The afternoon I meet Dexter Hadley, the haze from Camp Fire, 160 miles to the northeast, is thick enough to dim the afternoon sun. Hadley is a physician and scientist at the University of California, San Francisco, and for lunch we go to a food-truck gathering spot near his office. Under the circumstances, the small gas-burning fire pit in the center of the space seems superfluous, but its Mad Max ambiance—and the many people walking the streets wearing surgical masks—lends a suitably apocalyptic air to our discussion. It’s a good day to talk about tearing down the entrenched structures of public health.
Hadley has the smooth voice of a late-night DJ. He likes to say that ten years of medical school helped him figure out how not to practice medicine. “I went to a top-three medical school and I didn’t hear the word ‘genome’ once,” he says (even though genomic medicine is a hot topic these days). After earning an MD, and then a PhD in genomics and computational biology (with a Masters in systems engineering thrown in for good measure), Hadley took a residency in pathology at Stanford. In his downtime, he took a class in startup engineering that asked students to devise crowdfunding plans using bitcoin. “Clearly,” he says, “I was trying not to do pathology.”