Delve Talks: Adam Elsesser, Penumbra

Transcript

Dave Franchino Welcome and hello, everybody, Dave Franchino here and I'm once again joined by my host Stefanie Norvaisas, our vice president of strategy. As a reminder, my background is in engineering and Stef brings a background in the social sciences and cultural anthropology. So, we're tag teaming with some questions from different perspectives here. And we're very, very excited and privileged to welcome today Adam Elsesser. Adam Is chairman and CEO of Penumbra, a California based company, that's really developed some amazing and innovative projects for neurological and vascular conditions. Before entering the medical device world, Adam had a very successful career as a real estate lawyer. He has a B.A. from Stanford University and a J.D. from Hastings College of Law. So, Adam, welcome and thank you very much for joining us.

Adam Elsesser Yeah, well, thank you for having me. It's an honor to be here.

Dave Franchino As a reminder to our listeners, you know, we've used this podcast to explore how companies can create a culture of innovation. And in doing so, we've had the privilege of conversations with a wide range of people trying to glean insights into their experiences and what can be applied to any field. But in particular, in the midst of the pandemic, we know there are also new challenges to maintaining creative cultures. And we're probably going to do a little bit of exploring that this season.

Adam Elsesser So welcome, Adam. And thanks again for the time. You've had a really fascinating transition. One of the things that's really apparent is the transition from real estate law to medical devices is certainly not a typical route. Maybe could start by telling our listeners a little bit about your background and the origins of that transition.

Adam Elsesser Sure. It is obviously slightly an unusual transition. And after I describe it, I'll share with you what my mother, when she was alive, said about it because she didn't fully understand it. But I practiced commercial real estate in the San Francisco Bay Area representing a lot of the large tech companies in their quest for campuses over the years. And I actually loved my practice. I had a good practice. I was a partner at my law firm. I was had two young kids, a mortgage in San Francisco. I was not looking to do anything different.

I sort of thought I had my career in front of me. And this is way back in the late 90s. I had my best friend from college, a neuro interventionist type of doctor, who does catheter work in the brain. And back in the late 90s, it was really only one product that had recently gotten cleared to do that specific work, catheter-based work in the brain.

I happened to go to New York for sort of a holiday, had dinner with my friend, and we were social dinner talking about lots of things. And he started talking about ideas he had from medical devices. Things that he wanted to build that didn't exist that would be able to help countless patients that he saw every day. And the first sort of 10 or 15 minutes of his passionate description of this was pretty interesting because I didn't know anything about it. I didn't actually know what some of the diseases or medical conditions that he was talking about were because I was in my 30s and hadn't really thought about some of those unfortunate health issues. But it was crystal clear that if I kept talking to him about it, he was going to dominate the next two hours of dinner on this topic. And I had lots of other things I actually wanted to share that was more personal and what's going on our personal lives and kids and so on.

knowing him well, I knew that if I just asked him to stop talking about it, it wouldn't result in the kind of positive vibe of the dinner. So, I took a sort of different tack, maybe this is the lawyer in me, and I told him that it wasn't that hard to start a company. I'm from the Bay Area. We're doing it all the time. Let's just start a company and do it. Let's not worry about it. And he said, okay, and we spent the rest of dinner talking about other stuff.

The only difference was I was not serious. I just wanted to shut him up. And he was deadly serious. And the next day he called me to ask if I was still in New York and insisted that we get together on that very day to plan the company that I had promised him as his best friend, the night before, that we would start. And that's where the journey started, because I felt obligated, having really screwed that one up, to meet with him. We did the next day and about a month later, we started our first company called Smart Therapeutics. And we ended up making the first stent ever to go into the brain with that company and then sold that to a much larger company. And after a couple of years at that company, we started Penumbra with a very different sort of mission and set of experiences than we had with the first one. So that's the journey.

The story about my mother -- when I told her I was leaving my law practice; she did not fully understand it. She was little older at the time and highly judgmental of me my entire life. So, she asked what possible thought did I have? I'm leaving a profession to become a merchant. And I tried to explain to her that I wasn't going to be pushing a pushcart in the Lower East Side. I was actually trying to do something that would help a lot of people. But for the rest of her days, I don't think she fully understood that.

