Who’s the richest guy in Los Angeles?

Oh, and he has a plan to save the world.

Never heard of him? Many people haven’t. Until recently his reputation was strictly professional — as a pioneering transplant surgeon at UCLA in the 1980s, a widely published researcher, and the inventor of the cancer drug Abraxane. But there was always another side to Soon-Shiong. “You just meet some guys in your life who know how to make money,” says pharma analyst Elliot Wilbur of Needham & Co. “Patrick is one of those guys.” In 1998, Soon-Shiong cobbled together loans to buy a struggling generic drugmaker. He turned the company around, used the profits to develop Abraxane, preserved his equity, and cashed out a decade later with two spectacular deals that catapulted him into the upper reaches of the American plutocracy.

With wealth has come a measure of fame, at least locally. He bought a piece of the Lakers in 2010 — Magic Johnson’s 4.5% — and so gained a seat (four, actually) on L.A.’s most visible celebrity perch: courtside at the Staples Center. He made a very public run at the Dodgers last year and another at Philip Anschutz’s global sports and entertainment conglomerate, AEG; both fell short but garnered lots of press. He and his wife, former TV actress Michele Chan, are L.A.’s newest A-list philanthropists. They’re signatories to Warren Buffett’s giving pledge, sustainers of the tony St. John’s Health Center in Santa Monica (the Soon-Shiongs outrank Johnny Carson and everybody else on the lobby donor plaque), and rescuers of Martin Luther King Jr. Hospital in south L.A. His pal Peter Ueberroth calls Soon-Shiong “a true global citizen.” Lawyer and personal adviser Ron Olson, a Berkshire Hathaway board member, says, “He’s brilliant. He’s high energy.” Burt Bacharach (they met in a registration line at their kids’ school and have vacationed together in Hawaii) wishes he could be “cloned” and says, “It would be good for the world.”

Cloning may not be necessary. Soon-Shiong already has a plan to save the world. The next “arc of my career” is how he sometimes describes it; at other times he calls it his lifelong “mission.” It’s as if everything he has achieved so far — as a clinician, as a researcher, and in business — were mere prelude.

Simply put, Soon-Shiong believes we are on the cusp of a transformative moment in medicine. He is convinced that by leveraging all the cool stuff that’s happening right now in mobile technology, supercomputing, machine vision, artificial intelligence, cloud storage, mega-high-speed data transmission, genomics, and proteomics, medicine will emerge at long last from the Dark Ages. He sees paradigm-shifting implications for how researchers develop new therapies and doctors diagnose and treat even the most terrifying diseases — especially the terrifying ones. While he’s not talking about a cure for cancer exactly (he has gotten in trouble with the C-word before), he is confident predicting that within a decade, “if we work really hard, we can rid ourselves of the fear of cancer.” Cancer, in short, could soon become like AIDS — “a chronic disease, not a killer.”

Mission in mind, Soon-Shiong has spent the past several years making acquisitions — snapping up dozens of small companies, nurturing some, abandoning others, arranging and rearranging the pieces. He says he’s in for close to $700 million so far. Partners include Verizon; Celgene, the Coins2Day 500 company that now owns Abraxane; and Blackstone, which invested $125 million in Soon-Shiong’s injectable-drug business and put three of its own on the company’s board. As many as four IPOs are in the offing.

Which suggests we may not have to wait much longer to learn whether Soon-Shiong’s latest venture — and by extension, Soon-Shiong himself — is for real: whether he actually is a 21st-century Thomas Edison (as Blackstone founder Stephen Schwarzman has proclaimed), inventive and practical; or more like the dreamy frontier archetype Wallace Stegner described in his Pulitzer Prize-winning 1971 novel, Angle of Repose: “He met trains that had not yet arrived, and he waited on platforms that hadn’t yet been built, beside tracks that might never be laid. Like many another Western pioneer, he had heard the clock of history strike, and counted the strokes wrong.”

