It was like switching out the engines mid-flight. I remember the day we turned on this free service, had we probably gone on for about six more months, I think we might have died as a company. That was a defining moment and that was as late as 2013. I think every great company has at least three near-death experiences.

Day one of my first job out of college, my boss found out that I didn't know how to enter data into Lotus 1-2-3. That's a spreadsheet—ask your parents. His mouth dropped open and he said, ‘I can't believe you got this job without knowing that”—and then walked out of the room. I went home convinced that I was going to be fired. I thought I was terrible at everything… but it turns out I was only terrible at spreadsheets.

[Laughs] It was hard. I was working at a biotech company in California, as you may know, and so biotech companies in the States, they want results, right? They have investors that give a lot of money, and they want results sooner than later, especially in the US. So you know it’s great that the company I worked at was willing to work on it and to persist in funding it, and all of our venture capitalists and so forth. And I think in a real way it was a testament to the power of the biotechnology industry, but also it was a lot of pressure on me to manage the programme and to keep it going, with years and years of failure basically. Yeah, so I got pretty desperate: ‘Surely we’ll do it before this one’s completed!’. [Laughs]

And some of the things that we saw in the ’80s, really, they were failures, because patients died. But they allowed us to diagnose the systems’ problems and say, “This is where we need a community health worker system. This is where we need to make sure patients have food support while they’re getting these medicines,” et cetera. So those are examples of tragedies that certainly lead to — not just personal epiphanies — but collective epiphanies, where you say, “You know what? We can do this better if we have the system fixed.”