Priscilla Chan is running one of the most ambitious philanthropies in the world

Priscilla Chan remembers the moment she decided to become a doctor.

She was a 21-year-old undergrad at Harvard College working at an after-school program for students from a nearby low-income housing project. One of those students, a young girl, had gone missing for a few days. When she returned, Chan was shocked to find that the girl’s two front teeth were broken.

“I was flooded and overwhelmed,” Chan would tell Facebook’s COO Sheryl Sandberg more than a decade later. “What happened? Did someone hurt her? Has she got help for this? And like, what could I have done to actually prevent this?”

It was a moment that propelled Chan to UCSF School of Medicine, and also ignited her interest in education. Fast-forward 10 years, Chan is now a licensed pediatrician and a teacher who founded her own school. She’s also the first lady of Facebook, wife and partner to Silicon Valley’s most well known tech executive, Mark Zuckerberg, and mother to a 1-year-old daughter — with another on the way — and the most famous dog on the internet, a Hungarian sheepdog named Beast.

But in the past 18 months, Chan has added a new job to her resume: She’s also in charge of what will likely be one of the most well-funded philanthropies in human history.

Chan is running the day-to-day operations of the Chan Zuckerberg Initiative, the philanthropic investment company she created with her husband in late 2015, announced along with the birth of their first daughter, Max.

Known more colloquially as CZI, the relatively new effort has an ambitious tagline: “Advancing human potential and promoting equal opportunity.” Practically, that means Chan and Zuckerberg are focused on improving industries like education, medicine and even the criminal justice system. Some of their efforts have been straightforward and should have an immediate impact. Earlier this year, for example, CZI donated roughly $3 million to a nonprofit that gives students around the country free eye exams and glasses.

Other plans are so ambitious and grand as to seem almost fantastical. Last fall, CZI pledged $3 billion over the next decade to try and “cure all diseases” in their daughter’s lifetime. Chan has been vocal about the organization’s involvement in trying to map every cell in the human body, and CZI is spending $50 million over the next five years to fund research by scientists and engineers it calls “investigators,” like this Stanford professor developing a $1 microscope. Chan is also working with Summit Public Schools in California to fundamentally change the education system — she wants students around the country to be taught differently.

To try and turn these ideas into reality, Zuckerberg and Chan have pledged to spend 99 percent of their Facebook fortune over their lifetime to help fulfill that commitment. Today, that fortune is worth more than $63 billion, and Zuckerberg has started to sell his Facebook shares to fund their efforts.

For context, the Bill and Melinda Gates Foundation, one of the world’s preeminent philanthropies and the one CZI will most likely be compared to in the years to come, had an endowment of nearly $40 billion in 2015, not including another $37 billion it had already given away.

While those close to them say that Chan and Zuckerberg are both heavily involved in the organization, Zuckerberg is also running Facebook, which is a full-time job. That means that even though Zuckerberg is often the public face of CZI, Chan has emerged as the de facto CEO.

“She’s really the hands-on person,” said Robert Tjian, a professor of biochemistry at the University of California Berkeley and a member of CZI’s science advisory board. “This is really her day job now.”

At 32, Chan is one of the youngest people to helm of one of the most ambitious and well-funded philanthropic organizations in the world.

“We are all more capable than we could ever imagine or admit to,” Chan told Sandberg last October. “We need to make sure that we are using that power now, and not waiting for a different time or when we’re more ready. We’re ready now. We need to do.”

Priscilla Chan and Mark Zuckerberg first met in line for the bathroom at a party in the Bell Tower suite of Harvard’s Pforzheimer House, part of the so-called “quad” houses whose residents often see themselves as apart from the more traditional venues on campus.

Chan, an 18-year-old freshman from a nearby Boston suburb, was attending one of her first college parties. Zuckerberg was there, too, for what he assumed would be one of his last college parties. The 19-year-old sophomore had built a “hot or not” clone website called Facemash, which he thought would get him expelled.

“In what must be one of the all-time most romantic lines, I turned to her and said: ‘I’m getting kicked out in three days, so we need to go on a date quickly,’” Zuckerberg recalled in a speech to Harvard graduates in 2017.

CZI

The line apparently worked. Zuckerberg and Chan have now been together for most of the past 13 years and married for the past five. Those who know them describe their relationship as a total partnership.

