#145 Emi Gal, Founder & CEO of Ezra - Tracking 150 Biomarkers, Annual Challenges, Peak Health by 40, Becoming More Disciplined, and More

Listen as we decode how Emi Gal tracks more than 150 different biomarkers, what he’s learned doing an Annual Challenge for the last 14 years, why he’s focused on achieving peak health by 40, how to become more disciplined, and more. Emi Gal is the Founder & CEO of Ezra, which is bringing fast and affordable cancer screening to everyone.
Last updated
August 13, 2023
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#145 Emi Gal, Founder & CEO of Ezra - Tracking 150 Biomarkers, Annual Challenges, Peak Health by 40, Becoming More Disciplined, and More


About the Guest

Emi Gal started his first company, Brainient, when he was just 19. He spent 10 years building Brainient into one of the leading ad-tech companies in Europe before it was acquired by Teads—one of the largest advertising platforms in Europe, with 1.8-billion impressions per month.

After working with Hospices for Hope, a non-profit in Romania that builds and operates hospices for terminally ill cancer patients, Emi realized that one of the biggest problems with cancer is the lack of a fast, accurate, affordable way to screen for cancer everywhere in the body. He founded Ezra in 2018 to solve this problem using Magnetic Resonance Imaging (MRI) and Artificial Intelligence. To date, he’s reduced the cost of getting a full-body cancer screening by 80% and reduced the time required to get screened by 66%.

Emigal.com | Twitter | Ezra | Yearly Challenges


Episode Guide

Emi Gal shares the lessons he’s learned building Ezra, why he tracks 150 different biomarkers, what he’s learned doing a Yearly Challenge for the last 14 years, and why he’s focused on achieving peak health by 40, and more. As well as the origin story behind his extreme discipline and his advice for others that want to become more disciplined.

“To make progress in anything, but especially your health, you just need to nudge behavior a little bit every day. I find that tracking 150 different biomarkers does that quite well for me.” — Emi Gal

 Emi Gals’ Favorite Books

Emi shared his all-time favorite books including:

Antifragile: Things That Gain From Disorder by Nassim Nicholas Taleb

  • Antifragile builds upon ideas from Nassim Taleb’s previous works including Fooled by Randomness (2001), The Black Swan (2007–2010), and The Bed of Procrustes (2010–2016). It’s the fourth book in the five-volume philosophical treatise on uncertainty titled Incerto. The core premise of the book: "Some things benefit from shocks; they thrive and grow when exposed to volatility, randomness, disorder, and stressors and love adventure, risk, and uncertainty. Yet, in spite of the ubiquity of the phenomenon, there is no word for the exact opposite of fragile. Let us call it antifragile. Antifragility is beyond resilience or robustness. The resilient resists shocks and stays the same; the antifragile gets better." Emi Gal has read the book multiple times and credits Antifragile with helping him think about risk—which he engages in daily as entrepreneur—differently by layering in the concept of expected value.
  • Buy it now: Print | Ebook | Audiobook

The Patient Will See You Now: The Future of Medicine Is in Your Hands by Eric Topol MD

  • A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. Emi Gal loves the book and considers the shift in power from doctors to patients essential for the future of healthcare.
  • Buy it now: Print | Ebook | Audiobook

Related Episodes

If you enjoyed this episode with Emi Gal, don’t miss our other interviews with health, wellness, and longevity focused founders :


Daniel Scrivner (00:00):

Hello and welcome to another episode of 20 Minute Playbook by Outlier Academy, where we decode what iconic founders, renowned investors, bestselling authors, and outlier thinkers have mastered and what they've learned along the way. In each episode, we dive deep to uncover the tools, strategies, habits, routines, and hacks that we can all apply in our own work and lives, all in about 20 minutes. I'm Daniel Scrivner and on the show today I'm joined by Emi Gal. Emi is the founder and CEO of Ezra, where he is focused on bringing fast and affordable cancer screening to everyone. Since founding Ezra in 2018, Ezra has managed to bring down the cost of MRI cancer screening by 80%, and the time required to get your body scanned by 66%. And in a short order of time, they think they can get that down to 90%, all by harnessing the power of AI and machine learning.


And you're in for a real treat because this episode is just packed with incredible ideas from how Emi has been tracking 150 different biomarkers for the last five years to why he's focused on reaching peak fitness by age 40, to the yearly challenges he's pushed himself to do over the last decade and more. You can find a searchable transcript of this episode as well as our episode guide with ways to dive deeper at Outlier Academy/145. That's Outlier Academy/1-4-5. Please enjoy my conversation with Ezra's Emi Gal. Emi, thank you so much for coming on 20 Minute Playbook. I'm thrilled to have you on today. Thank you so much for making time.

Emi Gal (01:25):

Thanks for having me Daniel, it's great to be here.

Daniel Scrivner (01:27):

So there's a ton of stuff we're going to cover today. I was so excited about this interview and people will know why in a couple of minutes once we're a couple minutes in because there's so much to cover here. But it was a little challenging to figure out a place to start. But where I wanted to start and we're kind of diving into the deep end, so thanks for doing that with me is, you have one of the most elaborate health tracking setups that I have ever seen and it revolves around this single Google spreadsheet that you use to track a number of things daily. I think it's something like 150 different data points. Can you just share the origin story of that Google sheet and talk a little about what you track?

