Emi Gal
@emigal
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Founder & CEO / CTO @ezrainc , on a mission to detect cancer early for everyone using MRI & AI. Coder / ML engineer / biohacker on weekends. ❤️ @sabina_gal
New York, NY
Joined April 2007
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Pinned Tweet
Excited to announce that
@ezrainc
has raised $21 million in a round led by Amir Dan Rubin from Healthier Capital. Prior to starting Healthier Capital Amir was CEO of Amazon's One Medical, and is one of the most accomplished healthcare entrepreneurs in the US. The round was co-led
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My goal in life is to make cancer the smallest drug market by far.
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I believe we have a cure for cancer.
Early detection.
Here’s how
@ezrainc
plans to detect cancer early for everyone in the world (the secret Ezra master plan):
Step 1 (done):
Launch a 60-minute full-body MRI that screens for cancer and 500 other conditions in up to 14
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2. In a non-linear / fat-tailed system, it's important to be convex, not concave.
Convexity = positively exposed to an extreme event; think of a 🙂.
Concavity = negatively exposed to an extreme event; think of a ☹️.
It's better to be convex than to be smart.
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1/10: I turn 35 this year, so I’ve been researching what I should do in order to minimize risk of death at 35, while optimizing for longevity - aka do things now that will have a positive impact on my health for when I'm 65 years old. A thread on my learnings:
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1. Most real-world risk comes from fat tails.
WTF is a fat tail?
A fat-tailed system is one that is governed by a power law distribution (as opposed to a gaussian distribution).
In a fat-tailed system, one single event drives all the outcomes.
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But let's look at the wealth of these 100 tweet readers.
The average wealth of 100 people reading this tweet is, say $150k. But if Jeff Bezos somehow starts reading this as well (hi, Jeff!), the average wealth goes up to $1B. That's a power law. One event changes everything.
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6. Assess risk by optimizing for sleeping well at night.
Sleeping well gives you a 6th sense. Not sleeping well? You probably have too much risk somewhere. Clip your risk.
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10. My favorite heuristic from the whole program came in a session by
@financequant
:
Community is the ultimate hedge.
So in a way,
#RWRI
actually *is* the ultimate hedge - a community of real-world risk takers on a lifelong journey to take risks and learn from them.
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4. Concavity leads to ruin, and to protect yourself from ruin you should apply the *barbell strategy*.
WTF is the barbell strategy?
Put 90% of your stuff in safe stuff (e.g. cash), and 10% of your stuff in risky investments (e.g. crypto - sorry Nassim!)
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Huge thank you to
@nntaleb
,
@financequant
,
@normonics
,
@drcirillo
, Raphael Douady and the rest of the
#RWRI
team for creating such an incredible program.
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9. Only the hyperparanoid survive.
There *will* be a market drawdown, and if you haven't clipped your tail (aka mitigated your risks), you're ngmi.
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3. Ok, but how do you know if you're concave or convex?
The genius 1+a / 1-a rule.
Say you have $100 in a portfolio and calculate that if the market goes up by 10% (1+a) you have $110, but if the market goes down by 10% (1-a), you have $75.
You're obviously concave.
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8. Volatility is good, as volatile things are more antifragile.
As crazy as it may seem, it's safer to be an Uber driver than an investment banker, as you're more adaptive to unforeseen events.
The banker can get fired. The Uber driver can start doing Uber Eats if necessary.
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@EricRWeinstein
I grew up in communist Romania in a blue-collar family and can confirm tweet is 100% accurate.
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b) expose yourself to 1/N.
If 1 event drives all outcomes, you have to be exposed to that 1 event. So - own a portfolio of things. Don't put all your eggs in one basket.
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5. Ok, but how about convexity you ask. You want to be convex, right?
Two strategies:
a) tinker + trial & error: how do you end up with better spaghetti carbonara? By having a bunch of food lovers try various recipes, or by having chemists design one?
I know which one I'd eat
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7. You've heard that correlation is not causation, right?
Well - guess what. Correlation is actually not correlation.
Here's a good heuristic for that statement: take your grandma's blood pressure and you can probably find a stock that correlates with it.
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I grew up in post-communist '90s Romania. My parents were factory workers.
Today, I run a company that's saving people's lives every week.
Nowhere else would this have been possible than the United States of America.
