Richard Hanbury is the CEO and founder of Sana Health, the company behind the Sana device. It’s an innovative audiovisual device that trains brain pathways to reduce pain. Richard founded the company to save his own life after he was forced to drive his car off a bridge in Yemen. He was 19 and he lost the use of his legs. Richard developed Sana as a long-term solution to the root causes of pain and as an alternative to prescription drugs; which often only mask the pain and cause untold adverse effects on patients.
Find out how Bruce Willis saved his life and how he dove into wearable technology. Learn more about his clinical trials on fibromyalgia and neuropathic pain. Richard also shares three of the most profound daily foundations of success we have heard to date on the podcast.
Sana has won numerous medical industry awards including the MedTech Innovator Award and the Under Armour Innovation Award. Richard joins host Fran Racioppi to tell his entrepreneurial story of resilience, adaptability, innovation, and his mission to save not only his life, but the lives of all those suffering from chronic pain and opioid addiction.
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About Richard Hanbury
Founder of Sana – making a device that allows anyone to have deep relaxation and pain relief anywhere in an average of 8-10 minutes. We have decades of research and anecdotal data, completed 4 pilot studies, with two pivotal FDA studies underway – Fibromyalgia (Duke) and Neuropathic Pain (Mount Sinai). We have breakthrough designation for Fibromyalgia and anticipate FDA approval in Q4 2021.
Wharton Business School 1999-2001 MBA with major in Healthcare and Entrepreneurial Studies.
McKinsey and Co, London Office 2001-2003 Associate.
Sana Health – CEO Richard Hanbury
Resilience is defined as the ability to recover from or adjust easily to misfortune or change. Adaptability is the quality of being able to adjust to new conditions. As leaders and as people, we are defined by what we do after the misfortune, after the change, how we adjust to the new conditions and events that can often happen in the blink of an eye. Richard Hanbury is the Founder and CEO of Sana Health, a set of wearable glasses that use coordinated pulses of light and sound to reduce chronic pain and fatigue by guiding a user into a state of relaxation and training your body and mind to overcome pain.
Richard founded the company to save his own life after he was forced to drive his car off a bridge in Yemen. He was nineteen and he lost the use of his legs. Richard developed Sana as a long-term solution to the root causes of pain and as an alternative to opioids, which only masks the pain and causes untold adverse effects on patients.
Sana has won numerous medical industry awards including the MedTech Innovator Award, the Under Armour Innovation Award, the Bayer Self-Care winner and the Mount Sinai Rehab Competition. Richard joins me on this show to tell his story of resilience, adaptability, innovation, and his mission to save not only his own life but the lives of all those suffering from chronic pain and opioid addiction. He also shares the three most profound daily foundations of success that we have read on the blog to date.
Richard, welcome to the show.
It’s a pleasure to be here.
They say your life can change in a second. You can have everything and you can lose it all. You can have nothing and then you can have it all. You can be healthy and strong, and in an instant, you can be paralyzed or even dead. Sometimes, it’s our own fault. Many times, it’s not. I was telling you that I’m at Boston University and I’m reminded of Travis Roy, who was a hockey player here in 1995. Eleven seconds into his very first game, he fell to the ice, broke his neck and he became paralyzed.
It’s a story that impacted not only him and his family but the whole BU community, and still, BU talks about it at length. It’s what we do after the change that defines us. It’s how we pick ourselves up, dust ourselves off and refocus. We talk on the show about the Nine Characteristics of Elite Performance. Of these nine, it’s resiliency followed closely by our adaptability that defines who we are after these incidences.
You were nineteen when your life changed. You technically died. You lost the use of your legs but here you are very much alive sitting with me and you have won the MedTech Innovator Award, the Under Armour Innovation Award, the Bayer Self-Care winner, the Mount Sinai Rehab Competition winner, and many others that I don’t even have time to list them. You have developed a product that saved your life and now saving many others from chronic pain, depression, anxiety and suicide. I’m honored to sit here with you. Tell your story, tell the story of Sana and tell the story of resiliency and adaptability, so thank you.
It’s my pleasure. Thank you for having me.
Let’s start at the top. In 1992, you were forced to crash your Jeep off a bridge in Yemen. You were pronounced clinically dead for eight minutes, and then in a coma for six weeks. You spent the next fourteen months in the hospital. What happened?
During the accident itself, I was traveling into Yemen. I was a student and every time I worked with many people from your previous line of work, they were like, “We can again assure you are.” I really was a student. Arabic was my graduate degree.
No one goes to Yemen normally unless you are associated with some special operations.
We were living in Egypt but at that time, everyone in Egypt wanted to learn English. You would be in a taxi and the taxi driver would just have to say hello and he would spend twenty minutes practicing how to say hello rather than say anything in Arabic. Off we went to Yemen, it was the only place that would give us a visa on short notice when my roommate’s girlfriend, split up with us, so we didn’t have a place we were supposed to begun skiing.Meditation is a good painkiller. Click To Tweet
Luckily for me, fitness-wise, I have trained to be going racing and skiing for six weeks, which was another one of the tiny little pieces of stuff that haven’t had happen that would be made it through but I had been running up and down a ten-story building with a rucksack full of books to get fit for that. When I had my accident later in Yemen, I wasn’t in the bad physical shape of my life but on the actual accident itself, it was something that could have been a drunk driving accident here.
In Yemen, about 80% of the men took a drug called gap every day. We were just at the end of the Civil War so no guidebooks were saying, “Don’t drive in the middle of the afternoon because everyone is high but I was driving down the road. I was on a level with a petrol truck coming in the opposite direction. When I was leveled at the front of it, I couldn’t pull out from behind. In that split second, I had to make a choice, whether to head on straight for that Petrol truck or go off a bridge. That split second, I had this image of my dad wondering how a country truck finds their names. I figured that we were dead either way but at least, if I went off the bridge, we will be easy to find.
