He got induced into a coma 4 years ago

Welcome to another Founder Wisdom pod. We have a special one today with Patanjali Chauri. He's the founder and CEO at FortVital, but most importantly, he's got a hell of a story to share, survival story, which is, uh, amazing. And he was fighting for his life while building companies. Uh, hell of a background as well. Right now in Turkey, originally Canadian. Uh, Patanjali, honored to have you on. Can you tell us a bit more about yourself?

Hi, Charles. Thanks so much for having me. Great to be here. Yeah, so as you mentioned, I'm born and raised in Canada, but lived in different parts of the world, but really spent a significant part of my career in Silicon Valley, about 25 years or so, working for companies like Oracle and other startups as well. And yeah, and so nevertheless, we ended up now in Türkiye for reasons that were quite unexpected, although now it's very fortuitous in terms of Fourth Vital. We're actually setting up a Fourth Vital entity here, and we basically are going to be working with regional players in the space of what we're doing. And what Fourth Vital is, is basically we are an upstream kidney risk intelligence platform. And, you know, the reason why we— I started Fourth Vital is my mom got diagnosed with kidney failure and passed away just a few months later. And you know, we've lost loved ones, it's difficult regardless of the circumstance. But in this case, as an engineer, I was curious, why weren't there any warnings? Why weren't there any symptoms? And I was astonished as I dug deeper. I learned that close to 1 billion people in the world have chronic kidney disease, but 90% have no clue, often until it's too late. And the primary methods of detection are basically routine labs. And these are great. However, they primarily work after damage is done. And I thought to myself, there's gotta be some physiological signals in the body that can detect kidney disease much earlier and kidney decline in particular. And basically I found that signal clinically published 35 years ago, sitting in research labs. Nobody's actually brought it together in a way that physicians can use it. It'll be adopted easily by physicians and patients alike as well. And where there are some other things that I discovered that I think are really relevant to not only the way that kidney disease is in decline is detected, but also treated. And so I started on this journey of trying to figure out if there was a signal, found the signal, and then basically started Fourth Vital to bring this together in a very simple-to-use platform and technology.

I'm reading about your background as well. Your first company was at 17, so you were highly entrepreneurial already from the get-go, right? Yeah.

I started my first— actually, I think it was my second startup in Toronto, in my parents' house, in my bedroom. And later I actually ended up taking a year off before going to University of Toronto, to the chagrin of my parents. They were pretty upset with me, but I was actually getting so much— the early days of the PC, and I was like one of the main PC guys. I ended up being in Toronto building software for like Toronto Stock Exchange, Merrill Lynch. I mean, I had some pretty incredible clients and nobody knew how to use this box. So I was building software for them, turnkey systems, and it was fun. And, but then after a year, I recognized if I didn't make my way to university, I'd been in a lot more trouble with my parents. So, and I wanted to, learning has always been something very important to me in my life. And even more recently with what all the things that I've been dealing with, I continue to learn every day. But nevertheless, yeah, and then I ended up moving it into my dorm room as I tried to figure out if I wanted to do a kind of standard engineering or something unique. I realized my grades were suffering, so I basically ended up kind of winding things down and focusing 100% on my studies. Ended up studying AI at the University of Toronto, one of the world's first undergraduate programs, and the rest is history, right? So from there, that was really the start point. Point, right?

And you spent a lot of time at, uh, Oracle after that, right? Like, that's puzzling to me because it's like super entrepreneurial guy and then goes to work at like a quote-unquote boring company. I mean, Larry Ellison himself is not boring, but I don't think you were working at, at that level with him. So what, what happened there?

