Priscilla Chan is among the most intriguing emerging leaders anywhere, and not simply because she’s married to Mark Zuckerberg. As co-CEO of the Chan Zuckerberg Initiative, she runs the day-to-day operations of the world’s best-funded startup, with $45 billion pledged at its launch three years ago. Today CZI has grown to more than 250 employees, with several offices in Silicon Valley and projects underway in education, science, immigration, criminal justice, affordable housing, and more. Chan has been reluctant to step into the spotlight, given the attention her husband already gets. But over a period of a few months, she had a series of in-depth conversations with longtime journalist Robert Safian, discussing her own unlikely personal story, her relationship with Zuckerberg, and what her organization is trying to achieve. What follows is a condensed, lightly edited version of their discussion.
Quartz: You’ve been reticent historically to talk to the media. Why are you doing this story now?
Chan: We’ve spent a lot of time at CZI thinking about who we are as an organization. We’ve iterated a lot, and we think we’re at a point where we understand who we are and the role we can play.
Mark and I always knew that we were going to give back. For me giving back has been part of my life before I even met Mark. It’s what I would be doing in my career regardless. But when we were younger, it wasn’t clear what the opportunity was.
First in teaching and then as a pediatrician, I kept seeing issues on the front lines that were frustrating. As a practitioner, you grin and bear it, you do what it takes to make one child’s life better. But there is a fundamental lack of hope, because if you don’t have [the necessary] research, policy, development, there’s no way a frustrating situation will get better.
At the same time, Mark was building a company that scales tools to reach a ton of people globally. So what if we took the problems I’m seeing on the front lines affecting children, students and adults in healthcare and science and pair that with the ability to use technology to scale solutions. There are solutions that exist out there but they aren’t scalable and replicable. If we take that lens of a frontline practitioner, if we take the tool set of building technology, what niche would we be able to fill in the world of actually making social impact?
That’s the guiding principle that defines CZI.
Do you remember when you and Mark first had a conversation about giving back?
It was when he was considering selling the company to Yahoo in 2006. [Zuckerberg reportedly was offered $1 billion for Facebook.] It was the first opportunity to be like, wow, we could do a lot. He made the decision to continue building the company, but we started brainstorming. What could we do if those resources were a reality?
Do you miss practicing medicine?
My last clinic was March 3rd, 2017. I am still licensed to practice for another decade, so I’m not closing the door to that. But right now I have an opportunity to build something that’s a lot bigger, that could solve a lot of the problems that I was frustrated by.
I do miss the deep human connection you have when you’re a child’s pediatrician. I loved my patients. I loved being part of a family, getting to know them over time. And I also love the physiology. I love understanding, like, how breathing works and how to deal with it when people are not breathing correctly. I love both the science and the deep touch you have with a person when you’re really caring for them.
But it’s like the trolley problem, the good version: Do you try to make the world better for a few lives or do you try to have bigger impact?
One of our values is to stay close to the problem. It inspires me to do more when I’m connected to an individual facing a real problem. We just talked at our CZI staff all-hands meeting that we need to do better of that, to really live that value. I think it will allow us to know what the right problems are to be solving and truly just make us all better at our jobs because we’re going to want it so much more.
You’re a first-generation American.
My parents were refugees to this country from Vietnam, as boat people. The way you sent your children out of Vietnam at the time was to literally put them on a boat, say goodbye and hope to meet them on the other side. There are horror stories of families spending all their money, putting all their kids on one boat and it sinks, they lose their children. Both sets of my grandparents knew each other long before my parents ever dated. They were in the same community, and they paired their kids so they would have each other, and if a given boat sank, they’d only lose a kid each, which is a crazy calculus to make. My aunt and my mom were paired together, and became best friends. They’re still best friends to this day. That’s how my mom got to know my dad. They got married later on.
You grew up in a Boston suburb, Quincy, Massachusetts.
Quincy has a big Roman Catholic community, and the Catholic church sponsored a lot of boat people.
Are you Catholic?
I’m Buddhist.
You didn’t come from a family of doctors.
My parents didn’t go to college. They didn’t understand the American educational system. We were raised speaking Cantonese. They couldn’t help me very much in school.
But I was lucky. The public schools were pretty good, and I had great teachers help me along, unlock a lot of opportunities for me. I was really a big science nerd, and the science faculty are people I still keep in touch with. I knew along the way that they were opening doors for me. But when I got to Harvard and looked around I was like, oh, I’m not like these kids.
What made you different?
I came from a family that didn’t have the resources, didn’t know the opportunities, didn’t have the connections. A totally different background. The only reason I’m here is folks believed in me, shepherded me along the way. I knew then that I wanted to do that for other kids. I’m actually quite field agnostic as long as I get to spend time with children. And make sure that children can access the best opportunities.
