An Interview With Candice Georgiadis
Protect family time and personal downtime: Most marriages and romantic partnerships have plenty of ups and downs, and running a business often adds extra difficulties and stress. Remember to watch out for and help each other. Just like the saying “Friends don’t let friends drive drun,”, good partners don’t let each other get into dangerous amounts of stress and get burned out. Often people who are headed down dangerous paths don’t realize it in the moment, so you have to help them retain a healthy balance.
As a part of our series about lessons from Thriving Power Couples, I had the pleasure of interviewing Dr. Ruchi Thanawala and Jonathan Jesneck of Firefly Lab.
Dr. Ruchi Thanawala, Thoracic Surgeon and co-founder of FireFly Lab, was recruited to Oregon Health and Science University in late 2020. She joined the thoracic surgery faculty as an assistant professor, after completing her cardiothoracic surgery fellowship at the University of Iowa and her general surgery residency at the University of Massachusetts Medical School-Baystate Medical center. She also completed a Master of Science in Health Informatics from Northwestern University and a Surgical Education Research Fellowship from the Association of Surgical Education, becoming one of a very small number of thoracic surgeons informaticians with education research training in the US.
Jonathan Jesneck is the co-founder and CTO of Firefly Lab, where he coordinates data security, machine learning, and the analytics of surgical and procedural training. As an enthusiastic technologist, he has been developing machine learning and data mining applications for complex systems for 20 years. He has founded and grown several technology companies focusing on large-scale analytics, machine learning, and medical data. At Duke University, he earned his Ph.D. in Biomedical Engineering and M.S. degrees in Statistics, and Computational Biology and Bioinformatics.
Thank you so much for doing this with us! Can you tell us a story about what brought you two to your respective career paths?
Ruchi — I can remember a distinct early morning rounding as a 2nd-year general surgery resident. It was quite early in the morning, and we were making our way through rounds. At 7:30 am, the senior residents were going to head to the operating room (OR), and I knew that I would have to head to a computer to spend the 2–3 hours writing progress notes. It took that long because the Electronic Health Record (EHR) was not built for surgeon workflow. Ultimately, I was missing out on learning in the OR because of the challenges with getting the documentation done.
I was already interested in surgical education research, and now I knew that I needed to learn more about informatics. I wanted to build a system that was geared toward surgeon and surgical resident workflow. After that year, I entered my research fellowship, where I did surgical education research, got an M.S. degree in Health Informatics, and then did a fellowship in Surgical Education Research. I started Firefly Lab after this with my husband, Jonathan. Jonathan’s unique skill set with mine allowed us to take this experience and turn it into a start-up and a technology that is helping to reshape surgical education in the US.
Jonathan — I feel very grateful to be able to contribute to the intersection of two of my passions: artificial intelligence (AI) and learning. I’ve always been very enthusiastic about using computers for human empowerment, specifically helping people to achieve more and lead safer lives. In high school, I founded a tutoring club for math and computer science students. I preached the idea that math and science are not scary, but rather tools you can use to expand your life opportunities, similar to how learning a foreign language can help you dive into another place and culture. In graduate school, I built an AI system to assemble and leverage vast amounts of disparate medical data and enable radiologists to detect breast cancer in the very early stages, when it’s easier to treat. During post-doctoral training, I built the analytics for a robotic high-throughput screening system to characterize millions of molecules, enabling my fellow cancer researchers to understand drug effects more deeply and to identify promising new therapeutics for leukemias. At MIT, my lab and I built a city-scale system for scanning buildings for energy leaks. This helped to inform utility companies and empower homeowners with maps of lost building energy and guided plans for how to fix energy leaks. And most recently, with Firefly Lab, our team is doing fascinating work on mapping out how people learn in complex medical environments, using AI to measure and quantify skill transfer from expert to novice. It’s very motivating to empower surgical and medical educators to optimize their training programs on a system level, as well as help support the development of individual doctors on a human level. Also, there is something very meta about training large AI systems that learn how people learn.
Can you share the most interesting story that happened to you since you two got married?