Emi Gal (02:01):

For sure. Yeah, so the origin story when I moved to the US... So I'm originally from Romania and I lived in London for many years with my previous startup and then I moved to New York in 2016 and about 10 months of being in the US I gained about 20 pounds. And that was a little bit weird because my whole life I was quite lanky. I never worked out a lot in my 20s, but I never had to because I was just thin by design. And so I wanted to see what's going on, realized I have no data and so I built a spreadsheet that was originally just tracking my weight, my body fat, and that was it initially I just wanted to see the trend and then I started adding blood tests just because I wanted to see what's going on inside my body.


Then I added workout routine, then I added blood pressure, then I added a habit tracker and now it's become this kind of monster of a spreadsheet that has a couple of hundred biomarkers actually that I track on a daily, weekly, monthly, and annual basis. And it's been immensely valuable, It's helped me lose the 20 pounds, but it's helped me improve performance and know exactly how various different activities or various different types of food, et cetera impact my health. Very specifically recently, actually... Recently, I'm saying about nine months ago I hit a plateau in my performance like weightlifting and VO2 max was not improving and my runs were not getting better and so on. So I started working with Andrew Herr at Fount actually who I know you interviewed on your podcast.


And Andrew had a glance at my spreadsheet and he was like, "Oh Emi, you don't have enough protein. You need to double your protein intake." I was maybe having a hundred grams of protein or something like that and doubled it. And this year I've hit all my personal records on weightlifting and I've lost even more weight and I'm feeling great. And that was one very kind of specific example of how going really deep into tracking all your data can be very valuable.

Daniel Scrivner (04:22):

How much time does it take you to do and what is the process by which you input this data? Is it something you do daily? Do you batch it and do it once a week? What does that look like?

Emi Gal (04:31):

Yeah, so most of it I do weekly or monthly because it doesn't change that much. So I track my blood pressure for example, once a month and I have a recurring calendar reminder that's once a month on Sundays, last Sunday of the month or something. So doesn't take a lot of time. The one part that I do daily and it takes maybe three, four minutes every morning is I track habits. So I look at whether I meditated the previous day, whether I had meat, whether I was stressed, about how I slept, et cetera, et cetera.


And I have this kind of GitHub-like tracker where on the X axis you have the days of the year and the months and on the Y axis you have the day of the week and I just color code it manually, gray, yellow, green, red, depending on whether it's good or bad. Which gives me a really beautiful way to visualize my year in terms of stress, in terms of meditation and so on. And I have found that at least for me, it really helps nudge behavior. And at the end of the day, I think to make progress in anything but including an especially health, you just need to nudge behavior the right direction a little bit every day. And I find tracking does that quite well, at least for me.

Daniel Scrivner (05:50):

Yeah, it's a fascinating perspective. I want to ask one more question, which is, as I understand it kind of the... Not the origin story, but part of the reason that you're doing all this tracking is that you have this goal to get to peak health by the time you're 40. And I'm someone who's 36 that I've been in this kind of kick, so this obviously speaks to me. Talk a little bit about why that is a goal and I don't know all the work that you've put in now, which is, I don't know how many years you've been tracking habits and routines.

Emi Gal (06:16):

Yeah, so I've been tracking about five years now. Basically since I had that kind of moment, I was 30 when I moved to New York and all of my 20s I was like, I'd never had any concern for my health and then all of a sudden I add 20 pounds and I'm concerned. So decided that I want to reach peak performance by the time I'm 40 and I want to then maintain that peak performance for another 40 years. And so I then ask myself, okay, what does peak performance mean and how do you measure it and so on and concluded that it is from a health standpoint, you want to make sure that you have really strong body mass and very good bone density because as you age, if you fall you don't want to have a fracture because then that leads to comorbidities and so on.


I wanted to have mobility as I age. I wanted to obviously ensure that my internal organs are working well. So I track a lot of biomarkers. And then I kind of designed this program that looks at mobility, looks at weight lifting for body composition and bone density. I do a lot of martial arts, which helps with mobility and so on. So I've kind of designed a program aiming to get to peak performance by the time I'm 40. And then what I've also done is I've created measures for each of the different areas that I want hit. So basically, obviously for weight lifting I want to make sure that I'm making performance and increasing performance.


So I measure, I do barbell weightlifting and I measure the weight on the bar. And this year I did 315 deadlifts. I was very happy about that. I measure VO2 max for cardiovascular load, anaerobic threshold, I measure with the lactic threshold test and so on. And so that's the ultimate goal, reach peak performance by the time I'm 40, I'm 36 too, so I'm kind of like every year chipping away at adding more weight to the bar and improving VO2 max and so on.

Daniel Scrivner (08:18):

I mean you're doing great if you've got 315 on the bar so you're headed in the right direction.

