The Hidden World of Medical Ultrasound with Joseph Luis

Did you know the same principles used to design pro-audio speakers can be used to perform delicate eye surgeries or power life-saving heart monitors?

Joseph Luis, an engineering leader at Medtronic , shares his incredible journey from navigating MIT as a first-generation college student to designing concert-series speakers at JBL , and ultimately finding his true calling in medical acoustics. We dive deep into the fascinating mechanics of how high-frequency soundwaves are actively revolutionizing modern medicine.

Chapter Markers:

• 06:03 - Upbringing and navigating MIT as a first-generation student
• 14:10 - Leaving JBL to pursue a career in medical acoustics
• 15:51 - Exploring cosmetic ultrasound and subdermal lifting
• 21:23 - Engineering tools for cataract removal (phacoemulsification)
• 26:26 - Testing integrated circuits for Medtronic pacemakers
• 33:17 - How ultrasound-assisted liposuction reduces tissue damage
• 41:37 - The exciting future of non-invasive ultrasound therapies
• 44:26 - Career advice: The power of networking for young engineers

Transcript

SPEAKER_02 0:06

Welcome to the SDL Podcast, filmed in the MD Acoustics Anacho Chamber at their testing facility in beautiful Gilbert, Arizona.

SPEAKER_03 0:17

Today we welcome Joseph Luis, a seasoned RD leader with over 15 years of experience in medical device innovation and acoustic systems. As the senior engineering manager at Medtronic, Joseph leads global teams in developing critical IT testing solutions for class 3 implantable devices, leveraging his advanced degree in electrical engineering from MIT and acoustics from Penn State. Before his time at Medtronic, Joseph spent over a decade at MERS Aesthetics, leading transducer development and held engineering roles at JBL Professional and MOOC Medical. Driven by work that matters philosophy, he focuses on developing life-improving technology while monitoring the engineering teams that bring them to reality.

SPEAKER_04 1:05

Well, hey, we're here today at the Soundcave Labs Podcast. Welcome, Joseph Luis from Medtronics. Yep. So thank you for coming and being with us today.

SPEAKER_00 1:14

Yeah, appreciate you guys having me.

SPEAKER_04 1:16

Excited to have you here. So why don't you give us a little bit of background about who you are and your upbringing a little bit, and we're excited to hear more about your story.

SPEAKER_00 1:23

Sure. Um so I guess uh background in acoustics at least is uh you know, we talked a little bit before, but I kind of grew up loving audio, loving music, and uh when I was young, I was the kid who wanted to put the 12-inch, 15-inch subwoofers in the trunk and kind of annoy the neighbors, and that's you know, I I wanted to do that. And um, when I was an undergrad, I was lucky enough to take a course with Dr. Bose, um, who was still teaching at the time. And um then I really thought that's what I want to do for the rest of my life. I know, because I remember even he would bring in some examples, and just it was just it was like the one class I was really good at, you know. Um and got out of undergrad and went to graduate school, um, got to Penn State and came to find out, well, no professor really has uh a ton of funding to build the ultimate loudspeaker system, so I probably should find some other research project to do. Um and uh I also had a real big interest in the medical field. Um at one point I wanted to be a doctor or a surgeon, uh, and so I sort of merged the two together and I found a bioengineering professor who was doing some research on uh transdermal drug drug delivery uh using ultrasound. So kind of all of the um glucose monitoring that you see today, um that was some of the background for that. You know, we had a chemical engineering professor who was working on how do I measure blood glucose interstitially through the tissue. Um and then we were working on well, if we can do that, how do we uh sonicate the skin and make it more diffuse so we can push large molecule drugs through the skin? So no more pinprick and no more shots was kind of the idea. All battery operated was kind of the vision. Um so got into that, that's sort of the entrance for me into medical acoustics. Um and then I did for a little bit I went to work for JBL and got sort of the audio bug uh out of me, and I was uh an engineer there designing pro audio, so all of the concert series speakers, uh ceiling speakers, those kinds of things uh I was working on for a little bit. Um and then I just got back into medical. I felt like there was just more growth there at the time, you know. I was early starting a family, and I was like, okay, what what am I gonna do for the rest of my life? And I'm am I really gonna do audio? Eh, let's get into medical. Uh so I moved to Salt Lake City, worked for a company there doing surgical devices, uh, and then I got a call from a company here in Phoenix that was a startup at the time. Uh, they were working on the aesthetics industry, looking at using high-intensity ultrasound to make subdermal lesions in tissue, and then the healing process would actually create uh a bit of a lift in the skin. So we had an indication for brow lift, segmental lift, uh wrinkle reduction of the decletae. We were kind of at the time working on uh clinical applications of things like rosacea or uh acne. Um so a lot of really cool stuff going on that you would think, you know, just ultrasound applied in a lot of um uh different areas. And so um the company was acquired in 2014. I stayed on for a while building an RD team uh there, uh leading all of the uh transducer technology efforts. Uh and then when they decided, you know, to to move the facility uh back to North Carolina, that wasn't really where we wanted to be in. Um and so I decided, well, why not go into a completely different medical industry? And so I'm at Medtronic leading the IC test group. So I'm in charge of uh all wafer level testing um for any ICs that uh our design engineers come up with. So if you think about pacemakers and anything implantable, um we can't really just go to the digikeys of the world and pull ICs and chips from wherever. We're really concerned about um power consumption. Uh if you can imagine some of these pacemakers have to last 10 plus years, so we design our own chips, and so we have our own design engineering team, we have our own test engineering groups, uh, and so that's the function that that I lead there.