Dave Franchino Fascinating story. I actually wanted to build on that. One thing we know from having talked to members of your staff is that one of the things that has driven you and driven Penumbra is a search for products that have meaning. That's a word that comes up often in talking to your staff. So, it's clearly written through your culture. And by that, I know your staff has talked about products that really meet truly unmet needs. And the other thing that was mentioned by your staff is Adam's desire to go into areas that are really hard. And I was hoping you might be able to talk about that, because I think entrepreneurialism is hard enough without sort of upping the bar on the things you're aiming at. Maybe you could react to why those have been important challenges or goals for you.

Adam Elsesser Yeah, well, maybe the psychology of it is it was revealed in my story about my mother, but without spending too much time on that ...For me, it's a very simple thought process. And that is when once I understood a little more about the medical device field and what products did and what was still left to do it was sort of clear that a lot of people were making decisions, either starting companies to make products or bigger companies working on products, that felt that they had a sort of primary financial purpose to them. That that decision was being done because a market had been proven, somebody else had done some innovative work, and then they were racing into sort of capture that work and make money in the field. And I don't want to be judgmental about that. That's a capitalist society. There's nothing wrong with doing that. And I want to be very clear on that. That's the way it should be, and people have the right to do that. But equal with that is we get to decide. I mean, I'm fortunate enough that I personally get to decide how I spend my time. And that didn't sound like a viable way to spend my time. That wasn't that fun. I had been able to make lots of money as a lawyer. I made some money running the first company. And so, the idea that I would do something sort of with the primary focus to maximize my financial situation wasn't just how I was wired. That part I think I learned growing up with my father, who was a very well-known construction structural engineer, ran his own business, was one of the original designers or creators of the idea-based isolation. And he did his work as an engineer for the love of engineering in the most pure sense. And he really was that guy, and sort of put his financial gain back in secondary throughout his life. So, for me, it was just sort of hardwired into me in the way I think about that.

And when we started Penumbra, the idea of a taking on stroke and thinking that you could treat stroke patients in an emergent moment was really, I mean, people just thought that was stupid, you know? I mean, there had been, you know, 50,000 Americans enrolled in fatal stroke trials at that time. The sense that this was doable, you know, there was just this overwhelming sense of pessimism around it. And so, we really, we weren't naïve when we started. No, we understood the odds of success. We’re not there. But what if it worked? You know? What if we were able to take something like this on, then the satisfaction and the importance of it would be even higher. And you know, I'll be honest, I sort of put it in very human terms in my mind. You know, I would rather go home to my children and say, "Hey, you know, I failed in doing this. But it mattered, you know? And had we succeeded, it would have been cool and important. But it didn't work. And I failed." I would be prouder to say that than, "Hey, I made a product that already existed, and I took a bunch of market share from somebody. And I made a lot of money." And that's, you know, that's a judgment that I'm not going to make for other people. I don't mean that to be a moralistic or political statement. It was just my personal judgment in how we focused our energies at this company.

Stefanie Norvaisas That's a really inspiring story, and I wish more people thought that way. A question I have is you, obviously, from the things that I've heard, lead from this place, you know, doing good, working with a purpose, serving unmet needs, doing hard things, willingness to fail. How does that trickle down into your organization? I know people say that these types of values need to come from the top. Do you encounter any resistance in your organization of people who maybe are more risk averse? And how do you handle that? Or do you feel that you've been able to hire people who are of the same mindset?

Adam Elsesser I think it's a great question. I think it's a combination of a lot of those things. I think, you know, particularly it was a little different when we were small because there were just a handful of us sort of all sharing and talking about it. As we've gotten bigger, you know, we have 2,800 people, there's always been this conversation in sort of companies and particularly in the medical device field that the bigger companies lose the ability to innovate. You know, sort of how do you hold on to that small startup feel? You know, where the magic happened?

I solely reject that thought process because we are so much better than we were when we when we were a startup. I don't want to be a startup, you know. Those are hard days. You're challenged with money and risk and all kinds of things. You're building everything from scratch. I like the fact that we're a much bigger company with much more capacity to do things. So, I actually think we're stronger and better. The way, you know, this happens it may initially start with me because we started the company. But it really isn't run -- and the culture isn't at all -- run by me. It's run by everyone in the company. And it becomes something we talk about when people are hired very openly.

