Priscilla Chan — How We Can Do Better By Having Hope

Priscilla Chan: If you hide you’re powerless. If you hide in the bathroom, if you hide behind sort of who you think you should be, you are powerless. But if you name what’s hard? If you name why you’re different, if you name your story, that gives power. And so I always try to be upfront about who I am and sort of name my experience … name what I am feeling because when you’re not hiding you can be your best self.

Rex Woodbury: Welcome to View From The Top, the podcast. That was Priscilla Chan, the cofounder and co-CEO of the Chan Zuckerberg Initiative. Chan visited Stanford Graduate School of Business as part of View From The Top, a speaker series where students like me sit down to interview leaders from around the world.

I’m Rex Woodbury, an MBA student of the class of 2021. This year, I had the pleasure of interviewing Chan from Palo Alto. She shared how she transitioned from medicine to education to philanthropy, and how she balances breadth of impact with depth of impact. You’re listening to View From The Top, the podcast.

Priscilla, thank you so much for being here.

Priscilla Chan: Hey, it’s good to be here — here.

Rex Woodbury: Here — virtually. Well, it’s been an emotional week with the Chauvin trial with ongoing police shootings with gun violence, but I wanna say I’ve personally been so inspired by the work that you’re doing at the Chan Zuckerberg Initiative on education and racial equity and criminal justice reform. And I’m thrilled to be having this conversation, and I know that my classmates are thrilled to be here listening to you today.

Priscilla Chan: Yeah. Thanks for doing the work and putting this together. And I have to say, this past week, I was just a huge mixed bag of emotions, like relief for the verdict in the murder of George Floyd and sadness that it happened this way. But also hope, always hope that we’re going to do better.

Rex Woodbury: Yeah, I mean, I want to talk specifically in a little bit about some of the initiatives that you’re working on which I think touch on all of those aspects or values that you just mentioned, but I do wanna start with your family because you’ve a very incredible family story. You’re the daughter of Chinese, Vietnamese refugees. Your grandparents were business people in Vietnam who worked at canning pineapple and making paper and running a restaurant and I was wondering if you could share with us the story of how your family left Vietnam and came to America.

Priscilla Chan: So this happened before my time. My grandparents were business partners. My dad’s parents had six kids and my mom’s parents had — my mom’s dad actually had two wives. And a really interesting part of my family history that I just wanna name is my mom’s mom was a second wife and she was an indentured servant, who was brought into the family to have more kids.

And so between the mix of those two really large and eclectic families my grandparents were business partners and when the war was getting to be a pretty dark place, they decided to smuggle their children out. And they were gonna send their kids on boats — and in the United States they’re known as boat people — but the way they made their journey as boat people was incredibly, it was just real. There were stories of boats sinking, and people dying on the boats and so my grandparents decided that they didn’t want a single boat to sink with all their children. So what they did is they paired up their children into twos or threes so that they would have company on the journey, but if any boat went down they would only lose one to two children. And that’s how my grandparents said goodbye to their kids on these little boats in the middle of the night, sending them off into the South China Sea, in hopes that they’ll see each other again.

And I hold on — obviously, I wasn’t there, but I hold on to the image and sort of a moment of like how big a decision parents/people make for their families, for their livelihoods. And the immense amount of optimism and faith that you have to have in order to make that decision. I like to believe that that’s somehow genetic and I’ve inherited it, but that’s sort of what I always come back to — like, there has to be better and we will get there. And then long story short, everyone made it and it took about a decade for everyone to get back together and then, my parents stayed together for longer than the boat ride and here I am.

Rex Woodbury: That’s an incredible story. And you said that — yeah I’d love to hear if you’re open to speaking about it, those early kind of years in, I think it was suburban Massachusetts outside of the Boston area, your families building a home there and you’ve said that you were bullied when you were younger and put your head down and worked really hard and then got into Harvard and If you’re open, I’d love to hear about, how that early experience of being bullied or growing up in that environment shaped you. And then that transition moment. I imagine it was quite a shock going from that family life to to the world of Harvard when you were 18.

