Latest / The BEYOND Podcast / Dr Mohammad Al-Ubaydli: Patients Know Best and Turning Trauma Into Power

Transcript

Dr Mohammad Al-Ubaydli: Patients Know Best and Turning Trauma Into Power · The BEYOND Podcast

• 0:00
  Unknown: Mohammed, thank you so much for coming on Beyond the Boardroom podcast.
• 0:04
  You are the CEO and founder of one of the world's largest
• 0:10
  personal health records companies.
• 0:12
  Yes.
• 0:12
  You graduated from Cambridge for the first class degree.
• 0:15
  You are also a programmer.
• 0:17
  Which is crazy that you've got all of that and you've written a lot of books.
• 0:21
  Yes. Just we'll leave it at that for now.
• 0:23
  Yes.
• 0:24
  That's why I am happy to have you on, I want to hear from you what it took
• 0:29
  to achieve the success that you have.
• 0:32
  And then I also want pick your brain a bit about the the NHS
• 0:35
  and how we can all improve our health by taking control of it.
• 0:39
  Yes.
• 0:40
  So there's so much, so many interesting things we can learn from you.
• 0:43
  So I'll start with my first and favorite question.
• 0:46
  How are you?
• 0:47
  I'm very good, thank you.
• 0:48
  I've been looking forward to the conversation.
• 0:50
  I know you had an incident this morning, didn't you?
• 0:53
  You had an incident?
• 0:54
  Yes. Yeah.
• 0:55
  So what happened?
• 0:56
  I had a food related shirt accident.
• 0:59
  Just before your podcast, just minutes, literally 10 minutes ago I
• 1:03
  was sending you selfies, saying Yeah.
• 1:06
  Do you think this will appear on the camera?
• 1:07
  But camera picks things up though.
• 1:09
  I have no doubt.
• 1:11
  Your shirt's perfect.
• 1:11
  No thank you for the assistance with the replacement shirt.
• 1:14
  So tell us a little bit about where you grew up.
• 1:17
  I was born in the Arab world.
• 1:18
  I grew up in Yemen.
• 1:20
  I think the earliest thing that I'm aware of that happened to me
• 1:22
  is I was bitten by a scorpion as we were sleeping on the floor.
• 1:27
  No.
• 1:27
  And so we then had to get a bed after that.
• 1:29
  But my by memory of.
• 1:31
  Yemen is very happy.
• 1:32
  I had a little baby goat that would follow me around everywhere.
• 1:36
  It was surrounded by people in a school that my parents were teaching in who
• 1:40
  were friendly and protective and so on.
• 1:43
  So now I have children of my own and I'm aware of how.
• 1:48
  Terrifying.
• 1:49
  Everything that happens to your child is I I dunno how we got through that
• 1:54
  difficult environment for my parents.
• 1:55
  Okay. So just, so where were you born?
• 1:58
  I was born in Bahrain.
• 1:59
  You were born in Bahrain?
• 2:00
  Yeah. Yes.
• 2:01
  And then shortly after that, I went, my parents went to Yemen.
• 2:06
  Because my parents had set up a school by the border of Oman.
• 2:11
  That was teaching the children of people who were rebelling
• 2:14
  against the government in Oman.
• 2:17
  Oh. And which was a very isolated area.
• 2:19
  So my mom used to tell me she would walk for an hour to get to a bus
• 2:23
  that would take an hour to get to a city that had a Coke bottle that was
• 2:28
  one, one treat a week kind of thing.
• 2:30
  Wow. It was a very isolated place.
• 2:32
  But the.
• 2:34
  Community that they built and took part in was a very idealistic one.
• 2:38
  Okay.
• 2:40
  Okay.
• 2:40
  So what was taught in these schools and what was going on?
• 2:43
  Many of the people around that area thought that what should be
• 2:47
  done is you teach the children to region, and then get them back.
• 2:51
  Their families need them for the war that's happening.
• 2:55
  Yes.
• 2:55
  And my parents I mean my father particularly would say, look.
• 2:59
  One day there will be peace.
• 3:01
  And with peace you need education.
• 3:04
  So these children can't leave until they've got their O levels.
• 3:06
  This is old GCSEs.
• 3:08
  Yes.
• 3:09
  And.
• 3:10
  And one day there was peace.
• 3:12
  And as the new Ultan the new took over in Amman, he needed to rebuild the country.
• 3:19
  And for that you need a bureaucracy.
• 3:20
  And for a bureaucracy, you need people with university degrees.
• 3:24
  And who can you send for a university degree?
• 3:26
  The people who had O levels, who had O levels, the children that
• 3:29
  had been taught in that school.
• 3:31
  Wow.
• 3:31
  So there's a layer, a thin layer of that bureaucracy from the seventies that were.
• 3:39
  All children in that school who then became the university graduates
• 3:43
  who helped build the country.
• 3:45
  So it's it's idealistic and long term and it's time horizon around what
• 3:50
  you should do in investing in people.
• 3:52
  That that's how my parents brought me up basically.
• 3:56
  Okay.
• 3:56
  But your family was exiled from Bahrain in the 1970s?
• 4:00
  Yes. So what happened?
• 4:01
  So because they were teaching the children the rebels against one royal family.
• 4:06
  The other royal family of Bahrain didn't like them.
• 4:09
  So they were exiled from Bahrain for that.
• 4:11
  So what happened?
• 4:12
  What?
• 4:12
  Actually, you don't so we went from Yemen to Syria to Lebanon during the Civil War.
• 4:18
  Gosh, you were traveling around and trying to find a place to We were
• 4:22
  mostly following my father's education.
• 4:23
  So my father did a degree in Syria and then a master's in bay.