When CZI announced its $3 billion commitment to fight disease, the two shared the stage and presentation together. They have hired CZI’s senior leadership together, hold a company all-hands for CZI employees together every four weeks, and Chan has also started to become more of a prominent figure in Zuckerberg’s public life as Facebook’s CEO.

Though it was Zuckerberg’s personal New Year’s resolution to travel to roughly 30 U.S. states this year, the two have been together for virtually every stop of the year-long mission. Chan has also started to make the occasional cameo to help Zuckerberg show off new technology, like this video about his in-home artificially intelligent butler, or this exchange onstage when Facebook unveiled a new virtual reality product that lets users create avatars that can hang out in a virtual world.

And while sources say Chan is not involved in making Facebook decisions, many believe Facebook, one of the 10 most valuable companies in the world, would not be what it is today without Chan’s often invisible influence on its founder.

“She’s been like a compass, probably, for him, and a partner when you can’t trust anyone else in the world,” said Diane Tavenner, CEO of Summit Public Schools, a CZI partner. “[She’s] the person who really can be honest and give feedback and who he respects and listens to no matter what. And I think everyone needs that.”

Added Benchmark partner Matt Cohler, an early Facebook employee and close friend of Chan and Zuckerberg’s: “Mark, over the history of at least the last 13 years, has just made almost without exception an extraordinary series of decisions over and over and over again and just exercised incredible judgment. I think wanting Priscilla to be his partner showed as good judgment as anything he’s ever done.”

In some ways, Chan and Zuckerberg fit personality cliches. Zuckerberg is the Silicon Valley engineer, the builder and problem solver who has had to teach himself how to better interact and communicate with others. Chan, while also extremely intelligent, is also more inherently social. She’s empathetic and kind and emotional.

“Priscilla sees more of the people side of it,” explained Susan Desmond-Hellmann, CEO of the Gates Foundation. “When you’re around her it’s almost like it’s contagious how strongly she feels for the causes that she’s supporting.”

Added David Plouffe, CZI’s head of policy and President Obama’s former campaign manager: “Her empathy, her heart — that’s going to flow through the organization.”

Priscilla Chan/ Facebook

At least, these are the characterizations that have emerged based on conversations with nearly a dozen of Chan’s friends, business partners and colleagues, and from multiple interviews and speeches we reviewed on video.

Despite her influence on CZI, Chan does not draw much attention to herself. She has, historically, been visible primarily through Zuckerberg. Her public Facebook profile shows just 13 posts from the four years leading up the announcement of CZI. Chan also declined through a spokesperson to participate in this story.

“People normally tend to ascribe intelligence to people who are acting very alpha, trying to command the limelight,” said Greylock’s Reid Hoffman, an early Facebook investor and close friend of Chan and Zuckerberg. “Priscilla just goes and gets stuff done. She rolls up her sleeves, she works, she’s smart, she’s thoughtful.”

The big decisions at CZI are shared by Chan and Zuckerberg, but Chan has taken on much of the day-to-day responsibilities. She is in the company’s Palo Alto office three to four days a week, and meets weekly with each of CZI’s top lieutenants one-on-one. She’s also personally approving grants and investments on a weekly basis, and leads a company all-hands meeting and Q&A with employees every other week. Zuckerberg joins these Q&As once a month.

CZI has taken up so much of her time that Chan stopped seeing patients earlier this year at the Zuckerberg San Francisco General Hospital, which was named after the couple thanks to a $75 million donation. Chan is telling those close to her that stepping away is just temporary.

Part of the challenge is that Chan is virtually a first-time manager. When she isn’t at CZI, she’s usually working at The Primary School, a school in East Palo Alto she founded and opened in 2016 that’s focused on combining student health care and education into one organization. It’s also funded by CZI, though it operates independently. Chan is CEO, and meets regularly with teachers and the school’s leadership staff, and at the moment she’s focused on expanding the school’s model to other communities, sources say. While she makes major decisions for The Primary School alongside President and COO Meredith Liu, Liu handles most of the day-to-day operations.

That means CZI is where Chan is getting most of her startup experience — though her roster of advisers and mentors is impressive. Among them: Desmond-Hellmann, who runs another big-time philanthropic foundation. She speaks with Chan once or twice a month.