Yeah, so, um, soon after I graduated I was in New York and I got an opportunity to work in Singapore. I was actually trying to make my way to Japan. That's the true story. I studied Japanese in the last year of University of Toronto. I was getting pretty reasonably good at it. But I pointed towards Tokyo and I ended up in Singapore. I thought, ah, close enough, let's go there. And I worked for a top research institute actually working on virtual reality for kids, built and designed a platform and a team. Cutting edge. And then I actually spun a startup out of that way before the days of WebEx and push it. We actually, we had pushed the Java in the earliest days to do all kinds of crazy things in 3D and whatnot. And so I thought there's a huge opportunity here to use this for virtual meetings. So I actually spun off the startup and timing, uh, literally 6 weeks later the Thai baht collapsed, the Asian financial crisis, and I was left in a situation where I'd signed a lease and I didn't have any other options. And I was doing some consulting on the side just to try to stay afloat. And, you know, I basically said, look, I've always wanted to be in Silicon Valley. Maybe it's time. And I was getting, you know, opportunities there. So I took a shot, ended up at Oracle, who actually broke my lease and paid me to move back. And I thought, hey, this is great. I can, I can net zero out of this. So practicality set in, but I'm in the Valley and I'm like, hey, look, um, I'm in the center of entrepreneurship and that's what I want to be and whatever it is. But what ended up happening actually was really surprising. I ended up loving being at Oracle because I was surrounded by such brilliant people. And throughout my career, one of the things that I've always almost actively done is I literally get myself into situations where I really feel like the dumbest person in the room. And frankly, I am. But I get into there and I realize I'm surrounded by all these great people, and that's how you learn, really. I learned from osmosis. And Oracle was giving me an enormous foundation. I was learning new things all the time. And one of the great things about Oracle that people don't know, right? You hear stuff in the media, whatever. I mean, it was an extremely entrepreneurial environment. It was like a whole set of little startups and little teams coming together to solve a big problem, with the VC being Larry Ellison and Oracle. But it was like hugely intense. And we're all after trying to solve these problems. Exciting times. And I actually ended up staying there through the dot-com when actually I had another startup that I was thinking of spinning off, and that's a whole other story. But, uh, I ended up staying, and, um, I'm glad I did because I ended up getting a foundation really for the future that I've circled back to now with Fourth Vital, looking at how to build and design very large, complex data-intensive enterprise systems. And basically all of that is coming back with my AI background now to solve this real very big challenge in for kidney disease, right?

And how I see it on my side, right, you make a whole bunch of money with like, uh, working in corporate, and then you were like, man, I need to start something of my own, uh, which was Fort Vital, right, in 2022. Um, you also raised capital for that one as well, of course, but tell us about that story.

Yeah, I didn't raise any capital for quite some time actually. So, um, as I mentioned, the motivation for starting Fourth Vital, I went on kind of a research journey to learn more about this because it was— I'm not a physician and I got curious and I got interested in it because of what happened. And so I really went deeply into the research and then Finally, after we moved to Berlin for a startup, actually, and then I ended up leaving the startup and going full-time into Fourth Vital. And so, um, actually at that time was bootstrapped, primarily bootstrapped startup, raised two friends and family rounds only, very small, about $72,000. Um, we also had a grant from Canadian Mitacs which actually helped with our first pilot site in Canada at a top kidney unit. So yeah, we've kind of been bootstrapping. And so I'm kind of now under, you know, with the demand and what's going on, looking at raising kind of our first, you know, real capital, if you will. But nevertheless, you know, this has been quite a journey to get here. And really, I think the culmination of everything that I've done is sort of coming together now in a way to solve something very important.

Right. And what happened in the, in the process of that? You were in Paris, uh, at a conference, so all, all, all the hell broke loose.

It did indeed. I mean, in fact, I got Fourth Vital 2 weeks after I actually registered the company. Uh, at the time was an LLC because I didn't have anything at all. Um, got into a— your EU medtech accelerator and sponsored by the EU. I was very excited because it meant I could immerse myself in medtech for, you know, several months, which was exciting, and surrounded by a lot of talent across this area. So the last week actually was in Paris at an investor— kind of the last week was an investor event. And, um, well, the event was great. I met a lot of great people along the way, but we were living in Spain at that, you know, we were visiting Spain, and then I ended up going back. And 34 days later, all hell did break loose. I woke up on New Year's Day, and after that, let's just say that life throws you curveballs. Some of them you, you know, envision, and then others like this, you just never imagined it could happen to you.

And your mindset back then, everything was going well, wind in your sails, and boom, like You were hit from the sides, uh, and didn't ever see it. And, uh, so you— what, what happened on the, um, the morning you woke up?

