech consulting, product development, and strategic advising. BrainSpace is developing an innovative precision drainage system with continuous ICP monitoring designed to automate cerebrospinal fluid management for patients recovering from strokes, traumatic brain injuries, and neurosurgery. In this interview, Caitlin shares her advice on assessing the viability of a medtech idea, tells the story of how her prototype won over stakeholders, and discusses navigating the development phase while balancing clinical and regulatory demands.Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You’ll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and 3 packages that will help you make use of our database of 750+ life science investors more efficiently for your fundraise and help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost, including the latest Medsider Mentors Volume VII. If you’re interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Caitlin Morse.

When I talk with founders and they ask like, okay, what about starting a company? I say, look, is this something you want to talk about for the next 10 years straight? Is this something you want to eat, live, sleep, breathe for the next 10 years? And for me, a generic consumer widget is just not worth the sacrifice that a startup requires. And so if you're going to get 100% of what I have to offer, it's got to be because I think what we're doing is worth doing. Welcome to Medsider, where you can learn from the brightest founders and CEOs in medical devices and health technology. tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful life science startups in the world. Now here's your host, Scott Nelson.

Hey everyone, it's Scott. In this episode of MedSatter, I sat down with Caitlin Morse, co-founder and CEO of BrainSpace. Caitlin has a decade of experience spanning MedTech consulting, product development, and strategic advising. Brainspace is developing an innovative precision drainage system with continuous ICP monitoring designed to automate cerebral, final food management for patients recovering from strokes, traumatic brain injuries, and neurosurgery. Here are for the key things that we discussed in this conversation. First, not every medical issue is a fit for a venture-backed approach. Some challenges might be impactful, but don't offer the financial returns investors seek.

In those cases, bootstrapping or exploring alternative funding methods might be a better option. As you develop your idea, think beyond the immediate issue you're solving. Consider how your solution can address additional pain points and deliver even greater value. Second, safety and effectiveness are essential, of course, but not enough. Hospitals and clinicians need proof of value in ROI, studies demonstrating improved workflows, reduced ICU days, or better patient outcomes. Plan a post-market strategy to build this evidence alongside early adopters rather than relying solely on pre-market investor funding. Third, a prototype, even a rudimentary one, can shift conversations from abstract concepts to tangible solutions. When fundraising, it's important to communicate technical details, but you also need to frame the problem in a compelling way that helps engage investors.

Build credibility early through small wins like angel investments or competition prizes to create momentum, and structure fundraising and stages with increased valuations tied to milestones. All right, before we dive into this episode, I'm pumped to share that volume 7 of Medsider mentors is now live. This latest edition highlights key takeaways from recent Medsider interviews with incredible entrepreneurs like Bill Hunter, CEO of Canary Medical, Brian Lord, CEO of Christine Surgical, Don Crawford, co-founder of Safion and current CEO of Corvista Health, and other proven MetTech founders and CEOs. Look, we get it. Keeping up with every MedSider interview isn't easy. That's why we created Medsider mentors. The

ebook volumes distill the best practices and insider secrets from top founders and CEOs, all in a downloadable, easy-to-digest format. To check the latest volume out, head over to medsider radio.com forward-slash mentors. Premium members get free access to all past and future volumes, plus a treasure trove of other resources. If you're not a premium member yet, you should definitely consider signing up. We recently revamped Medsider with swanky new features, especially for our premium members. In addition to every volume of Medsider mentors, you'll get full access to our entire interview library dating back to 2010. You'll also get Medsider Playbooks, curated guides packed with actionable insights and topics like fundraising, regulatory challenges, reimbursement

strategies, and more. And if you're fundraising, don't miss our exclusive investor database, featuring over 750 life science BCs, family offices, and angels. We've even created three custom packages to help you with your next fundraise. Learn more about Medsider mentors and our premium memberships by visiting MedsiderRadio.com forward slash mentors. All right, without further ado, Let's dive in the interview. All right, Caitlin, welcome to Medside Radio. Appreciate you coming on. Yeah, thanks for having me.