I actually meet within the first month now, everyone who is on campus here in in a group setting to talk about the mission, talk about the culture. So, it's kind of out there and in all the recruiting process and people are aware of it. So, there’s some self-selection process. But notwithstanding that, it really just comes down to trust. The vast majority of people want to behave this way. You know, it's way less political. It's way less sort of, you know, taking care of yourself. You know, people want to be part of something that matters in life for the most part. And they just need to trust that that's true. You know, that if they sort of put themselves aside for a second and think about the mission in a collective way, that they won't be lost in that process, you know, and that they will succeed in their careers, in their jobs, notwithstanding that, you know, and that's the fear.

And once they learn to trust that and they just have to look around and see it, and that then breeds a different level of sort of understanding and then more people come. The more they feel that way, you know, it's so much easier now because we have so many people who trust that and are living proof of it, that the scale of the new hires are not, you know, percentage-wise in comparison. So, it's much easier for new people I think now to come and just see it everywhere and be that way. So, I think it'd be hard to come into an organization of scale and try to change it. You know, it'd be an interesting challenge. Not one that I necessarily want to take on at this age. But it's not impossible. But I think it is certainly easier when it's been this way since the beginning.

Dave Franchino Adam, I think that's brilliantly articulate. It's really inspiring to hear you articulate that you don't need to be a startup to be nimble, creative, and responsive, because I think that is sometimes a little bit of a copout. I mean, I think that common thread in your background of being a willingness to reinvent. I mean, I think there's no more intriguing example of that than the recent direction you took with the VR-based REAL system for stroke rehab. It's a pretty dramatic pivot from the types of products and technologies that you'd built up expertise in. And I was wondering if you could tell our listeners a little bit more about that system in its development and maybe the inspiration, what that stands for, for your company going forward?

Adam Elsesser Yeah, well, I always love the characterization that this was a pivot for us, because that makes and yet I'm not saying this disrespectfully, but it's not a pivot at all for us. I mean, that doesn't even make sense to me that that's a pivot. Nowhere did we ever say to anybody, including ourselves, that all we're ever going to do is make catheters that treat interventional diseases. You know, that wasn't who we said we were when we started the company. And it's not who we think about and how we think about ourselves. So, for us, there was nothing about this that was a pivot. It. It was exactly in line with everything we've always thought about who the company was. That being said, you know, how did this particular opportunity come to pass?

Like anything in life, sometimes, you know, it's luck and happenstance and and it always teaches me and reminds me that I have to keep paying attention to that because I almost didn't pay attention to this opportunity. So, a mutual friend of mine, somebody who I have a lot of faith and trust in the medical device field, not an employee, suggested that I go down and look at a company called Sixence and said it's amazing. It's down in Los Gatos. We're up in Alameda. So, it's an hour and a half drive without traffic -- back in the day when people were driving there was always traffic. So that would have made it a significant drive. And so, I sort of like, you know, I'm not going to do that. So, I sort of ignored it for a month or two. He was insistent and he kept saying, "You got to do this. You have to. You'll be amazed." And so, I finally, literally took me months, I finally typed in, Googled the company Sixense and I called him back and said, "Hey, I got the wrong company. How do you spell this company? You know, but I got the wrong company when I Googled it. I got a virtual reality gaming company, you know? And obviously, that's not what it is." So, he laughed and said, "No, no, that's the company.".

At which point I was partly intrigued, partly thinking he was crazy, partly wanting to prove that, you know, that he should stop bothering me. So, I made an appointment and I drove down to see this company. It was an awkward start. I am now wearing casual clothes because no one's here, but I typically wear either a suit or sport coat without a tie on campus. I'm old former lawyer. Those habits die hard. So, I showed up dressed like that to the gaming company in Los Gatos. I think every employee had a black t shirt. Maybe some had rock slogans. I can't tell. And I walked into this company. I think they thought it might be a police raid or something given the way I was dressed. They hadn't seen somebody like that. Wow. But the CEO of the company greeted me. They put a headset on me and taught me how to play one of their games. And in the middle of playing that game, which I don't really play video games, and so it was a new experience. And certainly, VR was a new experience for me.

And it was it was pretty compelling. The fully immersive nature of it. But somewhere in the middle of playing that game, I heard two voices simultaneously, very urgently yelling above the soundtrack that was coming from the game and my headset that I should close my eyes. "Close your eyes, close your eyes!" I heard. And I guess what had happened, this was older technology, not what we are working on and do now. But it was a headset that was tethered to a computer powered battery pack in the back of the headset. And I guess the battery pack, I gather, had started to slip out a little. And they were worried that some of the visuals would disappear in the middle of playing this game.