Emi Gal (08:21):

Actually I work with a coach obviously, and the goal next year is to get to a thousand pounds across all my lifts. So deadlift, squat, bench, and overhead-

Daniel Scrivner (08:30):

Is that loosely two times your weight? I've heard that as a common benchmark you want to try to hit.

Emi Gal (08:34):

Depends on the lift. On deadlift, you definitely want two times your weight. Squats, two times your weight, on the overhead press, if you can do one, one and a half a body weight, you're in the top 1% of the world. And I'm currently actually at .9 of body weight, so I'm kind of working towards one time body weight.

Daniel Scrivner (08:54):

Amazing. I want to ask one more question and then we'll move on. I'm interested in the bone density piece and I would imagine that maybe weight lifting, just putting your body under heavy stresses, heavy loads is maybe a way that you're approaching bone density. How have you thought about that? Is that the main way you're doing it? Just thoughts particularly on how to get more bone density?

Emi Gal (09:15):

Absolutely. So there's actually a lot of research that shows that strength training, whether it's weight lifting with weights or whether it's body weight based and so on, increases bone density. And then because of what I do, which is offer scans for people to get a look inside the body, I also have very, very good measures of bone density. Because I get a DEXA scan every year. I get a full body MRI scan every year and that gives me a lot of information about my body composition and I can see over time that how that progresses.


And actually when I moved to the US again, because in my 20s I didn't do a lot of weightlifting and stuff like that, I did a DEXA scan and my bone density was actually... I don't remember the exact number, but it was in the worst quartile I think. And now the last DEXA scan that I did, which was in March of this year, I'm in the top quartile in terms of bone density. So I'm a big believer in applying experiments to yourself and then seeing if those experiments work and then using data to determine how well they work for you.

Daniel Scrivner (10:27):

Yeah, it's a perfect segue into the next thing that I wanted to talk about, which is for anyone listening, I would encourage you, whether it's now or later, to go to Emi's website and look at Emi Gal, so that's E-M-I G-A-L.com/challenges. And one of the things that you've done since 2008, so for 14 plus years now, is you've done a yearly challenge and you've documented all those on your website. And I'm just going to quickly read a little bit of copy because I think it does a great job of framing up what it is.


This copy from your website, "Outside work, I enjoy spending time with my wife and learning new things. To address the latter, I've taken on a new challenge every year since 2008. Some of the most challenging and interesting ones were sleeping two and a half hours per day for two months." Which sounds brutal.

Emi Gal (11:06):

[inaudible 00:11:07].

Daniel Scrivner (11:06):

That's polyphasic sleep. "And then reading a book per week and training my memory with a world memory champion." I'm going to ask a couple of questions about a few of the particular challenges, but just to start, talk a little about why you decided to do these and what the experience has been like to choose one of these each year.

Emi Gal (11:26):

It actually started very much as a joke. Back in 2008 a friend of mine, I was still living in Romania. I moved to the UK in 2009 and a friend of mine came to me and was like, "Hey, I want to try this thing. It's called polyphasic Sleeping. I've read about it. It sounds amazing. We could basically have 22 hours of productive time a day." And the way you do it is you sleep for an hour and a half during the night and then you sleep for 20 minutes every six hours. And apparently in history there have been some... Benjamin Franklin was a famous polyphasic sleeper. There's some kind of-


... Was a famous polyphasic sleeper. There's some anecdotal evidence that Einstein might have been a polyphasic sleeper and these are people who slept very, very little at different intervals during the day. I tried it with this friend of mine, we did it together, and it didn't work. It was brutal. For about a month, we basically got no sleep whatsoever. Because think about it, your brain is used to sleep seven, eight hours, it takes you like 20 minutes to fall asleep on a good evening. We would put our head down to fall asleep, it would take us like an hour to fall asleep, and then a half hour later we'd have to wake up. And then we'd put our head down six hours later to sleep for 20 minutes and we couldn't fall asleep in 20 minutes. It was a brutal month.


Second month started getting better, but it wasn't... I was like a walking zombie. I wasn't getting the 22 hours of productive time that I wanted. However, I really enjoyed the attempt at something really challenging for the body. I used to drink a lot of coffee, I used to smoke back then, and to do this experiment, I quit both. And then I didn't take up smoking again, so I saw some very clear benefits from running this experiment and I was like, ''You know what, I'm going to continue.'' So since then, every single year I've run an experiment, and they've been wide ranging and incredibly fun.

Daniel Scrivner (13:34):

Yeah, they've been all over the map. So you talked about polyphasic sleep, there's reading a book per week, there's training my memory, there's also some amazing ones I want to ask some follow-up questions on shortly, like interviewing elderly people and ask them a set of 10 questions about life, and then posting that on your blog. One of the questions I wanted to ask is... So you've done a lot of these, if you had to recommend a single challenge to people listening, whether it's something to think about, something to attempt even for a short period of time, is there one that you would recommend to others, or recommend the most?

