Surbhi Sarna，nVision Medical创始人

我是杰西卡·利文斯顿，和卡罗琳·莱维共同担任社交雷达的角色。在这档播客中，我们将与硅谷一些最成功的创始人畅谈他们的创业历程。近二十年来，卡罗琳和我一直在Y Combinator携手帮助数千家初创企业。欢迎像墙上的苍蝇一样旁听我们与创始人的真实对话。卡罗琳，我真的很兴奋。

I'm Jessica Livingston, and Carolyn Levy and I are the social radars. In this podcast, we talk to some of the most successful founders in Silicon Valley about how they did it. Carolyn and I have been working together to help thousands of startups at Y Combinator for almost twenty years. Come be a fly on the wall as we talk to founders and learn their true stories. Carolyn, I'm really excited.

今天我们有幸邀请到Y Combinator合伙人塞尔维亚·萨尔纳。此前她曾是Envision Medical的创始人兼CEO，该公司研发了首个也是唯一获得批准的卵巢癌检测设备。塞尔比，我迫不及待想和你探讨这个话题。欢迎欢迎。

Today, we have on the show Serbia Sarna, who is a Y Combinator partner. And before that, she was the founder and CEO of Envision Medical, which was the first and only device it was the first and only device cleared to, like, test for ovarian cancer. And I can't wait to talk about this with you, Serbi. Welcome. Welcome.

谢谢邀请，能来到这里我太激动了。

Thanks for having me. I'm so excited to be here.

另外你去年出版了《毫无疑义》一书，我特别期待聊聊这本书。书中记录了你创业历程的点点滴滴。我想回到故事起点——你高中时罹患复杂卵巢囊肿的经历。能讲讲这个改变你人生轨迹的故事吗？

And also, you published a book last year called Without a Doubt, which I'm very excited to talk about. And the book chronicles your your journey through through the company. I wanna go back to the beginning when you were in high school and suffered from, like, complex ovarian cysts. Tell us that story because that sort of kicked things off for you, didn't it?

确实如此。其实在开始出现这些剧烈疼痛的囊肿之前，高中时代对我——就像对许多人一样——已经是段特别的时光。那时的我就有点科学倾向，算是个小书呆子。直到某天，我在卧室写关于爱默生的论文时，突然感到一阵越来越剧烈的刺痛。

It did. It did. I would say that even before I started getting these extremely painful cysts, High school was already an interesting time for me as it is for many people. I was already a little bit, I know, science leaning, a little bit nerdy. And then one day, I was writing a paper on Emerson in my bedroom and mid sentence, I felt this really sharp pain that kept getting sharper.

你知道有些疼痛会自行消退，但那次痛感却不断加剧。当时母亲正在厨房，我只记得自己踉跄走到门口，看见她站在窗前的剪影，然后就失去了意识。

You know, sometimes something, you know, passes but it kept getting more and more acute. And my mom was in the kitchen at the time and I remember getting there just seeing the silhouette of her back against the window and then passing out.

天啊。

Wow.

哦老天...是的。接下来有意识时，我发现自己短暂苏醒在车里，当时还想：妈妈是怎么把我弄上车的？那时我还没当母亲，但现在完全明白了。

And Oh my gosh. Yeah. And, you know, the next thing I remember is waking up in the car for a second actually and thinking, how did my mom get me here? How did she get me the Because I wasn't a mom at the time, but now I know.

母爱的超能力。

Super human strength.

没错没错。孩子晕倒在地，你总会想办法把他抱进车里的。

Yeah. Yeah. Yeah. Yeah. Kid's passing out on the floor, you're gonna get them in the car.

没错。你知道吗？

Exactly. You know?

对。是啊。但在医院里，他们无法准确诊断你是否患了癌症。跟我们说说这个吧，听起来真的很吓人。

Yep. Yeah. So at the hospital though, they couldn't properly diagnose if you had cancer or not. Tell us about that because it's really scary sounding.

是啊。那天去急诊室特别煎熬，因为我疼得厉害。我发现如果稍微弓着点身子，就能防止自己疼晕过去，就是别完全站直，这挺奇怪的。一开始他们以为我是阑尾炎。结果发现阑尾的影像检查也不怎么靠谱。嗯。

Yeah. It was the ER visit that day was excruciating because I was in so much pain. I realized that I could stop myself from passing out from the pain if I kind of hunched over a bit, you know, if I if I never stood up straight which is kind of an an odd thing. And at first, they thought that I had appendicitis. It turns out imaging for the appendix isn't that great either Mhmm.

这很有意思，因为这是个常见手术。他们都给我做好手术准备了，结果临上手术台前，主刀医生才意识到不是阑尾炎，是别的毛病，但具体是什么还不清楚。

Which is so interesting such as because it's a common procedure. And they were they prepped me for surgery and then only right before the surgery, the surgeon realized this isn't appendicitis, this is something else, but we don't quite know what it is yet.

他们本来打算直接开刀把你没发炎的阑尾切掉。就要直接给你开腹了

They were actually gonna open you up and remove your unburst appendix. They were just gonna open you up and

哇。天啊。真是。

wow. Yeah. Wow.

是啊。后来我才知道阑尾炎误诊率特别高。我前女友就是被漏诊的阑尾炎，结果感染扩散全身，住院住了一个多月。唉，太糟了。

Yeah. The appendix, it turns out that there's all this medical error around appendicitis. I had no no idea about until recently when I had a girlfriend who they missed her appendicitis and then she ended up in the hospital for more than a month because the infection spread everywhere. Oh, no. Yeah.

所以即便是常规手术也...

So even things that are quite routine, you know

要不干脆趁早把阑尾切了算了

Actually, maybe time. Getting your appendix out proactively based on that

这么一说倒也不失为好主意。确实。我当时真的吓坏了，毕竟才13岁。

story doesn't sound like such a bad idea. I know. I know. Yeah. So I was, I I mean, I was really like, I was scared that day, you know, I was I was 13 years old.

但幸运的是，就在手术前，那位外科医生进来，我记得他戴着口罩之类的东西，做了最后一次检查，让我踮起脚尖然后用力踩下脚跟。据说如果患有阑尾炎，这个动作会引发剧痛，但那次对我并没有产生这种效果。

But they luckily, the surgeon right before like, he came in and I remember he was, like, masked up and everything kind of doing like one last check and he's had me stand up on my toes and come down on my heels as hard as possible and supposedly when you have appendicitis that that should kind of make you feel excruciating amounts of pain, but that didn't trigger it for me that time.

当

As

所以他们留我观察了几个小时，之后又把我叫回去。直到接下来几天才确诊我卵巢上有巨大复杂的囊肿。真的。

they so they kept me for a couple of hours for observation and then pulled me back and then only in the next couple of days realized that I had very large complex cysts on my ovaries. True.

他们怎么扫描的？嗯。

How did they scan? Yeah.

嗯。通过阴道超声检查。

Yeah. Through a transvaginal ultrasound.

对。对。对。我正要说。好吧。

Yeah. Yeah. Yeah. I was gonna say. Okay.

他们通常不会对非常年轻的女性做这种检查。是的。所以我觉得这也是原因之一。花了几天时间才决定，好吧，我们得做这个其他检查。但超声的问题是，虽然能看到卵巢上有东西，能看到肿块，如果完全是液体填充的肿块就不用担心。

They don't readily do those on like very young women. Yeah. So I think that was part of it. It took like a couple of days to say, okay, to to know this, we're gonna have to do this, you know, this other procedure. But then the issue with the ultrasound is you can see that there's something on the ovary, you could see that there's a mass and sometimes if that mass is completely fluid filled then you know that it's nothing to be worried about.

只是个囊肿，回家等它自行消退就行。但我的肿块被称为'复杂型'是因为它部分实性部分囊性。

It's just a cyst, you know, go home, let it pass, it's fine. But the reason they call the the mass I had complex is it's partly solid, partly liquid.

天啊。

Oh god.

是的。遇到这种情况就很难判断。医生不想贸然手术因为患者太年轻。接着他们会做血液检测，但不幸的是，这个血液检测至今准确率极低。

And Yeah. And then so when when there's that sort of thing, you can't really tell. You don't wanna rush to operate because the woman's so young. Yeah. So then the next thing they do is a blood test and unfortunately, this blood test till today is extremely inaccurate.

以凯撒医疗为例，他们甚至不会对绝经前女性进行这类手术。正是由于缺乏诊断手段，根据克利夫兰诊所的数据，美国每年有60万例卵巢切除手术，但实际只有1.4万例卵巢癌病例，其中四分之三还是在晚期才被发现。我们就像在盲目手术，结果经常发现根本没问题。真是令人震惊。

So Kaiser for example, won't even do it in women who are premenopausal. So these lack of diagnostic options, this is why in The US, according to the Cleveland Clinic, there's six hundred thousand operations to remove the ovaries of women in The US each year but there's only fourteen thousand cases of ovarian cancer and still three fourths of those are caught at late stage. So we're like jumping the surgery, you know, and then often there's nothing there. Oh, wow.

因为这是唯一相对安全的选择。

Because that's the only sort of safe option.

当肿块位于卵巢上时，你不能直接进行活检，因为卵巢位于腹腔中央。想象一下，如果用针穿刺取出癌变组织，实际上等于把癌细胞扩散到整个腹腔。所以医生会尽量避免活检，而尝试活检时往往不得不切除整个卵巢。嗯。

You can't just biopsy the mass when it's sitting on the ovary because the ovary sits in the middle of the rest of the cavity. Yeah. So imagine if you go in with a needle, it takes something that's cancerous and you pull it out, you're basically spilling it into the rest of the cavity. So they really don't want a biopsy if they can prevent it and often when they try to biopsy, they end up removing the rest of the ovary. Mhmm.

而且，在13、14岁这样的年纪——其实任何年龄都如此——切除卵巢都不是好事。是的，单纯切除卵巢对女性健康非常不利。

And and doing that at, you know, 13, 14 truly, like, almost at any age is not great. Yeah. It's not great for women's health just to pull out the ovary.

你当时是双侧囊肿还是单侧？

Did you have cysts on both or just one?

单侧。只有

On one. Just

好的。那么理论上可以只切除一侧，保留另一侧卵巢还能保持生育能力？

okay. So so what can happen and maybe the case that you take out one but you still you're you can still keep the other one and still be fertile?

可以保留生育能力。但卵巢还控制着我们的激素水平。除了生育功能外，特别是双侧卵巢切除的女性，她们面临更高的骨质疏松风险，还有心脏病风险。

You can. You can't still be fertile. The ovaries are also sort of our part of what controls our hormones, you know. So in addition to the fertility part of it, women that have especially both ovaries removed, you know, suffer from a higher risk of osteoporosis Yeah. Of heart disease.

