Okay, this is David Zeiler, Director of the Caltech Heritage Project. It's Monday, April 28th, 2025. Wonderful to be back with Don Listwin. Don, great to see you. Great to be with you again. Thank you so much. Thanks, David. All right, today we're going to pick up. It's obviously a difficult story, a poignant story, but of course it's one that is central to your life and your career. I want to trace the narrative of your mother's illness and, of course, the impact and inspiration this had on you going forward in your life. So let's just start right at the beginning. Where were you and what was the news when you first got word that your mom was sick? Well, I was living, you know, where I am now, here in California, Los Altos, and... Actually, it would say, come to think of it. And my mom had been sick for some time. I have an older sister, Louise, who's a RN, registered nurse, and she had been worried that, you know, mom just wasn't feeling well. And, you know, when mom died, I just looked it up. She was like 62, 63. And so, you know, women go through menopause, and it turns out part of the big problem of ovarian cancer is symptoms mimic what women experience during menopause. And of course, culturally, they're just told to shut up and deal with it. And so that's what mom was doing. And she continued to not feel well. And, you know, I'd go up in Vancouver. They lived in the Vancouver area. And that's about a two-hour flight from here, and I had my own wings, so it is pretty easy to go up, even for a Saturday, Sunday, and you know, go visit the family and come on back down. And increasingly, she just wasn't well. I mean, it's almost like this ear thing. I've had this ear clog for five weeks now. I'm going to the audiologist tomorrow. And at some point, you're kind of like, okay, this isn't normal. So my sister managed to drag her into a clinic. Because her doctor had given her antibiotics. And, um... Thinking it was a UTI? Yeah, like... You know, hey, you know the drill. 30 years ago, it's like, hey, let's give you antibiotics and see what's going on. And Louise persevered, God bless her, and she got mom to go to a different doctor who was a little bit more blank sheet of paper. And, you know, did some tests and they said, well, this isn't right. And my memory is pretty fragmented on this, I must say to you, David, but that ultimately the tests came back that she had ovarian cancer. And a pretty late stage. I mean, it was, it was, yeah, it was late stage. It was stage four ovarian cancer, which... Now that I know as much as I do about it, it's not a death sentence, but the odds aren't with you. So that's, you know, sort of that was the, oh shit, and at that point... We ended up getting her into Vancouver General Hospital, which is in downtown Vancouver. They lived in a suburb called Langley. and And there was a doctor there, Dr. Diane Miller, who began to take care of her. And, of course, the first thing they do, in this particular case, not that it's all that important, but the way the cancer was located in the abdomen disqualified radiation as a treatment. And chemotherapy was the key thing. So, you know, she started on chemo and... I mean, gosh, 30, you know, chemo is still devastatingly hard, but 30 years ago it was even worse. nauseous, wouldn't eat, you know, I tried to get her to smoke a pot, but some pot, I couldn't get her to do that. And, you know, she went through the chemo. through the whole course, and then, you know, went back to VGH with Dr. Miller, and they opened her up, and she said, you know, when she came out, she said, I was very excited at the beginning. I had suction. I was suctioning out all this cancer, and then there was a veneer left that was not surgically... I couldn't surgically deal with, and... and soldered back up, and basically said, well... I think that's all we could do. So You know, continued to travel up, I think, almost every weekend. I was working at the time, we talked earlier, at OpenWave, and the mobile internet company, and we were in a hell of a tough month. I mean, for God's sake, it was September 2001. So 9/11 had just happened, and we talked earlier that, you know, we had over 200 employees stranded globally. So trying to figure that out. And so, you know, the end is coming, and so I fly up. I have a one-on-one with my mom, and she's just most worried about my dad because she's taken care of him all his life. Like, she was the brains of the family, he was the brawn. And I said, don't worry, I'll take care of Dad, and I won't, I'll make sure he doesn't have to go into a home or anything. We have all sorts of resources, don't worry about that. And she was in hospice at the time, so I expect that that was sort of the... trigger she was looking for. Nick went back to their house, stayed that morning early. I don't recall when. I got a call from the hospital saying, you know, it's... It's ending, her life is ending, and so I hopped in the car and drove, because she was actually in hospice at a place called White Rock in British Columbia on the coast. And I missed her passing by, I don't know, five, seven minutes or whatever. So you're sort of in the room and it's kind of shocking, you know, and it's your mom, and as we've talked about, she was, we were very close. And as I'm doing that, one nurse comes in and starts asking me if they can have her eyeballs. And some of the phone rings, and it's my CFO, Alan Black, and he goes, you know, I got bad news. We missed the quarter. So it was September 29th, it was, that was a Saturday. And that was when most of these... Internet markets had started collapsing, and in particular, the mobile internet still wasn't... a steady, viable kind of growth business. So I said, well, Alan, I've got bigger issues to work with right here today. I'll, you know, I'll call you back in a couple of hours. Um And we donated her eyes and anything else they would take, although after all that chemo, I don't know what they take. And... That was it. Don, did you, I know that the memory must be a blur, it all sort of gels together, but do you recall at any point from initially receiving news of your mom's diagnosis? Right to her last moments... Is there an ignition, is there a spark for you in that timeframe where you say, I'm gonna do something about this, or does that really come after? It comes after, David. It comes after. You know, it... The engineer in me kicked in and started doing more and more research on... Okay, ovarian cancer, and what became very clear is when found early, it's... Curable is a big word, but little c curable, you know, 80 plus percent of the time you can... You could cure these women by cutting out the stuff they don't need anymore in their 50s or 60s or whatever else it is. And that, and that after the fact, that's really when I started going... Um... You know, what can I do about this? And then during that whole period as well, I ended up going through my divorce. And so it was a rocky time. Now, the good news is I lost 26 pounds. So... But, you know, a lot going on, young son going back and forth, and so on, but I had thoughts. I had a very good team at OpenWave, a number of very senior Cisco people who came to work with me. And so I recall I was in a conference room, and I was going, you know, talking to the team after we missed the quarter, and I was like, hey, it's gonna be okay, we're gonna come back, and I burst into tears bawling, and... I'll get there. My buddy Kevin Kennedy, who is a... Brilliant friend and a genius. He walked me out. He was the number two guy, and he basically kept the wheels on the bus for me for months. It's not longer. But I kind of had to work through, there was, you know, global unrest. There was my personal unrest with the divorce, then the family. So it was a really long, tough time, several months till I kind of got my shit back together. I can't tell you really when I started. You