April 23, 2014

Anne Wojcicki wants to bring health care into its sci-fi, Big Data era. First, she’ll need your DNA. Then comes vanquishing the FDA.


(Photo: Bobby Doherty/New York Magazine)

When Eugenia Brin was young and still living in Moscow, her beloved aunt Serafima received a diagnosis of Parkinson’s disease. Serafima was just 50 years old, with no access to effective treatment, so Brin cared for her in the way of close families, going after work to her apartment to bathe her and prepare her meals. “I loved her very much,” she says. “I watched her deteriorate, and it was pretty awful.” When Brin joined the Jewish exodus from the Soviet Union, immigrating to College Park, Maryland, in 1979, she began mailing therapeutic doses of synthetic dopamine to her aunt, but Serafima, unsure of when the next batch would arrive, hoarded the medicine, never using enough of it to bring much relief.

As she neared her own 50th birthday, Eugenia noticed her left foot beginning to drag. Parkinson’s is only inherited in about 10 percent of cases, scientists believe, and when Eugenia was diagnosed in 1998, she became “extremely upset,” she says. Like her aunt, she was young to be contemplating the disease, a relentless degeneration of neurons that ultimately throttles the muscles and creates hallucinations in the brain: “It does not stop,” she tells me. But Brin was also a parent, and like all good parents she felt responsible for her children’s future. If she had inherited Parkinson’s, she could also pass it on. One of her sons, Sam, was 11 years old. The other one, Sergey, had just founded Google.


At that moment, Google had three employees and was run from a garage in Menlo Park belonging to an advertising executive named Susan Wojcicki. In time, Wojcicki would become Google employee No. 16, and her younger sister, Anne, a health-care industry analyst, would marry Sergey and have two children, prospective heirs to Eugenia’s genetic legacy. Now Susan runs YouTube, and Anne is CEO of a company she co-founded called 23andMe (so named for the number of chromosomes in human DNA) that could help forestall that legacy—could “solve health,” as she puts it—by collecting the genetic information of a critical mass of humans on the planet. Anne launched her company with the conviction, which happens to be the conviction of many of her friends and peers, that health care in America is broken, inefficiently treating the sick while insufficiently supporting the well, and that, enabled by the power of Big Data, Silicon Valley can fix it—accelerating to light speed the development of drugs and therapies by harvesting unprecedented insights from a reservoir of the nation’s genes. By last fall, 23andMe had extracted and analyzed DNA from 650,000 people, making it one of the biggest genetic banks in the world. That was when the Food and Drug Administration stepped in. 23andMe was performing what it regarded as a medical test without its approval and without the oversight of any doctor, the FDA said, and until Wojcicki could demonstrate that those tests would inflict no harm, she was ordered to retreat from her quest to hoover up the world’s DNA.

But Wojcicki is undeterred. With 23and­Me, she wants to do with DNA what Google did for data—because, after all, DNA is data. Want to compare huge numbers of people with hereditary Parkinson’s disease against people who carry a gene for Parkinson’s but are healthy? Here’s a database of millions: All a researcher needs to do is create the algorithm. Want to look at genetic variances among people with very complex diseases, like diabetes, or Alzheimer’s, or coronary-artery disease? 23andMe can isolate disease groups and scrutinize the genotypes within them. Want to figure out why a tiny number of folks taking a certain multiple-sclerosis drug also get blood clots? Cull the patients from the database, email them a questionnaire, and compare answers. And then there are those connections algorithms might make between genes and health that humans hadn’t even thought to ask about. These results might efficiently steer scientists toward especially promising targets for research, and the resulting discoveries—drugs, surgical procedures, nutritional information, eyeglasses, sunscreen—might then be marketed back to individuals who 23andMe already knows are predisposed to osteo­arthritis or hereditary blindness or melanoma. It’s a vision of seamless scientific research that is also a business—like, say, Google—tempting you with products the data engine has already discerned you need.

