#450 : Prof Shafi Ahmed: What it takes to get a "yes" inside the NHS

Speaker A: And when we looked at the feed, I Talked around about 14 and a half thousand students across the world in real time. I never thought the family would be watching a live stream of their own dance operation. That kind of. It blew my mind.

Speaker B: People talk about the NHS being very difficult to innovate. You're challenging that narrative quite clearly because the NHS is made up of people and there are innovative people and innovative people find a way.

Speaker A: If you don't, nothing will happen. We'll sit in mediocrity and there'll be no innovation or lack of innovation, which is what happens in hs. So you blame lack of innovation if then people around it. Do you have the right leadership?

Speaker B: Hey, everybody. Delighted to be joined this week by a man who really needs no introduction on the health tech podcast, uh, Shafi Ahmed. How are you doing, Shafi?

Speaker A: I'm good, James. And we finally get to meet on your podcast.

Speaker B: We finally get to meet on the podcast. It is an absolute crime on my behalf that you've not been on this podcast before. And actually I'm going to tell you a bit of a story first because, um, I think it was, I think it was 2016 or 2015 even, that I was at something called the Wearable Tech show in, uh, London. I think it was in the Excel.

Speaker A: It was.

Speaker B: And I was walking around the Wearable Tech show with my friend Andrew, Andrew Birch, who was doing at the time an MREs in at Imperial, uh, for Medical devices. And he's an anesthetist too. And so one thing that we connected on was technology and he said, oh, do you want to come to the Wearable Tech Show? So came down and we were going around and he was telling me all the stuff that he was learning on the MREs and, and we bumped into you. And I can remember at the time I was, I think I was at, ah, Digital Health London or just about to go to it, or it was that sort of time in my life where I was sort of on the cusp of medicine versus health. And Andrew was saying to me, oh, uh, we definitely need to go and speak to Shafi. You definitely need to get on the radar of Shafi. He's like, he's all over this, like, health tech stuff. He does all this VR surgery stuff. I love it. I've been in theater with him once. It was like, amazing. He was such a good teacher. You could hear him teaching the other, the other junior doctors, like, all this sort of stuff. And we came and chatted to you and you were so unbelievably. Nice to me. And you were so unbelievably supportive to me. And it was just one of those moments on the way towards health tech for my career that I can point to as being like. It was. It was another door opened, it was another green light. It was another, ah, uh, here's someone that's making a career out of it. This is possible for me. And so I can say that in, uh, in a not so small way, uh, you inspired me into the career that I have now. So I have to thank you for that, first of all, because I don't think I've had the pleasure of telling you that story before.

Speaker A: Thank you. I have. I haven't heard that. I remember the Wearable tech show, ah, very distinctly. Is that the exit I see? Yeah, yeah. So thank you for that. It's really kind of.

Speaker B: You're very welcome. You're very welcome. Um, so it's gonna be really interesting for the listeners to hear your story in full because I'm sure everyone knows who you are. I'm sure everyone has heard of you and some of your work across, uh, particularly the VR surgery stuff back in my day in inverted commas, that was the stuff that really kind of had you on the map. Um, but you do loads, you sit on loads of boards, you do lots across health tech space. Still practice clinically, I believe, as well. Um, and so learning how you keep and maintain that and build a career around remaining clinical and I don't know, everything that you've managed to, ah, achieve in your career, sort of before it was cool, I can remember when it was called healthcare it. And I'm sure you can as well. And I'm so intrigued to hear the full story. Shafi. So starting from the beginning, where does this all start for you?

Speaker A: Yeah, it's a long story. Ah, I haven't shared it that widely for a long time and actually it's one of the things I'll be doing the next few years is writing my autobiography as part of Amazing Stories. So I have been thinking about that for a while with my, uh, book agents saying how going forward. So it is a story that I want to tell at some stage because I think it's a good story and it's interesting story for a lot of people to hear about. So if you talk about my kind of what I do, first of all, so I'm a clinician. First and foremost, I'm a surgeon. I went through the traditional, um, pathway and journey to become a consultant surgeon. I specialize in colorectal disease. I'm a GI surgeon and I've been a consultant now for almost 20 years. It's a long time, but I've been a doctor for 32 years. So I've been working, uh, in healthcare through its various iterations in the NNHS for over three decades. So I still consider myself first and foremost a clinician. Having been through the hardcore academy route through your basic training, we used to call it basics, called core training now, uh, then doing high, uh, surgical training, all in London, doing a PhD in London and in the east coast of America around Princeton, and then being a consultant and become an academic. So this was a traditional, um, hardcore surgical journey that I took. You know, the endless hours of work to improve our craft, et cetera, the hundreds of hours per week we were working.

Speaker B: There was no working time directive then, was there?

Speaker A: No, um, people will be shocked. The longest shift I ever did was 120 hours in a week. And that was. Yeah, that was one long week. Um, I still remember that, where you came in on a Friday morning and you're on call Friday, Friday night, Saturday, Saturday night, Sunday, some night Monday finished at 6 or 7 o'. Clock. Uh, and if you got sleep it was a bonus. Right, those are the old days, uh, thankfully they're long past behind us. But people, they see my journey, they forget that part of my life. They see the tech side innovation, not the fact that I spent 30 years as a doctor, uh, and um, career in surgery, not the easiest. So I was a cancer specialist, I became a co doctor cancer specialist for a long period of my life. And I had many leadership positions in the nhs. Uh, I sat on the RCS Council as elected member for five years. I was associate dean the medical school at Barts for 10 years. Around education programs, I sat on national assemblies, uh, for the nhs. So what I found was I squeezed a lot in, in a short period of time. I think that's why I pivoted, um, later on in my career, having had a full career in surgery, which I didn't compromise on. So I'm glad that I had a full career and a very, um, satisfactory career, uh, that I've really enjoyed and I would do it all over again, of course, given the chance. And so I love being cliche and still, and I keep that practice now I work three days a month, two clinics, uh, a, uh, month, four day clinics at the Royal London Hospital and one theatre list a month. And that's just a case. I gave up the major cancer surgery and I pivoted round about 10 to 15 years ago when my life suddenly changed direction. And I guess I would call it a punctuation. In fact because I use that word is because I use it in my book and I talk about the punctuation of everything as a concept of how AI is going to change our world. So that's why I use that particular term. And we can discuss it later. So I pivoted, I saw the future. I saw where we were heading towards medicine. I really enjoyed uh, that part of medicine where we could almost predict that future and then be positioned to help create it or be part of that journey. So that's what happened about 15 years ago or so. Um, and that changed my mindset entirely about what was possible 15 years ago.

Speaker B: So what, what are we talking 2011

Speaker A: is my maths right there. So I think what I was always into innovation. I was a uh, kind of innovation thought leader in the world of surgery, doing new operations, trying to do new ideas into interesting. So I was always thinking about new ways of working. For example I bought in keyhole sewed to Royal London for cancer work and ah, we built the whole laparoscopic surgical practice from scratch at the Royal London which was quite late in uh, its kind of journey into laparoscopy. Then I used to do what's called single imprecision surgery. We took the multi port surgery into single port through the belly button. I did surgery through just one hole, tiny hole through um, the belly button, taking out whole colon for example. That was called single incision laparoscope surgery which I kind of was one of the pioneers I guess with that, ah, obviously I went to a lot of these centers with Johnson Johnson, Medtronic and Covid in a company to see how they're building their products and help them design some of the products for surgical practice. I was always thought to be innovative in surgery and I guess that's where my passion came from. Surgeons generally innovative and we're competitive by nature generally. And that builds that kind of, that creativity in what we do. Have experienced that my first foray into real innovation and disruption was the whole goo glass thing. You might recall, right?