I know we scheduled this a couple times. So I know you're living the busy entrepreneur life. So I appreciate it and looking forward to hopefully a lively, lively conversation. So let's start with your background, right? I recorded a very short bio at the outside of this interview. But let's start there. If you give us like a one or two minute kind of elevator pitch on your, what you've been, what you've did previously kind of leading up to the, the,

finding a brain space. Yeah, absolutely. So I actually grew up moving around a lot. So every time I'd move to a new city or a new place, new school, I'm trying to figure out, okay, what's the system? What's the rules of engagement? How does this work? And now we think about that as system thinking, but I was just thinking about surviving

middle schools. So what that really taught me was to understand, kind of put myself in other people's shoes, right? How do they think? What do they do? And so originally, I really wanted to solve meaningful problems. And I thought that meant nonprofits. So I actually started my career.

career working in nonprofits, thought that's where I would stay. And I made everybody crazy. They, I was looking at how do we get flywheel effects and, you know, what's the ROI here? And I didn't know those terms, but those were the kinds of things I was talking about. And what I found was actually the method of solving the problems I wanted to go after made more sense in a for-profit environment than a nonprofit environment, even though the types of problems I wanted to solve, I think some of the biggest problems we have on the planet are actually problems that nonprofits are going after, but a little different in terms of the strategy and the approach. So I moved over into MedTech originally as a temporary transition. I knew people in that

space. I could transfer some of my project management, finance, program management skills. And I got here and found I loved it. For me, MedTech was this perfect combination of being able to really use the levers of business to make meaningful change. And the more successful you were at solving problems, the more capital you had to do it again. So I was working for one of the world's largest contract manufacturers was getting to see about 200 products a year. What does it take to really go from hacked together prototype or Dr. Sketch to scaled production solution? And really what I found in that process was a lot of startups needed the expertise that these kind of big players had, but they just weren't there yet in terms of scale. And so I started a three-person consultancy,

and we basically insourced instead of outsourced. So we came alongside startup teams, worked with companies and recently acquired on how to integrate with their acquirer. And it was an incredible learning experience. I was able to share our expertise, but was also able to learn a lot about that journey along the way. And then nights and weekends was working on brain space. So I actually had studied languages in undergrad and had looked at how the brain processes language and how that was affected by stroke. And so had dabbled a little bit in the neuro side of things. And brain space was the sixth product that we incubated and built a prototype and built a business model and interviewed customers and looked at the market for. And it was the first one that we really felt was worth it.

So, yeah, it was a journey from big company to small company to now startup life. Yeah, from side hustle to, oh, this is a thing now, right? By the way, the name of your consulting company, Moore's Code, so clever. That's it. That's so good. Of course, you know, kind of pointing to your last name, Morris. That's really good. But that framework that you mentioned, earlier, almost, it's really applicable to MetTac, right? Because oftentimes, like, this is such a hard space to build startups in and you almost have to have kind of a philanthropic sort of, you know, kind of mission or vision, right? But like, you know, knowing full well that you got to sort of apply, you know, capitalistic mindset to like actually getting these, getting these products

approved and commercialized in order to make, make a true difference. That's a really kind of great, great sort of frame of reference. Absolutely. And I think really, if you're just trying to make money, there are easier ways to make money. And I'm sure plenty of your guests have said things similar. But I think the difference is if you really want to have the biggest impact, for profits actually give you an opportunity to do that. Because when you go succeed in the marketplace, you actually change the marketplace. You change the way medicine is practiced when you provide a truly revolutionary solution. And that also produces then your R&D budget for your next thing. And so what was really exciting to me was to see that combination of it's not just that you have to have a bigger vision.

than just making money, but it's also that actually when you succeed at solving real problems, it is both profitable and impactful at the same time. And so that's a really fun thing about our industry. Yeah, it kind of reminds me of, I don't know if this story is Trinner really looked into it, but like Steve Jobs is notorious, I guess, for like not, like not really donating a lot per se is like he kind of this mindset that I'm going to make the biggest impact and change through Apple, right? And so like all of like most of his sort of quote unquote donations went back into the company, but I'm kind of paraphrasing a little bit. It kind of reminds me that to, to a certain extent. But I'm totally, I'm right there with you, right? I mean, there's certainly other

