David Betts on ALS, AI, and What Happens When Fear Becomes Fuel (Part 1)

David Betts spent 22 years building teams at Deloitte, scaling their public health practice from one state to 20 during a pandemic, and getting very, very good at solving other people's problems. He's the kind of leader who walks into chaos and thinks: what's actually needed here? Then he figures out how to build it.

Last year, he got a diagnosis of ALS. The progressive neurological disease that destroys motor neurons—the kind that ends stories. Most people would take time to process. David looked at what was happening and thought: nobody's going to know if I fail at this, so I might as well try.

He taught himself to code in 80 days. Built an AI voice assistant called Talk to Me Goose that's now with more than 100 families. And did it all while coming to terms with a disease that's stealing his ability to speak—the exact ability he uses to solve problems and think and connect with the world.

But here's what makes this conversation worth your time: it's not about inspiration porn or overcoming adversity. It's about what happens to your clarity when the stakes get this real. When you can't hide behind strategy anymore. When the gap between what you think is important and what actually is gets impossible to ignore.

Foster and David explore:

• Why his background in theater—not consulting, not healthcare, theater—ended up being the thing that prepared him for everything
• What he found when he went looking for solutions for people losing their ability to speak (and why the technology was so spectacularly broken)
• The specific moment fear became something that propelled him forward
• How purpose shows up when you're paying attention versus how we talk about it in TED talks and LinkedIn posts
• What intentionality actually requires of you when your body's timeline is different from everyone else's
• How he's building a company that doesn't feel like a startup, but like a mission dressed up as a business

This is a conversation about resilience that doesn't require you to be inspired. It's about clarity. About knowing what matters and having the backbone to build it even when the fear is very real and very legitimate.

Learn more about David and Story Flight Labs: storyflightlabs.com

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Hosted by Foster Mobley
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Produced, Edited, and Promoted by Zettist

Additional support from Amber Jillard Consulting

Music for Season 3 composed and performed by Philip Aaberg. Courtesy of Sweetgrass Music.

Transcript

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SPEAKER_03 0:00

Less than a month after my diagnosis, I sat down and I thought, well, nobody's gonna know if I fail at this. So I might as well try.

SPEAKER_02 0:22

His resume says he's founder and board chair of Story Flight Labs, a public benefit corporation dedicated to restoring dignity, sparking imagination, and strengthening human connection with a focus on people living with speech limiting disabilities and conditions. He's a retired principal at Deloitte in their healthcare experience and transformation practices, where he served for over 21 years, and a former professor of theater at Carnegie Millen University. And while all that's important background data, I'm more excited by what David Brooks calls his eulogy virtues, service to others, resilience, optimism in the face of significant challenge, and a focus on his daily practice of intentionality. Oh yeah, David's also got ALS, the progressive neurodegenerative disease that destroys motor neurons in the brain and spinal cord. You may know it as Lou Gehrig's disease. But as you'll hear in this interview, that's a powerful and directional force for David, as it obviously must be, but not a limiting force in the way it might be for others. Inspiring on so many levels. Please welcome David Betts to Stepwise. David Betts, thank you for joining us in uh Stepwise.

SPEAKER_03 1:41

Foster, it's great to be here. Thank you for having me.

SPEAKER_02 1:43

I appreciate this. I'm so looking forward to this. You know, you're one of the few people that I've spoken to outside this short podcast thing that I said, I think we need more time. You're such a fascinating guy. You have great stories, and there's so much going on in your life that I want to make sure that we don't give that short shrift.

SPEAKER_03 1:59

So here we are. I'm thrilled to be here, Foster. It's a it's a privilege to be on with you, and uh I look forward to the conversation today. David, thank you.

SPEAKER_02 2:07

Hey, uh, so give us the uh elevator speech. Who is David Betts uh and what brings you here?