SPEAKER_04 5:56

That's awesome. That's amazing. But before we get there, because I feel like you just totally glossed over your childhood, your upbringing, because I know we have a little bit of comment, so I want to I want to hit that real quick, right? And this is all good stuff because you they just told that you guys haven't heard of this, so this is a lot to unpack. But first off, because part of the podcast is mentorship, right? And and uh I think your story is super unique, and I think it can be helpful to others out there. So why don't you tell us a little bit about like where you're from, where you were born, and you didn't even tell anybody you said Penn State, but you're undergrad. We want to hear a little bit about that, and like what was the challenge, if you don't mind telling us like going from where you came from to obviously here you are, but like that initial stage, like how did you go from where you came from to college, and then you know, can you talk a little bit about that?

SPEAKER_00 6:46

So I grew up in Southern California. Um, my parents are both from Mexico, they came here. Um, they didn't have uh college education, so I was the first one in my family to go to college. Um, but my mom in particular really sort of stressed education. She was really big on okay, well, if we didn't, then you will. Um and so uh you know, she was really always but like for her, it was sort of um natural, like you're going to college. She didn't know anything about the system or anything like that, right? So to kind of give you an example, we didn't really know a ton about stuff like the SATs, because that's not necessarily the way the education system works in Mexico or in other countries, right? A lot of times you go, you take an exam for the university, right? So I found out like, oh, there's a PSATs, oh crap, I forgot to sign up, you know. So I kind of in high school had to learn a little bit on my own um what what I had to do to even get in. Um and then I I did, I was lucky enough, I think, that um my junior year in high school, I think uh, you know, a lot of after you take that first exam, a lot of universities are like, oh, look at us, you know, apply to us, we have these summer programs. Um, and one of the universities that reached out to me was MIT. Um they said, hey, we have this like, you know, after your junior year of of high school, um, a full summer where you can kind of come and and do that. And I was like, wow, like I didn't know that I could go somewhere like that, you know. Um, so that's actually the only out-of-state school I applied to. Um, I didn't get into that summer program, by the way. I did apply and didn't get in, but uh I did get in for undergrad, so that's actually where I went to to undergrad. Um, you know, I I it was a big change for us as a as a family. Usually for us, it was everybody kind of stays local. Like if you see my family today and go back to Santa Monica where I grew up, everybody lives in the same apartment building, like literally the same apartment building I grew up in that my parents were in since the 1970s. Um so it or if you guys remember back in the days when you could actually take people to the gate at the airport, right? Yes, you could if you could visualize like my mom crying there as I'm boarding the plane because I'm like leaving. Her baby's leaving, yeah, yeah, exactly. That's kind of how it was, right? Um, so uh yeah, it and it was a good experience. I think um I had a little bit of a love-hate relationship with it, probably because one, it was academically very difficult, uh, and I had to manage that. And then um two, I didn't really I didn't really have the background and support of everybody else who had family that knew about the system and had gone to college, you know. I could look at like two doors down, somebody whose family maybe went to Harvard or another university didn't have to be a prestigious, but they had gone through the system, they had been there before. Uh, and I didn't really have that, so it was it was a challenge to go and find my own kind of support and and you know, how do I how do I get out of that?