verticals to make money. And I'm sure you've thought the same thing. Like, why am I, why am I building in med tech? It's so hard. You know what I mean? But, but you know, we're all like doing stuff that that impacts people's lives, right? Which is like, I've often asked myself, like, could I ever even do a startup in a different kind of arena that doesn't, like a t-shirt, right? A better, more efficient way to make a T-T. Like, that sounds kind of cliche, but like, I don't know. I don't know if I could ever do that just because it just doesn't have the same, the same sort of impact. No, I will tell you, when I talk with founders and they ask like, okay, what about starting a company? I say, look, is this something you want to talk about for the next 10 years straight? It's something you want to

eat, live, sleep, breathe for the next 10 years. And for me, a generic consumer widget is just not worth the sacrifice that a startup requires. And so if you're going to get 100% of what I have to offer, it's got to be because I think what we're doing is worth doing. And right now, MedTech is, there's no shortage of problems in med tech. The question is which ones can build an incredible business and which ones can have a real impact for customers. And that is both clinicians, patients, the hospital, the whole thing. But I do think, you know, everybody's wired differently. But for me, I, if I'm going to put in the blood, sweat, and tears, it has to feel like it's worth something in the end. Yeah, no doubt. I love it. All right, brain space. You mentioned

it earlier and you touched on a little bit, maybe the, kind of the origin story here. So I'm on the website, on the website, I should say, which is brainspacemed.com, just as it sounds, brainspacemed.com. We'll link to it in the full write-up on Medsider. But let's go just a little bit deeper, right, before we kind of get to the meat of the conversation. But tell us a little bit more about like, you know, how did this, you know, why did you choose to work on brain space? Like, what is the major problem here that you're trying to solve?

Give assistance for kind of the solution, et cetera. Yeah, absolutely. So my co-founder had had a colleague in college and then early on in the career who had had more brain surgeries than birthdays. And that as somebody who was in med tech, who was seeing all the problems people were working on, was just totally crazy to me that we as an industry could not provide a better solution than having to constantly come in and adjust what was at that time an implanted shunt and is still for a lot of chronic patients the best way to manage if they're not able to drain brain fluid on their own. And as I dug into it, what I found was there had been

over 160 attempts and improving this particular shunt. And so I said, okay, we're not going to be 161. We're not going to keep going down this path, especially as a first time founder, first time company, right? I was like, okay, but what is related to this that will give us the data and insight to better solve this problem? What is the way we can take a fresh approach? And so looking at neuro patients, looking at what really goes on in the acute space, is there a solution that is worth it, that is not a 10-year timeline for an implanted device that would solve that problem. And so what we really found is for decades, neurosurgeons have been going to engineering teams and saying, hey, we have this incredibly analog device that if the patient moves by even a few

inches, it's going to over drain and cause complications. It's a total headache for nurses to manage in the ICU. It's a big problem. And this seems very solvable. And there was a lot of, there were a lot of university spinouts. There was a lot of activity going on in that space, but no one had really cracked the code on that. So I said, okay, maybe there's something here. And then I had had a very close friend of the family with early onset dementia.

I had had a close friend with brain tumor. I'd had enough different things going on in neuro where I said, you know, let's dig into this space. And in talking with nurses, what I really found was a process that was incredibly labor intensive. And for all of that work was still high risk and didn't really generate any real insights into what was going on with these patients. So that was really the moment when we said, okay, this feels like a solvable problem. It already has reimbursement. It already has a clinical workflow. It makes sense from a solvable problem perspective.

And I'd worked alongside a lot of startups who had a 20-year journey. And I just said, you know, I want to get to market faster. I want to have an impact for patients faster than that and have an opportunity to do more development once we're in market. But I don't want to wait 20 years to find out whether or not the approach I'm taking is going I really do any good. And some people probably, you know, have a different approach. There's, those who will grind it out in the lab for 20 years. I really wanted something that within five years, I could know, are we making a difference here? And so I dug into the research. I talked with nurses,

I talked with patients. It was COVID. And so a lot of people were stuck at home. So I just started reaching out to people who'd published papers or done webinars or things and said, hey, well, you talk to me. And fortunately got quite a few of them who said, yeah, somebody should work on this problem. And really it was, we then built some technical prototypes, some early feasibility. It was my guest bathroom was our wet lab in those days because everything was still shut down in the Seattle area. And what we really found was we thought we had a solution that made sense for both the market, the clinical workflows, the gross margins that were needed from my experience working with the acquirers. I knew kind of what we were going for. And so we said, okay, of all the projects that

