The Journey from Patient to Impatient Entrepreneur

Surbhi Sarna began her journey into medtech when she had a health scare at the age of 13. The ordeal led her to founding nVision, a company focused on the detection of ovarian cancer. nVision was eventually acquired by Boston Scientific. Now she serves as a partner at Y-Combinator and CEO. 

Here is a brief transcription of the interview:

 Well, Surbhi, welcome to Let's Talk MedTech. Thanks for coming on to the show.

Surbhi: It's really my pleasure. Thanks so much for having me here.

 Now, I know you're the keynote speaker at BioMed Device Silicone Valley, correct?

Surbhi: That's correct. And I'm really looking forward to it.

Yeah, well, I want to talk all about that. I want to talk about that in your company, Envision, and the Boston Scientific acquisition. But you've got an interesting journey into medtech that I want to discuss first. And this started when you were 13, right?

Surbhi: Yeah, that's right. Actually, I was in high school and kind of had an affinity towards my English classes a little bit more. I always enjoyed science, and I would spend my recess collecting insects, but really wasn't thinking about what I was going to do long-term for a job, or for the rest of my life, for that matter. And like you said, I was 13-years-old, writing a paper on Emerson in my bedroom when I felt such a sharp pang of pain in my side that I could barely make it to my mom, who was at the kitchen at the time, and say that my side hurts before blacking out. And the next thing I remember is waking up in the hospital. And of course, there was no way for me to know it then, but it was going to be the first of many trips.

 What happened after that? I mean, you had many trips?

Surbhi: Yeah. That evening at the hospital, at first they thought that I had appendicitis, and so they actually completed prepping me for surgery. Luckily, last minute, the surgeon himself realized that it wasn't appendicitis, and I was suffering from something else. And later that week, they had me come back from an ultrasound, and that's when they discovered that I was suffering from a repeat complex ovarian cyst. The problem still today remains with complex ovarian cysts.

Why they call them complex is because they have a septum or a divider in the middle of them and they're both fluid filled and solid. And in that case, the ultrasound is just telling you that there is a mass, not necessarily whether or not it's cancerous. So the next thing we had to turn to from there was a blood test called CA 125.

And that blood test, unfortunately, is no better than flipping a coin, both in terms of sensitivity and specificity. In fact, it has such a high false positive rate that Kaiser will no longer administer it to patients who are pre menopausal for risk of inadvertently removing the anatomy, when in fact, there was no cancer present.

So I did take this test, CA 125, and it was elevated and I had this complex mass. So what do you do at that point? Well, the guidelines till today say don't biopsy, because an ovarian mass biopsy is quite risky, in that once you place a needle into the mass, as you would draw, there is a risk of spreading cancerous cells into the rest of the cavity.

Also, and I've heard this story many times in young women, if you are doing surgery and the ovary is injured at all or it's contorted in a certain way, you will end up having the entire ovary, along with the mass removed. So you'll have one ovary instead of two, starting at a very young age.

So at that point, my family and I were faced with a choice, if you can even call it that. Do we risk this invasive surgery and spreading one of the most lethal cancers impacting women? Or instead, do we play this waiting game, this watchful waiting game, to see whether or not this mass was in.

 I've had to wait for results before for various things, and I've talked a little bit about that on previous episodes of Let's Talk Medtech. But that weight and just thinking and just imagining the what ifs or the possibilities, that has got to be pretty hard or pretty difficult.

Surbhi: It was. And I think that many of us found high school to be complex enough without that. Right. And I clearly remember being in Spanish class one day and then being in so much pain that I had to leave. And the Spanish teacher then trying to explain in Spanish to the rest of the class that I had this mass on my ovary. And then a high school boy running up to me later and saying, hey, I heard that your ovary burst. Lost in translation. So, yeah, absolutely. Playing that waiting game out. And now being a parent myself, I can't imagine what it was like for my parents. But even for me as a kid, it was quite a difficult several months not knowing what to expect.

 And that kind of propelled you into medtech and to becoming the inpatient entrepreneur, right? I know you've been dubbed as that before.

Surbhi: Yeah, that's right. And fast forward six months. It turns out that I was one of the lucky ones. And I, in fact, did have a benign cyst, which was resolved in sort of a painful burst, but it, in fact, was not cancer. But at that point in time, I had some really fantastic science teachers who spent a lot of their after school hours as a kid, not understanding, hey, adults and teachers have lives too, and that meant something.

But who spent their time with me after school, helping me understand what I was going through, that turned some of that anger and confusion into intellectual curiosity and kind of walked me through various papers so I could understand my disease state.

And one thing that was apparent actually wasn't in the literature itself, but it was the lack of literature, and it was this lack of basic understanding of diseases which impact women. And so I realized then, or I had a dream, I should say the dream started that I would one day start a company that positively impacted women's health, starting with the early detection of ovarian cancer.

And I actually put that in my personal statement to the UCS and UC Berkeley, read it, and decided to overlook one quarter of mediocre grades that I had because I was dealing with all of this health stuff. So from high school, went to UC Berkeley, studied molecular and cell biology, did research in bioengineering, and basically everything I did after that health know, to my first job at Avid vascular, to the next device startup I worked on. I always thought, what I'm working on right now, how does this apply to women's health? How can this innovation make women's health better, be in a better place than it is today? So that was really what got me started on this journey.