SPEAKER_04 9:59

So um, yeah, I think that and then that kind of combined with just I wanted to do some kind of acoustics and medical and I merged that together and that's awesome because like I mean I think what really impressed me when you told me the story was like like you said, like being the first in your family, coming from you know Santa Monica in California vibes, right, and from the Hispanic culture, which is super obviously really family-oriented. Hey, stay close. You broke that, you went off, got into a phenomenal school. You get there, did they have those resources to help you? It sounds like it was still a like somewhat of a challenge as you kind of went through that process, right? And then when you leave, then you're like, what's the next step? And then Penn State. And I just I don't know, I find it fascinating because a lot of people take that for granted, especially if you come from second generation, third generation, but you kind of broke that mold, and that's that's phenomenal. I like that.

SPEAKER_01 10:56

I I was gonna actually ask, because you mentioned, you know, to this day you've got your family that all lives in the same apartment building, right? Um, did you find that there's like a cultural difference coming from Southern California um to like MIT?

SPEAKER_00 11:12

Yeah, I mean going there was the whole kind of California versus East Coast, right? I mean, they always say that like on the East Coast, at least I always heard that they're like you go to New York, everybody's really rude, you know. Uh I always say I just find them really honest.

SPEAKER_07 11:28

Yeah.

SPEAKER_00 11:29

Um California is more laid back, right? I mean, that there's there is a different feel.

SPEAKER_04 11:34

They pop their collars in the East Coast. Yeah.

SPEAKER_00 11:39

But yeah, for sure. I think I think one of the um one of the challenges was just finding my group of people. Yeah. Right. Uh I think it was it was kind of difficult to to fit in. I I made really good friends with the people that lived on my floor. I lived in the dorms all four years. Um and so those became really good friendships that helped. Um but at the end, even them, they came from backgrounds that you know their families went to school, they had they had that experience. Um we did uh have um you know a number of Latin organizations on campus, and one of the things, for instance, that uh multiple schools on the East Coast did was many of us couldn't go home for Thanksgiving, for instance, and a lot of people did. They just, okay, I'm flying back. And I'm like, well, I can't, I don't really have the funds to do that, you know. Um so they would actually put together a Thanksgiving that they would host at a different school uh each year, and you would all go, you'd kind of, you know, you'd sleep on the floor, but you'd have a group of people that you're interacting with, you know, and so it made it it made it okay, it made sure it made things a lot simpler. You know, we had uh the same thing those organizations knew a lot of people from California, a lot of people from Texas where it doesn't snow. Yeah, so they would even do something simple like let's go take a trip to the local department store or like you know the Burlington Coke factory. Let's go get you guys what you really need. Yeah, not like overbuy or things like that, right? Because when you when you don't know winter, you don't know winter, and these are the little things that'll catch you. It's weird, but those are kind of the things that for me were like, oh, thank you, I didn't know that. Yeah, that's amazing. That's a cool story.

SPEAKER_05 13:22

Winter, I imagine your first winter was uh kind of an eye-popping experience, huh?

SPEAKER_00 13:28

Yeah, I well, day one was really amazing because the first day it snowed, I remember uh me and a couple people who hadn't seen snow like right outside your window before. We ran out, we were taking pictures, we were playing in it, all that. But then by day two, you're like, okay, I'm I'm done. This is really cold. I'd I'd rather this just stop. Yeah, yeah.

SPEAKER_01 13:49

I I know the feeling. I I moved from South Texas to Utah when I was like 12. It's the same thing. We were so excited for snow, and then we didn't have coats. Yeah, yeah.

SPEAKER_04 14:00

So so now, so talking a little bit about, I guess going back a little bit on ultrasonics, what made you decide this is the place, right? Because you said you got the audio bug out of you, right? And you worked at JBL. And then for medical, is that because everything medical is in the ultrasonic range or no?

SPEAKER_00 14:21

So for me, I the medical came about is I I just always wanted to somehow make an impact, you know. I mean, that was if you look at anybody who's the the naive kind of high schooler, early college, what do you want to do with the rest of your life? Um I I wanted to make some form of impact, and I always had an interest in in medicine. Like I said, I wanted to at one point be a doctor or a surgeon or do something in the medical field. Um, and so medical acoustics really was the way to put those two together. I could work on things. I tell people like the world's a better place since I'm not a surgeon. I have coffee hands. Like if I if I do work under the microscope, I kind of start to shake. So you know, maybe it's a better place that I didn't do that. But I can work on technology that's within a space that I like, you know. I understand sound, I love acoustics, I love ultrasound, but then I can see the clinical impact it has, uh, and so it satisfies two bugs. Yeah. JBL was awesome. Uh, it I loved hearing what I was designing. Um, but there was just something about adding that kind of clinical component that that made it more satisfying to me.