Speaker B: I remember it well, incredibly well.

Speaker A: And that kind of changed my trajectory entirely. So in 2014, if the audience um, don't uh, know about this, let's share that story. I got a pair of Google glasses, um, and I streamed an operation live across the world using this smart technology. But let's go back a second about. I'll share the story with you in much more detail. So what happened Was I was teaching the medical school as associate dean and, uh, a lot of medical students around me. I was a passionate educator. One thing that troubled me in the surgical theater, which you all know, Jane, from your experience in and aesthetics in theatre, is the way that we teach in the operating theatre. And if you can imagine, you sometimes have 3, 4, 5, 6, 7 medical students, um, in the room. They come along for the entire day for theatre expecting some kind of learning experience. And the best part, they're ignored. They may scrub if they're lucky. They may even assist if they're very fortunate. But most of them will be in the back of the room being ignored for the entire day. I used to look at that, thinking, how is that learning? We expect students to come along, uh, with a goodwill, and they want to experience surgical practice. They spend 8, 10 hours a day largely being ignored in the operating theater. One or two may get asked a question or may even get scrub up if they're lucky. The experience has been poor. We've accepted that for a long time, uh, for decades. This is the way we teach surgery. Surgery, sadly, is built on dogma and tradition. It's what we do, it's how we do this. We don't want to change things because it's comfortable. So I was looking at new ways of teaching constantly for the surgical curriculum that I ran. I was head of surgery for year three and four and five, as well as being associate dean. So I had a bigger responsibility. How do I teach people better, to engage them to ensure they get good quality. So I was thinking about telesurgery and telemedicine as a concept. And the Google Glass came along. And the Google Glass obviously was a device that sat on your forehead. It had a camera, uh, you could see the display, it could recall, it could take pictures. I remember. I'll tell you something about when it came out. When it came out, it was 2014 and it was amazing kind of marketing campaign globally. So incredibly presented, uh, as this new wearable device. In reality, it was 10, 15 years ahead of its time. It probably still, when it came out, I remember you could apply to be an explorer with Google Glass. They opened up this portal on the Google, uh, saying, tell us why you want to use the Google Glass, the use cases, and if you're lucky, we'll allocate you a glass to be able to use it. Uh, as per your description, only open to the US and they selected 50 to 100 people who are going to be the first explorers. Obviously, I'm not from the Us could do it. Anyway, I said to myself, I really need this pair of glasses. So um, my FY1 called Sam and he remembers the story really well. He joined on the firm, uh, around September of that year. Um, and I said to him, sam, you've got one job. He said, what's the job? Your job is get hold of Google Glass for me. I will sign you off for your four months attachment, but you have one job. And so he took it seriously. Every day he phone Google, he'd email them, he'd write to them, he'd try to find out the right way to get hold of them. Uh, in the end he told me they've blocked me in troubling them so much. They just blocked all my phone numbers. And he felt really apologetic. But you know, I, I thought he was great. He did a really good job. And Sam now is a plastic surgeon. Consultant actually. So. I see. So then I saw this is the funny story. So shortly after it was released I was on ebay of all places, and there's Goo Glass for sale in the uk, in London. And this was a Friday evening. I was literally bored on my phone looking at a few things. So I, I text the person on ebay. He said yes, I have it available. I kind of um, um, uh, I'm in the uk, I live in London, blah blah. I said I'd love to get it. So he said fine. Sunday morning I met this gentleman, uh, at a coffee shop in um, uh, in, in central London, near his house. I had a long chat with him, we sat down, had a coffee. He was a investor from Silicon Bank, Silicon Valley bank from the us.

Speaker B: Interesting.

Speaker A: In pair of Goo glasses he couldn't find any utility. You know what, I'll just give them away. We had long term. I said no, I want to use it for training. I want to think about how we use it for telemedicine. He said that sounds a great idea, let's share that with me and I'll share with Google. It sounds a good use case. So I took it off him on the Sunday morning and during the Sunday I was playing around with it, etc. Walked around the streets with it, walked around the trains and whatever. People staring at me the whole time. Right. Because I had this thing I was talking to, I was messing around with it. His first one in the UK by the way.

Speaker B: Wow.

Speaker A: On Monday that week, I then um, was in my clinic. I called my two medical students, um, who are really good friends of mine and really good students, both very techie, um, Ollie, uh, and Ali, I said, come to my clinic. I've got a pair of good glasses. They were super. They ran, they, they. I think they just missed all their lessons. They came and played around in my clinic. I said, look, what I want to do with this is if I can do some training with it, do some live training. Can you see if you can figure it out for me? I gave it to them. They spent the next 24 hours working on this Tuesday came back and said, we think we've got it to work. We persuaded a company called Livestream to release their software to us before anybody else because they like what we're trying to do with it. So we had the first app on, the first apps on Google releasing just for us within 24 hours. Uh, and so we tested it Tuesday, the WI fi, it seemed to work. You could stream it live and send it out on their Livestream platform. So when Jess said, let's go to operate theater Wednesday. I played theatre on Wednesday to an open theater, which was, uh, there's no operations going on, but I was going to check whether the WI fi could work. Could I do it? What's the experience like? Just understanding it all. And it was all perfect, it was working nicely. I could stream it, we could watch on the cameras and on the computer, the laptops. I thought maybe we could do live operation with this. So I said, okay, I've got a patient tomorrow on my list who needs a right hemiculectomy. He'd be like, I'd be great if he could do. We could do live operation and just train my medical students. I hadn't thought about bigger scale at that stage. So I phoned him up. Um, and, uh, Mr. Paulfield was the name. I said, look, this is what we're doing tomorrow. I just want to see if I can teach people on a wider scale. Um, with your consent, obviously, we'll take every precaution. Blah, blah. Um, yeah, my patients are so supportive of me and my work. They have been all the. And so, of course it's for you. Of course we do that for you. It'll train people in the future. You have my consent. Absolutely. I talk, I spoke about the risks and the benefits of that and how I take caution and precaution around that. Then we thought we'd better tell the hospital. So I phoned up, the medical director said, this is what we're going to do tomorrow. Is that okay? You know, I, uh, better talk you through it. They were shocked. First of all, I was going to

Speaker B: say, I Wonder what that initial reaction was.