Jonathan — We would have to say that high-stress careers can come at a high cost. While launching Firefly Lab, I was starting my academic lab, and Ruchi was doing her surgery residency. It was already a very stressful time for us both, exacerbated by having to live apart from family and each other most of the time for work. For doctors in training, there’s never a “convenient” time to have a baby, but surgery residency is an especially tough one. It resulted in a very difficult pregnancy, with Ruchi once fainting due to exhaustion in the OR during a case, and we almost ended up losing our daughter. Luckily, the obstetrics and NICU teams at Baystate Medical Center were amazing, and with the surgery program giving Ruchi plenty of time to recover, we could just focus on being together as a family in a difficult time. Today our daughter is a happy, healthy 4-year-old. So the silver lining in going through an experience like that is that it helps us focus on the truly important things. It provides a solid foundation for support whenever life gets challenging.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
Ruchi — Looking back, we like to laugh at how naive we were at the beginning of the Firefly Lab project, when things looked much simpler because we just didn’t know anything. We hadn’t yet learned of the complexity of learning science and the interesting conflicting constraints of medical education in a busy hospital setting. Not to mention the extreme difficulty of doing business in the closed world of medical software. Our VC investor friend likes to describe the medical software space as a “place where startups go to die.” As entrepreneurs, we wouldn’t give the advice to try to build a company at the same time as trying to discover new science around it. Either of those goals is hard enough. But on the other hand, it’s empowering just to dive right in and see what you come up with.
Back in academia, Jonathan used to think that if there was a common need that people hadn’t already solved, then there must be a good reason. Maybe it’s even impossible, meaning only frustration ahead for anyone foolish enough to head in that direction. But now, we think that with the speed of modern technology development, the situation is shifting so that new research and commercialization opportunities are emerging faster than the entrepreneurship community can tackle them. So we suppose we’ve transformed from a skeptical mindset to more of a blue ocean outlook.
What do you think makes your company stand out? Can you share a story?
Jonathan — We are a company co-founded by two people who are not only domain experts in multiple fields, but overlap just enough to speak a common language. We’re unique enough from each other that we bring new perspectives. Plus, we are married and love being together as a family with our daughter and growing this company.
Some of our best brainstormings happen while enjoying doing things as a family, like giving our daughter a bath or making dinner together. That isn’t to say that we let our work take over our lives. We think it shows that Firefly Lab is a part of who we are and our creative thoughts flow at all times. Being married lets us share our lives and our thoughts fluidly without the constraints of scheduled meetings. We can have a quick brainstorming session and then back to the bath without skipping a beat.
Are you working on any exciting new projects now? How do you think that will help people?
Ruchi — Our current company Firefly Lab is a medical and surgical education platform that brings quantitative data science to the education of physicians. It is the perfect meld of our skills and what we are passionate about. With myself being a surgeon, surgical education researcher, and informaticist paired with Jonathan’s expertise in AI, informatics, and computer science has made for some exciting and innovative work in the space of learning science. The training of a surgeon is interesting considering the number of years that go into training, which is around 5–10 after medical school, especially if you are subspeciality trained. That time investment needs to be efficient and effective for both those training and being trained. Digital transformation has been slow to come into medicine and surgery, but it is here now. Education tends to fall lower in priority given that the budgets aren’t big but, arguably, has some of the greatest impact if targeted. As many residents do, I felt the pain of well-meaning but often inefficient learning models in training. So, we decided to build Firefly Lab and focus it on learners. We are helping by giving residents and those investing in training them control over understanding how they learn and driving it. It is about empowerment and accelerating learning.
What advice would you give to other CEOs or founders to help their employees to thrive?
Ruchi — We think some important advice is to find your passion. If you are passionate about the problem, you will find a path around all obstacles. You need that craving to make this work to get past the many challenges, contenders to success, and curveballs. And it’s essential for the whole team to feel this way. Each good thing and bad thing is a way to grow and get better. We think framing the process that way to employees is necessary to help the team and individuals thrive.
How do you define “Leadership”?
Jonathan — For us, leadership is being the one looking for a pathway in good times and in those times when it seems hard, dark, almost impossible. A leader knows that there is only one way, which is forward.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
Ruchi — My parents. I know that isn’t one person. Unequivocally. If I didn’t have my parents, I would not be where I am with all that I have. They emigrated from India and stayed here without their own family. They built a life and gave me the foundation to take on challenges. My parents still do that even to this day.
Jonathan — Similarly, I’m grateful to my mom. She showed us firsthand, as a single mother of 3 kids in challenging financial circumstances, how to develop grit and persistence through tough times. And of course, I’m very indebted to my mentors, especially Prof. Joseph Lo at Duke, who is a wonderful and caring teacher. He got me excited about AI and deep learning back when it was still a crazy idea that few believed would ever amount to anything meaningful.
How have you used your success to bring goodness to the world?
Ruchi — I am fortunate to have my career as a thoracic surgeon. On a daily basis, I get to partner with amazing people and patients. I am regularly astounded by the grace of people who are living with diseases and pushing forward. I get to be a part of that. I hope that I bring goodness into the world through my role in each patient’s journey toward better health. My role as an entrepreneur and informaticist is to inspire other girls and women to be bold, confident, and push forward in arenas that have not always been crafted for women.