As we were hitting the side of the bridge, the second thought was I would call the person who caused this. That wasn’t the reason why I was heading for the side of the bridge. My dad was 60-foot down into the dry river bed, chief crumpled up a keg and my passenger broke a lot more bones than I did, cracked thigh bone, arm broken in three places, collar blade, shoulder bone and he was responsible for getting me out of the Jeep. He said the moment I started screaming was simultaneously the somewhat sign that he had ever heard in his life but he was responsible for getting me out of the country. Even if I’m safe, he was bringing me food and water into the so-called hospital. I was in the hospital that didn’t have any food and water.
They came and rescued you, the Yemenis came and had to take you to their hospitals?
Yes. He got people who were on the other roads to come help or they started running. I was unconscious and luckily, he was the one who became conscious first because his Arabic was good enough in an emergency to shout danger, petrol cigarettes and they threw them away. If it had been me, I’m not sure my Arabic was good enough at that point. If the story was we bent right in Arana and they tried to smoke because everything was covered with petrol, they’ve got us back to go to the so-called hospital.
There was no food, water or drugs in the hospital. There was a Russian orderly and they had a fax machine. The insurance company said they wouldn’t send a plane unless there was a fax from a doctor. My friend said, “If you don’t send the plane, I will spend the rest of my life making it my mission to destroy your insurance company, so send the plane.” They said, “We will send a plane as long as you pay for it if it’s not needed.” He did all of that. He was responsible for getting me out of the country. The medivac plane came, picked me up, took me back to some hospital in the UK. That was the worst bit of it.
These places are tough. I think about my time in Africa and the Middle East. You would go and you visit these hospitals. You are absolutely right. there’s nothing there. It’s in the back of your mind that the last place I want to be is in a hospital in this country.
I wasn’t smart enough but I thought about that at one point. If I had been, I don’t think we would have been there. I will never say a bad word again about the National Health Service in the UK, especially having dealt with the American Healthcare System. There’s so much in the UK that we take for granted about how the National Health Service actually looks after us. It’s not a perfect system but I have had an episode with the US system and having to fight insurance companies to make sure they didn’t do what the doctor said would kill me.
The doctors are saying, “You can’t go home until this point. If you do, you will probably die.” The insurance company goes, “No, you can go home now.” That stuff never happens in the UK. It blew my mind. Luckily, I’m used to fighting with that kind of argument. I’ve got the lawyers involved and stopped the insurance company from killing me. It’s just one of those things as a Brit that the NHS really is something that we take for granted every day, mostly.
What was the extent of the injuries?
I had a traumatic brain injury and a spinal cord injury from T8 to T10, so belly button level. Three vertebrae that impacted fracture. Imagine the weight of a Jeep falling 60-foot. My spine took most of that impact. I then had an aortic tear, which would normally kill people in under 30 seconds. That was what nearly killed me.
I was clinically dead for 30 minutes when I was back in the UK because I bled internally and I lost 40% of my body weight during that four days from that accident until I was back in the UK, and a broken collarbone, which was an insult to injury because when I was lying in bed, I was like, “My collarbone is hurting.” They were like, “It’s not.” I was like, “It is. This must be broken.” When I was able to move my arm enough to touch it, I was like, “I can feel the bump. It was broken. Why did you tell me it wasn’t?” They were like, “You have to lie on it anyways.” I was like, “I just wanted you to acknowledge my experience. If you tell, ‘We are sorry. We know it’s broken but you have to lie on it anyway because otherwise, you will die.’” I would have shut up but it was a good lesson, even it was uncomfortable acknowledging someone’s experiences. It was really helpful anyway.
The doctors gave you five years to live citing the extreme chronic nerve damage and the pain that was associated with that. Can you talk a bit more about the extent of the pain? Why would they tell you that because of the pain, you have a five-year life expectancy?
If you think about the spectrum between fight or flight and rest recovery, we all move up and down that spectrum every day but the more you are in fight or flight, chronic stress from whatever it is in your life, the shorter your life expectancy, the more problems you have. A good example of this is something like fibromyalgia, where most people at some stage have PTSD, undiagnosed PTSD or some trauma. Those are examples that you get set on a more edgy fight or flight, so you are not getting as much rest recovery.
Extreme chronic pain is the extreme of that. The whole time, your body is in fight or flight, so nothing recovers, then sooner or later, something breaks. Christopher Reeve is one of the best-known people with spinal cord injury with that level of nerve damage pain. With his level of injuries, his type of lung issues or pressure injuries, that is the thing that breaks that finally gets him. With my level of injury, it is usually pressured injuries. They told me that after about six months of getting through the entire standard of care, there had been some improvements in some of the treatments since then but it’s really not a lot. It’s a scenario where it hasn’t been many advances.
At that six-month mark, were you mobile at that time? What was your condition?
It must have been 9 or 12 months because the first six months, I was still in bed. It’s fourteen months total in the hospital. It took a while before they could stabilize my spine because I wasn’t in good enough shape because of the aortic tear. Fixing the aortic tear was the first part when I was in the hospital, and then they took a while before they could stabilize my spine back and get me out. It was a stabbing pain that hurts almost 24 hours a day. The majority of the time I was sleeping, I was lucidly aware in my dreams how much pain I was in and I wasn’t getting deep sleep.
The only way I could get that stabbing pains to become a constant pain was lying double up with my arm across my belly, my break area, and then lying on top of that, my head in my ankles. I’m squatting myself up like a pretzel was the only way that I could apply enough pressure to get the stabbing pain into a constant pain, which then allows me to get some sleep.