No one gets to be as rich as Soon-Shiong is without pissing people off. He has been sued by his own brother. His Brentwood neighbors resent the nonstop construction at his ever-expanding family compound, encompassing a patchwork of 13 lots valued at more than $64 million and featuring a cavernous subterranean gym that would do just fine for the Lakers, illuminated by Soon-Shiong’s patented system for capturing and distributing natural light. Some entrepreneurs on whom his investment favor has alighted, thrillingly, only to be withdrawn, feel misused. “He knows how to work it,” says one who is still reeling. “Great salesman and personality, loves his friends and family, but when that switch switches and he perceives you as no longer serving his purposes, you’re not anything but an obstacle. When it’s over, it’s over.”

He’s not easy to read; I can attest to that. During the six hours we spent talking during two days in October, I found him at times charming, often baffling, sometimes patronizing. He speaks in a deep-chested baritone, soft and slow, round-voweled and oracular. He augments speech with his hands. “His ability to envision exceeds sometimes the capacity of language and visual representation to express,” Dr. Harvey Fineberg, president of the Institute of Medicine of the National Academies, had warned me. I remembered that when Soon-Shiong was taking half an hour to fill a wall-length whiteboard with indecipherable red scribbles, presumably for my benefit. Whenever I asked him a dumb question, he would drop his head like a stone, sigh, then look up at me and grin. “I’ve finally, finally, finally made peace with myself that not everybody can see the systems-integrative approach,” he told me once. “Everybody looks at the world in a very linear way, in a very sort of siloed way. That’s sort of the natural human phenomenon. But actually we live in a quantum world. When I start talking like that, I lose people almost immediately.” Then he grinned and laughed: ha-ha-ha!

Soon-Shiong’s family is from southern China. His ethnicity is Hakka, a distinction he shares with another famous Chinese capitalist, Deng Xiaoping. His parents fled during the Japanese occupation and settled in Port Elizabeth, South Africa, where Patrick was born. He is the ninth of 11 children — 10 boys and one girl — one of whom was adopted. The family lived comfortably if not richly. His father owned two corner food stores, each one bigger than a bodega but smaller than a supermarket. Soon-Shiong worked weekends stacking shelves and sweeping floors.

More than a shopkeeper, his father had an avocation: traditional medicine. Soon-Shiong remembers the tightly sealed shipments that would arrive regularly by boat from China, the silver tins inside them filled with smelly herbs wrapped in tiny packets, this one for fever, that one for energy. He assisted with the boiling and the blending. Neighbors lined up at their doorstep for consultation and treatment. Some brought gifts, but no one was allowed to pay.

Under apartheid, the Chinese were their own category: Not “coloured,” like Indians and mulattos; not “honorary white,” like the Japanese; but not white. They weren’t allowed to vote or own property. Soon-Shiong attended a Chinese school run by Anglicans. Unlike his black friends, he could go see movies at the white theater. He didn’t have to sit in the back of the bus, but intercity trains were a different matter. Chinese rode in a separate car. Soon-Shiong says he didn’t mind. It meant he had a better shot at finding a quiet seat for reading — an important consideration when, at 17, he enrolled in medical school at the University of the Witwatersrand in Johannesburg, 650 miles north of Port Elizabeth. He was one of two Chinese, together with two Indians, who filled the racial quota in a class of nearly 200.

“You didn’t come out as a rounded human being,” Soon-Shiong says of the focused professional training he received, “but you came out with an amazingly deep knowledge of medicine.” By the time he reached the age when most American doctors are just beginning their training, Soon-Shiong had delivered more than 100 babies and assisted on countless surgeries. He graduated fourth in his class and was assigned to an internship in Johannesburg’s NEH, the Non-European Hospital. It was like a war zone, Soon-Shiong says, useful experience but not what he was seeking. He lobbied for a transfer to a white hospital where he could get top-notch training in surgery. A kindly mentor traveled to the capital in Pretoria on his behalf and obtained a special dispensation, on the condition that Soon-Shiong work for half pay. He jumped at the chance. “I looked upon it as an opportunity to learn from the best in the world,” he says. “And my job was to be the best.”

