By Jon Coe, co-founder and CEO of Prescient Surgical, an FII graduate
Patients are the focus of everything we do in healthcare. Of course, it’s supposed to work that way, though at times, distractions, sheer system complexity and unintended or misaligned incentives can lead us astray. Healthcare innovation, in the broadest sense, is an arbitrage exercise of sorts, where we identify these deviations and deliver solutions that refocus human and financial capital towards optimizing patient outcomes.
Innovators charged with delivering these solutions quickly find themselves on a tortuous path winding through a complex ecosystem of stakeholders. The travails of the journey can at times obscure the mission.
At Prescient Surgical, we are focused on eliminating surgical site infection (SSI) with our device, CleanCision, an active cleansing technology used during surgery to fight and defend against the most pervasive sources of infection. CleanCision was conceived while observing a kidney transplant that resulted in an SSI — an outcome that at the time was deemed inevitable by the attending surgeon.
Well into our own journey, we are returning to those roots with a project highlighting the patients’ experience that is at the core of our mission. We’ve found many patients willing to share their stories, and today I’d like to share one of my favorites with you.
30 colorectal surgeries in less than 20 years….
I heard about Rebecca (fictional name used to protect privacy) through a friend. He offered to connect us so I could learn more about her seemingly improbable healthcare journey. At just 16, this high-flying, top athlete and student was slowed to a virtual standstill as she began her lifelong battle with ulcerative colitis.
When her symptoms first struck, Rebecca was forced out of school for six consecutive weeks, desperate for a reliable diagnosis and promise of the “normalcy” she once knew. She instead spent the remainder of her high school years in and out of the hospital. Undeterred, she forged ahead, excelling throughout college at one of the nation’s top universities — but in so much pain that she almost didn’t return for her last semester. Her experiences with myriad doctors inspired her to pursue a career in medicine, but her condition took a turn for the worse. While dissecting cadavers in medical school, she became seriously ill and was again admitted to the hospital for six weeks.
After more than six years of suffering, she found relief by undergoing surgery — a complete removal of her mutinous colon. Confident her troubles were in the rearview mirror, Rebecca underwent another surgery to reverse her stoma, which unfortunately set off a cascade of complications that would keep her in and out the operating room for the better part of the next decade — septic intestinal leaks, several stoma revisions, hernias, abscesses and wound infections. All told, she estimates that she ended up with five SSIs across the 30 surgeries, a number that, not surprisingly, agrees with the published literature on the topic. Yet, not one infection was diagnosed or acknowledged as such by her attending surgeons.
Unfortunately, pain and suffering persist despite a doctor’s missed diagnosis. She built her own wound care clinic, complete with wound-vac treatments and wound care supplies purchased out-of-pocket. Building on skills she picked up during her burn clinic rotations, she repeated excruciating dressing changes daily, picking out pieces of mesh as she tended to the horrible wound left by the infection. “It was barbaric,” she said. As a doctor, she couldn’t imagine how SSI patients coped, as they seldom had access to wound care clinics or quality nursing care. “I know how to work the system and I barely managed!” she told me.
Once again it seemed that Rebecca’s condition was encroaching on her ability to thrive. Her residency program wouldn’t let her return part-time during her long recovery. So, she improvised. She dropped the wound-vac and packed her wound with extra gauze to make it through the day, though it leaked like a gaping wound by the end of her shift. Still in her 30s, she loathed the resulting outpouching and bumpy surface of her belly. It was clearly stigmatizing, and I could hear the pain in her voice as she recalled the times she was told her abdomen “looks terrible” or that she should “get plastic surgery.”
“When you have these things happen to you, you are in denial,” she told me. “You say to yourself, ’I don’t want to have a stoma,’ ‘It means acknowledging I’m sick,’ ‘I’m being defeatist.’ You become stubborn, self-flagellating, and resistant to adapting to the new reality of your condition.” Today, Rebecca is living her best life, personally and professionally. She may never be totally free from ulcerative colitis, but she is most certainly past it.
“I love what you are doing for patients just like me”
Rebecca sent me a brief note after scheduling our call: “I love what you are doing for patients just like me.” It was exactly what I needed to hear. To be sure, we’ve helped thousands of patients like Rebecca avoid SSI, hastening the road to physical recovery, episodically improving patient outcomes. That is what we do. Rebecca helped me remember why we started doing any of it in the first place.
My advice to all early-stage entrepreneurs is this: Yes, we face a tough road sometimes, but during those times, think and read about the impact you are, or could be making on people’s lives. There is no better motivator.