Catherine Mohr: ex-pat Kiwi at top of medical robot game

Global Women member Catherine Mohr wasn’t always a doctor at heart – she never was the little girl who dreamed of a career in medicine. Instead, she has always been a tinkerer. And now, as vice president of medical research at Intuitive Surgical, she gives surgeons super-powers with her futuristic surgical robots.

She gave her inspiring life story at a cocktail event hosted by Global Women and Medicines New Zealand this month at GSK in Auckland.

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New Zealand to the USA

Mohr’s parents moved to the USA from New Zealand when Mohr was a small child – that’s where the jobs were in the 1970s for a biostatistician and a biochemist – with annual trips home only to their Glenorchy bach.

There was always an expectation that Mohr would follow in their career footsteps, however as a bicycle mechanic in her teenage years and an avid motorcyclist, she instead went into engineering.

At MIT there were no female role models in engineering but she thrived there with the help of a series of mentors including famed MIT professor and inventor Ernesto Blanco.

At MIT she became involved with building and racing solar cars and raced in the 1987 inaugural solar car race in Australia (with now-CTO of the USA Megan Smith on her team). There, she met and gelled with senior AeroVironment engineers which was the key to her future.

At the end of her master’s degree, she went to work for Dr. Paul MacCready at AeroVironment developing alternate energy vehicles, high altitude aircraft, and high efficiency fuel cell power systems aimed at reducing the world’s energy consumption and emissions.

Her first project was a hybrid electric off-road vehicle that could fit in a helicopter. This was at a time when no commercial hybrid vehicles had been developed yet – Mohr helped build the first prototypes for major automobile companies. But there was a still a niggling feeling of responsibility. Her decision to leave MIT still felt like a failure, because she felt a responsibility to be a role model and a female professor and instead she was “making toys at a toy factory”.

Edge of human knowledge

But these toys were incredible.

The next project was energy fuel cell systems for a solar craft to fly around the stratosphere day and night. Mohr soon became the world expert in this technology – there was no other team who had ever done what they were attempting – and this was her first taste of getting to the edge of what humans could do.

These days she tells all young women considering career choices that will make an impact, is that the technology that will govern their lives is ugly and still in the lab. “Heading into these [hi-tech] fields, you will very soon get to that edge.”

Med

Soon Mohr was promoted to running the whole of engineering at AeroVironment, but this was the beginning of the end. She accepted the job but despite the kudos she was miserable.

The next year involved intense soul-searching to find out what would make her happy.

One day she had the opportunity to watch a medical friend carry out a general surgical procedure, placing a stent in an aorta. When the procedure failed, she noticed the surgeons and engineers in the operating room were discussing the failure but not speaking the same ‘language’.

She thought it would be valuable to be able to understand both sides.

“This can’t mean going to med school in my thirties!” she thought. But it did.

Along with her supportive husband, she moved to Northern California.

Multitasking at med school

At Stanford medical school, she saw problems and, because she was still an engineer, she would design solutions for them. For example, there was an existing device that would inflate body cavities with carbon dioxide for endoscopic surgeries using a needle, but it would sometimes pierce critical organs instead. She prototyped an improved design, found Silicon Valley investment, got FDA approval. Realising that medical devices need to be sold as portfolio of products, she sold it into an existing medical company’s portfolio. All this entrepreneurship while still studying medicine.

Facing the prospect of delaying children until after a surgical residency, she decided to become pregnant in year two, taking a hiatus in her third year – doing research and “learning how to be a mum”.

“Life doesn’t stop when you have those things going on.”

An unconventional path

With a big plan to be a surgeon, while in med school she placed herself on various medical boards with the result that she was “politically set to do a residency programme anywhere in the country”.

But eventually she decided against the surgeon path – which elicited phone calls from many, many established female surgeons with “what are you doing?!”

“What happened is I realised I had lots more leverage as a designer of devices than as a single surgeon with a single patient,” says Mohr.

She had already co-developed a robotic gastric bypass procedure, so she went off to work on tele-manipulative robots, joining the company Intuitive Surgical where they had invented robots that could help surgeons carry out laparoscopy (keyhole surgery).

In the 1980s, keyhole surgery surged with a tech revolution in cameras and computer chips which meant images of the internal surgery could be projected to a screen. But it was very difficult to carry out complex surgery using laparoscopy, and the da Vinci had been developed to allow laparoscopic surgery in complex cases that would otherwise require an open incision – the da Vinci system’s tools work inside the patient following every motion of the surgeon’s hands, which are in a console outside the patient.

There are now 3400 Da Vinci systems around the world equalling half a million procedures a year.

Mohr says most surgical robots invented before the da Vinci had not involved the surgeon in the loop, while the da Vinci did and this made FDA approval easier. This same principle made another surgical robot – the Mako – equally as successful: the surgeon operated the drill but the robot provided boundaries as to where the drill could go.

Globally, laparoscopy has decreased complications like wound infection, and has decreased re-admissions. When da Vinci was introduced 96 percent of prostrate removals in the US were done by open surgery. Now 90 percent are done minimally invasively.

Exciting medical frontiers

Mohr is now interested in different ways of doing surgery itself – such as using biomarkers, dyes and lasers to identify tiny tumours and selectively kill the cells. She’s interested in new innovative companies which are developing technologies like detection of cancer at an early stage, through molecular sensing in biological samples, which is being carried out by New Zealand company Pacific Edge. Or novel imaging technologies like MARS in Christchurch, which has found a way to look at the chemical composition of a tumour not just the density.

She wants to fundamentally change how we do surgery.

She’s also excited about regenerative medicine: growing organs on scaffolds for example, or growing our own organs by changing the chemical gradients to simulate embryonic conditions, so that our cells self-organise into new organs – using the blue prints each of them already carry.

And Big Data – creating robots with the ability to give diagnoses to accuracies higher than human doctors, and notice patterns humans just haven’t noticed, to help humans with better decision-making.

Going her own way and finding happiness

Mohr sees her serial careers as incredibly valuable, because you keep all these skills and learnings in your toolbox and take them onto the next thing.

She took a year of soul-searching and unpacking her unhappiness to find her path.

“I had to identify why I wasn’t happy before I could figure out how to be happy. There was no ah-ha moment though. I spiralled into depression, talked to my husband a lot.

“But I eventually figured I needed to be back on the steep of the learning curve. It was a clarifying moment to realise that I didn’t want to be the expert – I wanted to keep learning.”

How did she stick to her guns?

“People said I was crazy. Now I’m successful, so it seemed like a good idea in retrospect, but it seemed crazy at the time. It felt contrarian. I was just muddling along, and they turned out to be good decisions. I guess I was seeking a difficult challenge.”

Captions: Top: Mohr presenting the latest in surgical robotics. Left hand side photo from left: At cocktail event, Global Women members Simone Iles (Independent Director), Karen Fistonich (Villa Maria chair), Catherine Mohr, Emma Parry (Clinical Director of the NZ Maternal Fetal Medicine Network), Gill Gatfield (sculptor and author)

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