• 4:27
  Ah, okay.
• 4:27
  And then he ended up doing a. PhD in the UK in Cambridge, but these
• 4:33
  were difficult countries to live in.
• 4:35
  Yes.
• 4:35
  Yeah, but again, my memory's happy.
• 4:38
  So difficult for your parents, but not for you when you were that honestly,
• 4:41
  so now I have children of my own.
• 4:42
  Yes. I have no idea.
• 4:44
  Yeah.
• 4:44
  How my parents managed to do it, but they did it in a way that
• 4:48
  me and then my brother as he came, we we felt secure and safe.
• 4:52
  Even in very dangerous environments.
• 4:53
  In Lebanon there were I remember once there was bombing and then we came
• 4:57
  back the next day from the shelter.
• 5:00
  The building across from us had been completely flattened.
• 5:03
  Gosh. And you'd walk to school.
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  But some days you can't get back home 'cause there's another air
• 5:08
  raid and the school, everyone stays in the school and the parents
• 5:12
  stay in their buildings and so on.
• 5:14
  But my ma my parents managed to shield me from that.
• 5:17
  Yeah. But you saw things still.
• 5:19
  You still witnessed things that you couldn't not witness
• 5:21
  'cause they were there.
• 5:22
  It's a war zone.
• 5:23
  But.
• 5:25
  The worst.
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  For, from a child perspective, the thing that you brought up first
• 5:28
  was a scorpion, I don't blame you.
• 5:29
  That's that's intense.
• 5:31
  Yes.
• 5:31
  So where did it bite you?
• 5:33
  At my foot, apparently.
• 5:34
  Oh, your parents must have been, again, going outta their mind there.
• 5:38
  So you generally had a nice childhood and they Yes.
• 5:41
  They managed to shield you from that.
• 5:43
  Looking up, looking at growing up in a, under these circumstances in Wartorn
• 5:48
  regions and then transitioning to the uk, what impact do you think that had on you?
• 5:54
  That's not an everyday occurrence for most people.
• 5:58
  You're going to completely different environments.
• 6:01
  Yes.
• 6:02
  So how was that?
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  So you learn something when you have to exist in different
• 6:09
  cultures in different countries.
• 6:11
  One is that you learn that most people's habits are random and arbitrary.
• 6:16
  I. I come to England, for example, first day in the canteen.
• 6:19
  In the school.
• 6:20
  They have gravy.
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  So what age are you now?
• 6:22
  10. You're 10?
• 6:22
  1986. Okay.
• 6:23
  So you come to the uk, you're 10 years old, correct?
• 6:25
  Yeah.
• 6:25
  You haven't seen anything like this Really?
• 6:27
  I've never seen gravy before in my life.
• 6:29
  So you're looking at this and thinking so they put gravy.
• 6:32
  It's a liquid.
• 6:32
  I pick up the spoon.
• 6:33
  I. Drink it.
• 6:35
  Oh.
• 6:36
  And the kids are laughing at me which is fine, but the thing I didn't
• 6:39
  understand is I said how do you do it?
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  And they showed me and they used a fork and the liquid was falling.
• 6:43
  So I'm just, it makes no sense to me.
• 6:46
  No, nothing.
• 6:47
  And every country has these things but then on the flip side, every country has.
• 6:52
  Some excellent things, and if you can pick them up if you can
• 6:56
  accumulate them, that's very useful.
• 6:57
  My teacher in the school, I spoke very little English and I, I asked
• 7:03
  her, how do you spell this word?
• 7:05
  Yes. And she says.
• 7:07
  Here's the dictionary and, okay.
• 7:10
  A dictionary is what you use when you know the spelling of
• 7:12
  the word, but not the meaning.
• 7:13
  I know the meaning.
• 7:14
  I dunno the spelling.
• 7:15
  Yes. Why are you giving me a dictionary?
• 7:16
  Yeah.
• 7:17
  And in fact Arab schools, the teacher would've immediately told you Yes.
• 7:21
  And for a teacher to not tell you, you think the teacher is lazy.
• 7:24
  Okay.
• 7:25
  However, what the English system is all about is teaching you independence.
• 7:30
  So what the teacher I eventually understood was, how many
• 7:33
  ways could it be spelt 10?
• 7:36
  15. It doesn't take that long to go through all of them.
• 7:39
  And eventually you'll find the right spelling by trying them on dictionary
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  and now you know how to check the spelling without waiting for se
• 7:45
  for another person to teach you.
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  So she taught me how to teach myself.
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  I think you took the positive out of that lesson.
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  'cause I think she was slightly rude, to be honest.
• 7:54
  I must tell you I'm positive now.
• 7:56
  I was very bitter during the first few years.
• 7:57
  Yeah.
• 7:58
  I don't like, yeah, I don't like, but the English system is very much about.
• 8:01
  Independence and sometimes it comes across as sink or swim.
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  But that is if you look at Arab countries or Asian educational systems in general,
• 8:09
  they're very much about rote learning.
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  Yeah.
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  They're gonna give you the answer and you're gonna learn the answer.
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  Whereas English systems are about getting you to think through the answer.
• 8:18
  Yes.
• 8:19
  Very interesting.
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  The.
• 8:21
  Something I noticed is that my parents who came from a Polish Yes.
• 8:25
  Background polish education in Poland, kids, in those days
• 8:30
  didn't really get anything.
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  There was no concept of homework or anything like that.
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  You really, yeah.
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  You got taught at school.
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  And then you went home and relaxed.
• 8:38
  Yes.
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  But the academics were dealt with by the teachers hands on in school.
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  And and today, the education system, it's absolutely brilliant.