23andMe collects that genetic information from individuals with a sleight of hand so quintessentially American that Tom Sawyer might have dreamed it up: It sells it to them. The first human genome was sequenced in 2003, after more than a decade of work and at a cost to taxpayers of $2.7 billion. But, over the next decade, the price of a gene-squencing chip plummeted while its capacity exponentially increased, and that chip is now the magical head of a pin on which a whole medical revolution could turn. By last fall, 23andMe could deploy genotyping technology to produce a personalized genetic report on more than 200 health conditions within three weeks for just $99—no prescription necessary. Customers spit into a tube in the privacy of their own homes, send the saliva sample to a lab, then wait for results, which arrive by email. The report gives users detailed ancestry information, the probabilities of their getting dozens of complex diseases, and their responsiveness to 25 drug therapies. It tells customers whether they have the BRCA1 mutations, which are associated with dramatically higher incidence of breast cancer, and whether they carry the genetic variant that corresponds to cystic fibrosis. It also provides party fodder: Do you smell asparagus in your pee? Are you prone to be addicted to nicotine or wired to run the 100-meter dash? To access all this tantalizing information, users have to agree to allow 23andMe to profit from their genetic data. “By providing any sample,” the terms of service read, “you acquire no rights in any research or commercial products that may be developed by 23and­Me or its collaborating partners.”

Eugenia Brin took Anne’s spit test in 2007, and the results revealed that she carries not one but two copies of a rare mutation in a gene called LRRK2, which is strongly associated with Parkinson’s in a small number of cases. Because Eugenia carries only the mutant version of LRRK2, she has only flawed copies to give to her sons; both carry one mutant version, putting each at a significantly higher-than-average risk for Parkinson’s. Sergey’s kids—one, a toddler, the other, 5—have a 50-50 chance of getting the gene, though their LRRK2 status has never been made public.

Sergey’s success has been good for his mother; formerly a computer scientist at NASA, Eugenia is now retired and lives with her husband in a house behind a tall hedge in Los Altos Hills in a neighborhood five miles from the Googleplex. Like Sergey and Anne, and like many of the other data geeks and tech wizards I met traveling up and down El Camino Real earlier this year, stopping in Palo Alto, Mountain View, and Menlo Park, Eugenia is a rationalist, the kind who might receive a test result not with panic or resignation but relief and something like empowerment. “There are things you can do,” she says.

But Eugenia Brin also grew up in what she calls “another world,” and experience has shown her how sickness or circumstance can shorten the lives and ambitions of even the most brilliant people. She sometimes feels anguish at the prospect that her sons might suffer. “I have a very strong hope” that they don’t develop Parkinson’s, she says, her accent still thick. “It’s a hope against hope, but a very strong one.”

For this reason, Eugenia regards the brazen confidence with which her American-raised children and their friends approach all problems with a mixture of fondness and bemusement. Sergey and his peers have changed everything about the world—research, shopping, sex, surveillance—and have been rewarded beyond anybody’s wildest dreams for doing so. It only makes sense that they might regard any challenge as surmountable, so long as they figure out the right tools, the right people, and the right approach to the question—even if that question is how to push back death or disease.

When I meet her on a Friday afternoon in January at the 23andMe offices, Anne Wojcicki has had a tough few months. In August, she and Brin announced that they were living separately after Brin’s affair with a Google underling became public gossip. Then, on November 22, Wojcicki received the FDA’s warning. The letter was irascible in tone, and it made head­lines. Many readers saw a culture clash: a ­tradition-bound government agency affronted by Silicon Valley arrogance, Google nepotism, and 23andMe’s critique of traditional medicine. The company “rubbed a lot of people the wrong way,” says Michael Nova, chief medical officer at Pathway Genomics, one of 23andMe’s competitors in a fast-growing field. Wojcicki got wind of the forthcoming warning while at a three-day corporate retreat: “I felt slapped in the face from out of left field,” she says. After receiving the letter, 23andMe stopped offering health reports to new customers, though it still provides ancestry information to them, and sales have dropped significantly.