know, thinking about... Like, OpenWave had got to a point where, for those of us who are gonna see this or listen to it, there was a board meeting that I was in. where the stock hit forty-three cents a share when we had five dollars a share of cash in the bank. Now, if there's a vote of no confidence in the CEO, that's freaking it. Yeah, yeah. And... And so that was part of it where I went, and, you know, my board is, you know, I'm getting death threats. I mean, really, you know, we had higher security and not from inside the company, but outside people wanted to put my whole, you know, my whole life savings in your company, mobile internet. And it's like, well, you shouldn't have done that. um And, you know, that company ultimately, thanks to Kevin, got stabilized. We actually got reengaged in a second product line in the messaging area that... We had abandoned it, it was too silly. It came back very strong. And that company got to a point where, you know, stock went back up to $25 a share, which was probably the right level. And I just said to the board, hey, you know, I think This is the time. I think Kevin's brilliant and should do it if he wants. Turns out he was on the board of JDS Uniface, which was the big fiber optic supplier back then, high-flying Canadian company. And they had just let go of their CEO and they tagged him, so he had two jobs. JDSU was 10 times the size of the company, so he decided to do that. And the board ended up doing a search process and brought in an individual to uh to take over. How ultimately did the ship get righted at open wave, or did it not? Well, it did well, Kevin and I were still there. er It was two things. It was, we were both the mobile internet tech that made the browser work on a phone, which that was hard years ago because the phones were so small. But it was this, if you recall from the earlier conversations, this large-scale email and, you know, internet service providers, unless they were the biggest of the big, top five, Google, whoever it was, they couldn't build this stuff. And we had, we had ignored it, abandoned is the wrong word, but we'd ignored it and hired a really Brilliant young guy named Richard Wong, MIT engineering grad, and came in and he turned that business around. So that gave us some cash flow. And then during the selling process, before me, before I came in, there were just so many promises made to service providers. And I say service providers, I mean, you know, telcos who think, oh, I've got to get in this business. And we just had salespeople who used... The suburb scale tactics in the short term, saying, well, your competitor just bought $3 million worth of stuff. And if you don't buy some software to make this go, you're gonna look stupid in the market. Well, so... It's like called stuffing the channel, if you recall that term. where then they paid for it, but they didn't use it because it didn't work. Not that our software didn't work, but the end-to-end. system, I mean, you're on a bloody Motorola flip phone trying to, you know, do something outside of text messaging, and... So I think time helped because the handsets got better and better. But I had to go, I mean, my saving grace is I ran the telco business at Cisco as my last big gig with Kevin. It's about a $12 billion business a year. And I knew many of the people that the company had sold to before I came in. And so, you know, like Telmex in Mexico City, and I go in and go, Carlos, look, I'm really sorry. I didn't do this. Let me fix it. That took probably two years to dig out of that inventory pile. And then Richard came along and really started kicking it on the other side. And it got stabilized. But unfortunately, you know, when Kevin and I were both leaving, we said, look... We're at a crossroads here. We either have to become one of three things. We either have to become a hardware gateway provider like a Cisco and sell ourselves to a Cisco or a Juniper. We either have to become a client-server company and be pure software. But there's three options that at least the two of us thought. And they went out and hired a CEO. um which I think is important for me to be very... to me on this, but... My deal was to stay till the end of the calendar year, so I think that was on the order of a hundred. Days, I moved out of the CEO's office, gave the new guy the seat. This is calendar year 2002. Correct. That's right. And Well, I'll go back, David. 02 or 03, 02 probably, 03 maybe. I'm not sure. Because it was September of 2001, so it could have been 2003. And... And the only thing that struck me is... The guy never came and asked me any questions. Like, if you think I'm a complete moron, then really you should ask me a few questions and do the opposite. Like, there's an algorithm in there that can work. And he never did, and... And the place never became what it could have. And I'll leave it on that note. Done all of the dislocations after September 2001 in the business world, in your career, do you think, I mean, not to put you on the psychologist's couch, but do you think that all of that tumult got you thinking about... Not a pivot because it's not your specialty, but at least a new focus for your energies. Is there a, is there an origin story of Canary that only exists because of all of these dislocations in your career? Yeah, well, I think so. I mean, as we talked about, I was blessed by when I exited Cisco in September of 2000, right? So I made good money on that because I hadn't sold much of anything during the journey. And then as OpenWave stabilized as a CEO back then, you were making five or six points on the company. So that was nowhere near the Cisco outcome, but still very nice. Now, you know, minus some percent, some big percent for your divorce, but I still, I thought... You know, this was enough money, and did I, is that what I wanted to do? Now, when I was at OpenWave, I was flying on the order of 300,000 to 350,000 miles a year. I was... And I was early 40s, but man, I came into a board meeting once and I remember one of the board members going, I've never seen it said this in 40 years of being a board member and a VC, but you need to stop working so hard. Or you're gonna be dead. But it was, the business was all Japan, Korea. And Europe. I mean, we were way behind in mobile internet technology in the United States and Canada and North America. So you were on a plane. I remember, I remember being in, going from San Francisco to London to San Francisco. To Japan. And then getting on what then was the longest flight ever on United, 17 hours, to be a host on CNBC, back when Mark was on, the big guy. And that was a three-hour gig from 9 till noon. And so, you're on the plane, I took my Ambien, I had my glass of wine, and I wake up, and the flight thing says, eight hours left. I'm like, oh, my God. So, you know, you land and I go, and I, whatever. I get up at 5 and I go to a Starbucks and I go to the studio. And they're very nice. He's funny. This is a funny story. He's sitting there. He was very cordial, not engaging, but cordial. He's in his suit and tie top and his boxers. And he's getting his makeup put on, and he leaves and he goes out, and he's got a giant bowl of Cheerios, which he keeps under the desk that he eats that commercial. And so we're going on, and as the news goes, it's like, do-do, do-do, Juniper misses their quarter! And I'm like, this is freaking fantastic. I know everything about Juniper. They're my arch rival in the telco business. So I was just... Really good. I have to say it was really good. Little adrenaline flowing and then they'd go on and they'd stop doing this segment for the following reason, which is then they'd start talking about global economic uncertainty and interest rates, and I just looked at the camera and go, I got nothing, which I got praised for at the end of the show. It's like, that's when people turn off the show, when