Speaker A: But what they what was really surprising then. Shakti, we love your innovations. Let's see how we can make it work for you. It wasn't enough. So much bureaucracy in this meeting. I will see how I can make it work for you. Within a few hours, you've got all the team together, the ethical team, the legal team. Everybody's saying how to make this work for Shafi. What are the processes? What are the risks here? Within a few hours, they figured it out. So all you got to do for our perspective is put a delay of 30 seconds to a minute. So if something goes wrong, you just stop the operation and carry on. So that was the only precaution they had. And of course, adept consent, et cetera, et cetera. Then, um, somehow the major TV companies heard about this and we were inundated with sky, itv, BBC, Al Jazeera, uh, all saying, can we be a part of this? We heard about this, right? In the end, we selected ITN News at 10. They said, we'll send the team down, blah, blah. So on the day of the surgery, which was Thursday, only three days since I had the glasses in my hand, we were then going live, which is the right hemiculectomy, cancer surgery, to a global audience. And we did. The operation went really well. I was teaching people in real time. Um, and when we looked at the feed, I Talked round about 14 and a half thousand students across the world in real time. Um, and what they could do, of course on the app was they could type a question onto the app which would come on my glasses as I was doing the operation. I remember this, yes, I could read the question, um, and then respond to that person who's asking the question with their phone and answer questions real time. So it was a live interactive operation, first of its kind to a global audience. 4,500 students in 118 countries joined that live feed. And of course ITN covered the story, is the main headline news in IT news at 10 that evening. And that was the transition because it worked. It seemed to be a good way of teaching people. It was using Google Art, which was an entity that had a lot of controversy around it. But it's a good use case. So that was my first real attempt to scale education using that smart technology. And that's what kind of put me on the map initially as someone who's a disruptor and innovator, uh, because merely want to say, how can I teach better? How can I improve what we do already do I have the technology available. And that's when it came through. That glass gave me the utility to be able to educate people on a global level. And I've always paid. One of my passions and my kind of mantras is, is this, um, one to many, we teach one to one. Uh, and that's great. It's good approach to teaching. We can teach 1 to 2, 1 to 3, 1 to a few people in an audience, 1 to a few people. Remember, on a kind of, perhaps a teaching session. This was before COVID where before there was telemedicine, before there was this dissemination of remoteness. I said, the future is going to be remote, it's going to be virtual. And, um, we're doing that for long term. That's why they call me the virtual surgeon. So this was six years before telemedicine or teletraining or telesurgery became real entity because of COVID And so, uh, people thought I was a maverick. Some people, people thought I was pushing the boundaries too quickly. And whenever you do these things, there's always consensus that this is dangerous, what are you doing? I mean, kind of thing. At the same time, they'll say, this is great. This is what we should be doing in the future. So you have to manage that as a clinician, a senior clinician, you know, you have to be very careful and mindful of the criticisms, the critique that people give. And, um, I was very mindful of that. To ensure that what we were doing was safe for the patient. I get the kind of value it might bring. It's. My first question is always, is it safe for the patient? Am I being unsafe? If I'm being unsafe, then that's. That's unforgivable. And that's. I couldn't do. And with my boundaries, if I think I'm being safe, not causing a risk, then I'm comfortable personally and I can justify what I do. So there's always been a delicate balance to make sure that we.

Speaker B: Can I just ask you about that. Shafi, just. Sorry to interrupt. I, uh, think that's. It's an interesting part, I think, of being a true innovator and breaking new ground in healthcare in that it's a complex system, it's a rigid, ossified system. And any attempt to bring something so new and not very well understood into it, something so modern as at the time, Google Glass, VR, remote teaching of a live surgery. There's so much fear, I think, in an ossified system like the nhs, that so many things are going to break that understandably, yes, you'll have faced a lot of criticism. Now, I think this is important just to double click on a little bit. Um, you got me in a tech mindset now, so I'm saying things like doubleclick. But, um, can I ask you how you dealt with that? Because I think as a practicing at the time, NHS consultant, you've, like, we, we, we're, we're, we're trained to be very empathic, right? So we're very receptive to criticism. And as medics, we don't like it. We're very high achievers, that Straight A's, captain of sports teams. We're, you know, we're always teachers, pets, if anything. And so to face a load of criticism from the very people that you are actually trying to help and push forwards into a new world that you believe in, you can end up being criticized by people that you actually respect quite dearly as well, like fellow peers and fellow innovators, even in different ways. And so I wonder, uh, for people. And the reason I think this is important, right, is because I think there is plenty. There is so much innovation locked up in people's minds that have got plenty of healthcare experience, consultants, registrars, etc. Whoever. But there's a fear of if I try and do this thing, I'm gonna face criticism. So how, how did you, how did you deal with that? Huh? Did you expect it? Did you plan for it? And yeah, did it hurt you? Did you, like, how do you push forwards in the face of all of that?

Speaker A: But yeah, that's a very good question. And I guess, yes, you face a lot of critique and criticism after these things because people want to bring you down, right? There's a lot of people that just want to see that as well, is part of medicine. There's a professional jealousy that you might get that's slightly different. You can kind of ignore that because that's just, uh, people trying to compete. What I've always been mindful of is, um, if you look at the response I got on social media, uh, through all the channels, FIT at the time and everything else, we had so much response about this procedure, as you can imagine, and 99.9%. So it's amazing, fantastic. It's kind of, wow, you do this incredible stuff and that's great. Um, and that's very supportive. But the bit I was more concerned with is what were the criticisms? What could I have done better? That's the thing I was interested in. And I looked at those in much more detail. I Looked at those who were complaining about something or saying, this is an issue, Shafi. That's what I needed to be learning from. So I took those on board, say, okay, okay. Some of these are quite generally sensible and about, you know, if something goes wrong, what do you do? And do you comfort zone? Are you doing it for yourself rather than the kind of bigger picture of education, for example, really pertinent questions. And then one person who is really useful. He was called online as the if I can get the skeptical surgeon or skeptical scalpel. I can't remember what his name was,

Speaker B: but he's a great handle, by the way, the skeptical scalpel. That's amazing.

Speaker A: He reached out to me via email, saying, shafi, uh, this is who I am. He's a surgeon. Um, and he said, I've looked your operation in great detail, and these are the things I've commented on. I'd love to get your feedback on it. I love to talk to you about it. I didn't see the email first. I ignored it, got busy. He went to me again, shaka, we will talk to you about this. So I engaged. I said, tell me what. I'd, uh, love to get your thoughts. And he gave me such good insights, saying, this what I thought, Shafi, this is what you could have done. This is what you need to be doing right? In a very supportive manner. So I'm being skeptical for a reason to support innovation. So I remember him really well, and great conversation. Initially, he just thought I would entertain this conversation. He's really pleased I reached out to him and said, this is important to me to know how I've done what I could have done better, what I could learn from, and how do we take this further forward? So my view is always take those criticisms on board. Learn from them. People generally want to help support you. They also have reasons to get touch with you about how they feel things could be improved. That's the essence of it all. And that one learning from me then led me to do all the other innovations, which we'll talk about in a moment, to make that better, to learn from those. That was the first experience anyone in the world had done this before. Right. So you're not sure about where you stand from the legal framework, from the, uh, patient's perspective, from the. From the. From the family's perspective, which are, uh, the Royal College, maybe the college were. So my boss at the time, Sir Norman Williams, he became the president of the rcs. He himself was very innovative. When he appointed me at the Royal London, he Was known to be an innovative surgeon. New operations, new techniques. His whole life was littered with innovation. And that's why he pointed to M me. He loved what we do together. He said, shafi, you have my support when you come here. You have innovate. I want you to do that. I'll support you. So I had his support entirely. The College of Surgeons sadly couldn't reflect that, uh, as boldly because it's too limited for a lot of people. It's too disruptive. And the college itself, as you know, is rather old fashioned at the time. Needed some modernizing. We're kind of stuck in the old ways of thinking. So that was always in contention with your own college was going to be, um, not as supportive as they might have been, but with good reasons. So if we take that experience, which was incredible, two years later in 2016, it was, I think it was. I decided to go one step further. I thought tenant medicine is about being remote. You're here, someone is in the middle of some other country and you're communicating in real time. What if I brought the audience into my theater rather than being separate? How do we bring them in? This was the world's first VR surgery. The next step on this evolution. So again, we managed to building VR tools at the time and we said, okay, what if we put a camera, a360 camera in the OR and everyone in their headsets, uh, or the VR headsets could then just beam into our brave theater and be with, around me almost. Right? That was a really big undertaking. So again we did this and this was a really crazy story, right? We created this whole concept, created the platform with some colleagues working another company who produced the cameras. And there was no real cameras. We had to literally design and 3D print a carousel that could house six GoPro cameras. We had to create it and, and then clip them all. Clip them all at the same time. They'll take the videos and we could then, um, capture that and then make it to a single feed. That was 360 before it'd been done before. Now you can do a camera. It's really easy. It hadn't been done before. So, um, some colleagues that had another company, they built this housing the camera systems. They came on board. We then went live. Um, in March again, a similar operation in virtual reality. This story was incredible, which I will share when I write my book on this. The hospital work all over it because I've done it before. They're very supportive. They went through the same process of governance, ethical, legal issues. And everyone was happy with it. This time we had Sky News who really wanted to be part of this conversation. And they came into theater my two bathroom at Sky News ii. So we had cameras everywhere already set. Um, the Trust actually gave me a small fund to buy, I think it was like about a thousand headsets. Google hubbled for the entire trust.

