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THOR Photomedicine: The Making of an Icon

Every iconic founder story tells of prevailing over the odds, overcoming difficult circumstances or is a stimulating tale of triumph that inspires new generations of founders. Bill Gates was arrested not once, but twice for driving and speeding without a license, then dropped out of university to start Microsoft. Brian Chesky of Airbnb was deep in credit card debt, had nightmares, sold cereal boxes with Obama's face at Democratic conventions, and was only just accepted into yCombinator. Travis Kalanick lived with his mother and collected unemployment benefits before selling his startup RedSwoosh for $23 million and then going on to found Uber. Mark Zuckerberg dropped out of university, convinced his parents to re-mortgage their house to fund Facebook before receiving angel funding. Jack Ma was an English teacher, rejected for jobs at places like Kentucky Fried Chicken, before becoming a tour guide; meeting Jerry Yang (Yahoo), who gave Jack angel funding to launch Alibaba.

What these entrepreneurs have in common is that they developed survival instincts with strong support from their families. Most of these companies would not exist if it weren't for the tenacity and determination of the founder, despite many obstacles and the voice of reason to "get a steady job." One thing they all have in common is that they didn't listen to that voice and simply give up.

I had a chance to spend the morning talking to one such iconic founder last week, whose story is on that same level of impassioned and extraordinary.

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James Carroll, Founder of THOR Photomedicine, the revolutionary UK biotech company conducting research and developing medical lasers in photobiomodulation (PBM).

James Carroll is the founder of THOR Photomedicine, a UK company making a Star Trek style medical laser that accelerates healing. For people who are familiar with the sci-fi series, when a crew member is wounded, the doctor aims a low intensity laser beam at the injury and the tissue heals instantly. Yes they make those, but it is not instant like on TV, but you get the idea, a special kind of light that is applied to the patient and they heal faster.

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Doctor Beverly Crusher applies the medical laser for dermal wounds on Commander Riker for accelerated healing in the sci-fi series, Star Trek: The Next Generation (1987-1994)

It is universally agreed by scientists working in this field that this is a medical breakthrough, yet mainstream medicine and the general public are mostly unaware of its existence. The treatment is called PBM Therapy (short for photobiomodulation) though it is also known by dozens of other names such laser biostimulation and Low Level Laser Therapy (LLLT), but now a core group of scientists and the National Library of Medicine have come to some agreement and photobiomodulation (PBM) is here to stay.

PBM Therapy is based on the use of low intensity laser or LED light to accelerate healing and reduce inflammation. It is non-ablative, does not burn nor heat the skin, and works more like photosynthesis in plants, (i.e. where light is used to produce energy so the plant can survive and grow). In PBM Therapy, mitochondria (the cell’s ‘power house’) absorb photons in the red and near infrared spectrum causing an increase in energy, a reduction in stress and improved cellular signaling.

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Like all the best scientific breakthroughs, PBM Therapy was an accidental discovery. In 1967, a Hungarian scientist and professor, Endre Mester, wanted to find out if the recently invented ‘laser ray’ might cause cancer. He shaved hair from the backs of mice, divided them into two groups, applied low intensity laser beams to the skin of one group of mice to see if they would develop cancer. They didn’t. To his surprise, the hair grew back more quickly in the laser group, so he called this effect ‘laser biostimulation’. Since then over 4000 laboratory experiments have since been published, and over 500 clinical trials published showing that PBM therapy improves the speed and quality of tissue repair (e.g. skin, bones, nerves, the brain, spinal cord, eyes), reduces inflammation and induces analgesia.

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Hungarian scientist and Professor Endre Mester is considered the Father of Photobiomodulation. He first experimented with photobiomodulation (PBM) on mice in 1967.

Researchers around the world have brought it into academic prominence, with several hundred papers a year published every year on this topic by well known research groups that include the US military, NASA and Harvard Medical School, yet it remains a secret from most medical doctors. James Carroll seems to be on track to change that.