people don't know anything and they start yammering on. So... I don't know, that whole period was... It was enough. You know, in hindsight, those are the power earning years. Like... I'd have a whole lot more money now if I didn't quit working after 25 years of working, but everything is lovely. Don, are you thinking, again, I wanna get to really when Canary gets running, at least in your mind, is it a soft retirement from you from the telecom industry, or are you thinking there's a next chapter or I'm gonna keep myself involved in investing or consulting? Or how are you thinking of the next stage of your career? That's the right question to which I don't know that I fully thought through the answer, but I do think, I think you're right. I think part one was, this is a soft landing from what has been a very hard four years, physically, emotionally, mentally. The bank account seems fine, and And can I do something to help? So that's the moment. Now, I continue to and still run this, my little venture firm, List One Ventures, and I do seed and Series A and all that kind of fun stuff. And I was more involved back then. That was my hand in the business. I was probably on seven or eight startup boards. So I didn't abandon that part of hopefully my talent, at least my engagement. But... It id It then started with... Well, okay, I have figured out the ovarian cancer. conundrum, which is you can't detect it early. And is anyone working on that problem? And one Saturday morning, I sent out a series of emails to major institutions after a good web search that had some amount of ovarian research and said, you know, here's what I'm interested in. and helping and Make up a number very quickly, 30 minutes or less later, a woman named Pat McGowan emailed me back from the Fred Hutch Cancer Center in Seattle. And Pat said, hey, we've got this great researcher, Dr. Nicole Kidman. That's not, that was not Nicole Kidman. I have met her at a cancer event. Dr. Nicole Irvin, and she's working on these things called biomarkers, which are, you know, blood tests or urine tests to find this. And I went, well, great. And so, I came up to meet The director, Dr. Lee Hartwell, he wasn't in, but Nicole was in and others, and I said, well, what's your biggest problem? And she said, I need a wet lab. And, because I'm basically a mathematician and statistician, but I think the next step on this is I think I know where I should be looking and I don't have wet lab, and I'm, you know, not even in the top 20. for doing this, And so that's when I gave my first. first million dollar gift. And it's not easy. I mean, a million dollars, you know, at least in my age, you grew up going million dollars is what you aspire to. So giving it away, even if you had more, is still a step. Don, orient me in the chronology here. What year was it when you emailed all of these institutions? Would this have been 2004? Yeah, it's 3-3-4. I'm plus or minus a year. 3, like, to make this the story. I can go back and maybe look at my notes as we do this. But I'd say, you know, late in 3. Did you hear back from anybody besides the Fred Hutch from that initial outreach? Yeah, yeah, you know, people came back spuriously over the time, but, you know, I was... As you have experienced, it generally doesn't take more than five minutes for me to respond to an email, so. Yeah, you're on it. I appreciate the same in kind. And then, you know, like any good development director, she engaged me and wanted to understand what was going on. And, you know, she was like four days ahead of everybody before they came back. You know, in team building... I believe proximity matters. You know, there's old HR terms of, you know, storming, forming, norming, you know, and so we actually used that, I used that principle in Canary when we built teams. And so... You know, I don't know. I mean, she set the hook, right? And said, you should come up. And OK, it's an hour and a half late to Seattle. I should come up. And I came up, and that's when the engagement started. Now, this is such an important point. I want to make sure I capture your perspective at the time correctly. There's a balance here, obviously. On the one hand... You understand that there are structural limitations in cancer biology and biomedicine. That's the basis of why you're reaching out to help. On the other, you need to know your lane, right? You're coming from industry, you're not a medical doctor. How are you striking that balance where you both want to sort of point out an obvious limitation and offer to help, but not appear to be so overbearing or assuming that you know things that the medical community doesn't? How are you doing that at the beginning that obviously sets this whole endeavor off on the right foot? Well, I would say I was pretty arrogant. I would just put that. You know, like I just finished helping build the internet and the mobile internet. I thought I could build stuff. And I thought, which I think is true, that one of the things that was missing is there was really back in the early 2000s, nothing like team science. People were individuals trying to get their grant, get their breakthrough, get whatever it was. So my belief was bringing engineering principles and team discipline was the thing that was gonna be the game changer for what we were doing. Additionally, over time, it also became a fact where I canceled stuff. Right, you don't cancel stuff in the science business. It fails quietly into a whimper, but it still sucks up all the money. So, you know, we got into different models, which we can discuss when you want, but there were many different funding models, and I brought those from my experience at Cisco. You know, here's a, here's a, you know, I'd have a lunch with somebody and they'd pitch me on something that I thought was really interesting. And I go to my backpack and I pull out my checkbook and I write him a check for 50 grand in the first hour, right? It's like, go. Now, that would take them nine months to get the 50 grand from somewhere. And as we talked about earlier, the other thing that became clear as I learned it, is when you give good scientists money to get early data, they win the big grants. And that's been part of our success is the leverage has been 10 to 12 to one. Sure, sure. So. So I think it was applying those things. As I got into it, David, it also occurred to me, which I didn't know up front, which is still a problem, is that the economics around diagnostics is terrible. Diagnostics get paid in this country cost plus, right? And people drive around with trucks full of blood going to mainframe processing centers. So, ah, okay, now the idea of... You know, a PC instead of a mainframe, you know, made sense. And we talked earlier about my dentist saying, hey, I could do that. So... It took time for me to... The arrogant said, I can help them with engineering. The learning became... I can help with team. And then I can help with how to get leverage out of what we're trying to get done. And that's where things continued. Now... Dr. Hartwell and Came back and we met and we talked about stuff, and it was he, who is a Nobel Prize winner, he said, look, This really needs to be a team. And he said, we don't have all the assets of the Fred Hutch. that we need. Because the Hutch was largely a standalone research center, not a hospital, so there's no imaging and others. So he said, you know, Don, what I'm good at is convening scientists. And so I'm, with your support, I'm going to convene a team of scientists, and we talked through in the past who they were. Go through that again, but... to study something and see if we can come up with this new model. And that's what we did. And the team, as I alluded to earlier in our conversations, picked ovarian cancer because of how challenging it was, as opposed to the fact that my mom passed of it. I wanna go back to that first visit up to the