• 8:46
  It's top it's really good.
• 8:47
  Yes.
• 8:48
  A hundred percent literacy in the country, very academically minded.
• 8:51
  Yeah. Country.
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  But in South Africa we had more of the English system where
• 8:55
  the kids were expected to, like you're saying, sink or swim.
• 9:00
  Yes. And if you had.
• 9:01
  Parents, you needed that support the parents to especially if
• 9:04
  you're very m young or maybe a bit, one of those kids that doesn't
• 9:08
  really wanna sit down and study.
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  You did need a parent to watch you and the kids that had, that, would do better.
• 9:14
  And then the kids whose parents were like a bit hands off because they expect the
• 9:17
  schools were a bit left and started having gaps in things, which is, what happened
• 9:20
  in our, and it builds up in our, yeah, because, it's not like that, and I see
• 9:24
  that even now with my kids having gone through the English education system.
• 9:27
  Yes.
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  How much they needed me to just make sure that, the academics are tick tick, tick.
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  And I think it is a bit single swim.
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  Yeah.
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  Yes.
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  But then again, we've got the best universities in the world
• 9:38
  you've been to one of them.
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  And those are brilliant and the minds are stretched.
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  But I think at that stage, you're not dealing with that anymore.
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  You're just dealing with.
• 9:46
  Yeah, the best of the best.
• 9:47
  That kind of so again, it's about each of those systems, Arab Polish
• 9:51
  has advantages and disadvantages.
• 9:53
  And as you live in different countries, the, do you learn to identify them
• 9:59
  and evaluate them objectively?
• 10:00
  Not because you grew up there and therefore it must be the correct way.
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  But because as an outsider, you are checking everything.
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  And then are you open to picking up the good things Yes.
• 10:10
  Rather than rejecting them from being different?
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  Yes.
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  So if you can get rid of the weight of local habits and pick up.
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  Accumulate the good local habits.
• 10:18
  It's very powerful.
• 10:19
  I love that you say to be open to it.
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  Yes.
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  Because I know, I would say that travel, I consider travel and going
• 10:25
  out there in the world and going to all as many countries as you can
• 10:28
  and sub, literally living the life.
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  Go and work in a country.
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  Don't just go on holiday.
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  Literally work there.
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  Yes, live there.
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  Doesn't matter like remote and.
• 10:36
  You suddenly start seeing things from a different angle.
• 10:39
  It's not all UK centric or polish.
• 10:41
  It's let's look at it from this point of view.
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  Look at football teams that these guys look how they dress, look how they speak.
• 10:47
  And it becomes less scary as well, that people are different.
• 10:50
  They look different to you, but it's or people Yeah.
• 10:52
  Laughing at the same silly things.
• 10:54
  Getting really hungry, wanting, you all have to work, you're on
• 10:56
  depression and you suddenly the world, it just becomes easier.
• 10:58
  But then you've got people that maybe they haven't traveled.
• 11:01
  I had someone in the family who hadn't traveled but he was so open
• 11:06
  and researching and reading on different cultures and really like
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  intellectually wanting to understand and even learning other languages,
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  as many as you could, and just.
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  Yeah, it's the openness that matters.
• 11:18
  The openness, right?
• 11:19
  Yes. Yeah.
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  You can do it in different ways.
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  Yes.
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  But yeah, if you're not open, then the world becomes scary
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  and then you become defensive.
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  Yes. It's true, isn't it?
• 11:26
  Yes.
• 11:26
  So true.
• 11:28
  Values, like family values and how you brought up, you obviously different
• 11:32
  influences and that's fine, but like what your parents tell you at home
• 11:37
  that really matters and what sorts of, what were the main values that your
• 11:41
  parents, I think the main things were and with the background that at various
• 11:50
  points in my life, there was sudden.
• 11:53
  Movement.
• 11:54
  So change.
• 11:55
  Yeah.
• 11:55
  The move from Syria to Lebanon was very sudden from Lebanon to
• 11:58
  Cambridge was very sudden, okay.
• 11:59
  From Cambridge.
• 12:00
  YPs was very sudden, so on.
• 12:02
  And therefore but it's okay if you are close with your family
• 12:08
  and you have an education.
• 12:10
  If you have those two things in place, it doesn't matter where you are.
• 12:13
  It's gonna be okay.
• 12:14
  It may not be fabulous, but it's gonna be okay.
• 12:16
  What about your friends?
• 12:18
  That's very frequent changes in friends.
• 12:20
  Yeah.
• 12:20
  And unlike my brother, for example, I'm not very good at making friends.
• 12:23
  So he was excellent at picking up friends.
• 12:25
  It takes me three years to make friends.
• 12:28
  Three years, and it takes me, my parents, three years to change country.
• 12:32
  So it was difficult for me.
• 12:33
  Wow.
• 12:34
  But, but the family was a constant and was very close.
• 12:38
  And wherever we turned up if I could pay attention to my
• 12:43
  education things worked out in me.
• 12:45
  So you were very studious and it was something that was important to you?
• 12:48
  I liked learning.
• 12:49
  I was I was probably.
• 12:51
  A bad student for most of my life.
• 12:54
  And yeah, I'd fail exams and so on.
• 12:55
  Really? Yes.
• 12:56
  But the mostly because I would like learning the topic, not the test.
• 13:04
  And as the teacher would focus on, you have to learn these three
• 13:06
  things, I would be distracted by a whole bunch of other things.
• 13:09
  But you learn the habits of studying for the exam along, but the.
• 13:13
  Enjoyment of learning.
• 13:14
  That was constant.
• 13:15
  I was always reading, I was always, it is something I pick up from you.
• 13:18
  You ask a lot of questions more than most people.