James Carroll, Founder of THOR Photomedicine, speaking at the United Nations headquarters on May 6, 2014

Like many founders before him, James had to overcome many obstacles, and like many companies THOR did not proceed along a predictable path. He struggled at school with undiagnosed dyslexia and left in 1978 at the age of 16 with a handful of low grades. Despite failure at school he talked his way into an apprenticeship in electronics at Audix (a public address and broadcast systems company), attended college one day a week but failed his exams. He took the year again and failed again! Despite this, James rose rapidly through the company thanks to a couple of mentors. “Mac", a former soldier with high standards was tough on James, requiring his work to meet military specifications. Later, John Freeman the company’s Technical Director adopted James as his protégé and had him lead a series of ‘revolutions’ within the company; implementing ISO standards in design, developing new production control processes, and eventually creating a technical support role within the sales department. Little did James know it, but this was the beginning of a substantial training in how to run a future biotech and medical devices company.

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"The Rocketts". James Carroll is pictured in the center with bandmates Gavin (left) and Simon (right), aged 13. Later they would go on to become BBC's Young Entertainers of the Year in 1976.

James left the company in 1984 for his first entrepreneurial venture when he convinced a friend to make him 50% co-owner of a sports and classic car restoration business. This is where James discovered one of his ‘superpowers’ - an ability to rewire vintage cars without an electrical circuit diagram. James also recalled in our chat together that in his earlier life he had the ability to play almost any musical instrument by ear. As a teenager he and two friends formed a band and became BBC Young Entertainers of the Year 1976.

"If you told me then that I would eventually become founder of a medical laser company and publish 30 academic medical papers, and that nine of them would be with Harvard Medical School, I wouldn't have believed you." -James Carroll, Founder of THOR Photomedicine

However, just as the car restoration company was taking off, there had been a fire. An employee was draining a fuel tank when suddenly it burst into flames. Before long, seven cars were on fire, along with the employee who had been covered in fuel; James smothered the employee in flames with the dust sheet from a car and they escaped around the back before the acetylene bottles exploded. They were underinsured and everything was lost, so it was back to electronics where James took on a job as production manager at a transformer manufacturing company. Here, he introduced computer driven test procedures by teaching himself how to connect an Apple III to test equipment via RS232 ports and wrote programs in Apple Basic to perform the tasks.

Back in the industry, he learned that making money for shareholders was important skill, and that quality or profit necessarily need not be compromised; both could be achieved, and that these goals could be symbiotic. The transformer company performed well and the owners accepted an offer for the business. James received his next piece of advice from a mentor, “you will never make much money just by being an engineer, you need to learn how to be a salesman”.

With a new suit and some grooming from a recruitment agency James discovered his next ‘superpower’. At the interview, the recruiters noticed James had moments of energy and enthusiasm that they found infectious. James had always been shy and self-conscious (and still consider himself as such). Being an inspiring introvert is an awkward superpower to have, but James managed to turn on the enthusiasm for a Pitney Bowes sales team interview; he got the job and underwent the renowned company sales training. Eighteen months later, in 1987, with a bit of sales experience behind him, James left Pitney Bowes and bought a franchise with a friend to sell government grant consultancy. One of their first clients was a medical device company that made lasers which healed wounds more quickly. At the time, all the UK research was based on lab rat studies, but clinical cases from Eastern Europe, showed its effectiveness on humans and James realised that this would become the future of medicine and had a vision of this treatment being used in every department of every hospital in the world.

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The Royal Highness Princess Zara Phillips using a Thor laser device on one of her horses. She is one of the dedicated clients of THOR Photomedicine.

This was an opportunity too good to miss, so he abandoned the government grant franchise and talked his way into the laser company. However, that business struggled and failed in 1991, so he and two of the engineers founded THOR Electro-Optics Ltd to develop their own products. Within a year this was closed, due to lawsuits for claimed copyright and patent infringement by the people who purchased the assets from the previous business. James and his wife were also being personally sued and as potential personal bankruptcy became imminent, they became eligible for “Legal Aid” and the plaintiffs withdrew their legal suit. THOR was restarted and the next chapter of the resurrection of the company began. 

With no previous medical industry experience,  progress was more than any of the three partners had imagined. James was making enough sales to make a comfortable living and things were going OK. Then about ten years later the US Navy purchased a THOR laser to experiment on nerve regeneration. This became a spinal cord regeneration project and James attended a conference where other research groups showed that PBM therapy reduced infarct size after a heart attack, and improved neurological deficits in rats following a stroke.

