November 18, 2025 • 46 mins
In this episode of Blind Spot, Zale sits down with Dr. Kieran Murphy, a renowned inventor and professor of radiology, to explore the essence of invention and creativity in medicine. Dr. Murphy shares his journey from medical innovations to his thoughts on the socio-economic factors that influence creativity. Discover how invention is not just about genius but a mindset, and learn about the challenges and triumphs in the world of medical creativity.
Dr. Murphy's Book 'The Essence of Invention'
https://www.amazon.ca/Essence-Invention-Medicine-Joy-Creativity/dp/1459754034
This episode is sponsored by Thea Pharma Canada - https://www.theapharma.ca
Become a supporter of this podcast: https://www.spreaker.com/podcast/blind-spot-the-eye-doctor-s-podcast--5819306/support.
Dr. Murphy's Book 'The Essence of Invention'
https://www.amazon.ca/Essence-Invention-Medicine-Joy-Creativity/dp/1459754034
This episode is sponsored by Thea Pharma Canada - https://www.theapharma.ca
Become a supporter of this podcast: https://www.spreaker.com/podcast/blind-spot-the-eye-doctor-s-podcast--5819306/support.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:13):
Hey everybody, I'm zaeo Mednik and welcome to another episode
of blind Spot. This episode is sponsored by THEA Pharma Canada.
THEA pharm of Canada is the Canadian subsidiary of THEA,
Europe's leading pioneering and innovative eye health brand. Founded in
nineteen ninety four by Henri Schibret. With five generations of history,
the Chubret family has been dedicated to I care for
(00:33):
more than one hundred and fifty years. Their commitment to
improving lives is born of their pioneering spirit. They continue
to lead the worldwide preservative free movement in eye care.
They've created innovative delivery systems. They've focused on making products
accessible and cost effective for patients. They live this mission
every day because everyone should have the same opportunities to
see the world through healthy eyes. So thank you THEO
(00:56):
Pharming Canada for supporting Blindspot. It be easy to look
at the present world and marvel at all that exists
and all that has been accomplished. The Internet, airplanes, travel
to outer space, artificial intelligence. It's mind bending to think
about where we are as human species. But one hundred
years ago, I would imagine humans felt the same way
(01:18):
that they were living in unparalleled times of innovation and development,
and one hundred years from now, I have to imagine
humans will still be marveling it yet even newer and
more exciting innovations. So how do we get from great
to better? What is at the essence of invention? How
have the greatest inventors in history gone beyond the preconceptions
(01:39):
of the status quo and found newer and smarter ways
to solve humanity's problems? Is invention a product of genius?
Or is invention the product of a certain mindset? I'm
joined today by Professor Kieran Murphy. Kieran graduated in nineteen
eighty six from the Royal College of Surgeons in Ireland.
He completed his Radiology residency and Neuroradiology fellowship at the
(01:59):
Universe of Michigan and Interventional Neuroadiology Fellowship at University of Geneva.
From ninety eight to two thousand and eight, he was
Division Head of Interventional Neuroradiology at Johns Hopkins. Since two
thousand and eight he has been a Professor of Radiology
at University of Toronto. He holds eighty one patents, including
verteber plasty systems, bone cements, biopsy systems, and other medical
(02:20):
devices to treat spine, neurovascular and disc pathologies. He's a
competitive race car driver in modern and vintage race cars,
driving for teams in Europe, at SPA, Silverstone and across
the US and Canada. His essays have been published in
the Toronto Star, National Post and the Christian Science Monitor.
His book, The Essence of Invention and the Joy of
(02:41):
Medical Creativity is published by Dunder and Press and is
available in bookstores and online. Kieran, Welcome to the podcast.
Thank you so much for joining me. It's very kind
of you. It's always an honor to be asked too.
Speaker 2 (02:52):
To speak to anyone, anyone well, you know really, because
in general I always feel a lot of people spend
their lives listening, right because they don't get to be heard.
Speaker 3 (03:03):
And I with my patients, I see this all the time.
There are a lot of people who live very quiet
lives and they'll never get to speak at a podium
or at a you know, in a church, or to
a group of people in a room, and nobody will
listen to them if they did speak. And how do
we decide that how does that get determined? And so
(03:26):
for you to say, would you mind chatting away, you know,
is an honor and it needs to be taken seriously
and the privilege.
Speaker 1 (03:36):
Oh, I appreciate that, and you're right, I can see
that with some patients as well. And yeah, it's my
honor that you're here. And we're going to talk about
about your book and a lot of the themes that
come out of your book. And I want you to
talk to me a little bit about why did you
write this book? What was I mean in the introduction
in your bio I talked about the fact that you've
(03:58):
got a lot of patents, You've you're an innovator, you're
an inventor. Talk to me about what the inspiration was
behind writing this book the essence of invention.
Speaker 3 (04:11):
Well, really, I think all the credit goes to my dog.
I'll you know, Althie wakes up at six o'clock every morning.
Whether I want to or not, I wake up at
six o'clock in the morning. He goes outside and goes
pp Sometimes I join them, No I don't, but it's
well there you go say from time there len sigma approached.
(04:35):
But then seek healthy and then if I do not
touch my phone. You know. He and I go back
to bed, and we sit in the bed. I play
with him and he'll you know, play with his toys,
and I get about an hour that is unplugged, and
in that hour, I get to think, and I hear
my own inner dialogue, write my own lucidity. And we
(04:57):
pretty much do the same at the end of each
day too, and I don't touch my phone. And since
we've had him for about four years now, and you know,
I during that hour, I began to think, you know,
there are things I think that are are maybe worth
(05:18):
sharing because I do believe in certain kind of immutable
principles about engagement socially, and I really view inventorship as
an act of social engagement.
Speaker 1 (05:30):
You know.
Speaker 3 (05:30):
It's like that guy in the movie saying, I'm mad
as hell. I'm not going to take it anymore. There
are diseases that you know better than I that we
treat badly. There are people in the world who can't
access technologies that you use every day, And then how
do how does a new technology get adopted? Think of
(05:52):
the grief that the inventor of the cataract lensing plant received.
Ridley in England ridicule nearly lost license for what is
now one of the greatest contributions to medicine ever. So
I began to think about, you know, why do people invent,
Where does the idea come from, what obstructions do they face,
(06:13):
How do we adopt innovation and creativity, How do we
handle inventories, where do they fit into society? And the
thing that bothered me most is the stereotype that people
are driven by money. People who invent are not driven
by money. They'd be a lot wealthier if they didn't invent.
I'd be a lot wealthier if I just put money
in mutual funds then putting them into ideas, you know.
(06:36):
And so it's really and that's why I wrote this
to try and explain to people and particularly kids, that
that inventorship is creative. It's a creative expression, like writing,
like poetry, like art, like music, you know, and that
(06:59):
medicine is is a creative art. It's an art, not
of science. So to kind of transfer those kind of
beliefs because a lot of the writing about inventorship, I
think is fundamentally wrong. And you know, people building big
monoliths like the Mars building downtown wasting a billion dollars
(07:19):
in that place thinking it will attract inventories, and now
it's filled with government people, you know, a handful of
of bench researchers, and they do discovery. Discovery is not invention.
Discovery is lucky. This is like the difference between Howard
and Big Bang and Sheldon. Howard's an engineer who observes things.
(07:41):
Sheldon is a thinker who creates things. And that's why
they fight all the time. Where they know there's a
fundamental philosophical difference between them.
Speaker 1 (07:51):
What's that difference between invention and innovation and the concept
and for those two For those who are in Toronto,
Mark Building is a downtown building affiliated with the University
of Toronto, which I guess the idea was invention. But
you're saying has not necessarily achieved that goal.
Speaker 3 (08:09):
We don't have enough inventries in the country. You know,
we talk about innovation all the time. Innovation, I think
people define it as taking somebody's invention and translating it
into a product. You know, and every boring administrator in
a hospital and the country talks about innovation. But God
forbid this innovation. It would disturb their nice billing plans
(08:31):
and structures and maybe be unreimbursed by ohip or insurance
company and things like that, you know, which is a
structural problem in our hospital system. But so invention, that
moment of creativity, the Robin Williams moment where he suddenly
says something funny out of left field that made no
(08:51):
sense and you didn't see it coming, you know, but
you feel it in your brain when it happens. You're
one liner that is appropriately timed, not later when you're
driving home in your car and you wish it said it.
Then that that moment of unconscious awareness and insight, that's
(09:12):
that's invention. And sometimes we uh don't realize that that
it's something significant until later, which is why it's important
to have notebooks actually to keep track records of when
you created things. But to do it it requires some pressure,
(09:36):
some need, some obligation, focus, engagement, and usually a cause.