• 13:20
  It's the first thing I notice about you, like firing questions.
• 13:23
  Me. I'm like, hang on a minute.
• 13:24
  Hang on a minute.
• 13:25
  I'm interviewing you.
• 13:26
  No. I find no, but it's nice.
• 13:28
  But you're inquisitive.
• 13:29
  I find everybody has a story.
• 13:31
  And it's really interesting.
• 13:32
  I'll tell you a story.
• 13:33
  Okay.
• 13:34
  Buzz Neil Armstrong.
• 13:35
  Sorry. The astronaut.
• 13:36
  Before two years before he died, he gave a lecture for the Australian
• 13:42
  Association of Accountants.
• 13:44
  He gave the keynote lecture and everyone was asking the guy, how did you get
• 13:48
  Neil Armstrong to come to Australia?
• 13:51
  Apart from coming to Australia, Neil Armstrong is very modest.
• 13:53
  He doesn't give lectures.
• 13:54
  So he gave a little bit of speaking tour after.
• 13:57
  The moon as a duty to nasa and, but he's a very private man.
• 14:02
  And he said I found out that Neil Armstrong's father was an accountant.
• 14:07
  And I said to him, will you help inspire the next generation of accountants?
• 14:11
  Aw. And of course you flew, right?
• 14:13
  Aw.
• 14:13
  So everybody has a story.
• 14:15
  Yeah.
• 14:15
  And if you understand that you can cooperate with people but I
• 14:18
  enjoy telling people's stories.
• 14:20
  That's a lovely story.
• 14:21
  As I said, it wasn't easy for you, and you've been telling us
• 14:25
  about, obviously, all the war torn countries and the movement.
• 14:28
  And as a kid and the difficulty, obviously it affected.
• 14:31
  Making these friends, you always have to leave.
• 14:32
  You always have to leave them.
• 14:33
  So why put, you know the effort and then da.
• 14:35
  And then you also had a rare immune disorder.
• 14:39
  Can you tell us about that?
• 14:41
  My immune system is weak.
• 14:43
  I don't, make antibodies in response to what tool?
• 14:47
  I make the normal antibodies that everyone has, but normally the immune system,
• 14:51
  when it finds something dangerous like an infection or a cancer, it then makes
• 14:55
  an antibody specific extra to that thing.
• 14:57
  Yeah.
• 14:58
  I can't make that specific.
• 15:00
  You can't make extra ones?
• 15:01
  Correct.
• 15:01
  So in Yemen the vaccines wouldn't work.
• 15:05
  Okay.
• 15:05
  And sometimes the vaccine would give me the infection that was in the vaccine.
• 15:08
  Oh, so if it was a live vaccine, for example, if it was a live vaccine, yeah.
• 15:11
  Growing up in, in a very poor area.
• 15:14
  Again I dunno how my mother kept me alive, but yeah, she noticed it early on
• 15:18
  and she began boiling water before she gives it to me to drink, to sterilize it.
• 15:24
  And she smoked everyone around her said, the Yemenis, there are tough people.
• 15:28
  So they said you're spoiling him.
• 15:30
  Yeah. And you are making him weak and so on.
• 15:31
  But she said there's something, give him the germs, they're good
• 15:33
  for him, but she said, no, there's something different about my son.
• 15:38
  And he needs protection.
• 15:39
  And so that, that's why, by the time I got to Cambridge to the UK in age 10, many
• 15:47
  other children would've been in much worse condition, even if they'd been in better
• 15:50
  countries than, Yemen, Syria, Lebanon.
• 15:52
  But she managed to maintain my health because she changed.
• 15:54
  Yeah, she was very educated.
• 15:56
  She kept a very good eye on me and looked after me until I was 12.
• 16:03
  And in those two years, I remember my mother constantly arguing
• 16:06
  with doctors saying, what you are saying does not match what he has.
• 16:10
  I've seen her intuition.
• 16:13
  No, she brought data to the conversation.
• 16:15
  She brought the receipts, right?
• 16:16
  So what you are saying doesn't match what happened this
• 16:18
  day, that day, the other day.
• 16:21
  So your diagnosis is wrong, and I'm okay.
• 16:24
  Dying of embarrassment because you think your mom's been too?
• 16:27
  Why are you embarrassed?
• 16:29
  Just, my my mother has a very strong personality and she's telling off the
• 16:33
  doctor for being wrong and I'm new in the country and I'm just trying to keep
• 16:37
  the low profile as a teenager, right?
• 16:38
  Yes.
• 16:39
  Just shush mom.
• 16:40
  Yeah.
• 16:40
  P but she was right.
• 16:41
  But she had the facts.
• 16:42
  She had the facts and she'd done the work.
• 16:44
  And eventually we got to see a super specialist in Great
• 16:49
  Ormond Street Hospital, London.
• 16:51
  And apparently the year that he saw me, it was only one year after the illness
• 16:56
  had been diagnosed in the first place.
• 16:58
  The Swedish registry had identified it because it's so rare.
• 17:02
  And so a year afterwards, a specialist in London sees me and says.
• 17:06
  Mohamed has this and we think it can be fixed by giving him
• 17:10
  antibodies from blood donations.
• 17:13
  And that changes my trajectory in my health.
• 17:15
  That's crazy.
• 17:16
  That is crazy.
• 17:18
  So when you.
• 17:20
  Had a live vaccine that you shouldn't have had.
• 17:23
  Was that one of the points in her data points saying we gave
• 17:26
  him, I don't know what, correct.
• 17:27
  You had TB or something like that.