SPEAKER_03 2:12

Well, uh Foster, I spent uh the better part of 22 years at Deloitte Consulting as a leader in our healthcare practice. Most of that time spent in the commercial healthcare industry serving hospitals, health insurance companies, uh, health technology companies, retailers at the intersection of consumers and health. Most of the work that I did focused on patient experience, doing a lot of the research on what really matters to people uh when they intersect with the healthcare industry. So important. In 2021, coming out of the pandemic, I got a phone call on uh New Year's Eve asking if I could lean in and help out a few hours a week with one of our state clients as they rolled out the COVID-19 vaccine. And uh a few hours a week turned into the, you know, all it 60 to 90 hours a week as we stood up 24 mass vaccination clinics in one of our larger state clients. And it's the hardest thing I've ever done, but also one of the most gratifying. And as I've said to people, it no good deed goes unpunished in the firm. I was asked by the firm if I would be interested in standing up a public health transformation business within the firm to serve the state and local market. So that's what I spent the next few years doing is building that business uh to serve the state and local market. We didn't have one coming into the pandemic. Uh, we were serving one state. And by the time I stepped away from the business in at the end of 2024, beginning of 2025, we were serving 20 states. We had a team of about 400 people transforming the public health infrastructure for the U.S. And uh super proud of what that team has accomplished and continues to accomplish. But I found myself with a diagnosis of ALS and I stepped away from the business in January of 2025 and stepped away from an amazing firm to figure a few things out, we'll say, and I'm sure we'll get into that conversation.

SPEAKER_02 3:55

We surely will. Before we run away from the Deloitte experience, though, you know, I'm a huge believer in how much our working lives shape us. They reaffirm or put a fine point on the values that we may have held since childhood, ideally. They give us a chance to stretch and grow and test ourselves in ways we've never been tested before. I can only imagine what it was like moving from your role uh as a senior leader in patient experience to healthcare transformation practices uh that eventually uh extended to 20 states. That must have been an amazing experience. If you could kind of boil out from that what you learned about yourself during that time. You got some nuggets for us?

SPEAKER_03 4:38

You know, interestingly, I'm I'm not a public health uh person. Truth be told, Foster, I'm not a healthcare person either. You know, my background's in theater. Studied theater as an undergraduate. I have a master's of fine arts, was on the faculty at Carnegie Mellon for five years before I went back and got my MBA to get into consulting. I landed at at Deloitte in a few years after my MBA, but landed in our healthcare practice and grew up in the business there. So my background is a bit circuitous, if you will.

SPEAKER_02 5:05

The best kind. They are the best kind. In fact, to that point, I've met very few people who ever had the quote calling to be in healthcare. It is just a lot of people who have either had an experience with themselves or a loved one or that kind of thing that said, you know what, I want to be in that, I want to make a difference. I like these people. They cared for me when I was in my, I was having my worst day of my life. Whatever it is, those are the people that are attracted into the industry, in my opinion. I wasn't a healthy care guy either, and I spent now the last 45 years in it.

SPEAKER_03 5:34

Yeah. When I was asked to to build the public health practice in the state and local market, you know, credibility and expertise matter a lot. And um, and that's something that I didn't have. And, you know, what I did have uh was uh a lot of experience, you know, building a team. And I learned a lot uh in in putting that practice together. I think I had to amplify uh my humility. I learned a lot about what it meant to put a team together of experts, uh, where I was probably the person on the team who knew the least about what we were doing in the market, but maybe needed to know the most about how to put the right people in the room and had to lean on those strengths uh to put the right team together.

SPEAKER_02 6:16

Excuse me a second, was there a moment that you've like realized like I'm the least experienced in this room and I better, you know, button it and listen? Or what how did that how did that awareness occur to you?

SPEAKER_03 6:28

Well, we we first stepped back and and I first stepped back and decided that we needed to have a strategy for what it is that we should be doing in the public health domain. And I I spent probably the better part of about six weeks talking to leaders around the country and asking the question, what should Deloitte be doing in this space and listening um to um some pretty amazing leaders who would take my call and then finding the people in the firm who did that, um, who wanted to put you know, put in the time and the effort to build this practice with me, and then actually giving them a platform to build from. You know, for me that was new because in the in the prior work that I had done, I was the expert. And I knew uh probably more than anyone else in the firm. So now suddenly flipping the tables of not being the expert. That was a switch for me. Um, but uh, you know, it was also super energizing and and and instilled a lot of confidence in me that we were doing uh the right things to build uh a practice that was gonna be successful, uh serving a market that is incredibly hard to penetrate because of the complexity uh of the public health infrastructure across the country and how fragile uh it turned out to be um in the pandemic.

