Jim Joyce, welcome to Wednesday. Here we are, my friend. Another week. I see you're in San Francisco, virtual San Francisco at least, right? I was feeling a little San Franny sunshine, California, Silicon Valley. We'll be there, not in San Fran, but we're heading to the West Coast in a couple of weeks, so looking forward to seeing Adino, of course, and then a bunch of meetings already set up. The weather looks good, that's important. No fires this time. I'd love to chat more, but I'm super excited to let our guest in already. We wish we had a couple of hours with Esther, but since we only have her for about an hour, we're going to just dive right in. Welcome, Esther. She's getting her camera and voice ready. Set up okay?
Great, just so you know, I never got your original thing because I had you listed for 5:30 p.m. today, so I apologize for the last minute scramble. No good. Are we going to see you too, Esther? We do this on YouTube, and we always like to say better late than never, or in this case, better early than never. We made it. Honored to have you. We've known you for many years. I think I had hair when we first had you. Your camera is still off, Esther, just to make sure. Okay, all good. Welcome. You probably remember Jim from Good Old Health Excel days as well. It's been a long time. I picked you up once at a Newark train station and used a fake name, that sounds about right.
I remember being on stage when Martin Kelly and I were biking around San Francisco coming to our meetings, and Esther said we should be careful if we had a few beers before the bike ride. So we were very careful after that. Two memories that come to mind. Just trying to find another little thing to make this a little higher. Oh there we go. Welcome to the shot.
All great. I can't believe it took us almost five years to get you on the shot with us. Jim and I started doing this right in the midst of the pandemic, and we thought that we would stop, but we kept going. Here we are, almost 100, this is the 165th episode. We typically ask our guests, because it's good to know for our millions of viewers and listeners to get to know the guest, we ask our guests to take them through their journey, both professional and personal, and tell us a little bit of the story. Then Jim and I usually interrupt very rudely throughout and dive deeper, then we go from there.
Okay. Projects, work. Yeah, I just don't really know the premise of the podcast. It would be helpful just to hear a couple of sentences first, thanks.
First of all, this was a Gemini intervention during the pandemic. I think both of us were pretty extroverted people, we needed a mental health break. The idea behind this was that we go to conferences, and unfortunately many times on stage it's a lot of yap yap. We joked around that a lot of these discussions, the real discussions about what's happening in the front lines of digital health, really happens over a drink at the bar. That's where you get to know people. This is the Shot of Digital Health Therapy. We're not drinking, however, but the idea was to get the guest in the healthcare industry to open up, tell us their story, their experiences. Like you, Esther. We have this great network of amazing people we've met either a little bit or we've known them through different events. We said can we just have a half hour conversation with them? Every single week for the last five years it works. We come out of the podcast rejuvenated. We take a little bit of energy and innovation off of people and we just share it and talk about subjects affecting healthcare. It's a little free form as you might expect, and we just want to share amazing guests with our audience.
Great, thank you. That helps a lot. So you want my life story?
Yeah, from the cradle out. We love it all.
I grew up in a bubble. My dad's boss was Oppenheimer, at the Institute for Advanced Study, not at Los Alamos, this is well after the war. Pretty much from the beginning it wasn't so much I was trying to escape but to explore. When I was 13 I got my father to send me to Lewis and friends of his outside London. When I was 16 I went to college and joined the college paper and rarely went to class. Got a sort of intellectual dishwashing job with a non-profit. Then for three years was a reporter and fact checker for Forbes. I had this notion that the Japanese computer industry was a threat, but software maybe not so much. The guys from Forbes said you can go, you just need to take your own vacation time and you have to pay your own way, but we'll let you represent yourself as a Forbes reporter. So I took half my year's salary and went to Asia, Hong Kong, Seoul, Taiwan, and finally Tokyo, where I met the guy who ran Fujitsu system software. I took him to dinner as a Forbes reporter. We sat down and I said, I'd really like to talk to you about your system software strategy. He looked at me and said, so funny to hear a woman ask about software strategy. The dinner was a waste, but I did have a cover story that became Japanese computer threat in the end. It was amazing. Much faster now. Spent 25 years with a tech newsletter and conference. Then floated around, trained as a cosmonaut in Russia, got really interested in healthcare, invested in 23andMe for the education, fortunately, because I did not make a financial return.
Yeah, we'll double click on that later for sure.
Then the more I looked at healthcare, the more it was like a repair job for damage that shouldn't have happened. To me the question was how do we keep people healthy. If I got unlucky with 23andMe, I got lucky with Square and Facebook. I had enough money ultimately to fund 10 years as the Wellville Project, which was working in five small communities, helping them to build, not so much this program or that program, but just to build social fabric. That ended December 42nd of 2024. Yes. Now I'm about to write a book called Term Limits, about finite humans in an age of infinite AI.
Oh my gosh. All right, so let's go back. What triggered you, first of all, to even train for a space thing? What was the aha moment?
