Gene Kakaulin

America's health care system is neither healthy, caring, nor a system.

[Liron Shapira @liron]

Jesus, I've never seen an interview like this! 🤯
Watch the whole thing or at least read my notes:

1. Yaniv was sitting in Row 11, not Business Class. He heard a woman up front yelling “Stabbings!" (She didn't say who.) Yaniv immediately stands up to see what's going on.

2. Wife & daughters are sitting around him. Then the plane starts shaking. Plane rolls very sharply leftward and back to horizontal in a terrifying way.

3. It hits him that the commotion isn't a fight in Business Class, it's happening in the cockpit.

4. He yells “Buckle up!” and runs toward the cockpit. He's 6 feet away from the cockpit when the plane suddenly nosedives.

5. It felt like it nosedived for an eternity. (In reality about 30 seconds at 30,000ft/min, reaching speeds of about Mach 0.96. Those 30 seconds of nosediving cut the plane's altitude in half.)

6. “I was flying.” He was blown around upward, sideways, he was pressed against the floor extremely hard. (A 180lb man would effectively have 540lb of downward force on their body as the first nosedive leveled out.)

7. “I kept trying my hardest to get up off the ground. At some point, I was finally able to, when the plane leveled off a little.” He speculates that a system kicked in to automatically stabilize the plane.

8. He goes to the cockpit door and there's a crew member in a white shirt, who looks like he's also a pilot. He's grabbing the cockpit door with both hands, with his body leaning down. I didn't know if he was trying to open the door, or trying to hold the door closed!

9. “I get to him, I move him away, he doesn't resist. I open the cockpit door — it was a little difficult because the pilot was lying down on the floor behind it, the one who was attacked.”

10. “I went in. The terrorist was crouching with his knees on the instruments between the two pilots' seats. There was no one in the pilots' seats. He was hitting the instrument panel, trying to break the equipment.”

11. Yaniv yells “Come help!” to any other Israelis who are also in the aisle. He doesn't know how many there are because his back is to them.

12. Yaniv immediately grabs the terrorist by the throat and starts moving him away from the controls. The terrorist resisted, but Yaniv's struggle to get him out of the cockpit only took a few seconds.

13. A handful of men who'd already gotten up from their seats together with Yaniv were already standing in the aisle dividing up responsibilities among themselves. They take over subduing the terrorist.

14. Yaniv turns back to the cockpit controls. At this point, the plane isn't nosediving, but it's still angled downward. He looks out the windshield and sees ground in the distance.

14. He leans over the pilot's seat, grabs the yoke and pulls it upward. He feels the nose of the plane come up.

15. A few seconds later, a pilot (not an Israeli) comes up behind him and says “Release the controls, I'll take it.”

16. Yaniv wasn't sure whether the other pilot was trustworthy, but he said “ok” and let him sit down at the controls. He intended to supervise the new pilot.

17. Yaniv turns around and briefly helps the men who are dealing the terrorist blows to subdue him, since apparently the terrorist is still resisting. Eventually the terrorist stops resisting, he possibly gets knocked unconscious, and the men tie him up with headphone cables.

18. Yaniv also helps the men remove the wounded Indian pilot from the cockpit. Then he goes to close the cockpit door with himself and the replacement pilot inside.

19. At this point, a member of the flight crew arrives at the cockpit door and wants to come in. Yaniv asks the replacement pilot whether to let the crew member in. He says yes, he's with us.

20. The flight crew member comes in. He has a tablet with a map. Yaniv closes the cockpit door with the three of them inside. He latches it.

21. Now Yaniv is focused on checking that the replacement pilot and the crew member are acting properly to land the plane. He sees that the pilot is talking on the radio to ground control. It sounds good to Yaniv, even though he doesn't speak much English. Yaniv can tell he's reporting that there are injured people, that we're heading in a certain direction, and that he's requesting help.

22. Some of the other Israelis were assigned to guard the rest of the flight crew. At this point, they feared that the whole crew could be conspiring. This is why the entirety of the stressful incident was about 40 minutes long. They couldn't relax until they landed and the flight crew got off the plane.

23. When they landed, one of the Israelis on the plane bought eSIM cards with a data package for everyone. As soon as they get reception, he gets a bunch of messages with pictures of himself on international news.

24. The landing was an incredible celebration. Singing, what fun we were having.

25. Let's rewind. You wake up in the morning before getting on this flight. Did something prepare you for this engagement? Something in the army? Some instinct? “Well, in the army, I was working the closest to the fire in the kitchen. (I wasn't a cook, I'd, you know, get the food and divide it up.)”