Yeah, so my health was totally fine. I'm doing great. Just, you know, presented to investors in Paris, was actually about to book my ticket to the Bay Area. Uh, January is the time of the JPMorgan HealthTech Conference. Is there— everybody's there. I'm like, all right, I'm gonna go there. I haven't been back in a while. I'm gonna spend a month or two and just go all over the place, hit every meetup, you know, the usual thing. Right. And, um, I woke up on January 1st, 7:00 AM, usual time, getting up to go to the restroom and everything below my waist gave way. And I was like, what is really going on here? Right. And it was just a very bizarre feeling. And I took my hand to touch my leg and the most surreal experience. My hand could feel my leg, but my leg felt nothing. So my leg felt like an object, like a table. And yeah, well, it's different from phantom limb because in phantom limb, because it's not there, but you had it. Exactly, I had it, but it was phantomizing. Anyways, so I got rushed to the hospital and things actually went downhill very quickly. Uh, by the evening they ended up medically induced coma because my organs started to shut down. Lots of other complications. And in the search for what was going on, I would say, uh, one of the many brilliant doctors in Spain basically said, wait a second, we think this is Listeria, which is often a foodborne contracted illness that hides in the body for up to 70 days. And it, it, it, sorry, it, it hides in the body. It doesn't show up on scans. So it notoriously doesn't show up in blood and, you know, other reports, images. So smart enough to throw about 9 different of the world's biggest, strongest antibiotics on me. I was in a coma for about 3 weeks on life support and everything you can imagine. And, you know, estimates are I was pretty far across the line. And, you know, the, the probability of me coming back was, was lower, right? Was low. But somehow I managed to come out of it on my own. And one night, apparently, I just started breathing on my own. They took me off the ventilator and all that. And but, you know, I was still paralyzed 100% from the waist down when I, when I came out. And basically, um, my left leg had almost no signal. My right leg, um, had a very low signal. And what we learned was that it was Listeria. It showed up on a an image, an MRI, I think, very briefly. And it basically— it's one of the 12 or so bacterial infections that can cross the blood-brain barrier. And so when it crossed the blood-brain barrier, it actually went and cut off my spinal cord. And that's exactly—

that's how I reached your spinal cord.

Yeah, well, it traveled down my spinal cord and cut off the signal effectively. And so how does it do that? Well, it's a pretty— it's, it's a very, uh, dangerous bacteria, right? Very aggressive. And so that bacteria, basically, it invades everything. And so it just have— it once it crosses the blood-brain barrier, I ended up with encephalitis, which is, you know, basically inflammation of the brain. Exactly. But then it made its way down to the spinal cord, and then everything just shut down. So, um, the challenge was coming out of that, the doctors basically had said I may never walk, talk, or eat normally again. I remember because I wasn't talking, couldn't talk at that point. And my wife was there and the doctor was telling her— I heard everything. And actually, at that moment, I said to myself, "Hell no. I don't care. Hell no." And so literally, that whole rest of the day, that whole night, I basically envisioned my toes moving, especially my left toe, which had no signal. And by the morning, I had the nurses just open the sheets over, and I said, look, I want you to see this. Very so slightly, ever so slightly, I was able to move my left toe. And the doctor— what's that?

Major victory.

Well, yeah, yeah. I mean, it's the start, I would say, of a whole set of incredible circumstances, um, where I've, uh, you know recovered and still recovering from it. But it was funny because I, I had them call the doctor in that morning with my wife there to basically show him, because he said never, right? And I'm like, don't ever say never to me. What's up, Doc? What's that?

It's like, fuck you, Doc.

Well, yeah, no, it's just—

I can move.