Realistically, I did think about this at the time, I had no reason why I would have wasted five years. I would have got out of the hospital. I would have said my goodbyes and I would have found a way to exit the stage, left because, at that point, I didn’t have my own family. I have my dad, my mom, my stepmom, and my sister but I didn’t have a kid that I was responsible for. Had I not got my lucky break in the hospital, I probably wouldn’t get outside the hospital.
Let’s talk about the lucky break. You called it your light bulb moment. You said it happened while you were watching a film in the hospital and it was a Bruce Willis film. You have credited Bruce Willis with saving your life and I laugh because Bruce Willis has saved a lot of people’s lives. He is John McClane. How did he save yours?
The movie was Hudson Hawk. At that stage, the hospital tried to, even back then, get me to learn some meditation and mindfulness to reduce pain. It’s a really bad idea if you are in constant pain or constant anxiety to try and learn meditation because all it does is make you more present moment aware of how much pain you are in. If there are people who have worked in that state, I would love to hear from them because I haven’t heard anyone say that.
What typically works is if you are an episodic pain or anxiety, and you are having a good day, and then you do some meditation, then you can expand those good days. For me, that had failed. What that movie did for me was really funny, fast-paced engaging when they were singing songs as they were burglarizing museums, that would put me into what we would now call a flow state. The bits in between where the dialogue was bizarre and obscure in places, for my experience, it’s a bit like watching adverts in the middle of your favorite show. You are engaged and then you are not.
By the end of the movie, my thought was, “That changed my pain levels more than morphine.” The bits of the movie that made me feel less pain made me feel like I used to when I was skiing. That then led down to a train of thought to, “If I had meditated all my life up until this point, I would be able to access this state at will and that would be a good painkiller.” That then led to the train of thought of, “If I had meditated all my life, how would my brain be different?” It turns out that with meditation, they are too different causes of benefit.
There is a whole bunch of wisdom, self-knowledge, and self-growth stuff that happens that you can speed up by getting the right teachers doing the right type of meditation for you and doing more practice. You could speed it up but you can’t shortcut it, and then the other side of the equation is how it changes the frequency distribution pattern in your brain. How do the electrics work? What frequency your brain operates on? It turns out that you really can’t shortcut. That’s what we ended up doing.
I find this fascinating because you were not a doctor. In fact, you studied History, Languages, Politics, Arabic and Middle Eastern Studies. It’s all the reasons why I studied Journalism, so I didn’t have to do Math and I didn’t have to take any of the Chemistry courses but here you are in the hospital and you faced with this position of, “I have to save my own life. If I’m going to get out of this situation, it’s not going to be because of these doctors who understand this. It’s going to be because of me and my ability to figure it out.”The longer people meditate, the more they end up with hemispheric balance. Click To Tweet
You said that the process of Sana works by entrainment. Entrainment is when the brain senses a speed and a pattern in incoming signals and adopts them. Sana device uses an audiovisual stimulation to increase the balance between the left and right sides of your brain, guiding you into this state of deep relaxation that you could achieve through some meditation. I have a question about the product and the sixteen-minute piece of it. If you would, maybe talk a little bit more about the design of the product, what it’s doing, how it’s putting you into this meditative state, and then how come it’s sixteen minutes?
The doctor a bit of it not being a medic. In my high school years, Biology, Chemistry, and Math were my three topics. My Biology teacher happened to be one of the world’s top experts on the Neurobiology of memory and nerves. He was supposed to teach us a whole bunch of stuff about plants and the rest of the human body but daddy one in that class was like, “I’m an expert in nerves. I’m going to teach you about nerves and the brain because the brain is the most interesting part. If you want to go and learn about other stuff, there are plenty of other Biology teachers in the school that will take you.” No one left that class. Out of 18 of us, 14 ended up doing lifelong stuff to do with brains stuff in one form or another.
I was really lucky that I had some basis before I went into all of this. In the hospital, two things happened. One is when they asked me the meditation question, I started reading out what this such had been done? I rested on the shoulders of some amazing research that was done by lots of people and a particular guy called Maxwell Cade, who wrote a book called The Awakened Mind.
He basically worked out that the longer people meditated, the more they ended up with what he termed as hemispheric balance. The two sizes of the brain are between 1 and 30 Hertz when looked at for people doing a basket of cognitive functions. If you just do one cognitive function, you could be daydreaming, which is mostly right-brain activity for right-handed people or you could be doing logic on Math, so right-handed people again would be more of a left-brain activity.
These are all real, gross simplifications of what’s happening that he worked out, “If we do people on a stabilize protocol, we looked through all these different little bits. The longer people meditate, the more on my approach call, they end up with a brain produce some same amount of activity on both sides.” Reading all of that made me go, “There is a way in which I could potentially have a roadmap here. I can buy the same gears he did. I can look at my brain compared to the long-term meditators and that will give me a roadmap.” We are talking about Windows 95 laptop at this point and a two-channel EEG that I bought and had shipped to me from Holland. That was that part of it.
The other side of it was as a typical fifteen-year-old, I wanted to do less work but I was also determined to get the same grades, so the question was always, “How can I do less work and still get the grade I want?” When most of my classmates were lying by the pool in the summer before exams and trying to work and lay at the pool at the same time, I was up at 5:00 AM, and I hated getting up early, working for two hours solidly in my room, and then I’m goofing by the pool for the rest of the day rather than trying to do both at the same time, which doesn’t work.
It was all about efficiency. I subscribed to this journal that was about learning a memory. It was an obscure academic journal and during this period, I was going to the hospital, I read this report about this guy who is teaching corporate times to speed read and he was using false light to improve how you are reading. My brain goes, “Skiing is speed reading. Skiing is taking everything from your environment and your body, and the pressure is not very succinct quickly.”