So I'm the kind of person that probably like most people when they hear somebody yell, "close your eyes," you certainly want to know what you're not supposed to see. So, I didn't close my eyes, of course. And what had happened is the floor, the castle wall that I was standing on in this game ... that while the castle and attackers and whatever went bright white, everything else was still there. So, the whole scene was there, but the floor went bright white and I kind of got a little unbalanced because I felt like I was falling and then I fell. I actually fell to the ground in my suit in front of everyone, and I was obviously embarrassed. But I also instantaneously understood, just from years of time spent with my co-founder, the neurologist and neuro interventionist, that if you can trick my brain to have that physical reaction, we are sitting on the magic tool to trick other people's brains to recover function in different settings. So that was the last time I played a game of theirs on the system. But we immediately start talking about how we collaborate. And here we are. So, it just seemed obvious.

And, you know, we did a lot of work. It took us a couple of years to understand the market, to understand, you know, it's not just can you make an important product, it's will the product be commercially viable? Is there a way to sell it? You know, how are those services delivered? And we spent a lot of time scoping a lot of that out, confirming that this technology that Sixense had was as novel and important as a player in the market. So, there was a ton of homework done after that.

But the concept came from the fairly obvious need that so many patients would have with this fundamental technology.

Dave Franchino A wonderful story and some serendipity there in terms of how it played out for you and for the patients who will certainly benefit from that. I think with addressing perhaps a little bit of the elephant in the room, the last thing that any of us were planning on our for our businesses right now was to be faced with a global pandemic, which has created challenges for not just our business, but our country and the world at large. And one aspect is that that's fragmented our design teams, fragmented our innovation teams, and sort of eliminated the type of kind of easy in-person collaboration that we'd gotten used to. I'm just curious how you and your teams have adjusted to keep momentum and continuity. Anything you've learned that might be interesting for our listeners to hear relative to how Penumbra has dealt with this crisis.

Adam Elsesser Yeah, it's a really good question. And it really is very sort of project by project. We, you know, we had the benefit, I guess you could say there were times when it felt overwhelming, you know, hard.

But we had the ability to keep operating because of the fact that we're an essential business. We really struggled with the definition of that, too. Obviously, our production of our current products, you know, we didn't struggle with. It's sort of written into the laws and orders that were issued. But, you know, this sort of non-essential, you know, the R&D and the other efforts that weren't as defined. We really wanted to make sure that we were keeping people safe and honoring the orders the right way. But we were able, you know, after a little bit of time to sort of figure out how to do this in a way that kept people safe, kept people from interacting a lot. Scheduling time in our R&D lab to do essential work. A lot of other work can be done at home. One project that is really important happened to be able to where the engineers were able to build labs in their garages that that they could actually do the work that they would have been doing here. And because they had a lot less of this sort of administrative part of the job sort of to push down a little, they were actually in that particular project able to accelerate the project timeline because of this. So, there wasn't one-size-fits-all around how we did this. You know, we've obviously, I think some degree and I'm sure lots and lots of companies are saying so. So, I don't think it's by any means unique. It's as it should be. We actually found that communication is sort of, you know, we were always struggling with what does communication mean? How do we communicate better? You know, we have six buildings on our campus. People, you know, in different places. How do we do that? And this has forced us to be better communicators than we used to be. And some of that has to sort of temper down. You know, there's a heavy toll on the number of calls and Zoom meetings and everything you can have. But it did teach us that there are ways to share information and not in sort of uninteresting, you know, here's your memo you've got to read every day. But, you know, in a way that keeps everyone on the same page and gives us the capacity to do that. So, I am actually optimistic that, you know, we've stayed pretty focused on how to learn from this and maybe use this to accelerate how we do things a little better going forward.

Stefanie Norvaisas Yeah, I'm interested in talking a little bit more about moving forward. Have the events of the last few months changed in any way your expectations or reframe what you see as opportunities for your company?