26. Yaniv personally didn't feel scared to board the second FlyDubai flight they sent. What are the odds lightning would strike twice? “Even being in this situation once was like winning the lottery.”

27. Did FlyDubai offer some kind of compensation for the incident? Did they contact you at all? “Nothing.”

28. Will you fly again? “Fly again? Sure.”

29. When are you going back to work? “I want to on Sunday.”

What an interview. Makes me proud to be Israeli.

[Daniel Negreanu @RealKidPoker]

This question was answered masterfully.

He didn’t bite on the direction the interviewer wanted him to, and instead, showed love for his parents, his country, and to those who lost loved ones on 9/11.

Truly impressive 👏

[Bill Ackman @BillAckman]

At midnight on February 6th, earlier this year, the doorbell to our apartment rang. The doorbell was followed by a pounding on the door. I answered the door and a security person in our building handed me his phone. It was my oldest daughter Eloise. She had found my 26-year-old daughter unconscious on the floor of her apartment and had called 911. The EMT team was already there, but they did not know what was wrong with Lucy or to which hospital they would take her.

I threw on some clothes and jumped in an Uber heading east toward Brooklyn. (Lucy lived alone in Williamsburg.) On the way, I learned that they were taking her to Elmhurst, a City trauma hospital in Queens. I arrived about five minutes after the ambulance to join Eloise, Lucy’s mom, and a friend, and waited to learn what was wrong.

After about 15 minutes, I asked a nurse where she was. I looked over his shoulder to his computer. Next to her name, it said “non-responsive.” I walked into the emergency room and wandered around looking for her until I found her unconscious on a gurney surrounded by several doctors and nurses.

By about 2:30am with the results from a CAT scan, Lucy’s doctors had determined that she had a massive brain hemorrhage and would need an emergency hemicraniectomy to release the pressure on her brain and remove the blood from the hemorrhage. I called our wonderful friend and family doctor Eddie Fisher and explained what was going on. He woke up Josh Bederson, Chairman of Neurosurgery at Mount Sinai, to find out more about Zach Hickman, the neurosurgeon on call that night. Dr. Bederson said Hickman was an excellent surgeon, which was comforting as we had no choice.

The surgery to save Lucy’s life began around 3:15am and finished around 5:30am. It was successful.

The following day, I joined Lucy in an ambulance while she was being transferred to Mount Sinai on Madison Avenue. Later that day, we determined from Lucy’s Oura ring that her hemorrhage had occurred around 9am, which meant that more than 19 hours had passed from the time of the hemorrhage to the completion of the surgery to release the pressure on her brain (I only wish @ouraring had an alert for this kind of a medical event. Imagine it could call a family member if the wearer doesn’t cancel the alert).

I later learned that the standard of care is not to do surgery to save a patient with a large brain bleed if more than five hours have passed since the hemorrhage. Even when the surgery is done, I was told that the likely outcome for the patient is a few months in a nursing home and death from pneumonia.

When I met Lucy’s doctors, I did my best to inspire them: “Let’s see what can be accomplished if we give her the best care possible and we invest unlimited resources to restore her to life.” And I promised that whatever we learned we would make available to everyone.

Dr. Chris Kellner, her neurosurgeon, and Dr. David Putrino, Director of Rehabilitation Innovation for the Mount Sinai Health System have led Lucy’s care team since that day. Words cannot describe the remarkable and compassionate care that she has received beginning with the EMT team and then from nurses, doctors, therapists, and the army of people who have worked to save her and return her to life. To this day, we have a daily Zoom where we discuss her progress and make adjustments to her care. While her care and oversight have been incredible, the learnings for the Mount Sinai team have also been elucidating and will assist in the care of many others.

Lucy began in a bad place. She was in a coma for several weeks and then awoke not being able to breathe on her own, unable to walk, see or speak.

Over the last six months, she has recovered her cognition – she understands everything including her circumstance – is able to walk a hundred or more steps at a time with assistance, is making progress with sounds, vowels and consonants and the beginnings of speech, but she remains unable to see.

Each day, she makes a little progress, and daily progress compounds. Every day I tell her that she just needs to make a little progress and it won’t be long before she is back.

We remain optimistic that Lucy will return to normal function. It will likely take years, but I believe it is only a matter of time, hard work, and technological progress, along with some, and perhaps a lot, of divine intervention.

Many people have been praying for Lucy and we are incredibly grateful for the prayers and remarkable support she has received. Lucy’s friends have been with her every day since the beginning, and their presence and friendship have saved her life and helped to rebuild and maintain her spirit. And on a very positive note, Lucy’s challenge has brought together our entire modern family who have all been incredibly devoted to her care and recovery.