Priscilla Chan: Yeah, so we were sponsored at the time. Refugees were sponsored by all different groups in the Catholic Church played a really big role. We were sponsored by the Catholic Church my family was. And so we ended up in an Irish Catholic town outside of Boston. And we were the first to arrive and which otherwise was just like straight up Good Will Hunting, with like Ben Affleck and Matt Damon as my neighbors. So I did not fit in, believe it or not. And I … it was … there’s so many reasons why I didn’t fit in, but I remember thinking that I don’t know what’s out there, but there has to be more and if I work really hard, I will get there. And I remember the day I made that decision. I was being bullied in middle school. Middle school is awful. Thank God we’re all not in middle school.

Rex Woodbury: It really is. It really is.

Priscilla Chan: And I was eating lunch in the bathroom, in a public school bathroom, because I didn’t wanna go out to the playground, the black top after lunch. And I was just like, this can’t be the rest of my life, right? Like, there’s got to be more. And so like, I remember as a sixth grader, I was like, I’m gonna buckle down. I don’t know what’s out there. I’m gonna work really hard and I’m gonna get there, so I spent a lot of time chasing that dream. And then I got into Harvard, which was a little bit confusing because you know my parents didn’t go to college. My parents didn’t really speak English and Harvard was like an idea, but it was unclear how attainable or unattainable it was. We didn’t have access to anything. So maybe this was just like normal inaccessible, not like out-of-this-world inaccessible, so like I didn’t know how to parse the idea of going there, or at least didn’t get nervous enough in time.

I got there and I was like, holy cow. These people. First of all, as an outsider going to Harvard, everyone dresses the same. Everyone’s wearing the same clothes, everyone’s talking about the same places. And I’ve never been there, and I definitely — I don’t even know where to get clothes that look like that. And I was also no longer a big fish in a little pond, and I was incredibly feeling like a failure or feeling like a fraud. And the turning point was realizing that I wasn’t the only one. I joined a service house at Harvard where I was a part of the Philips Sports House, and there were other people who had stories like mine, and they were people giving back and I wanted to do that too, and that’s been my mission ever since.

But the most important thing that I learned in that moment that I try to hold on to always is that if you hide, you’re powerless. If you hide in the bathroom, if you hide behind sort of who you think you should be, you are powerless. But if you name what’s hard, if you name why you’re different, if you name your story, that gives you power. And so I’ve always tried to be upfront about who I am and sort of name my experience, name what I’m feeling, because when you’re not hiding, you can be your best self.

Rex Woodbury: And I’m not sure if it was when you were at Harvard or later when you were a volunteer or educator or doctor, but you’ve talked about a moment when you realize that the problems were bigger, bigger than you, bigger than you thought, that the structure and the system was broken. And I’m sure that resonates with a lot of our classmates when you step back and realize that you have to be part of the solution or you have to get involved. And I’m curious, can you talk about when that moment hit for you and how formative that was and realizing that you actually needed to sort of build the new system, or at least have a part in that.

Priscilla Chan: Yeah, it’s a terrifying moment and one where I will add in the spirit of naming things I failed. I was taking care of an eight-year-old little boy in my practice at San Francisco General Hospital, and I’ve been taking care of him for like two or three years.

And like it was confusing because his mom kept telling me he had seizures and I was like, I don’t think he has seizures, like I looked everything up, he doesn’t have seizures. And then I was like maybe there’s something developmentally going wrong, like with the school, and I’ve been trying to get in touch with the school, but the school hours somehow didn’t match up with my clinic hours.

The only way to get information between the school and me was a piece of paper that were having mom bring back and forth. And so we’re kind of stuck like this for a few years. And then I realized he was eight, that there had been a giant miscommunication.