Emi Gal (14:03):

I think I would say two have made the biggest impact on my life, and you'll see there are obvious ones once I mentioned them, but I think it's really important that I do. The first one is I had an experiment where I started working out, and this was in my late twenties I want to say. And my goal was to work out every day for a year, and I think I worked out six days a week for a year. And what that did is it got me into this habit of working out and that's been quite great.


The other experiment that has made a huge impact was reading a book a week. I now, every weekend, sit down and spend six, seven hours, and read a book cover to cover. And I have the focus, the ability to just go in and finish a book in one sitting, almost no matter how thick it is. I can probably take a 700 page book and push through it in a single day. And having that ability means that I consume a lot of books, and I think consuming books is one of the best ways we have as a species to better ourselves.

Daniel Scrivner (15:17):

Yeah, that's well said. Is there anything that you learned? I just imagine, so obviously you're reading a book a week. You are training things, you're training your ability to focus for a long period of time, you're training your ability to just sit and just read and not get off track. Besides that, was there anything practical about the way that you approached it that was unique? Meaning, did you read at a certain time per day? For someone listening that say, ''Okay, that's amazing, I want to try to read a book a week.'' Any advice you'd give them, tips or just little hacks?

Emi Gal (15:47):

Yeah, by far the biggest hack is read stuff you like. I have zero FOMO about starting a book, 20 pages in, it's not for me, or maybe not for me right now, I just put it down and I pick up another book. I think a lot of people feel like, ''Oh, I've started reading a book, I'm invested into this book. I've heard great things about it. I'm just going to try to read it.'' For me, if I'm not interested in that topic or that story right then, I'm just going to put it on the side, pick another book, and then maybe come back to that book at a different time when I might enjoy it more. That's made the biggest impact by far in how many books I read.

Daniel Scrivner (16:36):

Yeah, because then you just actually want to read every time you actually sit down to read. Now there's no pressure. You can stop at any point in time.

Emi Gal (16:41):

You have to want to enjoy it, otherwise you're not going to want to do it consistently. You might do it like you did it in school, ''I have to push through this.'' But you wouldn't look forward to those seven hours of reading. And I always look forward to those seven hours of reading.

Daniel Scrivner (16:56):

That's one of the most underdiscussed parts of habit formation, is find a way to just do stuff you like and then find ways to enjoy it more, and then find ways to not do what you don't want to like. It's actually somewhat simplistic, at least in some of those areas.

Emi Gal (17:09):

And actually, a corollary to this that I learned in the experiment when I was working out, was, working out every day for seven days a week is actually really, really hard. I don't know how many people have tried it, but it's not easy, and I struggled with it for a fair amount of time. And then the tiny habit that ended up working for me the best was, if I would wake up in the morning and didn't feel like working out, what I would do is I would put my running shoes on and I'd be like, ''If I don't feel like working out after this, I'm going to take them off, have a coffee, go on with my day.'' But obviously, nine times out of 10 I'm like, ''Oh, I have my running shoes on, I may as well just go out and work out.''


I think that's very applicable to books, to just read the first five pages. And you'll notice that if it's something that you like, those five pages will turn to 50, and a 100, and 500, and before you know it you've read the book. At least that's what happens to me.

Daniel Scrivner (18:11):

Yeah, it's eliminating friction and eliminating excuses to not go and do it.

Emi Gal (18:15):


Daniel Scrivner (18:16):

Which makes a lot of sense. Okay, I want to ask a couple of follow-up questions specifically around some of the challenges, and one of them... This is from 2020 that I thought was interesting. I've recently gone through this book and... Because I've read pieces of Antifragile, I finally did the exercise of like, ''I just need to go cover to cover.'' And actually, I did enjoy it. But one of the things you did, I'm just going to read a little bit of what you described on your website that you did. So 2020, ''Inspired by Nassim Taleb's Antifragile, I'm working on creating more antifragility in my life. To identify areas of fragility, I'm spending 2020 documenting all the major mistakes I've made. My hypothesis is that I will find patterns emerging, and those patterns will shine light on fragile areas I can improve.'' How did that go? Did you find fragile areas? What was the outcome of that challenge?

Emi Gal (19:01):

Yeah, so it went very well. And actually documenting one's mistakes is a very useful practice, because it helps you think through the things that you maybe should improve, or could improve, upon the way you do things. I did that. I have maybe a dozen or so what I would call big mistakes. I've been fortunate in, for the most part, being pretty good at making good decisions. But I've made poor decisions many times, and I have concluded that almost every single time when I made a poor decision, I made it because I cared what others would think of me, which was... It did not occur to me that that would be my conclusion, but that was a conclusion.


And right now I care very little about what others think about me, because I've worked on it and I've been like, ' 'It doesn't really matter what...'' Nobody cares, at the end of the day, about me, and so I shouldn't care as much about what they think about me. That was a big insight. It was difficult going through and documenting. And I'm very methodical, so documenting in my case meant I went through, line by line, of what happened, these series of events, how they unfolded and so on. And I now continue with that, so whenever I'm like, ''I think I've made an incorrect decision.'' I go and I document it. And I have a whole log of them, and it's helpful to revisit them every now and then.