You know, and you have been in surgeries, I'm sure
where you thought you had everything under control and something
went sideways and you had to do something that was
creative to solve the problem, and it required some self
(10:00):
mastery to manage your stress at the time. It required
some improvisation to use two things together that didn't normally
be associated technically.
Speaker 1 (10:10):
And.
Speaker 3 (10:12):
You know, an inventive step to solve that problem. You know,
That's kind of what I wanted to write about.
Speaker 1 (10:21):
I recall when I was in my residency, my training
for ophthalmology, one of my mentors, he was talking to
me about a new technique in cataract surgery, and I said,
to him, is that really? Is that? Really? Does that
really have legs? Is it? We've got a really good
solution for that already? Is what's what's the point of that?
(10:44):
The difference that we're getting in surgery from that particular
technique is so marginal, why studying in it? And he
said to me, he said, and he's a really down
to earth guy, so I respect his opinion. And he said,
you know, if we didn't do those little steps, even
for marginal gains, then we wouldn't have He didn't use
(11:05):
the word invention. He probably used the word innovation, but
it stuck with me because I thought, you know what,
there's truth to that. Maybe this is such an incremental
advantage by having this particular technique that's being added to
cataract surgery. But if people aren't studying that then they
then the whole impetus and the whole kind of track
(11:27):
towards getting new things is going to be hindered. And
I wonder what you think about that, because there's an
old adage, if it ain't broke, don't fix it, And
I think that there's wisdom to that, and I guess
that's what I was saying to my mentor, and he
wasn't disagreeing with that. But how do you look at
that adage and realize, yes, it's good to just accept
(11:48):
that some things are good. We don't always need to
be chasing better versus Yeah, but we do always need
to be chasing better in the vein of invention.
Speaker 3 (11:57):
Yeah, it's complicated, isn't. But I think some ideas have
precursors and they have a family tree associated with the might,
and you can see a genealogy of where the idea
came from the first point in that family tree. The
kind of progenitor of it all is probably the greatest leap. Say,
(12:18):
when Palmas came up with the coronary stent, or Grunzig
decided to make an angioplastic balloon, that was the big,
big leap when there would have been the greatest opposition,
the greatest change to pre existing belief systems. It used
to be that, you know, doing cardiac surgery at all
(12:42):
was thought to be fatal and you should not touch
the heart. And then it became possible to open the
heart and replace a valve, and then bypass was invented,
and then angiography was invented, and then angioplast he was invented.
In so you see a cadence of things that occur,
kind of a concatenation of pre existing thoughts, and then
(13:06):
there is iterative improvement of things that is important that
we'll make something safer for the patient. And all of
them are valuable, but the big leap is the first one,
I think some I think optimology is a good example
of a field where it's now done so well that
(13:27):
it would be really hard to do it better in
many ways, unless maybe it's retinal surgery. Unless you could
make direct injection of a vast and into the eye
a pill instead of an intraocular injection, which must be
so uncomfortable, you know, but there's got to be a
way to make that an oral only pill. It may
(13:49):
not be in the best interests of ophthalmologists financially, but
from the patient perspective it's the right thing to do
because it'll decrease that pain and it'll decrease the fear
and diety and also allows spread of technology in some
similar ways with obesity surgery, right, we used to do
gas proplasty and you'd open somebody's abdomen and you'd make
(14:12):
their stomach smaller surgically, and now we have all these
drugs that you just take orally that effect hormones like
grayland secreted from the gastric fundus. That's kind of thing
we need to do with retinal issues. So that's that
would be iterative, but it would be a major step forward.
Speaker 1 (14:33):
When you think about the paradigms for invention, and you
give lots of examples in your books, and maybe there's
some to illustrate this. Where do a lot of inventions
typically start. Is it with a problem that's known that
people have been trying to solve and somebody finally comes
up with a solution. Or is it often when somebody
(14:54):
is identifying a problem that kind of we didn't really
know existed, or is it a mixture of both. When
you look at the inventors that you discuss in your book.
Speaker 3 (15:05):
I think it's usually in an inner city hospital, in
a hospital of last resort, when you've got a team
of people who are willing to accept patients for whom
there is no other solution. And that's why the great
academic centers still exist. You know, the places like U
Penn are Hopkins, inner city hospitals in the sort of
(15:25):
knife and gun club of the city like Philadelphia or Baltimore,
where you see dreadful things. I spent ten years in
East Baltimore at Hopkins as head of intivintional neuro I'm
really good at treating gunshot wounds and stab wounds, stopping
that exanguination, that bleeding. I was going to say, blead's
over Jesus. It overlaps with techniques that are now used
(15:50):
in other fields and other diseases. The most important thing
is that somebody like you or me steps up and says, okay,
we will try. And you know, Hopkins is a hospital
where there's probably sixty percent ICEEU beds, so everybody there
(16:16):
is really sick. And the other thing is that they
take immigrants. That these are hospitals with a tradition of
taking fellows and graduates from around the world. In the
nineteen thirties, U Penn hired Jewish physicians escaping the Nazis
(16:38):
and had this influx of brilliant minds from Charitay in
Berlin and other hospitals around Europe when doctors of that
religion were being terrorized and murdered. At one stage, eighty
percent of pediatricians in Germany were Jewish. The vast majority
of them were either external dominated or prevented from practicing
(17:02):
and were replaced by mediocre Nazi minds, and that shut
down German science until the sixties and seventies when those
guys died. Those Nazis died because they stayed in place,
you know, so talent. Adopting a policy where you recruit
talent is really important. I think also hospitals where the
(17:26):
university has power. Now, the University of Toronto, as much
as I love the new Dean, has no power, no
influence on my life whatsoever. It looks after undergraduate programs,
I met students and residents and fellows, but it has
no influence on adult life as a doctor. Unfortunately, at
most great institutions, the university and the hospital are one
(17:47):
promotion means something, and if you're non collegiate, you get
asked to leave, whereas here we have jobs for life
for thirty forty years. You could stay at University Health
Network even if you're mediocre, which means that young bright
minds can't get jobs and they wind up in like
(18:07):
with a central fugal force, being in Sudbury or Timmins
or or somewhere else. Cornwall, you know, Cornwall is a
town on the border of Quebec and Ontario. That's usually
the place people stop for a pee when they're driving
to Montreal. That's not where you want to work as
a bright physician, you know. So we don't give young
(18:29):
brains opportunities here, and you have to you have to
have job turnover. So inner city hospital of last resort,
where you attract immigrants, attract talent and give young brains opportunity.
That's the environment where you get creativity.
Speaker 1 (18:43):
And you're saying in terms of the system that we're
in Toronto. Obviously a lot of listeners aren't, but Toronto
is an example. You're we're not trying, we're not trying
to be mean to Toronto, but Toronto and a lot
of other universities. I guess it's the stim doesn't necessarily
cater to invention because of things like tenure, and because
(19:09):
it's not because it operates differently than other hospitals which
are going to be more ripe for innovation, like Hopkins
in Baltimore for example.
Speaker 3 (19:19):
Yeah, and if you look at the German system or
the Dutch system or the Italian system, the whole hair
professor thing where the professor gets to be right STI
Japan hardly any medical innovation. I can't think of anything
other than the Sheba needle that has really impacted healthcare
(19:40):
from Japan. You think of Germany hasn't been created since
the nineteen twenties and thirties. Norway fibulous resources, what are
they given us? Southern gefilter fish and cross country skiing?
You know both? Like you have to there has to
be pressure. And the American hospital's order such pressure for
(20:02):
revenue that they have to be creative. They have to
adopt new technology. Socialized systems where you know how much
about it's going to be every year, doesn't have that pressure.
Speaker 1 (20:14):
You talked about innovation before, and it's a buzzword. Innovation
is a buzzword and a lot of universities use. Can
you explain why, what exactly is the difference between that
and invention, because it is a word that a lot
of people, I think, when they hear they have, Oh,
(20:34):
that's a really really positive word. It's promoted by a
lot of companies, it's promoted by a lot of organizations,
and it's often used to attract people like we are
an innovative company, and people might be surprised to hear
you kind of scoff at that word as opposed to invention.
Speaker 3 (20:51):
Yeah, I honestly think that, you know, it's about inventorship.
That the moment of creativity, the Robin Williams type moment
where his humor just shocks, is at speed and it's brilliance.
It's about adulpe diesel, creating the diesel engine, you know,
and having no spark plugs. It's the past. It's a
(21:17):
moment and then being able to manage that moment in
many ways to be able to express it to people
around you who can then help you be successful with it.
Often inventors have a colleague that they work with who
enable them to be productive. Whereas innovation that's a process
(21:40):
and that's an excel file, and it's it's it's a
less exciting event. It's safer and fewer downsides, but less
significant to the planet. If you think of moment of
(22:00):
insight of Fleming and penicillin, or Barry Marshall and H
two pylorise, these are instances where a lot of us
would have not realized something significant had just happened, but
they saw it. You know, Fleming comes back from his
(22:21):
vacation and he realizes the mold on that agar plate
has rings in the fungus where the bacteria or the
fungus didn't grow. How did that happen? What happened right there?
