Why Empathy Is a CEO’s Strategic Advantage: Terumo CEO Antoinette Gawin

Antoinette Gawin: You don't let somebody fall into the ditch because they don't have snow tires on. In order to preserve the power of that blood, there's a lot of sophistication to handling it, separating it, storing it. 40% of people die in accidents that didn't have to die. Talent is equally distributed, but opportunity is not."

David Young: Antoinette, let's start by talking about your leadership journey and the experiences that have shaped the way that you lead. You grew up, I believe, in Cedar, Michigan, a rural family community of 400 people or so-- where going to college, particularly for girls, was far from a given assumption.

A scholarship, I believe, opened the door for you to attend the University of Michigan, and your career ultimately took you through more than two decades at GE, leadership roles at Baxter, and then to Terumo Blood and Cell Technologies, where you became the CEO in 2019. Tell us about this incredible journey that you've been through and also pull out some experiences that you believe have shaped your leadership to the CEO that you are today.

Antoinette Gawin: Yes. Thanks, Davy. And first, I think I'm an illustration of the phrase, "Talent is equally distributed, but opportunity is not." Of the people who encouraged me to go to college-- Even though I really didn't know people who had, what did that mean? What do you do?-- And they realized that advanced education shouldn't be just for people who were privileged to grow up in a community where by the accident of birth they had great school systems and had access to things like my children did.

That always forced me to look beyond at people's backstories and understand how they got to where they're at. We talk about the word grit. What does grit mean? Some of it is having intense life experiences because you've had to forge your own way. I thought about in this complicated environment today, and leading through challenging times, I thought I'd share two stories, maybe three, that really resonated with me that were formative.

When I was in my early 20s-- 23, 24-- I worked in corporate mergers and acquisitions under Jack Welch at GE, when he was reshaping the industry. As the analyst running up and down the stairs to provide numbers and insights, I realized that my voice was only relevant if I chose to speak up.

But Jack Welch inspired a lot of fear, and there were times when you spoke up where everyone else in the room said goodbye to you afterward because they assumed you weren't going to be there very long. But that speaking up about whether to buy something or sell something and share my observations actually turned into different opportunities for me, and why I went to a business like information services, because I told Jack not to sell it.

He said, "If she cares so much, let her go down there and see what she does," right? You can't predict those things. I grew up in an environment where if something's broken, you tell people, "It's broken," and you try to fix it, and you have an obligation to speak. You don't let somebody fall into the ditch because they don't have snow tires on.

The other examples I'll share, where as I was going into operating roles, I was leading an acquisition that GE had made in Switzerland when 9/11 happened in the US. And that day, I was hosting distributors from all over the world, and the first thing that happened as news was breaking was fights broke out because everyone was accusing other groups of being the perpetrators of that attack.

So you can imagine when tensions are raw and this major thing has happened, how do you navigate that, and do you get back to business? What do you do? And that experience made me realize you have to spend so much time understanding the context in which other people operate, their world, their historic passions.

We forget China's been around for thousands of years and has probably forgot some inventions we're just thinking about now. That was such a formative experience navigating through that, and also balancing. I thought my brother-in-law was on that flight and all those crazy things.

 But it makes you realize the importance of understanding why there is this historic tension, and not disregarding it or accommodating it, but respectfully navigating through it.

The other example I'll use was I was leading a joint venture for GE, and it was our first joint venture with a government entity, Harris Corporation. We did real-time power optimization systems for utilities, and this was in the year 1998, '99. I was sent to negotiate with the Egyptian government, and here I am, a young woman, trying to understand the cultural norms, being the only woman in the room, and really trying to understand why we could not get through this contract discussion or agreement.

What I learned was by listening and watching what people were reacting to was the issue wasn't our contract and the potential impairment and all the business things that we at GE were worried about. They were worried about what happened when Y2K hit, and would our software take down their power grid, and if it did, who was going to take responsibility for it?