Speaker B: Nice.

Speaker A: I would give them away. So everyone in the Trust is part of it. Pharmacists, you know, nurses, doctors, Everyone was walking around with these um, virtual headsets. Google cardboards. So we've got those built. And then we had medical students in the theater next door at the uh, Barts Medical School. They were the house in the big lecture theater already watching the stream and having their headsets in real time. Uh, and Sky News was there, ah, in both audiences in my theater and with the medical students. For the first time ever, we went live VR, uh, stream live, uh, globally and that day. So the first number I'll tell you about is that it was streamed to um, try Mohammed was. Yeah, it was 55,000 people in 160 countries around the world in real time. Okay. That's when people were visibly on the app watching the operation in real time with me. I was answering questions, interactive sessions, etc. So Sky News even crazier were in the lecture theater and in theater. And it's during the afternoon of that day I was operating, what's two, three hours operating. Okay. They would on uh, Sky News Live on Sky News tv they go uh, in and out the operation during the news channel. We'll go back to live theater, what's going on, what's happening back to main news and then back to the OR and the medical students. It was like a real afternoon show live on Sky News tv. It was really incredible. They loved the experience. They shared it widely. And then that went global. And uh, the story that I came across, uh, a while ago, I sent my son only a few days ago and had the story. I was famous in China before I knew I was famous in China. I had billboards about me and you know what happened? They heard about this China and uh, they got billboards about the date of the operation. Me and what I was doing. I had no idea. Across China they took the feed from our sets, uh, from actual stream and uh, pushed it across China. So we think hundreds of thousands of people watched the operation. Now we have no idea how many people watched it. Right? We have no idea. But I became this icon in throughout Beijing. I had no idea until I went there. They showed pictures of me on, um, these big walls, me and the VR headset and stuff. It was a really funny story. So that was a real interesting, uh, concept. The next one I did was, um, okay, this was again, 2017, a year later, again. What I do, once I've done the operation, I don't do another one. I stop, pause to understand what we've done, and I just go for the next one, next one. I think that's dangerous. I reflect back on all the criticisms, all the, uh, feedback, uh, that people have given me. So blood was okay, Actually, I will tell you one story about that, which is, again, to me, mind blowing. When I did the operation, I had consented, the family and the patient, um, they're really happy. So, Shafi, that's great. We will support you, our father. We'll support our father through this. And we're happy for you to do this. Obviously, important to get that proper informed consent. And I did it two or three times before the operation to ensure them change their mind. They understood the process, and they're very supportive when it comes to education and training. Everyone would love to support people globally, right? To democratize education. And so I remember I finished the operation. Broadcast went well. I came out the room, and I came to find the family, as I always did, to speak to family about the operation. I met them in the corridor, sat them down. I said, this is how the operation. They said, don't stop there. We watched the operation.

Speaker B: Brilliant.

Speaker A: And that, uh, my jaw dropped. We spoke live, and we were really relaxed and very comfortable. Because normally when you have an operation, you don't hear anything. What's going on? You go out in the distance having coffee. But we watched what was happening. My father was in good hands. We could see he was on the right operation done. So we're thankful we could watch it. I never thought a family would be watching a live stream of their own dad's operation. That kind of. It blew my mind. I didn't think about that. And the consequence of that, it could have been alternative. It could have gone wrong. For example, the risks around that, that really made me pause everything, thinking, you know, this is not just a fad. It's not. It's not television cinema. This is about real lives and real patients, right? So we have to really careful. So that's really the next step from that, I thought, was the, uh, the really big one, actually. This was the, um, Snapchat surgery. So a year later, I was thinking about, you know, what's next? Um, how do I teach people in different ways. Ah, Snapchat, obviously, the social media platform came out with their spectacles. These were fun spectacles that you could click and it record ten twenty second clips, um, onto your stories, for example, and you could create some nice narrative around it, nice emojis, make it useful and it would go into your story. So I got these spectacles really early, right, um, from America the day they came out thinking, how does this work? Um, you know, these are glasses, you can record social media. I, uh, thought would this be a utility for training? Hadn't been done before 2017. So I thought about, you know what, here's the deal. I'm not young, I don't really use Snapchat. I don't understand it very much, but I do know it's my students use it, it's their model and it's their platform. If you look at the users that time, There are about 200 million users per month on Snapchat and 80% were between the age of 17 and 25. Now for us it's irrelevant. What does it matter? Actually I thought, no it's not because those are my students, uh, every day on those platforms. So I thought I would do an operation on social media. So fast forward 2017, it was a Friday afternoon, I found a patient, went for consent process weeks before. This is what I like to do. You happy said, of course is on social media. No, no, I'm okay with that. So what we did, we, I did a hernia operation. Hernia is nothing difficult. It's a standard operation, takes an hour, right. And it's predictable. So I said beforehand, I said, okay, what are the clips that be useful? So we break the operation down into about 20 segments. In my mind, these are segments I can use for training. Then during the operation I had one of my assistants click the button every time I want to record it. So record this bit generation and push it to my story live. I'd asked 200 of my medical students, closed environment, just give me feedback. This was for me the ultimate risk social media platform as before, right? So what we did with them, we did these 20 second clips pushed to my story using some OGs and some nice ways of learning about hernias. And we pushed it out. I was this one, I was really worried about the other two. I was in control. This was something that I'd been uh, unclear about by the impact. Anyway, at the end I got some feedback from them, said, how did it go? They said, this is great, blah, blah, a lot of good engagement. I tried to close the system so that we could control the output. I thought it was a relief. Okay, it's gone fine. Patient's gone home. I'm happy. Fine. I got a phone call from a friend who was a journalist. Jack, I know you're doing this. Can I share a story? You can now, because I finished. I'm happy with it. It's gone. Well, do share a story. So he shares a story on some, uh, journal, a tech journal in the US And a lot of people were interested. That was on a Friday evening. On Saturday night, I got a phone call, uh, a plus one number from the US Randomly on my phone. This was eight or nine o' clock in the evening. On Saturday, I was at home with the family. I took the phone call. I wonder who this is? And the, uh, person on the other end of the phone said, you don't know me. Shafi'. I. This is Olivia Laurent. I'm, um, the editor of Time magazine. And I got your story. I've got your number from friends. I heard what you're doing. I'd love to share your story if you're up for it. I am prepared to come into the office on Sunday morning to interview with you about what you achieved. So this was really interesting. Sunday morning I went to the hospital, jumped on the call with Olivia Lauren. We shared the story about what I was doing and stuff. And that day he pushed the story out into the wide domain. It just blew up.

Speaker B: Yeah.

Speaker A: Every social media platform, every journal, every newspaper covered the story of the next few days. It went. Imagine, every news station covered the story. And people, even, uh, these Hollywood A listers were pushing out. They thought it was a great story. Right. Ashton Kutcher shared that story to his entire audience across the world. Right.

Speaker B: Big in tech now, isn't he?