You know, he'd left a window open. I've stood beneath
that window actually, and I looked up and there was
a moment where an observation occurred with Ridley and the
(22:42):
cataract lens. He was looking after a young man who
had pieces of the last canopy of purricane or spitfire
in his eye, and he realized that the eye did
not reject that glass sharred, and therefore that the eye
tolerated that material. And then he had the insight that
that piece of material could be used to create artificial lens.
(23:06):
So why did he do that? You know? And I
think chefs do this, and writers do this, and great
like Paul McCartney writing lyrics does this. Now, if you
ask any of them where does it come from, they
probably can't say. You can image it. You can do
magneto and cephalography a very powerful EEG of the brain,
(23:29):
and you can capture the moment. It's called the alpha
insight effect. And we're working on a project at Toronto
Western to do that because we have one of these
machines at one of our donors, Mitch Goldhard gave us.
And it's going to be fun to study. But you
can actually capture the electrical moment of insight.
Speaker 1 (23:50):
If that's fascinating, And I mean capturing the electrical moment
of insight is just the fact that you could even
do that is crazy. But yeah, I like how you
phrased that as invention being a moment. So for people listening,
there are people listening to this who perhaps have a
desire to be an inventor. If invention is a moment
(24:12):
as opposed to kind of innovation, which is more of
a process, And in some ways it's semantical, but I
think it's an important distinction that you're making. How does
someone become an inventor if it is just about having
that A Ha moment, because you can't really a ha
moments just come right? Is it about putting yourself in
that right circumstance, in those right conditions, working at the
(24:36):
right place, being around the right people such that you
were more likely to have that a HA moment as
opposed to just saying I want to be an inventor
and thinking through a process.
Speaker 3 (24:47):
Yeah. So the whole literature around the neuroscience of creativity.
There is a lovely book called exactly that, the the
Oxford Handbook of Creativity and Mind Wandering. There's the opposition
book by Cambridge and the Neuroscience of Creativity and Reflective Thought.
And of course I could imagine both all these authors
(25:09):
arguing each other with each other. It'd be brilliant. So
there's a lot of work around that. I think there's
privilege involved in this. Right. If you're in the right
socio economic environment where you're comfortable and you're surrounded by
books and comfortable chairs and things, then your opportunity to
do something about your moment of insight will be greater
(25:31):
than if you're poorer and cold and hungry, and nobody
pays attention to you. So there's privilege. But there are
creative people all around the world who are unheard. And
(25:52):
that's part of what I said the very beginning. It's
a privilege to be heard. Because I have a track
record of being right. I can I have an idea,
call John brum Leveett Cook one eight hundred four to
six eight one three seventy nine and talk to him
and he'll go, cring, you're mad, Just okay, we don't
do that, that's mad. But but he might. He has
(26:13):
said in the past yes, and his colleague Brian Bates
would say, oh g kreing a okay, yeah, and then
my thing would be made. It would and it would
be produced and would be used and shared around the
world within a year. You know file patterns that that
that success is more frequent when you've a track record
(26:34):
of being right. When you're a young inventor. Depending on
your environment, there may be nobody to tell. And if
you just think about medicine as the the place where
this is occurring. If you're in tim ands are Barry,
a small hospital in northern Ontario, you know two three
four hundred miles north of Toronto, very rural environment, trees, moves, lakes.
(27:00):
For those of you who are not from Canada, there's
no one to tell if you have a new idea.
The rap calling to deliver devices is probably working for
a distributor, doesn't work for a manufacturer. Your many steps
away from an engineer or a CEO can make your
idea happen. If you're at you Penn or Hopkins, those
(27:20):
CEOs and engineers call personally and you can talk to
them directly, and the likelihood is that they will be
able to do something about your idea. If you're a
writer or a poet, I feel for people with creativity
that is artistic. I'm fortunate that my creativity is financially remunerative.
(27:44):
It's the Toronto Film Festival this week. A few months
ago was our Documentary Festival. We often have people stay
with us like we do right now, because they can
afford to fly over from Europe, but they can't afford
to stay in a downtown hotel in Toronto. So but
they're phenomenally creative and it doesn't pay anything, you know,
(28:06):
they get less than minimum wage. They're filled with energy
and ideas and thoughts and wonderful intellectual effervescence, but it
doesn't support them financially, you know. I see the same
and the cello teachers who taught our children. They love music.
It's a huge part of their reason to get up
in the morning, but music doesn't really love them back,
(28:29):
you know. So it depends on the on the field
that you're in. How the rest of the world perceives
the value of your creativity. And we're fortunate, you and
I that we practice medicine and that it's rewarded if
you're in the right placed. That did that answer what
(28:50):
you're asking? Or rumble that that does answer? I mean,
I think it's it's pragmatic. I asked about kind of
if it's in a hum moment for creativity, how does
that how does somebody listening to this or just the
average Joe try.
Speaker 1 (29:07):
To become an inventor? And in some ways I think
what you said is clear. It's that you've got to
be realistic first of all, about if you have goals
for invention, what field are you in? Is it going
to be what's your goal? Is it going to make
you a lot of money or not? There's certain fields
in which that's not necessarily the case, and also that yeah,
sometimes the reality is you've got to be in a
(29:30):
location or around people that are going to trigger that
a humb moment. In Baltimore, for example, you're in a
position where one you're around really smart people. You've got
people who might be willing to invest and to get
that a humb moment. You've also got a lot of patience.
You said sixty percent of the hospitals in the ICU
where there's a lot of problems that need to be solved.
(29:52):
So you're putting yourself in that position. When you said
Robin Williams had his A hum moment, for example, some
people said might say, well, I'm not Robin Willilliams. Is that?
Is that just a genius? Because Robin Williams many would say,
is is a genius? And I can't relate to that?
Or is that something I can work on? And I
think in the arts it's tougher to maybe tougher to
(30:14):
maybe qualify what exactly that invention is or how to
get that inventive moment, because because there are less resources
for the arts, and it's tougher to put yourself in
that position to be heard than it is in the sciences.
Speaker 3 (30:30):
Yeah, I hear you. But when I see somebody like
Adele or Lady Gaga, I see talent, right, and the
stella boon. Sometimes you just see somebody and you go, WHOA,
that person has talent. They have it, they have yeah, yeah, yeah. Oh.
You see Stephen Fry, the English comedian, writer, poet, you know,
(30:58):
and you see that that association speed. Now some of
this too is like with Robin William's, awfully close to Tourette's,
isn't it. I mean he had so much talent. You think,
how do you control that? How do you have a
happy life and have that much talent. There's a wonderful
young English musician called Stephen Collier. My god, he's talented.
(31:20):
But when I watch him, I worry because he has
so much talent. You think that's on the brink of sadness,
you know. And and it was with Robin Williams. Yeah yeah,
yeah yeah. So we're fortunate that we have a passion
that we care about, we have a purpose that we
care about, we have a sense of duty right because
(31:45):
we're at the apex of Maslow's hierarchy of needs in
the world, in this country, in Canada, in North America,
in Europe, at a time in the world where people
are searching for one passport that means something that lets
them cross borders. We live in this beautiful country that
gives us an obligation to be creative. As an act
(32:05):
of thank you to this country, you know, I'm going
to pick up my new passport today. I was down
there a few weeks ago, and I just thinking, Okay,
I got to try harder, say thank you, and keep
pushing on my ideas. Now, the time between the invention
(32:25):
and the success can be years. With my Ozone device
which shrinks hernated discs twenty one years, and to carry
an idea that long is hard. So I invented this
on an airplane. I had seen her talk in Verona
(32:47):
in Italy, so traveling to learn because that's important, seeing
something different from a mad Italian. Then I flew on
the airplane for eight hours. I was left alone, continuous
on uninterrupted dudling away with like a fountain pen, you know.
And I use the same little pens all the time
(33:08):
and have notebooks. And then just I developed the idea
of the Ozone cow that you would milk for ozone
and the ozone generator that you that you could hold
in your hand. So three weeks ago, after years of resistance,
the FDA decided this was a breakthrough technology twenty one
(33:29):
years and in that time other people have caught up
and now think it's a breakthrough technology too. So it
takes ten to fifteen years for physicians to adopt new technologies.
They're more right, we have that.
Speaker 1 (33:46):
So how do you have that kind of patience? I
mean it's natural for people to say, there's just too
much red tape here, this has taken too much time,
and I don't want to give up in a negative way,
but kind of move on from that, because that's a
really really long time to sit with something and get
frustrated that it's not moving forward.
Speaker 3 (34:05):
I had heard then, Yeah, you know, I think if
you really believe in something, you're willing to do that.