And I took responsibility for it. I said, "We will make sure your grid is up." My team was very nervous about that, because the whole world was at odds. What would happen when Y2K rolled over, right? Yeah. Would everything shut down? But you had to make a call and have the courage of your convictions that you'd done the right things along the way.

David Young: Antoinette, fascinating stories here, and I just want to pull out a couple things that you said.

The importance of understanding context, taking responsibility, grit, and also just having the confidence to speak up, which is not always an easy thing. You've alluded to something that connects to my next question, which is you've always said if something was broken, you do what you can to fix it.

And if someone needs help, you step in. When you reflect back on your life, how have those lessons influenced the way you approach difficult problems as a CEO and the importance that you place now on empathetic leadership?

Antoinette Gawin: Great question. A little hand reaching out to say, "Let me share an example," or, "Let me help you understand this," helps people understand that they are not alone.

And there's an old phrase that the first step to getting help is asking for it.

But when you've grown up and you're trying to fix something on your own, you're new in a company, you're new in a team, you're trying to prove what you know, sometimes it's easier to say, "Everyone bear with me. I have experience here but not here."

And we have this fear of failure and fear of looking stupid. I see it all the time, for lack of a better way to describe it. You hear no question is stupid, but I have asked stupid questions where I've gotten a tech mixed up or something, and then someone said, "You're mixed up." It's okay. You move on.

But that takes some courage to say, "I'm not coming in here as the all-knowing contributor. I am coming in here to bring the expertise I have to bear."

Empathy is an underrated leadership attribute. If you understand what somebody's dealing with, you can walk in their shoes a little more and help them along.

And an example is at GE, it was nerve-wracking to present to these senior people, and often you didn't have someone helping you along the way. But I had a senior person, John Falcone, pull me aside once and say, "Why didn't you speak up in that meeting? I know you were the expert and you did all the work."

I said, "I wasn't sure if I should. I'd never been in an environment like that." And he said, "Shame on you," right? "You lost an opportunity." He said, "Go for it." So next time I spoke up. It helped me to have somebody say, "I believe you know what you're talking about. And either way, you're the one who did the work, so let your voice be heard. If you're invited to the table, you have an obligation to speak."

David Young: So Terumo Blood and Cells Technology, as we all know, is it's a global organization. You lead this around the world. It requires people from different countries, different functions to understand where the company is going, while also having the freedom to make decisions and to act.

You've talked about, and I think I quote you here, you've talked about being tightly aligned strategically and loosely coupled operationally. What does that mean and look like in practice? When you run this global organization, how do you give people the confidence and the authority to act without waiting for decisions to travel up and down the organization?

Antoinette Gawin: Yes, that's a great question. If you are tightly aligned strategically, then people know what the right decision is even if you are not in the room. And I think of it as a logical transition from a founder start-up mentality, where you tend to make all the decisions together because you're there, and you trust each other, and it's a small group.

If you're operating in a small team, it's easy to do that. You grab everyone. You call five times, "Hey, we're going to do this." Boom, and you're off and running. How do you get that translated to a large organization as you scale across different cultures and different organizations, different backgrounds?

I try to take examples, and we try to make them very visible. But someone gave me guidance before. They said, "When you're making a decision, is this something only you can do? And is it something only you should do?" If I'm signing off on a PO for 500 grand that is about an IT application, am I the best suited person to do that?

I take everything that comes across my desk when I'm new in a role and I challenge it and say, "I'm not signing this," because you know more than I do. And you have to conscientiously push things down. You also have to tell people you trust them.

An example I'll use from COVID is that because we deal with blood, we have to test with blood. We need blood to run our new product launches, to file for FDA approvals, et cetera. And the first thing that happened in COVID, people stopped donating because they couldn't leave their homes. So what do we do? And how do we get blood for the patients in the hospitals? Our technology's irrelevant if I can't get it applied.

I thought about who knows how to get blood. Everyone was asking me. And I took one of our clinical specialists, Carly Newton, who'd worked around the world, in Australia and different parts, clinical specialist. I said, "Carly, you know how to do this. You're in charge of it. Get everything you need and if you get stuck, give me a call."