SPEAKER_04 15:37

Interesting. On the ultrasonics, when you talked about like in Solic City and the application to the skin, did you find anything that it actually worked? Or was it promising or not promising? Or it got acquired, so I'm assuming there was some technique.

SPEAKER_00 15:52

Yeah, I started with here in Phoenix, but uh yeah, it it it did. I mean, you know, oh yeah, that's for for all of those uh technologies, you are doing a lot of clinical studies, and so you submit that to FDA as as evidence um that your technology works, and so um yeah, absolutely it's not a face lift, yeah, right. Um, but there absolutely was a measurable lift. And oftentimes what you find in uh in medical is in new technologies, even though they've launched and they're out there in the field, sometimes you don't always know a hundred percent the mechanism of action, right? I mean, we had thoughts about it, we were working on additional clinical studies to understand it. Um but a lot of our clinical studies were meant to show efficacy, right? Yes, it works. We are emitting a certain amount of ultrasound, we're burning tissue safely, you know, we're not creating burns everywhere and creating bruising and all of that. The tissue is healing and it's creating a lift. You know, the you're not required to necessarily say why that's happening, right? And so there's a lot of work, especially in a startup company, right? You can't spend all the time figuring out why and never launch, you just you'll you'll die. Um so yeah, that there's a big part of that that still kind of remains unknown. Got it. But it's fun. I don't know. For me, it's fun to work in that necessary.

SPEAKER_05 17:20

You're like, well, it works. Do we know exactly why? Well, no. I took an anatomy class in my undergraduate, it was the most eye-opening class. Highly recommend everyone take an anatomy class. You live in a body, you should know something about how it works. But one of the one of the lectures that blew my mind is um when we talked about the theory of how muscles contract. And I was like, the theory? Like, we know muscles contract. They're you know, like we know this is a thing, and they're like, well, yeah, but we don't know exactly how or why. And I was like, what? So um with uh so that was the facelift project that you just talked about um here in Phoenix. Was it your research in graduate school where you were working on like the the blood monitoring system? Yeah, the is that a technology that's out there?

SPEAKER_00 18:09

I'm so um I know that there, I mean the glucose monitoring obviously is now the norm, right? I mean that's that's kind of um a lot of companies are taking that on. Um the drug delivery portion, I think, is where there are still some challenges. Um my thesis advisor uh uh unfortunately passed away uh ac through an accident, and I know I think somebody in her lab picked it up uh in Jordan. And so he I haven't touched base with him, but he had been working on it still specifically for insulin delivery. But I know some people are working on drug delivery that way.

SPEAKER_05 18:54

Using ultrasound, but there's not necessarily that product on the market today. No, no, it's still experimental.

SPEAKER_00 19:00

So there were it didn't really quite catch on, I think, probably user experience, but there was the earlier technologies was you go in for a treatment. Uh-huh. So you go in, they sonicate because the skin days stays diffuse for a number of hours afterwards. So you could go in for a treatment uh and then you can put a patch on top of that that has the drug and that does the equivalent. I see. But you're going in for like a procedure, right? Rather than the ideal is a patch, forget. You know, that's kind of the the holy grail.

SPEAKER_05 19:34

Right. Interesting.

SPEAKER_04 19:37

So no needles, patch, forget it. It does its delivery that way. Yeah, that's that's the idea. That's cool.

SPEAKER_05 19:45

Uh when you said the skin remains diffuse, um diffusion is in like absorbing the medication.

SPEAKER_00 19:52

Yeah, so the ultrasound, what it does is it disrupts, and again, here's another mechanism of action that's still not a hundred percent known, right? Some say there's a little bit of a thermal effect, there's a little bit of a cavitation effect, um but the outer layer of tissue becomes a little bit more diffuse, and that's actually what allows um some of the interstitial fluid to diffuse out so that you can measure it. That's how we were doing it at the time. Um now they actually, if you look at the CGMs today, you'll actually press a button and it delivers a tiny needle that you barely feel that actually goes in, so it's not using any kind of energy-based delivery. Um but then because we were doing that to monitor interstitial fluid, you could actually diffuse drugs in. So that was kind of the idea. You do both kind of both at the same time.

SPEAKER_04 20:42

So um to put you on the spot, maybe you can explain what ultrasound so sound or ultrasonic means. Because for the listener, not everybody's in acoustics, let's say, right? We have that. Can you can you explain that for us?