We were working on this is the one that really was worth shutting down what by that point had become a successful consultancy. And I think having something I had to sacrifice to start this was really important because it set a higher bar. I said, okay, here's what it needs to be. I was basically the first one to do diligence on it to say this is what it's going to require for it to be worth shutting down what by that point was already working. Got it, got it. And so the device, I'm not sure how much you can tell about the device itself, but give us a sense for kind of what it's actually doing, like what it is and what it's doing. doing like where is it where where where do you envision it being used in the and the health care thing? Yeah, absolutely. So ventricular drainage and lumbar drainage are used right now to essentially

regulate brain pressure and spinal pressure in the ICU. And so that could be something like a traumatic brain injury where there's now swelling that's going on, right? If you think about if you were to injure your ankle, it would swell, your skin would just expand along with it, right? When the brain swells, the skull's made of bone so it doesn't expand. And so then you get this increased pressure inside the skull when you have that swelling. In other cases, it could be a hemorrhagic stroke that's increasing the blood inside the skull, but there's a variety of different cases. There's even a form of dementia where drainage is not happening properly. So fluid is being produced, but it's not being cleared. And so that's even causing a form of dementia or not a partial hydrocephalus. And so there's a

number of different conditions, but in each of these, there's a temporary reason that there's too much pressure inside the skull. The problem is if the heart is not providing enough pressure to get the blood up and circulating the skull because it's competing with this brain pressure, that's when you end up with long-term brain injury. And that's really that secondary injury. Maybe you had a head injury, maybe you had a stroke, maybe had these other things, but it's actually the fact that you can't get blood flow and that you have a brain shift causing nerve damage that really causes the long-term damage. And so what this device is doing is it's monitoring the pressure inside the brain, and it's a closed-loop system that's regulating the amount of fluid being removed from

the brain in order to keep this back. balance. So if you think we've got about a shot glass worth of fluid being produced every hour, that's not a whole lot if you're saying, okay, too much is a problem, but not enough is also a problem because your brain essentially floats. And so if you remove all that fluid, now you wouldn't be able to get blood flow because it wouldn't be floating. So there's this narrow window you're working with. And the solution right now requires leveling to the ear. You have this little kind of notch on your ear called the tragus. And nurses are leveling to that. And then any So loved one puts a pillow behind your head, echo tech goes and adjust the bed, anything,

even for a patient who's not mobile, let alone a patient who's getting up, moving around, rolling around in bed, that sort of thing, can cause over drainage. And so these are incredibly labor-intensive patients to manage. So our device involves a wearable that sits right behind the ear, or in the case of lumbar drainage, kind of like you would for an epidural after pregnancy, there's a lumbar tap, lumbar drain that happens there in the lower spine. And so with that wearable, it allows for patients to get up and move around. They're no longer constrained to that leveling with the IV pull. And then our closed loop system is continuously monitoring both pressure and volume. So let's say you want to drain 10

mils an hour. It will do that. And then it will stop. And it'll wait till the next hour instead of having to have a nurse there by the bedside. So all of this is pending FDA clearance. We are not on market yet, but this is this is how the device is expected to behave once it's, once it's in clinical use. Got it. And I presume, you said clear answer. It's a class two device then? Yeah. So this, this first device managing pressure and volume is, is a class two. There's definitely some opportunities down the line and happy to get into that around a CSF biomarker enablement platform where we really say, okay, now that we're here, what else can we learn along the way? And that may have another regulatory path, but this first device, we're essentially doing the same thing to the patient that existing

devices are. We're just doing it in a way that's a whole lot better for the clinician and for that patient comfort and mobility and all that. Got it. Sounds good. And we're recording this late 2024, started Brain Space, I believe, back in 21, I think, based on based on notes. Like, give us a sense kind of for where the company's at, you know, currently and, and where you're headed over the next, over the near term anyway. Yeah, absolutely. So we started in 21, just my co-founder and I were the first year, it was just the two of us. And we had a hand-sodered boards, 3D printed shells, Arduino code, very basic version, put it into the hands of doctors and nurses to say, is this what you want? How should this behave? Right. And so early days, it was things like,

