The Fall of Camelot

I have mentioned multiple times, since I began this blog post, that I recently left a place of employment at which I had worked for over 21 years. I did not retire. In fact, I am already working as a consultant in medical technology. What does this new job title mean? It means that I talk to very smart people in the medical profession and then I talk to very smart people in the field of technology, and I translate each one’s language into that of the other. People make the false assumption that intelligent people can just figure out the different terminologies. But just like translating, say, English to Russian, there are nuances in each language that are not readily translatable.

These nuances are sometimes the reflection of the culture behind the language. And there is a big difference between translating a language and translating a culture. I have personally witnessed the difference. My wife and I made a very conscious decision to raise our children in Hebrew. Despite the fact that both of us are Anglophones, we both also have a good command of Hebrew. My children went to Hebrew language nurseries and watched videos and listened to music in Hebrew. Over time, they picked up English but not as their mother tongue.

I can tell very easily what language they are most comfortable in by watching them as they watch a comedy show. When the comedy show is in Hebrew, but more importantly is based on Israeli culture, my children laugh, even hysterically. Most of the time, I don’t get the humor. I, on the other hand, will laugh at jokes by older English speaking comedians that made their names in the Borscht Belt. But my children will not necessarily follow this humor. And this is the point. You can teach a person a language, but a culture needs to be experienced.

Doctors think in a certain way. It is the result of years of study and training. Innovative thinking is not rewarded within the physicians’ world. The idea is to learn the rules and as much as possible, to stick to them whenever possible. While the white coat that a doctor wears might seem to indicate a comfort level with science and advanced thinking, in fact it is simply part of the standard garb that doctors wear. Many doctors do not understand/remember some of the basic principles of math, physics, organic chemistry and statistics that they learned before their medical studies. Many technologists, on the other hand, take this kind of knowledge for granted. It actually makes me sad that if you present me today with a problem related to chemical bonds and electron shifts, I will only have a bare recollection of these topics from my university years.

Technologists, whether physicists, mathematicians, engineers, programmers, biologists or system/interface designers, tend to be far more innovative in their thought processes. Often times, they are presented with a problem for which there is no answer yet available. They will sit and struggle to find that answer. In many cases, they will fail. But when they do succeed, it is considered a step forward in their field. And it is not uncommon for technologists to be constantly finding new ways to do their work.

Can you imagine a doctor telling a patient that he has only a 30% chance of getting the treatment right? Can you imagine a doctor telling the patient that depending on the data that is collected from the patient’s demise and/or recovery, the doctors will be able to develop a better model of how the patient’s disease works? This obvious exaggeration is intended to demonstrate how fundamentally different the mindset is of one group versus the other. Many doctors want a clear and point wise protocol to be laid out in front of them, so that they can follow it. Technologists, on the other hand, want to play with the data available and come to a conclusion after definitive testing (which includes plenty of trial and error). A physician absolutely fears failure. A technologist excepts that failure is a basic part of advancement (just ask any programmer).

One can easily argue that the distinguishing feature between these two approaches is simply that doctors deal with human lives whereas technologists don’t. But when technologists are working on new medications or new types of testing, the result of their work may very well save more people than the average doctor even meets in the course of his or her career. A failure in technology could lead to misinterpretation of a given result and definitely could cause personal harm to many many people.

Technologists are not lackadaisical about this reality. But they are practical enough to realize that advances in science are not linear. Information is being added to the sum total of human knowledge at a rate that is difficult to fathom. A solution to a problem may very well become available from one day to the next. This is the world of the technologist. Contrarily, physicians are stalwarts who hold almost religiously to their training and beliefs. Teach a doctor that Penicillin is the best medication for a given illness, and it takes tremendous effort to break that doctor of that belief.

Since many doctors unfortunately do not sufficiently keep up on the literature, and do not actively seek to update their protocols, it is critical that EMRs step in and force the doctors to choose correctly. Whereas a technologist might truly find it insulting to assume that he or she is not up to date on the literature, doctors wholly admit that they are “behind” on their reading, due to the stress at work.

I hope it is clear now why my role as a bridge is so necessary. Sometimes, I am able to translate the excitement of a scientist into a simple sentence that explains both the concept and even business potential of the idea. I should add at this point that many technologists do not have training or even an interest in business. Today’s doctors on the other hand, are overly aware of the cost of the things in their professional world. And almost invariably, doctors feel that they are severely underpaid for what they do. This is also a point of contention between physicians and technologists.

So after I have presented my simple sentence along with the comment related to the business potential of the idea, the potential investor will begin to ask questions possibly related to the practical aspects of creating a production line for the technologist’s idea. I have met technologists who are actually somewhat offended by the crassness of treating their innovation as simply another product to be sold. And in my experience, these technologists tend not to succeed in drawing in significant venture capital.

In cases like this, I explain to the investor why the technologist is so hesitant. As the next step, I speak to the technologist and explain that their idea and effort are clearly appreciated, and all that the investor wishes to do is to support that idea by funding it. This might sound childish, but people tend to be very wary when they are handing out money, and dreamers tend to be very careful when given the impression that their dreams can be bought for any sum of money. The hope is always to find a middle ground, based on mutual respect. The endpoint is meant to be that the technologists see the investors as facilitators, and conversely the investors see the technologists as passionate people who truly wish to succeed while preserving the essence of their innovation. In other words, a happy technologist is potentially a wealthier investor.

I named this blog post “The Fall of Camelot” because this is often the sense that developers and technologists feel when they are finally at the point that they have to put a number value  on their ideas. It is far too easy to create a bubble around oneself, whereby one believes that their work and effort and innovation will effectively “save the King/World”. When the product in question becomes just another item that is traded and exchanged, in the same way that you would trade a loaf of bread for pennies, the creators of that product feel their hearts cringe. Investors need to understand that the same passion that led the startup group to create their innovation, is not something that simply gets turned off the moment that money comes into the picture. As I said above, there needs to be mutual respect and trust so that even if the walls of Camelot fall, everyone agrees that the King must survive and persevere.

If it was easy to bring these two cultures together, anyone could do it. And that is my challenge in my work today.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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