• 17:28
  Did you then, like what I forget the one that she had but she didn't, she had all
• 17:32
  the, she had all those, yeah, because you would've had a lot of, you had to go
• 17:34
  through the whole program, didn't you?
• 17:36
  Yeah.
• 17:36
  Measles and all sort.
• 17:38
  Yeah. I dunno.
• 17:38
  Is measles a live vaccine?
• 17:39
  I don't, again, in those days, I dunno what it was, but Yeah.
• 17:43
  I dunno what it was.
• 17:43
  But you must have, and again, remember she's collecting them across.
• 17:46
  These different ages, they're diff different healthcare systems, right?
• 17:48
  And sometimes that's even more difficult.
• 17:51
  Yeah. Because that's even more difficult.
• 17:52
  But she kept all that information.
• 17:53
  Yeah.
• 17:53
  And she brought that and she's constantly reading and she
• 17:56
  brings that to the conversations.
• 17:58
  You actually need to Yeah.
• 17:59
  Be careful when you hopping countries because one program
• 18:01
  is totally different to another.
• 18:03
  Yeah.
• 18:04
  I actually missed out on a measles vaccination, and then I had to
• 18:08
  have one later in adulthood.
• 18:09
  And the only reason why they found out that I had missed out on it is because.
• 18:13
  I took my daughter to a and e for some, she was, and then they, there
• 18:18
  was someone with measles there, right?
• 18:19
  So they said, oh, sorry, you were you vaccinated?
• 18:21
  I found my mom.
• 18:22
  She goes, mom, was I vaccinated?
• 18:23
  She goes, I dunno.
• 18:24
  I was like, great, thanks.
• 18:26
  And then they did a test and then, yeah.
• 18:28
  Yes.
• 18:28
  Yeah. Now I'm glad they checked, but yes.
• 18:30
  So yeah, that was actually, that was a good moment.
• 18:33
  'cause that could have been.
• 18:34
  And a lot of people find that at scale during lockdown with COVID,
• 18:39
  they'd get one dose in one country and another one in the other country.
• 18:42
  The system fails across the borders.
• 18:45
  Yes.
• 18:45
  And they stuck in the admin as well as the safety of it.
• 18:48
  So it's very difficult.
• 18:49
  It's a horrible place to be stuck.
• 18:50
  Yeah.
• 18:50
  Yeah. Oh, that's really scary.
• 18:54
  You love your academics, that's your grounding, one of your grounding values.
• 18:58
  Yes. Besides, obviously family first.
• 18:59
  And you study computing.
• 19:02
  And you study medicine.
• 19:04
  Yes.
• 19:04
  It's two different, they share some parts of brain, but it's like it is
• 19:07
  two different parts of your brain.
• 19:08
  Yes.
• 19:09
  Like your brain must be very well exercised with the blood flow.
• 19:11
  Very healthy in the D regions because it's like.
• 19:16
  Sorry, go ahead with your question.
• 19:17
  No, I say it's just different.
• 19:18
  You don't get someone really that's done those two.
• 19:21
  When I, it's not a common thing, did my A levels, I read a book called
• 19:25
  chaos which is not about the NHS, it's about a new science of chaos.
• 19:29
  Science.
• 19:29
  Chaotic systems and things like the weather.
• 19:31
  Plates unpredictable volatile, unpredictable.
• 19:33
  Okay.
• 19:34
  And they're unpredictable because normally a small error in measurement
• 19:38
  means a predictable measure in your prediction error in your prediction.
• 19:41
  But non-linear systems, chaotic systems no matter how small the
• 19:44
  error in your measurement Yes.
• 19:45
  And there will always be error of your measurement.
• 19:47
  Yes.
• 19:47
  Can still lead to a very large error in your prediction.
• 19:50
  So they're very difficult systems to predict and model.
• 19:53
  Yes.
• 19:53
  But they're the most important systems.
• 19:55
  Yes.
• 19:55
  And so the book talked about to model the weather meteorologists learn how
• 20:01
  to program to modern model earthquakes, the geologist learn how to program.
• 20:05
  So they were combining disciplines, like you were saying?
• 20:07
  Yes.
• 20:08
  And then it has a whole chapter on the body is full of chaotic systems.
• 20:12
  The immune system, the heart, and so on.
• 20:14
  Interconnected, chaotic systems.
• 20:15
  Yeah.
• 20:16
  But there was no doctor who learned how to program.
• 20:17
  Yeah.
• 20:18
  So I said, I'll do that and I'll learn how to program and do
• 20:22
  medicine so I can write software to model the body's chaotic systems.
• 20:28
  Yeah.
• 20:28
  So I thought that was a cool idea.
• 20:29
  I'll try that and.
• 20:32
  I applied to the medical schools and they said, why do you want to be a doctor?
• 20:35
  I don't want to be a doctor.
• 20:36
  I want to write this software.
• 20:37
  So four of them turned me down on the spot saying, you are wasting
• 20:40
  our time while you're here.
• 20:41
  And but luckily one of them, Cambridge said yes, and they allowed
• 20:45
  me to combine the two disciplines.
• 20:48
  Yeah, it's fascinating.
• 20:49
  It's fascinating because you Yeah we're going into this direction so let's
• 20:54
  let's park this one for a little bit.
• 20:55
  Sure.
• 20:55
  So do you consider yourself an ambitious person?
• 20:59
  It's a yes or no answer first.
• 21:02
  No.
• 21:02
  If you mean competitive, ambitious.
• 21:04
  No.
• 21:05
  Ambitious.
• 21:05
  Yes. Yes.
• 21:06
  Go ahead, sir.
• 21:06
  Yes, you do.
• 21:07
  Why?
• 21:08
  I like doing things that seem difficult or impossible.