Fred Hutch. What were the big learning curves for you in the beginning? Even if you were coming from an arrogant place, what was the new information that you felt you needed to get read up on if you were gonna take this seriously? Well, everything. I didn't know a damn thing. I didn't know a damn thing, right? I mean, you know, what the hell is a biomarker? What's the difference between a genotype and a phenotype? I mean, I, you know, there's, there's 25 years later, I still know, like, the scratch on the surface of it. So it became clear that, you know, I had to learn, but that had never... seemed to be a problem, and human biology is all about... Software code, right? DNA and, I mean, at some level you can start to make some comparisons, but... Támh You know, I... I'm very instinctive. And so I was like, well... It's take a first step and see what happens. Now, what happened in that journey is... As we were trying to discover biomarkers, and Pat Brown got involved, Dr. Pat Brown, who I believe will win a Nobel Prize someday, who now has left that research community to be, he was the founder of Impossible Foods, Impossible Meats, because he's a passionate environmentalist, and he said, cows are killing us. And he had done some work, and he opened his laptop, which is very unusual, and said, okay, here's a selection of genes that I think we should follow. He just gave everyone the information, which should have been a paper. So we did, and what we discovered along the journey, and it wasn't just me, it was everyone, is that these antibodies that you use to try to find these biomarkers, there are commercialized antibodies out there. But what we've learned much through the path is that... Cancer looks differently over what is generally a twenty-year Journey before it becomes dangerous. And so you can find this stuff easy, except for it's stage 4, and it doesn't help you. And it doesn't look the same here. So we set out... And I did this through Canadian contacts and set up a lab in Victoria, British Columbia, to build our own. antibody bodies, which is not an easy process. So, you know, back to your question of what did you learn, where did you go, part of it was step-by-step, and we ultimately ended up helping commercialize one biomarker called HG4. which is a companion to CA-125, both of which are ovarian cancer biomarkers, but neither of which is powerful enough. To be one and done, you still need imaging to complement them. Cso I don't know, you know, it wasn't, David, it wasn't a master plan. I've never really had master plans. I've surrounded myself with good people. I... Trusted my instincts and I've tried to be honorable and supportive. And so, you know, after the ovarian team, well, then... We started getting known more in the community. We started a lung cancer team, which is still working in clinical trial in China. And he's okay with this. Frank Quattrone and his wife Denise started our prostate cancer team, which is probably our most successful enterprise we've talked about, where now you can really help men understand where they are in the cancer journey and what they should do, where there was so much uncertainty in the past. So we had, you know, we had team structures. And then I had the individual scientists, and then I had the smaller things, and then that's when Dr. Gambier said, you know... Maybe we should build a center at Stanford. And then that idea came along, and this wonderful man who has since passed, Bill Bowes, who was a founding venture partner at USVP. who I think was the founding investor in Amgen, he helped us, and he helped us start the Canary Center. So we went from that to today, where there are centers globally, which are not their Canary affiliates. I don't wanna be too overstep here, but I think we're inspired by the work that our teams have been doing. Let's go right back to the Fred Hutch, that initial million dollars. What was the nature of the ask, and how did you determine in your own mind, you know, this is a good investment, this is something that's gonna yield what the scientists, what the doctors want to achieve? How did you assess those things? Well, so you see, it... To this day, it's clear that there is some sort of biomarker test required to alert people, and this was way, not way before, but BRCA1, BRCA2 genetic tests that predisposed people, mostly women, but men too, to cancer, it was not the rage. I mean, right now, the whole idea is... Can you identify yourself as high risk through either genetic testing or family history? If you are, you should be more diligent. Okay, now what? Well... Sometimes it's imaging, sometimes there's nothing with ovarian cancer, right? There's nothing. So it... The pursuit for me was, okay, we need a blood test for this thing. What I missed is, unless it was damn near perfect... No one's picking up the scalpel anyways because the incidence of the disease is so low that false positives can be so high. So that was learning along the way that you got to have a confirming test, biopsy or imaging, to be able to have a surgeon actually engage. But, look, I like Nicole. Pat had won me over. I got a Nobel Prize winner saying, I agree. Like this vision was Lee's vision, not mine, of the one-step, two-step. Mine was the brute force engineer coming in and saying, okay, I'm going to break this bridge down. What's the next bridge? But I thought Nicole's approach was the right one, but she didn't have the kind of support in the lab, so I said, I'll give him a million dollars for the lab. Now, that stuff can be disruptive, right? Someone who thinks they're going to get a lab from the institution, and next thing you know, your neighbor got a lab. Well, it's because your neighbor was working on something that somebody cared about. So that, none of that has ever changed probably over a hundred years of research. But, you know, we got going with Nicole, then some more for Nicole in around that, and then I approached Lee and said... What about if I had ten million? What could you do here that's different than what we're doing on the ground? And what was the answer? What could you do with 10 that you can't do with one? The answer is he could build, he would build with support from the internal leadership there, an early detection group. And notably, what was missing, the hot technology at the time was proteomics, so the study of proteins. There was this belief that which is still true, but that as cancer develops early, there are unique proteins that are shed from the cancer, and if you could differentiate them from the normal ones, and so proteomics did that. They used mass spectrometers, which measure the... the time of flight of molecules across two surfaces, and by that time, you could assess the mass of the vehicle, of the protein, and you could identify it. That was missing at the Hutch at a scientific level. So a big part of that money went to recruiting a guy named Sam Hanash and a woman named Mandy Polovitch into the Hutch to round out that proteomics. Ultimately, Lee said, we need imaging, and that's where Sam Gambhir from Stanford got involved, and then some of the genetics whizzes like Pat Brown and Pat McCormick from UCSF. OK, so we're oriented in the chronology. Now institutionally, let me just make sure I have all of the players involved. So we start at the Hutch, and then where is Hartwell? Hartwell is the director of the Hutch. Okay, Hartwell is the director of the Hutch. And then where else? Is there any other steps before we get to Gambier at Stanford, or how does Gambier enter the picture? Yeah, so the ovarian, so there's Nicole's lab, biomarkers, then there's, can we do an early detection? I don't know, center is too big a word, but whatever, at the hutch. And Lee said yes, and he is a very consensus-building leader, and people said, yeah, good idea. And then that's where the initial money goes. And of course, you know, in