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Manchester United is one of many high profile clients of THOR Photomedicine.

James was aware of laser for healing wounds and sports injuries but this was something else. Seeing where this was going, James went to his partners saying they should write a plan and raise capital because this was going to be big. His partners objected, telling him that VCs would take over the company and fire the founders and “probably bankrupt the business anyway”. (See my previous blog post on Why Founders Get Fired From Their Own Companies) Eventually, James persuaded them, they raised £650K ($1M) in angel money and loans but investors decided that a "more experienced" CEO should run the business. As predicted, the new CEO fired the two of the founders, (tried, but failed to remove James), and, 18 months later, in October 2007 the angel money was all spent and THOR went bankrupt owing £1M to creditors.

James decided to start the business again, for the third time, but by himself. He bought the assets from the liquidator with a mix of cash and profit share over 3 years and set a target date of 1st January 2008 to relaunch. He secured a £100,000 line of credit which he used to keep the keys to the building, the lights turned on, the web site running, and the staff from finding other jobs . Everything was a negotiation, old suppliers need to be persuaded to deliver, telecoms reconnected, FDA approval and CE marks needed transferring, all by 1st January 2008.

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The US Navy acquired a previous generation THOR laser in the early 2000s, and discovered its effectiveness on spinal cord regeneration.

THOR was back in business as THOR Photomedicine Ltd, but the global economy was imploding. It wasn't the ideal time to restart and attempt to bootstrap a company, especially given the failure during good times in the previous two years. Every month that went by it looked like they would never make monthly payroll; but every month, the sales were dragged in, products somehow built and, if the UPS bills were paid, they could ship. “It was a white knuckle ride for all of us, every day,” says James, “the faith, resilience and resourcefulness of everyone in the company was tested many times over those years, but nobody buckled”.

As founder and CEO, the most important job is looking after relationships; staff, suppliers and customers. This is a mixture of honest updates and constantly restating the mission and vision: 

James tells me: “Everyone was clear that we were here to heal tissues and relieve pain, and that we were going to put a PBM system in every department in every hospital in the whole world (somehow). Napoleon was reputed to have said, the job of a leader is to define reality and give hope. Sometimes the reality was that we had run out of cash, but there was always another reality; we were owed money which we would collect (somehow), and we always had prospects close to ordering, so we borrowed my wife’s tax savings. People needed our lasers, I would say, they just did not know it yet. These were the realities I would talk about, and it gave everyone (including myself) a reason to be hopeful. Back then, and even to this day, everyone in the company gets a Monday morning email report on sales and cash (our sales department gets this every day, including weekends!”

“Kicking off in a global recession, with our suppliers owed £1M and just £100K to get us started felt like a high wire act with no safety net, but what else was I going to do? A life not working on my mission was not an option for me.”- James Carroll, Founder of THOR Photomedicine

In the first year, the company made revenues of just £500K- not enough to be viable; but each year they gained an extra £200K in sales until 2015, when sales jumped from £1.5M to £2.4M. Now Thor is on target to more than double that in 2016, which should put them over £5M in sales. (10x its 2008 figure).

THOR now has many prestigious clients including Harvard Medical School, US Navy, Royal Air Force, British Army, Manchester United and even her Royal Highness Zara Phillips (gold medal winner and granddaughter to Queen Elizabeth ll).

The biggest purchase to-date has been from Nike. They recently ordered a whole body light pod called NovoThor to help Nike-sponsored athletes improve muscle power, reduce fatigue and accelerate recovery after training.

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Nike recently acquired the whole body light pod NovoThor to use on their athletes to train for the Olympics.

PBM Therapy is best known for treatment of musculoskeletal conditions (e.g. back pain, neck pain, tendinopathies, osteoarthritis, ankle sprains). Interestingly, the treatment with the most evidence is a side effect of chemotherapy and radiotherapy called oral mucositis, a condition where cancer patients lose mucosal tissues (lining of the mouth, throat and esophagus) leading to such severe ulceration and pain such that that patients cannot eat, frequently having to be fed by tube). There are now 32 randomised controlled trials that show that PBM therapy is effective at preventing or significantly reducing these side effects.