SPEAKER_02 7:40

So I'm I'm teasing out a couple of things here, David. One is the realization fairly early on that what got you there won't get you where you want to go. Yeah. Two, that the path forward as a great leader is to listen and not necessarily feel like you've got to be the expert, but surround yourself with really talented people. And three, this notion about learning and humility. If we enter the room more authentically as real people, as opposed to role or contribution or billable hours, we get a lot farther, a lot faster. You and I talked before about kind of lessons you took away from your parents. Was there something in your upbringing that allowed you to get to that point of humility, of learning, of um taking on life, life's challenges as they occur?

SPEAKER_03 8:24

Yeah, you know, I think when I look at my parents and my family, I was the first one in my family to go to college. We were not a family of means. Um, you know, my parents worked very hard. They instilled in us, you know, that hard work ethic of, you know, you work hard, you do the right thing, treat people with respect and kindness. You don't know what other people are going through. Everybody's just trying to make their way in the world. And so you have to have this level of empathy. And empathy is a theme that I think winds its way through the work that I did in customer experience and in the research that we did. Empathy for what other people are experiencing. That's where that humility is born from, is listening is born from, is, you know, how do you empathize with what others are going through and listen and learn? And the more you do that, the more you grow. I mean, they were, I don't want to say simple people because I think that is not the that that that has the right wrong connotation, but sure, sure, sure. No, I think. But in my mind, that's the right way to frame it. You know, we were we had very basic values about who we were. The basic things mattered, right? Treat people with kindness, treat people with empathy, treat people with respect, treat people the way that you want them to treat you. Um, and and that still matters to me today.

SPEAKER_02 9:39

Yeah, that's outstanding. You and I talked about this before. We share similar kind of origin stories about the families of origin, where we came from, not having uh maybe as much as others. I never realized that we didn't have much, but we didn't have much. Therefore, the path forward is hard work. I've never questioned that. That seemed to make sense to me. And I, you know, all these years later, still doing it. It works perfectly well.

SPEAKER_03 10:03

That's right. You get up every day and and you figure out what needs to get done and you do it, and um you don't expect others to do for you what you can do for yourself. I I'm gonna wrestle with that a little bit, I'm sure, in the journey that I'm on, but I and I think about that a lot, to be honest, but but that's how I address every day.

SPEAKER_02 10:20

Back to this notion of empathy. You know, shameless plug from the book I'm working on now called Honoring. My sense about any difficulty in life is that when you are faced with a challenge, you lean into it. You don't pretend any other way, you don't lean back, you don't ignore, run whatever you lean into it. And same with today's challenges with leaders leading five generations across the workforce, none of whom whose value they might share. I've got a million stories in the preparation for this book that said, this is not what anything prepared me for. And yet the people that are doing the best, like you, are leaning into the challenges that they face. And I assume that's part of the uh kind of the origin story um message that you got.

SPEAKER_03 11:01

Yeah. I mean, my father used to always say, you play the cards you're dealt. Whatever they are, you have to play the cards you're dealt. That's what you have to do, and um, you know, that that's who I am.

SPEAKER_02 11:09

Yeah, let's live life that is, not as we wish it to be, as it should be, as we were used to be necessarily, but let's figure this out because dealing with reality is much much more uh actionable than dealing with fantasy.

