Illness leads to the discovery that a hospital is like a startup

Published in the San Diego Union-Tribune, March 18, 2019

ACDF. The letters spell out the fact that you are getting older, and things are breaking down. Welcome to Anterior Cervical Discectomy and Fusion (sounds like a rock band or a law firm). So yours truly had to finally come face to face with father time, and the question that interests me is how a hospital is like a startup.

First, they need a customer with a problem. OK, the tips of my fingers were getting numb, and I was dropping things. First response is to ignore it — i.e. we do not need your software at this time; we are doing just fine without it.

Then you fall off your bike – while it is standing still. Hmm, maybe it is time to rethink. Go to see the doctor for another problem. This is classic in the startup world, you think you are solving cyber and you really are an e-commerce company. He gives me a clean bill of health, except for the checked box under “neurotic.” On the way out, I mention, in passing, that I cannot feel my finger tips. OK, go see a neurologist. That sounds scary — close to neurotic again.

I go see a guy whose door sign says “sleep disorders.” I figure I have been conned, and all my physicians are in some cabal like the Matrix. Nope, the guy does neuro and sleep. He has a fine bedside manner, but his office has little furniture and no fancy machines. A couple of taps and a poke, and in 12 minutes, he diagnoses the problem — and he is absolutely correct. Maybe he works nights at the Magic Castle. Off to get an MRI. More scary letters. They put you in this coffin and it hums — very loudly. Then the next morning, the radiologist reads the MRI — severe stenosis of the cervical blah blah. Don’t get back on your bike.

Note to startup. Make sure the customer really listens to your solution. Say it a few times. Next move is to get an appointment to see a spine doctor. OK, here we need to pause. A spine doctor is like Bruce Springsteen. These guys are rock stars. They rank right up there with cardiac surgeons. My dad was a mere radiologist. The hero in the story is Dr. James D. Bruffey. This guy rides in, and he is tall, gorgeous, silver hair, smiling, calm, reassuring, a charter member in the Spine Hall of Fame.

Venture capitalists always bet on the whole team. The hospital is Scripps Green. Sure Bruffey is the man, but the support team is gigantic. There were nine different nurses and assistants and organizers. A little slice and dice, and I wake up and I am alive. (Let me tell you, the other thought does cross your mind).

So I’m thinking we have a deal here. Recovery room, smiles all around. But there is always one key moment before the term sheet. You’re hungry, you want the money. Me, I wanted food. The VC needs one more piece of due diligence. Not quite yet.

In my case, it was simple — no food until you fart. Huh. Remember this is a hospital so there is no modesty. You are just out there. I needed to wait for a fart in order to get real food. 3 a.m. Success! Be grateful for small wonders.

I love that a hospital reduces you to the simplest, basic issues — solve the problem, recover, move on. No drama; just do the work. The dance has elegance when it is done with style, skill and joy. Sometimes in the trenches of a startup, we lose sight of the higher objective. The challenge is to do it well and with a reasonable degree of happiness. It was clear that this team had been playing together for a long time, (good rule for your startup).

The Scripps Green team exhibited the same characteristics you are looking for in any entrepreneurial adventure — the focus to identify and solve a problem, great customer service, a workable product, follow-up with the customer, and attention to training the next generation (5th year fellow in the OR assisting.)

And today I am sure there is another aging dude in there getting a little ACDF. And I suspect that Springsteen will be playing his guitar.

My rehab movie — Free Solo.