Who you are is more important than who you arent
Transcriber: Cinthia Hernandez
Reviewer: David DeRuwe
I remember feeling incredibly small,
nothing more than a distraction,
right before I got up
to present my research in Tokyo
to a group of the world’s leading
cochlear implant researchers and surgeons.
I’d been hoping for a poster presentation,
maybe even a small PowerPoint
in one of the side rooms.
What I got instead was a prime time slot
in the main symposium
in front of 500 surgeons and professors,
many of whom had been practicing
for more than 30 years.
I’m young, as far
as researchers and doctors go,
but I cared deeply
about my team’s research,
which thanks to the novel
use of hydraulics,
had the capacity to make
a real difference to people’s lives.
Sitting down, waiting my turn,
on my left was an Italian
professor of surgery
representing a multi-million dollar
research team from Europe,
complete with their very own promo guy.
Across the aisle, his main competitor
was a Japanese professor,
esteemed and valued in the community,
who was also presenting
to the world for the first time,
a similar surgical robot.
In third place was myself.
Actually, I think third place
might have been a little bit generous.
I felt like one of the kids
who plays at halftime as entertainment,
to be honest.
(Laughter)
Sitting there waiting my turn,
with about 27 years less experience
than the two professors
sitting on either side of me,
I really wished I was doing
a poster presentation.
Cochlear implantation
is an amazing technology.
It gives an artificial sense
of hearing to the deaf
through a two-centimeter bit of plastic,
a little bit skinnier than a noodle.
This techno-noodle is implanted
into your ear by a specialist ear surgeon,
and whilst the results
aren’t quite as good as normal hearing,
they’re a fair bit better than nothing.
We used to only implant
those who were totally deaf,
either those who were deafened
through rotten luck
or were born without their hearing organ,
the cochlea, functioning quite right.
But in the mid 2000s,
we started to implant more and more
those who had age-related hearing loss,
who still had a tiny bit of not-quite-
so-useless hearing function left.
Now, age-related hearing loss
is a little bit different
from other types of hearing loss.
It tends to disproportionately
affect the higher frequencies more,
which is why grandparents
can sometimes have a difficult time
hearing their grandchildren
with their squeaky voices.
It’s kind of funny, but it’s actually
a really tough thing.
If there’s one thing
that grandparents really care about,
it’s their ability to communicate,
in particular with their grandchildren.
Now, it can still be a little
bit hard for us to imagine,
so let’s pretend that half of us
develop moderate to severe hearing loss
at some point in our lives.
At that level,
you can’t have a conversation
with the person sitting next to you
without one of you having to shout
to make yourself heard.
It’s a real impediment to communication,
and it’s not that unlikely, either,
considering 50% of people
over the age of 65
are affected by moderate
to severe hearing loss.
And for us, when we hit our 60s,
those numbers will be much higher,
considering growing evidence
about the long term use of headphones.
Now, we do have hearing aids,
and they are great,
they’re used for this exact reason,
but they have their limitations.
They’re pretty difficult
for old arthritic hands,
and they’re not very effective in those
who have severe or profound hearing loss,
which is quite a lot of people.
Scientists started to realize
that if you could preserve
someone’s residual hearing
whilst complementing it with that
of the artificial sense of hearing
from a cochlear implant,
the outcomes were much better,
particularly for nuanced
sounds like music,
tone, and conversation in noisy places.
The problem was we had
no idea how to do this.
Generally, it was taken as a given
that once you put
a cochlear implant into a patient,
you destroyed that patient’s
remaining hearing,
because the tiny movements associated
with putting an implant inside the ear
are the equivalent of a jet plane
taking off right next to your head.
It’s very loud and likely to ruin
all of your remaining hearing.
Now, that’s where my team’s
research comes into play.
We’re looking at hearing preservation
in cochlear implantation,
and at this point, I have to pay tribute
to my research supervisors:
Professor Gunesh Rajan,
Professor David Fletcher,
Dr. Aanand Acharya,
and Miss Dayse Tavora-Vieira.
Without them, I simply wouldn’t
be standing here today.
We all have our own roles in the team.
My role is to work in the laboratory,
coming up with new ways of trying
to reduce the variation in pressure
inside the cochlea during surgery.
The surgery itself
is incredibly intricate and tiny.
It takes a very steady hand
and decades of practice.
It’s actually not that different
to the board game “Operation,”
but it’s just the stakes
are slightly higher.
(Laughter)
My research was difficult because we were
having problems with human variability.
Namely, any variable I investigated
was dwarfed in comparison
to the innate human tremor,
which made the use of a surgical
robot an obvious choice.
Now, we do have a photo here,
but I must warn you this is real science.
It’s scary confronting stuff.
Please don’t be blown away
by how awesome it is.
Ready. Here we go.
(Laughter)
Yes, that is masking tape.
Yes, that is Blu-Tack there.
Yes, that is a clamp
from my local hardware store.
Look, it was a simple handheld device
which produced a slow, reproducible
insertion over the course of a minute,
and it was about as simple as something
you’d expect to find in a box of Lego.
I was shocked to find out that this device
not only matched our best surgical efforts
but matched the best efforts
of the leading surgeons
from around the world,
not with an expensive contraption
but with a $15 Lego rip-off.
We actually tested this experimentally.
The very best implant surgeon in the world
could only produce an insertion
that was about half as good as our device
with respect to variation
of pressure inside the cochlea.
All of a sudden, we had a device that had
the capacity to take cochlear implantation
into the next phase for the price
of three overpriced coffees.
So we took this idea to Japan.
Now, I’ll be honest,
I felt like a total fraud.
I was presenting
on novel developing ideas,
and I was the first
of three surgical robots
to be presented to the world
for the first time that day.
Surgical robots aren’t even that common,
even at a surgical conference,
so the odds were pretty small.
In any case, I got up on the dais,
I made my presentation -
the only speaker not a professor,
the only research team not backed by
millions of dollars of research funding.
I said my bit, I answered a few
polite questions, and I sat back down,
and it wasn’t until after the presentation
that I started to realize
that we might have
something of real value here.
People were coming up to us
and asking us all sorts of questions:
“Have you commercialized the device yet?”
“Is the intellectual property for sale?”
“Have you tested this in humans?”
I was blown away that a device so simple
could be held in such high regard
by the scientific community.
Even now, we’re in conversation
with companies overseas,
looking to develop our ideas
to incorporate into widespread models.
I’d been so focused on my age,
inexperience, and the relative
simplicity of my research
that I hadn’t thought about its value
to the wider community.
Now, I’m not pretending to be the next
great researcher or surgeon out there;
I’m just trying
to be a good one right now.
But I think the real lesson in this
is that great ideas don’t have
to be complex ones,
and they don’t have to come
from someone with years of experience.
On that stage in Tokyo,
I was so focused on what I wasn’t
that I forgot about what I was.
I was young, inexperienced,
but I was coming at the problem
from a fresh angle,
and I had no idea that I had the capacity
to help millions of people.
If you’ve got a problem,
and you’re passionate about fixing it,
that’s all that matters.
Thank you.
(Applause)