SPEAKER_01 11:27

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SPEAKER_02 11:54

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SPEAKER_03 12:42

Sure. No, I don't mind at all. I've been quite transparent about it. So yeah, 2024 was a was a strange year. I'm an avid cyclist. And um, and by avid, I mean I was riding, you know, a thousand miles a month. In 2024, I was training for a ride across Britain. Again, it was the second time we were going to do it. It was a thousand miles in nine days. 2023, I just completed a seven-day stage race through the French Alps. It's an amazing experience. I was probably at the top of my you know fitness. Now, by the way, I finished in the middle of my age range, right? So it's not like I'm a professional cyclist. Nobody was offering me a contract, but but I like to do hard things. And uh, and the and cycling was was a hard thing for me, and I like pushing my body to the limit. And throughout 2024, I was experiencing just strange um uh issues with my body, twitching, not really noticeable muscle weakness, but things that were uh hard to explain for me as an as an athlete. I had a number of neurologists basically telling me, you know, nothing was wrong with me. I had one neurologist tell me I should consider getting more exercise. I asked him exactly how that was going to be possible. We had a number of run-ins with the medical system, and I was reminded of all of the work that I'd done in customer experience and health, um, not having a great experience at the time. And and then I started having issues with my speech. You don't probably notice them today. I'm very intentional, but when I get tired, my speech slows down and I slur my S's and you know I work very hard not to let it show, but uh I do have more issues with my speech now than than before. And you may appreciate this. I showed up at a neurologist's office and I said to him, I'm having issues with my speech. It was the first time I had seen him, and he said, Well, I don't appreciate anything different about your speech. To which I said, Well, I appreciate that I just met you, so I don't know how you would appreciate anything different about my speech. I'm telling you, there's something going on with my speech. And he dismissed me, but I finally ended up in December at Mass General at the Healy Center for uh ALS, and and they were phenomenal and they listened to me. And my my primary care doc has been amazing throughout this whole journey, and she listened to me as well. She got me in, I uh they listened to me, and it was very clear to me in the exam. And by this time I had pretty much concluded that this was the diagnosis, and and in that that exam, I could see for myself um that I had a left-sided weakness. And so it was really somewhat confirmatory in some respects for me. Oh, absolutely. I imagine, yeah. Because I had been through every diagnostic already, and this is a diagnosis of exclusion, and the physician was great. And he said, you know, you can't give me a confirmed diagnosis, but this is most likely the path that I'm on. And and my weakness was subtle. Uh, you know, here I am having just finished this ride across Britain. But I was having trouble clipping into the pedals. My feet weren't doing what I expected them to do. And after 20 plus years of cycling, you expect your feet to just go into the pedals automatically, and they weren't. So I was diagnosed in early December and um and showed up at the partner meeting and was able to have good conversations with some very close friends and colleagues. And I hadn't yet decided exactly what I was gonna do. Um, but uh to be able to sit down at that point with folks who I hadn't seen in some cases in in a couple of years because of you know how the firm works. Oh, yeah. Uh to just have one-on-one conversations with folks about what was happening to me was was really uh a gift, an opportunity given the holiday to to start to make some plans about what I wanted to do with the next step in my career, which at that point was still uncertain, but I decided I I should take a few months off, which which turned into ultimately leading to my retirement.

SPEAKER_02 16:31

Got it, got it. After 21 years of the firm, that's a big shift.

SPEAKER_03 16:34

Yeah. I was very worried about you know, what was life going to be like when I got up without a full calendar of calls and travel, and that did scare me, um, you know, uh amongst all the other fears that I had. But uh I seem to have found some things to to focus on. Apparently so.

SPEAKER_02 16:51

Apparently so. You um you leave the firm, you take a couple of couple of minutes off. Kind of walk us through the process of moving from full calendar, triple hatting at Deloitte. They call that when you have multiple jobs, they call it triple hatting. It's a nice way of saying you've got multiple jobs and you're working too damn much. So from that point of full full outlook to time off to today, how did that path happen?

SPEAKER_03 17:18

It occurred very quickly coming off of my full schedule. My speech issues were pretty prominent because I was talking all the time. And I'm someone who processes the world out loud. And so I wasn't sure how long I would have the ability to speak. Um, now that I had a diagnosis in hand, and knowing that my speech was impacted, and knowing that that's how I process things, that's how I solve problems, that's how I think. I thought to myself, well, now I have this time on my hands, let me look to see what solutions people use when when they lose the ability to speak, because I'm a consultant, like once a consultant, always a consultant. And I immediately started scouring the market to see what tools are out there, and I was disappointed with what I found. The quality of the voice technology that was out there that was being used by the leading providers was still very robotic. And secondly, it every one of the solutions out there still requires you to type everything you want to say. And so for someone who is typing with their eyes, uh, as you lose motor ability in your hands, the length of time it takes you to type something, in today's world, people disconnect from you. And that human connection matters. Again, listening to the people who are living with this disease, that loss of connection was just so stark to me. Um, as people just get their world gets smaller, how could we reconnect people by using technology, using artificial intelligence to speed up the process to return not just efficiency to this, but some dignity? And then the third thing was you know, the process of getting one of these solutions is so hard and costly. Could we solve that more efficiently? And so I kept looking for better solutions. And apparently I'm not very patient, Foster. So I took a few classes to teach myself how to code. And well I got started on January 5th of 2025, so less than a month after my diagnosis. I sat down and I thought, well, nobody's gonna know if I fail at this, so I might as well try. And in 80 days, we put um uh Talk to Me Goose, the solution that I built, onto the app store kind of quietly, but it was out there, and now here we are what 15, 16 months later, uh, with a solution that we've now given away to more than a hundred families and have built a business around and are making available to people through a relationship, people living with ALS through a relationship that we have with the Live Like Lou Foundation. Super proud of what we built and now have a company that uh that we stood up around it and are building a team and doing the things that I know how to do. Have an amazing CEO that's joining us in August.