The reason I was involved in the first place, Oppenheimer my father was a physicist, did a lot of stuff with NASA, ultimately designed a nuclear power spaceship called Orion that my brother wrote a book about. Space travel seemed totally sensible. I was an investor in a company called Space Adventures, which was basically the travel agency for the six or seven space tourists who went up. They represented Russian Cosmos. They kept saying you don't need to spend the 20 or 30 million, you could just at least get the training for a couple of million. I said yeah, when I'm no longer so dizzy. Then the magic moment you're asking for: I was, believe it or not, at an internal Gates Foundation discussion about libraries or whatever, and got a phone call from my sister, who is alive and flourishing or I wouldn't tell this story. She called to tell me she was about to have a double discectomy because they discovered something. We both cried. Months later she was being treated. I was on the phone trying to set up some meeting and I had a conflict. I just said a double discectomy, I get a cancellation. Something's wrong with your life if you need a double discectomy to cancel your meetings. It probably took a day or two, but basically I called them and said when's the next opportunity. It was September 2008 to March 2009. I went and lived in Star City for six months and canceled all my meetings, except for one miraculous day, February 12th, 2009, I had three separate board meetings that day and I just told all of them can't come, training as a cosmomaut, sorry. I did not get the lottery ticket of getting to go. I was backup to Charles Simonyi, who wrote Microsoft Word, this was his second trip. On the other hand...
So how do they decide? Is it a pure lottery ticket?
No, no, I'm joking. The lottery ticket would be if Charles for some reason couldn't go. But in fact there was a lottery ticket that I didn't know that did pay off. Before you go, while you're still in training, they basically inspect everything. It would be really bad PR if someone went into space and died. So they discovered I had Barrett's esophagus, which is a precursor to cancer of the esophagus. After that I was being scoped every year. In 2016 they discovered I had cancer of the esophagus, but like stage 1A. Long story short, they took it out and I still get scoped every once in a while. I would be dead otherwise because I had no symptoms.
Wow! Amazing. Speaking of interesting health stories, maybe just a digression on keeping yourself healthy. I know you go swimming. What does your routine look like, your daily, weekly health routine? You travel a lot, for all of us to learn also.
Over the past couple of years it was so easy with fasting. Honestly, for your health in general, it's not good to go out to dinner and eat and drink a lot. It's one of the best known things, it's a lot harder than stopping eating chocolate cake. Since COVID I've been much more conscious of that. My routine is go swimming, eat a big breakfast, medium lunch, have something around 4 PM, and that's it. I'm now learning how to go to a cocktail party and not eat. It's amazing, they don't actually track it. At first it's socially awkward. Marina and I last night met up with friends at a bar, and Marina and I had water with ice, just because we know what it does to heart rate, to digestion, to sleep. We didn't feel apologetic about it. We had a drink with our friends and we just happened to have water and they had wine, and that's okay, no judgment. It's harder when you're sitting at a dinner table. I figure one time a week is a good tradeoff. I don't want to die having suffered to stay alive. On the other hand, it's a really nice feeling to come home from a dinner and say I'm going to sleep well because I just passed everything, didn't overeat, didn't have a drink. It's pretty binary, basically if your digestive system is running or has stopped a few hours ago. I'm also doing the rope machine, because standard female osteopenia, osteoporosis, that kind of stuff. I'm about to get a new device called OsteoBoost, which is built on the stuff that NASA did with vibration. If you stand on a vibrating plate it gets your ankles and maybe up to your knees. Laura... yes, Laura? I just spoke to her a couple of weeks ago. Another investor of ours introduced us, put her on the podcast. OsteoBoost, you strap something on and it's a vibration treatment. It's got approval and everything. It's probably not going to give me the bones of a 16-year-old, but it's got to slow stuff down. The drugs they're using now for osteoporosis are pretty scary, problematic.
Certainly. Let's jump into how you transitioned into being an investor.
That's another transition. The point of this book Term Limits is you have term limits in time, but also in scope. I had a newsletter and a conference. I was a journalist, I didn't invest in stuff. Then I started going to Russia in 1989 and learning about the Russian and East European computer markets. I started a newsletter called REL (Real East) as opposed to Release 1.0. A friend of mine, Lee K., said you keep talking about how people should invest in Eastern Europe. Suppose I gave you a million dollars, would you invest it for me? I said oh no, I can't. How much money did you say? In those days in Eastern Europe that was quite a lot of money. The second newsletter was a complete labor of love, it was for free, and it was my passport into Eastern Europe. People would talk to me because they wanted to be in the newsletter, and I knew stuff. I realized if I showed up with money they would probably still talk to me. So I ended the newsletter and started this fund, put in some money of my own as well, called Adventure Ventures. That's how I got started investing. My first investment was actually with Stepan Pachikov. I just saw his son on Sunday. He's the guy who founded Evernote, but he'd also done a company in Russia called TeraScript. He called me one day and said Esther, if he starts this company we want to give you one share. The lawyer called you and said you say yes to him, please. I know you can say this in Russian, by the way.
Anyway, they ended up selling to Nvidia for I think 90 million, so I made basically an infinite return on my first Russian investment. After that things were quite less crazy. I started doing it in Russia and Eastern Europe. The fund basically paid off with one or two deals and the other three or four vanished, but it was a great way to get embedded. Then when I ended up selling the newsletter I started investing in the US, in digital health and broader industry.
Esther, you're one of those iconic seeders. If we think about Health 2.0, I think you were one of the first and early investors. Startup Health has been around for 15 years.
I was an investor in Startup Health, not as an investor in Health 2.0, but I went to conferences. Yeah, time investor.