Because I can't add, and if she got stuck, she gave me a call, but you know what? She didn't get stuck, because she already knew what to do. I had to knight her, so to speak, in that situation. But sometimes you have to tell people, "Here's my thoughts on it, but I trust you. You've got it." The art of leadership is knowing when you need to give people a little more guidance and when you need to intervene, and sometimes it's okay, because it may not be how you do it, but it's another path, right? There's no one path.

David Young: I'm smiling to myself here because you work in science, but this phrase that you've come up with, leadership is an art. It's the art of leadership.

Antoinette Gawin: Yes.

David Young: Which I think resonates strongly. Let's turn the conversation and chat a little bit about innovation and the future of medicine here.

Terumo Blood and Cells Technologies sits at the intersection of some extraordinary advances in medicine, from life-saving blood transfusions to personalized cell and gene therapies. As I look at this, it's blowing my mind because what you guys wrestle with and the frontiers that you are trying to push are remarkable.

As our understanding here of blood and cells continues to advance, when you look at this, what excites you most about the potentials to fundamentally change how we treat disease over the next decade?

Antoinette Gawin: This is a big question. There's so much. But if I make it very simple, and you think of starting with blood, we have the ability to filter out things that don't belong, to filter out bad actors-

David Young: Yeah.

Antoinette Gawin: To redirect or modulate proteins, cells, all these components that we are really just at the early stages of understanding. So even as we get smarter about treating things that we didn't think were treatable, with all the data advances, we see the connections between rare diseases, as an example, and all that data can inform permanent cures.

That's big stuff. I like to say I'm not smart enough to cure cancer, but I'm smart enough to connect the people who can. But I'll take something that we all deal with and maybe it's my generation. I'm going through these cycles. Everyone talks about inflammation now, and by the way, stress causes inflammation.

When my doctor says that, yes, we all know that. This isn't good, but there are ways to address inflammation, and some of the things that influence rare diseases and how you react to them, whether it's MS or other things, they're aggravated by inflammation, this big word. With the data out there, we're starting to learn more and more about how our immune systems respond and what causes the inflammation. And some inflammation's good and some's bad, but that's just emerging, and that's not in our day-to-day vernacular yet.

For me, that gets so exciting. And if you think of the power of data and AI to plow through these decisions quickly and get more insights so we can see the connections that our brains just can't come up with off the bat, unless we're talking to 100 people about it-

David Young: Yeah ...

Antoinette Gawin: or peppering our doctors with questions, and then we make a random connection.

David Young: Antoinette, you've alluded to AI here, and it's hard in any conversation these days to not talk about the impact and influence of AI.

From your perspective, how is AI either helping or potentially hurting the industry that you're working in? You've alluded to the fact that AI can crunch massive data sets and, I'm assuming here, pull out insights that help with some of the advancements and discoveries that you're looking at. But I'd just be curious from your perspective on your thoughts with regards to AI and emerging tech.

Antoinette Gawin: Yeah, and I'll draw some parallels. In the early '90s, I worked on the introduction of the first internet-enabled EDI, and at that time we were like, "Could we harness the power of the internet and monetize the internet?"

And there were discussions about AI then, but it was the stuff of science fiction. When I think of artificial intelligence, it's the A part that is the challenge because it really is about advancing and accelerating intelligent decision-making. It becomes artificial if the old words still hold true: garbage in, garbage out.

We have an obligation to say how are we using it to accelerate those connections and that thinking? But it cannot replace a definition of garbage, right? It will get to that point eventually, and I think it can allow us to shortcut things but help us reflect. And one concern I had then, and I share it even more now, is if I can go online and get an answer to a point solution-- so I ask, "Oh, why was this war important?"

I get a simple sentence. I'm not learning the lessons and I don't understand the context of the war. So I end up repeating historical mistakes, and that's something I think my generation is at the edge of, and the next generations have to be eternally cautious. Don't repeat the same mistakes, and don't forget the humanity behind all of these things.