Lucy's vision and other faculties may require some form of brain computer interface, work that is underway at Neuralink, Precision Neuroscience, Science, Synchron, Nudge, and other companies in the space.

If you are going to have a devastating brain injury, now is the best time in history for that to happen. We are living in a world when you can be confident that the blind will soon see again. We are going to do everything we can to help make that happen, including by assisting existing companies in the space.

With respect to our promise to make Lucy’s care available to others, we have made good progress. In May, a real estate colleague made me aware of a 93% vacant, brand new, 400,000 square foot Class A+ purpose-built biotech facility on West End Avenue between 65th and 66th Streets that missed the market and was available for sale. The Pershing Square Foundation acquired the building 60 days later.

We also put under contract an adjoining 130,000 square foot building at 320 West 66th Street that is currently being used by Saturday Night Live for studio space. The building has 35-foot ceilings with massive column-free spaces that can be converted into superb rehabilitation facilities. We will close on the SNL building in December.

We are also acquiring an adjoining vacant lot with additional air rights. With just the existing zoning rights, we can add a 150,000 square feet for a total of 680,000 square feet, a lab footprint larger than Rockefeller University, and that’s without including the potential for an upzoning that would allow for substantially more buildable area on the site’s 3.4 acres with spectacular views of the Hudson.

Our goal is to build the world’s greatest brain research, rehabilitation, recovery, human optimization, and longevity institute. We have named it The Ackman Oxman Institute or the AOI for lack of a better name, but also to reinforce the point that Neri and I and our family are all-in on the mission.

The AOI will be patient-centric. It will not be an academic research institute that produces lots of papers, a Nobel Prize winner or two, but little if any results for patients. We will be laser-focused on cures, treatments, devices, rehabilitation and exercise equipment, and targeted and basic research with a goal of massively accelerating the time from idea to innovation to production to helping a patient.

While the AOI will be a non-profit, it will have highly commercial instincts. The AOI will have its own venture funding and will work to develop innovations to create companies that we will seed, assist, and spinout to ensure technologies, treatments, techniques, and drugs get to patients as promptly as possible.

On one 3.4 acre campus in what is still the greatest city in the world, we will do neurosurgery, neuroscience, rehabilitation, nutrition, BCI and device development, human trials, hyperbaric oxygen treatments, and life extension programs, and we will mandate and incentivize collaboration among the teams with no silos, politics, bureaucracy, or any other constraint that is inconsistent with the mission.

Mount Sinai will be an important partner and deservedly so, but it won’t be our only hospital or medical school partner as we don’t believe any institution has a monopoly on the best ideas or the best talent. We don’t believe in exclusive relationships because that is not in the best interest of patients.

Five years ago, we considered launching a brain institute inspired by Neri’s mom who sadly died from Alzheimer’s. We couldn’t make the math work as the real estate was too expensive and we believed it would be too difficult to recruit the best talent from universities to our effort.

Since then, the real estate became available at a 70% discount, universities became a much less attractive place to work due to politics outweighing meritocracy, protests that disrupt learning, the curse of antisemitism, and a decline in funding. Fortunately, during the same time, I made sufficient personal economic progress to make the AOI possible.

The advance of AI in the last few years will also enable us to greatly accelerate our mission. AI still has a lot to learn about human intelligence and the brain, and the AOI should be at the forefront of the interplay between the brain and AI.

Today, I am making a public filing disclosing a gift from Neri and me of ~$400 million or 10,000,000 shares of Pershing Square Inc. (PS) to the AOI. It is very early days for Pershing Square so these shares are intended to anchor the long-term work of the AOI as the shares compound over time while generating what we expect will be a growing stream of quarterly dividends to fund the Institute.

We will also be announcing an additional gift of similar and potentially greater size which won’t be in the form of Pershing Square stock to provide the AOI with the short- and intermediate-term runway necessary to enable it to achieve its goal of becoming a self-sustaining institute, which reinvests all of its revenues, royalties, and the economic rewards of company formation to advance the fields of brain health and human longevity.

Neri and I have chosen to anchor the funding of the AOI to maintain vision alignment and limit the need for the organization to focus on fundraising. We expect the AOI to be the best-resourced brain, rehab, recovery, and longevity institute in the world.

We are grateful to have been able to form a board which includes Dean Kamen (our generation’s Thomas Edison), George Yancopoulus (CEO of Regeneron), James Rothman (Nobel Laureate), Bernardo Sabatini (neuroscientist), Chris Kellner (neurosurgeon), Olivia Flatto (CEO Pershing Square Foundation), Neri Oxman, and myself.