I, I think, I think that, you know, for me, I'm like I've never liked people talking absolutes. It'll never work out. You can't do this. It won't happen. Just my personality. I'm like, hell no, right? And so the minute he said never, in my mind I'm like, oh man, I'm gonna prove him wrong. Just watch. So we're gonna will my freaking— there's no signal, you understand? There was no signal. They sent a signal down from my brain to— there's nothing in my feet. So the only way was willpower, and I managed to get that signal. And they were just shocked, right? But then after that, the issue was Spain and that facility in particular did not have the advanced neurological rehab that we needed. Ended up my wife just went all over the world and many hospitals were unwilling to sort of take the challenge because they said, look, this is, this is a very tough case. We're not sure there's much we can do. Right. And ultimately, a very top rehab center in Berlin said yes, and then 2 days before the medevac was to come, they basically said, no, we can't take your husband. So I ended up— we actually eventually ended up in Turkey, where my wife found a hospital in Bodrum with exactly the advanced neurological rehab that I needed. And more importantly, they, they said the same thing that everybody else said: this is a very difficult case, we cannot guarantee anything. But they said the magic words afterwards: but we're willing to try. And that was it. I was on a medevac 2 days later. And I think in so many ways, it's sort of a testament to, I think entrepreneurs are always dealing with uncertainty and there's only certain things you can plan for, right? And I think that, again, the phrasing, never say never, you have to have kind of the resilience to basically say, I'm going to keep going, I'm going to keep trying this. And, you know, my wife looked all over the world, and basically the minute they said we're willing to give it a try, all right, that's great, that's cool, let's go do it, right? So I ended up in Turkey, Arab medevac there, and it started a long journey of recovery. And when everybody else said you may never walk, talk, or eat again— by the way, I started, uh, eating on my own a little bit, although I needed help, uh, by the time I got to Bodrum. And within about 10 to 12 days they got me to stand up. And slowly— walking is a very exaggerated word at the time— the minor shuffling, I don't know what to say. But, um, anyways, after 3 months there, um, I was able to leave the hospital and start a very long road to recovery. So we ended up in Turkey for completely different reasons. We had visited there prior and loved it. We loved Istanbul. I think it's a fascinating city. Very unique in the world, historically unique. But I never thought I'd end up there for this reason. But now we've actually really fallen in love with the— not just the country, the people are just so amazing, and the level of care. And, um, you know, all of this while Fourth Vital was still— and to literally keep not only myself alive but Fourth Vital alive. And I really credit my advisors, who several of them are now board members, several of them are also my former classmates, who basically stepped up the minute this happened and said, "We got this, we're gonna keep it warm," and they did. And I didn't get back to it until July. So it was January to July is when I could actually hold a laptop. So that's what it, yeah. But we managed to keep it going and I never gave up. And we're here now. More momentum as ever.

So, and you wouldn't be here without your wife, basically.

Oh, of course. Oh yeah, I mean, right? Yeah. And the thing is, is that absolutely right? I mean, she was the one who, um, I don't know what she did. I really don't know.

I was in coma, everything, like the base, right? Like the 80%.

Yeah, I mean, she didn't speak Spanish. We're there in, in an area, and, um, She didn't, um, uh, you didn't know anybody there. We were just kind of visiting. And so she had to figure it all out on her own and figure out what she had to— like, literally, I mean, she's got, she's got guts and she's super brilliant and really resilient herself. And so I'm not surprised afterwards when I learned what mountains she had to cross. I'm like, well, if somebody's going to cross 10 Mount Everest, it's going to be her, right? But I will say is that you know, this has been a team effort, right? So beyond my wife, I think the shocking thing to me, not only just the Spanish medical team, my nurses and doctors are amazing, um, but Turkey, just the level of care, the level— I mean, they just never gave up on me, and I never gave up on myself. That's true. And together we worked as a massive team. And even to this day, they're still in touch with me regularly. I literally WhatsApp recovery videos to my doctors, nurses. Some of them contact me every day to see how I'm doing. 'Good morning, how are you feeling today?' I mean, like, and literally just for no reason except that they care. And so, you know, I think that no matter what, there's always people that play a pivotal role. But life is a team effort. Starting a company is a team effort. And I think that even some entrepreneurs, you know, uh, how do I say this, they naively think they have the answer to everything. There's a certain part of having confidence, but overconfidence is a problem. At the end of the day, you need to know what you know, and you need to know what you don't know, or just simply know that there's probably a lot of things I don't know that I should know. And you then surround yourself with brilliant people who know more than you do, with no ego aside, and let them run with it and let them do stuff. And that's how you build things. And I had to do the same thing with a team that was in it with me to get myself through this and get us, you know, out of this incredible catastrophe, basically.

And today, what's the state of your system?

Uh, 80% recovery, 70%, uh, you know, it's really hard to tell because, uh, I, I am— you can walk? I can walk now, slight jog. I just can't do it for a long time.

Well, that's epic right there. Yeah, yeah, it's incredible. This is like—

yeah, yeah. And, and I can't do it for long periods of time because my lower spine is still recovering, my hip flexors. There's a lot of things that turned off.