At 40, Wojcicki is a no-makeup person, the kind who wears sneakers and ripped jeans to work, and her conversational manner is casual, too. No is a word she takes as a challenge, she says. She may have been naïve in her dealings with the FDA, but now she is devoting every ounce of the company’s resources to satisfying the agency’s requests: “We’re playing in the big boys’ world,” she tells me. On the day of my visit, as we are talking in a small conference room, a knock comes at the door and an assistant with a purple streak in her hair pokes her head in. Wojcicki breaks off: “I just have to sign some papers.”

There’s a letter to the FDA, and supporting documents, and previous correspondence, and duplicates. “Here’s a blue pen,” the assistant says.

“Blue,” answers Wojcicki, putting down her black one. She scribbles. The pages have to go to Maryland by FedEx tonight; there’s a conference call on Monday, with 23andMe asking for a second chance, essentially, to prove to the FDA that its spit test can meet its approval. That it has taken 23andMe almost eight years to focus on this obviously crucial task has drawn a fair amount of comment, but the breakdown between the company and the FDA illustrates a profound divergence in their respective ways of thinking about consumer health as much as it does mismanagement within 23andMe. Now that she is in triage mode, Wojcicki seems to be channeling a former self, one that used to work long days and nights on Wall Street. Over the summer, she says, she was enjoying the therapeutic effects of regular meditation. Since the fall, “the guy I meditate with keeps emailing me, and I’m like, ‘Fuck you, I don’t have time. I’m drinking coffee and eating bacon and swearing a lot.’ ”

Wojcicki grew up in Palo Alto, the youngest child of a Stanford physics professor and a journalism teacher, the kind of parents who would take their three daughters to an all-you-can-eat salad bar and make them share plates. Easily bored, she has passed through health fads at warp speed: She gorged on low-calorie Snackwell cookies in college but more recently discovered the benefits of fasting. At 23andMe, there’s CrossFit three days a week and yoga on Tuesdays, and a sports masseuse sets up in the office every week.

But Wojcicki was always rebellious, a younger sister impatient with people telling her what to do. In this, she was temperamentally well matched to Brin. On their first date, she told theTimes of London, the couple went Rollerblading in New York; one time, after taking circus classes, Brin called her up: “Want to learn how to throw knives?” he asked.

Though her parents disapproved of her joining a hedge fund upon graduating from Yale, Wall Street was a good fit. Wojcicki loved the swagger of finance, the macho pose she characterizes as “I’m so fucking awesome,” but she didn’t see anything like that dynamism in the business of health care. Researchers guarded discoveries from their peers, slowing the pace of cures. Pharmaceutical companies cared more about selling the greatest number of drugs than they did about innovating therapies for maximum efficiency. “ ‘Yeah,’ ” she says during our talk, in the hey-guy tone of a pharmaceutical marketer, “ ‘we know our drug doesn’t work on everyone; it’s not our problem to figure it out.’ ”

The bright spot was biotech—genetics companies in particular. Before the completion of the Human Genome Project, geneticists could test for a very few, rare, heritable diseases, like cystic fibrosis and muscular dystrophy. After it, scientists could “see” the whole thing: 3.2 billion pairs of nucleic acids, arranged in tangled, dreadlocked threads. But what most of the genes meant, how they worked, which ones caused disease, and under what circumstances—this was entirely unknown. Big Data gave scientists the tools they needed to explore the genome in a meaningful way.

“It was so exciting,” Wojcicki remembers. “You could see the revolution coming.” The earliest discoveries were based on small sample sizes, in the thousands or tens of thousands, but “I saw that there was this potential: What if you could get millions and millions of people to share their data?” At the time, Wojcicki was already dating Brin. “The rest of your life is optimized because of Big Data,” she says today. “But it isn’t for health care, and that’s fundamentally the most important thing for you.”