medical research, like, there's three prices for stuff, $250,000, $500,000, and $1 million. You know, they start with the price and see what they can put in to sell to you. So proteomics machine mass spectrometers were expensive devices, so that chewed up, you know, a lot of dollars. But once that got done, he's like, you know, let's do this team thing. And that's when... Like, who else came in? Peter Laird with the methylation specialist from Southern Cal. Pat Brown, I talked about, Howard Hughes investigator at Stanford. McCormick from UCSF. I'm trying to go around the room. Marty Macintosh, a brilliant guy and statistician from the Hutch, joined for data analysis. And then Imaging, it was Sam, so make up the number, there was eight or nine of us in the family room when we had the first meeting. And then when exactly during this process do you think, I need something more than being a guy who writes checks and there needs to be a foundation, there needs to be a nonprofit that's associated with all of this? Well, I was running out of money. That'll do it. That'll do it to you, you know. Well. I think we had established a pretty good reputation, and I thought, well, you know, it's not that hard building a 10-person organization for someone who has experience. So, um... I was flying up with my buddy Dale to a Hutch meeting, and... And we were brainstorming on, we had already decided to do this foundation, and then we were brainstorming, and that's when... One of us, I think it was me, but he'll, he's a really good buddy, he'll say it was him, came up with the idea of Canary for Canary in the coal mine. And so, you know, when you say that to someone who's 30 years old, their eyes go, what the hell are you talking about? You say it to somebody my age, they go, oh, I totally get that. And so that's when Canary, and I started with Canary Fund. which it ended up being a mistake. We still legally Canary Fund, doing business as Canary Foundation, because I got emails from all sorts of venture people going, what are you doing? Why didn't you talk to me about it? But I was like, no, no, no, no, I'm doing cancer research. I'm sorry. So when that officially started again, you know, we're talking 20 plus years, David, but I'm guessing 04, 05, and started, you know, reaching out to people. I'd say the core of the foundation's success early on was people who thought... That I could run this thing more like a business than... What feels like for 100 years, what the black hole of cancer research funding just goes in and nothing comes out. And so that was, you know, the best example of that is the quatrons and the prostate stuff. Man, there was like an eight-page letter of agreement on milestones and what was going to happen and when. And then when you delivered, they gave us another bigger gift. And same thing with Bill Bowes. Well, build this, do this. OK, yeah. So it was a bit of a venture run exercise, if that makes sense, on building trust. And you know, I had a good reputation from the industry B. And then Mr. Valentine, my father-in-law, had, you know, lots of contacts. But like, I knew Frank years ago. And so... You know, that's where it went. On an aside, it's interesting where... It takes, you know, people who are working full-time in office jobs aren't very philanthropic. Because they're thoughtful, and they don't want to just throw money at stuff willy-nilly, right? So, you know, Steve Ballmer and I became good colleagues through the Cisco-Microsoft relationship, and I said to him, you haven't done much. He said, I'm busy running one of the world's biggest companies. Leave me alone. I'll do it when I retire. I said, OK. I get it. But, you know, for me, that whole class of investor and canary has basically passed. And so, you know, the question is. You know, for me, how do I continue to get money that's not just my own money to move things forward? Don, so it sounds like if I, let me see if I've captured this correctly. The idea is, you know, as you were joking before, once you start running out of your own money, you're being, you know, you're being very generous. You're excited. You're writing checks, but this is fundamentally an unsustainable business venture. The idea with Canary is that... You are a known entity in the tech field. You have now built up all of these relationships in cancer biology and biomedicine and oncology, and so that basically your peers, the investor class, who might not have the time or the inclination to do all of the homework that you've already done, to do all of the relationship building that you've already done, you're basically a proxy where they're saying, ah, Don knows what he's doing. I'm happy to help. I'm not going to develop these relationships directly, but I can trust Don that if I give money to the Canary Foundation, this is going to be the best bang for the buck. Is that basically the idea? I tell all my kids and grandkids, there's only three assets in the world. Time, talent, and trust. Right? And you can find faith, you can find love, you can find whatever you want in a combination of those three things. And the core asset I had with the investment group was trust. Both that I could get it done and that if I couldn't, I would be honest and tell them I couldn't get it done. So... You know that? And to this day, you know, the brand is strong, and, you know, many people, they think brands are... catchphrases and things. And I had a very good head of marketing guy named Keith Fox that came and worked with me for me at Cisco, and he came from Apple. So it was great. And he said, no, no, a brand is a promise of an experience. And so... And core to that promise at Canary is being trustworthy. So there's a new big foundation just this year interested in... Early cancer detection could be as much as ten figure. Foundation, and they said, we found us, we did all our research, and everyone says you guys are the cat's meow. And that's 25 years of trust. Wow, wow. Don, the obviousness of the importance of early cancer detection, right? Just to play devil's advocate for an investor that says, you know, I want to give to, you know, a St. Jude's or I want to give directly to a medical school or to a university. What is the hook for the Canary Foundation to say, this is really the part of the puzzle that we're focused on in a way that no one else is? What is, I don't know if it's an elevator pitch, but what's that message to the people who are on the fence? Yeah. Well, look. This business of this cancer philanthropy is the most competitive one I've ever been in in my life. Interesting, interesting. Most competitive, right? You've got hospitals selling hospitals. You've got doctors selling doctors. You've got organizations selling disease, pancreas, ovary, whatever it might be, right? And 80% of the people are... emotionally invested in either the disease, the doctor, or the institution that they went to. So right away, in this sort of intellectual pursuit, you're behind the eight ball. So you've got to be able to go to people like the venture people that I did and go, here's the disruption. Here's why it's gonna work, right? And be able to talk through all of those different nuances to their satisfaction. So... You know, that is, it's very clear, the facts are clear. Right, but then people go, well, if it seems so self-obvious, why is it that you can't sort this? And you can go through the statistics and the math, and the simple answer is... The face of cancer over 20 years looks different. And so when you've got diseases like ovarian and pancreas cancer that don't present early on, you don't have any samples. Our biggest problem in those two diseases is you don't have early stage samples to study because you only get lucky if a woman has a hysterectomy. And the doc goes, I'm really glad we did this because you had stage 2 ovarian cancer, you know, and we took out everything. So, И... There