Dr. Mani Menon
speaker
122 appearances
1 recordings
1 series
first heard Sep 2024
last heard Sep 2024
Dr. Mani Menon’s voice in public audio — every appearance, attributed to the second.
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Appearances
And, you know, here again, maybe this is affirmative action. When there was somebody from his home area who was working on cancer, he kind of felt a bonding and a friendship. And we just got along well. And that's how we decided to fund it. It may have helped because, and this is again the lack of filter in my mind, when he said, how should I set this up?
And I said, well, there are three major institutions in Detroit, four, but one you decided you don't want to fund because somebody else had funded it. And so the three institutions are the University of Michigan, William Beaumont Hospital, and Henry Ford. And maybe you should fund all three and make them work together. So he said, well, how much money should I give?
And I said, well, why don't you give $30 million to the University of Michigan? They can spend $20 million to do breast and $10 million for prostate. Give us $20 million, and we'll focus it on the prostate. And then give $10 million to Beaumont, who can focus it on breast. So roughly, you will have equivalent prostate and breast growth. And he liked that.
I almost got fired because it was not my business to advocate for Beaumont, the University of Michigan. But this guy felt, you know, this is a person I can trust. He's trying to do the best he can for me and my foundation, not trying to do the best for him. And so he decided to fund us. And here is his business foresight.
He decided the conditions that he placed were that only I would have sign-off authority. He did not want a committee, the cancer center, research department. I should have sole signatory authority. It was all current use funds. He did not want an endowment. He wanted me to spend it down because he felt that that would have the greatest impact.
Now, I had to put together a proposal, but the key note of that proposal was to develop minimally invasive surgery. And the reason that I wanted to develop minimally invasive surgery was to try to decrease the blood loss that I saw from the occasional radical prostatectomy. But more than that, Detroit, for many, many years, was the most depressed city in the country.
We had a 30% complete unemployment and a 50% underemployment rate. 40% of the patients I saw were African-Americans. We had... an HMO that was capitated, and we had computerized medical systems long before any other place, any other hospital in the country had it. And so when I searched the medical data, I searched it, Ashutosh Tiwari, who was my fellow, searched it for me.
What we found was that the survival rates were lower in the African Americans than in the Caucasians. But when we adjusted it for the type of treatment they had, A confounder that we could not exclude was that African Americans overwhelmingly chose to have radiation therapy as opposed to radical prostatectomy. And when I talked to them, it was two things.
One is they were worried about the Tuskegee experiment that they would be experimented on. But a lot of them, these were assembly line workers, they were brought up with the concept that if you cut someone open and expose the cancer to air, the cancer would spread. And no matter how much I tried talking with them, I could not break that.
I thought maybe they didn't trust me because I was in black. And so I recruited people from that background, from that community to go and talk with them. But they still were afraid of being cut open.
Given this health care system with equal access to health care and complete follow-up, because this was a capitated HMO and you didn't have to pay to get the thing, African-Americans, stage for stage, still did worse than non-African-Americans. We had a large Arab-American population and a large Caucasian population, and the overall survival and the cancer-specific survival were better than that.
And I got the idea that if we developed a minimally invasive surgery, maybe I could walk to them and say, listen, I'm not exposing your cancer to air. You know, I'm putting in a camera and taking the thing out and putting it in a bag. There's no exposure of cancer to the air. Why would you consider that? And that turned out to be correct. That's fascinating.
There was no business proposal. These guys were too smart. I did come up with the business proposal to do robotic surgery, but I had to preface it by saying nobody had done it. There were 19 robots, 18 robots in the world. This would have been the 19th robot. All 18 robots were in cardiac surgery departments. No cardiac surgeon had gotten it to work.
Prostate cancer was the furthest from the company's viewpoint. They had no idea that this would work, but I wanted to try it. And he said, sure. And I said, well, don't you want a business plan? So he said, you just told me that nobody's done this before. You don't know whether it will work. The company doesn't think it's going to work. What kind of a business plan are you going to give me?
They're all going to be fake numbers. So I trust you. Take it. Do what you want with it. Come back to me in a year. And if I'm not happy with what you did, I will fund you again.
Well, I had a very good relationship with Lonnie Smith, who was the CEO of Intuitive, with Gary Goodhart, who succeeded him as the CEO, and with Dave Rosa, who succeeded him. Those are the only three people that I had a good relationship with. So when I had the funding approved by Mr. Vaticutti and by Henry Ford, I flew over to Sunnyvale with Ash Tiwari.
I said, I'd like to think about doing this. And Lonnie said, well, are your cardiac surgeons on board? And I said, no, they don't even know that I'm coming and talking with you. Well, how about your laparoscopic general surgeons? And I said, well, I haven't talked to them either. So, well, certainly you've done a lot of laparoscopy. Actually, no.
Lani said, listen, there are eight people in this company. We desperately need to sell robots. But I'm not sure that I'm doing you a favor by having you buy the robot because I don't think you know what you're doing. And I said, well, no, I don't think I know what you're doing, but I'm not sure that you know what you're doing either because you built this for cardiac surgery.
You tried it for with 18 cardiac surgeons. And where has that taken you? So he said, OK, well, you know, if you decide to do this, I've warned you, we will support. So that was a good help. I realized that I loved working with the robot, but I didn't like working with their marketing division and I didn't like working with their sales people. And so I have never given a talk for Intuitive.
I have never proctored a case for Intuitive. It was a separation of church and state. I would do the cases to the best of my ability. I would collect the data as accurately as I could and then let the data tell me whether what I was doing right and what I was not.
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