Happy Independence Day 🇺🇸
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Here's an example:
Let's say 100 people are reading this tweet. The average height of the 100 people reading this tweet is 5'4". If LeBron James starts reading this tweet as well, the average height doesn't change much. Maybe it's now 5'5".
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Daily Cover Story on
@Forbes
today: Meet The Bryan Johnson-Approved AI Full Body MRI Startup That Just Raised $21 Million.
Couldn't have hoped for a better endorsement for
@ezrainc
than a nod from the most measured person in human history - thank you
@bryan_johnson
.
Link
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The first money I ever raised as a 20-year old Romanian founder with a weird accent was from
@seedcamp
. Thrilled to see that
@rsohoni
and the Seedcamp team are getting the recognition they deserve.
A record twelve investors from Europe, Israel and the Middle East appear on the 2022 global
#ForbesMidas
List. Here’s what some of the region’s top listmakers say is driving the venture boom, from Accel and Index to Sequoia and Seedcamp.
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Early detection is our best chance at beating cancer.
The
@ezrainc
Full Body MRI can help you screen for cancer in 13 organs.
The most frequent question I get when talking about what we do at Ezra, is how we handle false positives. Here’s what we do:
Incidental findings can
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I love learning new programming languages, so I spent a few hours today learning
@JuliaLanguage
.
TL;DR: it's incredible and might become a good alternative to Python over time. Here are my first observations (writing this for myself so I can come back to it in a few years).
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10/10: I’ve written a longer essay about all these recommendations, together with references to ~40 research papers: . Thanks
@edyson
@balajis
@kimballscott
for reading drafts of this.
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The Waymo experience in San Francisco is a marvel of technology. Indistinguishable from magic.
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Beat Cancer
Pitch your service/product in 2 words.
This one is a bit more difficult.
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Meet one of our
@ezrainc
members:
Sam’s doctor told him he was the healthiest 72 year old he had ever seen. He has run well over 200 marathons in his life, and conquered 10 ironman competitions.
Even though he showed no symptoms, exercised regularly and ate healthy, his doctor
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For some reason I feel
@bgurley
might have some thoughts on this.
Online automobile seller Vroom’s stock opened 83% above its initial offering price. The strong debut follows two other successful tech IPOs this year
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Some exciting news at
@ezrainc
today: we have raised $18M led by
@rickheitzmann
, founder of
@FirstMarkCap
, and we are introducing the Ezra COVID 360 - a LDCT lung scan paired with an antibody blood test.
More about the news here:
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I’m incredibly excited to announce that
@ezrainc
has received FDA 510(k) clearance for our Ezra Prostate AI — the first ever prostate segmentation AI to be cleared by the FDA. More details here: . Short thread on what this means for the Ezra Prostate MRI.
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Got access to
@MightyApp
this past week and have been giving it a spin. Some initial thoughts.
TL;DR: it's FAST!
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I am incredibly excited to announce the
@ezrainc
Full-Body Scan, covering up to 13 cancers in women, 11 in men -
@TechCrunch
@jshieber
. Sign up today at
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I’ve done 100s of hours of research on the science of longevity (so you don’t have to).
Here’s my protocol for longevity:
1st - As silly as it may sound, be careful crossing the street
Motor vehicle accidents are the leading cause of death in young people.
Look 3 times when
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Ezra Full Body Flash is now live at the majority of our facilities. The world's first 30-minute Full Body MRI, priced at $1,350.
You can sign up here:
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Marc Andreessen strikes again, with a phenomenal essay on AI. Best thing you can read on the whole wide web right now:
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Loved seeing this by
@SurbhiSarnaSF
in the new
@ycombinator
request for startups.
If only there were a startup working on literally every single one of the things below... 🤔 👀😃
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I do a 24 hour water fast once per week.
I simply eat dinner, and then don’t eat dinner until the next day. It’s gotten easier with time.
Why do I do this?
Fasting offers several benefits, including:
• Reduced inflammation
• Enhanced brain function
• Cellular Autophagy
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Silicon Valley is wrong.
They say if you're a non-technical founder, you should hire a technical co-founder.
I believe you should become technical yourself.
Learn to code; it's not that hard.
If you're smart enough to run a startup, you're smart enough to code or hire a CTO.
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I'm quitting alcohol for a year in 2022. Short thread on why I'm doing it, and why you should consider quitting as well.
