Day Zero is the moment before company formation when a founder decides to take the plunge, follow their dream, and commit to pursuing their vision of change. On Day Zero, you'll hear founders tell their story. From the initial idea, the reactions by critics and skeptics, setbacks and successes, we'll cover it all. Behind every company is a founder with ambition, goals, dreams, and wisdom to be shared. Let's explore them together.
Well, Tom, thank you so much for joining me at Day Zero here. As an advisor to Day Zero, I'm the founding and managing partner of Define Ventures. And, Tom, it's been such a great time to partner with you. You have a long standing history beyond,
we're going to talk a lot about Story, but even in the emergence of healthcare and technology, you were a engineer and leader, both at Verily and Google and was almost at Google about 17 years, and then also was an engineer at EA even before that. And so we're just so excited for you to join us. Thanks so much, Tom, for joining us on Day Zero. I'm happy to be here. I love to tell stories. Yes, you are a great storyteller. So, you know, I'll never forget, Tom, one of, like,
the pivotal times, andknow we will always talk about this is, we went on a really long walk one day, and you're laughing. We went and we were COVID friendly, if you will. And we talked about your journey in a lot of ways, and kind of going all the way back. So talk to me, I mean, Tom, you were one of the highest level Google engineers, strictly in technology at that time. And you had kind of a really inspiring story about what led you to healthcare. And I would love it for you to share because I think it's really your origin story of how you've dedicated your life now to healthcare and redefining it.
This is how it all began for me. I was working in Google, like you mentioned, on the core of the company: ads and payments of things at a time when the company was really exploding, so it was really being part of a rocket ship, a great place to be. And then as it would be I was, like to say, you know, life throws things in your way. So I was riding my bike in Palo Alto and I got hit by a car. I actually have no memory of any of this because I had a concussion. But I
woke up in the emergency department at Stanford Health Vare. And it's interesting, the things that you specifically remember. I remember staring at the ceiling tiles as you're being rolled on the gurney down the hallway, all the different dots. That's a specific thing that I remember.
And they told me, they're going to put you into a CT scan to see whether you have any broken bones, you've been in a car accident. And I felt fine. And for whatever reason, I was pretty lucid at the moment. So I went into the CT scan, came out, and they said, "good news, you don't have any major broken bones, you're gonna be okay." And I remember my wife and my kids were there as well. I couldn't really move my head much because you're in this big neck brace. So you kind of have these voices off to the side telling you things. They said, "but we did notice something else, though, on the scan, which is, it looks like there's some sort of mass in your kidney." And I was very confused by that. It turns out, the next day, I had an ultrasound,
and the day after that, an MRI. It turns out that I had stage one kidney cancer and had no idea. And there is no way of knowing when you have stage one kidney cancer because there's no symptoms, there's no way that that you would have any idea that this ticking time bomb was sitting there. By the time you typically do have symptoms, it's typically stage four. And the difference in survival is dramatic. So, at stage one, 95% chance of survival. At stage four, 5% chance of survival. So, pretty dramatic. So I like to say that getting hit by a car literally saved my life. To be clear, that makes you also step back and think, are you spending your time
on this earth on the most important thing to you? That time period between when you've been diagnosed and when you have retreatment makes you spend a lot of time with that question. I was thinking about the fact of, do I really want to spend my my life helping people click on ads and buy apps? Is that really the most important thing for me, as great as it is? And I came to the conclusion, no, what I wanted was to work on things that would give people the experience that I had, where we didn't have to hit people with cars in order to be able to change the way that their lives were going in terms of health. How can we do more that way? So that's kind of what got me to healthcare and it's interesting to go back to that because it's been 10 years since that and having that moment has been a defining persistent energy source for me to remind myself why I'm doing this and to always come back to that and say this is what I'm all about. Yeah, I mean, Tom wow, just hearing, it's not the first time I heard that story, but to hear it again, it means so much about who you are, what drives you. And you know, I always like to say, what is your vision of the future and how you want to enact that in impact. And I've got to believe,