Adam Elsesser Well, you know, the answer is yes and in sort of very specific ways. And then, you know, hopefully in sort of broader ways that we don't yet know sort of the benefit or the outcomes. So on products the answer is yes, both in the interventional side of products we make -- it's been widely reported in the mainstream media that a number of Covid patients, as you know, a significant percentage, develop their hyper-coagulation issues and clotting, which shows up both on the peripheral side as well as the stroke side, which really puts our products which remove clots from the body into a different sort of place in the current thinking. So, if anything, that's accelerated the energy around some of the work we're doing, then allowing us to sort of prioritize both on the development side but also on the sort of marketing and commercial side a little bit. In addition, you asked, David, about the REAL system. That is obviously the way therapy is delivered has dramatically changed in the last three months in some fundamental ways that I think will be better in the long term. But it has given us the opportunity to rethink how the system ultimately will work and interact with people and where they are and how many people we can probably impact. So, we've always sort of had that in the back of our mind, but we were sort of prioritizing that the delivery of this service, you know, is when a therapist and a patient were together. And now, given that many outpatient clinics are moving to sort of a different model, I think it allows us to think about a huge number of patients that might not have even been part of this sort of therapy. So, in that sense, there's a benefit to patients that may have come out of this from a long-term standpoint.

But, again, you know, those are sort of specific projects we're working on. You know, in my mind, what it does is it confirms and maybe even strengthens, is our fundamental view of doing things that matter. You know, when you step back and in the middle of April, when our sales rep weren't really allowed to go into hospitals, we were all slowed down and you start thinking about the time that we're now in, which is starting to emerge from this and having these conversations. It sort of feels like the things that don't matter still don't matter. You know, just because, you know, the world isn't likely going to go back to, quote, normal, people's feelings around things that matter might change for a long time now.

How long? Will things settle into a routine? Yes, but the length of time of people thinking about, you know, health and medical conditions, likely there'll be a longer period here where things that matter will stand out.

And I think that's true of all businesses, you know. I mean, you know, in our own daily lives, we're looking at things like what matters. you know, as opposed to sort of things like that I used to care about that I don't care about that anymore. So, I think it highlights that core view. And if anything, it strengthens our resolve not to, sort of, you know, get undisciplined around that.

Dave Franchino Your response has actually prompted a question I've been kind of dying to ask you, which is all about prioritization. You talked about prioritization a number of times. I think one of the largest tricks for companies that evolve out of a strong startup, entrepreneurial-minded community is making the transition to some method of prioritization other than, you know, what is occurring to you specifically. Or maybe that's not the case. Maybe your it's your vision that continues to drive Penumbra. I was hoping you might be able to share your thoughts on how you've evolved your thoughts on prioritization of all of the different opportunities that might present themselves to you.

Adam Elsesser Yeah, it's a great question. I think that's still and probably will be a work in progress forever because we don't know the story about how the REAL system, you know, that wasn't on a list, you know, that we were looking at. You know, and it sort of jumped in and, you know, we did a bunch of work in there.

There was a lot of interesting reactions to that, you know, because it's not an interventional product, you know, that did bring some viewpoints of, "Well, how does it fit, you know, and what does that mean?" But it just took lots of conversation around it. And I think now everyone views it very, very differently.

I think prioritization, you know, my goal and we're certainly imperfect at this is to do a couple of things. It's, one, to have as broad a group of people in this company be able to think and make decisions around prioritizing, if you will, products as possible.

You know, the goal is not to control that tightly. Have we controlled that maybe more tightly in the past? Yes. Because, you know, we are trying to build and if you will, you know, for lack of better terms, curate what we work on and sort of teach that mindset of what really matters. Is it true when you have a large organization like we do, that people react to market forces? You know, somebody has another product and so we need one of those because doctors are asking about it. That company is getting airtime with their doctors and so, God, but if we had one ... You know, I resist that a lot because by the time you catch up, it won't matter, you know, and what you think you're going to get isn't actually what you're going to get.

And so, you know, we talk a lot about that and it's OK to sort of cede some ground on innovative products to other people as long as, you know, you're just not copying them to be late to the game. And so, I do think people have learned that, understand it and try to be very collaborative in discussing and deciding that. But, you know, it is true that at this point we are still, you know, we do centralize those final decisions. And my goal is to get to the point where we don't have to do that.

Dave Franchino Maybe just one last question for me, and that is that, you know, I think what you've alluded to both in that response and I'll be candid, I talked to a member of your staff prior to this conversation. I was asking sort of what the magic of Penumbra was. The first thing that came out of his mouth was a trust-based culture. And I know there were some really interesting stories about the support you publicly gave, I believe, your former president who elected to leave Penumbra for a position helping out with the Covid crisis and the trust that has been conferred from you to members of your staff in trying to pursue their passions and how that can also help the greater good and help Penumbra as well. I was hoping you might be able to talk a little bit about that, because it was clear from those conversations that that's not just lip service. That's something that really does wind its way through how you feel penumbra needs to be run.

