Champion Story 34 | Wes Hodges
Recorded on January 17, 2019
Biography: Wes Hodges is a co-founder of Synaptive Medical, a Toronto-based medical device and technology company, which creates neurosurgical products that cross traditional departmental hospital barriers to provide bleeding edge, point-of-care imaging in and beyond the operating room. Synaptive has become a proven pioneer in robotic exoscopy, whole-brain imaging analysis, and mid-field MRI, with over 500 granted patents worldwide.
Prior to founding Synaptive Medical, Wes was the Director of Software at Sentinelle Medical, a Toronto-based medical imaging startup that created MRI breast coils, tables and a software system for MR-guided biopsy and diagnosis. Following Sentinelle’s acquisition by Hogolic in 2010, he continued in the role of Director of Software, MRI, integrating Sentinelle’s MRI software product into Hologic’s diagnostic software suite.
Wes holds a Bachelor of Applied Science (Engineering Science) from the University of Toronto, and now lives in London, ON.
Thanks for making the time, Wes. A really good place to start is to hear about your story as a founder and as a human being. How did you get here?
Yeah, it goes back to a path that I started down at the beginning of my career here in Toronto when I began a co-op placement in 2001 at eFilm Medical. It was a 16 month internship, and eFilm was a medical imaging start-up. This was at a time in my life when I wasn't quite sure what I wanted to do. Did I want to continue in engineering? Did I wanna go to med school? I've always had an interest in medicine.
So I landed this engineering co-op role, which, obviously, had a ‘building’ component to it. I found this was really important to me. I love making stuff, you know? Making tools that people actually use keeps me very engaged and interested. So this role ended up checking two important boxes for me with respect to career needs: one, the need to create, and two, the need to work in the medical field.
What I found was that there was another career need that I never knew was that important to me, and that’s the need to be in an entrepreneurial environment. In that environment, you get to wear a lot of hats. I got put in charge of a digital orthopedic templating project where I developed visualization software for implant planning and formed a collaborative relationship with Zimmer (a global producer of orthopedic implants). I went to Vail for an orthopedic conference, demoing this software to many orthopedic surgeons. All of this felt very unique and special for someone my age. I loved suddenly having all this responsibility.
It was a ton of fun. I had no problem staying very late at the office. I had no problem going in on weekends, because I loved the work. I love the freedom. I loved what we were doing, and I came to crave it. eFilm grew and became successful, and eventually got acquired by a company called Merge.
Merge was a large, publicly traded company, with several hundred employees. That was a very, very different environment from what I was used to. There are a lot of advantages to this: your salary is good, you're part of a stock option and RRSP plan, and you get great benefits. But, for me personally, there was that gap: that entrepreneurial environment wasn’t really there anymore. Even though I still got a good amount of responsibilities, it wasn't quite the same, because large companies are structured with people having specific roles and responsibilities in order to function effectively; you’re wearing just one hat, not multiple.
During my undergrad, I had been working with the Chair of Medical Imaging at U of T, Walter Kucharczyk, on an MR/ultrasound neuronavigation project where I met Gal Sela. Gal and I went on to become close friends. Eventually, he introduced me to Cameron Piron, who was at Sunnybrook working with Chris Luginbuhl, on an MR breast imaging table. The three of them had incorporated Sentinelle Medical, with the intent to distribute this table globally.
When the opportunity came up to develop the software division of this company alongside Dave Gallop, I jumped at the chance. It meant going back into that ‘jungle explorer’ mentality where you’re slashing your way through challenge after challenge, like swinging a machete through vines all day every day. Knowing that you go as far as you work, period. If you don't do something, it just doesn't get done. There's no one else to pick up that ball. You take vacations but you're still going to be working on that vacation. I remember taking a trip to Mykonos, and I’d bring my laptop to the beach. There was a deadline looming and I had to hit it. That was the only way.
Back in that environment, despite all the stress that can come with it, I was very happy. You become great friends with your co-workers because you're all committed, working closely, and putting so much on the line together. You develop these fantastic friendships and you really can become an incredible team.
Sentinelle started in 2004 and was acquired by Hologic in 2010, which included a two year earn-out period. This meant going back to the environment of a large, publicly traded company again. Great benefits, great stock, great salary, great structure, and great people, but you're not in the entrepreneurial world.
After we had spent two years with Hologic, we decided it was time to go try starting something new again. In 2012, we moved out of the breast space and got back into neuro with a decorated and entrepreneurial neurosurgeon, Amin Kassam, who has become a close friend of mine. This meant leaving Hologic and putting in long, late hours again for much less money, but there were so many exciting things to learn and do that didn’t matter.