Tom, that there are so many entrepreneurs out there, especially after COVID. We all have a lot more time, hypothetically, to think, right, and really think about the impact we have in kind of what we're doing every day. And so, you know, I can imagine this is going to resonate with a lot of people, especially now, all of what you said was pre-COVID, obviously. Talk to us about, you had this epiphany of sorts. Was it scary? What is the next thing you did? Was it, I'm going into healthcare and I've been a payments technologist, like, what did you do to get comfortable with leaping two feet in into an industry you hadn't necessarily touched before? It's not as simple as it sounds, right? It sounds like, oh, you had an epiphany, and then you just went in and did healthcare. It actually took me a while to figure this out. I came back to Google, told my story to a lot of people, and they said, well, you should meet some people at Google that are interested in this So one of the guys I met was this guy, Andy Conrad, who just came over from LabCorp. We immediately hit it off, like we had very similar ideas about, like,
hey, if you can measure these things, you can know these things. And what can you do with that knowledge and with all the technology we've built to deal with the messy world that is the internet? Can you apply some of the same technologies to the messy world that is healthcare? And so there was a lot of great ideas there at beginning. But, for me, it took a while to actually jump off the cliff. It probably took me about three or four months before I was ready to say, I'm ready to do this. And that part of it, that that kind of wanting to be clear, is not always the story that's told all the time, right, where everyone was like, well, I just had this idea, and I went, and I did it. No. It actually requires a lot of going back and forth and
talking with the people that are in your life to make sure that you were actually onto the right thing. So that's what it took for me to do it. And then about three months later, I left payments, went into Verily, and that kind of became my focus. And the rest is kind of history from there. Yeah, it's so well said. I mean, I think, as a founder and myself being a founder, too, there's the point of, you know, intense, if you will, mission, some clarity of vision, but like a passion, and then intense, like, you know doubt, too. Is this right? You know, this is, you know, if no one else is doing this, why should I do it? Or, am I the right person to do it? I mean, there's so many of these questions. What was the tipping scale?
Even though, I could imagine you don't have all the answers, having, you know, the intellectual curiosity and the confidence to say, we'll just get through that. Or was it, did you talk to a ton of people and just get, like, convicted? What allowed you to, after three or four months, kind of get to that point of, now my feet are running in that direction, if you will? Yeah. So there was two things I remember in particular for me. One was, talking to a lot of people about this notion of, you're successful in one area of your life, and you've built up this level of position and credibility, and you feel like you know what you're doing, right? And so you're like, why would I give that up? Why would I give that up to go someplace where I don't know anything, frankly, I'm going to be a complete novice, and I'm going to be starting all over. Do I really have the energy to start all over? And I think the fallacy we often tell ourselves is that we're starting over. It's actually not true. If you look at most people that switch between teams, even within a big company, which is in many ways, you know, jumping off a cliffs by itself, it only takes six months to a year in order for you to get back to the level that you were at. It's actually
not as much of a reset as you were. So, a lot of people told me that and it began to ring true. And so that helped. The second was, I got to know the people I was gonna go work with. And it became, you know, much more of a relationship there. And that also, I think, made it a lot more clear for me that, hey, these are people I want to spend time with. And every time I would go and spend time with them, a couple hours here or there, I would come back saying, oh my gosh, I just feel so at home and so energized by this. I got to do this all the time. Those things
together, I think, were the were the big things I had to get through in order to make it happen. Yeah. I mean, you've been a multi-time founder. One, which is Verily which I'd love to dig in now. And then, Story, which is outside of Google, from the very beginning, day zero, if you will. But let's first focus on your first founding story, which is Verily. How did that story kind of evolve, if you will, so it sounds like that first conversation with Andy Conrad.
