I’m really excited to have been able to invest in Respirix. Based in San Francisco, Respirix is a healthcare company on a mission to revolutionize cardiac monitoring. Respirix is developing a novel approach using software and hardware to measure hemodynamic parameters (that currently require expensive and invasive implants) at low cost and non-invasively. The technology has wide potential, but they are initially focused on bringing a game-changing monitor for congestive heart failure (CHF) patients to market that will allow their physicians to monitor them remotely and help prevent dangerous and expensive hospitalizations.
Heart disease is something I personally care about because it’s impacted my family directly in the past: several of my grandparents and pets died from heart disease (and some specifically CHF). Now, there are many companies chasing heart failure -- it is a very big market. Every year in the United States, about one million CHF patients are hospitalized for what is called “decompensation” (fluid retention in the body and lungs); the estimated cost of these hospitalizations in the U.S. for 2010 was $39.2 billion, and that number is forecasted to reach $70 billion by 2030. Importantly, over 50% of CHF patients are readmitted to the hospital within 6 months of discharge.
Today, there is only one FDA-approved device for CHF patients to monitor their status at home. It’s an implant that costs $18,000 and gets placed permanently inside the pulmonary artery in the heart through a surgical procedure. Despite these challenges, this technology was acquired for $455 million before selling a single device when it was demonstrated that the daily measurements it provided could predict decompensation in advance and allowed physicians to have patients take medication that reduced CHF hospitalizations by 38% in a 470 patient trial.
Now, imagine that instead of having a chip placed inside your heart for life, you simply had to breathe into a sensor and get the same analysis of your condition. Sounds amazing, right? That is precisely what Respirix is doing. Respirix’s approach involves using precise analysis of breath exhalation (proprietary signal along with machine learning) to monitor changes in pressure caused by the pulmonary vasculature, which may be a more sensitive indication of pulmonary artery compliance.
So far, the Respirix team has accomplished a number of important milestones, including building over twenty of their Cardiospire devices, acquiring animal model data, starting multiple clinical trials, winning grants, and recruiting a strong team and advisors.
If successful, Respirix’s first product would make it a lot less invasive and easier for CHF patients to have their health monitored at home. I know startup risks are large and the probability of success is generally low, but Respirix has a differentiated approach and has gotten very solid results to date, and they are tackling a huge market opportunity. That being said, I like that the CEO has a lot of personal skin in the game and cares passionately about seeing the Respirix solution become reality. I’m proud to have invested alongside Synergy Ventures, Signatures Capital, Theranova, and StartX.
I’m personally excited about the company because given my family history, I recognize that there is a strong need for new technologies to treat heart disease more effectively, at lower cost, and with increased patient access.
What I love:
I heard about How Proust Can Change Your Life by Alain de Botton from Tim Ferriss's podcast episode with the author. I love French literature, though I (ironically) haven't had time yet to read the seven-volume opus In Search of Lost Time by Marcel Proust that forms the foundation for Alain de Botton's recommendations.
In a neat and short book, Alain de Botton goes through 9 different parts of life (such as love, reading, suffering, time management, emotions, and friendship) to distill the lessons relevant to each from the various writings (and personal experiences) of Proust.
I found the section about how to put books down and the limits of reading to be most interesting and impactful. I also liked the lessons around appreciating art and objects around you, suffering well, and expressing yourself in an original way.
I had learned about Proust of course before but not in as much depth, and I actually think that Alain de Botton's book will give me a good path to better enjoying and appreciating Proust's actual book when I get around to reading it.
Some of my main notes and takeaways on the book are below.
It's never too early to learn about yak shaving: What Russian folk tales can teach about life and technology
Toddlers love to read the same book over and over again: it helps them learn language and gives them a small sense of security, comfort, predictability, and mastery over even a small part of the confusing world around them. While helpful for them, it can drive parents crazy (or lead them to come up with ridiculous premises for blog posts).
Yesterday my toddler insisted on my reading for the fifth time (that day) the Russian folk tale "Петушок и бобовое зёрнышко," or "The Rooster and the Bean." (Click those links to read the tale in the respective language.)
The gist of the story is that this poor rooster who is always rushing chokes on a bean, and in order to save his life, a chicken needs to solve one problem after another in an endless cascade of sub-tasks which finally allow her to save the rooster's life in the end.
The story teaches (at least) three obvious lessons. First, don't rush while eating (or in general). Second, accomplishing things in life (or getting anything non-trivial like a "project" done for that matter) is going to be much more complicated and involve a lot more dependent steps completed first. And third, often many other people will be involved whose help you will need in order to get what you want done.
But for me personally, I secretly got a kick out of reading the story because it also teaches a valuable lesson about technology development. When I was at Google, there were many times I tried to do something seemingly quite simple ("just change the color over here" or "just move this piece of code from here to here"), and it required 5+ steps of dependent work (refactoring, renaming, moving, etc.) to be completed in series before the final trivial change/fix could be made. I learned from a teammate that this is generally called "yak shaving," which refers to the seemingly endless series of useless activities which, by allowing you to overcome intermediate difficulties, allow you to solve a larger problem [Sources: 1, 2, 3].
And I've experienced the same thing in life and house projects as well: "I just want to install a camera here" devolves into "I need to run power here" which devolves into "I need to rewire, order, and set up a thousand other things first."
I guess it's never too early to learn the lesson that projects are complicated, and getting a big thing done requires patience with lots of steps, which is why this Russian folk tale about the rooster seem to teach this lesson so early on.
If you want to waste any more of your precious life, you can watch the pointless video below of the Ren & Stimpy Show episode about the (pointless) "Yak Shaving Day" that apparently inspired the term "yak shaving."