David Young: Yeah. Such important lessons. Scientific innovation-- I think it's only as transformative if patients can actually benefit from it, Antoinette. Yet access-- and from the CEO Center and The Conference Board's perspective-- access to health care remains profoundly uneven around the world.

Meanwhile, sophisticated new treatments such as cell and gene therapies require new infrastructures to reach patients. As medical science advances at an extraordinary pace, how do we start to ensure that innovation doesn't outpace access, and that some of these important breakthroughs actually reach the people and the patients that need them?

Antoinette Gawin: So a few things. And David, you know I went back to school later in life to get a master's in health policy, health care disparities and unequal outcomes. We need innovation around the access models themselves, and the tools are there. The simplest example of this is telehealth.

There are other examples though where you can use technology to eliminate the middleman. I can go get care. There are other Western countries with advanced health care systems where I don't need to go to a general practitioner and then get approval from insurance in order to get to the right person to give me care.

We have to embrace those things that help streamline the process, and a lot of that is driven by the funding. The US funds the majority of health care around the world because we have a profit-based model.

You have to have profit to reinvest in innovation. You have to make sure that you are not disproportionately penalizing the sick people who do not choose to go on that journey, and that's a very difficult tension when you have a market-based system.

It's not as simple as saying it's competition or not, but there are fundamental things that we can do with using nurse practitioners, using people at the front line of care, and saving the specialists for the real complicated disease paths, if you will. If we innovate around access and fully embrace those things, it will free up, frankly, the intellect and the ingenuity in the system.

David Young: Yeah. Interesting. Earlier, Antoinette, you gave the example of COVID on blood supplies. I think many people, myself included here, just assume blood will be there, right? I'm not exactly sure how, but it will be there. But it's actually-- and you've alluded to this already-- it's very fragile in and of itself, and it's got a very fragile yet important supply chain.

What do you think people most misunderstand about the importance and fragility of blood supply, and what needs to change to make the system potentially stronger and more sustainable for the future?

Antoinette Gawin: Yes. First, understand that blood expires. We think of, "I donate blood. It sits in a bank." But think if you cut yourself and, five minutes it's dried up, useless stuff.

David Young: Yeah.

Antoinette Gawin: In order to preserve the power of that blood, there's a lot of sophistication to handling it, separating it, storing it, and we work with the government to say, how long can we store that safely and still retain the efficacy of it, right? There's some deep chemistry involved there.

We've been debating some of these things since the days of Napoleon's wars. Is blood better colder or not? I think appreciating that in other countries, if I need blood, sometimes I have to go pay for blood in advance to make sure it's there. And in some countries, I bring my whole family with me for a procedure in case I need blood.

In the US, we take that for granted. We walk in, and we might participate in a blood drive. We all know somebody who has needed blood, whether in childbirth, a traumatic accident. And in other parts of the world, like Kenya, 40% of people die in accidents that didn't have to die. so there's preventable death from access to this basic.

But there's a lot of complexity and expense into processing and handling this substance that we think of as a free thing. I gave it out of the goodness of my heart. I would say give regularly. Know your blood type. I'm A plus, by the way.

David Young: Let's have a chat about just public policy, regulation, and innovation.

I feel like innovation is moving very quickly, largely fueled by different emerging technologies. It's hard to not see regulation behind the rate of innovation. As health care innovation continues to move very quickly, regulation must ensure that new technologies and therapies are safe and effective, and you've alluded to this.

Getting that right balance is very tough and only becoming more and more challenging as medicine grows increasingly personalized, connected, and data-driven. From your experience, how do we start to build a regulatory environment that maintains rigorous patient protections while providing a springboard for medical innovation to continue to flourish?

Antoinette Gawin: Yeah. I'll highlight three different elements.

One is just the basics of real-world evidence. The FDA has made some strides here, but as an example, I have a platform that is used to separate blood and process it that's been active over 20 years around the world, and we were just able to roll it out in the US last year, and we're still working on showing the proof cases from the rest of the world, but that shouldn't have taken 20 years.