That mom had been telling the school that he had a seizure disorder. He was eight, so by third grade he had missed 180 days of school, which is one school year. Because the school excused all of this for his medical issue, which was presumed to be a seizure disorder. And they were trying to do what was best for the kid. And meanwhile I was like no, no seizure disorder, he should be in school. And after we sort of like had an emergency series of meetings, we realized that he had been witness to a very severe domestic violence at home. And he was acting out in a way that looked like seizures, but weren’t. And so in that series of miscommunications he had missed exactly what he needed, a safe environment that understood his needs holistically. And instead he had missed a full year of school. And he as an eight year old, didn’t know his letters, couldn’t read, struggled with numbers.

And when we tested him, he was of a normal intelligence, like big time fail. And the teacher and principal thought that they were doing exactly the right thing for this kid. I thought I was advocating for the kid as someone who always asks about school, how things are going. And so we had a collision of people who are trying their best and the way we structure, the way we care for our most vulnerable, is completely broken and we’ve just completely missed the mark. And then I was like panic because I’m like, well, I gotta tell someone, like someone needs to know that there’s a big problem.

And I’m sure many of you are very good at identifying problems and like going to the authorities. The only problem is eventually you’ll find that there is no authority and that you’re the grown up in the room. You’re the only one who cares enough about this problem to do something about it. And so I spent a good six months, I was like if I do enough research, I’ll find a way that this problem has been solved. Or if I do enough of this, I’ll find the solution. And I realized that it didn’t exist. And when you confront that moment, you have to rethink, like what am I gonna do about it now?

And so that’s sort of what led me down the road of eventually starting the primary school where we … I started the school in a fit of insanity at the same time of having a child and starting CZI. It’s doing great now, but they really work on changing the way the system works, knitting together healthcare, especially those in our safety nets and the school environment.

Rex Woodbury: What’s so interesting to me about your sort of two lives or multiple lives here of being a doctor and some of this is coming from my own, my brother’s a doctor, and he and I talk a lot about depth of impact versus breadth of impact.

And you’ve spoken about what you call the trolley problem of would you rather help 100 people deeply or help everyone a little bit? And this will lead us I’m sure to talking about CZI. But I’m curious, in your career as you evolve through different chapters, have you thought about balancing depth of impact and breadth of impact?

Priscilla Chan: I’ve gone through all different versions of this and I think, a couple things here. One is, in order to make the, let’s see, which one are you calling depth and breadth? Is your brother taking care of a single patient depth and you’re breadth?

Rex Woodbury: I would say, and maybe this resonates with some business school classmates. I would say my brother subscribes to the philosophy, if he helps one patient very deeply in his career, I think he views it as a success and he’s fulfilled. Whereas I think somewhere along the road, and this is probably true of many GSB students, we think much more about breadth. Let’s scale this business, let’s grow the system. And I’m always telling my brother, I’m saying Carson, think big, fix the structural issues of healthcare. And maybe it’s a different sort of personal fulfillment of where you get fulfillment from. But I think of medicine as depth of impact, and maybe business or fixing the structure as breadth.

Priscilla Chan: Okay, good, I have the same definition. But I will argue that you actually … not every person needs to do both. People naturally gravitate to one or another. But to really make change, you need to understand both. And because in order to actually change the … we’ll take the change the system seed. You need to actually understand what the problems are. And you know what your brother really, what Carson, really, really understands? Is what are the barriers that made it hard for this patient to get to access care? Or what made it hard for them to remember to take their meds every day?

As a good doctor, he knows that and he has an intuition for it. And it’s oftentimes surprising. The bus schedule used to determine, and whether or not the BART was running on time used to determine whether or not my patients would get to clinic and whether or not my clinic would run smoothly.

So it wasn’t gonna be some sort of change management process in the way we check patients in. BART is screwing over my clinic schedule. And so you have to understand and have a clear vision of what the actual issues are, the real barriers that affect the lives of the people we want to impact in order to impact with breadth.