You know, talk to us just a little bit about the founding story of Verily. Like I said, a lot of our vision in the beginning was, how can we bring a lot of the tools that we've built in order to understand the messy world that is the internet, to healthcare, specifically around understanding data. What does data tell us and how can we use that to know things better, to be able to understand things better, and be able to eventually act on things better? That was really the vision of Verily from the beginning, but there was a lot of different questions about which data to start with and where to begin with. And one of the challenges always was,
well, if you don't have good data in the first place, how can you make good decisions as well, right? So we had to build hardware in order to actually measure things in the beginning, right. So that was a big focus of early in the early days was building the hardware, things like Study Watch, which is a great device that really created an entire category of the notion of a watch that can do ECG, at the time was kind of science fiction, right. And the other one being Continuous Glucose, which, Lynn, and I have a little bit of history here, but that actually has been transformational to the world of diabetes, and even beyond diabetes now. So that was really
the beginning was trying to figure out, how do we get better data? And then, how do we do that in the world of of partnership, and this is one of the things that was a bit of a new thing for me coming into Verily was, at Google, we really build things for users. And they would come and then, eventually, advertisers would come say, hey, how can we help as well and how can we derive value from the fact that you guys seem to know the right answer to all these queries? In healthcare, you can't do that. You can't just build your own system outside of what exists today. You have to partner, right? It's not a world where you can go it alone. And so, building that muscle for partnership was something that was, for me, new at Verily. From the very beginning, we knew we had to do it. That was a big thing that really led to us realizing that our culture and our DNA had to be different from Google because of that very different approach to the market.
Yeah. I mean, Tom, now that you can reflect back, because we're gonna focus on Story here. But what is the difference, because I can imagine, again, some of our listeners are thinking about almost intrapreneurship, right, within a big company, versus, you know, starting a startup from scratch. What are, if you will, the pros and cons of building a Verily within a large corporation, and then let's, we'll flip to Story in a minute here, but love for your reflection on that founding experience.
They're very, very different, frankly. But at the core of them is this beginnings of, like, you need to understand the through line of why you're doing what you're doing, how it's going to work, and how it's going to come to fruition, from all the way down, understanding the details of the science to the business, to the technology that's going to power it. That was the important thing across both of these businesses. But I would say at Google, you've got a great source of capital, right? You didn't have to worry about that as much. You also have an amazing brand that opens basically any door you want. That's a great benefit to have. So anytime you would ask someone to take your call, they would take your call, and that was an amazing superpower that I think is a wonderful thing to have. The other thing you have is, frankly, great access to technology and resources, right? So those three things are particularly valuable things about starting something inside of Google. The downside is you're
going to be a hobby project, frankly, right? So this is one of the things that, a lot of times, you're going to have a challenge at big companies is there's a core business. At the end of the day, when things are going well, there's an interest in doing more things, doing things great. When things are not going well, guess what are the first things to go. It's all the hobby projects are the first things to go. So you have to think about that and say, do I want to be the center of attention? Or do I want to be on the outskirts? And that's, I think, one of the harder things about doing things at a large company. The other thing you have to think
about is, do you want to match the state of what you're building with the state of the company that you're building, right? So if you are trying to build something nimble, experiment very quickly, trying new things, and you have a big company that's a lot of process that's trying to protect itself from various things, those things can be mismatched a lot of times, whereas if you were trying to do the opposite, it may be difficult in a startup as well, right? If you're trying to run a very reliable processes, it could be very difficult to do that as well. So that's the other thing, I think, that's a challenge for people to realize is, like, I think matching where the problem is to the company is very important. Yeah, I mean, Tom, it's such an interesting experience because there's been a lot of startups that have started from strategics, especially in the area of digital health. And so understanding the pros and cons, and what that relationship could be, could be very fruitful. But you don't want to be, you know, to your point, to always have it be a strategic edge. Some entrepreneurs will see that. So let's now flip to Story, which is, you are the current CEO
and founder of Story. So you're here at Verily, it's been almost 17 years between Google and Verily, you were a senior leader, part of the executive team, a founder of Verily. What made you want to start something again, and not only that, start it from outside, completely. Bring us through that thought process. And this really gets into my internal way of how I feel about things. And Lynn and I talked about this a long time ago, when we were on our walk. You know, when you're part of something that's really successful from the beginning, there's always this lingering doubt in your mind.