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3/10: Things you should do every day:
- Sleep 7-8 hours
- Exercise
- Practice meditation or yoga
- Eat healthy food, not too much, mostly veggies
- Do intermittent fasting (skip breakfast or dinner)
- Get a cold shower in the morning
- Spend time with people you love
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My first startup was one of the largest video ad tech companies in Europe.
I thought my second startup would be easier.
Here's the truth:
• Only 4% of all startups make it to $1M ARR
• Only 0.4% of startups make it to $10M ARR
• Only 0.04% make it to $100M ARR
That means 1
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I bought a CO2 monitor after seeing it on
@photomatt
's December list, and have been carrying it with me everywhere.
A couple of nights ago I got to one of those hotel rooms with windows that don't open. I didn't think much of it, went to sleep, and woke up in the morning with a
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Why I’m taking statins in my 30s (and why you might want to as well):
I want to share something that’s been on my mind lately—taking statins in my 30s.
It’s not a decision I made lightly, but after considering the research and my family history, I felt it was necessary. Turns
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Got my annual
@ezrainc
scan this morning. Went with the Ezra Full Body Plus, which includes a Full Body MRI + low-dose CT of the chest + Coronary Calcium Scoring.
Short 🧵on the types of things you can find in an Ezra scan, and why I do mine annually (just the MRI part)
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One of my biggest learnings from almost 20 years and 2 successful startups:
Focus is everything.
It’s not unheard of for a unicorn with a billion dollar valuation to raise $300M… only to go bankrupt a few years later. Why? Because they tried to do 𝘁𝗼𝗼 𝗺𝗮𝗻𝘆
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Breezed through 400+ emails from this week in 2hrs thanks to
@Superhuman
. They've built the absolute best GenAI integration out there:
Cmd + J, you type in what you want to respond in brief, and it composes an email in your voice. It's magic, congrats
@rahulvohra
and team!
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Given this is a significant milestone for Ezra, we wanted to tell our story in depth and lay out our master plan in detail.
So I'm thrilled that
@packyM
has agreed to write a deep dive on Ezra. It went up this morning, and it's a thing of beauty:
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An important learning for me over the years has been that physical health is upstream of mental health. It’s hard to get the latter without the former.
Startups are hard, and I’ve had many moments of deep anxiety and depression over the years. During these moments, I have found
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Very excited to announce that
@ezrainc
has partnered with
@RAYUSradiology
to bring full body MRIs nationwide.
Ezra now works with all major outpatient imaging networks in the US.
More here:
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What. A. Speech.
Don't be a loser. Don't be weak. Conquer your mind. Choose strength.
Wow. Wow. Wow.
Incredible powerful message (incredible speech writing)—to those who stumbled on the wrong path and may ruin their future for not knowing the past.
The weight of history
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I was able to routinely run < 7 min miles in my 20s. Trying to get back to at least 7:30 / mile by EOY
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I started
@ezrainc
to detect cancer early for everyone in the world.
But most people don’t know the other life-threatening conditions we detect, so I’d like to take some time to bring these to light. Here are 3 of the most common ones:
1. Fatty liver disease
We find fatty
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Women account for more than 70% of people affected by chronic pain.
The worst part?
Until 1993, women were mostly excluded from clinical research due to pregnancy concerns or hormone variability, leading to a lack of medical data regarding women.
This is why I’m so excited for
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The current standard of care for prostate cancer is broken and, um, unpleasant (to say the least).
Today I’d like to talk about why that is, and what we’re doing at Ezra to solve it.
The current standard of care:
First off, in order to test for prostate cancer you will undergo
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Really good piece by
@daisydwolf
and
@vijaypande
at
@a16z
why *now* is the best time to build a technology company in healthcare:
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3 companies using AI to shape the future of healthcare:
Every few decades, a technological paradigm shift opens a window of opportunity to create what we previously thought was impossible. Artificial intelligence represents one of these paradigm shifts.
Here are 3 companies
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What's crazy about the US higher ed system is not that it's subsidized - we have that in most of Europe - but the insane cost.
4 years of CS + Applied Math costed me $2400 in Romania a decade ago. It's about $4000 now.
20x lower than the US. What explains this difference?
The student debt crisis summed up in 3 quotes:
Everyone knows these students will end up financially ruined.
No one cares.
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Our mission from Day 1 was to create an affordable way to get screened for cancer everywhere in the body.
