Without a Doubt

January 23, 2023
In this inspiring debut, Sarna, partner at the startup accelerator Y Combinator, recalls the founding of her biomedical company nVision Medical. After Sarna experienced ovarian pains in her teens, and subsequent inconclusive medical tests led to a needless cancer scare, the author was motivated to address “antiquated approaches” to women’s health. Sarna recounts the sometimes-arduous process of networking and raising capital despite countless rejections, and describes how, after consulting women’s health specialists and scouting out hires, she started a company dedicated to early ovarian cancer detection. Following frustrating clinical trials, Sarna and her partners created the first FDA-approved device that collects cells from the Fallopian tubes, allowing earlier testing for ovarian cancer; they sold the company for $275 million in 2018. Along the way, Sarna chronicles her efforts to keep the company running during her pregnancy, as well as how she dealt with gender discrimination (she recommends not dedicating mental energy to others’ “negative assumptions” and instead focusing on one’s “task at hand”). Throughout, she dispenses entrepreneurial advice that’s sometimes useful (assessing work/life priorities to avoid burnout), though elsewhere overly general (ensuring one’s work is based in a “wholly felt passion”). Sarna comes across as thoughtful and upbeat while remaining forthright about the potholes awaiting startups on the road to success. Budding entrepreneurs will find this a motivating, accessible entry.

Starred review from December 15, 2022
An Indian American entrepreneur describes how her harrowing medical history spurred a lifelong obsession with advancing the field of women's health. When Sarna was 13, she went to the emergency room with an agonizingly painful ovarian cyst--a diagnosis she would receive 24 hours after a doctor recommended that she should go home and take some Tylenol. Although her cysts disappeared after puberty, her determination to improve care for uterine-related conditions lasted a lifetime. Sarna has based nearly every decision in her adult life--applying to Berkeley's biology program; taking an entry-level engineering position at a medical device company; starting her own organization after being laid off--on her desire to make women's health care better. As she demonstrates in her lively text, she pursued this goal through years of being underestimated, taken for granted, and ignored. Eventually, Sarna formed a research-and-development team whose closeness led them to call themselves "La Familia." That team developed a diagnostic medical device that Boston Scientific eventually acquired for $275 million. The author is now a partner at the innovative venture capital firm Y Combinator. Throughout this frank, vulnerable, and fast-paced memoir, Sarna returns to the central theme of the consequences of being "underrated and doubted." She realized that "the single most important decision I made in my career was to push forward even while being doubted by so many. Doubted by the famous inventor who fell asleep while I was speaking to him....Doubted by the guy who came to my booth during a trade show, looked over my shoulder, and asked to speak with the CEO of the company." Perhaps as a result of the ways in which she was underestimated, Sarna's approach to entrepreneurship, which she articulates through warm and humorous advice embedded in her life story, is profoundly empathetic, both for her co-workers and community and for herself. A wise, practical, and compassionate guide to startup success from a determined woman.

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