It's back, right? Like the spinal cord has regen— and that happens? Or why isn't that like, uh, an anomaly? Once it's gone, it's gone normally, isn't it?

Actually, no, right? In fact, there are people that have like, you know, really serious car accidents and motorcycle accidents where they really— they split, snap their spine, right? And they're able to recover from that. I mean, look, the body is extraordinarily resilient. I think we as people do not give enough attention, enough credit to our brain. Our brain is the most resilient organ in the world, I would say. And that goes for other mammals too. But we don't give it enough of a chance. And the reality is, is what I learned, I mean, I had nothing below my legs. I couldn't feel anything. I couldn't move anything. And I had to rebuild. When I landed in Bodrum, by the by the way. Um, I was just all bones. I had no fat, no muscle. I was completely atrophied because I was, you know, 3 months in an ICU and another 3 months in Bodrum. The difference is in Bodrum they got me up several times a day, like we were moving.

Yeah, that's what you need to do.

Yeah. And so I had to rebuild everything, you know, really change my diet— high protein, high fat— build up that muscle and fat. And the fat is actually really important, you know. It's interesting, going back to my AI program at U of T, it was invaluable not only for what I'm doing now, but it was invaluable to my recovery because I had studied such an interdisciplinary program, you know, cognitive neurology from the medical school, really understanding, you know, neural— how, you know, building and designing neural networks was about understanding how the human brain works, right? And so one of the things that we did is a lot of case studies, read a lot of case studies on patients that had damage to their brains that recovered completely from them. And I read these cases and I was astounded. Wow, how is somebody that lost all their speech able to talk again, right? It's the resilience of the brain.

And loses their speech but doesn't lose memory and doesn't lose cognition, right? It's like different areas of the brain. You lost your speech but you didn't lose memories and you didn't lose your cognition.

Like, yeah, yeah, yeah. Interestingly, I didn't lose, uh, I didn't lose my cognition my thinking, surprisingly, right? I mean, this is all a surprise because I came out of it and there was an expectation that there was—

you could think but you could not speak. So you were like trapped in your own brain with your own thoughts.

Yeah. And you know, the, the very funny thing was I couldn't communicate, but I had to communicate, right, with the nurses and my brother-in-law's eyes. Yeah. So, and I didn't know sign language and neither did my wife. So, and actually I could use my right hand, but my left arm did not— was not working. So anyways, My brother-in-law is a surgeon in Singapore, and he basically said, "Look, draw him an alphabet and let him point to the alphabet." So my wife drew an alphabet on a sheet of paper, and every time I wanted to communicate, I literally had to point at each alphabet and spell what I wanted to say. And the hilarious thing is my nurses, very few of them spoke any English. So I had to switch my brain to Spanish, which I spoke a little bit of, to communicate with them and then in English. And actually, what I learned later is this is great for the brain. It regenerates the nerves. Okay. The fact I was going to tell about is that I learned in, in back when I was studying AI is that something called the myelin sheath is what surrounds your neurons, and that's 100% saturated fat. And so the, the only way the nerve signals move is the stronger myelin sheath. And what I got killed the myelin sheath. It's called demyelinization. That's the medical term. So, I had to take enormous amounts of fat, actually.

Olive oil.

So, all of that together as a team effort, and then you're just constantly pushing signals every day, 6 times a day. I mean, training 2 to 4 hours— well, 4 hours, 4 to 6 hours a day training in the physio lab, 4 times a day, 2 times in the hospital room. I mean, that for 3 months. That's how I was able to stand.

It's a financial battle as well, right? So how did you and your wife, uh, won that battle? It's mostly a financial battle, actually. No money, no, no care.

Again, my wife somehow magically got some of it covered by insurance, but pretty much all of our—

Robbed a couple banks in Spain.

What's that?

Robbed a couple banks in Spain.

Yeah, well, uh, I would say it was not robbed, but basically, I don't know what she did. She convinced the insurance companies who notoriously, uh, you know, decline claims, uh, yeah, white skin. Uh, what's that?

Wives can be very feisty, right?

Like, oh man, I would picture mine screaming at them to, to get something. Yeah. Oh yeah, no, I don't know how she did it, but I'm not surprised she did But yeah, we had to look, I mean, um, spent our life building our, um, you know, our life portfolio, um, for the future. And that's all gone. We had to liquidate everything.