Soon-Shiong suffered trials and humiliations. Once he was detained for three hours in a Johannesburg jail — not just for failing to produce his ID card, but for snapping angrily at the cop, “Where’s your ID card?” He joined the nonviolent, anti-apartheid National Union of South African Students and volunteered during the 1976 uprising at Baragwanath Hospital in Soweto, where he tended to gunshot victims, many of them children. “He is very conscious of his background as a South African,” says L.A. County supervisor Mark Ridley-Thomas, who years later would work with Soon-Shiong to save Martin Luther King Hospital. “He knows what racial injustice looks like and what it feels like.”

Soon-Shiong accepted a position at a township tuberculosis clinic in East London, South Africa, three hours up the coast from Port Elizabeth. Conditions were beyond bleak. It wasn’t a hospital so much as a place where patients came to die, he says, “almost like a prison camp.” After six months, Soon-Shiong formulated a new plan: “Leave, find the resources, and come back.”

He moved to Toronto, where he and Michele were married, and then to Vancouver. At the University of British Columbia, while still in his twenties, he published widely and won prizes for surgery and research. In 1983 he was recruited by UCLA. Three years later he performed the first pancreas transplant on the West Coast, and in 1993, the world’s first pancreatic islet transplant.

The former was an established procedure. The latter was weird science, involving insulin-producing tissue harvested from cadavers, mixed with seaweed extract, and poured into an incision in the patient’s abdomen. It worked okay for dogs, and for a brief, electrifying moment it seemed to promise a cure for diabetes in humans.

The patient was ecstatic. He savored his first breakfast in 30 years without an insulin injection and told the Los Angeles Times, “They’ve done miracles for me.” But the miracles didn’t last. Soon he was back on insulin. He endured three more surgeries, and five years later, despondent over his poor health, as his widow told the New York Times, he shot himself in the head.

Soon-Shiong’s reputation suffered. There were some, including the president of the American Diabetes Association, who felt that he had let ambition get the better of scientific detachment, that he should have at least done more to discourage irresponsible hype — a charge Soon-Shiong vigorously denies, proffering a stack of 20-year-old newspaper clippings as proof. “We answered very important questions,” Soon-Shiong says now. Those answers would eventually lead him beyond diabetes to cancer research, and to the insights that would shape the rest of his career.

Soon-Shiong left UCLA in 1991 to work full-time on commercial drug development. One of the companies he formed, American Pharmaceutical Partners (APP), had a lucrative business brokering generic drugs to hospitals; he used the profits to fund research. He had a special interest in Taxol, Bristol-Myers Squibb’s bestselling cancer drug. Taxol had serious drawbacks. It had to be administered together with a powerful steroid to fight white-blood-cell loss and cut with a toxic solvent to render it suitable for injection. Soon-Shiong was working on a novel delivery mechanism that allowed for higher doses, lower toxicity, and, he hoped, greater efficacy — it was the drug that would become Abraxane. But he was still a long way from clinical trials, much less FDA approval, when his laboratory landlord, Japanese drugmaker Fujisawa, put its U.S. Division on the market.

Soon-Shiong flew to Japan. The chairman of Fujisawa, Dr. Hatsuo Aoki, was a fellow researcher; they understood each other. Plus they had done business together. Mustering all his passion, Soon-Shiong told Aoki that the work he was engaged in was “important for mankind. You can’t sell,” he pleaded. He left with a 30-day option to buy the division for $80 million.

Of course he didn’t have that kind of money. Over the next several weeks Soon-Shiong hit up every investor he could get to, including Michael Milken, Andy Grove, Gary Winnick, Richard Rainwater, Darla Moore, and Allen & Co. Invariably, he says, the conversation went something like this:

“Tell me about the company.”