SPEAKER_00 20:54

Yeah, so put simply, uh, just anything above our hearing range, right? Which is generally 20 kilohertz. So that's I I know a lot of people when we say ultrasound, it sounds fancy, but it's not really that fancy. It's just a lot of um and then a lot of tools actually operate above that simply because it's kind of annoying to hear something buzzing in in a procedure at 20 kilohertz, right? So for instance, um I designed a lot of uh facalulsification devices. These are devices that are used for cataract surgery. Uh they're tools that look like a big pen with a titanium needle that will uh vibrate ultrasonically. Um it'll aspirate the uh cataract that it breaks up through the center, and then there's an irrigation channel that keeps the eye chamber from collapsing. And so you can kind of imagine that process of jackhammering, sucking out, keeping fluid in. Um you can design low frequency devices, but there's issues with um you know the patient's awake, so there's a nuisance to the doctor, there's a nuisance to the patient. You also can get a lot of uh subharmonic effects where if you're operating at 40 kilohertz even you'll get 20 kilohertz noise coming off of the device. So we worry about that. So really you operate ultrasonically not just for efficacy but also for um patient comfort.

SPEAKER_04 22:24

What do you think of that saying I think that's a big thing. This is the he's the he went to school here at the uh University of Texas and has ult and and dealed with some I can well well I took ultrasonic I took a biomedical instrumentation class while I was at UT and um yeah and I also took an ultrasonics class.

SPEAKER_05 22:41

So this is uh this is really cool. So um not just having your device the primary frequency that it's driving at um operate above the range of hearing but any lower frequencies that may come off of it as well as like get an effect of what you're whatever shaking that pen whatever it's attached to and any any resonances as well you want that sufficiently high so that it's not um just so it's not audible annoying yeah or annoying. That's amazing.

SPEAKER_00 23:10

And a lot of that too I I mean I I these days especially early on in my career I was lucky enough to have um mentors who are really big on going and seeing what's happening out in the field. And so before really designing a lot of these FACO devices um we would go see cataract surgeries in the field. Oh I don't know if I could do that. Actually not that bad at there's like yeah the actually the stranger thing is going to uh cadaver studies where you know you're working on a cadaver for a certain part like if you think you're gonna do eye surgery or neurosurgery they don't give you the whole body right so they give you the portion that you need that's that's a little weird.

SPEAKER_04 23:54

So you just operate on an eye yeah or a head interesting so like you got so you just said something I think is kind of important right which is you get experience you they encourage you to go witness a surgery or whatever it is when you're so the operator has that experience so you're not just building and designing something that may or may not be useful you actually have to witness how it's being used.

SPEAKER_00 24:23

Yeah how how how important is that feedback I I personally think it's critical um I think understanding what the real use case is out there because we we generate as engineers and our marketing department will generate right an IFU so an instructions for use that says this is how you should perform the surgery this is how the tool should be used this is how you clean it if you need to and then you go in the field and when doctors start that's what they do but they have the freedom to do things off label and to do what they need based on their patients right uh so you come to find that a lot of experienced doctors will kind of do whatever they want sometimes. You know whether it be a surgical tool or even um for instance when we only had a brow lift on on our transducers doctors were already using it on the body off label. It's okay for them to do that. We can't advertise that it's that it can be used there. But doctors can experiment on their own and do what they feel like doing. So I think going and seeing what is really happening in the field is critical for people who are designing um these tools to kind of go and I mean one of the first things I remember witnessing was um we had off of the back of these uh devices a silicone over mold right that's meant to keep water from coming in because you have to stick them in an autoclave and disinfect them. We had a certain method in the IFU that you're supposed to fold all of these and you know that was all well and good. But the surgeon's bouncing back and forth so quickly that what the nurse does is she takes that wire and she just cranks it around the tool and you're like oh well that's why we're getting a bunch of failures back from the field right at the strain relief I know because that's how they're actually doing it. So it enabled us to come back and go okay if that's what they're actually going to do what can we do to better design it and manufacture it. Interesting.

SPEAKER_05 26:26

So your role right now you you test all the integrated circuits the ICs um and these are things that are everything from pacemakers to um to like the cataract pen. Neuromodulators yep tell us more about some of the different devices that you work on.

SPEAKER_00 26:44

Yeah so those are our two um biggest devices um you know we've got also pulse oximeter devices so you see you know you put your finger on right or um we've got uh an implantable that will monitor cardiac rhythm so it's called link um that device is uh temporary so it monitors your um heart rhythm to decide whether or not you need a pacemaker or uh some kind of defibrillation um tool put in and implanted um so we kind of cover a a broad range we're even involved now on some clinical studies um you know last year we got funding from the Gates Foundation uh to kind of merge uh and partner uh and look at preclampsia and women so monitoring blood pressure and different other um aspects of the body so we're trying to go to a clinical trial for that uh which my team is a part of right of anything that goes to a clinical trial needs to have some rigor within its testing. So yeah we kind of run the gamut from clinical studies you know maybe never meant to go to product development things that are in product development have really tight timelines they have launch dates and then operations projects that are more okay this has been in production for the last five years but wouldn't it be cool if we could save two million dollars and in scrap you know let's let's attack that so we kind of touch all aspects that's amazing there's a whole world of noise and vibration just in the human body and and all of the devices and and things that go along with that that's amazing.