Was I actually part of the solution or was I just in the right place at the right time? That's always something that I always wonder about, with my time at Google and Verily, and, I don't know why, but it's this kind of itch that you can't figure out. And I think the only way to really solve it is to go start over, frankly, and do it yourself. That's part of one of the reasons that I left to do Story, was really to prove to myself that I could. I realize
that that's, like, not very mission oriented and such. But it's also very personal, right. At the same time, though, I wanted it to be along the mission lines that I was passionate about. And I wanted that to be what the company was about from the very beginning and reflecting the values that I specifically had. So I really liked the idea of creating something that I wanted to do to prove that, you know, that I could do it. It also was this sort of delayed entrepreneurship
thing. Actually, when I was in college, I always wanted to start my own company. I was always the kid that was talking about his business plan, this or that, and all the professors were looking at, like, that's nice. And I kind of got this idea in my head of, well, I'll just go and get a job and then I'll figure out, I'll learn the next thing. And then I'll be competent and then I'll do it. 20 years later, I'm 45 years old, that hasn't happened. Like at some point, you have to say, okay, you need to do it, right. And so I felt like I had finally built all the right skills
and was in the right place. And if you're going to do it, you're going to do it now. So those are two things that were really important to me that led me to breaking out of Verily to start Story. Yeah, I don't know if I ever told you this Tom, but when you told me that on the walk, was the exact moment that I knew that everything we had thought about partnering with you was the right thing. And it was the moment that really just sunk in hard for us at Define because, like, what is motivating you that deep? Introspection, quite frankly, that it takes and the humbleness to even say that after you had built something that was quite impressive, and could have just stayed and ridden off into the sunset, if you will. And just that first founding story of Verily,
for you to kind of start over and say those things was just, I thought, just so mature, so thoughtful, so introspective, and really just fueled our passion to want to partner with you more. So I really respect everything you just said. It also resonates with me a lot, quite frankly, and my journey with Define, in a lot of ways. So we have the Tom a couple years ago, who was like, I'm going to go out, I'm going to finally fulfill this mission of like doing it completely on my own, if you will. What were the first steps? I am a big believer in teams, right? I actually think that almost every great thing that has been invented in the world came from a team of people, not from one person.
So the first thing I did was trying to find who was my team going to be? And I don't think I've told you this, Lynne, but I went through at least two or three different groups of people that I thought about, actually, you know, forming the company with. It's one of those things where, it's odd to say this, but it's almost like dating, like you're gonna meet these people, you're gonna spend a lot of time with them. Are you ready? Is this your group? Is this your team? The first couple, it wasn't, like there wasn't a good match there. And people ask me, Well, how do you know? Honestly, you end up knowing. Spend a good week, a hard week, with people and you will know whether it's gonna be a good fit or not. I intentionally was provocative in his meeting where, like, I would push us into situations where, like, let's disagree a little bit, because it's very easy in the beginning with people. When everyone starts, first meeting, everyone's
cordial. When things get hard, that's when the real kind of realities come out. So I think you need to get there as fast as possible with the team. So I did that and ended up meeting Nikhil, who I had worked with before, and Ashul. It's funny, I remember actually one meeting with actually a primary care doctor we were doing over Zoom, talking about some topic, and I looked up at the screen and I saw the three of us and this doctor talking. I'm like, this is it. This is the
team. I just kind of knew at that moment that this was going to be the team. And it's funny because that was an emotional thing that, afterwards, I'm like, nah, that's not right. But it was the moment and so that was the most important thing for me to getting started was finding the right team. And then we actually went through a bunch of different ideas. It was not very clear at the beginning what we were going to do. We knew we wanted to do something that focused on, frankly, the opposite end of digital health that hadn't been worked on as much. We know we wanted
to work with the elderly. That was a big focus from the beginning. We know we wanted to work in high acuity spaces where people were really sick. We only wanted to do things virtually. That was obvious from the beginning, given that COVID was going on and experience has shown valuable that was. And I knew I wanted to be really medical, right, I didn't want to just build something that was diet and lifestyle, as many digital health companies had focused on. So those things were