So I worked out them. So anytime you invent something
in medicine that it's new, you work out the mechanism
of action, how does it actually work? You work out
(34:25):
the regultary pathway, you do the clinical trials, and then
later you need to do the reimbursement pathway. How are
you get paid for doing this, but it boils down
to those three things, the mechanism of action, the regualtry
pathway which includes device safety, and then reimbursement, and then
you get adoption. And in there too you have to
(34:45):
make sure you use language that aligns with pre existing
belief systems. Medical behavior is really kind of faith based.
Often I look in the Anglio suite and I think
it looks like the Caravaggio painting. You've got the surgical
light shining down, We're all in gowns. There's the green
(35:08):
you know, drape over the patient. It's like one of
those Caravaggio works of art, you know. So there's a
lot of ritual, a lot of hierarchical adoption of beliefs,
the role of the professor, the acolytes underneath the the
(35:29):
you know, the different levels of a student. And if
something doesn't align with the pre existing faith or belief,
you may not get adoption unless you use the language
of the religion of that group. You know. So maybe Zen,
(35:49):
maybe Buddhism would be far out of the mindset of
people who were Presbyterian or a Lutheran. So your new
radical medical idea may have to be rephrased in a
way that can be adopted.
Speaker 1 (36:05):
I love the way you phrase that. I was going
to ask you as their pushback to a lot of
the inventions that you talk about in your book, and
I know the answer is yes, there is a lot
of pushback, because there's always pushback to things that are
challenging the status quo. But guess a strategy there, which
you've just outlined, and I'm repeating, rephrasing is as opposed
(36:26):
to necessarily trying to be a rebel and coming to
the general public and saying, hey, let's do this completely
differently if you rephrase that in a way that is
a little bit more palatable, a little bit more Hey,
I'm not trying to be radical, I want to talk
your language. Let's do this a little bit differently. Even
(36:48):
if the idea is radical, the phrasing of that and
the reframing of that not just for invention in medicine,
but that is really powerful as a mechanism to encourage
chain change more effectively.
Speaker 3 (37:01):
Yes, there's a beautiful person called Julius Shone who is
a PhD from Stanford in medical anthropology, and her field
of study is why do we have different medical beliefs?
How do we adopt new beliefs in medicine. She's an
incredibly ethical, talented person I met years ago and I've
(37:27):
stayed in touch with as her career as evolved, and
I think the challenge she has faced is that a
lot of companies want to work with her to speed
the adoption of their ideas, whether they're good for the
planet or not. And so she would be resistant to
working with people to facilitate that because it would be unethical.
But she does study in a cultural context why we
(37:50):
adopt and often, to be honest, it's reimbursement. You know,
if there are two procedures one of six hundred bucks
near there are six thousand bucks. Doctor will do the
six thousand dollar procedure. There are pain anesthesiologists in this
city who will do epidural steroids at multiple levels every
(38:11):
three weeks, and people who have back pain rather than
fixing their back pain. That's unethical, you know. So you know,
I think that cultural alignment involves thought, also involves reward
(38:33):
and simplicity and cost effectiveness can be destructive to perfectly
good product lines. But when I developed four d CT
with Tashiba, I developed their three twenty slice CT scanner,
so you get whole head coverage. Then you inject IV contrast,
(38:55):
you get the arterial, venus and capillary phases, and you
get a dynamic image of the whole head. Previously that
required a catheter, antigram, catheter angegram transfer role a risk
of stroke, risk of hymtoma, risk a retropertnel bleed, about
eight thousand dollars. Most hospitals in the US will do
them all the time. For DCT about six hundred dollars.
(39:19):
In Canada, we follow up aneurysms in the head with
for DCT or CTA using that technology. In the US,
they still get cather in geography. It's the same with
prostate cancer. You know, we don't do PSA here in
the US. It's done, and people have prostate surgery unnecessarily
(39:40):
and wind up been impotent and incontinent. So that financial
drive is a huge element in an adoption of approaches
or resistance to adoption.
Speaker 1 (39:51):
What's interesting because earlier you were kind of saying Canada
is an example, I guess where the academic institutions kind
of limit invention because of their process, because because of
the way they're structured, and you're praising the States for that.
But on the other side of that, when things are
more privatized, there's also more incentivization to do things for money,
(40:12):
whereas in places like Europe that you talked about, or
places like Canada where there's they're not socialists, but they're
more left leaning in terms of how their academic institutions
are built. While the downside is maybe less invention, maybe
it also leads to a little bit maybe it also
leads to decisions that are less financially motivated.
Speaker 3 (40:32):
I agree with you. The frustrating thing with Canada is
the process. The brilliant thing about Canada is the process
makes it fair and accessible, you know, but we do
need to make it easier for inventors here and health
Canada is in particular a problem in that regard, you know,
just stifling creativity here enormously.
Speaker 1 (40:55):
Karen, do you have any final thoughts for people just
about creativity? Maybe not even invention, because invention, I think
you've made it more accessible to people, But invention can
be a scary word, and creativity is maybe a little
bit less scary, and it's something that everybody can kind
of relate to because people, most people have passion projects
or ideas, and they want to be creative, but feel
(41:18):
stifled by themselves, by the world, by the ability to
eventually be heard. Do you have any advice or final
words about creativity for people?
Speaker 3 (41:28):
Well, I think it's it's fun, right, and it gives
you joy. And I'm in a room here surrounded by books,
some of which you know I should throw out, but but.
Speaker 1 (41:42):
You want to have a full library, you know.
Speaker 3 (41:44):
No. I actually win out down things about forty percent recently,
and then some books I kept because they'll have a
great sentence in them. And ninety nine percent of the
book might be crap, but it might have one great sentence,
and I respect the author for writing the book, and
I particularly love that great sentence. So everybody has everybody
(42:07):
has a moment in them, a great sentence in them,
a thing that they can do. It might be as
simple as a new sandwich. I'm a big fan of
the chip cheese sandwich, which I claim I invented. My kids,
you know, are constantly shocked by my cooking. The pink
omelet was a particularly big failure. Yeah, I meant, well, yeah, yeah, yeah.
(42:33):
But like you know, people can do amazingly creative things
because their talent lies in some particular area and we
can all do this. And to do those things, we
have to have some quiet time. And you know, I
pick up my phone, I have Google sending me messages
(42:55):
predetermined by what I looked at yesterday, deciding I need
to learn about this or that, interrupting my own internal dialogue.
We need some moments of lucidity where we can actually
hear ourselves. I don't use a smart watch. I wind
my watch. I don't charge my watch. I try to
have some analog time every day. Two weeks ago, we
(43:19):
met a beautiful family in Ottawa that has an analog room.
They've got a turntable with albums like James Taylor and
Lady Gaga and everywhere. A couple of drums in there,
some guitars and a big sofa and it's the kid's
favorite room because it's a jig sauce. It's an analog room.
(43:39):
This is an analog room, I guess, you know, except
for this computer. But we need those kind of prolonged
moments of quiet. It when you wake up and you
don't have to get up yet. It could be Saturday morning.
You know, Saturday is a great day Sunday's kind of
(44:02):
on Mondays next Saturday, Monday is a long way off.
Saturday morning is a great morning, you know. And I
think the other thing I would say is what do
you read that inspires you. I will walk to the
village here every Saturday to buy the Financial Times weekend
edition because the Life and Arts section contains one great
(44:23):
sentence every week, and that great sentence will will charge
me one week. It was a self comforting myth. That's
a great sentence, you know, a self comforting myth. It
could be about ourselves. It could be about a nation,
for example, that Canada is kind to immigrants. It's not.
(44:46):
Look at the eighty five thousand Uber drivers in Toronto,
most of whom have engineering degrees or medical degrees or
science degrees and can't get jobs. You know. We've taken
gifted people from around the world and turn them into
Tiff Wallace when they came here expecting something else. So
a phrase like that triggered a chain of thought, and
(45:07):
so we have to find places where we randomly pick
up something and have a moment to reflect in it.
But it's not driven by Google or Instagram. We have
to manage our signal to noise ratio and protect it
as much as we can.
Speaker 1 (45:25):
I think that's very sage advice. I think we could
all use a little more quiet, even as people are
listening to this podcast or watching this on YouTube. But
I think a lot of people can relate to quiet
in that analog room that you described. Sounds extremely appealing.
So doctor Kieren Murphy, thank you so much for joining me,
(45:46):
and we can get your book, his excellent book, The
Essence of Innovation and the Joy of Medical Creativity Care,
and that's available on Amazon, that's available in bookstores.
Speaker 3 (45:56):
It's the Essence of Invention. Yeah, it is. It's available,
and my students actually find it around the world and
take selfies with it when they find it on bookshelves,
which is really fun. And if I if I go
into a bookshop or find it when nobody's looking, I
signed them and yeah, which probably drops their value considerably.