And so at CZI, we hold that as a core value, and we call it staying close to the work. We have to be proximate to understand how to make systemic change. And we intentionally hire people with both. And I can tell you that there are disagreements, and I’m sure we can name many.

And sort of just language and orientation barriers around when you bring such different people of all different backgrounds, all different orientations around the work to solve a problem together. But that’s when you actually understand with clarity what you’re trying to do. And then you can scale something meaningful, something good in the world, but on a personal note, I plan on going back to a fellowship when I’m done with my my run at CZI. So I am someone who loves, loves being with kids and families. I mentor kids, little kids over Zoom and at the school, I love that, I need that to nourish my soul.

But I have to say the systemic work is what gives me hope. And that’s why a lot of, to use your brother again as an example, it’s amazing being on the front lines and that’s incredibly gratifying. But if you run into the same problem for the 100th or 1,000th time, you can lose hope.

And so it’s the work in changing the systems that gives me hope in that work.

Rex Woodbury: Well, it’s good to know that you can do both. You can have different chapters and reinvent yourself in different chapters of life and career. But I do wanna talk about the systemic stuff and CZI specifically, the Chan Zuckerberg Initiative.

I’ve heard you say that, I think you started it the same year that you had your daughter Max. And I’ve heard you say, being a new parent and starting a philanthropic organization are similar. So I’m curious what you mean by that.

Priscilla Chan: Oh man, keep you up at night. Lots of sleepless nights for different reasons. It’s either the baby or building an organization. And I think the core of it, though, is what I mean is when you guys all go out there and contribute to organizations of all different phases and stages. I’ll use a pediatrician term, it’s like, is it developmentally appropriate?

And you talk to people, all organizations have sort of goofy things about them and things that they’re working through. But some problems are developmentally appropriate for the stage of the organization and some aren’t. And when you’re up at night wondering like, is Max okay? Is she smiling? And you’re googling, for the parents in the room, they’re googling, smiling at five weeks, okay? There’s a similar version of what happens when you build an organization. Is it okay that we … there were moments at CZI where we had our Internet cut off, because we forgot to pay the Internet bill. And that was okay at week eight, but it is not okay at year five.

And so I think just understanding sort of the cadence and evolution and growth of an organization. And giving yourself some slack when, it’s okay, this is a problem that many organizations have, we’ll get to it. And solving the right ones at the right moment in time for the organization.

Rex Woodbury: And you stepped away from medicine to run/be Co-CEO of CZI. And I think one journalist wrote about you, she’s a doctor that has become a crusader. Now I’m curious, what is a trait from your medicine days that you carry with you that’s been surprisingly helpful in running CZI? And what’s sort of something you’ve had to learn net new?

Priscilla Chan: Let’s see, I love being a student. So I don’t know if that’s a crusader, but I will trade seats and just soak in knowledge at any moment. But I think the same thing that brought me to education, to medicine, and now to CZI is that these are people’s lives we’re touching. And you can track metrics, you can think about sort of dollars and impact and all different ways that you can quantify. But at the end of the day, we’re touching people’s lives and people’s lives are complex. We need to see the whole picture and we can’t forget that.

And when I think about the patient that I just told you about, I have a catalog of faces that’s sort of like, it’s getting me going better than coffee every morning. I can’t stop, because I have to do better, and there’s no choice to give up. I can fail and I fail all the time but I can’t stop.

Because it’s not an intellectual idea that I’m pursuing. I’m trying to actually touch and change people’s lives at the end of my time. And so quitting is not really an option. Let’s see, things that I learn new. Honestly at one point, I was like, I should go to business school. I don’t know anything about, I’m like, what is HR? Because remember, I think there’s a few MD’s in the room. HR, nobody has ever cared about me, nobody has ever told me, you know I’ve been yelled at in the middle. There are people that are supposed to take care of me? That’s cool. So, learning about HR, learning about operational management, Gantt charts, are a thing, and make things run smoothly. I think I’m just saying words that I’ve heard that now other people helped me do. But being smart about the way you prioritize, run projects, and convince people that you have a mission worth pursuing.