What makes CZI different?
We are in a unique position to use technology to solve some social problems and build a better future for everyone. Not that we believe that tech is a silver bullet, but it’s where we’re most differentiated.
How do you and Mark jointly run CZI?
It’s my job to get the people here to build on that vision, leading the organization day to day. I spent a lot of time on strategy and learning about the content areas. Mark generally spends Friday mornings here. On Thursday afternoon, at home, we have our one-on-one meeting where we go through the goals for Friday, what problems we’re trying to solve, what opportunities are in front of us. And we try to keep it contained because otherwise it’s spills into your whole life. We make sure we’re on the same page. It’s what you would do with any business partner.
Are there patterns about how you work together?
We’ve been very cognizant to make sure that we’re building a true partnership, balancing power or influence, making sure we understand each other’s priorities. Obviously we have disagreements. You have to have productive disagreements and come to resolution together.
This applies to both parenting and leading an organization together. I asked our pediatrician, can we talk about work in front of our children? We want them to be exposed to the type of issues [at CZI]. But I don’t want them feeling like there’s a lot of disorder in the world. And the pediatrician’s advice was, it’s fine to have those conversations, just take it to its logical resolution so they see that conflict gets resolved. I find that we have to do the same as co-leaders, where we have conflict we allow our team members to see us disagree and then come to a resolution. I think that’s very healthy.
Do you have a management philosophy?
At first I thought, oh, I don’t know how to manage people. I didn’t go to business school. And then I realized, it’s just talking to people, understanding what their motivations are. Doctors are supposed to do that. So the skillset blends.
I try to deeply care about everyone that I manage and know who they are as a person and what they care about.
How big a challenge is prioritizing?
There is a lot that we could do, but ultimately we need to be able to focus. One example is immigration. We have a goal of comprehensive immigration reform, but there’s also currently a crisis happening at the border. How much do you pivot to address the issue of the day versus the long-term goal?
In that area, we are figuring out how we can help build capacity in the individuals who are at the front lines now, but then going back to our lane, trying to stay aligned to our goals. There’s a lot of good stuff that can be done in the world—that’s a low bar, ‘do good stuff’—but does it ladder up? Is it going to resonate and have impact in the longer term? And do we learn from it so that we are better in the future at what we do?
Can you give an example?
The Primary School [which Chan launched in 2016] takes a holistic view of children, integrating healthcare, education and parent empowerment. When you adopt that mindset, you can end up in a scenario of, oh, this child can’t participate safely in the classroom, you trace the problem back, and you have to solve poverty. That’s not possible. We have to be able to get a child safely in a classroom and productive without solving all of poverty first. Right? You have to start somewhere, pick that, learn from it, do a good job, then take the next logical step. Otherwise you can be paralyzed.
We have significant resources, but if you try to do everything, you won’t do anything.
How did you come up with the priorities for CZI’s science initiative?
Mark and I spent probably six to eight months just talking to people in science. We would have one hour video conferences with all sorts of scientists, just learning from them.
We started looking for common themes, ideas that we’re excited about, and then eventually who is awesome and should be leading this. And that’s how we hired Cory [Bargmann, the head of CZI Science]. Common themes that we heard were the need for technology. Science researchers have access to postdocs who build great prototype tools, but there’s no one expanding those tools beyond what one person can run on their computer, no one thinking about common infrastructure.
This is how you’re trying to assist the Human Cell Atlas, a distributed global research effort?
If we actually knew all the cells in the human body and their different states, then we’d understand at a molecular level and a cellular level what we’re dealing with in different diseases. You could learn faster and enable people to develop therapeutics against them. The core bit is that we have to be able to learn from each other in an organized way.
Our hypothesis is that we could build a strong engineering team, one that doesn’t exist in science.
So CZI reflects your and Mark’s personal experiences?
We’ve made an investment to decide to run this place ourselves. That’s a proactive choice. If you look at us as individuals bringing our full selves, of course technology has to be there. That’s who Mark is.
We also realized that we need to start early. We had that panic of first time parents: The future is coming in four months, the future is coming in three months. You realize that you want to have this incredible world for your children. And we knew we had an opportunity to be part of creating that incredible world. But time was ticking, and we should get started.
You just came out of a meeting with one of your scientific advisory boards.
Those are definitely my favorite meetings. I would love to be in content discussions all day long. I always love to learn. Sometimes I like to sit back a little and resume a student posture, just absorb what people are saying and try to assemble my model. I’m listening for places where we can make a difference.
And I’m looking for a little bit of field sentiment. There’s always the question of, do you fund computational biologists in labs doing this or do you build your own team. I have certain intuitions around that, but it’s important to know what the field thinks about it.
