Dr Ilana Feain has never done anything the easy way; from getting expelled from high school, to leading the team that imaged Centaurus A, the biggest radio galaxy in the night sky - the co-founder and CEO of medical device company Nano-X has always taken the road less travelled.
Her journey took her from schoolgirl rebel, to a promising career in astronomy where she completed a masterful technical coup, mapping the closest black hole to our galaxy. Despite operating some of the world's most powerful telescopes though, she felt there was a bigger picture... and in her thirties, made the brave decision to switch careers into medical physics.
Now, Ilana is making her mark on the medical world running a company set to turn cancer treatment on its head.
Rebel with a cause
Ilana grew up on Sydney's leafy upper north shore. She admits to a rebellious streak during high school, and decided to leave in Year 10 to get a job. Three months of failed job-seeking later, Ilana realised education was important after all, and completed high school with a HSC mark good enough to get into a law/physics double degree at UTS.
At uni, she soon found the pressure of doing law overwhelming. “After about four weeks, everybody was so, "You must be so smart, you're doing law," and just the pressure and stress and everything, I dropped out [of law]," she says.
Continuing her physics degree, Ilana got to the end of second year before realising that because she'd dropped out of law she needed to go back and do a first year subject. “Just randomly, I found there was an astronomy course at Sydney University that I could do," she says. “I thought that would be fun and I loved it."
Up until that point, Ilana had never thought of astronomy - “I didn't even know what a galaxy was!" - but she became so engrossed in the field that she transferred to Sydney University to pursue an astronomy and physics degree. While many astronomers are inspired by the numinous vault of the night sky, for Ilana it was more the opportunity to understand how the universe works. “It was just the physics of it, it was mind-blowing. Black holes, the physics of wormholes, the beautiful images you could take with telescopes, it's so romantic and so intellectual at the same time."
Ilana continued at Sydney University, studying her PhD under Professor Ron Ekers, then International Astronomical Union President, the man forever notorious for kicking Pluto out of the planetary club. “He's a mensch, a real mentor," says Ilana. "He was always saying: Stop. Why did you say that? Justify that. Think about it the other way. My entire PhD, I was told, 'Don't follow the thundering herd. Question everything.'"
“Don't follow the thundering herd. Question everything.”
Stars in her eyes
In 2006, her PhD completed, Ilana took up a post-doctorate position, the Bolton Fellowship at CSIRO's Australian Telescope National Facility, but soon realised that pure research wasn't for her. She was appointed the project scientist for one of Australia's most ambitious astronomy projects in decades: the Australian Square Kilometre Array Pathfinder (ASKAP), a massive radio telescope at the Murchison Radio-astronomy Observatory (MRO) in Western Australia.
“That role was [about] putting together the science, the justification for the telescope, the survey science teams - organising all that. [And then] making sure the engineers were building what the astronomers wanted them to build, and that the astronomers understood what the engineers were doing," Ilana says. She loved it.
In 2007, Ilana won the inaugural Australian L'Oréal Women in Science Fellowship, which funded a citizen science project called Global Jet Watch, putting telescopes into girls' schools around Australia and the world. “I was the Australian contact to monitor microquasar SS 433 and I fed all the information back to the project's headquarters at Oxford."
At the same time, Ilana continued to work on the ASKAP project and somehow found time to get married. “My supervisor at the time, my mentor Professor Ron Ekers, actually suggested that I just get married at the telescope and he offered to throw a massive party. Because I was there so often, he didn't want me to go away.” Ilana was tempted, but her husband-to-be insisted they should get married at Bronte Beach – away from telescopes.
While working on the ASKAP project, Ilana also supervised astronomy PhD students and led another project team for what was to be the highlight of her astronomy career: imaging Centaurus A, the largest radio galaxy in the night sky. “Centaurus A is about 200 times the size of the full moon, it's 14 million light years away, a 40 million stellar mass black hole that's just shooting radiation out across the universe."
Ilana explained the original justification for building the Australia Telescope Compact Array at Narrabri had been to image Centaurus A, the closest black hole outside our galaxy.
“But it was never done because the source was too bright, because the system would overheat, because the imaging is too hard," says Ilana.
“Of course, I decided that's exactly what I was going to do. It took well over a thousand hours of telescope time but we put together the most exquisite, most detailed image of a radio galaxy that's ever been made ever anywhere."
By this time, despite taking some time off to have her two children, Ilana had built a substantial career. She'd led several highly successful projects and in eight years had produced or co-produced more than 40 peer-reviewed research papers in prestigious publications such as The Astrophysical Journal.