Adam Elsesser Yeah. Look, trust, you know, includes an awful lot of things to make up. How do you trust someone? And I do think that it is widespread. People, leaders at this organization, deep into the organization, I don't mean just direct my direct reports, but several layers into each department, have to spend their time and think about their leadership in a way that has generally built trust. We talk about it openly. I was on a call actually just yesterday with potentially a fund that was considering investing in Penumbra and they asked a lot of cultural questions because that's an important part of their thought around investing in companies. And one of the questions sort of was around who do we look for when we hire new people and what traits do we look for?

And so I answered that, you know, around young leaders, you know, obviously individual skills and performance is a baseline, but with individual and young leaders or even any leader, I don't mean to just a young leader, that the fundamental traits that we are looking for is sort of a self-awareness about themselves, a humility about their leadership, the ability as a leader to be wrong and not feel funny saying that publicly to your team. Those are very, very specific personality traits and things we talk about, look for and expect.

And so it's not surprising that if we're pretty good at that -- and we're not always good at it, we make mistakes -- but if we're generally good at it, that that engenders trust, you know? That seems you know, I always ask, you know, I alluded to the thing. I meet with all new employees now once a month, and we talked about some of these issues. And I always ask them, as the questions do have in your past jobs. If you worked before, raise your hand if you've had a boss that has been wrong. And of course, everyone raises their hand. I said, “Did that boss admit that they're wrong?” And of course, people generally say no, you know? And I said, “Did that make you think your boss was strong and better or would you prefer that they admitted they were wrong? And would you have respected them more?” And I mean, the answers are obvious to everyone. And so, you have to actually build and give people comfort. But you also have to ... the boss who then once is willing to admit that they're wrong, has to know that they're not going to get in trouble for being wrong. I mean, they do something catastrophic and inappropriate, you know, that violates our basic code of conduct, that's different. But for other stuff, you know, you have some leeway there.

Dave Franchino Stefanie, last questions from you?

Stefanie Norvaisas Oh, I was wondering if you could just highlight for listeners something that you used to do sort of in the before, that you want to leave there and not bring into the future.

Adam Elsesser Something, you mean, things I've done wrong?

Stefanie Norvaisas You know, mindsets or activities, travel?

Adam Elsesser That's a very good question. Look, I'll answer it. Yeah. Let me come up with a few specific answers. But I'll start with if I look at how I was even a year ago or two years ago or five years ago, I keep changing and I think I get better. Which means that there's a ton of stuff I look back at and say, leave it behind, because, God, I can't believe I did it that way. That, you know, there was just the issue today that I was dealing with. I can't describe it publicly, but, you know, it involved sort of a collective group of decision making, you know, a short while ago, that we sort of looked at through a lens of today going, "What were we thinking? You know, we have been better at this." And so, I think that's a constant process rather than a specific, you know, thing.

And that's what I think I'm losing to sort of go around what I hope and what I want the leaders of this company to have. You know, the organization is this sort of mindset that that we're going to constantly sort of get stronger and better and that the expectation is for doing that and sort of self-assessment as we go, which then by definition means there's a lot of things that we would look back at every one of us and say, "You know, wow. I'm so grateful that we're better than we used to be." I think that's the way I would frame it. I mean, you know, we probably don't have time for me to list the tons of things that specific way. But I think it's a constant process.

Stefanie Norvaisas I think that's very refreshing. And I think it's a very hopeful mindset. I've been studying resilience, and I think that's one of the keys to building a resilient organization is the sort of self-awareness and interest in sort of ongoing change and growth.

Adam Elsesser Thank you.

Dave Franchino Yeah, it's a refreshing perspective. But the humility, I think, is maybe not perfectly placed because you've clearly gotten more things right than wrong in your career. So, Adam, thank you so very much for joining us.

So once again, our guest for this episode has been Adam Elsesser, who's the chairman and CEO of Penumbra, a really remarkable California based company with a track record at innovation and the neurological and vascular space. And Adam, thank you so very much for your time. I wish you the best of continued success at Penumbra, particularly during these unfortunate times. Please stay safe and well.

Adam Elsesser All right. Well, thank you. Same to you both. Appreciate it.