Wojcicki may be Google royalty, but she’s also a civilian with two small children and uses Amazon all the time. The company “knows exactly what I want before I log in. Literally. ‘Oh, you’ve been buying Star Wars and princesses and camera equipment.’ They just know! Based on my past. Why isn’t health care like that? They should totally say, ‘Hey, you’ve been eating this, you’ve been exercising that amount, your genetics this. Hey! Here’s some recommendations for you.’ ”a3d76

Wojcicki launched 23andMe with $9 million, about half from Google, and two missions. The first, according to the executive summary by Wojcicki and her co-founder, Linda Avey, was to give people access to their own genetic information. “It’s theirs,” Avey told me over coffee in Palo Alto one morning. “It belongs to them. Get rid of the paternalism.” This goal had undeniable Silicon Valley sex appeal, the spit test a perfect holiday gift for the self-obsessed technophile. In the company’s first several years, Rupert Murdoch spit, as did Yo-Yo Ma, Eva Longoria, and Jimmy and Warren Buffett (the test discovered no relation).

The second goal was “creating the world’s largest secure, private database of genotypic and phenotypic information that can be used for comparison analysis and research.” This was a much harder sell. For one thing, it was difficult to explain. It raised questions about privacy and the ownership of intimate human material that evoked the various misdeeds of history’s racist eugenicists. And then there were the questions prompted by the company’s business model, which makes the database its profit center—an information mine, in essence, that charges fees for use. What are the ethical parameters of a system in which a user pays to hand over rights to his or her genetic data and then stands by as a company profits from it? 23andMe safeguards user identity by keeping names, credit-card numbers, and addresses separate from the genetic data itself, and it says a customer can withdraw from the database at any time. Nevertheless, the company’s own terms of use contain an explicit warning: “Genetic information you share with others could be used against your interests.”

Also, the practical challenge was huge. For the database to be really useful, 23and­Me had to sell millions of spit kits. And to revolutionize science in the way that Wojcicki and Avey envisioned, the company had to collect all kinds of data beyond genetics, since correlations can only be made if you know about a person’s genotype together with his or her manifest health. 23andMe had to know a user’s family history, drug allergies, and personal habits, and whether the subject takes vitamins and how often he or she exercises. In the founders’ ideal future, all data sets would be compatible so that 23andMe (or a company like it) could integrate into its algorithms every bit of the world’s quantifiable data: pollution centers and weather patterns, commuting times and the daily schedule of your coffeemaker, your life on Tinder or Grindr, the number of cigarette sales and yoga studios in your neighborhood, proximity to a Whole Foods and what you bought there last Tuesday.

For this reason, the 23andMe user interface is very “sticky.” It has a social component that allows you to connect with other people who share your genes. Before seeing a health report, you are asked to fill out a lengthy medical history. And then, every time you log in, there are more questions to answer. “Lisa Miller,” my page quizzed me recently, “do you cry easily?”

Eugenia Brin’s Par­kinson’s was vexing Wojcicki even before she founded her company or had children of her own. In 2004, she urged Sergey to attend a meeting in Menlo Park at which the biotech company Perlegen was presenting the results of a Parkinson’s study. The following year, researchers discovered the connection between Parkinson’s and the LRRK2 variation: In 2006 the New England Journal of Medicine showed that the variant, while very rare, was more common among Ashkenazi Jews. Anne called around, trying to get an LRRK2 test for Sergey. “I was told uniformly that there’s no reason to test him. ‘It’s very unlikely that he has it,’ people said, ‘and even if he does, what would you do?’ ” Wojcicki pauses at the memory. “I found their responses so obnoxious. It was like, really? It’s information. I want to know.” When the scientists at 23andMe were deciding what their kit should test for, they made sure the LRRK2 mutation was on their chip.

It was Anne, in fact, who alerted Eugenia and Sergey to the presence of the LRRK2 variant in their genomes after spending an afternoon at the kitchen table browsing through the family’s 23and­Me reports. She saw the double mutation in Eugenia’s data and immediately called her office to make sure she was reading it right. “I was like, ‘Sergey’s mom has two copies,’ and they were like, ‘No, that doesn’t really exist.’ ” The results confirmed, Anne called Sergey. Then they called his mother.