But yeah, yeah, anyways.
Speaker 1 (46:19):
Well, thank you very much, Dictor Kieran Murphy, author of
the Essence of Invention. It's it's been an absolute pleasure
having you join me. Thank you not just to chat
about invention, but just to chat about creativity and ways
to kind of access some peace of mind. So thank you.
Speaker 3 (46:37):
Okay, cheers, thank you, have a good day.
Speaker 1 (46:40):
So thank you doctor Kieran Murphy, and thank you everybody
for listening. Have a great day.
Hey everybody, I'm zaeo Mednik and welcome to another episode
of blind Spot. This episode is sponsored by THEA Pharma Canada.
THEA pharm of Canada is the Canadian subsidiary of THEA,
Europe's leading pioneering and innovative eye health brand. Founded in
nineteen ninety four by Henri Schibret. With five generations of history,
the Chubret family has been dedicated to I care for
(00:33):
more than one hundred and fifty years. Their commitment to
improving lives is born of their pioneering spirit. They continue
to lead the worldwide preservative free movement in eye care.
They've created innovative delivery systems. They've focused on making products
accessible and cost effective for patients. They live this mission
every day because everyone should have the same opportunities to
see the world through healthy eyes. So thank you THEO
(00:56):
Pharming Canada for supporting Blindspot. It be easy to look
at the present world and marvel at all that exists
and all that has been accomplished. The Internet, airplanes, travel
to outer space, artificial intelligence. It's mind bending to think
about where we are as human species. But one hundred
years ago, I would imagine humans felt the same way
(01:18):
that they were living in unparalleled times of innovation and development,
and one hundred years from now, I have to imagine
humans will still be marveling it yet even newer and
more exciting innovations. So how do we get from great
to better? What is at the essence of invention? How
have the greatest inventors in history gone beyond the preconceptions
(01:39):
of the status quo and found newer and smarter ways
to solve humanity's problems? Is invention a product of genius?
Or is invention the product of a certain mindset? I'm
joined today by Professor Kieran Murphy. Kieran graduated in nineteen
eighty six from the Royal College of Surgeons in Ireland.
He completed his Radiology residency and Neuroradiology fellowship at the
(01:59):
Universe of Michigan and Interventional Neuroadiology Fellowship at University of Geneva.
From ninety eight to two thousand and eight, he was
Division Head of Interventional Neuroradiology at Johns Hopkins. Since two
thousand and eight he has been a Professor of Radiology
at University of Toronto. He holds eighty one patents, including
verteber plasty systems, bone cements, biopsy systems, and other medical
(02:20):
devices to treat spine, neurovascular and disc pathologies. He's a
competitive race car driver in modern and vintage race cars,
driving for teams in Europe, at SPA, Silverstone and across
the US and Canada. His essays have been published in
the Toronto Star, National Post and the Christian Science Monitor.
His book, The Essence of Invention and the Joy of
(02:41):
Medical Creativity is published by Dunder and Press and is
available in bookstores and online. Kieran, Welcome to the podcast.
Thank you so much for joining me. It's very kind
of you. It's always an honor to be asked too.
Speaker 2 (02:52):
To speak to anyone, anyone well, you know really, because
in general I always feel a lot of people spend
their lives listening, right because they don't get to be heard.
Speaker 3 (03:03):
And I with my patients, I see this all the time.
There are a lot of people who live very quiet
lives and they'll never get to speak at a podium
or at a you know, in a church, or to
a group of people in a room, and nobody will
listen to them if they did speak. And how do
we decide that how does that get determined? And so
(03:26):
for you to say, would you mind chatting away, you know,
is an honor and it needs to be taken seriously
and the privilege.
Speaker 1 (03:36):
Oh, I appreciate that, and you're right, I can see
that with some patients as well. And yeah, it's my
honor that you're here. And we're going to talk about
about your book and a lot of the themes that
come out of your book. And I want you to
talk to me a little bit about why did you
write this book? What was I mean in the introduction
in your bio I talked about the fact that you've
(03:58):
got a lot of patents, You've you're an innovator, you're
an inventor. Talk to me about what the inspiration was
behind writing this book the essence of invention.
Speaker 3 (04:11):
Well, really, I think all the credit goes to my dog.
I'll you know, Althie wakes up at six o'clock every morning.
Whether I want to or not, I wake up at
six o'clock in the morning. He goes outside and goes
pp Sometimes I join them, No I don't, but it's
well there you go say from time there len sigma approached.
(04:35):
But then seek healthy and then if I do not
touch my phone. You know. He and I go back
to bed, and we sit in the bed. I play
with him and he'll you know, play with his toys,
and I get about an hour that is unplugged, and
in that hour, I get to think, and I hear
my own inner dialogue, write my own lucidity. And we
(04:57):
pretty much do the same at the end of each
day too, and I don't touch my phone. And since
we've had him for about four years now, and you know,
I during that hour, I began to think, you know,
there are things I think that are are maybe worth
(05:18):
sharing because I do believe in certain kind of immutable
principles about engagement socially, and I really view inventorship as
an act of social engagement.
Speaker 1 (05:30):
You know.
Speaker 3 (05:30):
It's like that guy in the movie saying, I'm mad
as hell. I'm not going to take it anymore. There
are diseases that you know better than I that we
treat badly. There are people in the world who can't
access technologies that you use every day, And then how
do how does a new technology get adopted? Think of
(05:52):
the grief that the inventor of the cataract lensing plant received.
Ridley in England ridicule nearly lost license for what is
now one of the greatest contributions to medicine ever. So
I began to think about, you know, why do people invent,
Where does the idea come from, what obstructions do they face,
(06:13):
How do we adopt innovation and creativity, How do we
handle inventories, where do they fit into society? And the
thing that bothered me most is the stereotype that people
are driven by money. People who invent are not driven
by money. They'd be a lot wealthier if they didn't invent.
I'd be a lot wealthier if I just put money
in mutual funds then putting them into ideas, you know.
(06:36):
And so it's really and that's why I wrote this
to try and explain to people and particularly kids, that
that inventorship is creative. It's a creative expression, like writing,
like poetry, like art, like music, you know, and that
(06:59):
medicine is is a creative art. It's an art, not
of science. So to kind of transfer those kind of
beliefs because a lot of the writing about inventorship, I
think is fundamentally wrong. And you know, people building big
monoliths like the Mars building downtown wasting a billion dollars
(07:19):
in that place thinking it will attract inventories, and now
it's filled with government people, you know, a handful of
of bench researchers, and they do discovery. Discovery is not invention.
Discovery is lucky. This is like the difference between Howard
and Big Bang and Sheldon. Howard's an engineer who observes things.
(07:41):
Sheldon is a thinker who creates things. And that's why
they fight all the time. Where they know there's a
fundamental philosophical difference between them.
Speaker 1 (07:51):
What's that difference between invention and innovation and the concept
and for those two For those who are in Toronto,
Mark Building is a downtown building affiliated with the University
of Toronto, which I guess the idea was invention. But
you're saying has not necessarily achieved that goal.
Speaker 3 (08:09):
We don't have enough inventries in the country. You know,
we talk about innovation all the time. Innovation, I think
people define it as taking somebody's invention and translating it
into a product. You know, and every boring administrator in
a hospital and the country talks about innovation. But God
forbid this innovation. It would disturb their nice billing plans
(08:31):
and structures and maybe be unreimbursed by ohip or insurance
company and things like that, you know, which is a
structural problem in our hospital system. But so invention, that
moment of creativity, the Robin Williams moment where he suddenly
says something funny out of left field that made no
(08:51):
sense and you didn't see it coming, you know, but
you feel it in your brain when it happens. You're
one liner that is appropriately timed, not later when you're
driving home in your car and you wish it said it.
Then that that moment of unconscious awareness and insight, that's
(09:12):
that's invention. And sometimes we uh don't realize that that
it's something significant until later, which is why it's important
to have notebooks actually to keep track records of when
you created things. But to do it it requires some pressure,
(09:36):
some need, some obligation, focus, engagement, and usually a cause.
You know, and you have been in surgeries, I'm sure
where you thought you had everything under control and something
went sideways and you had to do something that was
creative to solve the problem, and it required some self
(10:00):
mastery to manage your stress at the time. It required
some improvisation to use two things together that didn't normally
be associated technically.
Speaker 1 (10:10):
And.
Speaker 3 (10:12):
You know, an inventive step to solve that problem. You know,
That's kind of what I wanted to write about.
Speaker 1 (10:21):
I recall when I was in my residency, my training
for ophthalmology, one of my mentors, he was talking to
me about a new technique in cataract surgery, and I said,
to him, is that really? Is that? Really? Does that
really have legs? Is it? We've got a really good
solution for that already? Is what's what's the point of that?