SPEAKER_02 20:00

Oh, very cool. Congratulations. Yeah. You know, you make it seem so logical that you do a little bit of preliminary research, you figure out that there's not no great tools out there that really meet the needs. And within a month, you're taking coding classes, and within two more months, you've got a beta test out and people are using it. I'm guessing though, there was a lot more to it emotionally and otherwise for you, because you're still now learning to deal with ALS. What was going through your mind at that time, in addition to making some great progress with the you know, this app moving forward, what were your fears? What were you what were what was going through your mind?

SPEAKER_03 20:39

I'm terrified. And every day I'm terrified of what comes next. Um but if I let that dominate my mind, I will become paralyzed before I am paralyzed. The thing that has helped me manage that is to keep focused on the purpose of what we're doing. The funny thing is, as I've reflected, that's always been my focus. And if you look over my shoulder, one of my team members made this amazing plaque behind me on the wall that says impact. Yeah. You know, I didn't ask for that. He sent that to me unexpectedly after a project, and he said, you know, he thought of me and wanted to acknowledge some work that we had done. I mean, that's amazingly meaningful to me because that's what has always kept me going. You know, when I built the first prototype, I have to admit it was purely selfish. It was solve my problem. Sure. Put something in my hand that will that I know will work for me. I never thought about what it could be. And when I had it in my hand, it was wasn't until then that I was that I realized that I had something that would work for others. And immediately it clicked that that became my purpose, that gave me a reason to come down the stairs every day and push that fear aside. I'm on this journey that is going to result in a whole series of outcomes that you know that I'm not unaware of. And I can process now rationally, Foster. I know exactly what's going to happen to me, but uh, and I'm still terrified of, but this purpose and focus allows me to process rationally and not emotionally. You know, that's the only thing I can do is focus on that.

SPEAKER_02 22:28

This notion about service to others permeates your entire career and now your life. Uh, it sounds as though part of the early stories, messages you got from your folks. But initially, after diagnosis, that got you into coding and trying to figure out the better mousetrap, if you will, was some fear about for yourself, which is completely rational. We always look in story arcs about, you know, when fear gives way to purpose. And it sounds as though fear gave way to purpose when you had that thing in your hands and went, oh, am I hearing that right?

SPEAKER_03 23:03

Yeah, here's my ticket. Not my ticket to anything else, but for helping me get back to what has always driven me, which is purpose and focus on making an impact.

SPEAKER_02 23:28

If this conversation was worth your time, and I hope it was, do one thing for me before you close the app. Leave us a review on Apple Podcasts. It's how people like you help people like me find this show. And if what we talked about today sparks something in you, there's a book called Leadership Rethinking the True Path to Great Leading. Yes, that's the real title, that goes deeper into this territory. It's on my website at fostermobley.com. And then sign up for our email list to be notified when my next book, Honoring, goes into pre-sale in 2027. And if there's one person in your life who needed to hear this episode, send it to them. Not because we need the numbers, because they need the conversation. Set the table, invite cool people, magic happens. I'm Foster Mobley. As always, friends, step wise. Our music for season three is composed and performed by Montana musical legend Philip Auburg, courtesy of Sweet Grass Music. Phil's recent passing was felt by many, including those of us associated with this podcast. We thank Patty Auburgh and Sweetgrass Music for access to this beautiful piece.

SPEAKER_00 24:39

Thank you for listening to Stepwise. Stepwise is produced, edited, and promoted by Zedist with support from Amber Gillard Consulting. Find more episodes and resources at fostermobli.com and follow Foster on social media at Fostermobley. We'll see you next time.