SPEAKER_05 28:29

I mostly work in building acoustics so I'm uh same principles of wave propagation at sound energy but uh just on a different scale a different application that's amazing you said something earlier about um earlier on in your career your mentor some of your mentors were big on you getting that kind of exposure to hey how are these devices used in the field um I'd like to hear more about like kind of how you got started in the medical acoustics field like how did you find your first mentor how did you what was kind of like your breakout role there yeah so I mean my graduate work was in medical acoustics so that was the beginnings of just my interest um but I'll be honest really it it kind of found me while I was working at JBL there was a company at the time the name was Z Vex out in Salt Lake City that had been looking for an ultrasound engineer to design these surgical tools I think they had been on the search for like a year to a year and a half you know for somebody and I remember they came calling they found me at the time it wasn't as easy through LinkedIn right now everybody there's just kind of the information age um but they found me and uh the director of the ultrasonics group not that it was really big I mean it was something like five people right um but he kind of took a chance on me right and um I'll never forget that because it was an opportunity to get back into medical for me and to get back into that space.

SPEAKER_00 30:10

And he was hiring a guy who well maybe you have some medical background but all your stuff is kind of in audio your industry experience is in audio you haven't you don't know anything about the FDA you don't really know a ton of manufacturing uh the company at the time the revenue was really generated from manufacturing we were small RD house and then we would then manufacture all of those transducers in house that's that's that was our revenue generation um and so he really just took a took a chance on me and I I really appreciated uh that but um that's kind of how I got my my start back into into medical uh sort of literally they came after you recruited you out of the away from the JBL side was were you in JBL like north north where were you at in it was in Northridge Northridge okay yeah and then you go there and uh and how big you said it was five how big was that company that's you said it was a startup so the company was larger they weren't a startup they were a spin-off um of a company in Salt Lake City that did a lot of defense contracting um but the founders of the company um sort of created a a two-part company the first was uh ultrasonic level sensors so if you think of in the medical whatever you're feeding into a patient you need to know accurately what the level is and so they had little ultrasonic sensors that just um did a very simple you know what your level is is there fluid in front or air in front um and then also uh they looked at pumps uh and they got into pumps in part because they also had bubble detectors if you look at um lines that are also going into the patient you don't want bubbles forming and going into the patient they had ultrasonic bubble detectors uh that they were working on uh and that turned into also designing the full on pump and they ended up having entral feeding pumps uh ambulatory pumps uh and so that kind of became two parts of the company the pump side and then the ultrasonic side that was um designing surgical tools so we designed fecal multification devices which I was a big part of uh we did neurosurgery so tools that went uh kind of up the nose and did a lot of um uh emulsification of tissue um we had ultrasonic uh orthopedic welders uh that that we designed and then there was even a um which is now it's an orthopedic welder is a weld bone welder specific yes welding bone welding plastic tacks onto bone yeah so at the time there were uh specific locations and they were metal um tools that they would have to weld in so the the doctor had um specific spacing that they had to adhere to uh with plastic tacks you could weld that ultrasonically wherever you wanted so it gave them a little bit more freedom um we dove into uh you need to be a doctor my word you guys are way out of touch and all this uh or multiplication of the of the yeah I've been sitting here just like I'm fascinated right now on all this like I never thought about it I thought the coolest though was uh uh uh uh ultrasound assisted lightbow section and if you go and if you look at the console yeah if you look at lightbow section right now it's almost kind of standard of of of the industry that's called the Vaser yeah um essentially what it is you've seen I don't know if you've seen the video right of the doctor the doctor's up there and he or she is like cranking on this thing right just going through and it's like oh my gosh that's gotta be awful um so if you vibrate that long cannula ultrasonically you can emulsify just that little layer of tissue that's in front of the cannula and what it does is it creates this nice little glide. Oh right uh so instead of just like puncturing through that fat and aspirating it out you can emulsify that tissue and create less damage for the patient but also less fatigue for the doctor.

SPEAKER_05 34:12

Yeah emulsify what does emulsify mean?