Along the way, there's been no shortage of bumps and challenges, but I’ve been very, very lucky. The core group of us - myself, Dave, Gal and Cam - well I really see those guys as brothers. I've been able to weather a lot of storms thanks to them. I think that without these relationships I would be telling a very different story right now.
I would love to know more about that bond, because it sounds very special.
Yeah, absolutely. It's funny, jumping back to being a startup. We've always joked that as you're building a company, it's like you're chopping through a jungle. You've got like a big machete and you're just hacking away one branch after another, getting eaten alive by all kinds of bugs, making just a little progress each day. Same tough grind day in and day out, working towards IPO or acquisition.
“Keep going, keep hacking. Eventually we're gonna come out with this beautiful hotel oasis, and there's gonna be a gorgeous pool and cold drinks.” We've all said, “We'll get there, have a drink, and sit for a bit. Then, we’ll just run back into the jungle, because that's where we're happiest.” Getting eaten alive, cutting a new path through the trees. And that's exactly what we did.
I'm lucky to have met these guys. I’ve gone through some personal challenges, and they’ve been incredibly supportive throughout. Back in 2011, I was diagnosed with thyroid cancer. As cancers go, it has a phenomenal recovery rate, but there's still plenty of treatment you have to go through. I also found out, as an incidental finding to the cancer diagnosis, that I had a significantly dilated aorta that ideally should undergo surgery as a preventative measure to avoid a spontaneous rupture in my senior years.
In 2012, I went through a divorce that was very sad and difficult. That's something that nobody ever wants to go through, having such a big piece of you cut away. And in 2013, I suffered a retinal detachment and went blind in my right eye, which, fortunately, was restored; it was put back into place and anchored with laser therapy.
So all at once I was hit with medical issues, while having to pack up the house and move back to London, while the company was still running in Toronto. If it was just me, not only would the company have failed, but I don't know what kind of position I would have been in mentally. These guys were able to carry me through.
I did some men's support groups during this time. I met a great guy named Dale Curd; he was a therapist that I spoke to a lot. He invited me to a couple of group sessions where I heard all kinds of difficult stories from the other guys going through their own life challenges. It was comforting for everyone there to know they weren’t the only one going through terrible things.
I mean, everyone gets dealt a different lot; that's just life. Some are bad and some are worse. Seeing how those guys were coping and supporting each other was a very big boost for me. But, for me, hearing my co-founding friends say "It’s ok, you can just work in London.” and “No worries, you can crash at my place when you come to Toronto." really got me through things. They never made me feel like a burden. They were always very positive.
Can you share more about your journey and what you have learned about yourself?
For sure. With the company before this - the breast imaging company, Sentinelle, which got acquired by Hologic - that changed me a lot in my late twenties and early thirties. Those are actually very formative years. The events of that time challenged me to do things that I wouldn't have otherwise.
For example, I would be in front of the computer developing till two or three in the morning each night, for better or for worse. That obviously wasn't healthy for my marriage, sadly. But it led to me doing many trade shows, hospital demos, and conference presentations - extroverted challenges for someone like me who was relatively introverted. Those events were always extremely stressful, but I grew from it.
It was a different kind of stress and anxiety because you had to demo the software that you built. You had to do it live, while speaking, knowing that the software was by no means perfect, and that there was always a chance that it might crash. This was not a released product. You've got this fear, “Is the software going to perform?” But you still have to keep talking and carrying on a lucid conversation with whoever you're speaking to, while half your mind is busy thinking about what you can safely click next. You're just thrown into that environment. Trial by fire.
Over the years, these experiences really developed my resilience. Whatever situation I’m thrown into for work, I feel like I can cope, adapt and manage regardless. And that resilience certainly extends to my health issues as well; I’m able to push through.
I've had many, many surgeries. Some of them took many months to recover from, like with the open heart surgery. It's painful for the first while. You worry you’ve lost so much weight and strength, but then come around to, "well I'm just going to have to build it up again." You start back from square one, and just tackle it. And you take it one problem at a time and I’ve actually come to really enjoy that.
I take comfort knowing that, if the blocks get knocked down, I can build them back up. I've got that now. I’ve got mental fortitude to be okay with it. It's not easy those first couple of times when they tip over, but now I can handle it.
As a human being, what are your values? How does it show up and how is it reflected in the work that you do now?
I'd say one of the biggest ones is understanding that everyone has a different perspective. Everyone has their own challenges and needs. So I think empathy has always been a really, really big one for me. I think empathy is the best tool we have against hypocrisy, which is the worst human vice, in my opinion, and something we’re all guilty of at one time or another.