Daniel Scrivner (20:45):

I'd love to go a little bit deeper on two areas of what we just talked about. One of them is just the benefits of sitting down and thinking through an area where you made a mistake. I've done this recently as well too, and it is enormously beneficial. I think one of the benefits, at least that I took away from it, was it encourages you and it helps you to think about yourself a little bit more dispassionately, and to actually, almost like a scientist, you're studying this thing. You're not judging yourself in the moment, you're just trying to uncover, and log, and think about, and analyze. Is that a benefit that you've seen as well? And how else would you talk about the benefits of doing that, just some of the skills you're learning?

Emi Gal (21:29):

Yeah, so the nice thing about documenting mistakes once they've happened and some time has passed, is you can do it very objectively. And if you happen to have a very clear way of looking at the way the events unfolded, you have some emails, you have some stuff, then it really helps you objectively assess what actually happened, once the emotions have passed and so on. It's useful because you can learn from the experience. I also find it really useful to revisit these. I wrote them down, I have them in a folder, and I revisit them maybe on a monthly basis, maybe every couple of months. And I click on each of them and I read through and I'm like, ''Oh, okay. I was an idiot.'' It helps me remember to not make the same mistakes again.

Daniel Scrivner (22:23):

Yeah. Yeah. That's fascinating. Okay, I want to talk about one more, which was... Well, okay, I have to ask about two more. So start with 2014 first. In 2014, I'm just going to read this again and we can talk about it. You trained your memory ''with a world memory champion for a year, in order to be able to remember anything. That was awesome.'' Was just the commentary you provided. The question that I wanted to ask is, I think people listening would be fascinated to hear a little bit about, what does it mean to train your memory? What are some of the things you did there? And then, if you could give everybody a cheat sheet, or one hack, or one thing that's an effective tool to be able to do. Is there anything you can share there? Any simple, easy tools?

Emi Gal (22:59):

Yeah, so there's a story behind each of these experiments, and the story there was that I had forgotten to call my mom for her birthday the year prior, so 2013. And I felt really bad about it and my sisters told me the following day I think, ''Hey, you didn't call mom.'' And I was quite upset. And so I decided, ''You know what, I'm never going to forget stuff like that again.'' So made it my experiment for the following year. Found this guy, Mark Channon, who is an incredible memory guy, and he was a memory champion in I think late 90s. He had a show on the BBC, training people to improve their memory. And when I say train, I mean train in the most direct way you can think about that, which is, you have some strategies, as you do in anything, and then you just apply the strategies day in and day out, and you practice them until they become muscle memory. And an example that I'm sure a lot of people have heard of is the concept of a memory palace, so if I-

Daniel Scrivner (24:03):

The concept of a memory palace. So if I tell you to think of the road between your house and your favorite coffee shop, you will right now be able to picture it. Everyone listening will be able to be like, "Oh yeah, I see everything." Every single building, every single sign, it's in your memory. A memory palace basically attaches something that you want to remember to areas in this memory palace. So let's say that you wanted to remember the first 200 digits of pi. There would be two steps to that. I know because I used to recite the first 200 of pi just for fun at dinner parties. There are two steps to being able to do that.


The first one is for every number from zero to 99, I used to have an image associated. So I don't know, number 53 would be an elephant. Then what you would do is on your way to your coffee shop, right outside your building of a house, there's an elephant and that's the first two digits you want to remember. Then you just put these objects all over your path from home to the coffee shop. It sounds silly but it works incredibly well.


A very practical example of a memory strategy is remembering names, right? How do you go about remembering someone's name because you're just meeting them, you're shaking hands? You're already thinking about what you're going to say next, and before you know it, you don't know what they're called, right? There's a very simple strategy that I now apply every single time that's really effective, which is I find the closest funny thing I can think of that kind of sounds like the name of the person and I just attach it to their head.


So if I'm meeting someone called Rich, I will just see a bunch of dollar bank notes around their head and then next time I see them, I'm very likely to remember that they're called Rich because I will just see their head and bank notes floating around. It sounds silly but it works. These strategies are incredibly effective.


Well, it's fascinating that in both of those examples there's a visual spatial element to memory and to trying to remember these things, which makes sense. One, it seems like you're including other senses and making it a richer experience. But yeah two, it's like less 2D, less floppy disc, more three dimensional, immersive.

Emi Gal (26:30):

Absolutely. Mark who trained me had this phrase that really stuck with me, which is that a person with a great memory is a person with a great imagination. Because if you have great imagination when you're speaking with someone and you're trying to picture things to remember things and so on, it makes you more present and it makes you more likely when you're looking at that person to remember the things because you're seeing objects floating around them.

Daniel Scrivner (26:56):

I'm just make literally making a note. It's amazing. Okay, last question that I have to ask is, and this is a treat of an interview where I have so many questions I want to ask and the exercise is just try to pare it down. So the last question I'm going to ask about your yearly challenges is in 2015. I kind of talked about it earlier, but you interviewed elderly people and asked them a set of 10 questions and you posted some of those interviews on your blog. So the question I was curious just with that is what you took away. I think part of it would be what you took away emotionally from that experience. I imagine it was probably powerful in many ways. Then also just what you took away if there was a single reminder, a single lesson, a single, I don't know, just what you took away conceptually from those conversations as well.

