Medical innovation does not always begin in a laboratory surrounded by engineers, investors and complicated technology. Sometimes, it begins with a physician looking at an everyday clinical problem and thinking: There has to be a better way.
For Craig Troop, M.D., that realization eventually led from a simple foam positioning device to an entrepreneurial journey that took his idea into hospitals, medical textbooks, lectures and markets around the world.
Dr. Troop tells that story in There is a Bomb in My Vagina: Short Medical Stories from 45 Years in Practice, a collection that looks back on his long career in emergency medicine and anesthesiology. While the book contains plenty of strange, funny, frightening and deeply human patient encounters, it also reveals another side of his professional life: the physician as inventor and reluctant businessman.
The problem that caught Dr. Troop’s attention involved anesthesia and obesity.
For an anesthesiologist, safely managing a patient’s airway is fundamental. Once a patient is under general anesthesia, breathing may need to be supported and an endotracheal tube placed into the trachea. In patients with obesity, however, anatomy can make both ventilation and intubation more difficult. Dr. Troop observed that positioning these patients more effectively could help make airway management safer and easier.
In 1999, he developed a simple foam ramp designed to elevate the patient’s upper chest, head and neck.
That apparently straightforward solution became the Troop Elevation Pillow or TEP.
The goal was practical rather than glamorous: improve positioning, help align the airway, reduce difficulty during intubation and allow the weight of the abdomen to fall away from the diaphragm so that breathing and mask ventilation could become easier.
Creating the device, however, was only the beginning.
Encouraged by anesthesia colleagues, Dr. Troop decided to make the TEP commercially available. Suddenly, a physician accustomed to operating rooms found himself dealing with manufacturing, warehousing, advertising, promotion, distribution and the realities of turning a clinical idea into a product.
He also became an educator and advocate for the positioning concept. Dr. Troop writes that he lectured on the subject across North America and Europe, while university anesthesia programs began teaching with the TEP. The device was eventually referenced in medical textbooks and numerous articles.
Success did not make the journey easy.
Some medical colleagues initially rejected the product and Dr. Troop encountered competitors who created their own versions. His account of entrepreneurship is refreshingly unsentimental. Innovation, he discovered, could involve professional resistance, commercial rivalry, intellectual-property frustration and lessons about whom to trust in business.
Eventually, the TEP reached customers around the world and Dr. Troop writes that the rights to the product were later purchased by medical distribution company Bone Foam.
That journey makes an important point about innovation.
Inventors do not always begin by trying to become inventors. Sometimes they simply encounter a recurring problem often enough that ignoring it is no longer acceptable.
That spirit runs throughout There is a Bomb in My Vagina. Beneath its unforgettable title is not only a collection of medical stories, but a record of decades spent observing, adapting, questioning and learning.
Dr. Craig Troop’s foam ramp began as an attempt to solve a problem at the operating table.
It became proof that one practical idea, born from experience, can travel much farther than its creator ever expected.
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