Sue Desmond-Hellmann, the CEO of the Bill & Melinda Gates Foundation will be Ohio State’s Spring Commencement speaker. Credit: Courtesy of OSU

Sue Desmond-Hellmann knows what it feels like to be unprepared for a pop quiz. Like the surprise tests many students at Ohio State might not be prepared for, the most recent exam she failed was in finance.

But the pop quiz wasn’t in a class. Or in college. It happened in her adult life, around that time she began acting as the vice president for one of the largest cancer technology companies in the country.

That feeling she and so many felt going into a test unprepared in a subject that should’ve been known stays with her as a lesson, she said — and as a bit of comedic relief.

“It was horrifying,” Desmond-Hellmann said laughing while recalling one of her biggest F’s. “I could talk about science and medicine all day long, but I kept hearing words like ‘earning per share’ and ‘MPD.’ You just have a whole grasp of new acronyms that I’ve never even heard of.”

Desmond-Hellmann, Ohio State’s Spring Commencement speaker, has a few acronyms of her own, though, including CEO, MD and MPH.

After failing the test, she asked members of the finance department to come up with a list of financial terms and practices she could learn to improve as a leader.

Now the CEO of a $40-billion-endowed charity, the Bill and Melinda Gates Foundation, Desmond-Hellmann knows her way around finance, especially when the money she manages can save thousands of lives.

The gig began to formalize in 2013 on Halloween — the only night Desmond-Hellmann, then-chancellor of University of California San Francisco, and the Gates could work in their schedules. Although she did not see Bill Gates dressed as a Pokemon or as Eleven from “Stranger Things,” she did see something that made her want to take charge of the finances for the richest people in the world’s organization. She saw a family.

“When I first got to the house, nobody was there. They were all out trick-or-treating,” Desmond-Hellmann said. “I remember sitting down on the couch and chatting with Bill and the whole evening being populated by kids coming in and out, and trick-or-treaters coming in and out. It just had this atmosphere that in retrospect was just right, as a family business.”

That welcoming atmosphere also came paired with a passion Desmond-Hellmann has had since she was a college student. Since she was in her 20s entering the world of medicine, Desmond-Hellmann has always wanted to help people, especially when the means aren’t there for them to find help alone.

She began her work as a doctor one year after AIDS was defined by the Centers for Disease Control. The epidemic hit hardest in big cities like San Francisco, where she had just began her career.

San Francisco was basically an epicenter for the disease, and in 1981, not a lot was known on how to treat it, and what would happen to medical professionals that tried to treat it.

“It wasn’t clear as a caregiver, whether or not you could get AIDS from being a caregiver,” she said. “As young physicians, we were enrolled in a trial and they would draw our blood to see if we had acquired AIDS on the job.

“It had a profound impact on me as a caregiver. No one should be faced with such an early death. That sense that you were personally at risk was really weird.”

Getting treated for AIDS in the ‘80s also was much different for patients, specifically gay men.

“You had to have two conversations [with your parents],” Desmond-Hellmann said, referring to what her patients had to go through on top of treatment. “Conversation one was, ‘I have AIDS,’ and conversation two was, ‘You didn’t know this before, but I’m gay.'”

She said she saw how much a negative stigma can get in the way of proper medical and health care.

“People felt like they had to hide that they had AIDS,” Desmond-Hellmann said, a secret she called the saddest thing she ever came across in her line of work.

The threat of catching the disease never led to Desmond-Hellmann questioning her job, or the people she treated.

“That was why I signed up as a physician: to help people that were suffering,” she said.

Her work to combat AIDS and HIV led her to become one of the first experts in specialized care in treating the sarcoma that pairs with the disease. It also led her to Uganda, where she began work in a war-torn country with little resources to help its citizens.

“Everything from running water, electricity, roads, was in disarray. Nothing worked in Uganda,” Desmond-Hellmann said. “When we got there, a lot of things that we thought we would do from a research perspective turned into much more service.”

Getting used to the minimal technological and medical advances wasn’t the only thing Desmond-Hellmann had to prepare herself for. She’d never been out of the country before going to Uganda. In fact, the furthest east she’d ever traveled was during her residency in a Midwestern city — Columbus.

In Columbus, she made two great discoveries. One, learning in-depth the practice of cardiology at Ohio State’s medical center. The other, that Columbus is home — and a very quick walk from campus — to what would become a beloved fast-food chain to her: Wendy’s.

“They were doing a beta test of breakfast. So my main meal everyday was to go to Wendy’s and eat their breakfast and get as many calories as I could to sustain me because I was very poor and had no money,” she said.

While her love for Wendy’s might have changed a bit — she’s known for being incredibly healthy, getting up at the crack of dawn and running 5 miles every day — her passion for higher education, and helping students who are soon-to-be alumni find inspiration has been consistent.

At Ohio State, she will take part in one of a student’s and family’s most memorable events. “There are few things in life that are as happy as graduation,” she said. “It’s all about celebration.”

But until then, Desmond-Hellmann said she’ll be studying.

“I take this very seriously and I spend a lot of time thinking about what I want the students to hear from me and try to put myself in their shoes,” she said.

Unlike that finance pop quiz, it seems like she’s taking her material very seriously. Because unlike that paper test, she’ll be giving a speech to thousands of people on their happiest day in one of the nation’s largest stadiums. And she plans to pass with flying colors.

Update, 4/25: this article previously stated Desmond-Hellmann was CFO at a technology company.