Rex Woodbury: Mm-hm. I think we’re seeing this bleeding, I mean, social impact, business. At Stanford, our social innovation is important to a lot of students and it’s a big focus of their curriculum. But I think we’re seeing bleeding lines between the two. And I was really moved by your letter to Grant Partners from a couple weeks back about the attacks on Asian Americans, and how it personally resonated with you and your grandparents’ story. I’m curious if you could speak about what that emotional time for you but also from a business perspective, what are ways that leaders can get involved and can take issues and actions on those different problems?

Priscilla Chan: Yeah, I have to be honest, I had to take a step back and do some learning and reflection and when this all happened. Because in sort of my experience growing up in one of the only Asian American families in our community and then going to Harvard where being really involved in social justice and often in our country that’s about black and Latin X and the historically underserved populations. That’s been my calling and I relate because I’m like, I get it. I’m an immigrant, I’ve been an outsider, I identify with the issues that you face. And I’ve never until recently, never really taken a moment to reflect on my own racial identity. Because I sorta just always assumed one, that it was an anomaly. And two, and this is probably the result of being raised by refugees. Just put your head down. It’s gonna be fine. Just take what you can get and keep going and you’ll be fine. And the interesting impact is, it made it easier for me to advocate for others than it was to advocate for myself. And this is not a new phenomenon. It’s well studied and well documented that for instance, women can advocate very well for other women and struggle with advocating for themselves.

So I did some reflection. There’s a five part PBS series that’s excellent, called Asian Americans. I highly recommend it and I started to really think about how to make sure that we’re not always forgetting the Asian American, AAPI community when we talk about people of color because they are people of color that have very complex relationships with their own race, other minorities in our country and we need to examine it collectively.

And I have to say I’ve spoken to many Asian American leaders in the wake of the shootings and it’s a very similar story. They’re like, yeah, I gotta wake up to this. And so I would say for others in the business community is understanding, like do some learning and also think about how just because a group doesn’t speak up doesn’t mean that there aren’t needs because this is a group that’s historically in our country for one reason or another not trained to speak up for many reasons.

Rex Woodbury: Priscilla, I have one more question for you before we hear from two students and I wanna go back to your grandparents and parents coming to America on the boat from Saigon and you’ve spoken about them. You’ve spoken about your own kids. What’s one important lesson, if you had to pick one lesson that your parents, grandparents that you’ve taken from them, that you wanna teach your own kids, what would that be?

Priscilla Chan: So, the optimism, I hope it’s in me. I want them to feel that optimism too, and not a Pollyanna type of optimism, but a faith that people will continue, if we work hard and we continue the fight, things will improve and to always believe that there has to be better. Gratitude … I grew up as a child of people who were politically persecuted, refugees on boats, just grateful for every day. And the last one is sometimes for many reasons not seen as a very popular sentiment, but I love our country and it’s popular to sometimes one side of the political spectrum gets to love our country or there’s so many things broken that, how can you love the United States of America? This country is founded on strong ideals that are not perfect. But it is our responsibility to build a better country. And if you don’t love it and you don’t nourish it, then it cannot live up to its potential. Gosh, I didn’t realize I was so patriotic until just now.

Rex Woodbury: That’s great. Thank you. Well, actually one more, I know I said that was last but one more question for you. First, we’re gonna hear from two of our students and I wanna make sure we have time for them. I think first up is Jessica. So we’ll hear from Jessica now.

Jessica: Hi Priscilla. Thanks for being here today and sharing your wisdom with all of us. My question is around the huge health disparities we’ve seen, especially during this pandemic. Now as a doctor and as a philanthropist, how do you think we can solve some of the health inequities in this country?