If I can get the EEG meditation stuff and somehow put the two together, then maybe I can end up with something that’s going to help me, and it did. The EEG gave me a massive imbalance, and then the visuals and working out how to sequence that. It was a very large amount of trial and error. I was in so much pain, any slight improvements in the algorithm, I felt, and then I went to look at the EEG, whether it was backing up what I was feeling. My pain sensitivity was more than the EEG at that point. That’s how that bit came together.
The first day that I had been pain-free after using the device rather than just during was the day I still stumbled on something that was more than a distraction. For example, Virtual Reality is used in some ways that are a distraction. Does it show someone is engaging, seeing, and does lower their pain temporarily? The answer is yes, it does.
There are more sophisticated things that are now done with using that technology with cognitive-behavioral therapies to change the way people think, which has longer-term benefits. That day, when I’ve got those first two minutes of being pain-free after using it, I now did what we call design freeze, and I thought, “I’m just going to do this for a bit and see what happens.”
Three months later, I’ve got up to 24 hours without pain. That was October 30th, ‘93. That was the first day that I had 24 hours’ pain-free. I have spoken to some people who are cancer survivors and I had some of them say not wanting to believe that it was okay, being scared of believing that it wasn’t going to kill me and it was going to come back.
At that point, I’m going to write a note in my diary in six-month time. If I hit about a six-month note without pain, I’m just going to acknowledge that it’s fixed it, it’s not coming back, and it’s okay. At that time, I didn’t allow myself to stop thinking about how can I help anybody else with this because I wasn’t allowing myself to be convinced that it would help me. I’ve got to that six months note in the diary and I was like, “I hit six months. It does really appear that I have to admit that this is gone and I don’t have to worry about it anymore. Cool. Who else can I help with this?”
That led to the first person I helped with panic attacks, who I begged not to tell anybody else because I was like, “I don’t know what I’m doing. You are asking me to help you. I will try to help you but I’m really making this stuff up as I go along. Please, don’t tell anybody.” He promised, and then promptly I went until three girls, all of them who had PTSD from rape. That was a hardcore entry into, “There are plenty people with really big problems.” I’m the first person who refused to help because I was like, “You are asking me to do something, which is way over the realm into doing things that I am not trained or licensed for whatsoever to do.”
Her response to me was pretty brutal. Her response was, “My therapist makes me flashbacks every time I go. I see my therapist because I ended up reliving my trauma and it makes it worse. My priest makes me feel guilty about being raped so I can’t go to him anymore. The drugs that I was given make me more suicidal. Your worst-case scenario is that I commit suicide slightly faster than I might otherwise have done it. Your best-case scenario is you stopped me from wanting to commit suicide because I’m not suicidal now but it comes and goes in waves and sooner or later, it will come back, so you either want to help me or you don’t.” I was like, “I will have a look at it.” She had a flashback the moment I had her wind up to the EEG. That’s how that started that whole line of how else this technology can be used to help other people.
The current version of Sana is much like a VR headset, almost, in terms of you wear it over your eyes and it has the light pulses. There’s that algorithm behind it that learns your patterns, and then it connects with the app. It learns over time how you receive that information and takes the data from your body, and then allows you to go into states of deep sleep, relaxation or meditation faster. You had mentioned the first version of this.
You worked with a gentleman named Bertrand Piccard, who flew one of the nonstop around the world flight and used your device to put him into a state of sleep where he could only sleep in twenty-minute intervals because it actually had to be touched by human controls every twenty minutes. Can you talk a little bit more about that and how you used that flight as a test base for this? I listened to a funny interview with him where he was talking about you coming with this box and wires. He didn’t really know what to expect but he said, “Let’s go. Let’s try to do it.”
The first version was two desktops. One is wired up to the headset and one is wired up to the EEG. That was me changing everything in real-time then it became laptops because I was like, “I need to do this while I’m laying in bed so I can use it to put myself to sleep.” That was in the first few months that it became laptops. It stayed laptops, wires, and boxes all the way through Bertrand Piccard. The current version is a step back from that. It’s wearable so anybody can use it anywhere. We are measuring heart rate vibration on the forehead as a proxy for EEG.
We aren’t yet putting that into a close loop feedback system. That’s in the next generation. It will be in the middle of 2022. It’s down to a standard set of signals that we are putting through clinical trials to get FDA approval. We are focused on sleep and wellness in terms of what we are approved for. We have a 513(g) designation, which the FDA says, “You are safe to go sell for a wellness indication.” We are now going to clinical trial to prove out the efficacy and all of the other areas that we have touched on. In many ways, the current version is less capable than the laptop, wires, and boxes but the next generation will bring back in a lot of that adapting to the individual without me having to be there, which is what I always wanted to build but couldn’t in the time in between.
Ninety-three laptops, wires, and boxes. The Bertrand Piccard came about because when Richard Branson was flying around the world by balloon had used the device to put himself to sleep in a blink. In a balloon, you don’t care about weight. Weight is not a problem. You’ve got a massive cam that is extremely heavy and adding an extra laptop on top of that was not a problem. Getting Richard Branson to use a laptop, that was a problem. He was making fun of me for making him use a laptop for the first time. He used it in that context.
He was flying over Turkey. When he got ill, the ground crew said, “You are using that device or you are landing.” He then used it and slept for sixteen hours. They didn’t have to land the balloon because he was better. The only reason why that flight didn’t get all the way around the world is that China made him fly around that and flying horizontally on a balloon uses up too much fuel. That then led to Bertrand Piccard asking me to see him about sleep. I turn back in Lausanne with my laptop’s wires, and boxes because that’s where Bertrand Piccard was based. I put him to sleep in the meeting with the device, not boring him. I have done that.