“Well, it’s got 500 people, they’re under FDA consent decree, they’ve got $62 million in revenue, and I want to run it.”

“Well, Patrick, have you ever run a company like this?”

“No.”

“Is it making money?”

“It’s losing a million and a half a month.”

“What do you want to do with this company?”

“I’ve got this nanoparticle I’m going to invent that’s going to treat cancer patients.”

“Is it in clinical trials?”

“No.”

Soon-Shiong conceded defeat. He flew back to Japan. But Fujisawa offered him terms: We’ll front $35 million — it’s equity but you can pay us back. All you have to do is find a bank that will loan you the other $45 million and promise not to lay anyone off. He got $10 million each from the venture capital arm of Premier, a hospital buying group; and a private Hong Kong investor. Banks loaned the rest.

Over the next decade the new APP, bolstered by Fujisawa’s factories and product line and Premier’s customer base, proved immensely profitable. Soon-Shiong took the company public in 2001, managing nevertheless to hold on to most of the shares himself. After a 2002 investigation by the New York Times skewered Premier for steering hospitals toward APP products while purporting to save them money (Premier denied any conflict of interest), APP repurchased Premier’s 2.9 million shares. Soon-Shiong’s stake grew higher still.

Wall Street was always skeptical. Soon-Shiong was forever combining, dividing, and recombining the companies he controlled. There were investors — his brother Terrence and pharma giant Mylan included — who felt that he had diverted resources intended for work on diabetes to feed his unlikely and expensive obsession with Abraxane, and they sued. (According to court documents cited by the Los Angeles Business Journal, Terrence’s complaint spoke of “betrayal, arrogance, greed, and personal aggrandizement that resulted in corporate misconduct of enormous proportions.” Soon-Shiong ultimately settled with his brother and Mylan for $32 million. They have since parted ways.)

Short-sellers launched periodic assaults — right up until the day in January 2005 when Abraxane received long-delayed FDA approval for the treatment of breast cancer, and APP shares soared 47%. Soon-Shiong memorialized his triumph by ordering up a batch of blue plastic paperweights emblazoned with the stock chart. That was a good day. June 30, 2010 — when Celgene announced it was buying Abraxis BioScience, the company that by then controlled most rights to Abraxane, for $3 billion — was an even better day. Soon-Shiong, who owned more than 82% of the company, took payment in cash and stock. Since then, as Abraxane’s sales have risen and Celgene has prospered, his nearly 9 million shares have tripled in value, and he still hasn’t sold any. “I say to my people, ‘You’ve got to be the bet,’ ” Soon-Shiong says. “It was a fantastic decision.”

But even as Abraxane nears $1 billion in annual sales — that’s blockbuster territory — the oncologists I consulted don’t seem all that excited about it. “It has a slightly different toxicity profile,” says Dr. Harold Burstein, a breast cancer specialist at Harvard’s Dana-Farber Cancer Institute. “For some patients it’s a nice trick to know about. But in terms of its benefit [over other drugs] in breast cancer, there is none.” To be fair, Burstein cites the results of a Phase III trial recently published in The New England Journal of Medicine suggesting that Abraxane may yet prove to be more effective against pancreatic cancer than existing treatments, but he offers this final thought: “There’s a big difference between medical advance and commercial success.”

Imagine you’re on vacation in a faraway place. You don’t feel so hot. You see a doctor. The doctor orders a CT scan, maybe an X-ray, draws some blood, and uploads the results via a dedicated high-speed pipeline that links hospitals and research centers all over the world. Somewhere out there in the cloud, superfast computers crunch the numbers and process the results.

You come back after lunch. The news is terrible: You have a rare and deadly cancer. The doctor has never seen a case like yours before and would have no idea how to treat it. But there’s hope. Along with your results has come news of a promising option. It’s a regimen that hasn’t done much for the general patient population, in which the mean survival rate is only six months. But for the seven other patients in the world who share critical elements of your genomic and proteomic makeup, the results have been spectacular: complete remission.