no, it should go as slow as possible. I said, are you sure? Yes, take the whole hour to drain that 10 10 mils. Okay. So we did put it back in their hands. And they said, uh, nothing's happening. It's not working. I said, well, yeah, what you told us to do is essentially a drop or two a minute. like this is basically watching paint dry. So it was a lot of back and forth. Anytime you're trying to automate something people do intuitively, there's definitely some of that back and forth to figure out what do they really want, right? Because they can't really give you that from an engineering spec standpoint. They just know what it should look like for the clinician. And then we raised a seed in 2022, hired a few people, brought on a team, and really developed

the device that would go through into commercial use. We are just wrapping up B&B and we expect in 2025 to have both FDA clearance and our first clinical use. So it's a pretty exciting time. It has been a pretty incredible journey of the last few years. And so much fun to get to be bringing this device into market. And now really looking forward to it being in clinical use and seeing that benefit. Yeah, yeah, that's awesome. Yeah, it's definitely a fun time, especially after, you know, three-ish years of, right,

of kind of behind the scenes development. Like, there's so much work there, right? But like, no one kind of really truly appreciates until you start to get into these like more publicly facing kind of mile town. So really cool. So brainspacemed.com is the website again, brainspacemed.com willing to it in the full write-up on MedSetter, as I mentioned before. So with that said, Caitlin, let's jump through some key kind of cross-functional initiatives, right? It's been the next 20, 20, 30 minutes talking about some of these various topics. And then, you know, kind of going from ideation to development to Ray Klin, you know, to, you know,

and really the fundraising, right, to effectively do all that. So with that said, I want to, I want start with something that's probably like right at your warehouse right which is uh especially considering you worked alongside like so many startups we were starting starting our founding brain space um is really like how how do you how do you choose an idea right like like how do you know something that set looks going on paper right maybe even maybe even solves like a real like a like a pressing need like how do you choose to work on it knowing that these these windows right that you mentioned before oftentimes you know five to 10 years right that you're going to be working on this uh before you know before it eventually sees the light of day so give give us a sense for kind of

for what you've gleaned over the years in choosing the right ideals to work on. Yeah, absolutely. I think one of the big things we saw, if you're in consumer, there's a lot of a question of should this exist, right? In MedTech, it's a little different. Almost everything somebody's going to bring to the table,

there will be somebody out there saying this should exist. The question really becomes, is this a problem that can be solved either with bootstrapping level investment for a bootstrapping level return or that requires venture dollars, are you going to get a venture level return? Right? So there's some problems that I've come across where I'm like, this should absolutely be solved. But unfortunately, it's going to take 10 million to get there. And it's never going to give a return that any investor would put 10 million into to determine, right? There's other things where it's like, yeah, you could make money on this,

but is it actually solving a problem anyone cares about? Is it really making a difference? And again, some people may choose to pursue that for me. That's not really worth it. So it started off by saying how much investment is required to get to the milestone and then does the return make sense relative to that? I think the other thing is, are you solving a problem that solves other problems? So this is where that kind of flywheel effects come into play. And everybody talks about Simple is beautiful, but I think you have to think about it a little bit more like a tapestry. So the front side, may be a single image. But if you look at it on the backside, there's all the threads, crisscrossing all over the place, getting the colors where they need to be. It's fairly chaotic,

right? And the more simple you make the experience for the user, the more simple you make the final product, often the more work that had to go into getting to that point. And so you can often say, well, it's a simple device, which means it's often more clinical training. It's more complex to understand and implement. Or you can say, okay, we're going to make this, feel simple to the user, but that means there's a whole lot more work for us on the front end. And so I was really looking at it going, where's the trend in MedTech? Where are things going? And this at that point was a lot of conversations around data and how data could be used and a lot of people kind of collecting data and dumping it in a data lake and hoping someday it would be

worth something. And I really looked at that and I said, what are the trends that have happened? You know, people talk about 1.0 with the internet and they talk about 2.0 with mobile. But what they miss is the fact that it wasn't just the internet for 1.0, it was also the PC, right? It wasn't just the software layer. It was having that hardware at our fingertips. With mobile, it wasn't just apps. It was actually the fact that you had that computer in your pocket. And so I think sometimes in MedTech, we undervalue the fact that actually we're the physical interface between the human and whatever that software looks like, right? And so I think there was really this opportunity that I identified at that point and that I still am a huge advocate.

for to say MedTech shouldn't just be dumping data somewhere and letting some other app figure it out. We actually have an opportunity to really build much more rich data sets while we're actually solving a meaningful problem. And so for me, it was this combination of, yes, the unit economics have to work and you have to solve a real problem. And, you know, there's kind of a checklist of seven or eight items, I would say, in terms of market and margin and opportunity and the solution and how you're going to roll it out and regulatory and all that.