But, in what seemed like a moment of madness to her peers – especially as she had secured a permanent job rather than being on contract – Ilana resigned from her position at CSIRO.
Medicine the Big Picture
In March 2014, Ilana took up a three-year senior research fellowship working with Professor Paul Keall, head of the School of Medicine's Radiation Physics Laboratory at Sydney University. At the same time, she joined with Keall to set up Nano-X - a company that is developing a prototype for his invention, a revolutionary radiation therapy machine. Earlier this year she became CEO of Nano-X, heading both the company and the R & D program..
Ilana had always thought that if she wasn't an astrophysicist that she'd like to do medical physics and once she started investigating possibilities, she discovered several renowned medical physicists had started out as astrophysicists.
“So once I had made the decision to look elsewhere, it was always going to be medical physics. I had two young kids, I was 35, if I ever wanted to change fields, it was going to be now or never," she said.
"The more I looked at the projects and the research in medical physics, the more I realized what a fantastic crossover it was. And I really liked the idea of just jumping and seeing what would happen."
Traditional radiation therapy machines require a patient to lie motionless while the three tonnes or so of steel, plastic and circuitry that makes up a high-end linear accelerator rotates around them, directing x-rays into tumour cells in the patient.
These machines are very expensive, require lots of people to set them up and must be housed in a specialised radiation-shielded room. The size and cost of these therapy machines means that a lot of radiotherapy - an effective treatment for many cancers - takes place mostly in large cities.
The Nano-X design turns the problem on its head. It moves the patient around the machine, instead of moving the machine around the patient.
Instead of relying on a CT or MRI that may be weeks old, Nano-X images the tumour in real time and adjusts the beam to suit. It needs less shielding as the beam is focused downwards; and it does a better job because the beam is so much more precise and can use smaller levels of radiation.
Because it's not necessary to engineer for three or more tonnes of moving machine, this machine can be more lightly built. Nano-X predicts its machine can be built for 20 to 40 percent of the cost of current technology machines and will take up much less space.
Not surprisingly, the Nano-X design is controversial. Many in the medical profession predict it won't work, or that patients won't like being rotated.
While Ilana is not dismissive of those concerns she also says, “If you're always doing the same thing, you always do the same thing. If you've always learned it that way, you'll always do it that way."
While Paul Keall was responsible for thinking, 'Why not move the patient, instead of the machine', Ilana's experience proved invaluable almost from the moment she took up her research fellowship, because Nano-X was having trouble locating the patient in space.
“Coming in [from the outside], you really have an ability to think outside the box because you're not entrenched," explained Ilana. “And where [my expertise] came in is [developing] the ability to make 3D images in real time while the patient rotates. That [means] working out where the tumour is in the anatomy and what [it and the patient is] doing in real time," she says.
"That's come across from astronomy, the knowledge of how to extract information from that data set fast enough and in real time. The signal processing, the platform physics is really important, because without that, there's a certain way things are done and you just do them that way."
Only weeks away from a trial at Prince of Wales Hospital where 100 patients will help test a rotating bed prototype, Ilana is excited and looking forward to the future – as long as she can keep getting funding grants to keep Nano-X in the black.
“The bed's ready, the prototype's ready, we're just finalising the factory acceptance testing and the risk tests and then it'll be installed in the hospital within weeks."
When asked what she's learned through making the change from astrophysicist to startup CEO, Ilana turns pensive for a moment.
“I've learned so much. I knew nothing about companies, business, innovation, none of that. This is all brand new."
In astronomy, she says, your focus is on astrophysics and telescopes. "I had no appreciation for how much bigger the world is and how interesting and intelligent non-boffins are in their own areas, and how much you can actually learn from other things."
Making the jump to medical physics has been empowering. "I think that I have a much bigger risk appetite than I thought I have. I've learned that I take a lot of validation from my work. I changed fields, but it's what I do now and I'm going to make this work one way or another."
Interestingly, Ilana says, she's also taken some big lessons from her failures - something she didn't get to experience in astronomy.
“I've learned a lot of humility. The first year out when we went through all the grant processes, I just expected to get everything. When I didn't, I was like, "What?!"
The jump was a big one, she acknowledges. "It's not a permanent job with a big telescope you get to play with." It's been a hard road.
“I've learned that I love the excitement, the anticipation, the reward, the idea of solving some big problem in a different way. Going in somewhere completely new and just doing it differently. That always is awesome because it's so obvious and so simple in many ways, the idea, and it's so controversial."
Writer: Darren Baguley
Photographer: Brendan Fitzpatrick
Video: 90 Seconds