“[She] is doing what startups do, which is sort out how do you want to run the place? What’s your governance? What are the key roles? What are the capabilities you need?” Desmond-Hellmann said. “They want to make an impact. In the end that’s how all of us will be measured and that’s what we share in common is wanting to make an impact.”

Chan’s motivation to make an impact can be traced back to Quincy, Mass., a suburb of Boston and a short half-hour drive south from Harvard. Chan’s parents, ethnic Chinese living in Vietnam, had each separately fled the war-torn country. Chan’s father, Dennis, arrived in Boston in 1978; her mother, Yvonne, went to New York that same year. The two were family friends while growing up in Vietnam and later reconnected in the States.

In Quincy, as the young pair worked long hours at a Chinese restaurant, Chan and her two younger sisters were raised with the help of her Cantonese-speaking grandparents. Chan’s first memory is of trying to help her grandparents with the dishes while her mother was in the hospital giving birth to her sister, Elaine. Chan was just 2 years old.

At Quincy High School, a public school, Chan became captain of the tennis team and joined the robotics team. She was named Quincy High’s valedictorian, and when she stepped foot on Harvard’s campus in the fall of 2003, she became the first member of her family to go to college. As the daughter of refugees and a first-in-her-family college student, Chan has said numerous times she considers herself to be very lucky. “It’s a miracle that I’m sitting here,” she said at the Makers Conference in early 2016.

In fact, both Chan and Zuckerberg believe they got to where they are today, not just because they’re both incredibly smart and worked hard, but because they caught lucky breaks along the way that many people don’t get, a kernel insight that seems to prop up both of their motives.

“If I had to support my family growing up instead of having the time to learn how to code, if I didn't know that I was going to be fine if Facebook didn’t work out, then I wouldn’t be standing up here today,” Zuckerberg said during his Harvard commencement address in May. “If we’re honest, we all know how much luck we’ve had to get to this point in our lives.”

Chan Zuckerberg Initiative

CZI’s efforts are meant to remove luck from the equation. Or at least spread the luck around to a lot more people, children in particular.

On the education front, CZI is focused on a concept called “personalized learning,” which means that each student learns at her own pace. It’s an approach Tavenner’s Summit Public Schools takes and one of the reasons Chan and Zuckerberg donated to the school in 2014, but it’s also why Facebook has been building software programs for Summit since 2015. (Now, CZI is building those programs for Summit Public Schools instead.) The Primary School that Chan started is also changing the traditional equation model by blending a student’s health care and nutrition with their schoolwork.

Chan’s role as a doctor and teacher means she’s seen firsthand what happens when students don’t have proper health care or support from parents at home. It’s hard to get a good education if you’re constantly going to the doctor.

“Kids can’t be present at school because there’s so much going on at home — they’re sick, they’re hungry,” Chan said at Makers. “School’s the last thing on their mind.”

Which explains why Chan and Zuckerberg are eager to part ways with $63 billion.

“I think they both see this as, this is not their money,” said Tavenner. “They are the stewards of this money. And they got into a fortunate place and they feel [they] have a real sense of obligation and responsibility to the world, given the position that they have found themselves in.”

It turns out, giving away your money can take a lot of work.

As the former campaign manager for President Barack Obama, a White House senior adviser and then head of policy at Uber, Plouffe knows how to brief important people for important meetings.

Briefing Priscilla Chan, though, is different. It’s exhausting.

“Usually it’s, ‘How do we slim it down?’” Plouffe said of briefings. “With her it’s like, ‘Are we giving her enough?’”

Plouffe says that Chan will devour background memos that are 20 or 30 pages long, and then recall small details in meetings that prove she’s read every last word. “I don’t know if I’ve ever worked with somebody quite that voracious,” Plouffe added. “She’s a grinder.”

Chan is an avid reader and is obsessed with learning. Those close to her recall books they’ve discussed together, like “Evicted,” a Pulitzer prize-winning book about poverty in 21st century America, and “Hillbilly Elegy,” what the New York Times described as a “compassionate, discerning sociological analysis of the white underclass that has helped drive the politics of rebellion, particularly the ascent of Donald J. Trump.”

Joe Scarnici/Getty Images for Fortune

In the years leading up to CZI, Chan and Zuckerberg hosted a number of dinners at their Palo Alto home where learning was a major component.