SPEAKER_04 34:15

Uh liquefy yeah see I know smart words somebody's got he reads books that's pretty cool yeah wow so uh I have one other question because you're talking about this and you're talking about all this design and when you do you actually measure the ultrasonic portion of this as well meaning like hey when you're testing the tool I'd be curious to know what transducers are you using to measure.

SPEAKER_00 34:42

Yeah it's about so it it depended on what we were working on right I mean a lot of the tools even if it's an ultrasonic tool that vibrates you're not really worried about the acoustic radiation so much as what your actual displacement is. Okay. So for example in cataract surgery um one of the things that needed to be very consistent is as they press on the pedal that they use to operate the device there had to be consistent pedal displacement to needle displacement. Okay. Because that's what matters oftentimes they're under a microscope they're not always able to see what the tool vibration is. Of course not yeah so you've got to you know and then what if they go to the next room and it's a different transducer they're using it can't be wildly different. Okay so you have some strict tolerances on that. Yep. So that's really what we would measure is we would look up okay for a particular depending on how you're driving it you know if you're looking at a voltage driven current driven how are we getting what displacement are we getting based on the inputs to the device. So are you using accelerometers or the voltage or the electric are you looking at electricity accelerometers you can we would actually have just a very simple um kind of a laser looking at a shadow with a camera that then you just projected on that was you know pretty simplistic interest but accurate enough for us in terms of the displacement.

SPEAKER_05 36:04

Yeah and then you got you said you were making a lot of your transducers in-house for the for the transducers. For my my master's degree I was making capacitive micro machined ultrasonic transducers and in order to to kind of to get finished my my thesis I had to I had to prove that it worked. So there I was in the lab and I've got these two tiny like the size of your fingernail transducers and it's like aiming an invisible laser trying to pitch and catch. But that was in air uh you're in fluid um do you guys ever have that kind of issue where you're like hey where is the and how much is it moving? I guess you just said you use like a uh a laser and count the shadow the movement of the shadow tell us more about that.

SPEAKER_00 36:53

A lot of our our measurementals from displacement when we really wanted to get accurate um we did have what are they called the Polytech makes them uh vibrometers we would use some of those if we really wanted to take a look at what the exact displacement was or displacement along that needle but oftentimes it just needed the tip right so it was essentially a needle gets put into a small water bath if you can imagine just you know holding your hand like cup size there's a laser that's hitting that needle tip and so you're you know using uh your adjustments to make sure that tip is hitting just on that needle and then you have a camera on the other side.

SPEAKER_06 37:36

Gotcha.

SPEAKER_00 37:37

And so that shadow can you can look at that on a TV screen and take a look at what the displacement is.

SPEAKER_04 37:42

Does heat obviously comes into play because you don't want to make burns like you're saying or or just that's does that change like the frequency then how much heat's coming off this and that's how you decide okay hey we gotta lower the the amount or how does that work?

SPEAKER_00 37:57

Heat isn't such an issue because you're in a fluid bath and so a lot of the heat is just dissipated out and so you have this constant irrigation at least in those tools okay that are going on uh what mattered more there was out of plane motion so depending on what you were designing a lot of times we wanted if you can imagine a jackhammer motion you wanted strictly up and down right if at the same time you were getting transverse motion you'd start getting this kind of wobbling and then that was no good right because then the doctor's going in thinking he's just jackhammering at tissue but he's also doing this.

SPEAKER_04 38:33

So we depending on the customer's needs would have specifications for how much out of plane motion we could produce so in your career would you say like obviously you've learned a lot this obviously beyond just the acoustics or the vibration it's like also material science right I mean it sounds like you've got to know a lot about a lot but you didn't know this in college. So a lot of this is as you're going through and talking to their mentors but like how you know is that is that safe to assume like there's just a lot of like research on your own understanding what these materials do and how to build something that doesn't do what you're saying right and and keeping keeping it yeah for sure so my background by training is electrical engineering all right but I tell people I'm absolutely not an electrical engineer anymore right I mean getting into ultrasound and getting into acoustics I did have to become a little bit of jack of all trades right you're looking at mechanical motion so you have to do a little mechanical engineering.

SPEAKER_00 39:33

In some cases you might be looking at sound radiation if you're looking at high intensity ultrasound or medical imaging so you become a little bit of a physicist. We had problems um uh with um in manufacturing and in one transducer that was in a water bath and for some reason you know we had imaging on it and over time it was getting cloudy and we were getting some kind of debris in there kind of find out there was some sort of chemical reaction that was going on in there so you become a little bit chemist you know interesting so you may not be a hundred percent expert in one thing but you start to really be good at at being jack of all trades.

