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Guild founder Rachel Romer had a stroke at 34. Her nurses inspired her company’s next phase

Paolo Confino
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Paolo Confino
Paolo Confino
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October 15, 2024, 6:01 PM ET
Guild founder Rachel Romer
Guild founder Rachel Romer at Fortune's Most Powerful Women Summit suffered a stroke in August 2023 at just 34 years old. Kristy Walker

As Rachel Romer lay in a hospital bed, recovering from a stroke she suffered at just 34 years old, the edtech founder conducted some light market research. 

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Just as Romer, then CEO of Guild, was recuperating from a debilitating stroke that had left the right side of her body paralyzed, her company was in the midst of an expansion into upskilling programs for health care workers. Romer eventually began polling the various nurses taking care of her about their work. 

“Every nurse that would come into my room, I would drill them about their career path and ask them lots of questions,” Romer said during her first public appearance since her August 2023 stroke at Fortune’s Most Powerful Women Summit in Laguna Niguel, Calif. “Some nurses started to get weary when they would come in and they would say, ‘I heard you interview every nurse.’ And I would say, ‘yes, I do.’”

Romer’s time in the hospital only reinforced her commitment to expanding Guild’s upskilling platform to include a dedicated program for health care workers. The idea had been percolating for a while. As far back as April 2023, Fortune reported Romer was considering a program aimed at helping drugstore employees move into health care jobs. Her untimely stroke gave the idea new urgency, and more than a touch of personal relevance.  

“I ultimately got my own residency in health care, living in the hospital for many months,” Romer said. 

Romer turned Guild into one of Silicon Valley’s largest success stories. After a $175 million Series F raise in June 2022, Guild reached a valuation of $4.4 billion, a major milestone for a privately owned company. Alongside Romer for the past six years was her “soul sister” Bijal Shah, Guild’s current CEO. 

After Romer unexpectedly landed in the hospital, Shah, who was out on maternity leave, found herself called into action at a moment’s notice. Shah said she got an unexpected call from one of Romer’s family members who had scant details and a request: call the board of directors to notify them of Romer’s current health condition. 

Guild founder Rachel Romer fist bumps the company’s CEO Bijal Shah on stage during a joint interview at Fortune’s Most Powerful Women Summit.
Kristy Walker

Once the details emerged, it became clear Shah was needed back at the office. She obliged without hesitation. 

“We had a business continuity plan,” Shah said onstage with Romer during their interview with Fortune’s Emma Hinchcliffe. “Friday is when I got the phone call. On Monday morning, I stepped back into the business.”

Months later, after Romer awoke from a medical coma, her first thought went to Shah. “When I woke up from the first medical coma, the first thing I did was I saw my dad in the hospital room, and I said ‘someone call Bijal and put her in charge.’”

Eventually, Romer recuperated enough to host her longtime business partner and newly minted CEO for a hospital visit. That first visit was meant to be personal, not professional, Shah recalled. Easier said than done, she added. 

“The first time I saw her, we were not allowed to talk about work, which, if you know Rachel, it’s really hard,” Shah said. 

After a few pleasantries, Romer was eager to share what she had learned from her many conversations with her nurses.

“She’s like, ‘okay here’s some ideas I have based on what I’ve seen. There’s a shortage. Here’s what’s happening,’” Shah recalled. 

Over the last year and a half, Romer underwent a grueling rehabilitation process. As Romer does five hours a day of outpatient therapy, which she deemed “boring,” and her mind can’t help but wander to the helpful therapists administering her care. Even they can’t escape Romer’s probing questions.  

“I still interview the occupational and speech and physical therapist and then give Bijal and team every idea I’ve got,” Romer said.

See who made the 2025 Fortune Most Powerful Women list. The definitive ranking of the women at the top of the global business world tells us both who wields power today and who is poised to climb even higher tomorrow.
About the Author
Paolo Confino
By Paolo ConfinoReporter

Paolo Confino is a former reporter on Fortune’s global news desk where he covers each day’s most important stories.

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