is a unique... swat That matters. This new, bigger foundation... disease in the family, there's a particular disease, which I'll just keep offline, that they're interested in, that we've been working on, but have been underfunded. And I hope it's a breakthrough, but, you know, I'm at this point now where strategically... I believe... The rest of the technology development in genomics and biomarkers, it's all moving along nicely. It's imaging that's a little bit behind, but it's a giant industry with a lot of money in it. So finding new products for that industry makes good economic sense for them, and that's where I'm mostly focused over the next five years. Don, I wanna go back to the origin point with Stanford, because institutionally, of course, that's what brings us together. Tell me about the connecting point to Gambier and why this was compelling for you. Well, the Well, number one, it's five miles from the house, right? So, and as I, I digress, but as I built teams, I was, and people did not like it, but they were West Coast teams. Because I said, we're going to get together every six or eight weeks. I need face time. We need to build trust before we can Zoom, you know, it wasn't even Zoom or whatever, before we can get to that norming kind of phase. So, you know, great guy in MIT. Nope, because you're not going to come out to the meeting and you're going to try to get on the phone and it's not going to work. So when we built the ovarian team, or when we were going to build the team, Hardwell said, we need imaging. And he said, it's Gambier. He's the guy who innovated in PET and innovated in all these different structures over time. I think it was at the time when he moved from UCLA, it was the biggest move Stanford had ever done. $50 million and I think 50 people came with him. Wow. Wow. So that's, so it was Lee's introduction that, you know, solidified that and then Sam's help got us in, you know, in the door and then started to, you know, make this pitch about a center, which now is turning into... God willing, an institute of a much broader scale. dat Joe diesmon is Yeah, wow, so exciting. Dan, you mentioned, you know, building out the foundation, 10 people. What are the areas of expertise? What is obvious to you? Where are you bringing in outside counsel to say, who do I need to make this all work? Well, I don't know that I needed outside counsel. I mean, it was the number one challenge we had in building these teams were the general counsel's office at the universities, who said, what do you mean, we don't own this? I said, well, there's 10 universities working on this. And their whole model for all the years they'd been in this kind of business was, well, there's one company, and there's one drug, and there's one royalty stream, and that's how that all works, right? And I was like, so who, so I must have had a dozen meetings. Here's the 10 people working on this. Here's the workflow. Who owns this? And they said, well, are you gonna own it? I said, no. bar You can't own it, and you can't own it, and you can't own it. We're just gonna let people have it. So that took a one or two years to kind of get through the rat hole. And is that done? Is that a new model in the field, not having sort of a proprietary sole owner relationship of any technology that comes out of it? It was 25 years ago. Wow, okay. Interesting. Yep. Not now. It's not now, for sure. I mean, everything is about, you know, teams and doing things. Пач You know, so we had to get through a bunch of those hoops. Sam was very influential on campus, you know, one of my best friends and a great guy, brilliant as the day is long, but also humble and could make... Complicated subjects. digestible And so he really was the anchor in Stanford, and then... I don't recall, I think he brought Bill in, because Bill Bowes was funding BioX. So he also said, why is no one working together on this business at Stanford? And so there's a program, a big program now called BioX, which was all of this business of, you know, exchanging things. Now, over time, we got to the point at Stanford where there's dozens, if not 100 plus affiliates. So Jim Brooks, a prostate cancer doc, well, he's not on our payroll, but he's doing research on the prostate team, right? And so you just ended up and, you know, we built a place where the water seemed warm and people were. Wanted to be part of, part of the party. What was the first product or first idea where you had to think about, okay, we now have this new non-proprietary model, but here's how we're actually going to deal with it because it's a real thing now. What was that? Was it a drug? Was it a technology? What was the thing where you said, oh, this is actually working. We need to figure out how it all comes together. Who gets credit? Who gets paid? Havneanlæg. I mean, the HE4 biomarker we talked about earlier, we helped nudge through. That was the... Someone else, I think it was in Seattle, had actually come up with that. We helped validate it, and then it ended up going to a company, which we just, like, I was just like, hey, how can we help you get this commercialized? Outside of that, There had not been, you know, any commercial successes. Now, I'll back up and say... There have been at least 10 or more spin-outs from the Canary Center and Sam's imaging labs on technologies in and around this, but not necessarily, you know, doing biomarker testing on your iPhone. Right, I mean, a number of people have done that, and I digress a bit, but I had said, and I have to be more careful when I say it, is... If these people, who are the best and brightest in the world, can go to Google... and make more money. We got to at least give them a path to consider. commercializing their technology and making some money on it. And so that, I'd say I have nothing to do. Stanford is particularly good at that, and we encouraged it and we supported people, and I still to this day help people understand how venture rounds work and why they only get common stock and not preferred stock. So, so there have been those successes, but there hasn't been... The clinical success. that you can go, we did that. Now, I think it's gonna be in imaging. We've been working on this microbubble stuff for 12, 15 years, and I actually think the team is getting close. But, you know, the vagaries of this, the bubbles we were using were from a company called Bracco, Swiss-Italian private company, family held, and they fight about, well, I don't want to do ovarian cancer, says the brother, because the market's not big enough. And the sister says, why don't we just save some lives too? It's only bubbles. So, you know, you gotta work your way through that whole... Pretty fragmented. Whenever you're doing anything new, it's highly fragmented, and, you know, you're... You're betting on startup. You're doing a startup yourself and you're betting on startups. It's tricky. Don, it's a great opportunity to ask you to reflect on the legacy of Sam Gambier, what he built, and if you connected with him, because I know that he experienced tragedy in his own family that... was obviously a big impact on what he worked on and what his motivations were. Well, yeah, I mean... It is sad for the world and it's sad for the community that he's no longer with us, because he was brilliant and an inspiration and respected and loved. The tragedy is triple-fold. His son, his wife Aruna, P53 mutation. ended up with multiple surgeries. Devastatingly hard. Their son, Millin, ended up with glioblastoma at 15. He died first. Despite an incredible effort by our entire team and a shoutout to Duke, Am And then Sam... At Buck's Restaurant some years ago, Said, you know, you know, Don, I haven't been feeling well, and I said, yeah, I know, I'm trying to get you to a doctor. And he goes, well, we've discovered I have cancer. And I'm like, oh. Excuse me, we can edit this right? What