SPEAKER_04 40:15

That's cool. Yeah so for Metronics because you talked a little bit about that can you just tell us how big they are could kind of give us some scale there for those that don't I mean I I've heard of the company I know people.

SPEAKER_00 40:25

So to give you an idea they are about a 9000 plus employee company um yeah they they're global we've got here in Tempe um we do have manufacturing of of ICs and then we also manufacture um overseas as well so uh the the Tempe plant is primarily manufacturing but we do have a small um product development team that takes a look at product development within IC design uh and then my group falls within that in test engineering is we also fall under the kind of product development umbrella um and then do you build your IC chips here too then you say manufacturing yep so you manufacture your chips so you guys have like clean rooms and we do have clean rooms yep yep cool so we'll get we'll get the wafer from the foundry right we'll test that uh depending on what we're gonna do with it we will um separate that out and create hybrid components again sometimes we ship it out then to create uh stack components um the device level though is generally done overseas somewhere okay so what's the future in terms of ultrasonics do you have any insight on that like something that's exciting or could I mean that you can share with us or yeah I mean I've or where you'd like to see it go I've been super excited about non-invasive technology. I've always been thrilled to see that kind of stuff happen. Um you know things like so I've got unfortunately in in my own family um uh breast cancer history and so seeing applications of high intensity ultrasound uh within that space uh really fascinates me. Uh if you look maybe uh a couple years ago I think a company um Histasonics uh was able to get FDA clearance here in the US uh treating liver tumors um and so that's been huge I mean things like um uh lithotripsy have been around for for quite some time um and a lot of people are working on a lot of non-invasive technologies for ultrasound and I think I think the technology hasn't been so understood and not a lot of people have gotten into it uh like other technologies um but as it's as it's making waves I feel like there's there's more noise around it punish more like yeah and there's there's just people are looking at it like oh you can deliver like therapy you know everybody thinks ultrasound and they go I'm gonna go get an image yes that's true but I tell people if you take that same thing and you focus it and you turn up the sound you'll liquefy the tissue and you'll do nothing to the surface in some cases right so if you can control that I mean people have been working on getting into the brain too the skull was a big challenge. And now people have resolved that you know we can we can emit high energy pulses into the brain uh of ultrasound and it's like that used to be unheard of back in the day. So I think those technologies really excite me and seeing the clinical outcomes.

SPEAKER_05 43:44

That's cool.

SPEAKER_00 43:46

So it's just getting started Yeah very much so I think yeah it's it's a challenge here in the US there's a lot there are a lot of hurdles that you have to to go through in order to get into a clinical study. Rightfully so, right? You don't want to touch patients and injure them, but sometimes it feels limiting. But FDA is creating new or has created new areas and processes where new technologies can kind of not cut in line but not go through the standard process. They realize okay, there are technologies that are at the forefront that are new. We have to have a different process for them.

SPEAKER_04 44:26

So if you could go back to your younger self and tell yourself some advice, what would it be? Through your crew through your journey. Or to the the young college kid who's struggling out there or trying to find a mentor.

SPEAKER_00 44:39

I think probably networking is a really big thing, and I I don't think I did that well along the lines of the challenges of going to school. So my I have a son in college right now, and one of the things I tell him, he's studying mechanical engineering uh at Penn State, and I tell him, don't really worry as much about the school you're going to, how prestigious it is. You know, these days everything is even online. Like MIT has open courseware. You could take every class online if you wanted to, from lectures to problem sets to exams. Um but one of the things that I didn't do well is connect with people in industry. Right. I went to a really prestigious school. I should have been rubbing elbows with a bunch of Nobel laureates, right? That's what I should have been doing as an undergrad is going and talking to them and learning from them. But I kind of put my head down and did as well as I could in all of my coursework, you know. Um and I got a great education, it was it was good. But I think that's one of the things, if you're up and coming, that I would suggest is really focus on yes, you're there to learn how to learn whatever you're studying, um, but really connect with people who have done it for a long time because there's a lot of learnings to be had. You you know, if you're studying engineering, psychology, whatever it is, find out what they've learned about their industry and just tie yourself to them, whether it's an opportunity for research, whether it's just conversations. I think you know those are the things that I'm telling my son now, like, go do that. You know, he had an interest in psychology, and I was like, talk to him, talk to that professor. And he has, and that's he's built a relationship around that. And cool. I think I think those are things that's great that can be helpful.

SPEAKER_04 46:28

Well, thank you for coming today, and we appreciate your time. Yeah, thank you for having me. It's been fun.