Speaker A: Yeah, he's into tech. He's the best in tech. Mhm. And so when we looked at a month afterwards, because I did the operation, they covered it, they shared it. Mashable covered it. AJ covered it. All these, uh, now, this, the future, they covered it. Small bits of video. And it was watched. We think. Well, we saw the numbers. It was watched by 50 million people in 30 days. Yeah. Ah, it just literally went everywhere. And that became the real scale of that procedure. And that really put me. The others were huge for me, globally. This put me in the international limelight because suddenly people use social media in a different way. Got me an article in Cosmopolitan magazine, for example. Right. They covered my story in Cosmo. Every tech journal was interested. The last one of this Foursome I talk about it was like that year, uh, where we developed some software for holograms and, uh, avatars. So I did the first hologram surgery where I was in theater with a HoloLens on, um, a augmented reality device. There was two other surgeons around the world, one in India, uh, the team in us, who in real time with the avatars, were in my theatre at the Royal London at the same time. And we're discussing a case. We got the model out, the anatomy, the CT scans, three of us in real time, three time zones, three countries, or as avatars in my. Or in real life. Okay. Talk about a case. So that was the first avatar hologram surgery. Those are the four things I really pushed hard, thinking this is how we connect. This would become virtual. Remember, this was three years before COVID hit us. Yeah. And so I experimented all these ideas, and then we experimented with AI at the same time trying to build an AI platform for this. So I was kind of predicting this is where we should be heading towards. And, uh, those are the four things that people may have not heard about. And I haven't shared for a while because it's now in the distant past for me.

Speaker B: Yeah.

Speaker A: But those are things that gave me the energy and the. I guess the. The credibility of innovating in that space. Pushing the boundaries, if you like.

Speaker B: Yeah. It's an amazing story, Shafi, and thanks, Sharon. I think there's. There's so much in there that's. That's interesting to me, but I think if I was to kind of conclude almost. I think what's what. What almost seems disproportional or particularly fascinating is the scale. And it's. And it's funny how quickly the world can sort of adapt and adjust. To what? To a new normal, I guess. But in the moment, it was so unbelievably groundbreaking. And that's what brings so much attention. And because it's not been done before, you get all of the kind of emotive. And we're humans, you know, we're emotive creatures, you know, of course, like you. You'll get the emotion of excitement and passion. And people love the new. But similarly, there's obviously people on the other side that will worry about risk and danger, and they'll feel very passionately about those. And, uh, you know, it's an attention economy, isn't it, where those two collide? Then all of a sudden there's even more attention on it. But I. I think for me, the interesting thing about who you are that I'm learning now speaking to you because you've never actually sat down at, had this conversation before. What I'm learning about you is you're the, you're the guy that will break the new ground and actually show the rest of the world what's possible. And actually I think that requires a certain skill set in order to do that. And what's funny for me is that I talk about innovation a lot as you, as you well know. Like I'm out and about on um, panels and doing talks about the ingredients of innovation, particularly in health care. What I think is fascinating is that yes, you're a tech guy, you love tech. There are other people that love tech as well. But what you were able to do that set you on this entire path that no one else was able to do was get a hospital to agree within 72 hours of you holding a Google Glass in your hand that you were going to put this in surgery and actually get this done. You know, the amount of people, they say it's all about execution. Everyone's got the idea it's all about execution. Everyone thought, what if I could order a cab on my phone? You know, was it Travis Uber? That guy went and created it. You know, uh, I think what it comes, that what innovation comes down to in healthcare, and I say this a lot, is relationships. And I think the most innovative thing you ever did was develop the equity in those relationships and the belief that people had in you, that this is someone and something worth backing, that you've got a whole group, group of people who are incredibly risk averse for the right reasons, as you quite rightly pointed out as well, they're risk averse for the right reasons because they've got an NHS to protect, they've got patients to protect, they've got, you know, all of the status quo that has emerged for all of the safety reasons. It has, they've got all of that to protect and yet they believed in you and yet they, they decided to go. I don't know what the upside is. Potentially there is one, there's a massive downside, but hey, we're going to do it anyway and we're actually going to figure out a way. And I think that's the thing as well, what you said, you know, we're going to find a way to do this. We took, uh, you know, I'm on here a lot. I feel like talking to people over 500 episodes of this. Like people talk about the NHS being in, being very difficult to innovate in it's very. It's a. Not very innovative. I think you're challenging that narrative quite clearly, because the NHS is made up of people and there are innovative people in what might be an ossified structure, but there are innovative people and innovative people find a way. And I think what you had and what you garnered and what you managed to, uh, galvanize people into doing was finding a way. And I love that because it backs up this thing that I just believe wholeheartedly, which is that innovation is so much in healthcare, about building good relationships with people and getting them to believe in you. And I. I love your story for that. And I think where you then convince people and it goes well and it goes right then are able to do it again and push a little bit further. And push a bit further. I love the bit we said about you. You take the time to reflect as well, because I think that. I think that said, that's the thing that people worry about in healthcare is that, you know, move fast and break things might be fine in tech, but you don't want to do that in. In clinically facing innovation. You do not want to move fast, you do not want to break anything. And actually taking that time to reflect and take criticism to heart and all that sort of stuff in order to build the next phase even better. I think it's a really nice story, I think, of how to innovate in healthcare and do the right things. And I'm so glad that it rewarded the relationships that you'd built over a huge amount of time. What's it like reflecting on all of that and, uh, looking at it as a whole?

Speaker A: I haven't spoken about that for a while, actually, because I kind of forgot those stories, which we all share at some stage in an autobiography. Going from what you've said, I think there's two things that come out of it. One is leadership. Yeah, so you're senior, you said, and you have credibility and people respect and trust your decisions, which is built over 30 years of clinical practice. It's not just come overnight, they trust you. You've had leadership positions, you've built cancer services, you've had good outcomes, you're respected in your profession. And then search trust. So then it's about understanding the problem you're trying to solve. Okay, here's the problem. Schematic glass. What are the issues here? Yes, we've got a utility to stream. So, okay, fine. What are the barriers to that? If I have to go to do live stream, how do I articulate and Define those limiting factors, the barriers for care, the risk for patients. Okay. Right. Let's get consent, proper consent. Go through the process of, um, not once, two, three times, have the conversation. So sure, they understand and you're transparent about the process. Okay. Legal framework, what does that actually mean? Uh, things go wrong, there's a certain factor. What can we do? Right, let's put delay in the feed. That's fine. Doesn't be absolute life. It can be minute to minute, doesn't matter. Fine, they're happy. That means we can stop the operation, stop the feed. If things go wrong, it goes wrong. What's the framework of conversation with the patient and the relative? What do we do? There's a framework. Okay, in what about infection risk? How do we manage that? So there's a process, we manage that. A, B and C ensure that what we do is very clean and whatever. Okay. During the operation, who's going to manage people? Goes wrong, for example, so it happens to me. So you look at all the problems you might foresee and you solve them as best you can. You mitigate risk, you can't reduce risk entirely. Impossible in medicine. We can say, I predicted these outcomes, things that may have gone wrong. We have a process in place to avoid that as much as possible. Medical director, here we are. This is what we've discussed. Are you happy with this? The way we thought about it, the structure, the conversations, the right people in the room? Yes, we are as safe as we possibly can. And we will support you with innovation. If you just go and start doing something without that thought process, then you become a maverick. And surgery is littered with mavericks over decades and centuries who've just gone down something without any thought around the process. So for me, it's more about leadership, having someone who understood this process. And I remember I'd been innovating in surgery long before that, um, in surgical practice. New techniques, new ideas, new surgical operations. So it wasn't completely immune to me. To understand this is the process I need to go through, methodical, sensible, safety being paramount. Suddenly, actually, you can innovate in that framework. Uh, and then, of course, being able to take criticism, to get feedback, to re refine your processes in light of what's happened already and that introspection and flexness required to ensure that you're safe going forward, you don't get carried away with the optimism of the public who thinks it's amazing. It's very easy to get wrapped up in the optimism and the euphoria that comes in the innovations, saying, no, no, I need to be much more sensible about this and we think about it very carefully in my own mind to make those choices. So that's what it taught me and that's my reflection on this. Not just about innovations. Yes, it's great, but what was the learning around that? Innovation. And, you know, innovation can happen at scale. It can happen and it just does provide that support. But it requires leaders, it requires disruptors to say, we want to do this. What are the barriers? How can you help me? Can I become the barriers and taking charge of that conversation, if you don't, nothing will happen. We're sick in mediocrity, um, and there'll be no innovation or lack of innovation, which is what happens in hs. So we blame lack of innovation if then people around it, do you have the rights, leadership, do you have the right people to make those choice decisions, to navigate through potential issues that might arise? That's what it taught me.