(10:44):
The difference that we're getting in surgery from that particular
technique is so marginal, why studying in it? And he
said to me, he said, and he's a really down
to earth guy, so I respect his opinion. And he said,
you know, if we didn't do those little steps, even
for marginal gains, then we wouldn't have He didn't use
(11:05):
the word invention. He probably used the word innovation, but
it stuck with me because I thought, you know what,
there's truth to that. Maybe this is such an incremental
advantage by having this particular technique that's being added to
cataract surgery. But if people aren't studying that then they
then the whole impetus and the whole kind of track
(11:27):
towards getting new things is going to be hindered. And
I wonder what you think about that, because there's an
old adage, if it ain't broke, don't fix it, And
I think that there's wisdom to that, and I guess
that's what I was saying to my mentor, and he
wasn't disagreeing with that. But how do you look at
that adage and realize, yes, it's good to just accept
(11:48):
that some things are good. We don't always need to
be chasing better versus Yeah, but we do always need
to be chasing better in the vein of invention.
Speaker 3 (11:57):
Yeah, it's complicated, isn't. But I think some ideas have
precursors and they have a family tree associated with the might,
and you can see a genealogy of where the idea
came from the first point in that family tree. The
kind of progenitor of it all is probably the greatest leap. Say,
(12:18):
when Palmas came up with the coronary stent, or Grunzig
decided to make an angioplastic balloon, that was the big,
big leap when there would have been the greatest opposition,
the greatest change to pre existing belief systems. It used
to be that, you know, doing cardiac surgery at all
(12:42):
was thought to be fatal and you should not touch
the heart. And then it became possible to open the
heart and replace a valve, and then bypass was invented,
and then angiography was invented, and then angioplast he was invented.
In so you see a cadence of things that occur,
kind of a concatenation of pre existing thoughts, and then
(13:06):
there is iterative improvement of things that is important that
we'll make something safer for the patient. And all of
them are valuable, but the big leap is the first one,
I think some I think optimology is a good example
of a field where it's now done so well that
(13:27):
it would be really hard to do it better in
many ways, unless maybe it's retinal surgery. Unless you could
make direct injection of a vast and into the eye
a pill instead of an intraocular injection, which must be
so uncomfortable, you know, but there's got to be a
way to make that an oral only pill. It may
(13:49):
not be in the best interests of ophthalmologists financially, but
from the patient perspective it's the right thing to do
because it'll decrease that pain and it'll decrease the fear
and diety and also allows spread of technology in some
similar ways with obesity surgery, right, we used to do
gas proplasty and you'd open somebody's abdomen and you'd make
(14:12):
their stomach smaller surgically, and now we have all these
drugs that you just take orally that effect hormones like
grayland secreted from the gastric fundus. That's kind of thing
we need to do with retinal issues. So that's that
would be iterative, but it would be a major step forward.
Speaker 1 (14:33):
When you think about the paradigms for invention, and you
give lots of examples in your books, and maybe there's
some to illustrate this. Where do a lot of inventions
typically start. Is it with a problem that's known that
people have been trying to solve and somebody finally comes
up with a solution. Or is it often when somebody
(14:54):
is identifying a problem that kind of we didn't really
know existed, or is it a mixture of both. When
you look at the inventors that you discuss in your book.
Speaker 3 (15:05):
I think it's usually in an inner city hospital, in
a hospital of last resort, when you've got a team
of people who are willing to accept patients for whom
there is no other solution. And that's why the great
academic centers still exist. You know, the places like U
Penn are Hopkins, inner city hospitals in the sort of
(15:25):
knife and gun club of the city like Philadelphia or Baltimore,
where you see dreadful things. I spent ten years in
East Baltimore at Hopkins as head of intivintional neuro I'm
really good at treating gunshot wounds and stab wounds, stopping
that exanguination, that bleeding. I was going to say, blead's
over Jesus. It overlaps with techniques that are now used
(15:50):
in other fields and other diseases. The most important thing
is that somebody like you or me steps up and says, okay,
we will try. And you know, Hopkins is a hospital
where there's probably sixty percent ICEEU beds, so everybody there
(16:16):
is really sick. And the other thing is that they
take immigrants. That these are hospitals with a tradition of
taking fellows and graduates from around the world. In the
nineteen thirties, U Penn hired Jewish physicians escaping the Nazis
(16:38):
and had this influx of brilliant minds from Charitay in
Berlin and other hospitals around Europe when doctors of that
religion were being terrorized and murdered. At one stage, eighty
percent of pediatricians in Germany were Jewish. The vast majority
of them were either external dominated or prevented from practicing
(17:02):
and were replaced by mediocre Nazi minds, and that shut
down German science until the sixties and seventies when those
guys died. Those Nazis died because they stayed in place,
you know, so talent. Adopting a policy where you recruit
talent is really important. I think also hospitals where the
(17:26):
university has power. Now, the University of Toronto, as much
as I love the new Dean, has no power, no
influence on my life whatsoever. It looks after undergraduate programs,
I met students and residents and fellows, but it has
no influence on adult life as a doctor. Unfortunately, at
most great institutions, the university and the hospital are one
(17:47):
promotion means something, and if you're non collegiate, you get
asked to leave, whereas here we have jobs for life
for thirty forty years. You could stay at University Health
Network even if you're mediocre, which means that young bright
minds can't get jobs and they wind up in like
(18:07):
with a central fugal force, being in Sudbury or Timmins
or or somewhere else. Cornwall, you know, Cornwall is a
town on the border of Quebec and Ontario. That's usually
the place people stop for a pee when they're driving
to Montreal. That's not where you want to work as
a bright physician, you know. So we don't give young
(18:29):
brains opportunities here, and you have to you have to
have job turnover. So inner city hospital of last resort,
where you attract immigrants, attract talent and give young brains opportunity.
That's the environment where you get creativity.
Speaker 1 (18:43):
And you're saying in terms of the system that we're
in Toronto. Obviously a lot of listeners aren't, but Toronto
is an example. You're we're not trying, we're not trying
to be mean to Toronto, but Toronto and a lot
of other universities. I guess it's the stim doesn't necessarily
cater to invention because of things like tenure, and because
(19:09):
it's not because it operates differently than other hospitals which
are going to be more ripe for innovation, like Hopkins
in Baltimore for example.
Speaker 3 (19:19):
Yeah, and if you look at the German system or
the Dutch system or the Italian system, the whole hair
professor thing where the professor gets to be right STI
Japan hardly any medical innovation. I can't think of anything
other than the Sheba needle that has really impacted healthcare
(19:40):
from Japan. You think of Germany hasn't been created since
the nineteen twenties and thirties. Norway fibulous resources, what are
they given us? Southern gefilter fish and cross country skiing?
You know both? Like you have to there has to
be pressure. And the American hospital's order such pressure for
(20:02):
revenue that they have to be creative. They have to
adopt new technology. Socialized systems where you know how much
about it's going to be every year, doesn't have that pressure.
Speaker 1 (20:14):
You talked about innovation before, and it's a buzzword. Innovation
is a buzzword and a lot of universities use. Can
you explain why, what exactly is the difference between that
and invention, because it is a word that a lot
of people, I think, when they hear they have, Oh,
(20:34):
that's a really really positive word. It's promoted by a
lot of companies, it's promoted by a lot of organizations,
and it's often used to attract people like we are
an innovative company, and people might be surprised to hear
you kind of scoff at that word as opposed to invention.
Speaker 3 (20:51):
Yeah, I honestly think that, you know, it's about inventorship.
That the moment of creativity, the Robin Williams type moment
where his humor just shocks, is at speed and it's brilliance.
It's about adulpe diesel, creating the diesel engine, you know,
and having no spark plugs. It's the past. It's a
(21:17):
moment and then being able to manage that moment in
many ways to be able to express it to people
around you who can then help you be successful with it.
Often inventors have a colleague that they work with who
enable them to be productive. Whereas innovation that's a process
(21:40):
and that's an excel file, and it's it's it's a
less exciting event. It's safer and fewer downsides, but less
significant to the planet. If you think of moment of
(22:00):
insight of Fleming and penicillin, or Barry Marshall and H
two pylorise, these are instances where a lot of us
would have not realized something significant had just happened, but
they saw it. You know, Fleming comes back from his
(22:21):
vacation and he realizes the mold on that agar plate
has rings in the fungus where the bacteria or the
fungus didn't grow. How did that happen? What happened right there?
You know, he'd left a window open. I've stood beneath
that window actually, and I looked up and there was
a moment where an observation occurred with Ridley and the
(22:42):
cataract lens. He was looking after a young man who
had pieces of the last canopy of purricane or spitfire
in his eye, and he realized that the eye did
not reject that glass sharred, and therefore that the eye
tolerated that material. And then he had the insight that
that piece of material could be used to create artificial lens.
