Interested in enrolling in college as a premed student, Del Carmen sought out potential summer internship opportunities at Queen of the Valley Medical Center to gain clinical exposure before heading to Northeastern University in Boston in the fall.
That outreach connected her to Dr. Mark Borsody, a neurologist at the hospital who also served as the senior scientist for the local nonprofit NeuroSpring. Borsody told Del Carmen the organization was looking to start an internship program and asked if she’d be their very first.
"Mark was the first ever mentor I had in this country," Del Carmen said of the experience. "I learned a lot and had so many good conversations with him where he really guided me."
That summer, Del Carmen performed surgeries on rats, established research protocols, and learned, as she puts it, everything from preoperative care to the fine art of stitching up a rodent.
"We also learned how they (interns) learned," said Grace Montenegro, NeuroSpring’s technical project manager, who has helped shepherd the internship program since its early days.
Del Carmen was, in the words of both Borsody and Montenegro, the pioneer who made it easier to train every intern who followed her.
She’s also exactly the type of person the organization launched its internship program to help produce.
“If our interns fail, we fail,” Borsody said. “We’re only as good as what they can do. We want to be the resource to make sure that they’re successful in the long term.”
FROM ONE PROJECT TO AN UMBRELLA ORGANIZATION
xSpring, a 501(c)(3) nonprofit public charity headquartered in a nondescript building in Napa, began as something smaller. For about 12 years, the organization operated under the name NeuroSpring, focused entirely on neurological disease research.
That changed when a wave of high school interns who followed Del Carmen walked through the door and immediately pushed their mentors further.
Although Borsody and Montenegro had always wanted an internship program, their direct partnership with the Napa Valley Unified School District came about through a series of fortuitous events. New Technology High School began implementing a graduation requirement for seniors to complete 60 hours of internship work, which led NeuroSpring to sign on as a placement site.
As students began interning and growing, word spread about the program, and students from Justin-Siena, Vintage and American Canyon high schools followed.
But the interns brought more than youthful enthusiasm. They brought a collective, insistent worry about climate change that Borsody said shaped every conversation.
"The thing they kept telling us about, in a very pessimistic, gloomy manner, was their fear of climate change," Borsody said. "We took that to our board in our annual report.”
The board’s response was to issue Borsody a challenge to figure out young people’s concerns.
“That’s the whole point of the organization, to facilitate a better future,” he added. “So, we did it.”
What followed was a methodical, mathematical ranking of the biggest threats to humanity that measured likelihood, scale of impact and a 100-year time horizon, using death tolls as the hardest available metric.
The results? Neurological diseases ranked fifth. All diseases combined ranked second. Nuclear war ranked first and third. Climate change was fourth.
"We were, in a sense, wiping our brows because we were doing something of meaningful impact," Borsody said of NeuroSpring's existing work. “We were already playing in the top five, so to speak.”
Out of that exercise, xSpring was born as an umbrella organization. NeuroSpring continued as one project within it alongside two new initiatives. EcoSpring was created to address ecological challenges, while NuclearSpring focuses on nuclear disarmament awareness.
Each branch of xSpring follows a similar model that begins with identifying a champion with a promising idea. The organization then funds the idea for three to five years, pairs the project lead with interns, and sometimes spins the work out as a for-profit company whose royalties flow back into the nonprofit, creating what Borsody and Montenegro describe as a circular economy.
THE VIRTUAL NEUROLOGIST
The next market-ready product to emerge from the xSpring model is a virtual neurologist that uses a wearable headset to deliver critical neurological assessments from the back of an ambulance. It is being commercialized through a for-profit startup called Ody-C.
The device, developed over years of research under the NeuroSpring project, works by having a patient wear a sensor-embedded headset during transport. An AI-powered avatar, playing the role of a neurologist, begins an adaptive intake interview, asking about symptoms, medical history, medications and social habits.
Simultaneously, sensors track eye movement, detect limb weakness, monitor facial symmetry and flag abnormal speech. Cameras, positioned at multiple angles inside the ambulance, are being trained to catch involuntary movements that might occur briefly and be missed entirely by a human responder.
"The machine is not going to miss it, though," Montenegro said.
