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How Unconventional Thinkers Unlock Medical Innovation

— An excerpt from Murphy's book, The Essence of Invention

MedpageToday
A photo of Kieran Murphy, MD, and the cover of his book The Essence of Invention.
Murphy is a clinician, researcher, teacher, and inventor.

Despite the uphill battle that most inventors must undertake to bring their innovations to market, the global market for medical device technologies was valued at . By 2030, it is projected to reach $850 billion, reflecting a compound annual growth rate of 5.5%. This raises the question: could the medical device industry be more successful? The answer is yes, but only by fostering a more supportive culture and environment. To achieve this, we must first understand who these inventors are and what drives them to create the tools and techniques of the future.

Inventors, by definition, are often eccentric, and there is a notable relationship between the prevalence of eccentrics in society and overall creativity. In any society, the acceptance of eccentricity serves as a barometer of its intellectual health. Creative caution can lead to dullness and mediocrity, and such caution, along with linear thinking, is antithetical to the mindset of an inventor.

I believe that a specific personality type, the "divergent" individual, is responsible for the inventions that have transformed modern medicine. These individuals do not think linearly; rather, they approach problems in a manner described by cognitive science as "emergent." This means they think in a fluid, non-linear fashion, simultaneously generating multiple potential solutions and exploring them in parallel, uncovering unforeseen connections. The ability to shed mental constraints allows inventors to search through their past experiences, knowledge, and skills for unexpected associations and solutions.

When faced with a patient exhibiting complex needs, a clinician's skill lies in their capacity to devise a solution by drawing widely from various fields of medical expertise. This is not a common ability; most individuals rely on established linear thinking. In contrast, the divergent thinker borrows techniques from adjacent medical specialties and even from industries outside of healthcare, evaluating and selecting from these in the problem-solving process. This adaptability is characteristic of the great inventors I have encountered.

Intuition plays a significant role in this creative process. It is a cognitive skill that enables individuals to make judgments based on incomplete information. This process requires a flexible, adaptive unconscious capable of associative thought. Just as in the liberal arts, creative individuals often thrive in ambiguity and can adjust to unusual experiences. A common trait among them is a quest for engagement, truth, and order, paired with an appreciation for the universe's complexity and a desire to understand how things work.

In September 2020, the New York Times published the , Robert Gore. He had died at the age of 83. Gore was a chemical engineer whose experiments with his father in their home basement laboratory created a polymer that led to the invention of Gore-Tex. Gore's mom (Genevieve) and dad (Bill) formed W. L. Gore & Associates. They ran it from their basement for the first 2 years while Gore finished college.

Gore's obituary captures the spirit and soul of the classic inventor. His discovery was initially thought to be a mistake. He was trying to make an inexpensive form of plumber's tape. He discovered, by aggressively jerking his polytetrafluoroethylene (PTFE) polymer, that he could stretch it up to 1,000% of its length.

The polymer became one of the most important ever developed. This versatile material has been used in ski jackets, aortic stent grafts, and Apollo spacesuits. I have deployed many devices covered with Gore-Tex to prevent someone from bleeding to death. The last time I used a Gore-Tex-covered graft was for a patient whose head and neck cancer had eroded into his carotid artery. The patient was drowning in his own blood. I had to work so fast that I didn't even put on a surgical gown.

What struck me about Gore's obituary were the descriptors used to characterize him: "He was super curious about things; he was rigorous...Bob entertained any kind of idea."

Gore was also well-trained, holding a bachelor's degree in chemical engineering from the University of Delaware, followed by a master's and PhD from the University of Minnesota.

In him, we see the quintessential inventor: a curious mind shaped by education yet unconfined by it, capable of identifying unexpected results and envisioning their potential applications.

When we discuss where inventions come from, the conversation often becomes very academic. Clearly, many components influence the path toward discovery. Ideas in all contexts can come from the subconscious of a well-trained mind and result in unexpected outcomes, as well as through a conscious search for knowledge. Those unexpected outcomes may be seen and identified for their potential value, or missed and considered errors or outliers.

Three things are certain about discovery: discovery is unpredictable, discovery requires serendipity, and discovery is a creative act. And yet, sometimes, discoveries happen by accident rather than by design -- this often drives inventors onward when they realize that the way they thought they understood how something works wasn't entirely accurate.

In his book, Happy Accidents: Serendipity in Modern Medical Breakthroughs, Morton Meyers, MD, recounts stories about how scientists often make significant discoveries when they stumble upon unexpected findings. I am particularly interested in Meyers' insights, as we share a common background in academic radiology. His book illustrates how accidental discoveries have been pivotal to our current existence. The term "serendipity" itself is intriguing; it derives from an ancient Persian name for the island now known as Sri Lanka, referenced in the fairy tale The Three Princes of Serendip, where the princes made fortuitous discoveries.

Wilhelm Conrad Röntgen accidentally discovered X-rays in 1895 while testing cathode rays' ability to pass through glass. He noticed a fluorescent glow in his darkened laboratory and initially attributed it to sunlight filtering through the shutters. Upon realizing it was something else, he understood he had identified a new form of light invisible to the human eye, which he termed an "X-ray."

Similarly, Alexander Fleming discovered penicillin by chance when he left a window open, leading to a fungal contamination of his culture media that created zones devoid of bacterial growth. This unexpected finding has since saved countless lives, turning once-fatal infections into treatable conditions.

Meyers succinctly captures the essence of serendipity: "Although the term has become popularized to serve as a synonym for almost any pleasant surprise, it refers to searching for something and stumbling upon an unexpected finding of even greater value." However, serendipity is not merely a random occurrence. It is a process in which creative individuals recognize and seize upon chance events, unraveling their mysteries and finding appropriate applications. While discovery requires a moment of serendipity, it also necessitates a creative mind capable of discerning value.

To foster a culture in medicine that is conducive to invention, we must take steps to encourage curiosity-driven research and creative "hunches." By embracing serendipity and encouraging openness to unexpected findings, we can accelerate medical discovery, potentially leading to transformative breakthroughs that save lives and improve patient care.

is a pioneering clinician, researcher, teacher, and prolific inventor with over 80 patents to his name. He previously led the Division of Interventional Neuroradiology at Johns Hopkins University and held significant roles at the University of Toronto and University Health Network. Murphy's new book, , from which this piece was excerpted, aims to encourage everyone to embrace their inventive potential.