Why Big Bets?

I was staring at the thatched ceiling of my hut. It was dark out, but the heat and humidity were still overpowering. A mosquito coil burned next to me, doing little to stop the biting swarms around my cot. As I tossed and turned, hoping to catch just a few hours of sleep, it became clear:

I wasn’t cut out for this.

That was in 1995. I had decided to spend the summer before medical school volunteering at a clinic founded by the legendary Dr. Hanumappa Sudarshan in the B.R. Hills of southwestern India. Dr. H, as we called him, is as close to a living saint as I have met. Years before, he had walked away from prospects of a wealthy medical practice in bigger cities to live in the rustic BR hills and establish a clinic to assist the Soliga people—a native group of around 30,000 in the region—who were struggling with hunger, poverty, and disease, particularly leprosy. And in the years before I arrived, Dr. H and his team had helped nearly conquer leprosy in the community.

When I showed up eager to do my part, I soon realized it was easier said than done. Life in the B.R. Hills wasn’t easy for anyone, but as a 22-year-old who had spent much of his childhood living in the suburbs of Detroit, I struggled and slipped into self-doubt. We would go hut to hut with a small plastic stick probing for shedding skin, one of leprosy’s telltale signs. We would sit with Soliga children sharing a basic but nutrient-rich meal—what is known as a ragi ball, a bundle of millet soaked in curry—each evening. We would go to bed in the stifling heat and quiet.

The experience was overwhelming but so was the math. The Soliga were about half the population of the BR Hills region. Nearly a billion people were living in India at the time, and billions more lived around the world. There was not enough ragi balls, plastic sticks, and people like Dr. H to tend to them. The proof was in the data: that year, eleven million children under the age of five—56 percent of whom suffered from chronic malnutrition—died, almost all in lower-income countries.

How could we do more for more people? And how could I do more, especially when I realized I could not live in a place like the B.R. Hills?

You might have similar questions, be doing similar math.

Finding the answers has taken me a long time and, while I don’t have them all, I’m excited to share what I’ve learned with you. My upcoming book, Big Bets: How Large-Scale Change Really Happens, available October 10, is filled with the lessons I’ve learned for improving lives, livelihoods, and the world at scale. I wrote Big Bets to help guide you on your journey to making our world a better place—for as many people as possible.

What is a big bet?

Big bets are concerted efforts to fundamentally solve—not just improve—the world’s most pressing problems. That means setting ambitious, seemingly unachievable goals and working to achieve them. Successful big bets require finding innovative solutions, building broad alliances with unlikely partners, and persistently tracking and following through on measurable outcomes.

I’ll admit that is not easy—and I’ve failed in big ways, too. In Big Bets, I share stories from successes and failures in my two-decade career across philanthropy and government. But Big Bets isn’t just about what I’ve done in the past. It’s about what you want to accomplish in the future—and how you can make good on your boldest ambitions.

Adopting a big bet mindset doesn’t require you to be a living saint like Dr. H—I’m certainly not one. I learned that about myself in that hot hut in the B.R. Hills almost 30 years ago. Very few people are cut out to be saints, but anyone, from an intern to a president, in any organization, can benefit from a big bet mindset. It unlocks an ambition for change that is all too rare in this world, and it makes getting out of bed every morning invigorating and fun—because you’re working to make a meaningful difference.

Big bets are needed now more than ever. Our world has no shortage of issues to address, and no one person or organization can take them all on. Too many people are going to bed hungry every night. Women and people of color have been left out or left behind. Democracy in many nations is under attack. And the threats created by climate change require immediate action.

My hope is that the book will give you the information and inspiration you need to make big bets of your own. You don’t have to get it right, right away. If you pursue a calling to change the world, you’ll have missteps and false starts. I struggled to find my path for nearly a decade after leaving the B.R. Hills. But I’ve learned—and hope you will too—that once you see what big bets can accomplish, you’ll believe it’s realistic to be optimistic. Pre-order my book today and join me in making Big Bets.