That’s not the world we live in, but it’s one aspect of the world Soon-Shiong is trying to create. The level of difficulty dwarfs that of any large-scale reform medicine has ever attempted, from electronic medical records to evidence-based medicine to payment by outcome to Obamacare. It will demand computer processing power beyond anything the NSA has ever dreamed of, and a communications infrastructure to make what Netflix relies on look like smoke signals. And privacy? Just imagine: every last detail about every last cell in every last body on earth — all 7 billion of us — residing in the cloud.

It’s not where medicine is headed on its own, says Dr. Fineberg of the National Academies; someone is going to have to take it there. In fact a lot of people are already on the case: at startups like Foundation Medicine, which can examine cancer tissue samples at a molecular level and marry the findings with specific therapies, and at IBM, with its Watson artificial-intelligence project.

What sets Soon-Shiong apart is the sheer scale of his undertaking. “He has a vision for stitching together all the parts of health care that are disparate today,” says David Rose, a product designer affiliated with MIT’s Media Lab who sold Soon-Shiong one tiny part of that vision — a patented medicine bottle cap with Internet connectivity that reminds you when to take your pills. “It’s a pretty sweeping and bold and ambitious vision. If he didn’t have the resources, you might say, ‘Why don’t you try to scale that down a little?’ ”

On a fall day in 2011, Soon-Shiong hosted a gathering at the Beverly Wilshire Hotel. Guests arrived from all over the country, CEOs and founders of companies Soon-Shiong has been buying nonstop from the moment he came into his billions. First to speak was Jim Stewartson, founder of a digital media startup called Fourth Wall Studios, soon to win an Emmy for interactive television programming. Last up was Eric Golden, CEO of Equipois, an innovative manufacturer of zero-gravity mechanical arms that had recently opened a new facility in Playa Vista, Calif.

Between the two headliners, nearly 40 companies presented — pharma companies, tech companies, mobile app inventors — all of them elements in what Soon-Shiong describes as “an ecosystem of digital connectivity never before seen on this planet.” Soon-Shiong himself was everywhere at once, working the room, making introductions, highlighting synergies that, while obvious to him, were not to others. ” ‘I’m going to help you do what you’ve always dreamed of doing,’ ” one attendee recalls him saying. ” ‘We’re going to change the world together.’ You believed it because the guy had supposedly cured cancer. And you certainly wanted to believe it.”

That was two years ago. On the day after Thanksgiving 2012, Fourth Wall ceased operations and laid off most of its employees. What’s left of Equipois, including all the jobs, now resides with Granite State Manufacturing in Manchester, N.H. Another attendee, KeyOn Communications, a wireless broadband company that was supposed to link rural hospitals in the Midwest to cloud-based data storage centers around the world, has been stripped of all its assets and survives, barely, as a pink-sheet ghost.

“Not good for them,” Soon-Shiong concedes during an interview at the Culver City headquarters of Nant-Works, his holding company, but he’s not apologizing. “I can tell you company after company that I’ve funded that I’ve shut down in these last four or five years. Fourth Wall, was that a failure? Yeah, it was something I wanted to try, and it didn’t work. But I don’t consider failure as failure. I consider failure as testing a hypothesis.”

Chinh Chu, senior managing director at Blackstone, has been watching Soon-Shiong closely for more than a decade. He remembers the first time he listened to Soon-Shiong’s grand vision. “I was absolutely blown away,” Chu says. ” ‘This is revolutionary; this is what medicine needs.’ Then I went home and thought, ‘This is really challenging.’ ”

Exactly. Really cool, really hard. So what are the odds? Chu has come to believe that “if anyone can do it, Patrick can. He has the intellect, the resources, the resolve, and the ability to turn on a dime.” And all he has to do is enlist everyone else in the world in his project.

Reporter associate: Marty Jones

This story is from the December 09, 2013 issue of Coins2Day .