• 21:14
  That's the ambition I have.
• 21:15
  It's not the ambitious to beat someone or to win.
• 21:18
  Yes.
• 21:18
  It's but thinking, everyone thinks this can't be done,
• 21:22
  let's figure out how to do it.
• 21:23
  That's the ambition I have.
• 21:25
  It's okay to say you're ambitious on this podcast.
• 21:28
  It's okay.
• 21:28
  No. Because you have to have ambition Yes.
• 21:32
  To want to combine computing and medicine Yes.
• 21:36
  In the way that you did, especially when you did.
• 21:38
  Yes.
• 21:38
  And still now when we need it, more than ever you have to have ambition.
• 21:42
  Yes.
• 21:42
  So are you ambitious?
• 21:44
  Yes, I am.
• 21:45
  Yes, I am.
• 21:46
  Yes I am.
• 21:46
  It's quite therapeutic this conversation.
• 21:48
  It's not meant to be therapeutic.
• 21:51
  Keep going.
• 21:51
  Sorry.
• 21:52
  What did your early career look like then?
• 21:56
  I think my big break 'cause I was trying to combine the computer and the medicine.
• 21:59
  I was getting summer jobs during medical school to write software.
• 22:04
  Which was really interesting because the, for the professors to get the software,
• 22:10
  they had to teach me their specialty.
• 22:13
  But my big break came when I worked for this one professor and I kept
• 22:16
  on saying to him, gimme more work.
• 22:18
  He said, you've got a whole day.
• 22:19
  I said, I still wanna do work in my whole day.
• 22:22
  And I irritated him one day.
• 22:24
  And so he said, fine, come with me to this meeting tomorrow.
• 22:29
  So I come to a meeting where there's a room full of radiology professors, and
• 22:33
  for an hour they're telling me about what they want done for the DICOM file.
• 22:36
  What is that?
• 22:36
  And I'm 20 and I'm too embarrassed to say, what is that file?
• 22:39
  What is a dicom?
• 22:40
  Yeah, what does that word mean?
• 22:41
  Yeah, it's the file format for radiology pictures, like x-rays and CT scans format.
• 22:45
  Okay.
• 22:46
  Okay.
• 22:47
  And now we're into it.
• 22:48
  I still don't know.
• 22:49
  Yeah.
• 22:49
  And at the end they say, they hand me a stack this stick and say, these are the
• 22:53
  specifications for the DICOM file format.
• 22:55
  And your boss says that you're gonna write the software for us.
• 23:00
  So software to do what with it though?
• 23:03
  So what they wanted was to take their.
• 23:06
  X-ray or the CT scan the file.
• 23:10
  And then have software that lets them, annotate it, highlight it.
• 23:14
  Just explain.
• 23:15
  Oh, okay.
• 23:16
  Just to make edits to, to, to the file.
• 23:18
  Okay.
• 23:19
  Yeah.
• 23:20
  I know this now anyway, so I'm in a panic because next day I have to go on
• 23:24
  my whole day, I've got this stack of fold, this stack of instructions and
• 23:28
  I still dunno what a DICOM file is.
• 23:31
  Luckily that year there was a new website called Google, and so I figured out
• 23:36
  what DICOM file is and then I found one bit of software that would read a DICOM
• 23:41
  file into a picture and another one that would take a picture and let you
• 23:44
  annotate it and do all the things already.
• 23:46
  And I joined up the bits of software, so I do it in two days.
• 23:49
  You programmed conversation between, I programmed the connection between the two.
• 23:52
  And I want to be clear with you what I was clear with my boss, which is.
• 23:56
  All the work was done by these two guys who'd written the software.
• 23:58
  So I just found them and stitched them.
• 24:00
  Communicate.
• 24:01
  Yeah.
• 24:01
  But my but my, from that point onwards, he just kept on giving me difficult stuff.
• 24:08
  Nice.
• 24:09
  And I kept on enjoying it.
• 24:10
  What programming language were you using?
• 24:12
  What was your favorite?
• 24:12
  This was Java. Back then.
• 24:13
  You were your Java.
• 24:14
  Okay.
• 24:14
  Java developer.
• 24:16
  Okay.
• 24:16
  So you allowed these systems to talk to each other, these apps Yes.
• 24:20
  Or whatever you wanna call them to, to talk to each other.
• 24:22
  You found a way to link that.
• 24:24
  So that was a, like a little breakthrough.
• 24:26
  And then at what point did that turn into a business?
• 24:32
  So I'd always done little programming jobs or writings.
• 24:36
  Just anything that would, I done, a few hundred pounds a year, nothing much, but,
• 24:39
  and most of the stuff I did was for free.
• 24:41
  But what I liked about doing these things is I would get freedom to do new things.
• 24:47
  And that's what I enjoyed.
• 24:49
  And in contrast, as I was going through academia and medicine, it was very
• 24:52
  clear that although there would be very clear career path and monetary
• 24:56
  path, there wasn't the freedom.
• 24:58
  So around about university, I realized I was gonna start my own company.
• 25:02
  Okay.
• 25:03
  And I didn't know.
• 25:05
  What it was going to be about.
• 25:07
  I just knew it would be very difficult to start your own company.
• 25:10
  Yeah.
• 25:10
  Therefore, the only way you could persist through the difficulties is if
• 25:14
  you found the problem so interesting.
• 25:17
  You would keep going for years because most startups fail.
• 25:20
  They're just, that's what, they're very difficult.
• 25:22
  Yeah.
• 25:23
  And most people are incompetent when they begin.
• 25:25
  It's just hard.
• 25:27
  But what keeps you going is this problem is so interesting.
• 25:29
  I really want to fix it.