Brin has written that discovering the LRRK2 variant within his own genome was transformative. “I know early in my life something I am substantially predisposed to,” he wrote on his blog in 2008. “I now have the opportunity to adjust my life to reduce those odds (e.g., there is evidence that exercise may keep Parkinson’s at bay). I also have the opportunity to perform and support research into this disease long before it may affect me.” Brin declined to speak for this story, but a recent article in Vanity Fair suggested that Brin might have stepped out on Wojcicki because the specter of Parkinson’s in his future triggered an emotional crisis. Wojcicki wouldn’t talk about the split but affectionately uses the married “we” in reference to her family, and when she talks about who’s picking up the kids and what the chef is preparing for dinner, Sergey is implicitly present. And so is the prospect of Parkinson’s.

Was there a moment, I ask Wojcicki, when you and Sergey decided to devote yourselves and your resources more aggressively to Parkinson’s research? “There was never a plan,” Anne remembers. “I’m action oriented. It was more like, ‘We should probably meet Michael J. Fox more. We should probably give him a lot of money.’ ” Brin has said that if he knew that a billion dollars would cure Parkinson’s, he would write the check in an instant, and since his 23andMe results came in, he and his wife have developed a symbiotic relationship with the Michael J. Fox Foundation that involves so much mutual admiration, and so many dollars passing back and forth, that the lines between the two organizations can seem sometimes to blur. Wojcicki and Brin have donated more than $150 million to the foundation, and the foundation has established 23andMe as a “research partner,” working with it on Parkinson’s studies and donating half a million dollars to its Parkinson’s efforts.

At home, Anne made Parkinson’s prevention a family project. A zealous believer in exercise, she hired a trainer for her in-laws. Brin started springboard diving and drinking green tea. “If Sergey gets Parkinson’s,” Anne says, “I’d like to be able to say, ‘I’ve put my best foot forward and we’ve done everything we can to effect change.’ ”

At work, she was even more hard-­charging. In 2009, Wojcicki announced that, with help from the Fox foundation, 23andMe would begin amassing the largest collection of genetic data from Parkinson’s patients in the world. And in the fall of 2011 that work appeared to have paid off. 23andMe researchers discovered a genetic factor called SGK1 in a number of people with the LRRK2 variant who did not have Parkinson’s. The implications were enormous: Did SGK1 fend off Parkinson’s? Could drug therapies be developed that emulated those effects? And what would the timeline be, in a medical universe still governed by long-burn clinical trials and FDA approval? Would it arrive in time to help Sergey? His children? Their children?

23andMe issued a press release an­nouncing “the first-time discovery of the potentially protective nature of” SGK1, as well as that $500,000 grant by the Michael J. Fox Foundation to the Scripps Research Institute to explore the development of a new drug. “Sergey Brin’s Wife Might Have Figured Out a Way to Save His Life,” wrote Business Insider.

Then Wojcicki made a misstep. She announced on the company’s blog that 23andMe had won approval for a broad patent protecting all the company’s Parkinson’s-­related genetic discoveries. From the beginning, 23andMe had staked out, in public at least, a radically democratic stance: It would give genetic information, formerly meted out at the discretion of an anointed few, directly to the people. Linda Avey, especially, had forcefully opposed the patenting of gene discoveries (“I disagree fundamentally that you’ve invented anything,” she says), a battle line around which skirmishes frequently flare in the biotech world. Avey says she hadn’t known about plans to patent; she left the company in 2009. “If I’d known they were going to patent genes, I wouldn’t have signed up,” tweeted an eminent British geneticist. Wojcicki had promised to “democratize genomics,” but a patent looked like a profit-making play.

