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If you like Elizabeth Holmes's story, you might also like:
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Elizabeth Holmes's
recommended reading: The Meditations of Marcus Aurelius

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Elizabeth Holmes
Elizabeth Holmes
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Elizabeth Holmes Interview

Health Technology Revolution

September 13, 2014
San Francisco, California

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  Elizabeth Holmes

When you were in your teens you'd already lived in China, learned Mandarin and started a business. How did you come to work on devising new medical testing technology and founding Theranos? You were still an undergraduate. What prepared you for that?

Elizabeth Holmes: I was at Stanford at that point, and really wanted to be back in Asia, and got a job at the Genome Institute in Singapore, and was working on a project for the detection of the SARS virus. This was right during the SARS outbreak. We were checking our temperatures three times a day and logging it into a computer at work and wearing masks and the whole thing. And certainly, I mean in the lab people spoke Mandarin. So, that was a wonderful thing. But I really got the opportunity to be put into a position in which I needed to learn very fast a lot of biology that I had not been exposed to before. That was a wonderful opportunity to be working at a very applied level, and at the same time thinking through some of the fundamentals, because it shifts your viewpoint on why certain things are done and should be done, and especially coming from an engineering background, whether there might be a better way to do it.

Most engineers or scientists wouldn't even consider starting businesses until they've got their Ph.D.s. You left school in your sophomore year. Could you tell us about that decision? How was that received?

Elizabeth Holmes: I think this is one of the amazing things about this country, and Silicon Valley, where people who have a great idea and a dream can pursue it and realize it. For me, I got to the point in which I knew that this is what I was born to do. When you find what you love, then you end up spending all your time on it, and I was spending all my time on it. So I had the opportunity at Stanford to start working on these Ph.D. programs, but I hit the point in which I was spending all my time on this, and I knew that this could be done. I didn't know exactly how we were going to do it, but we knew we were going to do it.

Did you have a sense of impatience about making this happen?

Elizabeth Holmes: It was a sense of knowing that this was what I wanted to spend my life doing, and that there was nothing that I would rather do more, and also in my mind nothing that I could do that could mean more. And so my parents had saved all their life to be able to send me to private school and to Stanford, and they took what otherwise would have been the money for them to be able to comfortably retire, and they let me take it and put it into this business. And it was my Stanford tuition. So I took my Stanford tuition and started the company. And that was a really special thing, because I can imagine that some might say, "Why are you leaving school?" but they didn't.

[ Key to Success ] Courage

Very early on, you persuaded your mentor, Professor Channing Robertson, to join you. Did he sign off on your dropping out of school?

Elizabeth Holmes: He did. And that started with, "Are you sure?" and then it kind of went to "Okay, I'll join you." That was a wonderful thing too. He was our first board member.

How did you zero in on blood diagnostics?

Elizabeth Holmes: It came from believing that it's possible to realize a world in which early detection is the norm, and a world in which you're not finding out once someone already has a symptom that makes it so late in the disease progression process that you can't really intervene effectively -- to one in which people are intervening at the time it matters. And if you spend a lot of time thinking about that, you learn that laboratory information and blood diagnostics -- blood and urine and feces and these other matrices -- drive 70 to 80 percent of clinical decisions. If we could make that information more accessible at the time it mattered -- which is our mission, access to actionable information at the time it matters -- we could begin to help create a world in which early detection becomes the norm. So we've spent the last 11 years transforming people's access to actionable health information.

[ Key to Success ] Vision

You're doing it faster, but you're also doing it much cheaper.

Elizabeth Holmes: Exactly.

Cost is one of the really fundamental elements of access, because today, even if you have insurance, deductibles are so high that people are faced with the choice of paying a few hundred dollars out of pocket or not being able to get a test done. I really believe that no person should have to make that choice. I have just been so moved by a recent experience I had, in which we had a woman show up at one of our wellness centers, which are the centers we build for people to come get their samples collected. She had been sent to us because she couldn't afford the cost of testing anywhere else. So her doctor told her about us. She was pregnant, and when she walked in she was so scared that she was going to be turned away because she wouldn't be able to afford it here either. Seeing that fear on her face, and then the gratitude when she saw that all these tests that she needed -- which would have been hundreds of dollars in other places -- only cost her a little more than a sandwich, and that gratitude, I mean it just struck my heart, because no one should have to live in that fear. And today -- I was talking about this last night -- health care is the leading cause of bankruptcy. If people have to make a choice between -- especially today -- paying for a set of tests that insurance doesn't cover so that they might find out earlier in the disease progression process that they're really sick, and then being forced to pay thousands of dollars to do it, people will go broke if they have to do that. And how crazy is that? Because we're spending $2.1 trillion on health care and yet all that money is being spent because we're paying for management of these conditions that could be prevented or sometimes reversed.

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