Michael FitzGerald

Michael and his business partners wanted to build Submittable as a kind of company they would want to work for, in Montana. Their goal was to create jobs for them and their kids, a company that would allow a career trajectory for people to stay and work from Montana, instead of going out of state. It has been that way since.

Montana is an outdoorsy state. You can surf and fly-fish in the middle of downtown Missoula, and you can go skiing just a short 15-mile drive away. A national forest is just 3 miles away from the @Submittable office. Elk graze around the neighborhood.

If we could all collectively upload and analyze our genetic data, we'd find the solution to our health problems much faster than we would otherwise, so why don't we? We don't share health data because the insurance companies would use it against us.

Michael FitzGerald, CEO of Submittable, told Crazy Wisdom he started haipump.com while he was being treated for cancer. The site is a way for patients to find hospitals that implant a hepatic artery infusion pump, the HAI pump he travels to New York once a month to have serviced. He said it is not offered more widely because a hospital needs a surgeon who can implant it, and he had to leave Missouri to get the procedure. Medicine, he said, prefers a pill, because a drug scales and an operation does not. A teacher or someone working at a tire store would not have his freedom to make that trip. He called the barrier mostly insurance and bureaucracy.

People are very sick.

As a society we let people with chronic disease go broke. Medication is crazy-expensive. Most of the money goes to administration.

People can't work because they are sick. They lose their jobs and can't work. They lose their health insurance.

At first, Submittable was struggling to get talent to work in Missoula. They would find a lot of senior people who loved Montana and wanted the jobs, but would eventually be unable to take on them because of family commitments. It is, after all, hard to move your kids out of school, or find a matching job for your spouse.

Once Michael realized they needed to shift focus to people who already had a history in Montana and wanted to move back, hiring became easy.

Early on, hiring was definitely not effortless and it took a particular kind of person to live in Missoula, MT. Ten, nevermind thirty years ago, it was a big commitment. Nowadays, it's gotten a lot easier.

Y Combinator boosted Submittable's ambitious to be bold and to grow big. Michael and team were in their early 40s, and a YC they saw a lot of younger founders, hungry to win. They saw what they were really up against, something that was not obvious back in Missoula.

Submittable started around 2009 and for two years, before getting into Y Combinator, most of the founders had kept their day jobs while working on Submittable nights and weekend. Even though they already had customers and revenue, it was not yet enough to pay for the team.

When you are sick, the hardest part is lack of control. Chemo is basically poison for your body, and every two weeks you have to poison yourself. Life starts to swing from times where you are feeling low on energy and unable to do anything, and times when you are desperately trying to catch up, before you are down again.

First, don't ask what you can help with. That simply puts the burden of creating and scheduling work onto the sick person and their family. Instead, just do. Bring food, mow their lawn, rake some leafs. The best you can do is show up, do it, and leave without asking for attention.

It might help people who believe it works, but there are also a lot of tangible things you could do to actually help a cancer patient.

This particular CEO is getting paid less than some of his employees, putting all his money and energy into the company, banking on the future success for all.

A typical scenario for a cancer patient, they first go broke trying to cure the disease, and then they die. Most people cannot afford stage four cancer.

When Michael found out that he got sick, he posted a message on the internal Y Combinator board asking for suggestions. It turned out, founders were eager to offer to help. Some were doctors with knowledge of the disease, some were founders going through a serious illness, and of course, there were even startups working to cure cancer.

The day after Submittable's Series A, Michael FitzGerald had to phone True Ventures and say he was terminally ill, then leave for major surgery. He says the board did not hesitate. They told him to get treated and not to worry about the company. He calls that call one of the scariest things he has done, apart from the surgery. He was cancer-free afterward, then found a very small recurrence in his liver, which he says is nothing like the year before. When he posted in Y Combinator's internal forum, oncologists and founders working on cancer offered practical help. He is still grateful to those investors.

Metastasized colon cancer gets into your organs, liver first, and liver is the hardest to treat. The whole point of your liver is to remove toxins, and when you start to blast the body with chemo (toxins), the liver gets overloaded.

The solution, which saved Michael's life, is a slow-drip chemo, delivered by a HAI pump , attached to a patient's liver.

One day Michael felt sick, went to see his doctor, and got scheduled for a colonoscopy. Missoula being a rural place, the procedure was three months out. Michael forgot about it and went on with the business, raising money for his Series A.

The day after the deal closed, he got called to the doctor. Feeling stoked about money in the bank and the prospects of a greater future, FitzGerald went to the hospital, only to hear some awful news. His prognosis was death.

"If you get the answer that you don't want, you go find another answer!"

Adding 10 more people does not make your company 10x faster, and in some cases it makes it slower, for a while. It's normal, but you have to anticipate it.