It was. Wojcicki belongs to a group of entrepreneurs who see profit-seeking as the quickest path to a greater good and profitability as the best proof of intrinsic value: “I’m always thinking in the back of my mind, If I’m someone with Parkinson’s or sarcoma, what do I want the company to do with my data?” Wojcicki patented her Parkinson’s discovery, she says, because she wanted it to be as alluring as possible to pharmaceutical companies doing drug development, and her lawyers assured her that no pharma company will even look at a target unless it knows it’s exclusively theirs. You can always give your discovery away later, Wojcicki argues, but you can’t make that choice unless you lock it up first. “There’s not a business if we don’t own the aggregate data,” she told me.

In the end, Scripps came up empty working on LRRK2 and SGK1, finding nothing meaningful in the association—a sign that the patent was even more speculative than it might have seemed. But this failure does not shake Wojcicki’s determination. “My science team doesn’t like to talk about SGK1 as much because it didn’t pan out. But you only succeed once you’ve failed enough times. We should revel in tons and tons and tons of ideas. Some of them will manifest and lead to a drug discovery, and some will not.” In the meantime, the family will wait.

Igot my own 23andMe results through a loophole: The company’s publicist had squirreled away a stack of spit kits manufactured months before the November warnings. The bar code on the kit I was given was pre-dated, in effect, and in March, I received my report.

My first thought was: There has been some mistake. This couldn’t be me. For one thing, the report said I was likely a sprinter, which I am emphatically not, and that I was lactose intolerant, when I’ve never had a problem polishing off a cheese plate. Moreover, coronary heart disease sat at the top of my “Health Risks” list, giving me a 34.2 percent chance of it—well above the average risk. I worry about a lot of things, but my heart has never been one of them. Doctors are always complimenting me on my blood pressure and slow pulse. My cholesterol levels are, frankly, enviable. Members of my family have died of all varieties of cancer (including colon cancer, for which I’m at high risk, according to 23and­Me) and Alzheimer’s disease (lower risk), but never heart disease. Most incredibly, it said that my eyes are “likely brown.” They are definitely blue. “What is this, astrology?” my husband asked. “What good is a test that knows less about you than a stranger on the street?”

Wojcicki believes that, though 23andMe had been in conversation with the agency for years, it drew the special scrutiny and ire of the FDA in August, when the company began running national television ads with the slogan “This is me.” (The FDA would not comment on the specifics of the dispute for this story.) The ads show earnest, good-looking people of all ages and ethnicities looking at the camera as if it were a mirror, professing that their 23andMe results unveiled invisible truths about themselves. Through 23andMe they might find out about unknown ancestors, hereditary diseases, and food sensitivities. They might change their lives, their diets, and their approaches to procreation with the knowledge unlocked by a simple genetic test. “Change what you can. Manage what you can’t,” the ad intones.

The commercials were provocative for two reasons. First, they signaled the company’s ambition to operate on a mass scale—to become truly a national genetic database rather than the DNA equivalent of a FitBit. Several months before the ads aired, the company hired Andy Page, formerly the president and CFO of Gilt Groupe, to be its president. “You can read it between the lines of the warning letter,” says Felix Frueh, who ran the genomics department at the FDA between 2004 and 2008. “FDA said, ‘Now you’ve passed the threshold, and we’re not okay with that.’ ”

Second, the ads prompted scrutiny of the obvious question: Are the company’s claims valid? That is, does the 23andMe kit give consumers true information that they can apply to their lives? The FDA intervenes when something it regards as a diagnostic test is being sold over the counter, which is why it chooses to directly regulate the pregnancy and HIV tests at the drugstore but not the blood, urine, or gene tests your physician orders for you. It cares when a private company tells you that you have a gene that might kill you and sends you that tidbit in an email, which you can open alone, at night, without anyone near for comfort or consultation. When the FDA raises questions about the reliability of the company’s reports, it really is this disintermediation that concerns the agency. 23andMe uses state-of-the-art technology and draws its results from an accredited lab, which means 23andMe probably isn’t going to get your genes wrong; the worry is more about what the company will tell you about those genes, and how you’ll interpret that information. (In contrast to more expensive whole genome sequencing, 23andMe’s genotyping technology gives a representative but incomplete picture.) The FDA would concede that Big Data is already an extremely useful tool for exploring the relationship between genetics and health; it’s even possible that in some near-term future 23andMe’s reports could be a reliable guide to an individual’s health-care choices. But that is not the state of state-of-the-art genomics today, a point that Wojcicki acknowledges, too, in her own way. “Over time, we’re going to learn more things, and we’ll refine the results,” she says. “Lots of things are going to change, but we’re going to have to embrace that rather than be fearful.”