I’m sure I have done with him. I’m putting on a headset and getting someone going to sleep in a meeting is a good party trick. It works. It gets people’s attention but he took it off thinking that he had been asleep for maybe 30 seconds and his assistant had come in and laid out all his lunch on the table in front of us. He’s looking at it like, “How did that get there? I must have been asleep longer.” I’m like, “I let you sleep because you need it.” He was like, “Great but I’m not going to try them.” His best friend touched them. He said, “Great but I can’t take something heavy in there. You can make this the weight of a cellphone and you’ve got five weeks.”
That moment was the time when I have been busy to go and borrow money from friends and family based on, “There’s a real opportunity here now that’s really time-sensitive, so let me borrow money. I will pay you back if I have to sell my house to do it just to let me do this thing.” That’s what happened. I flew off to Silicon Valley. I had a medical device mentor from business school who has said to me over the years, “When you are ready to build, come see me.” I went to go see him. He drew up some circuit diagrams and was like, “I can do this but a minimum of twelve weeks.”
I’m like, “I’ve got five.” His response is, “Good luck with that because I don’t know how to cut any more corners. I’m already telling you, I’m cutting with twelve weeks. I really want to help you but I can’t, so come back when I can help you.” I went back to my motel room in Silicon Valley that night thinking, “What do I do now?” I rang up a former friend in the UK. I said to him, “I don’t even know what kind of engineers I need. What are they called?” He said, “You need a firmware engineer, a software engineer, a hardware engineer and a chemical engineer.”
I’m like, “Where do I find those people?” He said, “You went to Silicon Valley, right?” I’m like, “Yes.” He’s like, “There are these tech places. They are basically like gyms where every instruments and machine that any engineer could want all in one place. They go there for their hobbies. If you go hang out there, you might find all these hobbyist people.” I immediately looked it up. There was 1, ten minutes taxi ride away from me. I’ve got in a taxi and went straight down there.
The people at the front desk were like, “If you put something on the electronic board and maybe someone will get back to you.” That doesn’t really work for me because if I can’t get this done in five weeks, I have lost this opportunity. I borrowed this money so I’ve got to make it work. My next stop will be to try and fly off to China. I had one engineer friend in China who said, “If you can’t be done it in Silicon Valley, come here and I will get it done for you.” I said to them, “Would you let me hang out in your lobby while I draft this simple thing so you can tell me if it’s reasonable to put it on the bulletin board?” I used that as an excuse to sit in the lobby and harass everybody coming into the building.
What did you say to these people?
I said, “I’ve got this really cool project which I need really quickly. Anybody can help me with it.” There was this one guy who said, “I’m semi-retired and I’m going to start this new job on Monday but this sounds much more interesting. Let me talk to my wife and I will get back to you” He rung me back at 11:30 at night and said, “I found a software engineer, a firmware engineer and a mechanical engineer. I’m finally one of the persons who complete the team. Can you meet us at 8:00 AM back in the tech space?” I’m like, “Sure.” Off we went, they sat me down and they told me, “We think we can do this in your timeframe but we all going to drop everything we are doing just to do this and you are going to have to pay us upfront. You have to pay us by the hour.Efficiency is doing less work and still getting a high grade. Click To Tweet
Looking back, what they charged me was nothing but that time, it was every penny I had. Literally, they work round the clock to get the first prototype. We bought a sleep mask and the other bit of it was the batch of a big mask. He said that he needed to be able to open his eyes and see the instrument panel straight away.
We had to build those two versions of the device straight away and I couldn’t figure out how we were going to get that done until I saw my first Google glass, and I was like, “That’s the form factor we need. That’s what a pilot can wear that he’s going to immediately open his eyes and see his instrument panels.” I went on Craigslist and eBay buying every broken Google glass I could lay my hands on and we literally use Google glass frames. We 3D printed two side pods instead of one eye. We had that signal going into both eyes. Google never got upset about it.
I’m sure if any of the engineers who were involved in making it, would have been intrigued by someone using it for that but they had worked out the perfect form factor. They had spent tens of millions of dollars making that form factor as good as it could possibly be and we were just able to borrow it temporarily. They worked night and day, and the very first working version of that standalone thing that didn’t be, the laptop was ready to fly to Abu Dhabi. I went straight from the tech shop all the way to the airport to Abu Dhabi.
I’ve got into the Uber in San Jose. I had to go to San Francisco International. I was stuck in traffic and I was like, “Are you kidding me? After all of this, I’m going to miss my flight. I’m not going to make it.” I was ahead of it. “Why am I getting stressed? It’s either I’m going to get there or not. I’ve got a device that’s designed to put me to sleep.” I told the Uber driver to wake me up when we’ve got to SFO. He looked at me and like, “What?” It was the first time that a standalone device had been used to put someone to sleep because we hadn’t been able to take that out of the tech shop. I laid there fast asleep because one thing when you are tired and using the device, it works. You sleep really fast.
It’s the easiest thing to put someone to sleep from. He woke me up when we’ve got to SFO. I’ve got on the plane. I flew straight to Abu Dhabi, which is where Dr. Piccard took up from. We had about a week there while he was prepping. We had to get the FAA to agree that the device wasn’t going to be dangerous if it was taken on the plane. That was the restart of the company. All the time between all that early work with laptops, wires, and boxes through to 2000, I couldn’t use it when I really wanted to because of everything to do with pain, sleep and mental health.