(23:06):
So why did he do that? You know? And I
think chefs do this, and writers do this, and great
like Paul McCartney writing lyrics does this. Now, if you
ask any of them where does it come from, they
probably can't say. You can image it. You can do
magneto and cephalography a very powerful EEG of the brain,
(23:29):
and you can capture the moment. It's called the alpha
insight effect. And we're working on a project at Toronto
Western to do that because we have one of these
machines at one of our donors, Mitch Goldhard gave us.
And it's going to be fun to study. But you
can actually capture the electrical moment of insight.
Speaker 1 (23:50):
If that's fascinating, And I mean capturing the electrical moment
of insight is just the fact that you could even
do that is crazy. But yeah, I like how you
phrased that as invention being a moment. So for people listening,
there are people listening to this who perhaps have a
desire to be an inventor. If invention is a moment
(24:12):
as opposed to kind of innovation, which is more of
a process, And in some ways it's semantical, but I
think it's an important distinction that you're making. How does
someone become an inventor if it is just about having
that A Ha moment, because you can't really a ha
moments just come right? Is it about putting yourself in
that right circumstance, in those right conditions, working at the
(24:36):
right place, being around the right people such that you
were more likely to have that a HA moment as
opposed to just saying I want to be an inventor
and thinking through a process.
Speaker 3 (24:47):
Yeah. So the whole literature around the neuroscience of creativity.
There is a lovely book called exactly that, the the
Oxford Handbook of Creativity and Mind Wandering. There's the opposition
book by Cambridge and the Neuroscience of Creativity and Reflective Thought.
And of course I could imagine both all these authors
(25:09):
arguing each other with each other. It'd be brilliant. So
there's a lot of work around that. I think there's
privilege involved in this. Right. If you're in the right
socio economic environment where you're comfortable and you're surrounded by
books and comfortable chairs and things, then your opportunity to
do something about your moment of insight will be greater
(25:31):
than if you're poorer and cold and hungry, and nobody
pays attention to you. So there's privilege. But there are
creative people all around the world who are unheard. And
(25:52):
that's part of what I said the very beginning. It's
a privilege to be heard. Because I have a track
record of being right. I can I have an idea,
call John brum Leveett Cook one eight hundred four to
six eight one three seventy nine and talk to him
and he'll go, cring, you're mad, Just okay, we don't
do that, that's mad. But but he might. He has
(26:13):
said in the past yes, and his colleague Brian Bates
would say, oh g kreing a okay, yeah, and then
my thing would be made. It would and it would
be produced and would be used and shared around the
world within a year. You know file patterns that that
that success is more frequent when you've a track record
(26:34):
of being right. When you're a young inventor. Depending on
your environment, there may be nobody to tell. And if
you just think about medicine as the the place where
this is occurring. If you're in tim ands are Barry,
a small hospital in northern Ontario, you know two three
four hundred miles north of Toronto, very rural environment, trees, moves, lakes.
(27:00):
For those of you who are not from Canada, there's
no one to tell if you have a new idea.
The rap calling to deliver devices is probably working for
a distributor, doesn't work for a manufacturer. Your many steps
away from an engineer or a CEO can make your
idea happen. If you're at you Penn or Hopkins, those
(27:20):
CEOs and engineers call personally and you can talk to
them directly, and the likelihood is that they will be
able to do something about your idea. If you're a
writer or a poet, I feel for people with creativity
that is artistic. I'm fortunate that my creativity is financially remunerative.
(27:44):
It's the Toronto Film Festival this week. A few months
ago was our Documentary Festival. We often have people stay
with us like we do right now, because they can
afford to fly over from Europe, but they can't afford
to stay in a downtown hotel in Toronto. So but
they're phenomenally creative and it doesn't pay anything, you know,
(28:06):
they get less than minimum wage. They're filled with energy
and ideas and thoughts and wonderful intellectual effervescence, but it
doesn't support them financially, you know. I see the same
and the cello teachers who taught our children. They love music.
It's a huge part of their reason to get up
in the morning, but music doesn't really love them back,
(28:29):
you know. So it depends on the on the field
that you're in. How the rest of the world perceives
the value of your creativity. And we're fortunate, you and
I that we practice medicine and that it's rewarded if
you're in the right placed. That did that answer what
(28:50):
you're asking? Or rumble that that does answer? I mean,
I think it's it's pragmatic. I asked about kind of
if it's in a hum moment for creativity, how does
that how does somebody listening to this or just the
average Joe try.
Speaker 1 (29:07):
To become an inventor? And in some ways I think
what you said is clear. It's that you've got to
be realistic first of all, about if you have goals
for invention, what field are you in? Is it going
to be what's your goal? Is it going to make
you a lot of money or not? There's certain fields
in which that's not necessarily the case, and also that yeah,
sometimes the reality is you've got to be in a
(29:30):
location or around people that are going to trigger that
a humb moment. In Baltimore, for example, you're in a
position where one you're around really smart people. You've got
people who might be willing to invest and to get
that a humb moment. You've also got a lot of patience.
You said sixty percent of the hospitals in the ICU
where there's a lot of problems that need to be solved.
(29:52):
So you're putting yourself in that position. When you said
Robin Williams had his A hum moment, for example, some
people said might say, well, I'm not Robin Willilliams. Is that?
Is that just a genius? Because Robin Williams many would say,
is is a genius? And I can't relate to that?
Or is that something I can work on? And I
think in the arts it's tougher to maybe tougher to
(30:14):
maybe qualify what exactly that invention is or how to
get that inventive moment, because because there are less resources
for the arts, and it's tougher to put yourself in
that position to be heard than it is in the sciences.
Speaker 3 (30:30):
Yeah, I hear you. But when I see somebody like
Adele or Lady Gaga, I see talent, right, and the
stella boon. Sometimes you just see somebody and you go, WHOA,
that person has talent. They have it, they have yeah, yeah, yeah. Oh.
You see Stephen Fry, the English comedian, writer, poet, you know,
(30:58):
and you see that that association speed. Now some of
this too is like with Robin William's, awfully close to Tourette's,
isn't it. I mean he had so much talent. You think,
how do you control that? How do you have a
happy life and have that much talent. There's a wonderful
young English musician called Stephen Collier. My god, he's talented.
(31:20):
But when I watch him, I worry because he has
so much talent. You think that's on the brink of sadness,
you know. And and it was with Robin Williams. Yeah yeah,
yeah yeah. So we're fortunate that we have a passion
that we care about, we have a purpose that we
care about, we have a sense of duty right because
(31:45):
we're at the apex of Maslow's hierarchy of needs in
the world, in this country, in Canada, in North America,
in Europe, at a time in the world where people
are searching for one passport that means something that lets
them cross borders. We live in this beautiful country that
gives us an obligation to be creative. As an act
(32:05):
of thank you to this country, you know, I'm going
to pick up my new passport today. I was down
there a few weeks ago, and I just thinking, Okay,
I got to try harder, say thank you, and keep
pushing on my ideas. Now, the time between the invention
(32:25):
and the success can be years. With my Ozone device
which shrinks hernated discs twenty one years, and to carry
an idea that long is hard. So I invented this
on an airplane. I had seen her talk in Verona
(32:47):
in Italy, so traveling to learn because that's important, seeing
something different from a mad Italian. Then I flew on
the airplane for eight hours. I was left alone, continuous
on uninterrupted dudling away with like a fountain pen, you know.
And I use the same little pens all the time
(33:08):
and have notebooks. And then just I developed the idea
of the Ozone cow that you would milk for ozone
and the ozone generator that you that you could hold
in your hand. So three weeks ago, after years of resistance,
the FDA decided this was a breakthrough technology twenty one
(33:29):
years and in that time other people have caught up
and now think it's a breakthrough technology too. So it
takes ten to fifteen years for physicians to adopt new technologies.
They're more right, we have that.
Speaker 1 (33:46):
So how do you have that kind of patience? I
mean it's natural for people to say, there's just too
much red tape here, this has taken too much time,
and I don't want to give up in a negative way,
but kind of move on from that, because that's a
really really long time to sit with something and get
frustrated that it's not moving forward.
Speaker 3 (34:05):
I had heard then, Yeah, you know, I think if
you really believe in something, you're willing to do that.
So I worked out them. So anytime you invent something
in medicine that it's new, you work out the mechanism
of action, how does it actually work? You work out
(34:25):
the regultary pathway, you do the clinical trials, and then
later you need to do the reimbursement pathway. How are
you get paid for doing this, but it boils down
to those three things, the mechanism of action, the regualtry
pathway which includes device safety, and then reimbursement, and then
you get adoption. And in there too you have to
(34:45):
make sure you use language that aligns with pre existing
belief systems. Medical behavior is really kind of faith based.