Step 1 was our 60-min scan, launched in 2018
Step 2 launches today, with our 30-min scan
Step 3 will be a 15 min scan
All part of our master plan:
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It’s crazy how much the act of walking improves mental clarity. A 2-hour hike with
@sabina_gal
is always significantly more productive than just sitting down at my computer for 2 hours.
There’s lots of research to back this up. In fact, a Stanford study found that walking
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Physical health is mental health.
To maintain my own, I follow a routine:
• 2-3 runs/week
• 3 barbell weightlifting sessions
In periods of anxiety, I increase my workouts to 2x/day.
For managing my psychology — there's nothing better than a good workout.
Here’s a link to
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This new AI reduces noise and improves the quality of MRI images, enabling us to create a scanning protocol with twice the speed and same image quality.
This creates cost savings for Ezra, and we're passing these cost savings to our customers.
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I just PRed my deadlift - 350lbs (2.2x bodyweight), and my bench press - 200lbs. Happy Thanksgiving
#turkeypull
Short thread on why I do this, how it all started, and why you should do it as well.
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10 supplements I recommend to everyone for longevity and performance:
(Use the list below as a blueprint – h/t to my friend
@bryan_johnson
for that term – not as a shopping list):
I was having dinner with some friends a few months ago.
To the amusement of my guests, after
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I spent a decade on my 1st startup.
I'm almost 6 years into my 2nd startup.
I'll likely be 40 by the time we hit $100M ARR at
@ezrainc
Delete the idea of being an overnight billion-$$$ startup.
Commit for a 10-year ride or don't get on.
Thank you for coming to my TED talk.
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Sleep is crucial.
Without 7-8 hours/night, you'll be at a higher risk of diseases, like:
• Obesity
• Diabetes
• Hypertension
• Cardiovascular disease
The recipe for high-quality sleep:
• Pitch-dark room
• 65 Fahrenheit temp
• Blue light-blocking glasses
• Melatonin
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Journaling is the most useful mental health tool I use - by far. It’s one of the most effective ways to manage my anxiety and work through problems. Today I want to share a simple technique I learned from
@tferriss
that revolutionized the way I journal.
I carry 2 journals with
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I'm obsessed with small teams achieving great things using technology. So over the years, I've compiled a list of small teams that have achieved incredible things.
Was talking about the list with
@ZReitano
the other day, and decided I should publish it
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This is the best distillation I've ever seen on what makes America the best place on Earth for scientific innovation, and what we need to do in order to maintain our edge.
Thanks for doing this, and well done
@wolfejosh
.
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Machine learning (also often talked about as… AI) is the future. But most people have no clue how it works.
So I decided to write a quick explainer, along with a brief summary on how machine learning is changing 𝗰𝗮𝗻𝗰𝗲𝗿 𝗱𝗲𝘁𝗲𝗰𝘁𝗶𝗼𝗻:
In a nutshell, training a
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3 things I’ve learned about building the “right” team:
1. Hire for mission alignment, not just job experience
2. Explore whether you can automate something before hiring a human for it
3. Learn to be technical rather than bringing on a technical co-founder
This can be even
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I’m happy to report that as of Dec 2023, my blood results are nearly perfect across 127 biomarkers. I owe this largely to my longevity protocol (exercise, nutrition, supplements).
Today I’d like to talk a bit about supplements. I’m a big believer in personalization, and this
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My friend
@cleoabram
dove into the topic of cancer, and came out with an incredible insight: there *is* a cure for cancer, and it's available *now*.
Watch her video to learn more (featuring
@ezrainc
and yours truly):
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I do very comprehensive blood testing every January, looking at about 100 different biomarkers.
I might publish a thread on what biomarkers I look at, and why - anyone interested?
For fun, here's all the tubes my phlebotomist had to fill this morning 😱
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I've been under a lot of stress lately, so I thought I should write about how I manage my mental health & anxiety.
Covering:
- exercise
- meditation
- journaling
- coaching & therapy
- psychedelics
- supplements
... and more. I hope some folks find it useful.
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Have been a Messari customer from day 1, and now I wish I were also a Messari investor from day 1.
Congrats Ryan and team, this is a huge step forward for the ecosystem.
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The 5 year survival rate for early stage cancer is ~80%.
The 5 year survival rate for late stage cancer is ~20%.
Early detection saves lives.
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