MEET Casey

Casey Lynch is co-founder and CEO of Cortexyme, a biopharmaceutical company that’s pioneering disease-modifying therapeutics for Alzheimer’s and other degenerative disorders. She learned to snowboard when she was 14.

What advice should first-time founders heed?

My favorite advice, which I still tell myself often, is to take the next right step. Especially as an entrepreneur, it’s easy to get caught up in either overconfidence or fear of failure. Instead of thinking about the meeting you have later today, you start thinking about all the meetings after that, and all the experiments in process, and all the potential outcomes. At Cortexyme, we just went public and we’re really excited about the long term. But our focus right now is on executing our clinical trial—making sure the patients are safe while getting the best quality data as quickly as possible, so we can bring a new therapy for Alzheimer’s disease to market as quickly as possible.

Taking the next right step isn’t the same as moving slowly. You need to play out the full chess game to know the next step to take. And you might have multiple next right steps to take at once. For example, our team started working in parallel as early as we could—doing animal studies and developing a drug at the same time. I feel very strongly that, as long as what you’re testing is safe, the work can’t just be a science project that goes on indefinitely in animal models. We owe it to patients to be efficient.

What question are you asked more than any other?

A lot of people ask, “Do you really believe the same bacteria that causes gum disease also causes Alzheimer’s?” If you haven’t seen the data, it can seem like an overly simplistic explanation—and we only started publishing our findings in January. Of course, I absolutely do believe it. But I understand the skepticism, too. We’ve spent five years working on this project, and for the first two, we were doing studies just to convince ourselves.

Now, other people are catching up. And while we had years to make the case to ourselves, I usually have a half-hour to make the case to someone else. Distilling all our findings into a couple of slides isn’t easy, but it can be done. And once people understand the data, it’s usually not hard for them to start believing. They realize what may have seemed simplistic is actually a really elegant theory that explains a lot of the more complex information we have about the Alzheimer’s brain. Sometimes the simplest explanation is the right one.

What experience shaped who you are?

Two of my grandparents had Alzheimer’s disease, and I’m sure that experience made me want to solve this puzzle. It’s very emotional and almost surreal to have a family member go through that. It’s definitely a motivator not only for me but for a lot of people at Cortexyme, some of whom have parents with Alzheimer’s right now.

Graduate school was formative, too, because I was working on the research with my own hands. I was trained to hypothesis test and do controlled experiments, and that mindset of moving things forward in a linear way has stuck with me. I still participate in lab meetings at Cortexyme; I like to hear what everyone’s working on and put in my two cents.

But grad school also highlighted who I’ve always been—my parents would be the first to tell you I’ve always questioned conventional wisdom. It was really frustrating to me to see the single-minded focus on beta amyloid as a target, because we’ve already had 30 years of failures in that space. So I wanted to look elsewhere.

What’s the best interview question in your toolbox?

I often ask, “What was your relationship like with your last manager?” It’s a version of the traditional interview question, “What was a problem you encountered and how did you solve it?” But I like to focus it on relationships because they’re so important to building company culture—and at the same time, it’s so easy to overlook those subtle personal dynamics when someone has amazing technical skills.

In their answer, I want to hear what worked, what didn’t, what decisions their boss made that they disagreed with and how they handled that. I want to hear that they know how to ask for the support they need and are comfortable speaking up if they think something’s going in the wrong direction, but also that they understand difficult decisions sometimes have to be made.

What book should every company-builder read?

I read a good one recently called The Great Ulcer War, by William Hughes. It’s about a scientist in Australia who discovered that the bacteria H. pylori caused ulcers. At the time, people thought ulcers were caused by stress and spicy foods. Patients were treated with antacids. There was a huge amount of groupthink, and it took 10 years for the scientific community to finally accept that you could treat ulcers with antibiotics instead.

It’s essentially a story about entrenched interests and unconscious bias, which a lot of entrepreneurs run into, especially in the sciences. Whether they realize it or not, scientists have biases just like everyone else. And as I often remind people, “You wouldn’t ask the person who started Pepsi how Coke tastes.” So why would you ask someone who’s spent 20 years working on the link between the beta amyloid and Alzheimer’s what they think of the role bacteria plays? When people actually look at the data, though, they become converts. I think it’s a testament to the power of an innovation if it eventually breaks through.

What’s a lesson you learned the hard way?

The co-founder relationship is so important—it’s like a marriage. You have to be on the same page about how the company will be built. And I’ve seen a lot of companies, including some I’ve consulted for, where the co-founders have run into conflicts on everything from equity to board decisions to simply how they handle frustration.

When you’re working on an opportunity you’re really excited about, it’s tempting to jump in with both feet. But I feel lucky that with Cortexyme, my co-founder and I had about a year to get to know each other while we were generating key data and building out the business case for the company. We did experiments together and got to learn a lot about how we think and communicate, and it turned out that we had synergy and very complementary styles. By the time we actually launched the company, it wasn’t even a question. We couldn’t not do it.

What invention do you hope to see in your lifetime?

More hours in the day? But seriously, this won’t come as a surprise: More than anything else, I’d like to see a world without Alzheimer’s. The disease takes such a huge medical, financial and emotional toll on patients and their families. I’m excited about the progress we’ve made with our collaborators so far, on understanding the role of bacteria, and also about the opportunity we have to test our efforts clinically. There’s still a lot of work left to do, but we intend to do everything we can to make a difference.

Hard-won advice