12 April 2017

The steep part of the learning curve

Pickering Lecture 2017 IPENZ, Pickering, Engineering New Zealand,

Curious opportunism led Dr Catherine Mohr to mechanical engineering. Then medical school. Then to the world of surgical robotics.

Catherine is returning to her native New Zealand to deliver this year’s IPENZ Pickering Lecture series, discussing how engineers are writing the script for the next revolution in surgery. She talks about what motivates her to keep learning.

Meet Dr Catherine Mohr: surgeon, bike mechanic, inventor, roboticist, mechanical engineer, hybrid car builder, sustainability champion and medical technology pioneer. 

This year’s Pickering lecturer is also a New Zealander. In fact, she’s a World Class New Zealander, awarded the title in 2014’s World Class New Zealand Awards. That same year, she also became a Flying Kiwi – a member of the country’s Hi-Tech Hall of Fame. All in all, apt recognition of her work in life sciences, her achievements in the emerging technologies industry and her contribution to surgical robotics and minimally invasive surgery.

With more than a dozen patents to her name, Catherine is currently Vice President of Strategy at California-based Intuitive Surgical, a world leader in surgical robotic design and manufacture. She’s a former Consulting Assistant Professor in the Department of Surgery at Stanford School of Medicine and is on the Medicine and Robotics Faculty at Silicon Valley business think-tank, Singularity University. 

And by the way, she’s also learning to play the cello.

So how has this Dunedin-born, American-raised self-confessed geek achieved so much? 

“I’m a curious opportunist,” she says. “When I see something new and exciting, I seize the opportunity to go start building that new something.” And while she is an expert across many different areas, it’s not a label she’s entirely comfortable with. “I love being on the steep part of the learning curve,” she says. “Once I’ve reached a certain level of expertise I start looking for shakier ground where I don’t know quite as much; where I can solve problems by bringing thinking and knowledge from other places I’ve been.”

But making those transitions is not always as easy as it sounds. “Throughout my career, with all its twists and turns, I’ve had to learn to trust my instincts and not be afraid to fail”, she says. “It took me a good long year of unhappiness and soul-searching, wondering why I wasn’t satisfied with being a senior engineering manager, why I felt this quixotic need to go do something completely different like medicine before realising I just had to go do it.”

Taking things apart…

Even Catherine’s original decision to study engineering meant a change in direction. With a biochemist father and a biostatistician mother, Catherine had always assumed she’d be a scientist; the plan was to major in chemistry. “But when I got to Massachusetts Institute of Technology (MIT), I discovered I was a real tinkerer at heart,” she remembers. “I loved building things, taking things apart, putting them back together, discovering how they worked.” At high school she’d had a job as a bike mechanic and at MIT was spending all her spare time on a solar car project, constructing and racing electric cars. The writing was on the wall. In 1990 she graduated Bachelor of Science in Mechanical Engineering, followed two years later by a Master’s degree. Her thesis title, The Design of a Compact Actuator System for a Robotic Wrist/Hand was, in some ways, a portent of things to come.

The next sea change saw her abandon a long-held intention to study for a PhD and a life in academia. “It was a difficult decision but I took the opportunity to work at [Unmanned Aircraft Systems manufacturer] AeroVironment, building very exciting things – high altitude aircraft, electric cars, regenerative fuel cell systems,” she says. “We were making things that really didn’t have a lot of precedent. It was the early days of solar cars and everybody was learning together, there were no journal articles, no blueprint.  It was a very ambitious and exciting time.”

Over nine years with the company, Catherine moved steadily up the ranks. “Eventually it got to the point where I was managing people who were managing people who were doing what I had originally gotten into engineering for – that steep part of the learning curve,” she says. “I was really not very happy – it’s not that I minded the responsibility but I wanted to be part of the design process.”

Change, again, was imminent. Catherine began looking to the medical engineering and technology world. She says “I quickly realised that to solve problems in that arena I needed to understand the human body as a machine, the same way I understood a lot of machinery. And I needed to communicate in a different way. The languages clinicians and engineers speak aren’t mutually intelligible – engineers use geek-speak, medical people speak their own jargon and people who speak English struggle to understand either! To be effective, I would have to learn to bridge those gaps.”

…and putting them back together

In 2001, Catherine enrolled at Stanford Medical School. “A lot of people were very supportive. Others told me I was absolutely nuts. There’s definitely a skill in learning not to be too undermined by the naysayers and having a certain amount of belief in your own judgement,” she says.

Nevertheless, going back to studying in her thirties, in a completely different field, was challenging. “Medicine requires a different way of thinking for someone who is very engineering oriented,” she says. “I had to learn how to learn in a new way, to think about how my mind worked versus the way my colleagues’ minds worked. But even as a medical student, my engineering notebook was always in my hand because I was designing things while I was learning about the body.” Catherine started a company to commercialise one of those medical device designs – the LapCap, used to prevent accidental puncture of abdominal organs during laparoscopy – while still a student: “You can take the engineer out of the engineering company but you can’t take the engineering out of the person – even when they’re in the middle of medical school!” she says.

As luck would have it, Catherine had significant exposure to surgical robotics throughout her training; certainly more than any non-engineering medical student who didn’t have an engineer-husband working for the then-small start-up Intuitive Surgical and its da Vinci surgical system.

The da Vinci system is all about minimally invasive and safer surgery: fewer, smaller incisions and tiny wristed instruments – eight millimetres diameter – with a greater range of movement than the human hand going where hands and eyes can’t ordinarily go. Tip in the system’s 3D HD vision and surgeons are operating with enhanced vision, precision and control. Patients can expect faster recovery times and better outcomes.

Catherine has played a pivotal role at Intuitive since graduating in 2006. “We’ve used the da Vinci robots to get to the point where you can do everything you’d do through open surgery,” she says. “We could be happy with that but I’ve always wanted to push us beyond the limitations of what the human eye can see and what the human hand can do. That might mean near infra-red fluorescence vision, using molecules to tag structures or cancer within the body and achieving good outcomes more easily by avoiding unnecessary cutting or leaving disease behind. It’s a bit like giving surgeons superpowers and I believe it’s the next big thing.”

And as for job satisfaction, she says it’s about making a difference. “Some of the most exciting times are when your intervention changes the course of a patient’s life and you remain in their life-history as the person who gave them back functionality or a future they thought they weren’t going to have. That’s such a profound interaction,” she says.

Catherine is sure she’ll re-invent herself several more times before she’s done. For now though, there’s the cello – that weekly lesson, that struggle for daily practice – keeping her on the steep part of the learning curve. “It’s hard. It keeps me humble, keeps me from thinking that I pick things up too easily. But it’s worth doing. So I keep at it!”