Speaker B: Where does it go from here then? Because it was a really interesting criticism, actually, that you mentioned. You know, are you doing this for you? Are you doing this for the patients or are you doing this for the medical students? Are you doing this for the good of medical education? You know, it's an interesting, it's an interesting question and it's an interesting criticism, but clearly you're someone that cares about teaching. Whenever I've heard you speak, actually, I've always been, like, really, like, genuinely impressed with, like, how good of a, an educator and a teacher you are. Because, um, yeah, it's always one thing that's actually struck me when I've seen you, when I've seen you present. But, um, it's clear, because I know your career, that you care about teaching. So how. I mean, I can tell you actually that by breaking ground like you did, you changed what people thought was possible in medical education. And then entire businesses get built behind that. Uh, and they have. There are entire medical education VR businesses now. There is, you know, the likes of what PROXMI are doing as well. There are like, there's. There's loads that comes out of what you did breaking new ground. And so, you know, for a lot of that criticism, I just want to say, like, is this not enough stuff? Like, all these entire industries that have been built as a result? Um, but how did you, how did you serve you. How did you serve your own desire to educate beyond that? Because it's not just about one video. I mean, one video is great for when it's the tune of 50 million. Um, but. But where did you, where did your passion for this lead you? Did you continue breaking new ground at other places? Did you focus on building something in one area? Like what did you do after this?

Speaker A: So it led me on entrepreneurship. Um, I've always been a bit entrepreneurial, uh, throughout my surgical career. Built various companies, um, for surgical practices, that is, but then opened my doors into tech. Because suddenly you are a successful tech guy, uh, almost. Now you have many opportunities that would come your way without you realizing it. So I built a VR company, XR company called Medical Realities. We pushed out the boundaries of medical education, VR and simulation. We built over many years. I worked with companies that built the metaverse to go from that into avatars, holograms, uh, virtual worlds called Ayomedis. Uh, we built some virtual worlds for training, for simulation. Um, we built some other augmented reality companies for surgical training and remote training, for example, so led me to do that. But since then, of course, I've built many companies the last 10 years in different medical tech verticals. From uh, an events company, from a publishing company to agency, health agency that we have also, uh, I've sat on many boards, uh, across the world, supporting big, um, blue chip companies around the innovation platforms. I'm an advisor for governments on the flat of innovation across the world. I've traveled widely as you know. And then I became this kind of, uh, international keynote speaker, which was not by design. My role in surgery was not to become a speaker, but I've become a speaker as uh, a result of this. That you're a, you're a thought leader and someone who innovates and disrupts. And I been on the circuit for about 10 years now. Speaking of the biggest global events, um, again, I learned that from scratch. So what I've done now is I'm still learning, um, and I left full time clinical practice at the age of 50. I thought, I've done enough. I needed to move on. I took a sabbatical for a year. Uh, that was an interesting sabbatical. When I came back, I realized I'd moved on, my life had moved on. I hadn't missed surgery as much as I thought it might miss it. Despite it being my DNA, I needed to achieve more. And so I made those choices. Uh, at the height of my clinical performance, I was at top of my game. I had leadership roles, I had a huge private practice, huge clinical practice. I was a national leader in surgery. I was in the RCS Council, for example. I came back to my sabbatical, I said, this is not what I want to do the rest of my life. I gave it all up. I gave um, up 80% of pay. I gave up my entire private practice where I built them for 10 years, thinking this is not going to make me happy in the long term. What I want to achieve, this isn't going to give it to me. I love surgery, I want to have more impact. And um, now I think about my life in two things. If I get opportunities coming my way, I have my inbox always full of different opportunities. Ask myself two questions at my stage. Does it have impact? Will it leave a legacy? If it's yes and yes, I'm gender interested. If it's no, there's other people out there far better suited for those posts than me. So I have autonomy, I've controlled my life. I do things that I'm passionate about and I travel widely. So I love the freedom that I have now that I've, I've, you know, that, you know, by God's grace, I've been given this opportunity to have autonomy, freedom, still do clinical work, but do global health impact. And so I have a real portfolio career, I guess what you call it now, right. Which is not something I had imagined being a full time clinician, academic. So I enjoy either. I do, I travel to 20, 25 countries every year for the last five years, speaking, working with governments and all sorts of things. And it gives me opportunity to work with entrepreneurs, build businesses, uh, advising governments, NGOs, working humanitarian, uh, regions and conflict zones that I'm passionate about. So it gives me the kind of experience I really yearn for. I did a lot of teaching IMBA programs globally, aiming teacher Sudden Bosch in Cape Town, South Africa, teaching the cohort of African uh, leaders on the MBA program, for example. So I see my role now, um, transcending just a single practice in the Royal London. Don't get me wrong, I enjoy my job there, but it doesn't give me the impact that I want and the legacy that I'd like to leave behind personally. And so all these innovations of what I'm doing for the last 10 years has given me this opportunity to do something much more profound than I would imagine doing a single clinical job until I was 65 and I made that choice, um, and took a risk at the age of 50, right? It's a big risk to giving up your entire career. It wasn't like I was unsuccessful. I had a very successful job, top teaching hospital, being an academic and everything. But then say, this is not m enough. People actually thought I was crazy. They Thought he's going through midlife crisis. What's he doing? You know, what's going on? And they thought I was, what m. Am I doing? But now they come back to me all the same. People say, shafi, how do we do what you do? How did you manage and now teach about career pathways, making choices? I do a whole, uh, lecture on personal branding and career pathways at the business school. Tell them about how they should approach the next parts of their journey, um, in healthcare, and how much they can contribute. So that was the kind of story from that perspective, and, uh, the story that your audience would love to hear is when I took my sabbatical the year before COVID um, I had this invitation to go to Bolivia to build a hospital. I'm not sure you ever saw the video. I will share that with you. Ah, James.

Speaker B: Yeah, send it.

Speaker A: The whole story of Bolivia was a fascinating one. But because of my innovations and groundbreaking news, I got a random offer to go to Bolivia to meet them, uh, to build something extraordinary. Hospital and medical school. Right? And the whole story you can see on the video, Wired, uh, Health, uh, called the hostel of the future. It's my funniest ever, uh, talk that I gave for about 15 minutes and still for why they still think it's their most popular talk ever. Right, because of the story around that journey, uh, to Bolivia. So do watch if you get a chance. It's on the. It's on the YouTube.