What the conflict between the FDA and 23andMe boils down to, then, is an epistemological dispute over what counts as scientific knowledge. Traditional science works in a straight narrative line, from the specific to the general. Hypothesis, experimentation, proof, thesis. Petri dish, mouse, human, Rite Aid. It’s an incremental, slow-moving process with visible outcomes; the standard of replication is intended to ensure that results are reliable and enduring. A single human person is always at the center of the story, and the cure or treatment of that person is always the goal in mind. Big Data computer science works in an opposite direction. It starts in the cloud, from within a massive universe of information, and through algorithmic queries seeks patterns and similarities that reveal general insights about whole populations—insights that can accommodate some misperceptions and mischaracterizations about actual idiosyncratic humans, because Big Data is not designed to perform at the level of the individual.

And, at that level, science still knows very little about how genes work—or about how much, exactly, they matter. Inherited eye color, which you learned in high school was a simple matter of dominant browns and recessive blues, is in fact a much more complicated story, and although the overwhelming number of people with my genotype have brown eyes, a few of us (1 to 7 percent, according to 23andMe) have blue. Most diseases are activated not by one gene but by many, and though sometimes scientists know which genes correlate with disease, they have not established causality: how genes trigger the disease and under what circumstances. Unpublished research shows just over a hundred genetic markers associated with schizophrenia, for example, but “our ability to predict schizophrenia is basically zero,” says Daniel MacArthur, a geneticist at Mass General. In all, “we only understand about 10 percent of genetic risk,” MacArthur says. “It’s not so much a fault with 23andMe; it’s a fault with the complexity of genetics. They do a pretty good job, but it just turns out that genetics sucks.”

Perhaps that’s why I disbelieved my 23andMe report. My genome is not, in fact, me. It’s only part of me. Try as it might, 23andMe doesn’t know so many things about me—some of which I don’t know myself. What was my mother’s diet when she was pregnant with me? How was her mood? How did my stint on the JV lacrosse team affect my future heart health? What about my late-in-life pregnancy, or the fact that I’m the oldest child and have brothers but no sisters? In light of all there is to know about me, and all that’s unknown about how environment and genes work together, a to-the-decimal-point prediction of heart disease is easy to push aside, a tiny-seeming data point alongside an entire lifetime of accumulated understanding about risks and proclivities and vulnerabilities.

But family medical histories elide things, too. Always anecdotal, always selective, they only tell one side of the story, an unconscious narrative choice that we hope may defend against sickness and even mortality itself. My people don’t die like this. I am about to discount the report, and in particular its warning about my alleged heart problems, when I remember something. Last summer, just days before her daughter’s wedding, my paternal aunt, who was not yet 70 years old, had a “small heart attack,” according to a note I received from my father. She was “fixed up with one stent and is going home today.”

Wojcicki is unsettling in person. She is tiny and extremely fit. She is charming, smart, funny, sarcastic, and voluble, with none of the gracelessness common to Silicon Valley’s visionaries. If anything, she seems too normal to be revolutionary—and at the same time too rich to ever be remotely normal.