• 25:31
  And I didn't know what that problem would be for me.
• 25:34
  So I thought, I'm just gonna go through as many problems as quickly as I can.
• 25:38
  Individual problems, individual things anything that people would come to me
• 25:41
  with, I would just start researching it.
• 25:43
  And that would often involve writing a book about it.
• 25:45
  That would be how I learn.
• 25:46
  And in the meantime, I set myself a syllabus of, by the time I
• 25:49
  found the idea, I wanna make sure I've got all the knowledge.
• 25:52
  At least the most I can get away with for starting a business.
• 25:55
  I work for management consultancy.
• 25:56
  I read business books and so on.
• 25:58
  I learned more software.
• 26:00
  I learned more about industry, and so that was syllabus until I would
• 26:02
  find the problem that I would.
• 26:03
  Just a second.
• 26:04
  So when you're doing these assignments.
• 26:05
  Yes, you're taking this to who's paying you to do them?
• 26:09
  Much of the time no one was paying me.
• 26:10
  Ah.
• 26:11
  But there was somebody who wanted the problem fixed.
• 26:13
  And often I would do it for free, but I would just wanted, so how were you living?
• 26:16
  How were who?
• 26:17
  Oh, so my day job was after medical school.
• 26:19
  I worked for one year as a doctor and then I went to the States and worked as a
• 26:23
  scientist for the US Federal Government.
• 26:25
  And then.
• 26:26
  During the time that I had my idea on patients, their best,
• 26:29
  I was a management consultant.
• 26:31
  That was the final bit of my syllabus.
• 26:32
  I wanted to learn.
• 26:34
  Okay.
• 26:34
  How people run hospitals.
• 26:36
  So you actually have a job and you're doing all this other
• 26:38
  stuff in your spare time.
• 26:39
  Yes. You're reading business books.
• 26:41
  Yes.
• 26:41
  You've got conferences and things going on.
• 26:43
  You're taking on these little side projects?
• 26:45
  Yes.
• 26:45
  And you're writing your own books because you're learning while you're writing.
• 26:49
  Correct. It's a very interesting recipe for how to.
• 26:52
  Start a business.
• 26:54
  It's just, so what I like is the learning and the experimenting.
• 26:57
  And a business is a vehicle to do that.
• 27:00
  Yeah.
• 27:00
  Rather than yep.
• 27:01
  So my wider family is very commercial.
• 27:04
  They're all businessmen.
• 27:05
  But my parents, my father's an academic and my mother's an artist.
• 27:09
  None of us are particularly commercial.
• 27:11
  Yeah. But we love learning.
• 27:13
  And so we see business as a way, I see business as a way
• 27:16
  to learn rather than, yeah.
• 27:17
  To make money.
• 27:18
  I was listening to something Elon Musk said the other day, I think it was Elon
• 27:22
  Musk about people sometimes when you have people in the business and they,
• 27:26
  all these consultants and the experts and they really learn this subject.
• 27:31
  They're brilliant.
• 27:31
  Business minds learned business and they were always, when you present an idea.
• 27:37
  To them give you a million, extremely valid reasons why it will never work,
• 27:41
  cannot be done work and cannot be done.
• 27:42
  And yeah, you sometimes need to just say thank you now let's spend equal amount
• 27:47
  of time talking about why it can be done.
• 27:49
  Yes.
• 27:50
  Let's discuss that and I suppose the freedom, the fact
• 27:52
  that you weren't commercially.
• 27:54
  Deadlines allowed you to expand that mind, the two sides of
• 27:58
  your mind working together.
• 27:59
  I suppose that's like the apps, the connections.
• 28:02
  Yes.
• 28:02
  Like it's interesting because that's what exactly what you're doing.
• 28:05
  Life is interesting in the interfaces.
• 28:07
  Yes.
• 28:07
  So whether it's two countries Yes.
• 28:09
  Or two disciplines interface, because there are two different,
• 28:12
  there's a little bit of overlap.
• 28:13
  Yes. But they are two different.
• 28:15
  Yeah.
• 28:16
  Was is it prefrontal cortex in your hyper hip hippo camp?
• 28:19
  Is it the hippo?
• 28:22
  But yeah, two different sides.
• 28:23
  But it's tourism for the mind, right?
• 28:24
  Tourism for the mind.
• 28:25
  Yeah.
• 28:25
  Gosh, your mind is definitely being active there.
• 28:29
  Okay. So you are.
• 28:31
  Then deciding you wanna start this business?
• 28:34
  And then tell me about the business.
• 28:36
  What's, what is the name?
• 28:37
  What is it?
• 28:39
  So in 2007, one work for that management consultancy.
• 28:42
  My job was to write three books a year on topics that my hospital clients chose.
• 28:48
  And so one of them several of them said, we want to know how to share medical
• 28:54
  records with patients because everyone's asking us to, as a hospital, CIO, but.
• 29:00
  This could go really badly and it could end up in the press if you do it wrong.
• 29:04
  Yeah, for sure. So tell us how to do it right.
• 29:07
  I did, I wrote a book by interviewing all the ones who've done it how'd you do it?
• 29:10
  What do you avoid?
• 29:11
  And so on.
• 29:12
  And I and that book.
• 29:14
  Included me interviewing Microsoft CTO and Google, CTO, who were
• 29:18
  launching their platforms on personal health records that year in 2007.
• 29:23
  Okay.
• 29:23
  How did they, how did you get them to talk to you?
• 29:25
  I just worked the phone and just said, I'm writing this book it's gonna go
• 29:30
  to all the hospital CIOs in the USA.
• 29:32
  I know you're launching this platform.
• 29:33
  I saw idea quite nicely.