必须谨慎行事。

You wanna proceed with caution.

但当年你13岁时并不了解这些。医生只是告诉你们发现肿块，可能是癌症也可能不是。你和家人不得不做出艰难决定——我记得你说最终选择暂不手术继续观察。

So back then at 13 though, you didn't know all this stuff. You were basically told, we see a mass. It could be cancer. It might not be. And you and your family had to make the scary decision of what to do, which was I think you said, let's not operate and wait.

是的，没错。这一切都发生在2004年，那时谷歌还没真正兴起。记得我在创业学校给一群年轻人演讲时，提到自己曾在雅虎上做研究，甚至跑去图书馆查资料。我的老师们非常出色，他们极有耐心地帮我理解我所经历事情背后的科学原理。

Yeah. That's right. And this was all happening back at 2004 and Google really wasn't a thing yet. You know, when I I was speaking at like startup schools to to crowds of kids, I'm like, did research on Yahoo and actually went to the library. I had really spectacular teachers and so they had a lot of patience with me in terms of helping me understand the scientific concept behind what I was going through.

同样重要的是，我想说——这也最终促使我写了那本书——有位叫米德尔斯特德的英语老师与我关系亲密，她教会我如何将情感倾注于写作中。没错，就是通过写作保持我的创造力。

And I think equally importantly, I would say, right, and I think this is what led me eventually to writing the book. I had an English teacher named miss Middlestad that I was really close with and she taught me how to channel the emotions I was feeling into writing. You know? Yeah. To keep to to to keep me productive.

最初我写些幽默文字，甚至自嘲某些经历。比如做阴道超声复查时，他们叮嘱我要大量喝水且提前憋尿，结果我做得太极端了。写作确实能帮你处理艰难情绪，也能让你事后以更轻松的角度看待问题。正是这些方法，加上母亲的支持，帮我度过了那段时光。

And I started with writing funny, almost making fun of certain aspects of what I was going through, you know, like for a follow-up transvaginal ultrasound, they told me I should drink a lot of water and not pee before and I think I took that to an extreme. And so, know, writing can help you process really difficult emotions and it can help you see things in a more light hearted way as well, you know, when you're looking back on it. And I think a combination of those things got me through. And of course, the support of my mom got me through that time.

当时他们如何管理你的疼痛？

How did they manage your pain?

好问题。记不清是否用过处方药，但确定当时全天候服用止痛药。毕竟缺课总有极限，如果感觉能返校，至少能获得些许常态感。

That's a great question. I can't remember if I was on anything prescription level, but I do know I was on painkillers around the clock. Yeah. Because eventually, you there's a limit to how much school you can miss and if you feel like you can go back, at least you have some sense of normalcy, you know.

最终囊肿自行消解了吗？还是发生了什么？

Did it ultimately correct itself or what happened to the complex cyst?

六个月后它——用词不太雅观——破裂了，问题就这样自行解决。破裂时引发局部组织扭转，记得当时正在上西班牙语课，剧痛突然袭来，所有老师都清楚意识到我的状况。

Yeah. So eventually after six months, I know this is a not a pretty word, but it bursts and that's how it kind of like corrects itself. When it does, it causes torsion in that area like things kind of twist together. So I was I remember I was in Spanish class when it happened and it was extremely painful and then all the teachers were alerted to what I was going through clearly. Right?

然后我不得不...对，自己挣扎着去医务室。那位老师坚持用西班牙语向同学们解释：我卵巢上的肿块破裂了——面对一群...嗯...初中男生。

And and then I had to like Yeah. Remove myself and, like, you know, make it to the nurse's office. And of course, the teacher is doesn't wanna speak in English because it's Spanish class, you say. So she she tries in Spanish to explain to the other kids that I had a mass on my ovary which is ruptured to, like, a group of t yeah. Like Middle floors.

就是青春期男孩。天啊。

Like, teenage boys. Teenage boys. Oh,

这下他们学会'卵巢'这个词了。

if you learn the word for ovary.

我知道。对。后来有个男孩跑过来跟我说，呃，我听说你的卵巢爆了。我说，那不是我的卵巢。好吧。

I know. Yeah. That's just had a boy run up to me later and say, ew, I heard your ovary burst. I was like, it's not my ovary. Okay.

算了。你懂吗？所以

Never mind. You know? So

哦，那太难了。太糟糕了。尤其是13岁的时候，你对一切都那么敏感。每件事。哦，

Oh, that's so hard. It's terrible. Especially as a 13 year old when you're so sensitive about everything. Everything. Oh,

是啊。但是对。一旦它

yeah. But Yeah. Once it

破裂了，然后你的身体自然就解决了，你就没事了？

bursts, then your body naturally sorted it out and you're okay?

所以在那之后，我每年都会长一种囊肿，每次长囊肿，实际上患癌的几率会增加一些，但这反而让我们每次都不那么紧张了，因为我们知道要面对什么，知道如何监测，知道如何观察。对吧？但经历这样的事情，尽管我在一所进步、非常支持的学校，我只是意识到历史上女性健康的优先程度存在差异。这在我心里埋下了一颗种子，有一天我想在这个领域创办一家公司，你知道吗。

So after that, I I would have sort of a a cyst every year, and every time you have a cyst, there's some actual, like, increase in the chance that it was cancer, but it actually made us less nervous each time because we knew what we were dealing with, we knew how to monitor it, you know, we knew how to watch it. Right? But going through something like that, even though I was at a a progressive, very supportive school, I I just realized that historically, there had been this difference between the way that women's health was prioritized. And it kinda started this bug in me that one day I wanted to start a company in the space, you know.

好吧。但我们先停在这里，因为我觉得这真的很有趣。你在想，我想在这个领域创办一家公司，但为什么你不是想，我要去一所名牌大学当研究员？比如，你怎么知道你想做的是商业，而不是只想在实验室里发现能帮助女性解决这个特定问题的东西？对。

So okay. But let's stop there because I think this is really interesting. You were thinking, I wanna start a company in this space, but why aren't you thinking, I wanna go to a prestigious university and be a researcher? Like, how did you know you wanted it to be a business versus just like, I wanna be in a lab and discover the thing that helps women's this particular issue? Yeah.

我爸爸是工程师出身。他是软件工程师。他是Netscape最早的那几百人之一，就是作为一名工程师在那里工作。但天啊，他太爱那份工作了。他总在谈论创业的事情。

My dad was a engineer by training. He's a software engineer. And he was like one of the first like few 100 people at Netscape like just as an engineer working there. But oh my gosh, he loved it. He would talk about it all the time like the start up the start up thing.

他会穿公司的周边，你知道，那件夹克。我记得Netscape上市的那天。所以我们当时正处于科技创新的爆发期。

He would wear the swag, you know, the jacket. I remember the the day that Netscape IPO'd. So I would we were, like, in the middle of this, like, tech innovation, like, burst.

是啊。那时候可是发源地。

Yeah. That's ground zero back then.

是啊。网景。

Yeah. Netscape.

对。对。对。

Yeah. Yeah. Yeah.

没错。当时网景和微软就像在互相打仗，网景在微软的地盘上留下了一个巨大的、像Mozilla那样的标志，然后微软就在上面加了个m的标志。我看到我父亲在参与这件事后变得多么充满活力，要知道他之前一直在非常大的公司工作。是的，我特别喜欢发现和构建新事物的概念。

Yeah. And Netscape and Microsoft were, like, warring with each other, and Netscape left a, like, a giant, like, Mozilla thing on, like, Microsoft's ground and, like, Microsoft put an m on top of it, you know. And I saw how energized my dad was being part of this after working at, like, very large companies before that, you know. Yeah. And I just love the concept of finding and building new things.

甚至在我生病之前，当我还是个孩子的时候，我有一本笔记本——现在还在——我会...我知道这听起来有点书呆子气，即使是现在，但我会改变不同昆虫的栖息环境，观察它们对事物的反应。我觉得这其实...我也不知道。或者，你知道，我父母研究用的跑步机，在我大概六七岁的时候，我就试图自己组装它。我不太...懂吗？我觉得这是个很好的问题。

And I would even before I got sick, when I was a kid, I have I still have a notebook where I would I know it sounds a little bit sounds so nerdy even today, but change the habitat of different insects and see how they would react to stuff. I think that's actually I don't know. Or, you know, my parents study, like, a treadmill and at the, like, the age of six or seven, I was, like, trying to assemble it myself and put it together. I don't you know? I think I it's a really good question.

你知道，为什么我没有立刻说我要去搞研究呢？我一直保留着这个选项，但那种兴奋感，作为一个在那个时代湾区长大的孩子，看着我父亲即使只是参与创造那样东西的一小部分也那么开心，我想我可能有点被这种热情感染了。

You know, why didn't I just say immediately I was gonna go to research? And I always kept that part of my that option open, but that excitement, you know, being a Bay Area kid growing up in that time, like watching my dad be so just happy being even a smaller part in creating something like that, you know, I just got I think I just got infected with the bug a bit.

你妈妈也有创业精神吗？

Was your mom entrepreneurial too?

我妈妈有印地语文学的博士学位。嗯。所以她并不算传统意义上的创业者，但她一直想教印地语，那是她的目标。后来她安排了加州大学伯克利分校的面试，结果发现怀上了我。嗯。

So my mom has a PhD in Hindi literature. And Mhmm. So she so she's not traditionally entrepreneurial, you know, but she always wanted to teach Hindi. That was her goal. And then she had an interview lined up at UC Berkeley and then she found out she was pregnant with me, you know, and Mhmm.

她决定暂时搁置这个计划。如今我特别为她骄傲，因为她真的在斯坦福大学教印地语了。

Decided to hang back from it, you know. I'm I'm super proud of her today because she is actually teaching Hindi at Stanford.

哇，这太棒了。

Oh, wow. That's amazing.

真了不起。

That's awesome.

刚带她去了。虽然有所延迟，但她最终还是实现了目标。

Just took her. It was delayed, but she eventually reached her her goal.

现在看到她站在斯坦福校园里的照片真是令人惊叹。实际上，我甚至不知道我还资助过她的一个学生。

And it's amazing now to see her, you know, photos of her on the Stanford campus. And in fact, I didn't even know I funded one of her students. And

真的吗？

so Really?

他们走过来问我，'你是阿努帕玛的女儿吗？'那场景特别可爱。

They came up to me. Yeah. You're like, are are you, you know, Anupama's daughter? And it was really cute. So Aw.

是啊，这真是太美好了。

Yeah. That's so that's wonderful.

还不错。

Not bad.