Your mission to cure, treat or manage all disease is so ambitious, some people find it hyperbolic, preposterous even. When you guys first started talking about it this way, did you realize you would get that reaction?
Oh yeah, we knew. We know it’s a stretch goal. That was purposeful. I think it’s only hyperbolic if we thought we were doing it by ourselves. As a scientific community, this is absolutely possible. If you look at the trajectory of the history of medicine, penicillin is 80 years old, right? The question is not whether we’re going to be able to address the illnesses that we have today but how those illnesses and humans themselves evolve. Alzheimer’s wasn’t really a problem 200 years ago. I think we’re just going to learn more and have different expectations and nuances. But the goal was set purposely to be a stretch goal. Our strategy has been to empower all scientists to get better at their jobs.
Did you always have change-the-world goals? Were you ambitious on that scope? When did you start thinking that way?
When I was a teacher and then early in my medical training, the problem was whoever was right in front of me. I think that’s the right unit of change for me, at least to start with: understanding the kid in front of me. But there are only so many times you can tackle the same problem before you realize, this is terrible. There are hundreds, thousands, millions of children facing the same peril. And then you start thinking, who else is trying to solve these problems? Who has gone before me, and what lessons are there to learn? How could I do better? Or be part of a movement to do better?
Hitting the same wall over and over again, you realize that you have to think at a systems level. My heart and soul is fed by one-on-one interaction, but the only way we’re going to address the needs of all the kids who actually need support, well, it can’t be achieved by a single person on the frontlines.
I know we have great scientific advisors. But I look at them and think, you’re so accomplished, you have a worldview that’s allowed you to be successful and that’s great, we can learn from that. But where’s the 30-year-old postdoc who has the next version of what the world should look like, a future model.
We just added a computational biologist to our science advisory board. We asked a question, why we couldn’t solve a certain biology problem by using computational science. And all the Nobel prize winners in the room said that’s not possible. And then we found this woman who did it quietly, in her lab as part of her postdoc. The older generation has already defined what’s possible, and you need to get to folks who are younger to widen your eyes.
You have called yourself a science nerd. Why?
I identify as being a nerd. It has two meanings for me: Being a really avid learner, wanting to absorb, discover things, but also being the underdog. In middle school I was bullied and I spent all of seventh grade in the bathroom at lunch. No teacher ever noticed, but I never went to recess. I would eat lunch and then just wait in the bathroom until it was over. I became friends with kids who were not that popular, but truly kind. Those were my people. We did robotics, loved science. Nerd doesn’t really encapsulate all of that, but that’s my shorthand.
One of your high school teachers who I talked with describes you as a leader.
It’s not humble to say, but I was a leader in high school. I could convince people of things. In my senior year, our tennis team, which was not very good, made it to the state championships tournament. I was captain, not because I was good at tennis but because I could rally people to do things. Our first round game was on a Saturday. The problem was, prom was on Friday. I convinced everyone to not go to prom.
Can you tell me about your grandmothers?
My mother’s mother was an illiterate slave. She was sold to the family of the man who ultimately became my grandfather when she was like, eight or nine years old. He had a wife first, a few children, and when she couldn’t bear more children, he married my grandmother as well. My mom is the child of that union. My dad’s mom, I would describe her as a feminist of her generation. She made most of the money for the family, raised six kids, was the first woman to get a driver’s license in Vietnam. She lived with us, raised us in a sense. She had very high expectations and never let me or my sisters [Chan is the eldest of three girls] ever forget our heritage, the immigrant story. A very big part of who I am is because of her influence.
She had always hoped that my parents would have a son. She would say, someone needs to carry on the last name. The Chinese side of her wanted a grandson but the feminist side of her believed that her granddaughters were just as capable. Both existed in our home.
You’ve talked about being a teacher. Where did you teach?
At Harvard, I ran an afterschool program, but did not teach in a formal setting. Then I taught at a school called the Harker School. I applied for Teach for America, but they couldn’t guarantee that I’d be placed in the Bay Area. And moving to the Bay Area [where Zuckerberg was] was a priority for me. The Harker School is in San Jose, a very nice school for academically gifted children. It’s the one break in my lifelong journey serving the underserved. I taught fourth and fifth grade science, introductory physics and introductory biology. I was there for a year.
You ended up at medical school in the Bay Area too. I assume that was also the priority?
I was willing to go to whatever was the best medical school that I could get into. [Mark and I] were sort of finding ourselves that year. Stanford didn’t even grant me an interview. I hadn’t heard back from Harvard yet. But UCSF came through, so it worked out all right.
You talk a lot about learning. You like to learn.