We used to joke in the old days, you did a pilot, you had a proof of concept, and if something was creating efficiency, you moved forward. But now, when we have the complexity of devices, software, biologics, all kinds of things rolling in there, you might have multiple competing regulatory paths. So the more we can look at how the whole system works and learn from other countries and real-world evidence, the more powerful it is.

The second is to understand the realities of access, as we discussed earlier. Take out the middleman, and if I have a new solution that is really addressing access, but it's not changing the fundamental delivery, don't make me go through the same process. As an example, we're all dealing with cybersecurity now. I should not have to reprove all of my 20 years of settled science in order to modernize. That creates a burden on many medical technology manufacturers.

And then the third thing is look at how people are entering the market. If I am Amazon or Google, I am entering not through an FDA path, but because I have tons of data. We're evolving from the device focus into the data focus, so we're in that device path. But those regulations are wildly different, and it allows people to move fast. So how do we find the pathways that take advantage and say it's not fundamentally harmful?

An interesting data point, I served on the technology and regulatory committee of AdvaMed.

The things that were incorporating AI were actually getting approved faster than some of our traditional equipment because it's predictable, it's reliable, it's repeatable. As humans, though, and as with blood, we are not predictable and reliable and repeatable. Yeah. And our systems are all wired differently.

So we have to find that happy medium and say, " We are proud this is safe. It is safe. It is compliant. There is a point of diminishing returns to that regulation."

David Young: Antoinette, let's close with a reflection about what lies ahead. You're certainly very passionate about what you do.

You're driven to make a difference. You run a remarkable company that is driven alongside you to make a difference. And not just at Terumo but also before, just your ability and skill and empathetic leadership to navigate uncertain times. As you think about the next generation, what gives you optimism about their ability to tackle the challenges that lie ahead, and what advice would you give them about building a career and, actually, in addition to a career, a life that makes a meaningful difference?

Antoinette Gawin: Big philosophical question, and I feel that we should have a bottle of Barolo here as we go through this. But what gives me optimism is this generation has all the tools at their disposal. They have access to the data. They can explore. You can research just about anything. But with that comes an obligation, as I referenced before, to understand the context and understand your role in making sure that context is based on facts, and that you keep your questioning, critical thinking skills honed, that you take the time to listen to different points of view, and really walk through and say, "Boy, somebody said this thing that we're outraged on social media. It sounds hateful." And did somebody mean that? Did somebody wake up and say, 'I want to be a jerk today? Probably not.

So how do you separate the noise from the substance? You do that by creating your own real-world evidence. Talk to people who say something and say, "Do you really believe that? Why? Help me understand your point of view."

It's easy in a corporate environment, it's easy in life to surround yourself with people who think like you. How do you have a constructive conversation with someone who doesn't? Not throwing out sound bites, but saying, "Have you ever met somebody who did that? Let's unpack it a little bit."

I think about that as just a societal challenge. At the individual level, take the time to make sure that the choices you make are intentional, and the things that you're doing are helping you build competency, capability, and empathy, and that they are keeping you close to the things that matter. If you have a passion about making sure the elderly are taken care of, how much time are you spending with the elderly? What are you doing to translate their voice back?

If you have a passion about dogs or bikes, how are you connecting into that and bringing your whole self to bear? There's so much out there, it's overwhelming. Find the people who can help you cut through the noise and that's probably the most important thing.

David Young: Antoinette, thank you.

I've just have written down here confidence, capability, and empathy; and the final point is to work alongside people that have like-minded values and that work alongside you as a team.

Antoinette, thank you so much for joining us today, and again, many congratulations from the entire Conference Board on being a recipient of our 2026 Distinguished Leadership Awards.

And thank you for just being honest and your insights and reflections and sharing both your personal and your professional story. And we very much look forward to celebrating you and the entire Terumo organization in New York this October.

Antoinette Gawin: Thank you, Davy. I appreciate the kind words and the honor, so thank you.

David Young: Our pleasure. Thanks again, Antoinette. Really appreciate it.