所以你后来去了伯克利读本科。毕业后你进入了一家更传统的工作，我记得是在雅培血管公司，后来又加入了一家医疗科技类初创企业。能告诉我们你决定创办一家癌症检测设备公司的契机吗？

So then you went to Berkeley then. You the undergrad. And then after you got more of a traditional job, I think it was at, like, Abbott Vascular and another med tech type of startup. Tell us about the moment when you decided to start a company to make a device to test for cancer?

当时我在做另一份工作，收获很多，但总觉得在医疗领域创业前需要积累足够的经验。那时我24岁，祖母的乳腺癌复发了。从伯克利到第一份工作期间，我曾在印度度过一个夏天照顾她。

I you know, I was working this other job. I was getting a lot out of it, and I always felt like I needed a certain number of years of experience before doing a company in health care, you know. So Yeah. I was 24 at the time when my grandmother's breast cancer came back. And between Berkeley and working my first job, I had spent the summer in India helping to take care of her.

学术上研究癌症是一回事，亲身经历恐慌并直接照料病患又是完全不同的体验，对吧？

That's a very different experience studying cancer academically, even having a scare and taking care of someone firsthand who's suffering from the disease. Right?

是啊，确实如此。

Yeah. Yeah.

但当她去世时，我才24岁，你知道吗，那时候我刚订婚，原以为她能参加我的婚礼。那一刻我突然意识到，如果真想攻克这个课题——当时我对这种疾病已经研究得极为透彻，能接触到的每篇论文我都读过——就必须全身心投入才可能有所发现。

But when when she passed away, when I was 24, you know, like, I had just gotten engaged, you know, and I thought she was coming to my wedding and, you know, I think at that point, I I just realized if this is something I really wanted to work on, I had understood the disease so well at that point. I had read every paper I could get my hands on that I just needed to dedicate myself to it fully if I was gonna discover something, you know. So I think that

嗯。

Yeah.

正因之前没这么做——虽然和挚友订婚，工作也顺遂——但内心总有不满足。而当我专注解决这个问题，决心倾尽所有寻找答案时，那种满足感瞬间充盈心间。是的，即便前路艰难未卜，那个空洞的部分却即刻被填满了。

And and because I wasn't doing that, you know, I was engaged to my best friend and I was doing well at my job, but I just wasn't satisfied. Like, there was something in me that wasn't satisfied. And the joy that I got from then focusing on this problem and knowing that I was just gonna spend every ounce of myself trying to find a solution, the joy was instantaneous. Yeah. Like, even though it was so hard and so uncertain, like that part of me, whatever was missing was solved instantaneously.

我甚至不知该如何准确描述这种感受。

I don't even know how to describe it accurately. Yeah.

就像义无反顾，认定这就是命中注定该做的事，毫无保留。

Like, no looking back. You're like, this is what I was meant to do. No reservations.

那么你最初具体做了什么？比如，是先把设计草图勾勒出来吗？我的意思是，你当时怎么确定的？因为你的设备是要穿过输卵管检测那些细胞的。你甚至提前就知道最终形态会是这样吗？

So what was the first thing that you did though? Like, was it like, I'm gonna sketch out what it'll look like? I mean, how did you even know? Because your device, like, goes in through the fallopian tube and test those cells. You even know that that was what it was gonna be?

当时约翰霍普金斯大学Vogelstein实验室发表了一篇论文，指出'卵巢癌'其实是个误称。他们认为应该称为输卵管癌，因为大多数卵巢癌实际起源于输卵管。那里是细胞更新最活跃的区域。这成为了解这种疾病的关键转折点。我研究了所有其他癌症类型，想弄明白社会在哪些方面真正取得了突破——宫颈癌有巴氏涂片检查，结肠癌有结肠镜检查，乳腺癌有乳腺X光检查。

So there was this paper published by a lab out of Johns Hopkins, the Vogelstein lab that said ovarian cancer is actually a misnomer. They we should call it fallopian tube cancer because the majority of ovarian cancers actually begin in the fallopian tube. That's where the most cellular turnover is happening. It was like the seminal moment in understanding this disease and I as I had studied every other cancer to figure out how have we as a society really made an impact, On cervical cancer, you have the pap smear, on colon cancer, you have the colonoscopy. Mammogram for breast cancer.

关键在于找到癌变源头，这才是创造差异的根本。在所有取得重大进展的癌症治疗中都是如此，虽然并非总能实现。比如胰腺就很难直接检查。但我想，如果能轻松检查输卵管呢？于是我开始研读所有FDA备案文件，所有关于输卵管或卵巢检测的文献——真的是所有相关研究。

Really, we have to get to the source of origin, you know, that's what's really made the difference like where wherever we've made the biggest difference in whatever cancer and that's not always possible. You can't easily access the pancreas for example. Right? But I thought what if you could easily access the fallopian tube? So I started reading all of the FDA filings, all all of the papers ever written, truly ever written on anyone that tried to access the fallopian tube or ovary for any reason.

这就是我的起点。

That's where I started.

明白了。

Okay.

什么是

What are

非手术的。非手术的。无需开刀

Non surgical. Non surgical. Without having to open

无切口。比如，过去人们是怎么做的？我不想重复发明轮子。过去人们做过什么？我能从中学习什么？

the No incisions. Like, what have people done in the past? I don't wanna reinvent the wheel. Have people done in the past? What can I learn from it?

我了解到，过去曾有过多次尝试为其他原因接触卵巢。其中之一是为了不孕检查对输卵管进行成像。如果输卵管有阻塞，你知道，如果能将导管插入那里，就能实际观察到阻塞并进行治疗。是的。这是导致不孕的主要原因之一。

And I learned that there had been multiple attempts to get to the ovary for other reasons. One of them being imaging of the fallopian tube for infertility workup. If there's a blockage in the fallopian tube, you could tell you know, if you can get a catheter up there, you'd actually be able to visualize the blockage and treat it. Yeah. And that's one of the leading causes of infertility, you know.

是的。所以这就是我开始阅读所有能找到的资料，并实际勾勒出想法的地方。最终，我知道我需要和医生讨论，以确保他们也认为这是个好主意。

Yeah. And so that's that's that's where I started reading everything I could and then actually sketching out the idea. And then eventually, I knew that I needed to talk to physicians about it to make sure that they thought it was a good idea as well.

你当时还在工作吗？就是说，你是在晚上，空闲时间做这些事情的，

Are you still working at this point? Like, so you're doing all this like at night, you know, in your spare time,

但我仍然有我的工作。

but still have my job.

是的。但你开始和你认识的一位妇科医生讨论。

Yeah. But you start talking to a gynecologist that you knew.

嗯，是的。我是说，这很有趣，对吧？我真希望YC能参与这段旅程，你知道，那正好是在YC开始涉足医疗健康领域之前。对吧？

Well, yeah. I mean, this is interesting. Right? I, I so wish I had YC on the journey, you know, it was right it was right before YC was doing health care stuff. Right?

是的。

Yeah.

但我当时直觉认为，我必须尽可能多地与用户交流，也就是尽可能多地接触医生。要知道，年轻人创业时哪有什么庞大的人脉资源。我最多能联系10位医生，听听他们对这个想法的看法。

But I I just felt intuitively, I I I must talk to as many users, you know, as many physicians as I possibly can and I it's not like you have a huge Rolodex when you're young wanting to start a company, you know. Like, I can all I can call 10 physicians and see if what they think of this, you know.

你可以先给自己的妇科医生打电话。

You can call your own gynecologist.

她确实这么做了。没错。我先是打电话说'嘿，我有个新型导管概念想和Cook医生探讨'，结果前台以为我是推销的，直接挂断了电话。

And I Which is what she did. Sure did. Yeah. Exactly. I called and first I, you know, it's like, hey, I have a new catheter concept I'd love to talk to doctor Cook about and of course, they think you're someone soliciting them for something and I got hung up on by the front desk.

于是我等了一周，假装腹痛去就诊。毫不夸张地说，这就是'主动接触用户'的典范——当时我双脚架在产检蹬腿架上，隔着帘子对医生说：'我想跟您聊聊这个导管概念，我想创业，请听我说...'

So I waited a week, feigned a bellyache, got seen immediately and I kid you not, that's like the definition of putting yourself out there to talk to users. I she had my feet up in stirrups and then she was like peeking up for the curtain. Was like, I have this Kather concept I wanna tell you about. I wanna be a founder. Listen.

她当时连连说'现在不行，真的不行'。但最后妥协道：'如果你现在停止讨论这个，我可以和你去附近咖啡店聊聊'。

Listen. And then she just she she was like, not right now. Not right now. Please. But if you stop talking to me about this right now, I will meet you for a coffee at Oh, that's nice.

后来她确实赴约了，并且认可了这个概念，还把我引荐给了当时斯坦福大学妇女健康部门的负责人。

At a nearby coffee shop and that's what she did. And then she liked the concept and she introduced me to the head of women's health at Stanford at the time

哦，是

Oh, to

加州大学戴维斯分校的。突然间我就从零开始建立起了医生人脉网络，他们都认为'如果这个构想能实现，将会给患者带来巨大改变'。

UC Davis. Yeah. And then all of a sudden, had this network of, you know, going from nothing to this network of physicians who thought, hey, if this was idea was in the world, it would make a big difference to patients.

当时这个构想具体到什么程度了？是有可运作的原型机，还是纯粹想听听妇科医生的意见？

Yeah. At this point, how conceptual is it? Like, did did you know was it a working prototype and that you knew it would actually work or was it more like this is a concept and I just wanna hear what gynecologist think of it.

完全停留在概念阶段。这是个全新构想——如果能在女性年度体检时，特别是针对卵巢癌高危人群，实施一种无需切口就能获取细胞的技术会怎样？

Just conceptually because it was such a Yeah. It was a brand new concept. Hey. What if a woman during her annual exam, there was a procedure you could do especially if she was high risk for developing ovarian cancer. There's a procedure you could do that would grab these cells without making an incision?

你会如何反应？这是你想做的事情吗？懂我意思吗？是的。哪怕只是确认人们会说‘我绝不会那样做，因为...’这些理由，你明白吗？

How would you react to that? Is that something you would want to do? You know? Yeah. Even just making sure that folks were like, I would never do that for these reasons, you know?

而我收到的负面反馈与正面反馈同等宝贵。正是在产品设计过程中，我通过这类反馈最深刻地了解到，要让妇科医生采纳这个产品，它必须体现哪些关键要素。

And then the negative feedback I got was as valuable as a positive feedback. I mean, that's where I learned the most about as I went into the design of the product, what were some of the key things it would have to embody in order to be picked up by gynecologists.

具体是什么？说来听听。

Which is what? Tell us.