• 29:34
  Yeah. Yeah.
• 29:35
  And and they wanted all the hospital CIOs to connect to their platforms.
• 29:38
  Okay.
• 29:39
  Okay.
• 29:39
  Was it the interest.
• 29:41
  It was in their interest and they they spoke candidly, but also I
• 29:44
  think from the people who had spoken to them, I got really technical.
• 29:50
  So I spotted several bugs in what they were describing.
• 29:54
  Love that. I love that.
• 29:55
  Yeah. Yeah.
• 29:55
  And to their credit, they enjoyed the comment.
• 29:57
  They'd say, oh yeah, nobody's spotted that before, but yes.
• 29:59
  Yeah. Oh yeah.
• 30:00
  But we had to do this decision.
• 30:01
  The devil is always in the detail.
• 30:02
  Brilliant opportunity.
• 30:04
  I knew I came to a conclusion during that year.
• 30:08
  One is that this technology of giving people their records is
• 30:12
  going to be really important.
• 30:15
  And I knew that from my, not just from the research, but from my personal
• 30:17
  experience, that when my nurse in the UK taught me how to inject myself with
• 30:22
  those antibodies I was very grateful.
• 30:26
  I had my independence, I could travel, but I also stopped taking
• 30:30
  up a hospital bed every three weeks.
• 30:33
  And me doing the injection was higher quality than
• 30:36
  waiting the hospital to do it.
• 30:38
  And giving the data to the person does that at scale for many more people.
• 30:43
  So this is a really big idea.
• 30:47
  And the second thing I concluded was everyone was doing it wrong.
• 30:51
  Including Microsoft and Google.
• 30:52
  So they're going, I can just see this is gonna fail in three or four years
• 30:55
  time and I really need this to happen.
• 31:00
  As a pers, as a patient, I really want this P problem fixed and
• 31:04
  they're all doing it wrong.
• 31:06
  So I. I want, I'm gonna, I'm gonna fix it.
• 31:10
  So you had in terms of an entrepreneurial side here, you had a really firm, possibly
• 31:16
  somewhat naive, but belief, but determined that even these great big companies,
• 31:21
  like actually you're doing it wrong.
• 31:23
  And I believe that I've got the solution, but then what's interesting that you had,
• 31:28
  and I wonder where you got the skill.
• 31:31
  I can't see where you got it.
• 31:32
  But like you realize that you had to sell this like mutually beneficial thing
• 31:39
  to get these people in to talk to you because they're the credible people,
• 31:43
  the big names that you need so that you can start to develop these Yes, these
• 31:47
  ideas, this platform, this business.
• 31:49
  So you had the guts and the know-how to sell your concept to
• 31:54
  them so they would talk to you.
• 31:56
  That's quite interesting.
• 31:57
  So growing up even though it takes you three years to make friends.
• 32:00
  So growing up my brother makes friends quickly and he's the salesman.
• 32:04
  Yeah. And I don't, and I'm the academic.
• 32:06
  Yeah.
• 32:06
  He's now an academic with amazing friendship groups, by the way.
• 32:10
  And you're the salesman, but I'm the businessman, so it's strange how
• 32:12
  these things flip, but if you see it, watch my brother, as a young yeah.
• 32:16
  He's four years younger than me, but still talks very eloquently if you watch him.
• 32:20
  He's always looking in.
• 32:23
  What can I do for you?
• 32:25
  That's how you make friends.
• 32:26
  That's how you get cooperation.
• 32:27
  How can I help you?
• 32:28
  If you find that then they'll help you.
• 32:31
  You start small and you keep going.
• 32:33
  Even, even in medicine convincing a patient to take a pill.
• 32:38
  It's a sales job.
• 32:39
  Yeah.
• 32:40
  You have to, what's in it for them with all the side effects
• 32:42
  and all the problems they have.
• 32:44
  You don't, it's just given the prescription does nothing.
• 32:48
  And so on the wards, talking to patients and figuring out what's
• 32:51
  going on in their lives and saying, this is why you should take it.
• 32:54
  Yeah.
• 32:54
  That's enjoyable.
• 32:55
  So one last question about the business side.
• 32:58
  What's the one thing about running a business and no one tells you that you've
• 33:02
  learned that you can feed back now.
• 33:05
  You wish you had known.
• 33:06
  Yeah.
• 33:06
  That everybody in the company is there to fill in to fix your, fill in your gaps.
• 33:16
  So from that perspective, once you understand that, you realize being the
• 33:20
  CEO is, and to be trite it's very easy because you're surrounded by people whose
• 33:25
  job it is to fix all the mistakes that you make and all the gaps that you have.
• 33:29
  But then the flip side is that means your job is to.
• 33:33
  Find these people and convince them to work on this problem with you.
• 33:40
  And that's your role.
• 33:41
  And finding them takes time.
• 33:43
  'Cause it's not just about do they have the skills, it's do they have the values
• 33:47
  and are they really, will they become as obsessed with that problem is you.
• 33:51
  And people always say you should hire people smarter than you and you should.
• 33:56
  But the flip side of that is the world is full of people working
• 33:59
  for people dumber than them.
• 34:00
  Which is very irritating.
• 34:02
  So you must be as minimally irritating as possible for these people who are smarter.
• 34:09
  Yes. Irritating.
• 34:09
  I love that.
• 34:10
  For these people who are smarter than you Yes.
• 34:11
  And agreeing to work with you on this problem.
• 34:13
  Yes.
• 34:14
  So that, that's where the, that's where the focus has to be.
• 34:18
  Thank you.
• 34:18
  And thank you so much for that and for coming on the podcast.
• 34:21
  It's my pleasure.