Emi Gal (27:48):

So emotionally, I'll start with that because it was indeed at times very emotional. Remember this one interview with a gentleman called Jeff and I bumped into him in Union Square in San Francisco. I was there for some meetings and I was doing my thing and I went to the square and I went to a couple of people and all of them said, "Oh, I don't want to speak with you." Then I stumbled upon this guy Jeff and he was 82 but full of life and he had lost his wife and he was traveling by himself at 82 traveling the world. He told me that the biggest thing that he learned from 82 years of life is that it all goes in an instant.


So the emotional takeaway that I kind of often think about is how short life is actually. Then if you take that further a little bit and think about events that you might have in your life. My dad's 74. He lives in Romania. I go to Romania twice a year in a good year. So that means I have another 25, 30 times max to see my dad. That really puts the shortness of life in perspective. The kind of more interesting rational insights from speaking with all these folks were, one, I started with some hypotheses when I started this experiment.


One of the hypothesis was that if you ask people at the end of life what mattered, none of them will mention money as it. They'll all say family or whatever. Actually most of them said that money's very, very important because you cannot bring a family up, you cannot enjoy life, you cannot travel, you cannot do anything if you don't have money. So it wasn't money for the purpose of having money, but it was money for being able to bring up a family and enjoy happy moments with family and so on.


That was a really interesting... It changed my approach to things. So I was like, "Okay, that makes sense. Let's make a bunch of money then." So whereas before I had a more ambivalent attitude towards it, then I was like, "You know what, it's actually important to be able to afford things with your family so let's focus on that."

Daniel Scrivner (30:15):

Yeah. I mean, I love that insight because one, it's controversial or at least you wouldn't expect that that's what you would hear. Then two, it's I think, yeah, to your point, depending on how you grew up, a lot of people have very different perspectives on money. What I mean by that is I've met a lot of people that view it very negatively. Just viewing money as a negative thing and viewing the pursuit of money as a negative thing and viewing having money as a negative thing obviously shows up in a lot of areas of your life. So I also just love that it's a, I don't know, a reframing of it's positive but it's positive because it's fuel for life, not because you want to have it and be Scrooge McDuck and go dive through coins in your house.

Emi Gal (30:57):

100%. Actually, that's a perfect segue into the second thing that I learned that kind of was an interesting thing to see, which was none of these people, and I spoke with a whole bunch, regretted anything that had to do with work or career or profession or whatever. It was always to do with family and not spending enough time with family or loved ones and not pursuing one's love. It was always related. Regrets were always related to people not related to careers, which was a very interesting insight as well.

Daniel Scrivner (31:31):

Yeah, that's fascinating. So we will link to all these in the show notes. Again, if you're curious, if you're on your phone now or the computer, you can find these at emigal.com/challenges. Super cool. I'm so glad you put those online and were willing to talk about those. So thank you. Okay, I'm going to switch text and go to some of the more traditional questions that we typically ask. The one that I wanted to start with, we've talked about obviously tracking your habits.


Before we started recording, you were talking about a tool that you use called work cycles that maybe we can put a nod in in this answer. But the way I typically ask this is if people listening could shout you for a day from the moment you get up to the moment you go to sleep, as creepy as that might be, what do you think they would be most surprised by in terms of how you live your life or how you work or just any aspect of your day?

Emi Gal (32:14):

I think by far the thing that would be most surprising would be the insane amount of discipline that I put into my life. I start at a very high picture. I have three things that I want to kind of achieve in life. I want to contribute an important idea, I want to work towards an important goal, I want to have a happy life with my family. That's it. Those are three. That's what I'm working towards. To achieve those three I kind of have every decade I put together a plan and then every year I look at my decade plan and I put together an annual OKR doc basically.


Then every month I set objectives that month and every week I set objectives that week. Every day I wake up and I look at all of that stuff and I make a list of things that I'm going to do that day. Every day I also review my calendar and I go like, "Am I working towards these goals or not?" Obviously I don't succeed most days, but the process of going through and making sure that I'm working every day on something that is important to me creates a lot of accountability, kind of self accountability. Then I'm very disciplined towards that.


So I run my meetings. I'm never late and I'm never one minute over my meeting because they're always stacked back to back. This year I'm doing an experiment. I'm not drinking for example because, again, I wanted to further enhance this performance and ability to be very, very disciplined. I make time to squeeze in five workouts a week and so on. I think the thing that would surprise most people is the level of discipline across every single aspect of my life that I apply.

Daniel Scrivner (34:06):

I'm going to ask a kind of follow up question which is that answer is not surprising to me when I think about the spreadsheet that you use to track all those 150 biomarkers or even the yearly challenge. Executing a yearly challenge requires enormous amount of discipline. So I'm not surprised by that. But it does seem like potentially you didn't used to be disciplined and this is something that you've evolved and grown into. So I guess one of the questions there is advice for anyone listening that wants to become more disciplined, is it as simple as picking a discipline and then you've just stacked it over time? As you reflect back on how you got disciplined, I don't know, could you decode that for others listening, give them advice?