I couldn’t put it in a position where people could use it every day, multiple times a day, whenever they wanted to, and wearable technology just wasn’t a thing. That all happened at the beginning of 2015, which coincided with how wearable was really catching up where it wanted it. It’s still not quite there. The sense we’ve got from the device is the best we could get on a wearable device. Still not good enough to do the proceed feedback system, which is why we develop a new sense to create that final proceed feedback system. In 2022, I will finally have exactly what I wanted to build all the time since I have first admitted that it affects me.
It’s so close to 30 years.
I don’t know about resiliency but that’s stubbornness.
It draws even persistence.
Lots of people ask me how did you keep going on that? It’s very simple. It’s every single time I met someone who I thought I should be able to help you because what I have done can potentially help you. I felt like a total loser. I was like, “I have this thing that could help a person and I can’t. It irritated me.” That was the drive. It was knowing that every single time that I met someone that the technology should be able to help and I couldn’t.
The first drive was, do this or die. The neuropsychiatric drugs really don’t work. They all have side effects and issues. They are all the work of decades of people working hard to produce the best thing they possibly could but the drug route has a problem. The brain has so many interconnected feedback loops but you can’t affect one thing in the brain without affecting multiple other things. That’s the limit of neuropsychiatric pharma. It’s seeing that need and going, “You potentially have something that could be a useful addition so everyone took it.”
Let’s dig into that a little bit more. When you talk about Sana and the effects of the device, you speak in terms of both the wellness benefits and the pain relief. We have talked about clearing the busy mind, supporting enhanced relaxation, improving sleep management, reducing feelings of stress, and enhancing recovery from fatigue. I want to read a testimonial from a patient on this because it really ties this together.
This concept that your pain that you are in then leads to all of these other secondary conditions, and those secondary conditions are what take you over emotionally, so here’s this physical aspect but then because of it, you now begin to degrade mentally and physically because of that pain. The testimony from the patient reads, “When you live with conditions like fibromyalgia, lupus or struggle with the pain of rheumatoid arthritis, or spinal stenosis like I do, the pain can often be accompanied by brain fog, blurry vision, frustration, depression and anxiety.
In my experience, this can all contribute to a feeling of deep disorientation and disconnection inside your body.” Can you talk a little bit more about the interconnectedness of physical pain with mental and emotional wellness? You experienced that yourself and you have seen that in others. Now, how is Sana breaking that down at this point?
If you think about pain, anxiety, and sleep, just those three, the more pain you are in, the more it’s going to damage your sleep. Once you damaged your sleep, you are damaging everything. You’ve got to break that cycle somewhere. My own personal experience started was, “I’m luring my pain while I’m sitting with my two desktops. I’m lying down to try to get to sleep and I’m reaggravating the damaged nerves, which is stopping me to sleep, and I’m in much pain as I was when I wake up.” For me, it started with, “Can I do this while I’m lying down to help me go to sleep better as well?” That’s what really started the cycle improving.
Fibromyalgia is a good example. The average person with fibromyalgia is taking 5 to 8 different drugs to deal with the different problems that they have. A drug for anxiety, depression, sleep, pain, and the list goes on. All of these things then have side effects that then build up each other and all the way through, you are getting more into the fight or flight, not less. You are solving one problem by creating more problems in another area. What we are trying to do with the device and the clinical trials will prove out, whether you have actually cracked it or not is to break that cycle.
Give people stress and anxiety relief on demand. Allow people to sleep better, and then to allow everything else that is being done in the medical care to working better. That’s where we are going for. Almost no pain that doesn’t have central mediation components, the processing of the signal that goes on in the brain. The more stressed or anxious you are, or the less sleep you have, the more pain you feel for any given signal that’s coming up from your body.
We want to help in every area we can possibly help with on that. It’s the same with mental health. It has almost no area of mental health that’s isn’t made worse by sleep problems, stress, and anxiety so likewise, we want to help in those areas, too. There will be some areas and some people like me, where they don’t need the solution that much else but it’s basically the rare ones. The vast majority of stuff is we are going to be hopefully a useful tool in the tool kit to help people figure out what other things are working for them and what isn’t.
One of the real mistakes I made in the very early time was living that there would be a silver bullet. That’s what the drug mentality is. It’s like, “Where’s the pill that I can pop that’s going to solve my problem?” The human body and the human brain really don’t work like that. There are whole fields of intricative or what’s now being called more often recall method where the entire emphasis and the holistic approach to solving these problems. We are striving to be the best in there and that is, let’s help people sleep better, let’s lower anxiety, and see what are the problems we can help solve.
In my ideal world, in five years’ time, if you go to a private physician and you’ve got a pain problem or a mental health problem and that doctor goes, “This person’s problems are being made worse by sleep and anxiety problems. Let’s help them with that, and then see what that does to everything else they’ve got, and then I will add in the next thing.” That’s where we want to end up. We want to end up helping solve lots of different problems by being the rescue med as it were for anxiety and sleep problems.
You are attacking the root cause versus the symptoms. The symptoms are what is being masked by opioids and prescription drugs. This is really interesting because the CDC, the number they put on is that there are about 130 Americans die every day due to overdose of opioids. Sana is non-narcotic and non-addictive. We have had conversations about this in other episodes. We spoke with Dr. Chris Frueh about what he termed the Operator Syndrome. That’s where you operate at this enhanced rate all the time. You push yourself too far, too long, to the extreme. You never take time to rest.
His theory is that you have to find ways to build in wellness. You have to be able to sleep. You have to have increased and improved nutrition. You have to have mindfulness, and you can do that without narcotics, without drugs. We are going to speak with General Peter Chiarelli about TBI, PTSD, and wearables that are being introduced to treat, specifically, TBI and PTSD as replacements for narcotics and prescription drugs.