the fuck? Yeah, I have this thing called tumor of unknown origin. I'd never heard of it, and I was like, give me a break. So this is a cancer that manifests where the immune system jumps on it. And it's so rare that there's no real... Practice. Half the community says your immune system is getting it done, leave it alone. And the other half says it's cancer, dummy, go do something about it. And... through a torturous, torturous... Set of... Interventions, they didn't work and he died. So, I mean, that entire family, the tragedy, and then partly what set us back was Jürgen Wilhelm, who is our VP of strategy at Canary Center. He ended up dying in a car accident in and around that same, and he was the lead on the microbubbles. So between that and the pandemic, we've probably lost five years of progress. Tell me about connecting with Joe. Well, I'm happy to say I flew him on my plane with a couple of friends and his... brother-in-law to the Philadelphia game, and we kicked their ass, the Niners kicked their ass, so that was fun. Um... When Sam was... Sick. There was a kid who had been, and I'm gonna be delicate here, he was being recruited by Harvard. to become the Dean of Medicine. I think you wanted to stay and be the dean of medicine at Stanford. They gave him an outrageous offer. have both money, faculty, and facilities. It was a family conundrum, you know, Aruna's like, let's get out of Dodge. Sam's like, I got 500 people I brought here. So ultimately, Stanford countered with a spectacular offer, which involved this group called AIST. and a broader vision than just early detection. Early intervention, I would just say, is the addition to it. And, um... And then as he got more and more sick... the dean of Madison, Lloyd Minor, reached out, and I don't remember the chronology exactly, but we ended up building a chair. In Sam's name, which was ultimately the funding that brought Joe. And Sam said to me before he died, he said, this is one of the best scientists in the entire world, like on three academies of science, nobody's ever done that. And... You know, we, he's an A player, I'm a B player, and I was like, well... I don't dispute that Joe is an A, but I will push back on Sam being a B, but... So, you know, I have not spent a ton of time with Joe yet. I think what he's doing is, what he describes, and I'm fine with, is a reverse merger, taking the Canary Center and merging it with a bigger... financial pot of ACE and its capabilities and keeping the canary brand, which I'm proud of. And, you know, we're still in that progress, in that process, you know, that Sam made this Don Liston Award for our annual symposium, which makes my skin crawl, I have to admit. And... And so recently I said to Joe, look, I wanna split it, I wanna bifurcate it, and I wanna make the Sam Gamveer Award for scientists, and I wanna make the Don Lessman Award for support and staff, people who are... lifting heavy statisticians, all the rest of the people that make this world turn. So, you know, that's one of our first projects and his... You know, nothing moves quickly in institutions, and especially Stanford, but... I think it's the beginning of... of the next generation of what it can be at Stanford. Time will tell, but, you know, we've got the talent, and we've got the money, and we've got the motivation. Well, Don, that brings our conversation then right up to the present. What exactly will it look like as we're in this sort of transition period from center to institution building? What will be lost and what will be gained as Canary sort of, I don't know, folds into this operation, loses some degree of its independence? How are you thinking about these things now? I don't know yet, David. What I will say is it'll be different. And I will say the people Sam recruited may not, you know, it's been a long time, 10, 12, 15 years. They may move on. But I think that Joe will hold the broader... am The broader idea, I mean, some of the stuff he's working on... You know, patches to deliver drugs can be used to actually take blood. Like my daughter is deathly afraid of needles, so if I could just put a patch on her forearm and get my biomarker, I would. Yeah, what Joe's better at than Sam was... is getting out there and talking to rich people. Just to be, right, talk to... the Walmart family or whoever else is out there, and he can project. Sam could do it, but he would rather be... Worked in 72 hours on an NIH grant because he knew he was gonna get it. So... I think Joe brings some gravitas that that will be helpful. It's just unfolding as we speak, so, you know, as you say, you're cautiously optimistic, we'll we'll see where the duck lands. Don, I use the term soft landing in your technical professional career. Do you think that this is the way that eventually... You can let go or step down from the level of activity that you've maintained for the past 20 years by rolling this into Stanford and not keeping Canary as a separate entity where there's a successor that takes your place? Yeah, so Kevin Kennedy, we talked about earlier, kind of gently chastised me on saying, why after 22 years would you just let this go? And so I think... On one level, the fact that Joe is willing to integrate and develop under the brand, which is about trust, is a big step forward. Right now, I'm as energized as I have been. During the pandemic, I was like, you know, I'm putting on Iron Man 3 and watching on the couch. But, you know, right now, I'm energized. I think there's new... funding sources that are substantial, which are great, and then trying to build a new imaging center for ultrasound at UCSD, and so that's my number one priority. And then bringing more attention to pancreas cancer, I think there's an opportunity there. So the foundation and me will be here for another decade, but, you know, it'll be in that... business dev, market dev role. Like, we have... one full-time program manager and then three part-time. admin staff and me. You know, so... But Heidi's great. She's our PhD from Yale, and she's a program manager on the teams and just keeps them clicking forward for us. So I'm not going anywhere for now. And you know, I've got two big initiatives that I want to get done in the next 24 months, pancreas and ultrasound. Don, do you think in this new political and budgetary brave new world we find ourselves in, where the federal government, of course, the Trump administration, is cutting back funding, is there a renewed sense of importance that the canary model, the ability to interface with the private sector, the ability to interface with wealthy individuals, is that taking on a renewed sense of importance right now just because the dollars might not be flowing from the agencies? It certainly is noisy out there and people reaching in. And so next week as it turns out, I have a whole series of meetings with team leaders about what are the implications. Even just pragmatically, we have some of the best agreements in the world with institutions because we did them so long ago, like low overhead tax and stuff, and I don't wanna lose those, right? So, you know, one of these new big donors, I said, look, she said, Should I give the money to you or to Stanford? And I said, Right now, you should give it to me because I got 7% and you're gonna get 20, right, when you go in as a new donor because they're gonna be freaking out. So we have an asset there. How long is viable, I don't know, but I would say in a word... Everyone's confused. Everyone's confused, but you do have, there's a model that you have that can be emulated and that can grow. Absolutely. So, you know, Is private money Triply valuable now? It absolutely is. Yeah, yeah. Well done. Now that we've worked up to sort of figuring out what might come in the future, I think it's a little bittersweet, but I think we could wrap up these wonderful series of conversations. Let me ask some