core values from the beginning. But we spent a lot of time going through a lot of different ideas until we really found the right kind of hook that was the first thing that we wanted to build as a product. And that's when we kind of started to put together the first product pitch as it were. Yeah, amazing. I love that moment of, you just saw the team and you just knew it. And then you kind of were like, is that really the team? And then like, yes, you knew it. And
it's funny, I kind of think, like, you get to a certain point in your career, in life, like trusting your gut, like just knowing when that moment hits and actually running with that, especially in this, like, building startups. There's just something there. And that gut spoke at that moment, but it was really probably informed by the multiple teams you had seen before, which I did not know. So that is great. So you got to your idea. I'd love for you to talk about the idea of Story, the vision. It sounds like you went through some iterations, but like maybe talk about that vision and when you knew that that was the right vision. Where
did the gut kind of say, yep, this is it after you had gone through some iteration? We did go through some iteration and I remember reading, actually, a bunch of papers. A lot of stuff that we did actually started very much in literature, trying to understand, you know, where was the science at today and what were the kind of major problems that medicine was dealing with and didn't know the right solution to, but maybe we have a different approach to. Really, it was reading a couple of different papers in the field of cardiology, where I was looking at some of the problems. They did these massive registry trials looking at these problems of like, look, we're not able to get people the care that they need, and just showing this massive gap between, this is what the state of the science is, and this is what actually happens in practice. And I knew, oh, well this is exactly the right place for us to focus because the science has been done already. It's just a question of, how do we actually use technology to make it happen? And oh, by the way, they probably haven't thought about these different approaches, for example, how can we actually be able to deliver that care outside of the clinic, rather than just making the clinic better? That was the kind of the key thing that I felt like, they hadn't thought of that, right.
And then also thinking of all the other things that get in the way. Just in my own experience, seeing in other places, where do patients fail? It wasn't they failed because the doctor did something wrong in a visit. That was never the problem. It was always a problem of, they would either not be able to get on the right medication at home because they would go to the pharmacy and there were barriers to affording it. Or they would have side effects from the medications, they wouldn't know how to deal with that, or they didn't understand what was going on, or all these different things that would conspire against people in order to just get in the way of getting the best care. And I'm like, okay, well, that I can work on. That's a logistics problem and a technology problem. We can build that.
And that was kind of the aha moment with Story was looking at that from the perspective of, not just simple things, but places where complex care is really needed, and how difficult it was for a clinician to actually be able to project that out of the clinic. Does that make sense? Makes total sense. Makes total sense. So let's go to the next phase. So you have the team, you've now settled on the vision of the company, is fundraising. And how did you think about that? How did you go through that? And what has been your experience? And I know this is a little funny, because, obviously, we've partnered together, but I'm sure I'm gonna learn something new, just like your team here and in this conversation, but like, how did you really approach that as a founder? We decided we were going to raise money early on, frankly, before we actually built anything, because we were just like, well, we should go talk to some investors and just see, like, if we can get good investment early, why not? It would make it a lot easier for us to go faster.
And so we went out and, I remember, we chose an interesting time to raise money, I'll say that. Like the first month or two after COVID started, the venture world didn't know what it was doing right? There was this, like, are we writing checks or are we not writing checks? And we walked right into that, right? So luckily, it actually worked out fine. In fact, the VC world was really fast to adapt. But I do remember putting our first pitch to get back together, which was important. And we're like, well, maybe we should get some feedback on this from a couple of different people. So I actually called my friend Anthony Philippakis at the Broad
Institute, who I'd worked with at Verily and is a venture partner at Google Ventures, and I said, "can I share a pitch with you and can you give me feedback?" And we pitched him, like, the first pitch, and he's like, "sounds like vaporware. I have no idea what you're building." I'm like, "oh, we're nowhere." And he was absolutely right. It's very easy, I think, as a founder to get trapped in the high level vision without getting very specific about what you're actually going to do. So you have to be able to talk about both 5, 10 years from now, and also next year at the same time. And that was the thing that I think was the hardest challenge for us was to be able to talk out of both sides of our mouth at the same time. And so we had to work on that a lot. And you end up navigating and eventually, you know, it's funny. I actually talked to Greylock.