Other diseases James and his academic friends are collaborating on include traumatic brain injury (e.g. concussion), reducing infarct size dramatically after a heart attack, treatment of non-healing wounds (e.g. venous ulcers, diabetic ulcers and pressure sores) and various forms of severe nerve pain (e.g. burning mouth syndrome, shingles and post hepatic neuralgia), depression and cognitive enhancement (i.e. speed and accuracy in memory tests of healthy students).

I asked James what the most impressive research he has come across so far and the answer was unequivocally: dry age-related macular degeneration (AMD). James maintains a biblical collection of medical research on PBM Therapy going back to the 1960s and even has built a personal search engine, which he has nicknamed "Thorgle". He told me of published studies showing that his lasers were was able to stimulate the production of stem cells simply by treating bone marrow with light. Theses extra stem cells had significant effect on infarctions of the heart (heart attack), and is a potential treatment for traumatic brain injury, ischemic infarctions (stroke) and Alzheimer's disease.

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James Carroll has created his own private personal search engine with extensive research on photobiomodulation that goes back to the 1960s.

Although there has been a few literature reviews dismissing PBM Therapy as being ineffective, this has more to do with the authors lack of knowledge about dosing. The optimal treatment parameters (i.e. wavelength, irradiance, interval, time, pulses and location) for effective treatment are not always adequately understood. Sometimes less is more; just like photosynthesis, plants need a period of darkness to release carbon dioxide. In a similar way, the body needs a period of downtime to let the activation of mitochondria, stem cells and white blood cells do its work after PBM therapy. The PBM dose response is dependent on the density of the light and the dose rate. Too little, and there is no effect, but too much can be inhibitory. This has become James’s area of academic expertise and why he is included on so many research papers despite his leaving school at 16 with a handful of low grades.

James is obsessive about treatment parameters so not surprisingly THOR also makes range of laboratory systems called specifically for universities to accurately experiment all the treatment dimensions and dose (i.e. wavelength, power, area, timed various pulse regimes). James says this is the Formula 1 racing department: "Like Mercedes, Ferrari and Renault, we use development of extremely accurate laboratory equipment to inform our next generation of clinical products."

James is also co-founder of another photobiomodulation (PBM) company Lumithera Inc., which is angel-backed. “This is a patented treatment for the leading cause of blindness in the developed world, (dry age related macular degeneration),” he says, “millions of Americans are going blind with this disease and nothing else works on on it. Lumithera have treatment data on over 100 eyes, some with one year follow-up data showing patients have sustained clinically meaningful improvements in visual acuity. We also have OCT scans on 43 eyes with that show a reduction in the presence of the fatty deposits (Drusens) which are the hallmark signs of this pathology." ISO certificates have been awarded, clinical instruments design is complete and placebo controlled clinical trials are in progress. LumiThera is closing its series A financing round and the company plans to launch its Series B financing round in August.

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Acorn Computers, founded in 1978, was a revolutionary UK computer corporation that once rivaled Apple, but failed to scale globally after being acquired by Morgan Stanley in 1999.

There have been many UK corporations in its history that have failed to scale after a period of tremendous growth (e.g. Acorn Computers in the 1970s-1980s); however, with James as the captain and CEO of THOR Photomedicine, I feel that he has the right vision and competence for this early stage technology which has potential for a £multi-billion revenues (whilst improving lives and potentially saving the NHS and international healthcare markets billions too). As a Harvard professor put it, “James is the world's leading ambassador for photobiomodulation,” and I think could put the UK back on the map of global iconic companies.

THOR Photomedicine is still 100% owned by James Carroll. His goal is to have photobiomodulation (PBM) therapy established as a part of standard care for 100 diseases in 100 countries by the time he is 100 years old (7th May 2062). The first will be with Lumithera for dry age macular degeneration (AMD), then oral mucositis in cancer patients. There is a long list of options for No 3. In the near future, we might even all have a THOR laser device in our first aid kit in the form of a light emitting bandage.