retrospective careers to bring it all together. Let's start first... In what ways do you feel like all that you've accomplished in this space... is a way to honor your mom's legacy. And I wonder if you've thought about all of the moms who are still with us because they were luckier than your mom. What does all of that mean to you as you reflect? Well, I haven't succeeded. All right. Em I think I can before. Igo. Pá. I think we can. Meaning that the motivation right now is that... Sadly, devastatingly, there's still too many other moms like yours. Even 20, 25 years later. Yep. I mean, right now, the tools we give women like Angelina Jolie, oh, you're bracket one, bracket two. Cut off your breasts and take out your plumbing. Holy God. We can do better. We will. So your perspective is... 25 years, 50 years in the future, we'll look back at this. We're still in like the barbaric period of cancer care. Boy, before antibiotics, we'd just say, how far is that infection? And we'd cut off the arm. Right? So I think we're very glad. I mean, everything else... Genetics, proteomics, methylation, all those technologies continue to get twice as good every year, and we will understand this problem, as long as at this point, there's enough money in the system. In the past, there weren't enough IQ points. That problem has been solved, I believe. There are enough IQ points and enough people dedicated to trying to get this solved. The other part, and why, you know, you think about it, where's the big money in these industries? Well, NIH funds. Drug companies fund And imaging companies fund. And the next goal for me on a market development point of view is to make the imaging companies give a shit about this new technology that can save lives. and money for them. If there were any do-overs for the past 25 years, knowing all that you know now... Would you have done anything differently? We need another whole session, dude! Come on, come on. What sticks out in your memory, knowing all that you know now, is there anything that you would have done differently as you approached this from the beginning? The people you talked to, the things that you funded? Oh, if I knew what I knew now... I would have tripled down on imaging a decade ago. Why? Because I think that's going to be the answer. I think what we've learned is the infrastructure exists. It's there, and all we need is, I mean, my God, this ultrasound stuff for ovarian is an injection that can be done in a GP's office. There's no cost structure, it's easy, and... What I knew now, I would have accelerated that, and I don't know if I could have given what happened with Sam and his family and whatever else, but... Well, I'm gonna freaking do it right now. Yeah, yeah. All right, so let's look ahead then, Don, the next 24 months. You mentioned two big initiatives. What's the best case scenario? What's the outcome there? Um... Ai Establish a relationship with this funding agency on pancreas that is strategic, not tactical, and I get a relationship at UCSD to build the world's premier cancer ultrasound detection lab. Who do you need beyond your own Rolodex, beyond your own capabilities? Who else needs to be brought in to make this happen? or no one. All the things are in place already. Um... The wild card is the administration and the funding. And whether or not that screws up the UCSD stuff. That's my wild card that I got to work on, and I don't know how to mitigate that at this point. I mean, who knows, you wake up every morning and go, what the hell happened today? But on the other front... I think the trust that we've established... allows us to continue to move on. I did say, I would say to you, I do wanna see... I think there's an opportunity for progress in the ovarian biomarker stuff, and I'm having a meeting with the head guy. Chuck, we've been doing this 25 years. What I don't want over the next five years is projects to fund scientists. What I want is, take a swing. Say, I think this is our best bet, take a swing and I'll fund it. Because we've been doing bottoms up for 25 years and we're no closer than we were. That's a hard-nosed engineer's kind of way of looking at things, right? Well, Don, on that note, two more questions to wrap up all these wonderful conversations. As the Stanford Canary partnership develops into an institute, Five years out, 10 years out, 15 years out, however you measure your own personal timeline, your own personal involvement, what are you most excited about in the ways that this could develop? Ou! I... It's a good question. I would say... if it we wēr The gravitational center of this, and then Sam died, we weren't. And I think being able to make that happen again and provide the leadership. You know, I, an aside, I go to these conferences, these annual conferences that Cambridge and Portland and ourselves, and we fund and everyone comes. And some of the conversations are the same conversations we had 20 years ago. Yeah, yeah. So I've reinserted myself and I said, look, people. We've done that. We know the answer to that question. And for instance, you know, it's like we had this one group from the UK come in and say, well, we have to provide equal access to everybody. And I said, and I stood on the stage and I said, absolutely not. I said the way technology development works is the rich get it first. And then they drive the cost down, because it's elastic. And then everyone gets it. Remember the cell phone. Remember internet access. So I don't want to get distracted about you doing anything but Cambridge suburbs and proving out the technology. So I got to get more vocal because a bunch of this stuff, we know the answer to, and people are rehashing old conversations, which we've put a fork in. Sorry, that was a little aggressive. No, it's uh and born out of well-founded frustration that uh the needle has got to be moved, right? Yeah, yep, absolutely. All right, Don, one last question. I'll make it, I'll make it a challenging one for you, but it's an important one. Let's say, let's just imagine, you know, beyond our lifetimes, 50 years from now, 100 years from now, you gotta hope that... Cancer is going to be something that is solved, or at least highly solvable. It's in a way better place than where we currently are circa 2025, both on what you've achieved up until this point and what you know is achievable in the next X number of years, not in terms of your own personal legacy or in terms of people celebrating or even remembering your name. What's most important that you feel like you have accomplished and that you want to accomplish that gets us from where we are now with all of the limitations that you know as well as anybody to where you think we can be, which is, of course, what is motivating you to stay on this train to get there? Well, look, I think the technology will get there. 10 years ago, I wouldn't have said that to you, but I think we will. What needs to shift in developing nations is the business model to deliver it. Because even in developing nations, it's different in, you know, there's no research funding in the UK. There's all sorts of delivery funding. So sometimes you go and work on delivery in a country like that. So do I think 50 years from now, cancer will largely be? dealt with in a pretty easy, perfunctory way, I do. Now, the other 10 billion people in the world, I don't know. And that's a problem above my pay grade. But I think that if we can solve the delivery problem and the technology problem, Somebody else can solve the problem, or... The scaling issue. The scaling issue. Okay, what a legacy. Don, I wanna thank you so much for spending this time with me. You're a legend in the field. There's so many people who admire you. If I have done my own little part to get the message out for the magic that is Don Listwin, it's my great honor to do so. So I wanna thank you so much for spending this time with me. It was great fun!