操作简便性至关重要，因为还有另一种内窥镜或可视化设备。内窥镜本质上是医用摄像头，医生在诊室检查子宫时会使用另一种现有摄像头。当他们观察子宫时，就能看到输卵管两侧的开口对吧？但此时他们并非直视患者，而是盯着屏幕操作，双手像这样在身前动作却不用看手。嗯。

The simplicity of the procedure was incredibly important because there's another endoscope or visualization. So an endoscope is basically a camera used for medical purposes and there was another camera that they're already using in office to take a look at the uterus and so when they're looking at the uterus, they could then see the openings of the two sides of the fallopian tubes, right? But they're at that point, they're not looking at the patient. They're looking at this they're looking off at the screen and they're using their hands like this in front of them but they're not looking at their hands. Mhmm.

所以如果设计不够直观，医生就不得不移开视线查看设备，这样容易导致操作事故。这些认知都源于我作为患者时建立的以患者为中心的视角——这也正是我创立公司的初衷。通过持续与医生交流改进，甚至手柄设计阶段也是如此。想象一下，长期以来医疗创新者多为男性，当大多数医生也是男性时，医疗器械的手柄设计会怎样？

So if you don't make something that's intuitive to use, they have to take their eye off the ball to look down at the device. It you're they're they're gonna be prone to making accidents, you know. So those were the type of things I learned really on coming from it from a very patient centric viewpoint being a patient myself that being the motivation of why I wanted to start the company. So these were the things that I learned by just talking to them and iterating with them every way even when we had a handle design. You can imagine that for a long time when most innovators for physicians were men and when most physicians were men, the handle of medical devices, what?

比如，它只适合男性手掌。不是女性...不，也不是女医生的手型。因此我们的手柄设计提供了两种握持方式，适配不同手型。

Like, it fits the hand of a man. Not not a woman, not a fee Yeah. But not a female physician. And so that was something where even the way that our handle was designed, there was two different ways to grip it depending on your hand size.

哇，明白了。确实。

Oh, wow. Okay. Yeah.

是的。正是通过与医生保持密切沟通，我们在开发过程中才能注意到诸如此类的细节。

Yeah. So there was just a lot of attention to detail like that that came from being in constant touch with our physicians as we were developing this thing.

有没有检测子宫内膜癌的方法？我们知道巴氏涂片查宫颈癌，但如何获取子宫内膜癌细胞？你能否像创新卵巢癌检测那样，同时为子宫内膜癌设计解决方案？还是说...

Is there a way to test for uterine cancer also? Like, we know the pap smear does cervical, but how do you get cells for uterine cancer? Could you have done something for uterine cancer as creative as you did, you know, for ovarian at the same time or is like, no, you have

不，我确实尝试过双管齐下。这问题问得好。经过多年试错，我们最终设计出的是一根能自主导航的导管。

No. I did I did try to do both. That's a great question actually and Okay. What we ended up designing after like years and years of trying and failing. What we ended up with was a catheter which was self navigating.

所以如果你想想其他进入体内的设备，比如支架植入，医生必须一直盯着屏幕，实际操控导管准确进入心脏的正确位置，然后释放支架。对吧？而输卵管是如此曲折，有无数弯道，内径仅有一毫米。我们说的是极其微小的尺寸。

So if you think about other other devices that go into the body like stent placement, the physician has to kind of watch the screen the whole time and and actually navigate the catheter right into the right spot into the heart and then deploy the stent. Right? The fallopian tube is so torturous. There's so many twists and turns and it's only a millimeter in inner diameter. So we're talking like tiny tiny tiny.

是的。当时任何人发明的其他器械进入输卵管都会刺穿它。天啊。因为材质太硬，导航精度又不足。输卵管还有个特点——不同于冠状动脉天然保持开放状态，输卵管平时是闭合的。

Yeah. Anything else that anyone had invented at that point would go into the fallopian tube and and puncture it. Oh my. Because it was too stiff because there was a small air in navigation. The other thing about the fallopian tube unlike your coronary vessels which stay open naturally, the fallopian tube lays flat.

它是个潜在腔隙，需要加压才能打开。所以发明这种器械简直复杂得离谱。我们最终创造了线性外翻球囊导管，想象从烘干机里取出袜子然后试图把它捋直的样子。

It's a potential space. It needs to be pressurized to open. So it was like it's crazy complicated to try to invent something. What we created was a linear averting balloon catheter which if you imagine pulling a sock out of the dryer and then trying to straighten the sock. Okay.

球囊在导管内的状态就像这样，然后慢慢展开。我们在球囊外设计了独特纹理——就像口腔拭子需要一定摩擦力，但摩擦力过大会损伤输卵管，这也是我们要避免的。

The way the balloon sits inside the catheter is like this and then it slowly unfolds. Then we put a unique texture on the outside of the balloon. So you could think about how you get like a cheek swab. There has to be some friction, but if you put too much friction in, you're gonna damage the tube. And I didn't wanna do that either.

因此我们首创了能从身体任何部位采集细胞的纹理球囊。这个球囊会展开进入输卵管获取细胞，然后回缩到子宫内的鞘管中。我的理念始终是：通过独特诊断检测，既能分析球囊上的样本，又能避免污染——毕竟不能让器械接触其他身体部位。

So we were the very first people to create a textured balloon to grab cells from any part of the body. Okay. So we created a textured balloon that would unfold into the fallopian tube, grab cells, but then you would pull it back into a sheath that was sitting in the uterus. So my idea was always as we're looking at unique diagnostic assays, we can look at what's on the balloon and to prevent contamination because you don't you don't want it to touch any other part of the body. Yep.

将其回缩到外层鞘管时，鞘管本身会接触子宫。

You pull it back into this outer layer, the sheath, but the sheath is making contact with the uterus.

没错。所以可以用鞘管上的材料做相关检测。

Yeah. So you could use something with the sheath to test that.

正是如此。我长远的构想是打造女性健康全项检测系统，覆盖宫颈、子宫和输卵管。

Yeah. Exactly. Yeah. So I was I in my brain where I wanted to take the product long term was a full panel for women's health, cervix, uterus, fallopian tube. Right?

哇。你们的导航导管需要进入输卵管多深才能获取细胞？比如只需要进入起始段，还是必须深入很远？

Wow. And how far did yourself navigating catheter have to go in any given fallopian tube to get the cells? Like, you know what I mean? Like, could you just, like, go into the beginning of it or did you have to go really far into it?

我们通过临床研究解答了这个问题。输卵管末端有伞状结构，像手指般的突起覆盖在卵巢上。人体非常精妙——在非排卵期，卵巢会主动远离输卵管，这样即使发生感染也不会波及卵巢。

We did clinical studies to answer this question. So it's a great question. Okay. So at the very end of the fallopian tube, you have something called fimbria which are like finger like extensions that sit on top of the ovary and our bodies are so incredible. Outside of a certain time of the month, the ovary actually physically pulls away from the fallopian tube so that if you do have an infection, it doesn't reach the ovary.

哦，哇。

Oh, wow.

但当它准备好时，确实非常灵活。可一旦需要捕捉目标，它就会收回。而这些手指状的延伸部分恰恰是癌症最易发生的区域。所以尽可能深入检查至关重要。

But when it's ready to yeah. It's very dynamic. But when it's it's ready to capture whatever it needs to, it actually comes back. But these the finger like extensions is actually where the cancer is most likely to start. So so getting as far in as you could was important.

基础文献中关于输卵管平均长度的研究是缺失的。

The basic literature on how long the fallopian tube is on average was missing.

我正想问这个。我们总在讨论肠道和结肠长度，但你觉得输卵管看起来有多长？

I was gonna ask you that. Like, cause because when you we all talk about how long the intestines and how long the colon, but like how long does it look to you?

怎么会没人研究这个？

How has no one researched that?

就像生殖健康领域总不被重视。

It's like reproductive health. Health is not as important.

是啊，长久以来都不是优先事项，懂吧？天啊。

Yeah. Just not a priority for a long time, you know? Oh my god.

连需要进入的深度都不知道，怎么设计导管？太离谱了。

How do you build a catheter when you have no idea what the length that needs to go is? Like, that's crazy.

光是替你想想我就觉得压力山大。确实...这个...我们还有很多要探讨的，不过这个话题太有意思了。你刚才提到FDA。

I'm feeling overwhelmed on your behalf actually thinking Yeah. This. Yeah. And and that we I have a lot that I wanna get through actually, but this is so so interesting. You've mentioned the FDA.

如果直接跳到获取FDA许可的过程会不会太快？

Is it too quick to if we jump to, like, what was the process of getting FDA clearance?

要知道，创业初期最关键的部分——或许是最重要的部分——就是选择与谁共事。有位叫辛迪·达米库斯的女士，她在女性健康领域与FDA保持着极佳的关系。事实上，她曾代表FDA担任过专家组成员。但她非常忙碌，属于那种需要你主动争取才能获得她时间的人。

You know, so part of a big part, maybe the most important part, I don't I'm not sure of building a company in the early days is who you surround yourself with. Right? And there was one woman named Cindy Damicus who had the best relationship with the FDA in terms of women's health. In fact, she had sat on a panel on behalf of the FDA in the past, that sort of thing. But she was so busy that she was one of those folks that if you wanted her time, you would have to pitch her.

直到今天依然如此。现在我为YC旗下的公司争取她的支持时还在说：'拜托了，接下他们吧，让我告诉你这为什么如此重要'。她和我见过几次面，我解释了项目理念。而她有位挚友正是因某种女性癌症去世，她一直想在这个领域做些什么。

Like, just and it's still it's still like that today, you know. I now I'm pitching her on behalf of YC companies. I'm like, come on, take them on and let me tell you why this is so important. And she she met with me a couple of times. I explained the concept and she had a dear friend pass away with a related, you know, a woman's cancer that always wanted to do something in this area.

我想正是基于这个原因，加上几次会面中听到的项目理念，她最终同意成为我的合作伙伴，协助处理FDA相关流程。

And I think the combination of that and, you know, meeting with me a couple of times, hearing about the concept, she took me on as my partner, to think through the FDA, process.

哇，这太棒了。

Wow. That's awesome.

我实在太幸运了。在Envision能招募到这些人真是机缘巧合。我的首位技术合伙人是我前上司，他曾是我前公司的研发副总裁。记得离职时我对他说想创业。

I I I was so lucky. I got so lucky with the people I got to hire at Envision. I mean, my first technical hire was my previous boss. He was the VP of r and d at the other company I just worked worked for. And I remember telling him when I was leaving, you know, I wanna start a company.