There’s also a cost component to this. Prescription drugs are expensive. These major pharmaceutical companies make a tremendous amount of money off of prescription drugs and because you have become addicted, you are just masking the pain and not treating the root cause of the pain, you consistently having to go back to buy more drugs. They are expensive if you don’t have insurance. It bankrupts you if you really do need these things and you become addicted to them. Sana is $450. I’m interested in your thoughts on that.
On our pricing, we are going out with the subscription model and at the moment, it’s $100 a month. Over time, hopefully, we are going to be able to get that down. There are some drugs that I would be happy if they went away because they are not the better option. Top on that list would be Ambien. There are other things like opioids where they have their place. What we have seen in some of the longer time follow-ups and trials are people dropping opioid consumption across all anchors by 30%. The ideal is that people end up being able to use the correct tool for the thing at hand.
If you are in a lot of pain and you don’t care about being able to drive or spend time with your family for the next 4 or 5 hours, a heavy-duty opioid content might not be the best tool to use in that timeframe. If you do want to do those things, then you might want to hope for less pain relief but more cognition and more ability to do stuff, then you are going to go for a device used. If you cut down opioid use by about 30%, you probably cut down the risk of those opioids by 60%. Each incremental bit that you take off, you are then lowering people’s other risks. We don’t know exactly what those numbers are but I have heard numbers like that talked with opioids.
AIM is an example. The AIM isn’t, “Let’s get rid of opioids.” The AIM is, “Let’s add another option into the toolbox so people can use less risky alternative when it is appropriate. On the PTSD side, it was the first 2 or 4 people that I helped other than myself. That has always been really close to my heart. We’ve got awarded our first DOD grant to run the first part of the PTSD study. We will be picking up TBI data in that PTSD study, and then as soon as we have the data from that, I’m very much hoping they are going to be good enough that we will be able to get funding and do a larger study in those two areas.The more pain you're in, the more it's going to damage your sleep. Once you damage your sleep, you're damaging everything. Click To Tweet
I’m very interested in the studies as well. You are conducting the clinical trials now for FDA approval for fibromyalgia and neuropathic pain. You received a designation for the breakthrough device in April or earlier in 2021. You have completed two studies so far. One on fibromyalgia and one on opioid dependency. The results have been very good.
In the fibromyalgia results where the perception of pain was reduced by 20%, anxiety by 36%, 84% of participants had a reduction in pain and 85% of participants chose to continue using the device after the study. The numbers in the opioid results are somewhat similar. I’m interested in what exactly is the breakthrough device designation. What does it allow you to do and what does it not allow you to do?
Your breakthrough designation is for fibromyalgia. The update is saying, “Your pilot data is interesting enough and fibromyalgia is big and serious enough problem that we are going to give you breakthrough status. That affords faster track through the FDA to get full approval.” What’s a bit of a physical hacked data at the moment in Washington are faster routes to reimbursement? The reimbursement piece, CMS, is evaluating how they are going to implement this or an alternative to it but either way, we will end up getting reimbursement a lot sooner than we would have done without it.
It is a speed-up review by the FDA once we have completed the pivotal trial. Hopefully, faster reach to helping people, and then also a faster reach to reinvestment. Breakthrough status is about helping people like us developing technologies in areas that are helping either save lives or radically improve lives, whether they have alternatives to get to help people faster.
In addition to the two studies that have already been completed, what’s next?
The two studies that have been completed to be pilots to give us data to figure out what are the next ones to do. Fibromyalgia is the one that we are targeting first to get through the FDA. The pivotal study on that is really important. The next one to complete should be neuropathic pain, and that’s with Mount Sinai, then it will be anxiety, which we are doing with The Mighty.
The Mighty is a 2.5 million strong patient advocacy group. We are also doing with them 1,000 people, one arm fibromyalgia, which should end up being the largest non-drug fibromyalgia study ever done to help us figure out where within fibromyalgia we can most help. The next one after that to complete should be PTSD, which we just won a DOD grant for to do the first 40 people with PTSD.
As we close out, I ask every guest the three things that they do to be successful every day. This is important because, in World War II, The Jedburghs had to do three things with the utmost competence every day to set the foundation for them to focus their efforts on other challenges. Those three foundations, where they had to be able to shoot, move and communicate. What are the three things that you do every day to set the conditions for success?
I’m not going to do these in the right order. I’m going to start with the end of the day.
It’s the first time somebody started with the end of the day. Everybody always starts at the beginning of the day.
In terms of what I do slightly differently, it’s probably the most important one. That is a diary or journal. I start every journal entry by writing “I am grateful for.” I write a mixture between a diary and a journal, and I try to think through all the people that have helped me during that day. There’s no way that we get to any of the people that we are trying to help with Sana without an incredible team. Many times, “I am grateful for,” the first thing I write in my diary in the evening ends up being my team or specific members of my team or some of the really awesome, helpful advisors.
They are just giving us lots of time and effort to help us move forward. Doing that every day consciously in your head going, “This is what went well.” That is a massive boost against all the slings that narrows at the age of fourteen that come your way that screw things up. However bad a day is, I can guarantee anybody can find 1 thing or 1 person that did something who have helped them that day, especially on the good days. On the good days, you read those as well. Those are also driven by all people that are helping you and anybody who’s doing anything useful at all. I can guarantee you, it has got rims of people that are helping them in small or large ways. It really helps focus on that.
Within that diary thing, the other bit I do, which is a bit geeky is at the end of the day, I put a happiness score on it. I put one line of what made it that, so if it was a five, what made it that? If it was a 9 out of 10 on a happiness scale, what made it that? If you do that, day after day, week after week, month after month, helps you realize certain things.