Speaker B: You described it as a portfolio career. It's kind of like the ultimate portfolio career, isn't it? Like, it's. It's. It's. Yeah. Um, what was that advert? If Carlsberg did portfolio careers. Something. Something along those lines. Um, yeah, it's.

Speaker A: It's.

Speaker B: It's interesting. One question that I have is that when you're looking. And actually, I know you're probably sick about talking about your book, but given the recent launch. But I will. I will press you on that before I let you go. Um, but before I do. When you're looking at, uh, getting involved in something now, and am I asking this selfishly? Well, kind of, maybe, I guess. But you talked about impact and legacy, um, as like, being a framework for making the decision about, you know, do I get involved? Do I not? Uh, you have a lot of opportunity. You can choose to put your time into certain things. And you, as you rightly say, with a portfolio company, you don't have the one single business that you're CEO of. Your CEO of Shafi, Inc. Inc. And Shafi Inc. Needs to Distribute Shafi's time to certain activities and find the best opportunities. You know, you've got a lot of hay to sift through to find the needles right, that are, that are in that inbox somewhere. So when you think about impact and legacy, what is the impact and legacy that you want to have? Like do you have, do you have, do you have a vision for that? Is it, is it more nebulous and just a feeling? Is it certain clinical areas that still light you up? Is it certain patient groups that you really want to help or populations that light you up? Because you're very global and you're very, it's, it's, it's very disparate. The things that you, that you do. And I mean, I mean that with love. Like it's, it, you're wanting to have a great impact it seems, because it's, it's quite spanning. Like all that stuff you're talking to you from a longevity clinic that you're on the board of, for example, you know, that's obviously something that you, you, that you believe in. And I've done, you know, a lot of stuff with the Necco events recently and having Yalmar on the podcast and I've learned a lot about, you know, where we are, prevention in the uk and I'm finding the longevity and prevention space fascinating myself. Um, and drawing the line between that and the public sector, by the way, is the bit that I'm really interested in and I'm really enjoying learning about that. Um, I can share some, some of, some of our write ups with you on that actually, which you might be interested in. But anyway, point being I'm interested in that framework. So like what does impact and legacy actually mean for you?

Speaker A: So look, my view is this, as you get older, you have less time to think about what you'd like to achieve. Yes. Um, and I'm in the twilight of my surgical career in the sense. So if you think about surgery in the vertical that I'm in, colorectal surgery, uh, in cancer specifically, which was my special interest, you have a lot of patients in one locality in the eastern of London. And I work in, and I chose to work in a part of London, a, uh, place where it's under resourced, you have ethnic diversity and you have a huge poverty. That's where I chose to work because that's where I see my life being much more impactful. Right. I had offers as consultants in other places that were much more affluent, that didn't have the same level of uh, disparity so it's always been my driver to think about health care more equitably. So that's fine. And I do, I'm really pleased with that. But then think, okay, as an individual, where could you have great impact to populations, to large amount of people by, uh, working that vertical is very satisfactory, don't get me wrong, that could I individually have a bigger impact either on policy, either on strategy, or on innovation, either working in conflict, so where, uh, your skills are really required, or using your skills to build companies or to work with an NGO or to work in different countries. I'll give an example. Uh, things that I have done. So I do talks all the time. And I got this random call saying, can you come to Jamaica to come and give a talk? Now I haven't really thought about Jamaica or the Caribbean at all. Um, but I love going to new countries. I've now been to 70 countries over the last 10 years.

Speaker B: Amazing.

Speaker A: And so they reached out to me, said, shafi, we'd love you to come here, we can't afford you. Um, would you mind, would you come and assist the Caribbean to think about innovation strategy and your legacy will be long term, but we can't afford you because you charge too much. Um, I don't think I charged too much, but clearly it was. And so I said, let me get on the phone with you. I said, what do you want to do? So look, it's us, we're early now. Innovation phase. We try to set up this whole innovation program for the start. Would you come? I said, you know what, what, what's the budget you have? I said, fine, that's enough for me. I'll come. Don't remember the budget. It's not a big deal. I will come because you asked me. And what your impact is going to leave is much bigger. So I went and gave a keynote, spent a day or two with them, visit the hospital, spoke with them, um, and I walked away. But I know that sets the seat something much more profound long term. You won't see what's happened in five to 10 years time. People in that room, the leaders, take your ideas, get inspired, build something, a health system that's much more powerful. Uh, think about some ideas, for example, you change their mindset. That impact you couldn't have in any other way. So you might m. You might not be immediately visible or demonstrable, but you've left a legacy. I remember when I was in Abu Dhabi and I was asked to go and become an advisor to the government for a Year I went there, spent time with them, um, you know, about, talked about innovation stuff and we create strategy. And I did my year, then I walked off. But one of the senior leaders said to me, shafi, you have no idea the impact you left. We are now where we are with our strategy because you came to see us that one day and you became our advisor. You won't understand the impact you had long term. But we took ideas on board. We are now really innovative. So you never know where you sow those seeds, where it leads to inspiring people individually or collectively. I share one story with you actually, which was really powerful, which you have no idea about your impact. Well, I did that Snapchat surgery, the story I was telling you about, I pushed to my story and a lot of people watched the operation on their Snapchat feed. So one day I was doing one of these operations because we'll do a few more after that. I said to the audience, you know, tell me about yourself, where you are watching it from and who you are. I'll often get to know the audience because otherwise it's just me and this social media platform. I remember there was one girl who wrote back to me and I can't recall her name. It'll come back to me in a second. Said, hi, this is so and so. I'm a third year medical student. I'm watching the operation from the Marianas Islands. I said, wow, where is the Marianas Islands? Right? So I Google earthed it and went to the Pacific Ocean, kept going in, in, in tiny island of 13, 000 people in middle of Pacific Ocean. Who's connecting? And I was training her and she was so grateful for the opportunity. Right. That really was a story I told of my TED talk. So I connect to that person and my TED talk, one of my TED talks was called Connecting a billion Minds. So my role is how do I connect more people? Yes, Peter, uh, demandis often. He's uh, the obviously great entrepreneur and innovator in the US and, and I met him a few times at ah, Singularity and things. And he said this great stable, he used to say to earn a billion dollars, you have to help a billion people. If you have a billion people, you're a billionaire. That was his concept. Okay. And I asked him, actually do something if you want to help a billion people. Let's go back one further. Just connect their minds. That's the first step in evolution of becoming a billionaire. Ah, if you wish to become that, if you connect people's minds, then you've done a much better job. So Connect a Billion Minds was one of my TEDx talks. And that's kind of a thought process around connecting, scaling, sharing knowledge on a wider level, um, and scaling your ideas, also understanding other healthcare systems and learning yourself, improving who you are. And so that's kind of the concepts that we've come across. And that's the thing that empowers me even further when I get that kind of feedback. Irrespective of any material thing that you might achieve, it's the genuineness about people connecting to, helping support them through, uh, their own journeys. So that in a nutshell, explains what motivates me and has for a long time and how I use my skill sets to be able to justify to myself that I am doing the right thing. Or these are the kind of, uh, areas that I want to support, for example, and use my time more wisely. As you've suggested. We don't have much time. I can't do a single job anymore and I refuse to work 9 to 5. I made that promise myself after, uh, I went part time because I was working hundreds of hours a week every week for however long. Right now I have autonomy. I choose what I want to use and use my skills. I can be light touch, I can be strategic, I can be visionary. But I'm not too operational, um, because if I become operational that I become effective to what I want to do. So that's why I can do so many different things and use my skill sets at the same time. I'm out of my comfort zone. This year, for example, I pivoted. I had four things in my mind. Every year I do different things. This year I've joined as a senior partner in VC firm in Eastern Europe for early stage health tech startups on the investment side, maybe business, private equity as well. I want to start my finish the book and I want to do a podcast. I've done all four already. I kind of think this is where I need to be. So I'm very strategic about my ambitions. And this year was those four things, which I've already done. So again, every year I start thinking what's next for me? And actually, and I like being out of my comfort zone. Well, I'm not the best person in the world. In surgery, I was one of the best in the room. You're an expert. Uh, you do things. What I do now is I'm out of my comfort zone. I'm not the best and I can accept that. Sometimes the worst, I'm learning the Whole time. It keeps my brain stimulated, young and active. I, uh, like that stimulation of not knowing where I am, but trying to learn. And that's important. Otherwise in surgery you get stale. The same thing over and over again. It becomes repetitive in any profession. And how do you break that cycle? Was the question. To lie, stuff to be divided. And that's kind of my story.