I do. I’ve learned a lot of things as part of CZI. We want to be able to advance the field and you can’t do that unless you place some bets. Some are going to pan out and some aren’t. If you don’t learn from the bets that don’t pan out, then you’re just wasting opportunity and time. That’s why the learning’s important.
You guys made a big bet in Newark back in 2010, a $100 million commitment. That effort has gotten a lot of criticism. Does that bother you?
Our skin has, as you can imagine, gotten pretty thick over the years. You have to be patient. There was a lot of criticism about Newark, by people who thought it was a silver bullet. You make this big splash and then in two years, or whatever, they decided it was failing.
What’s good about being in the public eye and what’s bad about it?
It’s good for keeping you honest. And being in the spotlight helps us attract talent.
There’s skepticism in some places that CZI’s story is a way to counter the controversy that Facebook has been facing.
We’re two different organizations. We are unrelated. There is a lot of work we do to make that true. Facebook obviously has had a ton of issues in the past year or so. In the public’s eye, the two are conflated. But it’s important for CZI to be able to do our work in education, science, justice and opportunity. It’s not about my reputation, it’s not about Mark’s reputation, it’s not about Facebook. It’s about clarifying this organization’s mission.
There are lots of conversations about the time people spend on their phones today, particularly kids, and sometimes Facebook is seen as complicit in that. How much should kids be on screens?
I think what they’re doing on their screen or phone time is a much more important debate than the total quantity. Part of the focus on quantity is it’s measurable. I personally don’t have my kids watch a ton of TV or use an iPad a bunch, but I find video calling with their grandparents incredibly valuable.
I think in education, we should be asking the same questions: When we are using technology in the classroom, is it a good use of time, producing outcomes that are in line with what we want in school? I have visited classrooms where it’s used as a safety device, just to keep children in place. I don’t think that’s an ideal use of screen time. Our aim is to be precise about what a child needs, and use the power of technology to track and deliver that to the student.
An image I have from visiting one of the [Summit Schools, a charter network that CZI supports and relies heavily on as a technology platform] is when I saw four kids standing around a whiteboard, and they were debating a math problem. This is middle school. They had done their background work on the [technology] platform, and they were trying to figure out what the next step was. On the platform, it lists what each of them is good at. So they would be like, Bob is really good at the Pythagorean theorem. And so I would come to you and say, I don’t understand the Pythagorean theorum, can you help me out? The platform side should be a tool to get us to engage in real world projects and problems.
Do you and Mark have a philosophy about screen time for your own kids? Have you discussed, say, when they’ll get to have their own phones?
Well, they’re one and two. It’s a little bit early. We’ve spent a lot more time engaging on what they should be doing. We’ve talked about having the girls learn how to code. That’s important to Mark. We’ve looked into ways we could introduce that type of logic. When we talk to a two year old, it turns out it’s a little early. We want them to be fluent, we want them to have skills. But it’s just too early, really.
There’s a pejorative in business about being emotional. When I sat with you last time, you were crying within 15 minutes. I hear from other people that you get teary sometimes, overcome. Mark in business settings certainly doesn’t show a lot of emotion. Do you think being firm and emotional are at odds in business?
I think you can be both, and I think being both is important. In leading an organization, you do have to be clear, upfront, direct. That’s key, and I think that’s what a lot of folks in the traditional business sense are focused on. But I don’t think that’s exclusive of also showing why you care and how you care. I care deeply about the issues that we work on here. It’s still raw for me and hits close to home.
I get emotional when I think about it, but it makes it even more urgent for me to be a strong, capable leader. I don’t think they’re opposites.
You seem comfortable sharing your vulnerability.
I think each person here comes with a different story, but they’re here for reasons that are similar. We have a ritual called My Journey where folks at all-hands meetings share what brought them to CZI. I don’t want to represent that you have to have some sort of trauma or illness or anything to want to work here. But having a deep emotional tie to this work is important. I know I’m not alone here.
You’ve focused a lot on building a certain kind of team.
My goal is to have smart people working on the hard problems. There are some folks that are here until their careers are over. And then there are folks that come because they want to learn a certain skill set, they have a few years to do something different, they want to do a tour of duty. I’m completely comfortable with that. We’re in a phase of startup. We need different folks with different skill sets, with different appetites. You need the explorers who are going to go in and figure out a new space. You need the folks who are going to build a finely-tuned machine and keep it going and have it be excellent. Sometimes those are the same people and sometimes they’re not. And that’s okay too.
I would like to build a stable leadership team where we know how each other works and we get to execute. I’m envious when I look at Mark and his leadership team [at Facebook] that’s been in place for a decade. I’m excited as I think we’re getting close to that here.