Laina Emmanuel On Brain Mapping Technology Creating Change In Medical Systems

Laina Emmanuel has over 20 years of experience in technology, international development and business.

She has worked on operating system development, worked with international development organizations like Clinton Health Access Initiative, Video Volunteers and now runs a startup which focuses on brain mapping for neuro-psychiatric illnesses.

Laina discusses how she has directed her passion and skill for systems change across various sectors to build 3D visualization solutions for diagnosing neuro-psychiatric disorders

Highlights from the interview (listen to the podcast for full details)

[Sarah Ripper] - To start off, could you please share a bit more about your background and what led you to where you are now?

[Laina Emmanuel] - That's a big question given the fact I've had a very varied career. Let me start at the beginning. Almost every Indian becomes either a doctor or an engineer, and that's where I started my career from. I am an engineer, and I spent a couple of years of working on cutting-edge operating system development. I loved the technical challenges there, but I didn't find it impactful enough. I made a conscious choice of moving towards a completely different space, which is that of international development. That was where I met you Sarah. I was interning at Video Volunteers, and that's where we worked together. We used to talk about everything from impact to social entrepreneurship, and that was the first year where I was trying to figure out what I could do beyond technology. I did that for the next couple of years of my life; I worked with international development organisations like Linton Health and Access Health International. I was seconded to the Ministry of Health in India at the centre and state levels. I did a bunch of different things; I'm always looking for interesting and challenging problems for India, which includes everything from maternal mortality to revamping the vaccine supply chain. Public policy and international development work was great, but it was very slow for me.

I went off to business school to learn more about how you can bring about fast change. I learnt from this and came back to public policy, and I still found it slow. Then I decided I would start off by building my own business. I joined this program called Entrepreneur First, where I met my Co-founder Dr. Agrawal. Her PhD was in brain mapping, and I found that fascinating given my background in public health. It just made so much sense to do something in brain mapping, which is so deeply technical, impactful, and made for a great business.

As a Co-Founder of BrainSight.AI, you tell us more about the organisation and the impact you're creating?

The easiest way to explain what we do at BrainSight.AI is by saying we create a Google map of the brain. There are parts of that which are already done, and you can map the structure of the brain quite easily. You can also map the roads of the brain in a non-sharp way. That's what doctors use today. But what we can do is use advanced neuroimaging modalities to map the roads and traffic of the brain in much more detail and with finesse. This in fact is one of the earliest indicators for various serious psychiatric illnesses, such as schizophrenia, bipolar and OCD. It is also one of the earliest indicators for dementia.

When looking at a lot of these psychiatric and neuropsychiatric disorders, brain mapping can have huge implications for early diagnosis and for directing the therapeutic journey for patients.

You can see certain networks in the brain, like your default mode and salience networks, which have huge implications on your higher functions as a person. Just like there are language and motor areas in the brain, there are also areas like the default mode network, which decide how you pay attention and take in information from the world around you. When these networks are affected, it can have serious implications for the patient. What we can today do is give the location of these networks to various doctors, which helps them have a better conversation with the patient about the implications of surgery or any image guided intervention. There are a bunch of these when opening the brain; so how do they ensure they're not affecting those areas? These are questions you're now able to answer when looking at the traffic networks of the brain.

Could you give us examples of patients who have used your programs and the outcomes they've experienced?