But I think when you go beyond that, you say, okay, when I solve this problem, do I unlock solutions to more problems? And that's what gets me really excited about brain space is because by automating and digitizing this process, we're now at step one on this biomarkerney moment platform. So if you said, hey, nurse, I'd like you to, instead of draining four drops at the beginning of the minute, I'd like you to drain two drops at the beginning of the minute and a drop at the end of the minute, right? The nurse is going to look at you like, oh, that's sweet. You think I have time to sit there and do that with the patient every minute? Never going to happen, right? I see you nurses are incredibly skilled and have an incredibly difficult job. But an algorithm is more than happy to do whatever version of that you want, right?

And so we really developed a solution that has single drop precision. We can decide exactly how many drops we want to drain each minute. And then that really opens up a whole world of possibilities. So, for example, you have an unsecured aneurysm. let's look at a study. Does it actually produce better results to go faster versus slower, right? Maybe it does, maybe it doesn't. We can't tell you that right now, but our first users will be able to tell you that by using our device. Traumatic brain injury, you know, you look at diabetes and when you had a data point once every few hours, you said, okay, it's high, take insulin. It's low, eat sugar, right? Now with CGM, you say, oh, it's trending in this direction. Let's go ahead and leave it. It's

trending back into range or it's trending out of range. Let's intervene early before we get that spike. We believe the same thing will be true with traumatic brain injury, where keeping that pressure in a healthy range is actually more important than a single value. But we can't prove that yet. That's exactly what our clinical collaborators are going to be able to prove with our device, because they'll be able to control that as tightly or as loosely as they think is appropriate for their patients. And we expect to see a whole lot of clinical publications come out of that where they say, okay, here's how we're going to improve life for our patients. And we're just providing the mechanism to do that. And that really comes from my, so my first W-2 job. I did a bunch of kind of side hustle things as a young teen,

but my first W-2 was working in a restaurant. And at the end of my first year there, we moved from a manual cash register to a digital one. And my job as a cashier didn't change. Take the money, give the food, clean the tables, right? But the data that was available was transformational. So now we could see, well, why did people order a glass of wine with this meal, but not with that meal? Or how often did they order the special versus the regular, right? How do we need a staff differently? All of that insight was available, even though I was not doing any more work. I wasn't sitting there tallying all that. And so when we look at healthcare, we often want all this insight, but we say, hey, use this extra app, record this extra data, do this extra thing. And I think that's totally

the wrong approach. We need to actually say, how can I solve a problem you have today? And in the background, I'm building that data set for that research and those scientific discoveries. But I'm not putting more work on the plate of frontline workers who are already doing a lot to try and keep us alive. Yeah, yeah. And even certainly back to the lines with that sort of that analysis that you, that tapestry analogy that you used earlier, right, of like making it as simple and easy to use front line, right, while you're doing all the magic, right, it's happening behind the scenes. It kind of reminds me, have you seen this videos on, I think I've seen him on X mostly, where it's like someone in an art gallery, and it looks like a bird. And then as they zoom in,

like you see like what's actually behind the bird or what actually makes for that kind of that visual illusion. It's like bizarre. It's like there's a, it looks like a total mess behind, behind sort of the visual layer. But it kind of speaks to this idea of like whatever solution we're making has to be as simple as possible. That doesn't mean that it's going to unlock, right, a lot of potential, you know, interesting things. And it's either fairly complex on the, you know, sort of behind the scenes. But that's a really good, really good, really good point. The other thing that you mentioned, too, that I really want to highlight for, for those listening that are kind of new to the world of met tech startups is just that that, that,