Empathy is reflected as one of the values of Synaptive, along with an effective communication environment. At the end of the day, what we do comes back to the patient. Without empathy, I think you're severely limited in understanding the clinical environment and what the patient and practitioners are going through.
Another value is believing you get out what you put in. You’ve got to put the hours in. Elbow grease is gold.
Risk tolerance also is very important; you’ve got to be okay with high-risk situations. When your company starts to grow though, you’ll bring in more personalities that maybe don't have the same level of risk tolerance that you do as an entrepreneur. You have to adapt for that and do what you can to keep them comfortable and productive. Again, empathy plays a large role here. These are very talented and skilled people and you want them working effectively. Communication is often your best tool here. Speaking to them both as a group and individually about the progress the company’s made, the challenges it’s facing, and the risks ahead and how they’re being mitigated helps to get everyone on the same level and feeling they’re part of a team.
I also value being okay with failing, albeit failing fast. Blocks are going to get knocked over; you’ve got to build them up again, and quickly. Look ahead, make the best decision you can with the information available, and then execute. Don’t wait. Don’t stall. Execute. You’re running through a maze, and you won’t find your way out unless you drive ahead. When you hit a dead end, turn around and correct. I don't think there's any other way to do it.
When you hear “mental health,” what does that mean to you?
It’s interesting: with what we do at Synaptive and the neuroimaging space, I've had some great conversations with neurosurgeons regarding the physiology of the brain. Not having been to med school, I'm always fascinated to listen to them.
Within the brain, the amygdala is thought to be the emotional center associated with fear and stress. There have been scans done, particularly (and sadly) on orphans, showing that prolonged exposure to fear and stress can lead to a larger, swollen amygdala, and the frontal lobe cortex, where high-order reasoning and control resides, can thin. So, when you live with constant anxiety and pressure, your brain may actually reshape itself in response.
Now to go back to the question of mental health, you have to be aware that your brain - your amygdala, cortex, etc. - is an organ just like your heart. You have to strengthen it and not turn a blind eye to your emotional wellbeing. I feel lucky having met some incredibly talented neurosurgeons in the field who have given me some unique perspective here.
In the future, with imaging, I think we're actually going to be able to track and quantify mental health. I think you'll actually be able to see the state of your mind. At an SBMT conference I was at, a group presented their research on the use of SPECT imaging to help visualize addiction, and it stunned me. For example, with addiction, some patients exhibited a very rippled brain surface pattern prior to treatment on SPECT. Then, post-therapy, that same surface was significantly smoother and more even. So, more and more, I think we're going to be able to measure certain mental states that are currently very qualitative.
There’s also great mental health commercials out there now to drive awareness. I remember one in particular where two people are talking on the job site. One says, "Did you know Doug's off on mental health leave? He's got bipolar disorder." The other then thinks, "Really? I guess it means extra work for the rest of us." But instead he says, “Wow, that's too bad; I hope he's okay.” They go back and forth, highlighting the negative thoughts in his head. In the end he realizes he shouldn't be thinking dismissively about this stuff; it’s a real and serious situation.
In terms of where we're at now, I think awareness is growing, which is key. The other part is actually being candid, and some people aren't okay with that. I think a lot of people don't want to share or expose themselves in that way, which is entirely fair. I'm personally in a position in life where I'm okay with sharing some stuff because part of me feels that this can help other people. No one is going to have the same experience, but to some degree it can be relatable. So that’s what I've tried to do, and tried to do at work as well. I feel being candid can also foster trust, which is important in any kind of entrepreneurial setting.
To wrap up, what would be a parting lesson, if there's one thing that you could pick?
For people to understand themselves.
The four of us have an adage that goes all the way back to the early, early days: out of blood sweat, and tears, it’s the tears that matter the most. It’s easy to bleed (in fact it’s easy to bleed a lot) and it's easy to sweat. But tears, well, those are hard, and you need a lot of them. Tears are, sadly enough, the way that you create value for your company, and you've got a whole jar to fill with them. You have to plow through those really tough times when you don’t feel you can anymore.
Each tear can be weeks, months, or years worth of pain. That pain can come from all kinds of different things, whether it's planning, documenting, developing, financing, trying to hit a deadline, going through a restructuring, having some personal life event, etc. "Just a few more tears in the tear jar." You don't get to the end until that jar is full.
That's where the value comes from. If it was easy, someone else would’ve done it already. You have to just keep pushing through, chopping with your machete, getting over hurdle after hurdle. Some of those hurdles can be very painful. If they are, then good: you're on the right track. Put a couple more tears in the jar and keep going.
Thank you so much for your time and for your support. I'm very moved by this conversation. It means a lot to me.
I really appreciate the chance to talk.