The gatherings were small, a dozen or so people, but the guest list included experts in areas that the couple was interested in. Desmond-Hellmann and a few of her Gates Foundation colleagues attended one in 2014 where the conversation was focused on Ebola; Tavenner was at an education-themed dinner in mid-2015, where Summit Public Schools was the focus. Hoffman has been to a number of these dinners, including others on bio-research and immigration. Others guests have included those tied to Facebook, like board member and Netflix CEO Reed Hastings, early employees like Benchmark’s Cohler, investor Chamath Palihapitiya and Facebook co-founder Dustin Moskovitz.

Attendees say that Chan and Zuckerberg usually start with a happy-hour gathering in their living room, then move the conversation to a large, live-edge wooden dining table where they eat healthy California cuisine.

Chan and Zuckerberg usually ask a lot of questions, nudging guests to share about the big ideas they are working on and that CZI should consider exploring, or who else from their respective industries the couple should be talking to — or hiring.

“Some people are know-it-alls, and some people are learn-it-alls — most people aren’t either one,” Cohler said. “The two of them are both total learn-it-alls.”

(Chan has interests outside of work and reading, too, though many of her friends and colleagues were reluctant to share details. She likes board games and is a fan of Settlers of Catan. A friend recalled the time she once binge-watched “The Great British Bake Off” when Zuckerberg was out of town. And she also has a close group of friends from her college and med school days, and has made close friends through Facebook, including the company’s VP of Social Good Naomi Gleit, and Visra Vichit-Vadakan, wife of Facebook’s product boss Chris Cox.)

Chan’s obsession with learning takes on added importance when you consider the amount of money Chan and Zuckerberg plan to spend and their time horizon. What separates Chan and Zuckerberg from most other philanthropists is their age. Chan is 32; Zuckerberg is 33. That means they have decades of investing ahead of them.

Chan Zuckerberg Initiative

And Chan and Zuckerberg know what happens when gifts aren’t properly managed. In 2010, the couple donated $100 million to Newark’s public school system, a donation that was later labeled by many as a failure.

The effort was criticized for being out of touch with the needs of the local Newark community and unfamiliar with New Jersey laws. Critics argued that the money wasn’t well spent — much of it went to expensive contractors — and the politicians who were supposed to champion the effort either moved on to bigger roles (Mayor-turned-Senator Cory Booker) or got sidetracked by scandals (Governor Chris Christie). Dale Russakoff, a former reporter with the Washington Post, even wrote a book about the effort.

(Zuckerberg later admitted that he and Chan “learned a lot of lessons” from that donation, but also pointed out some positives — like an increased graduation rate — as a sign that the donation actually worked.)

When Chan and Zuckerberg donated $120 million to local Bay Area schools four years later, Russakoff saw that as a sign the couple had learned the importance of being more hands-on and involved with community leaders along the way.

“It's a very, very different and much more humble approach to trying to change education,” she told NPR in 2015.

This is where Chan adds a hands-on element may have been lacking back in 2010, when she was still in medical school. When Chan and Zuckerberg first started working in education, Chan told her husband that she wouldn’t work with him until he spent time actually teaching in a classroom — it was that important to her. Despite some protests, Zuckerberg ended up teaching a class about entrepreneurship to students at a local Boys and Girls Club. Zuckerberg first discovered Summit Public Schools because Chan urged him to visit after her own tour.

“What I bring is the lens of an educator and as a pediatrician to make sure that those tools aren’t built in isolation,” Chan said at a conference in October. “My perspective shapes how that tool really gets leveraged in the real world.”

Listed as her favorite quote on her Facebook page: “Teach me, and I will forget. Show me, and I will remember. Involve me, and I will understand.”

Whatever Chan does next, you’ll probably hear about it. Her profile has grown considerably in the past 18 months. Her once-sparse Facebook page had 24 posts from 2016, including photos of her with former presidents and world leaders, videos of her speaking in front of crowds, and even a picture with the Pope. Some have started to compare Chan and Zuckerberg to other well-known philanthropists, like Bill and Melinda Gates. The two couples are friends.

As Sandberg and Chan wrapped up their conversation at Fortune’s Most Powerful Women’s conference last October, Sandberg ended her Q&A with this: “What would you do if you weren’t afraid?”

Chan replied: “I’d be right here doing this.”

This article originally appeared on Recode.net.

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