他当时说：'好啊，创办Servico时记得找我'。这件事让我深刻体会到——全力以赴对待每份工作的意义。要知道我比他年轻二十五岁，而他早已有多次成功退出的经历。但就因为记得我工作拼命、富有创造力，这个初级工程师来创业时，他居然愿意说：'行，我试试看'。

And he said, okay. Just remember remember me when you start Servico. And, you know, and I still remember I still and and this is part of, like, why it's good to give everything you have to any job that you're in or anything that you do because here I, you know, I think I'm twenty, twenty five years younger than him and he already had several exits under his belt like going now all of a sudden this entry level engineer is like coming to you and saying like, I started a company, you know, But he just remembered, you worked so hard, you were so creative, you're you know, like, there was something about our interaction where he said, okay, fine. I'll give this a shot, you know.

说真的...哇！关于FDA的事我们稍后再详谈——你提到团队建设让我想起个问题。外界误以为Y Combinator不投资单人创业者，这完全不对。我们一直支持单人创业者，无论男女。

Yeah. Actually Wow. I wanna put That's a pin in the the FDA thing because I'm now I'm reminded that I wanted to ask you about being a solo founder as you're talking about your team and how the importance of bringing on amazing people. There's a misperception out there that Y Combinator doesn't doesn't fund solo founders, and that is not true. We have always funded solo founders, male and female.

作为单人创业者，能谈谈这段经历吗？

You are a solo founder. Tell us about sort of that experience.

我花了一年半才筹到首笔25万美元，那是2009年2月。市场环境很差，当时甚至没有'女性健康科技'这种时髦词汇，女性健康根本不算个投资类别。

So it took me a year and a half to raise my first, like, $250,000. This was, like, in in 02/2009. The market wasn't great. There were And now and now there's like pretty words like femtech to describe women's health. Women's health wasn't a category.

我去路演时，投资人会说：'抱歉，我们不投比基尼医学'。简直荒唐！

Like, the I would go pitch it and people would say, oh, sorry. I don't do bikini medicine. Like, that's this Are you kidding? This

真恶心。

is Ew.

不，不。比基尼医学。我从来没听说过

No. No. Bikini medicine. I have never heard

这个说法。比基尼医学？听起来超级有趣。

that either. Bikini medicine? That's super fun.

是啊。我当时想，比基尼医学...花了我一会儿才明白。哦，任何比基尼接触到的地方，我懂了，你

Yeah. I'm like, bikini med like, it took me a second to get it. Oh, anything that a bikini touches, I get it, you

懂的。对。对。对。

know. Yeah. Yeah. Yeah.

好吧。首先，我职业生涯早期合作的许多工程师都是男性，当时女性健康甚至不是一个分类。你知道，我们现在生活的世界完全不同了。那时这个领域没有太多关注，即使有女性健康公司，表现也很差。所以所有对标案例都不理想。

Okay. So first of all, a lot of the other engineers I worked with early in my career, were men and women's health was not a category at that point. You know, it's just we're living in a very different world now. It wasn't like this category that had a lot of focus and if there was ever like a women's health company, it did poorly. So all of the comps were bad.

对吧？这就是为什么我总是对过度模式匹配非常谨慎。是的。明白吗？就像，如果你只投资已经成功过的东西，怎么可能发现下一个新事物？

Right? And this is why I'm always really careful about too much pattern matching. Yeah. You know? It's like, well, how are you gonna spot the next thing if you're only funding the thing that has already worked?

这出于多种原因很危险。但在这种情况下，过去十年左右都没有出现过大型的女性健康公司。嗯。所以我觉得，当时我找到几个愿意尝试的男性合伙人。

This is dangerous for a variety of reasons. But in this case, there was no big women's health company that was created anytime in, like, the last the previous, like, ten years. You know? Mhmm. And so I think it was, like, I found a couple of guys who were like, okay, I'll give this a shot.

他们愿意在晚上抽些时间。但要让他们对这个产品真正兴奋起来，我觉得比较困难。我也接触过一些女性工程师，可能当时存在某种动态——我现在只是猜测。对吧？尤其在那个年代，女性工程师要找到稳定工作本就不易。

I'll give you some, like, hours in the evening. But for them to get, like, super excited about this product, I think was just more difficult. And I did approach some some some women engineers as well and I think that maybe there's this dynamic and I'm just guessing at this point. Right? It's really hard to get to a comfortable job as a woman engineer especially back then.

所以这种'好吧，你曾是工程系唯一的女生，现在放弃一切来做这个还没人投资但未来会很棒的项目'的提议...真的很难找到愿意接受的人。

So this whole idea of like, okay, yeah, you were the only woman in all your engineering classes and now just leave everything, come do this thing that no one's funding yet but it's gonna be great, you know. It was it was really hard to find that.

哦，完全理解。因为他们会坐在那里想，比如，想在我得到这份工作的地方打破玻璃天花板。所以如果我离开去加入你们，就意味着我无法实现那个目标。所以我完全明白为什么我很难说服

Oh, totally. Because they're gonna they're sitting and thinking like, wanna break the glass ceiling at the place where I've got this job. And so for me to leave and go join you means I'm not gonna be able to accomplish that goal. So I can totally see why it was hard for me to get

女性加入。是的，这很可怕。我是说，我记得在大公司工作时，走在走廊上，两边都是玻璃隔开的办公室。看到的全是男性、男性、男性、男性。

women on board. Yeah. That's scary. I mean, I remember being at the larger company and walking walking down the hallway and being surrounded by glass with the offices on either side. And it's like, men, men, men, men.

你懂我的意思吗？所以已经，就像，只有一个女性。所以看起来事情本来就设置得非常困难。所以是的。至少让我留在这里打破这个玻璃天花板吧。

You know what I mean? So it's already, like, one woman. So it's it already seems like things are set up to be really difficult. So yeah. You know, at least let me stay here and break this glass ceiling.

比如，女性创始人的成功榜样在哪里？你知道，这只是一层又一层的复杂性。所以，是啊。

Like, where's the example of success to female founder? You know, it's just layers of complexity. So Yeah.

一层又一层的障碍。

Layers of barriers.

但无论如何我都要这么做。这是关键。

But I was gonna do this no matter what. That was the thing.

好吧。

Okay.

你知道，就算我要花一年半时间融资，就算没有合适的合伙人，我也会想办法搞定。现在当我同时资助两个项目时——上一批我就资助了两位独立创始人——我亲眼见证了有人分担重担的好处。情感上，如果你在外融资，公司的运营并不会停下。我看到我的独立创始人们精疲力竭，因为如果你已经在市场上，怎么可能全天候融资的同时还要让客户满意呢。

You know, if it took me, like, a year and a half to fundraise, if I didn't have the right partner, I was gonna make it work. And now when I fund both, right, I did two solo founders last batch and I get to see firsthand the benefit of having someone there to help you carry the load. Emotionally, if you're out fundraising, things don't stop operationally and I see my solo founders. Now I I burnt out they get because how do you fundraise around the clock and also keep customers happy if you're already out in the market. Yeah.

明白吗？是的。后来我最早全职聘请的那几位高管，我完全信任他们，他们从公司初创期一直陪我走到被收购后的两年。他们帮了大忙。

You know? Yeah. Yeah. Eventually, the first couple of, you know, execs that I hired full time, I I freely trusted them and they stayed with me through early days of the company all the way through two years into the acquisition. So they were a huge help.

但独立创始人这条路确实艰难。

But the solo founder thing is tough.

这很艰难。而且现在你正在投资公司，你能看出独自创始人和有联合创始人之间的区别。

It's tough. And and now that you are funding companies, you can see the difference between the solo founders and ones with with cofounders.

是啊。独自创始人被打击得很惨。这...抱歉，我不该笑的。

Yeah. The solo founders get beat up. It's it's Sorry. I shouldn't laugh.

确实很艰难。真的很艰难。

It's rough. Is rough, though.

对，对。就是有太多...不，我懂的。

Yeah. Yeah. There's just so much No. It is I know.

有太多工作要做。

There's so much work to be done.

早期阶段有太多太多工作了。创始人要做的事太多了。创始人得和客户沟通，还得和投资人交流。

There's just so much there's so much work in the early days. There's a lot of founder work. You know. Founders have to be talking to customers. Founders have to be talking to investors.

所以，特别是在早期阶段，真的非常艰难。

So, yeah, I think in the early days especially, it's really rough.

你在书里讲了很多关于融资的事。我想聊聊这个。主题是拒绝。我得说你加入了这个播客里一群令人印象深刻的人的行列，他们都经历过大量投资人的拒绝，比如卡罗琳，对吧？

You talk a lot about fundraising in your book. I wanna talk about this. The theme is reject. I will say you join a list of impressive people who have been on this podcast that had tons of investor rejection that I just Carolyn. Right?

我们听到这些故事时都有点难以置信。但你说花了18个月才拿到12.5万，跟我们说说你的25万吧。

We we kind of can't believe it when they tell us. Oh, but yeah. Wow. When when you said it took a year and a half to get a 125 k, tell us your two fifty.

25万。是的。

Two fifty. Yes.

两块五。两块五。

Two fifty. Two fifty.

一年前。

A year ago.

我是说，我是说对的。

I mean, I mean yeah.

跟我们分享一下你的融资经历吧。

Tell us about your fundraising experience.

我是说，我我明白。我当时年轻，经验不足，也没有高等学历，对吧？

I mean, I I get it. I was young. I didn't have much experience. I, didn't have a higher degree. Right?

就像之前提到的，我一直保持开放态度。也许我会回去读个博士，也许去拿个医学学位，但对大多数人来说，不仅是健康科技领域，即便在健康科技行业，人们总期待你有更长的医疗从业经历或更高学历之类的。但这可是硬核的传统医疗硬件设备领域。作为一个没有高学历、缺乏经验的年轻女性，天哪，我被拒之门外无数次。不过，如果他们礼貌地拒绝，那也就算了。

To the point earlier, I always kept the door open. Maybe I'll go back and get a PhD, maybe I'll go get an MD, but for most people doing not just health tech, even in health tech, there's some expectation that there's, you know, a longer time spent in health care or a higher degree, that sort of thing. But this is kind of hardcore like hardware medical device traditional traditional health care. So to be a young woman without a higher degree, without much experience, man, I got the door slammed in my face like multiple times. But, you know, if they slam the door politely, that's fine.

我记得有家知名基金。我好不容易进入了他们的合伙人会议。当时确实有位先生非常认真地对待我。而你...

I just remember one prestigious fund. I had made it all the way to their partner meeting. So there was actually one guy there who took me really seriously. And while you

能参加合伙人会议，很了不起。

Partner meetings, that's impressive.

是啊。他说，哇，看看你吸引到谈判桌的人才阵容。你的知识产权策略听起来他仔细研究过，还咨询了医生意见。

Yeah. And he's like, wow. Look at the talent like you've attracted to the table. Your IP strategy sound like he took a a real close look at it. He talked to physicians.