Jonathan — I’m very motivated by helping people for “social good.” For example, with my previous companies, I helped people upgrade their buildings in a smart way. This was for them to feel more comfortable and lower their energy bills, while also helping the environment by lowering building energy usage. And with Firefly Lab, we’re empowering people in a much larger way: To achieve their potential and to do it faster. That social good has a very large multiplier effect on improving society as a whole.
What are the “5 Things You Need To Thrive As A Couple”? Please share a story or example for each.
Jonathan –
Trust and support each other: This is probably the most important one. There were many times when I was feeling burned out or doubting whether we could somehow pull it all off. We were developing a new learning theory science, building a new learning measurement technology, developing the market by educating the medical training field, and building a company to commercialize the solution too. We needed all these simultaneous efforts to make sure Firefly Lab can survive long-term and grow to make a national impact. Ruchi always trusted that we would figure out each step as we came to it, and she was there to support and remind me that we should keep going, even when it all felt too impossible.
Remember what comes first, the business or the relationship. There is usually friction that builds up between business partners, especially during challenging periods. I strongly advise each couple to talk about priorities and figure them out together. For example, if the startup is causing too much stress in the marriage, and you can’t do both, which one to you keep? How big does the startup have to get before you’re “done” growing it and are willing to hand it off to others? Exactly how much financial risk are you ready to accept before you call it quits or try a different strategy? Financial stability is, of course, important for long-term relationship stability. With solid priorities, you build a solid foundation to stand on and a prepared game plan to use when things get tough.
Protect family time and personal downtime: Most marriages and romantic partnerships have plenty of ups and downs, and running a business often adds extra difficulties and stress. Remember to watch out for and help each other. Just like the saying “Friends don’t let friends drive drun,”, good partners don’t let each other get into dangerous amounts of stress and get burned out. Often people who are headed down dangerous paths don’t realize it in the moment, so you have to help them retain a healthy balance.
Complement each other’s strengths: Especially first-time founders can feel that they need to do everything personally, for things to get done right. This is not sustainable. Figure out which activities are natural fits for you and your partner. Which ones give you energy and feel satisfying, rather than a chore? Let each other handle the right areas, and figure out when to bring in outside help for the pieces that are hard for both of you. Try to enjoy seeing your partner (and your employees and other team members) developing their own interests and skills.
Focus on the process: Achieving something valuable in any field (startups, research, etc.) is difficult and takes a significant amount of luck. Often it’s hard for founders and innovators to acknowledge that certain things are just not in their control. So when things don’t go perfectly according to plan, this can lead to a lot of frustration, which can derail things both professionally and personally. Rather than getting hung up on external factors, it’s vital to focus instead on the process of innovating and growing your business or project. For example, you can figure out how much time and energy to put into product development, networking, fundraising, etc., in order to increase the probability of success. Try to anchor your energy and self-worth internally rather than on external milestones you can’t control. That’s all you can do, and keeping that in mind will help to keep stress at manageable levels. This more sane thinking also helps people to keep a back-up plan ready, in case the main project doesn’t work out.
You are people of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Ruchi — A movement we would like to bring is making knowledge and information accessible to all, especially regarding your own learning and future directions. For this, we all need to meet in the middle. Technology needs to bring content well-matched to people’s goals and needs, and we need to educate people that they have control over their learning and future in both small and big ways. We all have an individual right to learn, grow, and inspire, and to have a say in building our futures.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“The only real mistake is the one from which we learn nothing.” -John Powell
Ruchi — We must decide a path. Not choosing is not an option. Because of that, worrying about a choice is only as good as its role in helping to choose the most informed option. After that, when all the beads are sorted as perfectly as they can be, we should not be afraid to choose because of the mistake of being wrong. But choose and then be prepared for what comes next. This empowers us to learn, grow, and take smart risks to make choices. We try to avoid being stuck in indecision. If anything, each time we make a choice and wish we had done the other, we learn from it and learn something new we might not have known if we always made the right choice.
We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂
Jonathan — There are so many people doing amazing things nowadays. Just to pick one, it would be great to chat with Sam Altman, the former president of Y Combinator (a very influential startup incubator), and now CEO of OpenAI, which is doing fascinating work in large-scale AI. I’m especially interested in the intersection of artificial general intelligence and leveraging it to help people in previously unfeasible ways.
How can our readers follow your work online?
Jonathan –Linkedin, and Firefly
Thank you so much for joining us. This was very inspirational.
Lessons from a Thriving Power Couple, With Dr Ruchi Thanawala and Jonathan Jesneck of Firefly Lab was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.