External factors have very little to do with your mental or internal mental state because they don’t change a lot and your mental state changes hugely from day-to-day. That’s the diary writing thing. It gets you to be aware of what is making you happy, productive and what’s not. That whole diary thing is a massive piece right there. That’s probably something I do differently from other people but I strongly advise people to do that one.
That happiness score is incredibly insightful. That’s important that we should talk about more with more people because we often think about reflection. We have had a lot of guests who have talked about meditation and spending a few minutes a day looking in words trying to identify what’s driving them and what do they truly want.
We have had a tremendous amount of conversations about identifying your authentic self and trying to find out what drives you to happiness, and then focus on those things in your life and cut out the other stuff. We haven’t had it quantified in this way with a score and a reason. I find that incredibly insightful and an amazing way to tie that up at the end of the day, and then build that over time where you can actually then look back and see the path. Are you making progress to where you want to be? I’m going to take that from you. I’m going to talk a lot about that in future episodes. I know it.
The reason why it happened was that I was reading the Dalai Lama’s The Art of Happiness while I was doing my stint in McKinsey. If they had a mantra, it would be, “What doesn’t get measured, doesn’t get done.” Dalai Lama talks about 45 minutes a day being the minimum. He spends every day analyzing how his day went.
I used to do a pain killer score when I was going with my pain and happiness score, and making that day after day, week after week, month after month, and realizing the number of painkillers I took was what was changing my level of happiness, not my external reality at all. It became a habit. I don’t take painkillers anymore. I took 3 or 4 lots of Acetaminophen a week. It’s not enough to note in a diary but whatever your main goal is in life, you should be putting a score on it each day. Happiness is a really useful one. It helped me with the thing I’m doing for myself. Building a team around you is definitely the most important thing of getting stuff done but of internal stuff, I would say that was number one.
Are you ready for two?
I’m going to go for a cheesy one that most people have told you. Make your bed at the very first thing in the morning. It’s really simple. It gives you a little bit of feeling of control in your life. It must make you feel more like something you want to get into at the end of the day if you made it at the beginning. It’s cheesy but it’s true. The number three is once you have identified the things in your life that bring you the most joy, you have to have a bit of that every day.
The number one thing is my son. He just makes me smile. Even when he’s not with me, I’m doing a little story time with him on FaceTime. You’ve got to do your thing each day that is not related to work at all. It just makes you smile and happy because of what it is. If you are not doing that, then what are you living for? You’ve got a self-care.
There was a moment where I was flying to Brazil and I was in the very front row. The air steward got up and we did the whole spiel about your face marks and everything else. He was acting just camping everything up, just being dramatic and funny. He was giving serious look to the people in front of me, and then he leaned to me and he goes, “I feel so stupid that you don’t understand this point, then you do deserve to die.”
It was that big a-ha moment because on my own business at the time, I would be running around trying to help everyone else and not putting my own gas mask on first. My kid is that bit of self-care. That’s the most important. The self-care. That’s what makes me laugh or smile guaranteed in the day. Everyone should know what that thing is in their life and make sure they do that some other day regardless of every day.
Your three have been easily three of the best that we have ever talked about on this show. Truly thoughtful in the sense that you just understand the things that drive you, and you understand yourself to a level that a lot of people don’t. That’s a testament to what you have been through and what you have overcome. We talk about the Nine Characteristics of Elite Performance in every episode. Drive, resiliency, adaptability, humility, integrity, effective intelligence, team ability, curiosity and emotional strength.
We referenced a lot in this episode your resiliency and your adaptability. We always say that elite performance requires a combination of these nine elite performers that have all nine of these characteristics but depending on the situation they are in, they will use different versions of each of these. I say that and I always apply one to my guest. When I think about you, it is this resiliency and adaptability.
After our conversation here, it’s also this drive. I normally don’t give more than one but I’ve got to give you these three because there’s the drive to just never quit, to find an answer, to push forward, to make things happen. There’s the resiliency of this perseverance in the face of challenges and you have faced the utmost challenge. There’s adaptability to adjust your behavior to the situation, to figure it out. You have faced some of the most consequential challenges that anybody can face in their life and you did it at a young age.
You exhibit the elite performance when you look in the face of those challenges and you say, “This doesn’t matter, I’m going to figure it out. I am going to succeed in this life and this world.” It’s an inspiration to know your story. It’s an inspiration to see what you are doing with Sana, to understand where it’s come for years of pushing this thing forward and see that having the effect it has on you, on others, and to see where this is going to go throughout the next 5 or 10 and even further. Thank you for joining me here. I have really enjoyed talking to you and telling the story, and I look forward to watching Sana and you as you move through clinical trials and field this thing to the masses.
I really appreciate that. Thank you very much. I always feel a little bit of not exactly what I can afford when someone says these things but privileged. That’s a better word because there are a lot of the things that you talked about, which I’ve got because I had a family background that wasn’t always easy but I had that basis of stability and safety net that I still have that everyone I see around me has to some degree. I’m aware of the privilege that that is. I’m able to keep going because ultimately, I know I could screw up as much as I wanted to and I’m not going to stop.
I’m still going to have a bed at my dad’s place, and that stops me from ever thinking that any of us do any of this stuff alone. We were able to do it because of the people around us, our families, ur teams, and the other people that share the same needs, desires, and aims in the world, so I feel privileged. I really appreciate your words and I want to just to say thank you to everyone in my team and my extended family for helping us get to where we’ve got to and giving us the platform because without people hearing our stories and what we are doing, we can’t grow either, so a huge thank you to you.
It’s an important message. I look forward to it. Thank you.
- Sana Health
- The Awakened Mind
- Bertrand Piccard
- Chris Frueh – Past episode
- The Mighty
- The Art of Happiness