Speaker B: I love that. Uh, and time, time goes so quickly when you're doing that repetitive, uh, repetitive grind as well. And imagine it slows down significantly when you're learning new things like that. And, and be willing, be willing to be the fool. I think that's such an important lesson. I think as entrepreneurs as well, we probably are more than most, we're willing to be the fool a lot more because we, we just want to get to a level of understanding across basically everything. Um, particularly when we're advising or running companies. But before I let you go, Shafi, I know that we're running over time, so apologies. But the book, um, this is an example of you in the one to many model. This is an example of you putting your time into something that can live beyond you educate the masses. And um, it's an incredibly important theme. Like it's the most important theme probably in healthcare if we're going to move to a place of solving what is an unsustainable model, which is the evolution of AI, transforming health care. It's called intelligent. The book you just did the launch. I couldn't go because I was in Greece unfortunately, on, on, on a rare holiday with my, uh, family. Um, but I did get the invite. Thank you. Uh, and apologies I couldn't be there. But, um, just quickly before I let you go, tell us, tell us about the book. Um, you probably learned a lot whilst writing this book as well and researching this book. So, um, are you, are you opting optimistic? Are you pessimistic? What, what kind of world are we moving into with AI and healthcare?

Speaker A: Yeah. So let me tell you a bit about the book for the audience. So I've been on a global book tour launch. In fact, I was in London at the Natural History Museum where I first announced the book. Then I went to Toronto in Canada.

Speaker B: 1.

Speaker A: Yeah, we did one here. Um, of course, just last week, the official launch of the Ross site of Medicine. I was supposed to be Morocco that weekend, do a launch in Morocco. Couldn't quite make it. Uh, next week I'm in Greece, in Thessaloniki to do a launch.

Speaker B: Excellent.

Speaker A: Then Saudi Arabia next month and then there will be Cape Town in October. And other places. So, um, m my journey and my network has allowed me to use uh, um, uh, my network globally to be able to push this book out wider. I got a book contract 7 years ago pre Covid to write a book on technology and digital health. I started writing it in earnest. There's PAC publishing and I thought this is. I need to write about this. Because I was so much involved at the forefront of innovation. Yeah, I wrote two thirds of it and I wasn't happy with it. They weren't happy with it. I wasn't happy with it. It wasn't good, I think. Yeah, I couldn't tell the story that I wanted to tell. It made no sense to me thinking, how do I tell the story? I couldn't get my head around it. Write a book is really hard. Right. It's not easy. You have to have the clear mindset of this. Then Covid came and uh, the book became obsolete because all things I was taught by innovation was becoming true during COVID because it accelerated change. So I paused for a few years. I started writing more last few years on AI technology. And last few years I thought, you know what, it has to be AI. It became obvious that was the bit that I needed to teach people on and share my skills and knowledge. I've been teaching AI for about 10 years in diverse guises. What I noticed was a number of things. One, the basic intuitive AI is really low in healthcare. It's worth negligible. Uh, there's those that super keen. Absolutely. But vast majority, 99% don't understand AI at all. First of all, how do I convey the knowledge I've acquired to these people? Um, I've been running courses on AI. Then the themes are how do I tell the story? I'm a storyteller. If you watch my talks and everything else I tell stories. They call me a storytelling scrubs. That's how I'm renowned. Because when you're giving big keynotes, they will be entertained and they want to hear stories about how you envisage the future. And that's kind of what I do for living. My problem was how do you tell the AI story? Is it a story? And that was the bit that was really difficult to concept in mind. Once I got that story in my head. This is story I want to tell. So the themes of the book are these. There's the evolution. It's called the evolution of AI transformer Healthcare. It's how do I tell stories about the beginning of humanity or who we are, where we come from? Where does AI sit in the arc of civilization that makes sense to everybody. That was one story. And you see the story around punctuation, around Darwin's theory of evolution. I describe it all. Next level is what's the language that I understand by AI, that people understand? What is medical superintelligence? What is singularity? What is the pyramid of innovation? I describe that. So everyone has the same understanding of the terminology because people don't know about it and they're worried and anxious about it. Then it's the anxiety of fear to get rid of that, to be a considered approach to AI rather than over imagine, um, what it could achieve. Then each specialty, where is the current research validation on the areas and then the technologists, the ambient AI, the genetic AI, the process, how does that work in collaboration? At the end it's philosophy, it's that human agency, are we in control? How do we manage AI going forward? Those are the five themes you see throughout the book. That took a time long while thinking about. I'm really pleased with the outcome. I'd buy the book, the book that I'm proud of even nobody else reads it. I'm happy it's out there, but I think it fits a description. And also it's autobiographical. It's a personal story.

Speaker B: Yeah, it's not.

Speaker A: I could write a book just on technically I. But that's more vertical and not be interesting. So Journey. I've shared this today on um, this, in this podcast is the journey of the book itself. So that's what is intelligent.

Speaker B: Yeah, amazing. Um, I genuinely look forward to reading it. I wouldn't say that if I wasn't going to. I'm reading two books at the minute. Um, how Google Works is what. Uh, the first one, I read that every couple of years just to refresh my memory on building a company in the right way. I think it's an absolutely fantastic book. And the other one I'm reading is Company of One, which is an interesting one. Paul Jarvis. Um, I mean you do not need to read that book. He's basically written that book on how to do it by looking at you. So you absolutely do not need to read Company of One. For anyone listening, it is a Penguin published book. So uh, it's one of those that's a classic, it's done very well. But um, yeah, if you are looking to downsize a company or develop a portfolio career that pays you back in time as well as in wealth, then read that. But Shafi, you've the epitome of that book. Um, and I genuinely, I do genuinely look forward to reading yours and I'll, um, I'll send you my thoughts as

Speaker A: and when I'll have to.

Speaker B: It's been a pleasure. I can't believe it's been so long, uh, for us to have done this, but I'm so glad we have. This won't be the last time you're on this podcast, Shafi. I can tell you that now. Um, but it has been, it has been an absolute pleasure, um, for people that want to learn more about your book. It's published by Evolution Books. You can get it foils, you can get it on all of the bigger companies.

Speaker A: It's on Amazon as ebook and hardback and it'll be in the shops the next month or two.

Speaker B: Nice. Perfect. And for people that want to get in touch with you or want to learn more about all the million things that you're up to, what's the best way for them to do so?

Speaker A: Ah, LinkedIn is my third mechanism of connecting with, uh, like minded people. Social media, Instagram, um, Facebook, uh, X. Um, still on Snapchat. No, that's a lot of time. Profshaffee.com and you can link with. I share my newsletters there all the time.

Speaker B: Beautiful. It's been a pleasure, Shafi. Thank you.

Speaker A: Great. Thanks, James.