And then Greylock's like, "well, we're not really a healthcare investor, but you should meet this should meet this person, Lynne". And that's how I got introduced to Lynne and then I remember our first pitch, and we were really excited about it, because we're like, oh, look, someone who really understands healthcare. That's the other thing I think that I took away from that fundraising was, it really is vertical specific. You really want an investor that understands your vertical because, especially in healthcare, the way that delivery is, the way contracts work, the way timelines work, the way evidence generation works, like, all these things are very different from the rest of the world. And I'm sure every other industry has something similar where you can talk to a diversified investor, and they will have somebody, maybe that is an expert, but you really do need someone that knows how your field works in order to make sure that you're on the right page. So I met Lynne and it was pretty clear very early to me that this was going to be
different than our other conversations. At the end of the day, I think we chose an investor based on the relationship and the fact that we felt like this was gonna work more than anything else. That to me was kind of the central part of it. It's funny because I look back on it now and I say, well, maybe I raised money too early, maybe we should have gotten some angels and, like, waited, and we would have made more progress, and we could've gotten a better valuation, and everything like that. I'm like, but Lynne brought us this. And without this, we wouldn't
be this, and therefore, no, that actually would maybe not have actually helped at all. In fact, that could have slowed us down. So in retrospect, I think it was exactly the right approach. Yeah, well, A, thank you. I mean, I think, Tom, it's always that push
and pull with a founder, like what do you build? When do you take in capital, partnership, valuation, these are all things that you have to balance as a founder, in so many ways. So now we've funded the company. So now we're through this. Once you had that funding, what went the way you thought and maybe what didn't go the way you thought, as you're building the company? Building the product actually went, for the most part, the way that I thought it would go. I'm very aggressive in my approach to these things. I want it now and I want it better. We've taken that
approach and gone as fast as we possibly could and we were able to achieve that much faster than I would have been able to do a Google with a lot of the constraints removed from that. So that was great. Things that did not go as well as I thought or different than I thought was, I think there's this notion of, well, if I just get to X, then everything will be figured out. And that's just not the case, right? You figured out X and, guess what, there's the next thing and the next thing is even scarier than the thing you just solved. right? So that's the thing I think that was not surprising to me. The other thing I expected was a sense of agency, that I could kind of make whatever decision I wanted and make it make it happen. And that's mostly played off. But you
also have to understand that everybody, everybody has stakeholders, right? And so just because you want to do X doesn't mean that your partners want you to do X, doesn't mean your investors want you to do X, doesn't mean your employees want you to do X. So you just always have to be thinking about not just your own agency, but like, how is that actually going to fit into the ecosystem that you're now a part of, even though you don't necessarily have a boss, right? Yeah. Wow. So well said. So, just kind of, as you're looking now, is what words of advice, Tom, would you give entrepreneurs? So first of all, I think you should be an entrepreneur. That's the first thing I'll say,
right? I absolutely love it. And I think more people should do it, and not enough people do, and it's not as scary as it sounds. So that's first thing is, if you're thinking about, should I do this or not, you absolutely should. I will tell you that right now. More people in the world need to take more risks, that is my biggest belief. Other advice I would say is, you should think about doing with people, like with co-founders, and friends, and I am a big believer in teams that, like, you're not going to just do it yourself. You need a
group of people around you. Other people I know disagree, but I'm a big believer in teams. And then the third thing is partnership, right. So how are you going to approach the world? It's very, I think, romantic nowadays to talk about, oh, I'm going to build this product. And then I'm going to go launch it and then the users will come and then I'll do some growth marketing and I'll get more users. I actually think that it's much more important to start to think about who are the partners in the world you can work with that are going to amplify what you're going to do, and are going to build relationships that, frankly, will transcend your business, right? So some of the early partners that we worked with at Story, I think of them actually as having relationships deeper than the business and I think that's really valuable. I think you should look forward to that,
right. So don't look at this as, like, oh, this is my master plan to take over the universe. Look at this as, like, this is just life in a different facet. I enjoy the heck out of that. Wow. Well, Tom, thank you so much, just what motivates you, how you've built two, you know, truly, I think, two organizations that will change healthcare and then just, like, to your point of, just, inspiration. Thank you so much,
Tom, thank you for not only inspiring other founders, but what you're doing for healthcare. Appreciate it and I hope that we can make a dent. Absolutely. I know you will.
2022-01-20