Late last year, before an audience in Santa Clara and in the presence of Walt Mossberg and Kara Swisher, the high priest and priestess of technology journalism, Wojcicki was asked to share her favorite gadget. With a flourish, she pulled out of a satchel a bulky rectangular handheld device with a probe, which looked like it might have been dreamed up by the Star Wars props department. It was a volatile-organic-compounds—or VOC—monitor, which measures the level of evaporated chemicals in the environment. Inspired by a test she and Brin once took that gauged the toxicity in their bodies and found that she was especially high in flame retardants (thanks to long hours in coach airplane seats), she measures her furniture, her bath soap, and her face lotion; when she was shopping for a new car, she measured them, too. Particularly high in VOCs was the upholstery on a certain couch in the 23andMe offices, she said. “That’s the FDA couch?” joked Swisher.

Wojcicki puts up her hands and begins to laugh. “I’m just saying, when visitors come, sometimes we let them sit there longer than others, depending on how much we want them to absorb.”

In Silicon Valley, what used to be called “wellness” has been elevated to a religion, and Wojcicki is one of its evangelists. But what’s so likable about her is her defiance of any orthodoxy. She eats mostly raw these days but indulges in the occasional hamburger. While so many of her peers are counting calories with FitBits and measuring their heart rates with Basis watches, Wojcicki maintains an offhanded allegiance to gadgets. She had a Jawbone Up but lost the charger, and accidentally ran her FitBit through the wash. When she was at Yale, she tells me, she majored in biology and loved lab work, but precision wasn’t her thing. “I was like, If you run an assay for 10 seconds or 13 seconds, who cares? People in the company know I like the big picture, not as much specific detail.”

The big picture is the fight for her company, which she believes could deliver a life span 10, 20, or 30 years longer than it is now—for her, Sergey, their kids, and everyone else in the world. This obsession with longevity is not Wojcicki’s exclusively. Many of the wealthiest people in Silicon Valley share it, a side effect, perhaps, of possessing every good thing existence can provide—wanting more of it and not understanding how anything could be out of reach. Last year, a group of tech billionaires established the Breakthrough Prize in Life Sciences, six $3 million annual awards given to scientists working on curing “intractable diseases” and extending human life. Facebook’s Mark Zuckerberg and his wife, Priscilla Chan, are among the sponsors of the prize. So is the venture capitalist Yuri Milner, an investor in 23andMe. So is Art Levinson, the biotech guru who was the CEO of pharmaceutical giant Genentech, sat on the board of Google, and is now chairman of Apple. And so are Anne Wojcicki and Sergey Brin.

In September, just a month after Wojcicki and Brin announced their separation, Google announced the launch of a new venture called Calico. Though its exact mission and purpose remain unclear, the general idea is for Calico to “solve death,” as Time magazine put it, in an uncanny echo of Wojcicki’s promise to “solve health.” Google did not look very far for its Calico staff. It hired Art Levinson to run the company. And Cynthia Kenyon, a geneticist at UCSF known for manipulating the genes of roundworms to lengthen their lives—and who supervised some of 23andMe’s anti-aging research—is now a scientific adviser to Calico. So although Wojcicki insists that the two companies are not competitors, it’s hard not to see them as rivals. On my recent trip to Silicon Valley, more than one person I spoke with joked that the obvious solution to 23andMe’s current problems is to be bought by Google.

But Wojcicki is tenacious. She is known for her independence and for her determination not to let her powerful husband or his behemoth company subsume her. When I met with her, she had just had dinner with Levinson. Sitting Indian style in her chair, she looked, in her jeans and ponytail, much more like 26 than 40. We were talking about longevity, and the possibility of developing drugs to promote it, and she mentioned, almost in passing, that at dinner, Levinson had told her that clams live forever. “And I was like, ‘Really? If only I was a clam.’ ”

“That can’t be true,” I say.

“Apparently they do,” Wojcicki responds.

“Nothing lives forever,” I say.

“Apparently clams,” she says.


The following day, at my hotel, I receive a clarification from the 23andMe publicist in the form of a Wikipedia link. There was a clam named Ming that lived to be 507 years old and died in 2006 as it was being experimented upon by researchers in the U.K. No one knows how long Ming might have lived had the scientists left it alone.


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