Emi Gal (34:43):

I can actually pinpoint the moment in life when I started pursuing discipline, which was I was very good at math in school, in high school, and because I was very good at math, our kind of math teacher taken me and another girl in the class under her wing kind of. So we would do kind of private tutoring with her in order to get even better. I remember this one time, both myself and this girl were there and then we finished the session and then my teacher was like, "Emi, you should stick around for another five minutes."


So the girl leaves and I stick around and she goes, "Well, you are much better than this girl at math. However, you are significantly lazier, therefore she's going to get ahead much more than you are because of that." That for some reason made a bit of an impression on me and it stayed with me and I didn't do much of it through high school and so on. But then when I started my first company when I was in college, and because I had to go to university and run a company, it forced a little bit of discipline into me. Then I discovered how valuable it can be and how much stuff you can get done if you're insanely...


... how valuable it can be and how much stuff you can get done if you're insanely disciplined and just layered in more and more and more discipline over the years. I don't think there's any silver bullet added to it. I think it's just you have to decide you're going to be disciplined and just do it and be okay with the fact that most of discipline is actually failing at discipline and then-

Daniel Scrivner (36:25):

It's true.

Emi Gal (36:25):

... not giving up on it.

Daniel Scrivner (36:27):

Yes. Yes. I mean, and that totally makes sense, and that's been my experience as well, too. I feel like there are part of its as well, too. I think something that I've often thought about a lot as my life as become more disciplined is I don't see my life as boring, and yet I think for many people... Again, if they were to follow my daily routine, I work out in the morning, I go to the same restaurant for breakfast, I order largely the same things. It's almost cookie cutter.


And one of the best quotes that I saw recently that I was like, "There we go. That's starting to maybe get at what I see in discipline," which is basically something along the lines of sometimes extreme routines can be a sign of ambition. And I was like, "That actually makes a lot of sense," because in many ways, there's a boringness to it, but there's also a fulfillment in the fact you're doing all of those things all the time. Anyways, it's just kind of an observation on discipline.

Emi Gal (37:19):

Absolutely. And the way I think about it is life is essentially an accrual of things you do and decisions you make and habits you form, and you have complete agency on what those things are. And if you create a lot of discipline in doing the right things, it kind of creates a sort of positive complexity to life, because you're doing all the right things. And you can still get unlucky, but you're more likely to get lucky if you're doing all the right things, which would then kind of steepen the positive end of the convexity curve for your life.

Daniel Scrivner (37:59):

I'd be curious if you have a take on this. I mean, one of the little thought experiments or one of the questions that's run on a loop in my mind is if you were to try to pinpoint why discipline is valuable, what would you point at? And the way that I've kind of framed that up or thought about it is we all know that compounding is one of the most powerful forces in the universe.


What is compounding? I mean, one of the core ingredients is just literal consistency, because you have to do it time and time and time again. And even just hearing that story of your teacher having a conversation with you about another student, it's almost like what she was saying is this student is more consistent with her practice, so she's going to make more progress. So for you, do you kind of boil it down to consistency? Does that ring true for you as well, too?

Emi Gal (38:44):

I couldn't have said it better. I think compounding is the most powerful force in the universe, and that everything compounds positively or negatively. And therefore, you want to compound positive things, and I think one hack to get there is discipline.

Daniel Scrivner (39:05):

Yeah. That's well said. Well, I want to ask a couple of closing questions. So you had a challenge for a year where you read a book a week. You now regularly sit down over the weekend and read. So one of my questions is just really simply, what books that you have read have had an outsized impact on you? And these can be fictional books, these can be books about business. When I ask that question, when you think about books that have had an outsized impact or that you just regularly recommend to others, what comes to mind?

Emi Gal (39:33):

Yeah. The one book that I recommend to everyone that has made a huge impact on me is Antifragile by Nassim Taleb, and I've actually now read all of his books multiple times. And that book has really made me look at my life in very different terms than I did before.


And I'm an entrepreneur, I'm an optimist, I'm a risk-taker, but that book has kind of helped me layer in the concept of expected value and the concept of, okay, you're taking risks, but the risk should be high enough that it has a big impact, but not so high that it can go bust. Not financially, but in whatever endeavor you're taking. And so I'm a huge fan of Antifragile and Taleb himself. I was actually part of a course he did, and he's a very interesting, incredibly smart character, and he really lives the stuff he writes.

Daniel Scrivner (40:43):

Yes, he does. Yeah, he does. And if anyone's curious about that, just go follow him on Twitter.

Emi Gal (40:48):

Exactly. Yeah. And then-

Daniel Scrivner (40:50):

One of the best things I think that you could say about him, or the thing that I would say about Nassim Taleb, is he's a provocative thinker. I think there's deep thinkers, there's strategic thinkers. I think he's someone that just has very provocative thoughts, meaning he comes to conclusions and has insights that I don't think anyone else would get to.