Today we work with neurosurgeons who are helping brain tumour patients. What we help them do is map out surgeries better. Before the surgery, we can give them information about various networks in the brain, which means that after the surgery, the loss of functions can be minimised for the patient. It's brain cancer, so obviously the surgeon' s main agenda is to remove as much of the cancer as possible, but you also want to do it in a way which ensures the functional loss is minimum and you're not affecting traffic networks or roads. This can lead to profound change in the patient. We are working with over 20 hospitals in India where they're piloting our products. We are in the spaces of deep tech, deep science, and highly regulated medical devices, and so it has taken some time for us to be at the point where we are confident when doctors use this it, it will be highly safe for the patient. We just got our licenses from the Indian government to be able to test our devices, and so we are at the point where doctors can now use this confidently for surgery. But that's just the first point, we also get a lot of different requests. We are getting a lot of requests from people who have epilepsy, and one of the things doctors would like to do for these patients is figure out the focus of the epilepsy. Think of an epilepsy as an earthquake in the brain which leads to a lot of further effects in the brain. You need to know where exactly the focus of the epilepsy is, so that is something we can do. Dementia is another problem we can address. People have used our brain mapping to have better conversations with patients suffering from dementia about what is happening with them.

What I love about when my team goes out and talks to patients with severe psychiatric illnesses is the fact that for the first time in their life, they're seeing a brain map which is telling them there's something physically wrong with them, rather than just being a character flaw.

Often in mental illnesses, that's the one thing families tell them. People will say, "if you just buck up and you do things, that's going to make you feel better." It might work for some people, but in a lot of cases there are also things happening in the brain. When patients see this, it's such a sigh of relief for them.

As a female leader of the social impact space in India, what are some challenges and opportunities you are seeing?

India has a lot of tech leadership in terms of women at the helms of organisations, but there's obviously still a vast set of women who have probably not stepped out of the home. There's this whole dichotomy where you have well educated women who are at the helm, and then people who've not stepped out. The challenge which I've seen as a woman leader is bridging that gap for a lot of the people I'm talking to. I’m a woman who's building this deep tech, deep science business, and we are probably one of the two or three companies across the world doing this kind of work. It takes people a little time to first wrap their head around the science and technology of it, plus the fact that it's two women building it out in India. There's that piece we must constantly fight back against, but I think as people realise, and given the number of people in tech in India, it invariably does pass on. People do understand that India and technology is quite big, but that has various ramifications. When you go to investors, there's a longer period where you must sit down and convince them than a guy in the same space as me would experience. It takes some amount of navigating the medical device industry in India, which has been traditionally quite male dominated.

What are some inspiring projects or initiatives you've come across recently that you feel are creating a positive social change?

Because I've been looking at the brain and AI space quite a bit, I see there's a whole conversation about AI ethics being spearheaded by women. I find this exciting. Usually, the conversation is about how can AI make things more productive? But it's mostly women like Timnit Gebru who've been talking about how do we make sure AI is ethical? I've enjoyed following those conversations. There are also so many social entrepreneurs in India who've been doing fascinating work in this space. There are social entrepreneurs who are thinking of new lending models. There are things like Run the Sector, which have been around for a while, and they've been figuring out how to reach out to the unbanked millions of dollars in India. There's that whole space which has been around for a while, and this has been a constant problem. I've met many entrepreneurs who've been working on fortifying meals for children to tackle the problem of nutrition. I have seen so many amazing women spearheading the conversation around climate change in India and across the world, and I find all of them amazing. I also love the whole community media and video space. I find it so fascinating that using community media and giving a voice to the people is literally the most important thing you can do. I've been following people in that space; and podcasting is one of the new areas emerging.

To finish off, what books or resources would you recommend to our listeners?

I read more fiction than non-fiction these days. Fiction for me is a way to get into other people's shoes.

BrainSight.AI wouldn't be here if empathy was not a guiding principle for the company; it is something we actively hire for. For me, people who read literature are generally a lot more able to put themselves in another person's shoes.

I love reading Aeon Magazine, which follows the latest philosophical debates across some of the latest technology and learnings from different fields. There's 3 Quarks Daily, which I think is beautiful. There's also ribbonfarm, which is written by this philosopher who thinks about the zeitgeists of now and what they mean for us as humans? Azeem Azhar’s Exponential View looks at all new technologies and how they’re changing the world around us. These are the podcasts, websites, and newsletters I follow, but also, I listen to The New Yorker Podcast for poetry.