好吧。你在解决一个真实问题，而且他本人极其成功。你会以为他除了对我保持礼貌外，也会要求合伙人们给予一定尊重。但事实并非如此，他们开始自顾自交谈，仿佛我不在场。

Okay. You're going after a real problem and he is extremely successful himself. So you think he he would also demand a certain level of respect from his partnership in addition just to be being courteous to me. But that's not what happened. They started talking to each other like I wasn't in the room.

我...我就像永远不会。是的。我就是...我永远忘不了，你知道吗？

I'll I'll just like Never. Yeah. I just I'll never forget it, you know?

他们是在讨论你的想法还是只是在闲聊？

Were they talking about your idea or were they just chitchatting?

他们在闲聊，而且他们是在屏幕上...他们，就像，在屏幕上，然后...我不知道。他们突然开始互相展示手机里的东西，谈论另一笔交易。然后他们看过来，像是意识到该静音了，就静音了。而那时我正在全情投入地做我的推介...天啊

They were chitchatting and they were on they were, like, on a screen and they I don't know. They just, like, started showing each other stuff on their phones, like, talking about another deal. And then they look they looked over and they're like, oh, we should probably mute this and they mute it. And I was like in the middle of pitching my heart out and Oh my

这故事真让我震惊。

god. I am so appalled at this story.

是啊，我也是。这完全是失礼的行为。

Yeah. Yeah. Me too. That's just bad behavior all around.

是的，很糟糕。这是不专业的行为。我想，正是这些经历让YC的合伙人对创始人如此保护，因为我们记得当初出去碰壁的感受，以及那种情绪上的打击...是的。要重新振作找回自信去进行下一次推介有多难——不过那次之后的下一次推介我成功了。

Yeah. It's bad. It's bad behavior. I mean, and part of these experiences, I think, is why partners at YC are so protective of our founders, you know, because we remember what it was like to go out there and get beaten up and what that did to us emotionally and Yeah. What it took to kind of rebound into a place of confidence for that next pitch, which I closed the next pitch right after that, you know.

但那很艰难，新领域，年轻创始人。我常说被拒绝了50次，但...后来我连邮件都不数了，可能远不止50封。

But it was rough, you know, new category, young founder. I used to say that I got rejected 50 times, but, you know, I wrote the book by part of it was rereading like I don't even know how many emails. Like, I yeah. And, I think I just stopped counting after 50.

天啊...听这个我就来气！就像你说的，如果他们礼貌拒绝你，你完全能接受。你在书里写过：不需要每个投资人都喜欢你，只要有几个认可就够了——这很正常。

Oh my gosh. That's so oh, I get so mad when I hear that because like you said, if they rejected you politely, you'd be okay with that because you did say at one point I was reading, you said, like, you don't have to make every investor love you. You just have to make Right. A couple. And that's fine.

不是每个投资人都想投每个项目，这我们都懂。但在创始人独自全情推介时，他们却无礼地开小差聊天...太让人愤怒了！不过你最终说服了两个投资人对吧？

And not every investor wanna invest in every company. You get we all get that. But to be rude and to be having, like, separate conversations when a founder is there by themselves pitching their heart out, just, oh, it makes me so mad. But you finally did convince, two investors. Right?

然后凑到了25万美元？

And you scraped together 250 k?

是的。这其实也是个挺有趣的故事。当时有位来自湾区的女士叫Anala Jayasharia，她非常喜欢这个创意，负责帮我引荐各种潜在投资人。她介绍我认识了另一位在波士顿的女士Darshita。

Yeah. This is a this is also kind of a funny story. Okay. So there was this, woman named Anala Jayasharia who is from the Bay Area, loved the concept, and she was making all of the introductions into sort of, the the various potential investors. She introduced me to this other woman named Darshita who was based out of Boston.

Darshita和我整整聊了六个月才邀请我参加她的合伙人会议。她基本是我名单上最后的投资人了——无论是朋友推荐名单还是分析师名单。我们已经穷尽了所有渠道。我记得走进那场会议时心想：这必须是我人生中最完美的一次路演，必须一鸣惊人。我觉得自己做到了，而且他们似乎真的理解我在做的事情。

And Darshita, she talked to me for a full six months before inviting me to her partner meeting. And it was basically the last investor on my list, on my friends of friends list, on analyst list. Like, we had exhausted all of the other channels. And I remember going into that partner meeting, like, this needs to be the best pitch I've ever given in my entire life. Like, I have to like just knock this out of the park and I felt like it did and then I felt like they were really understanding what I was working on.

他们回答的问题都切中要害。你知道的，当路演顺利时会有那种感觉。结束后Darshana送我去停车场，她说：‘祝你回旧金山的航班平安，明天我会给你带来好消息。’那时候真的很难不提前庆祝。

They're answering all the right questions. You know, it's a feeling you get when a pitch is going well. And Darshana walked me to my car after and she said, have a safe flight back to San Francisco. I'm gonna call you tomorrow with some good news. And it it was really hard not to count chickens at that point.

是啊。肯定是好消息。

Yeah. It was good news for sure.

对，对。而且你知道吗？我觉得她当时也对结果非常乐观。

Yeah. Yeah. And and you know what? I because I think she was really optimistic about how it went too. You know?

所以我回家后特意把闹钟调早，就为了等东海岸时间的这通电话。结果她打来只说：‘听着，我没能说服合伙人。你这个投资风险太高了。’天啊，太难受了。有趣的是这些艰难时刻的每个细节你都记得特别清楚。

So I went home and I set my alarm early so that I'd be awake East Coast time, you know, for this phone call. And she calls and she just says, listen, I couldn't get my partnership over the line. You're just too risky of an investment. And, oh gosh, it was so rough. It's so funny these, like, really rough moments how all of the you remember all of the details.

挂掉电话后，我直接跳回床上，用被子蒙住脸想着：至少我全力以赴了。

I got off the phone with her. I jumped back into bed. Yeah. I threw the covers over my face and I thought, you know what? I gave it my all.

但即便是我，也得知道什么时候该放手。我已经竭尽所能，是时候认输去找份普通工作了。有时候我们需要让自己沉浸在这种情绪里——当我度过最初被拒绝的痛苦后，我意识到她其实很想同意这笔投资。

But even me, like, I have to know when the ends the end. Like, I I did everything I could. There's nothing left, Serbia just like go get a normal job. And I think there's some value in letting us like sit in our emotions sometime because once I got past that initial feeling of rejection, I realized that she really wanted to say yes, actually. She really wanted to do this deal, you know.

我就想：我能给她什么来推动这件事？于是我回电说：‘我知道自己是个高风险投资，但如果你愿意赌一把，我也愿意赌——我可以两年不领薪水，搬回父母家住（虽然这事可能该先和他们商量）。’那时候我已经订婚了，还没结婚。

I was like, so what can I give her to push her to to empower my champion and and and just like get them over this line? And so I called Darshana back and I said, I know I'm a risky investment, I know that but if you're willing to take a chance on me, I will take a chance as well. I will not give myself a salary for two years and I will move back home with my parents which is probably something I should have discussed with my parents first. But, you know, like, I was I was I was engaged at this point. Not married.

当时是订婚状态。所以我可能该先和我丈夫商量...

I was engaged. So I should probably talk to my husband. I should have probably talked

他可能对此有自己的看法。

He might have an opinion about that.

是的，亲爱的未婚夫。你知道，这是创始人常见的处境。那一刻我在想，我该怎么解决眼前这个问题？幸运的是，大家都表示支持。

Yes. Dear fiance. You know, it's a standard founder thing. In that moment, I'm like, oh, how do I solve this problem in front of me? And then luckily, everybody was supportive.

于是我回电话给阿莎，告诉她这个情况。这时她回到合伙人那里说，要么给我的合同开个特例，让我以个人名义投资，要么我们就以基金形式操作。你猜他们当时怎么回？他们说：行，只要你再找个人愿意出12.5万，我们就匹配12.5万。

So I called Arsha back and I tell her this and at this point, she goes back to her partnership and she says, either allow an exception for my contract and let me invest as an individual, you know, or like let's do this as a fund. And you know what they said at that point? They said, okay, fine. We will give a 125,000 if you find somebody else that's willing to give another 125,000.

我讨厌这种狗屁条件。真让人恶心。

I hate that bullshit. I hate that stuff.

经典套路。

Classic trick.

其实卡洛琳已经废除了这种规定。这就是我如此热爱YC的原因。像YC的SAFE协议，YC的文化，现在这些陈规陋习都不复存在了。

Well, I mean, like, Carolyn got rid of this. See, this is why I love YC so much. Like, with the YC safe, like, the YC culture, like, that's out the window now.

是啊。你

Yeah. You

明白吧？对。所以我来YC时才恍然大悟，原来如此。

know? Yeah. So that's why I I yeah. When I came to YC, was like, oh, I get why.

他们总部在波士顿。

They were Boston based.

就是这样。

This is it.

这是波士顿基地。

This is a Boston base.

波士顿基地。是的。

Boston base. Yeah.

是的。但你设法找到了其他人。对吧？不是吗？

Yeah. But you managed to get someone else. Right? Didn't you?

是的。我成功联系到了一位曾担任爱德华生命科学公司总裁的女性。她叫科琳娜·维尼，备受尊敬。他们两人共同投入了25万美元，要知道当时根本没人愿意投资，所以我至今仍非常感激。

Yeah. I managed to get a a woman who used to be the president of Edwards Life Science. So she was her name is Corinna Vinnie. She's really well respected. So together, they put in two fifty, you know, when nobody else was willing to at all, so I'm still very grateful.

后来我遇到了蒂姆·德雷珀，他是第一位投资的男士。他匹配了25万美元，这样我就有了50万美元来建造原型机，然后我就正式启动了。

And then I met Tim Draper and Tim Draper was the first man who invested. He matched the $2.50, so I had 500,000 to build a prototype, and I was off to the races.

我正想说，无意冒犯，但25万美元听起来在医疗器械公司根本撑不了多久，但你成功让它翻倍，50万正好符合你制作原型机的计划。

I was just gonna say, no disrespect, but $2.50 does not sound like it would have gone far at all in a medical device company, but you got it doubled and 500 k fit your plan for how you could get a prototype.

是的。我很幸运。用这笔钱完成了足够的台架测试，并在动物组织上展示了效果。我让所有投资者都看到了它在50万美元支持下正常运作。

Yeah. I was able to It's lucky. Do enough bench testing and then show in animal tissue on the bench. I had all my investors there. Take it out working, you know, with the 500,000.

然后接下来的第二轮融资获得了450万美元。

And then, you know, the 500 the next Yeah. Round after that was four and a half million.

因为你成功交付了这个原型机。

Because you had delivered on this prototype.