Often I look in the Anglio suite and I think
it looks like the Caravaggio painting. You've got the surgical
light shining down, We're all in gowns. There's the green
(35:08):
you know, drape over the patient. It's like one of
those Caravaggio works of art, you know. So there's a
lot of ritual, a lot of hierarchical adoption of beliefs,
the role of the professor, the acolytes underneath the the
(35:29):
you know, the different levels of a student. And if
something doesn't align with the pre existing faith or belief,
you may not get adoption unless you use the language
of the religion of that group. You know. So maybe Zen,
(35:49):
maybe Buddhism would be far out of the mindset of
people who were Presbyterian or a Lutheran. So your new
radical medical idea may have to be rephrased in a
way that can be adopted.
Speaker 1 (36:05):
I love the way you phrase that. I was going
to ask you as their pushback to a lot of
the inventions that you talk about in your book, and
I know the answer is yes, there is a lot
of pushback, because there's always pushback to things that are
challenging the status quo. But guess a strategy there, which
you've just outlined, and I'm repeating, rephrasing is as opposed
(36:26):
to necessarily trying to be a rebel and coming to
the general public and saying, hey, let's do this completely
differently if you rephrase that in a way that is
a little bit more palatable, a little bit more Hey,
I'm not trying to be radical, I want to talk
your language. Let's do this a little bit differently. Even
(36:48):
if the idea is radical, the phrasing of that and
the reframing of that not just for invention in medicine,
but that is really powerful as a mechanism to encourage
chain change more effectively.
Speaker 3 (37:01):
Yes, there's a beautiful person called Julius Shone who is
a PhD from Stanford in medical anthropology, and her field
of study is why do we have different medical beliefs?
How do we adopt new beliefs in medicine. She's an
incredibly ethical, talented person I met years ago and I've
(37:27):
stayed in touch with as her career as evolved, and
I think the challenge she has faced is that a
lot of companies want to work with her to speed
the adoption of their ideas, whether they're good for the
planet or not. And so she would be resistant to
working with people to facilitate that because it would be unethical.
But she does study in a cultural context why we
(37:50):
adopt and often, to be honest, it's reimbursement. You know,
if there are two procedures one of six hundred bucks
near there are six thousand bucks. Doctor will do the
six thousand dollar procedure. There are pain anesthesiologists in this
city who will do epidural steroids at multiple levels every
(38:11):
three weeks, and people who have back pain rather than
fixing their back pain. That's unethical, you know. So you know,
I think that cultural alignment involves thought, also involves reward
(38:33):
and simplicity and cost effectiveness can be destructive to perfectly
good product lines. But when I developed four d CT
with Tashiba, I developed their three twenty slice CT scanner,
so you get whole head coverage. Then you inject IV contrast,
(38:55):
you get the arterial, venus and capillary phases, and you
get a dynamic image of the whole head. Previously that
required a catheter, antigram, catheter angegram transfer role a risk
of stroke, risk of hymtoma, risk a retropertnel bleed, about
eight thousand dollars. Most hospitals in the US will do
them all the time. For DCT about six hundred dollars.
(39:19):
In Canada, we follow up aneurysms in the head with
for DCT or CTA using that technology. In the US,
they still get cather in geography. It's the same with
prostate cancer. You know, we don't do PSA here in
the US. It's done, and people have prostate surgery unnecessarily
(39:40):
and wind up been impotent and incontinent. So that financial
drive is a huge element in an adoption of approaches
or resistance to adoption.
Speaker 1 (39:51):
What's interesting because earlier you were kind of saying Canada
is an example, I guess where the academic institutions kind
of limit invention because of their process, because because of
the way they're structured, and you're praising the States for that.
But on the other side of that, when things are
more privatized, there's also more incentivization to do things for money,
(40:12):
whereas in places like Europe that you talked about, or
places like Canada where there's they're not socialists, but they're
more left leaning in terms of how their academic institutions
are built. While the downside is maybe less invention, maybe
it also leads to a little bit maybe it also
leads to decisions that are less financially motivated.
Speaker 3 (40:32):
I agree with you. The frustrating thing with Canada is
the process. The brilliant thing about Canada is the process
makes it fair and accessible, you know, but we do
need to make it easier for inventors here and health
Canada is in particular a problem in that regard, you know,
just stifling creativity here enormously.
Speaker 1 (40:55):
Karen, do you have any final thoughts for people just
about creativity? Maybe not even invention, because invention, I think
you've made it more accessible to people, But invention can
be a scary word, and creativity is maybe a little
bit less scary, and it's something that everybody can kind
of relate to because people, most people have passion projects
or ideas, and they want to be creative, but feel
(41:18):
stifled by themselves, by the world, by the ability to
eventually be heard. Do you have any advice or final
words about creativity for people?
Speaker 3 (41:28):
Well, I think it's it's fun, right, and it gives
you joy. And I'm in a room here surrounded by books,
some of which you know I should throw out, but but.
Speaker 1 (41:42):
You want to have a full library, you know.
Speaker 3 (41:44):
No. I actually win out down things about forty percent recently,
and then some books I kept because they'll have a
great sentence in them. And ninety nine percent of the
book might be crap, but it might have one great sentence,
and I respect the author for writing the book, and
I particularly love that great sentence. So everybody has everybody
(42:07):
has a moment in them, a great sentence in them,
a thing that they can do. It might be as
simple as a new sandwich. I'm a big fan of
the chip cheese sandwich, which I claim I invented. My kids,
you know, are constantly shocked by my cooking. The pink
omelet was a particularly big failure. Yeah, I meant, well, yeah, yeah, yeah.
(42:33):
But like you know, people can do amazingly creative things
because their talent lies in some particular area and we
can all do this. And to do those things, we
have to have some quiet time. And you know, I
pick up my phone, I have Google sending me messages
(42:55):
predetermined by what I looked at yesterday, deciding I need
to learn about this or that, interrupting my own internal dialogue.
We need some moments of lucidity where we can actually
hear ourselves. I don't use a smart watch. I wind
my watch. I don't charge my watch. I try to
have some analog time every day. Two weeks ago, we
(43:19):
met a beautiful family in Ottawa that has an analog room.
They've got a turntable with albums like James Taylor and
Lady Gaga and everywhere. A couple of drums in there,
some guitars and a big sofa and it's the kid's
favorite room because it's a jig sauce. It's an analog room.
(43:39):
This is an analog room, I guess, you know, except
for this computer. But we need those kind of prolonged
moments of quiet. It when you wake up and you
don't have to get up yet. It could be Saturday morning.
You know, Saturday is a great day Sunday's kind of
(44:02):
on Mondays next Saturday, Monday is a long way off.
Saturday morning is a great morning, you know. And I
think the other thing I would say is what do
you read that inspires you. I will walk to the
village here every Saturday to buy the Financial Times weekend
edition because the Life and Arts section contains one great
(44:23):
sentence every week, and that great sentence will will charge
me one week. It was a self comforting myth. That's
a great sentence, you know, a self comforting myth. It
could be about ourselves. It could be about a nation,
for example, that Canada is kind to immigrants. It's not.
(44:46):
Look at the eighty five thousand Uber drivers in Toronto,
most of whom have engineering degrees or medical degrees or
science degrees and can't get jobs. You know. We've taken
gifted people from around the world and turn them into
Tiff Wallace when they came here expecting something else. So
a phrase like that triggered a chain of thought, and
(45:07):
so we have to find places where we randomly pick
up something and have a moment to reflect in it.
But it's not driven by Google or Instagram. We have
to manage our signal to noise ratio and protect it
as much as we can.
Speaker 1 (45:25):
I think that's very sage advice. I think we could
all use a little more quiet, even as people are
listening to this podcast or watching this on YouTube. But
I think a lot of people can relate to quiet
in that analog room that you described. Sounds extremely appealing.
So doctor Kieren Murphy, thank you so much for joining me,
(45:46):
and we can get your book, his excellent book, The
Essence of Innovation and the Joy of Medical Creativity Care,
and that's available on Amazon, that's available in bookstores.
Speaker 3 (45:56):
It's the Essence of Invention. Yeah, it is. It's available,
and my students actually find it around the world and
take selfies with it when they find it on bookshelves,
which is really fun. And if I if I go
into a bookshop or find it when nobody's looking, I
signed them and yeah, which probably drops their value considerably.
But yeah, yeah, anyways.
Speaker 1 (46:19):
Well, thank you very much, Dictor Kieran Murphy, author of
the Essence of Invention. It's it's been an absolute pleasure
having you join me. Thank you not just to chat
about invention, but just to chat about creativity and ways
to kind of access some peace of mind. So thank you.
Speaker 3 (46:37):
Okay, cheers, thank you, have a good day.
Speaker 1 (46:40):
So thank you doctor Kieran Murphy, and thank you everybody
for listening. Have a great day.
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