Yes.

401k, all of that.

Millions and millions. Yeah.

You know, well over a million, you know, more than that. Uh, and I wasn't working. It wasn't working for 3 years. Right. And so we've got to sustain ourselves. Luckily, uh, we had the means. Many people don't, right? So we had the means to get us through it. We had to stretch even further, but at least we could stretch, right? And, you know, I'm still recovering and still building, um, and we still haven't paid ourselves anything for Fourth Vital. So that's hopefully soon, raising capital. We need to do that as well. But nevertheless, you know, honestly, I mean, um you just never imagine that something like this can happen to you. And the probability, if you look at the statistics, it's very low, right? But, and a lot, you know, a lot of people actually get Listeria, but it doesn't cross the blood-brain barrier. It just dies off. Mine did. And then the probability of living was low. Most of people die from it. I survived.. And the fact that I survived was one thing, but now I'm literally getting back function that everybody said is not possible. And, you know, actually a friend of mine, and I learned this back in undergrad, but a friend of mine actually from the startup, she had finished her PhD in neurophysiology at the University of UCL, University College London. And I spoke to her very early when I came out of coma, when I could talk again, and she said, "Look, do not underestimate the power of imagination." I said, "Even if you have no function, imagine it. Imagine running a marathon. Imagine walking and moving." And in so many ways, that's the willpower I use to get my toes to move, right? And everything is like that. And that's— we were talking just beforehand. I really appreciate what professional athletes go through now and what they do.

It's not just nothing compared to what you've gone through. Like, just full disclosure, like, we're not, not even the same game. But yeah, no, visualization's everything. I finish all my days going on my roof overlooking like the, the city and the mountains, and I visualize myself, um, in very successful situation, right?

Like every single day.

And I've been doing that pretty much forever. Um, I think while you're getting back on your feet right now, you're becoming dangerous again. I would definitely invest in you and bet on you, right? Because you're like another species. There's not a lot of people like you. But yeah, just one last thing. Walk us through the very dark days, right? You must have had very lows and just being like, fuck it, let's not continue fighting or some stuff. Did you have some of these very low moments?

Really interesting. I never hit that low point, actually. I never got depressed. I never woke up thinking, oh, this is it, I'm done, you know. And I credit, honestly, my, um, my wife's uncle, who unfortunately passed away last— a couple years ago. Um, he was in his 80s, and he was, uh, oddly, he was trained as an OB-GYN, but he did medical school back then, way back when, when they learned everything. And when I came out of coma, I spoke to him and he basically said, look, if you want to recover from this, right, there's 3 things that you must do every single day. Wake up every morning willing to work hard, right? Be positive every day and never give up. And I literally follow that mantra every single day.. So, the days where you feel, "Oh, I feel so tired. I can't move." Those 3 things came to my mind, right? And that was a huge blessing, I would say, before he passed away, passing that to me. And, you know, for Fourth Vital, it was literally a lifesaver as well, right? And I think when your life is sort of on the line like that, I mean, that really helped. And to be honest with you, Working hard every day, done it my entire life, right? Being positive every day, pretty much people who know me well know that that's easy for me, right? And never giving up. And that's a, that's something that I have, and I think not everybody knows that to the extent that I do. But I think people who've worked, uh, for me know because I, all of that I have done for others, never for myself in this way, right? So it's like all of a sudden you're focused on yourself, and I'm not used to, I was not used to that.. But I recognized that if I'm going to recover, I'm going to have to do that. And, you know, I think the funny thing— sorry, the surprising thing is I also had to do that and still keep Fourth Vital alive. And, you know, and it was the team and people were all working together. And I think when my, you know, teammates basically saw that I'm not going anywhere, we're going to make this happen, we persevered at the same time, right? We made it happen.

We'll do an episode 2 on this one, because on Fort Vital itself, because next— yes, but where can people find out more about you, Patanjali?

So, uh, our website, which by the way doesn't have everything that we're doing just yet for good measure, is, uh, fourthvital.ai, and can contact me there as well. Um, and hopefully soon we'll have some really exciting developments to share as well. Looking forward to that.

With Patanjali and Charles Cormier, founder