Stroke is one of the top four causes of death in the United States, claiming about 150,000 lives annually. The clot-dissolving drug tPA is potentially lifesaving, but only effective within a narrow time window after symptom onset.
Currently, about 40 percent of stroke patients are eligible for the treatment. Only around 7 percent receive it because the rest are diagnosed too late.
Kristine Mechem, the CEO of Ody-C, said back-of-the-envelope calculations suggest the virtual neurologist, by moving clinical diagnosis into the ambulance and cutting 30 to 45 minutes off the diagnostic timeline, could bring another 11 percent of stroke patients into the treatment window.
"That equates to over 80,000 people," Mechem said. "My brain immediately started thinking, ‘Oh my God, this could have a tremendous impact if it were available in ambulances."
Mechem, a serial entrepreneur who previously took a company public and has built startups in oncology and maternal-fetal health, said she joined the project the moment she heard that number.
"When I heard the story, I was just really amazed," she added.
The device is designed to complement paramedic work rather than disrupt it. Borsody and Montenegro said early conversations with first responders confirmed their hope that there was a real need for something like Ody-C.
"They said, 'We feel frustrated that we know the person is having some neurological issues, but we cannot do anything,'" Montenegro said. "They love the idea that they can now do something."
The prototype, which currently includes eye tracking and limb assessment, is being expanded to include facial asymmetry detection, speech analysis and seizure detection. xSpring is in discussions with American Medical Response, a major ambulance service provider that serves Napa County, and is preparing to submit an Institutional Review Board application to begin a pilot.
"Hopefully, we start right here in Napa," Borsody said. "That would be our preferred place to really bring it out."
A presentation of the device's stroke detection model is scheduled for the American Academy of Neurology conference in Chicago next month. Within a couple of years, Mechem said, the team hopes to have a telehealth version of the headset commercially available.
In Napa, NeuroSpring is looking for volunteers to help train the technology by acting out simple body postures and movements while being recorded. Those interested in a one-hour session can find more information at neurospring.org.
Long-term, the platform is designed to expand to traumatic brain injury, epilepsy and other neurological emergencies that, she noted, often look deceptively alike in the field.
While Ody-C is the commercial arm of the product, NeuroSpring retains the intellectual property itself. That means that anything not commercialized by Ody-C can still be pursued independently.
"This is for humanity," Borsody said. "We don't think this is just for Americans or Californians."
PREPARING THE NEXT GENERATION
Back in the Napa lab, the internship program that began with Del Carmen has grown considerably.
Currently, a group of four to six students comes in during the week and on Saturdays, learning the ropes in preparation to lead a larger summer cohort. Undergraduate and graduate students are also involved, as are medical students from partner institutions in Egypt.
The program is deliberately structured to give students more than technical skills. Montenegro described the goal as instilling a philosophy of seeing problems in the world and working toward solutions rather than simply lamenting them.
"We are trying to build a methodology," she said. "How can they come from that idea to something that could work in the end?"
Borsody said the organization's operating philosophy is partly borrowed from the book “Enlightenment Now: The Case for Reason, Science, Humanism, and Progress” by Steven Pinker. Each student who interns with xSpring is given a copy of the book Borsody described as a data-driven argument about the realities of human progress, even when it’s invisible amid a backdrop of daily pessimism.
"The only unforgivable sin is not trying," he said.
Del Carmen said she eventually wants to become a physician-scientist like Borsody. She is now applying to medical school in Miami, holds a master's degree in bioinformatics from Northeastern, has published research on Alzheimer's disease at Massachusetts General Hospital, and continues to volunteer with xSpring.
"Getting to work for this organization early on really shapes you," she said. "It guides you to a specific path."
She’s now on the other side of the work, mentoring younger interns remotely whenever she’s needed.
Del Carmen said the most lasting gift Borsody gave her was a framework for thinking about why the work matters.
"Whatever work you decide to do, always think of it like you're working towards making the world a better place," she added.
Mechem, who has watched Borsody mentor students as an outsider coming into the organization, put it plainly.
"Napa doesn't realize how incredibly lucky it is to have NeuroSpring," she said. "Some of these high school kids are getting to work on stuff that you have to be a postdoc to do."
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