We launched The Essence of Invention on a Friday evening at the Arts and Letters Club in Toronto. I carried the idea for a book on medical inventorship around in my head for years, assembled and disassembled it as a thought experiment just as I do my spine devices. I read extensively about all types of creativity, from Lady Gaga to Lucien Freud, to Colin Chapman. It all comes from the same place, intrinsic talent. That rare earth element that powers the world.
For me most ideas come from never saying no. I make it a policy of agreeing to doing things I do not want to do. This can be personally, socially, but most usually professionally. As an interventional neuroradiologist, I treat diseases none of you want to have. I spent most of my life at Hopkins or University of Toronto treating brain and spine abnormalities under image guidance. This ranges from strokes and ruptured aneurysms to gunshot trauma to the head and neck or fractures in the spine from cancer or osteoporosis. When my colleagues come to me with a very ill patient who has a very challenging clinical problem, as long as it’s safe, I would agree to care for that person. I then wind up awake at two or three in the morning, thinking why the hell did I agree to treat this person. That’s where the inventions occur. You know the phrase pressure turns coal into diamonds? Similarly, pressure turns problems into inventions.
You have to be willing to go beyond your comfort zone to work like this. The characters in this book have all lived beyond the fringes of the acceptable. Medicine is a profoundly conservative field often driven by billing reimbursement. When you start treating things that are challenging but using novel techniques that are not covered by insurance companies or FDA approved, you stray into the unreimbursed realm where institutions lose money, but that’s where the creative future lives, where the future of patient care lives.
There are so many examples in my book of great physicians being horribly treated by their colleagues, rejected by the departments and institutions, and risking their own and their family security in the pursuit of their new technique or invention. In our eyes, this rejection is shocking and inexplicable but we need to reflect on what we are rejecting today in order to have the insight to adopt new approaches.
When Kurt Semm invented laparoscopic surgery his colleagues sent him for a head CT scan because they thought the idea was so bad he must have a brain tumour. They unplugged the projector that he was using or lecturing students lest his deviant ideas would corrupt their delicate young minds.
When Ridley invented the cataract lens implant his colleagues threatened to take his medical license away and he had to meet engineers under streetlamps and parked cars at nighttime after work to discuss his idea. It took 20 years for him to gain acceptance.
When Semmelweis suggested handwashing for surgeons who came straight from teaching anatomy on cadavers to delivering babies, he was fired and ultimately died in an insane asylum.
When Katalin Karikó proposed vaccines to treat cancer and infections, University of Pennsylvania cut her salary and research funding, and threatened to fire her. Yet she won a Nobel Prize for her research which saved the world during COVID.
On a positive note, key individuals create key innovative cultures that stimulate windows of incandescence at key institutions that allow young minds to flourish. We see this with Kurt Senning at the Karolinska Institute supporting the development of angiography and coronary stenting. We see this with Kurt Lilyhei at the University of Minnesota supporting Christian Barnard who developed his techniques for heart transplantation. We see this with Stanley Baum at the University of Pennsylvania supporting his gifted faculty who are mainly Jewish immigrants escaping the Nazis in Europe to develop modern interventional radiology. Clearly, the right mind in the right position of power can create microclimates that change the future.
These inventors are interesting when they gather. They are funny, they are not motivated by money, and they are socially engaged. There is no age limit to their creativity. Creative people are creative throughout their lives. Look at comedians or artists or musicians.
All sentences, stories, or books need a resolution. When I got to the last chapters I didn’t know how to make all the stories symmetrical and resolve them. When I interviewed medical inventors I found that most were in fact motivated by a sense of duty, not money, and often by a sense of guilt. There had been some event for a patient and a bad outcome either because of an unfixable disease or technical problem in a procedure that resulted in that person deciding that they were going to make sure that problem never happened again. This is a motivator that will sustain you long after money for a project runs out. This is something that groups like the creative destruction labs and innovation centres will never understand. Physician inventors are because-based. They are engaged. They are not financially motivated.
Dr. Kieran Murphy is a pioneering clinician, a renowned researcher, a revered teacher, and a prolific inventor. He is also an author, public speaker, and racing driver. He has eighty-one patents and his devices — such as the Murphy needle and Murphy cement — are used globally thousands of times a year. He lives in Toronto. Learn more here.