对。从获得50万投资到能向他们展示成果并获取下一轮融资，这期间用了多久？

Yeah. What was the timeline between, like, the 500 k investment and then being able to show them it works and getting another

2012年1月是第一个02/1950项目关闭的时间，然后那年夏天我又获得了额外的250万。接着到了2013年4月，也就是一年零几个月后，我确实做出了原型机并成功筹集了450万美元。

January 2012 was when the the first 02/1950 closed, and then that summer was when I got the additional two fifty. And then, April 2013, so that's a year and a few months later is when I had Yeah. The prototype working and raised the 4 and a half million.

哦，太棒了。

Oh, that's great.

其实时间并不算长。

That's not that long, actually.

是的，我们所有事情都进展神速。

No. We did everything super fast. Yeah.

哇，真厉害。那你在2018年被波士顿科学收购之前，获得FDA批准了吗？

Yeah. Wow. And did you get, FDA clearance before you got acquired in 2018 by Boston Scientific?

拿到了。当时用那450万资金，我们完成了两项不同的临床研究并获得了FDA批准。这也是我现在投资医疗器械和生物科技时试图传递给YC的理念——这个行业存在很多不良风气，因为我当时太年轻了。

I did. So that so that 4 and a half million that I raised, we completed two different clinical studies and got FDA clearance with that much money. And that's and that's something I tried to bring to y c with the medical devices, but also the biotech that I fund now. There's a lot of bad behaviors from that industry that I try to because I was so young. Right?

我是从第一性原理出发的。实际上，如果不像行业常规那样同时推进六个原型机或五种候选药物，不采取那种'先筹集1亿美元再说'的做法，而是按部就班推进的话...我的第一个FDA批准是在2015年。2013年拿到450万，完成两项临床研究，2015年首次获批，2016年第二次获批时又筹集了1200万美元。

So I was coming at this from first principles And actually, if you do that without some of the other learnings from the industry where you need to hedge and you need to try six different prototypes and bring them forward or, you know, like, five different drug candidates that bring you know, let's let 's raise a $100,000,000 when we could be doing this in '10, you know, that sort of thing if we did it sequentially. My first FDA clearance was in 2015. So the yeah. 4.5 was at 2013, finished the two clinical studies. 2015 was my first FDA clearance, and then 2016 was my second FDA clearance, and that's when I raised $12,000,000.

哦，明白了。真了不起。

Oh, okay. Wow.

那1200万是用于生产吗？具体计划是什么？

And was that for production? Like, what was the 12,000,000? What was your your plan for that?

用于商业化早期阶段，以及再做一项临床研究来强化我们对医生的宣传依据。FDA批准的是从输卵管采集细胞样本并检测恶性特征的技术。

It was for so Commercialization. For commercial for early commercialization and to do one more clinical study that would bolster the claims we were able to make to physicians. So the FDA clearance was for collecting a cell sample from the fallopian tube and then looking at the cells for malignant features.

嗯。

Mhmm.

我们甚至想要更多，因此我们计划在癌症患者中进行一项临床研究，以证明我们也能提取出癌细胞。那时我们进行了五次试验。这是一个五十名患者的研究，五次在输卵管中发现癌症，五次我们都成功捕获。由于这些患者已知患有卵巢癌，一旦我们取得样本，她们也随即接受了器官切除手术。因此我们将自己的结果与金标准——组织横截面检查进行了对比。

And we wanted even more so we wanted to do one clinical study in patients who had cancer to demonstrate that we could also pull out cancerous cells. And what happened at that point is we did it five times. So we it was like a fifty patient study, five times there was cancer in the fallopian tube, all five times we got it. And because these patients were known to have ovarian cancer, as soon as we got the sample, they also had the anatomy removed. So we were comparing ourselves to the absolute gold standard which is cross section examination of tissue.

哇。所以这临床研究设计已经尽可能严苛了。是的。我们做了五次，我当时想，好吧，太棒了。

Wow. So so it was as difficult as it could be, the clinical study design. Yeah. So we did that five times and I thought, okay. Great.

我们发表这篇论文吧。提出一些主张，然后推广到一些机构。我一直以来的想法是将这个项目推进到底，因为，你知道，作为年轻人，从零开始创办公司，再加上没人真正关注过女性健康领域。我不得不为一切奋力争取。所以当那些大公司在看到这五名患者的数据后开始联系我时，我感到非常非常惊讶。

Let's publish this paper. Let's make some claims and let's push this out to some sites. And my idea was always to take this all the way because, you know, again, being young, starting the company from the place that I did and plus no one has showed any real interest in anything to do with women's health. I had to claw for everything. So I was very very surprised when the larger companies after seeing that five patients worth of data started reaching out to me.

有多少家公司联系你了？

So how many did?

天啊。我想有七家。一开始是七家。而且——

Oh my gosh. I think seven. Seven to start with. And it was

都是主动找上门的，比如，我们看到论文后觉得，天哪，你创造了这个东西，我们超级感兴趣。

It was all inbound, like, we saw the paper and, my god, you built something and we're super interested.

是的。有个叫ACOG的大型妇科医学会议，我记得当时感觉，这是怎么回事？大概在2017年5月，我原以为只会见一两个人，结果他们带了团队里十来个人。在医疗器械领域，尤其是后期融资阶段，为了真正商业化，我可能需要筹集4到50亿美元。那时通常战略投资者会开张大支票。

Yeah. There's a big medical conference for gynecologists called ACOG, and I just remember being like, what's going on here? And like May 2017 where I I, you know, I thought I was like maybe meeting with like one or two people and they would bring like 10 people from their team, And you in medical devices, especially like later stage for the next round of funding that I would have had to raise to actually commercialize, you know, maybe be like $4,050,000,000 dollars. At that point, often the strategics write a big check. Yeah.

我之所以与他们接触，是因为我们拥有这些出色的数据。我正准备可能在明年进行一轮大额融资。但收购这件事感觉来得太早了。公司还没有收入，我们只有五页纸的数据。我完全没想到事情会这样发展。

And so the reason I was engaging with them was because, you know, we had this great data. I was getting ready, you know, maybe in the next year, I'd raise this big round of funding. And, yeah, it just didn't like, the acquisition thing just didn't it felt so early. Pre revenue, you know, we have this five pages worth of data. I had I had no idea the way things were gonna go.

从心理层面讲，我知道从表达兴趣到最终被收购之间有很多技术性工作。但心理上，这是你的心血。对吧？这是你的公司，你经历了所有这些挣扎。

Well, so psychologically, I'm sure there was a lot of technical stuff that happened between expressing interest and ultimately getting acquired. But psychologically, this is your baby. Right? This is your company. You've had all this struggle.

你是怎么走到那一步的？比如，好吧，我能理解出售。那么，导致这个决定的所有因素是什么？

How did you get there? Like, okay, I can sell it. Like, what were all the factors leading up to that?

就在我们获得FDA批准后，在我还未向癌症患者展示任何成果前，另一家公司就联系我谈收购。那时我还没开始融资，你知道的，就是那轮1200万美元的融资。记得当时我在AT&T巨人球场后面的Soma区散步，对，就在旧金山。

So right when we got FDA clearance, before I had demonstrated anything in patients with cancer, another company had approached me about an acquisition. And so this was before I raised, you know, that, that $12,000,000 round. Okay. And I and I remember taking a walk and sitting behind the AT and T Giants ballpark in Soma Yeah. In San Francisco.

我和一位挚友望着水面，那笔收购在当时会彻底改变我的生活——因为我要赡养母亲，父母刚离婚，我和丈夫住在Soma区700平方英尺的一居室里。

And and looking at the water with a dear friend of mine and it was a life changing that acquisition at that time would have been a life changing amount of money for me because I was supporting my mom. My parents were recently divorced. My husband and I were living in a 700 square foot one bedroom in SoMa

哇。

Wow.

就在地铁站旁边。为了省钱，我们每天去买当天的特价长条三明治——他们每天轮换不同口味，一英尺长的三明治只要5美元，我们就分着吃而不是各买一个。

Which is right next to yeah. Which is right next to Subway and to save money, we would go get whatever sandwich was a foot long of the day because they every day they rotate. They have a different sandwich on sale for, like, a foot long for, like, $5 and then we would split that instead of getting foot long.

是啊，5美元的长条三明治。当天特供什么，你们午餐就吃什么。

Yeah. $5 foot long. Whatever you'd get, whatever it was, that's what you'd be eating that day for lunch.

对，就是这样。这样每人午餐只花2.5美元，明白吗？

Yeah. Exactly. That's that's it. Yeah. Because it would that way we're spending $2.50 each on lunch, you know?

那时我一直在拼命工作，我们过得非常节俭谨慎。面对是否出售的决定时，我和朋友Suneet说：'向癌症患者证明疗效的下一步太重要了，我还没准备好放弃。我必须推进到下一阶段。'当然，后来我和Rajeev也深入讨论过。嗯。

So and I've been grinding at that point and we've been like so frugal and so careful and I'm having to make this decision about whether or not to sell and I just thought, you know, I was talking to my friend Suneet and I said, this next step of showing that we can do this in patients with cancer is so important. I'm not ready to let go yet. Like, have to I have to take it to this next step. And then, of course, Rajeev and I had long discussions about it. Mhmm.

顺便说，那家想收购我们的是家小型上市公司，有位出色的女CEO。她说：'交给我吧，你将负责新成立的医疗器械部门'（因为他们本是诊断公司），'这部分完全由你掌控'。

And by the way, the company that wanted to buy me was a smaller publicly traded company with this amazing female CEO. She was just like, I'm gonna take care of this. You're gonna be running a new medical device division because it was a diagnostic company. Mhmm. And like, this will be under your control.

明白吗？我相信她也信任她。

Okay. You know? And I believed her and I trusted her.

这很吸引人。

That's appealing.

是啊。所以这是个...嗯...重大决定，但最终我拒绝了。哎呀。

Yeah. So it's a yeah. Yeah. It's a big decision, but ultimately, I said no. Yikes.

太疯狂了知道吗？确实疯狂。两年后突然就出现了大量投资意向。

That's crazy. You know? Yeah. It is crazy. And then two years later is when, like, the flurry of in like, the flurry of interest happened.

那时我已经初步考虑过这个问题。我们总共只融了1750万美元，很多投资者都是小型基金。所以当时前几个报价（1亿、1.5亿）我都拒绝了。

And so I had already had a taste of thinking about it. We had so we had only raised, like, 17 and a half million total. So and a lot of the people that invested in the 17 and a half for smaller funds. So I actually said no even then to the first couple of offers that came in. A 100, 150, like, No.

直到报价涨到2.75亿时，投资方展现出极大兴趣。那时我已深入了解波士顿科学团队及其文化，也明白商业化医疗设备的难度。这让我开始认真考虑，但情感上仍难以割舍。

No. When it hit $2.75, it was like the investors were really, really interested and I had really gotten to know the Boston Scientific team Mhmm. And their culture and just, you know, thought what are the chances that I'm gonna be able to raise this huge round of funding, commercializing a medical device is no joke. Right. And that's why I started taking it really seriously, but still I the emotional transition over.