Emi Gal (41:08):

Absolutely. And I disagree with him on some stuff, but he has skin in the game whenever he makes a statement. I'll give you an interesting anecdote from this course that I did with him, because I think it illustrates to what extent he goes into the stuff that he preaches. So he runs this thing called Real World Risk Institute, and I signed up for it, and we were doing it. It was a thing on Zoom.


And midway through the course, the course is about two weeks, he was going to Lebanon to see family. That's where he's from. And he dials in from Lebanon midway through the course and he goes, "Guys, I'm here. I have one computer on one internet connection here. I have another computer on another internet connection here in case this internet connection drops. I have a generator in my house in case electricity drops. And if all fails, there's a driver downstairs to take me to the closest internet cafe so we can continue the course even if the world collapses." And so that's kind of the extent to which he practices what he preaches, which I was quite impressed by that. But he is a character on Twitter.

Daniel Scrivner (42:29):

No, he is. He is. And, yeah. He's polarizing. Everyone has a strong opinion, but I think he's someone that, if you can just look past any parts of his personality that might be off-putting and just focus on the ideas he's presenting, the ideas are incredibly strong and interesting, and they're very rooted in a lot of research. So I'm going to ask one more question, but before I do, I just want to thank you. This interview is about two times longer than we normally do. Thank you to everyone listening.

Emi Gal (42:55):

Sorry, I guess.

Daniel Scrivner (42:57):

No. No, no, no. This has been amazing, so thank you so much for the time, Emi. The last question, and this is one that I always ask, is if you could go back to the start of your career and whisper some words of advice in your ear or whisper a reminder in your ear, is there anything, knowing what you know now, having been through everything you've been, that you would tell yourself?

Emi Gal (43:16):

Actually, there is, and it's very related to what we were just talking about, Taleb. And the one thing that I've learned is that life is very path-dependent, and so what is really important very, very early on in life is to increase the optionality of this path dependence. So what you want as a young 20-year-old is to be able to pursue any and all options that present themselves with a potentially high payoff from a career, life, whatever you want to achieve standpoint.


But you can only pursue those options if you have the optionality to do so, if you are open to those opportunities. And that might mean not choosing a career very early on. It might mean not getting a job and just instead exploring various different things, even. Whatever that means for you, it is important to absorb the concept of optionality and keeping options open so that you can pursue any path that might be better than the current one.

Daniel Scrivner (44:26):

I've always really appreciated that advice, and I've tried to live that advice. On the flip side, I feel like for some people, that advice can almost be don't have conviction. Just be open to a lot of different things. Is that how you think about the cynical view of it? What is the opposite of being path-dependent, I guess?

Emi Gal (44:45):

The opposite of being path-dependent is having very, very strong views, and I believe it's important to have strong opinions, but hold them very weakly. Strong opinions, weakly held. You should obviously pursue something that you're really interested in, that you think is really important for you, but not to the extent that you put blinders on and you don't see the rest of the opportunities that might present themselves.

Daniel Scrivner (45:21):

Yeah. I mean, I love the connection you made there, which is it does seem like those are perfectly connected. The strong opinions, loosely held, and you want to have a strong point of view about where you're going, but be open to a lot of optionality.

Emi Gal (45:33):

Absolutely. Absolutely.

Daniel Scrivner (45:34):

Very related. Thank you so much for the time, Emi. This has been so much fun.

Emi Gal (45:38):

Thank you, Daniel. This was great.

Daniel Scrivner (45:39):

Thank you so much for listening. You can follow Emi Gal on Twitter @emigal, that's at E-M-I-G-A-L. And you can learn more about Ezra, which is bringing fast and affordable cancer screening to everyone, at Ezra.com. That's E-Z-R-A dot com. You can also find a searchable transcript of this episode as well as our episode guide with ways to dive deeper into the topics we explored today at Outlieracademy.com/145. That's Outlieracademy.com/145.


For more from Emi Gal, listen to episode 146 where we decode how Ezra has brought down the cost of cancer screening via MRI by 80% and the time required to get screened by 66%, all by harnessing the power of AI and machine learning. We cover how the cure for cancer already exists and why it's early proactive detection, as well as the incredible technology behind Ezra's approach to cancer screening. You can find that episode at Outlieracademy.com/146.


For more from Outlier Academy, follow us on Twitter, LinkedIn, Instagram and TikTok. Subscribe to our free weekly newsletter at Cheatsheetnewsletter.com. Subscribe to our YouTube channel at Youtube.com/outlieracademy, where we have videos of all of our interviews, as well as our favorite short clips from every single episode, or visit Outlieracademy.com for more incredible 20-minute playbook episodes. We'll see you right here with a brand new episode next Tuesday.

On Outlier Academy, Daniel Scrivner explores the tactics, routines, and habits of world-class performers working at the edge—in business, investing, entertainment, and more. In each episode, he decodes what they've mastered and what they've learned along the way. Start learning from the world’s best today. 

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Daniel Scrivner and Mighty Publishing LLC own the copyright in and to all content in and transcripts of the Outlier Academy podcast, with all rights reserved, including Daniel’s right of publicity.

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