Priscilla Chan: I think it is important to realize that, related to this, sort of understand the problem that you’re trying to solve, is that everyone has different barriers and there’s not a one-size-fits-all. So then we have to take a community-centric approach to addressing health disparities. Very early on in COVID, we ran a study on the prevalence of Coronavirus in one census track in the mission and what we realized. Diane Hablar did this and from UCSF is that in this one census track, zero people of Caucasian descent had Coronavirus. And I think it was near 20% of individuals with a Latinx background had Coronavirus during this period that they were doing the test. And first of all, that name in the disparity that you named. And the two groups had different access and different barriers to actually accessing testing and accessing care. And what that group then did was partner with the community. They partnered with a Latino task force and said like what is the best way to get tested? What is the best way to follow up and because it was such a deep partnership, the testing and treatment and now vaccination of that community is incredibly strong and we sort of spread those learnings across the city. But the same thing that would have worked for honestly I had a colleague who fell into the census track. Who wouldn’t work for David, doesn’t work for someone else who has an entirely different set of life circumstances. And so, it’s not about scaling. What work sometimes can work for you I, it’s about working deeply with the community to understand like, help us name the solution together.

Jessica: Thank you.

Rex Woodbury: Thank you, Jessica. Next we have a question from Mary Grace.

Mary Grace: Hi Priscilla, my name is Mary Grace Reeves. I’m in my fifth year of Stanford’s doing MBA program and I’m looking forward to starting residency this summer and it’s such a privilege to hear you speak. Thank you for being with us. I’m wondering in founding and leading the Chan Zuckerberg initiative, you’re tackling the most pressing societal challenges of our time. And through that process, what have you learned about building a successful team? And how has that allowed your team at CZI to navigate diverse initiatives?

Priscilla Chan: Building, I think building a good team is sort of it’s, I wouldn’t say it’s specific to our work at CZI, but it’s naming things being clear about what problem you’re trying to solve. Prioritizing it, and being really direct with other people when things are working or when they’re not working and I will name I fell into the same traps like, I don’t wanna say it, it might hurt their feelings. I don’t wanna be mean. And I realized along the way like look, I am who I am, but they’re in they’re gonna like me or they’re not but I do know that people like to be successful. And the way I make them successful is I tell them as clear as I can with what I wanna see and what feedback I have. And so I have to say not specific to our work at CZI, but just say it like it is Mary Grace.

Mary Grace: Thank you.

Rex Woodbury: Thank you, Mary Grace. Priscilla, I have one last question for you, which is actually a question that we’re asking to all of our speakers this year. And it is what are the principles that you rely on when you’re facing the toughest moments as a leader.

Priscilla Chan: In my toughest moments, the pictures of the kids that I’ve served and I’ve had successes and failures with, I keep them in my mind. And I remember those lessons, how would I solve this problem for him or for her. And like build up from the community, I was just saying earlier, try to understand the context that people’s lives are in and solve from there. And that collaboration is key. Not one person understands the solution fully and not one person can see no one sees the problem and no one sees the whole solution. But if we come together with different tools, different skill sets, we can solve this together. And those are the two bits and this is also, it’s a lifetime of work. And so you’ve gotta break it down into little pieces. And the only way to eat an elephant is one bite at a time.

Rex Woodbury: Can’t say I’ve heard that phrase, but that’s what I’m gonna take away.

Priscilla Chan: I didn’t invent that. That’s either Desmond Tutu or Mandela.

Rex Woodbury: Well, thank you Priscilla, I think I speak for everyone when, we’re inspired by your story, by what you’re doing at Chan Zuckerberg by the different lives and chapters that you’ve had and how you live with values and with those principles. So, thank you so much for your time, we hope to have you back hopefully in person one time soon, but thank you for joining us virtually.

Priscilla Chan: Yeah, thanks for having, me next year in person.

Rex Woodbury: You’ve been listening to View From the Top, the podcast, a production of Stanford Graduate School of Business. This interview was conducted by me, Rex Woodbury of the MBA class of 2021. Lily Sloan composed her theme music and Kelsey Doyle produced this episode. You can find more episodes of this podcast at our website www.gsb.stanford.edu.