尽管收购时我已完全套现，但我还是选择留在收购方公司。

You know, I stayed with the acquirer even though I was fully accelerated at time of acquisition.

所以你留下是为了引导产品完成后续发展？当时产品实现全面商业化了吗？

Yeah. So you stayed to sort of shepherd the product to where it got before. Did you get did it get all the way to commercial commercialization So while you were there?

没错。我负责领导商业化工作。医疗设备需要预先向医院推销，而医院有年度采购周期。我们会在他们招标阶段派销售驻场，临近签约时则由我出面敲定交易。

Yeah. This is a this is a so I headed up the commercialization effort and what what for a medical device, because it's a physical device, what you do is you pre sell to different hospitals and a lot of these hospitals, have they're on yearly contracting cycles. So what you wanna do is while they're in the contracting phase is when you wanna sell them. So Right. We'd have salespeople on the ground and then when we got we got close to when we got close to someone saying yes or signing on, they would send me in to close a deal.

想想这个转变：我从每天为省3美元吃同样的三明治，到坐着私人jet一天跑五个城市——'去签这个500万合同''去搞定那个1000万订单'，这感觉...

Right? And I've never traveled on a private jet for fun, like, you know, like, just for personal stuff. But the the very first time I did and just like the shift, I'm eating, like, the same sandwich every day to save, like, $3 to being on this jet where they're flying me to five different cities a day to tell go close this $5,000,000 deal. Go close this $10,000,000. Go you know?

天啊，这变化太大了。

Oh my. That's a big shift.

那是个巨大的转变，突然间我就要面对满屋子的医生做演讲，并成功签下这些合同。我们当时完全进入了商业冲刺模式。我最近在波士顿时，有人问我上次来是什么时候？上一次正是2020年1月。

It's a it was a big shift and it's like all of a sudden presenting big rooms of physicians and I'm closing these deals. We were definitely all in on commercial mode. And I I was just in Boston and someone asked me, when was the last time you were in Boston? And the last time I was in Boston was January 2020.

天啊，就在新冠疫情爆发前。

Oh my god. Right before COVID.

没错，就在疫情前。我们当时正在筹备销售启动大会，那个盛大的产品发布会。因为医疗器械上市就像场庆典，毕竟所有预售合同都已签好。

Yes. Right before COVID. And we are planning the sales kickoff meeting, the big launch. Because when you launch a device, it's a huge, like, party, like a big deal because you've presold all these contracts

确实。

Right.

这类产品很难快速迭代。我们原计划2020年4月正式发布。

And it's not quite as easy to iterate on the product. And we were planning the launch of it April 2020.

噢天，这也太残酷了。

Oh, man. Oh, that's brutal.

他们就说'好吧，回头见，或许三月份再来看看临床研究的最终数据，四月份再办发布会'。结果呢，平行时空里，2024年我飞回波士顿参加创业学院，而不是去开发布会。

They're like, okay. You know, see you later. Maybe you can come back at March. We can look at the final readout of the clinical study, and then April, we'll do our big thing. And then, of course, you know, parallel universe, I'm actually flying back to Boston for y c for start up school in 2024 instead of later.

是啊，永远没能回去完成产品发布。

Yeah. Instead of ever being able to, you know, go back to launch the product.

发布产品。太魔幻了，老天，简直难以置信。

To launch the product. That is wild. Gosh. That's crazy.

这段旅程的结局真是疯狂，像部荒诞剧的收场。

What a crazy end, like, conclusion to that journey.

嗯，我认为毫无疑问人们需要读这本书。不过我得提一下这本书的封面设计——'without a doubt'用的是常规字体，而'out'这个词像是手写体嵌在那里，仿佛在说：尽管遭遇重重拒绝，Serbi，你以赫拉克勒斯般的努力让这一切成真并挺了过来，这实在太鼓舞人心了。完全同意。

Well, I I think people need to read the book without a doubt. And I I just need to mention the book though. The cover, the way the typeface is, with a doubt is in regular typeface and sort of out is sort of stuck in there as if someone had handwritten it, which suggests, like, despite all of this rejection, Serbi, you made this happen and you got through this with like a Herculean effort, which is just so inspirational. Totally.

是的。关于Truly，我唯一从未怀疑过的就是患者需要它，而我想成为那个为此奋斗的人，你知道的。

Yeah. The only thing I was ever without a doubt about Truly was that patients needed this and that I wanted to be the one working on it, you know.

至于其他事情，你大概一路都在自我怀疑吧。

Everything else, you probably second guessed yourself all along the way.

时时刻刻。每分每秒都在怀疑。

All the time. All the time.

天啊。但至少...

Oh my god. But at

至少你清楚自己的使命。

least you knew the mission.

没错。那就像我的指路明灯。

Yes. And that was my my guiding light.

这话真棒。我知道我们时间不多了，感觉还有好多问题想问你...我必须说——虽然这更像评论而非提问（我讨厌别人这么说）——你曾说过'我想为那些被低估的人提供追逐梦想的路径'，这句话真的触动了我。

I love that. I I know we're running out of time. I feel like I have questions that I wanted to ask you. I I just have to say I love this isn't this is this more of a comment and not a question, which is I hate when people say that. But you said once, I wanna offer people who feel underrated a path to pursuing their dreams.

因为这个理念某种程度上就是Y Combinator的缩影。

That really spoke to me. I love that idea. Because in a way, that's what y Combinator is.

正是这点吸引我加入YC。我能帮助那些或许出身不够优越、或许尚未建立自信的人，让他们看见最好的自己，成为他们的榜样，在他们最艰难的起步阶段伸出援手。

That's exactly what drew me to y c, you know, that I could help all of these people who may not come from the most privileged backgrounds or may not have that faith in themselves yet, but I could help them see the best version of themselves and maybe be an example and maybe help them out on those early days which are so difficult.

当然。毫无疑问。太棒了。了解Envision的细节真是令人着迷。我之前不知道，世界需要更多地了解这个领域，而且绝对应该更加关注女性医疗保健。

Yeah. For sure. Well, awesome. It has been so fascinating learning the details about Envision. I didn't you know, the world needs to to know more about this, and the world definitely needs to shine a bigger light on women's health care for sure.

所以，听啊。听啊。是的。恭喜你们，了解这些真的非常非常有趣。

So Hear. Hear. Yeah. Congratulations, and it's been really, really fun learning about that.

天啊。这太有趣了。非常感谢邀请我。

Oh my gosh. This has been so much fun. Thank you so much for having me.

谢谢你能来，

Thanks for coming,

非常感谢。我们很快再见。

so much. We'll see you soon.

谢谢。很快见。再见。

Thank you. See you soon. Bye.

她的故事充满了挣扎。我认为那些经历无数拒绝和挫折的故事往往最精彩，而她的故事就是如此出色。

Her story, like, tons of struggle there. And I just I just think the stories where there's all this rejection, all this struggle make the best stories, and she's got a great one.

她从未放弃。是的。这太不可思议了。而且发明一种新设备——哦，完全正确——进入仅一毫米宽的输卵管，这是多么了不起的成就。

She just never gave up. Yeah. That's incredible. And what a feat to be sort of inventing a new device to Oh, totally. Into the fallopian tube, which is a millimeter wide.

我是说，这个故事里的每个细节都让人想问：面对那么多阻碍——就像我们说的那些成功路上的障碍——你怎么可能成功？但她就是坚持不懈地努力。这实在令人印象深刻。

I mean, there's like everything about that story is like, how did how do you how do you ever have success when you have that many like, were saying barriers before. Like, there's all these barriers to success for that. And then you just keep on grinding away. That is incredibly impressive.

还有她指出的那个观点，我可能知道但并未真正意识到：那时候女性健康根本不被重视。而我们占人口的一半啊，看到了吗？这就是...

And how she pointed out, and I think I knew this, but I didn't really realize it, about how women's health at that point just wasn't a thing. When we are half the population, see Levy? Come This is the

我记得她说的是比基尼健康之类的。这让我觉得不可思议。但我想这就是故事的重点。这部分是最不令人意外的。因为你知道，在创业领域之外，女性健康问题一直处于次要地位。

the I think she said bikini health or something. That's crazy to me. But I mean, I think that's the story. It's that part was the least surprising. That, you know, because women's health not completely outside of the entrepreneurial context has always played second fiddle.

所以当然，再加上一位女性独立创始人——她一直强调自己不具备人们预期的那些资质——却在推销这个产品，简直就是双重打击。

So, of course, combined with a, you know, a female solo founder who's who like she kept saying, like, you know, wasn't you know, didn't have the credentials that you might expect is is selling it like, she just had double whammy.

不。抚养我长大的祖母死于卵巢癌。哦，真的吗？而且我觉得我们可能都认识被这类疾病影响的人，我奶奶就是死于子宫癌。所以这非常普遍。

No. My my grandmother who raised me died of ovarian cancer. Oh, really? And, like, I think we've all probably known someone who's been touched by, you know, my grandma died of uterine cancer. So it's just very prevalent.

我知道。我渴望这些设备能彻底改变早期诊断方式，我是说...

I know. I want these devices that can be just just revolutionize the diagnosis in early I mean, I

我觉得我们都希望它像宫颈抹片检查那样简单。对吧？如果其他检查都能有这么简单的诊断工具就好了。塞尔维亚解释的就是这个，那正是她想要的。

think we we want it all to be a pap smear. Right? Like, it can be that simple and that easy, you know, that easy to do, if all the other parts could have that simple of a diagnostic tool. Think that's Exactly. I what Serbia was explaining like, that's what she wants.

是啊。也许她将来真的会再创办一家女性健康初创公司。我们会继续鼓励她的。

Yeah. Maybe she maybe she does have it in her someday for another another woman's health startup. We'll keep poking her.

对。对。没错。

Yeah. Yeah. Yeah.

太精彩了。我很喜欢，而且绝对会毫不犹豫推荐她的书。没错。这既是回忆录又是实用指南。

Well, that was awesome. I loved it, and I definitely would recommend her book without a doubt. Yep. For sure. It's it's like a memoir slash instructional.

显然她

Clearly, she's

写作多年了，所以我想优秀的文笔加上精彩的故事成就了一本好书。

been writing for a long time, so I would imagine the good writing combined with a good story makes for a good book.

是啊，太棒了。我觉得那一集播出时会很精彩。好的，下次见。

Yeah. Awesome. I think it's gonna be a great episode when that comes out. Alright. See you next time.

再见。好的，拜拜。

Bye. Okay. Bye.