that phrase that you used, right, are we going to bootstrap this and get bootstrap like returns? Or, you know, is this a, is this a venture funded, you know, company that's going to expect venture like returns? I think that's so, that's so, so critical. And it's such a great way to kind of, you know, answer that key question because it's so hard sometimes to, if you're stuck on an idea, and maybe it's an idea that does solve, to your point earlier, most of these ideas solve a real need, right? But that's really a healthy kind of way to look at this is like, is this, let's say I'm passionate about this thing, right? And I do, it's not maybe a huge market, but I want to spend the next five to 10 years talking about it, right? I feel like I can do

that. If it's not a venture like business, don't go out and raise venture money, right? like try to find other creative ways to kind of get this out at starting blocks. And that does provide a lot more optionality down the road for, you know, maybe it's a boost trap right turn. Maybe it's a bigger return, right? But I think that alignment has to be there early on. I think it's such a good point if you're kind of weighing, weighing, you know, weighing whether or not to pursue a certain idea. Yeah. And we definitely did some of that on the global health side of things. So there were some initiatives that we knew would be transformational for a given country, but we knew we're never going to produce those kind of returns. Right. So we said, okay, how can we help make this?

happen, but we're not going to go raise funding for that. I mean, same thing with our consultancy. I was looking around going, there's a real problem here and there's a real opportunity to solve it, but I wasn't trying to build, I wasn't trying to 10x the business in five years. You know, if anything, that was probably the best work life balance I ever had because I took on clients. I cared so much about their outcomes, but at the end of the day, I was billing by the hour and I was going home, right? So I think that's the other thing is sometimes, and I will say I've had some conversation with neurosurgeons where they've kind of glamorized the startup life and they're like, oh, maybe I should quit neurosurgeon but become a startup founder. I'm like, how much do you

make per year? How much are you guaranteed to make for the next five or 10 years? Here's what the outcomes actually look like. When you see that big announcement, here's what founders are often getting in return. And here's the percentage of probability. And I'll often say, you know, if it's really what you want to do, go for it, but go in eyes wide open. You are probably much better off being a co-founder, CMO of a half a dozen startups and having a portfolio as an neurosurgeon, then you are quitting what took you 10 years to build the expertise in just to come jump in. But I do think recognizing the type of problem you're trying to solve and the opportunity of impact it has, I think the other piece of that is how disruptible are you.

So there was one we looked at in laparoscopic surgery, meaningful problem, big operational. to solve. However, as we dug into it, we found out really the biggest player could make a software update and our whole solution would become obsolete. I said, okay, well, that's not an investable idea. You know, it's great that there's a problem to solve there. And, you know, if somebody wants to do it as a PhD project, I'm happy to provide some advice, but I can't build a company around something that a software update will resolve. So I think that's the, that's another big piece. And then the last piece I would look at is you have to assume that every clinic, wants everything they already have plus whatever they're asking you for. And so Me Too products get a lot of

are often derided in the startup world, but just be aware if you want to add one great feature, you have to start by getting back to the baseline of what they already have and then add on that one great feature. And so sometimes people underestimate what it's going to take to actually get back to baseline. And we saw this with with some of the previous projects I worked on where it was like, man, actually, that was a 20-year lift to get to what they already had. So although you could solve the new thing, are you actually a comprehensive solution? Because in order to move from what they have to you, you have to solve enough of it. And in the ICU, that means all the patients. So we couldn't just do something for TBI or just do something for stroke, because in the ICU,

they want nurses to be trained on, here's the solution, and you use it across everybody. So it depends where you are. But there's a lot to consider if you're going to if you're going to go after this and have a, have a decent shot at success. Yeah, yeah, no doubt. I love the example that you just brought up to about, like, being disruptable as well. Like, there's this, you know, fairly popular notion in Silicon Valley Tech of, like, could Google push an update and kill your business, right, with one, one code update? And it's like, well, that's probably not something that has much of a moat.

You know what I mean? So it's really, really good point. Let's transition to early stage development. Hey there, it's Scott. And thanks for listening in so far. The rest of this conversation is only available via our private podcast for Medsider Premium members. If you're not a premium member yet, you should definitely consider signing up. Here's why. First, Medsider Premium members get access to every single interview dating back to 2010.

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