We have recently identified a CEO who we expect to announce by October along with other key hires, and are beginning searches for a Chief Scientific Officer, a Chief AI/Technology Officer, a Chief Operating Officer, a Chief Financial Officer, and other key leadership roles.

If you find what we are building compelling and want to be part of the leadership team that creates and builds the AOI from a standing start, please send an email to: [email protected] with a short note as to why you believe you can help. Please include your best three ideas for the AOI along with a summary of your background and your most important accomplishments.

We promise strict confidentiality to those expressing interest in working with us.

We have learned from Lucy that the brain can recover from even catastrophic injury. There is so much more work to be done as the mind is a terrible thing to waste.

For details from my Pershing Square SEC filing see:

https://t.co/gZKafCw6Ia

[Matthew Prince 🌥 @eastdakota]

Thank you for coming to my TED talk. https://t.co/VsvZM8lSqc

[Ray Dalio @RayDalio]

I had a blast being out until 4am with my family and friends at UNVRS in Ibiza for my 77th birthday and thought I’d pass it along to turn you onto it, in case you’re in the neighborhood.

[Aporia @aporia9n]

I think ambitious people should treat life in “seasons” rather than trying to balance everything every day.

A few years massively overallocated to work. A period getting seriously fit. A year or two nomading. Then family takes priority for a while. Then maybe at 35 you go completely insane again and spend four years building a new company, and so on.

The mistake is thinking every metric needs to stay green all the time. Most great outcomes (building a company, writing sth serious, training for an event) need uninterrupted runs, not daily moderation. Sometimes work should suffer cause you’re travelling, sometimes your social life should suffer cause you’re building, sometimes career progression should slow cause family matters more. That’s fine.

And tbh it probably makes life more fun too. You get actual chapters and completely different versions of yourself instead of spending 40 years maintaining the same perfectly optimised routine. A few intense years in one city, a weird nomad phase, an obsession that takes over your life, then something completely different. Probably much more memorable than one very long well-optimised Tuesday.

It's why I encourage everyone to think of balance in years, not days. A good life can look horribly unbalanced on some random Tuesday and still be very balanced over 10 years.

[Vinod Khosla @vkhosla]

Honored to be selected to co-lead when you could pick almost any VC firm in the valley or the world! Almost unbelievably impressive list of accomplishments/expertise on this team.

[Michael Dell 🇺🇸 @MichaelDell]

This one page changed my life.

42 years ago today, it convinced my parents I shouldn't go back to college.

I started by upgrading PCs from a dorm room.

Today @Dell is helping build the infrastructure that powers AI, from the edge to some of the world's largest AI factories.

You never know which small decision will change everything.

Keep building🚀🙏 #PlayNiceButWin

[Jesse Pujji @jspujji]

When I left Goldman Sachs in 2010, the first book I read was “Rework.”

I never understood why the frame was you either 1) raise venture money and change the world or 2) you build a cute (pejorative) “lifestyle” business.

There’s a 3rd: ambitious companies that scale on their own profits.

That’s what Ampush (my first biz) was. Profitable every year and an awesome exit. I’ve since co founded several others with a similar profile.

There’s not nearly enough advice, community and support for these types of founders.

I feel so strongly that I’ve launched the first residency and fellowship for seedstrapped founders. Take $1-2M from us, we’ll help you get profitable and never raise again. Build on your terms.

In an AI Era, I think this becomes the default path and we want to lead the charge.

Come join us!

[Football Tweet ⚽ @Footballtweet]

🇪🇸 After the final whistle, Unai Simón was spotted introducing himself to the Argentina squad.

It was the first time they'd seen him in 120 minutes.

[Brad Gerstner @altcap]

Buffett is the greatest investor of all time - synonymous w the American Dream. He inspired me to start Invest America | @TrumpAccounts. So as he considers donating all of his Berkshire shares by 2034 - along w Howard, Susie & Peter - there could be no more fitting legacy on this 250th anniversary of America than sponsoring a Buffett dividend of Berkshire shares directly to 70 M American kids accounts to seed the next 250 yrs of American capitalism. @MichaelDell & I look forward to sharing our pitch. 🇺🇸🤍🚀

[TOMISIN🏅 @tomisinfcb]

🚨🎙️Mbappé Responds After Lamine Declares Spain Will Win 👀

"I heard what Lamine said about Spain winning, and I like that confidence. Great players should believe in themselves. But when you speak before a match, you also accept that your words can come back to you. If France wins, I'll definitely remind him of this moment—not out of disrespect, but because that's football."

"People are building this as Mbappé against Lamine, but it isn't. It's France against Spain, two nations fighting for a place in the World Cup final. We respect them because they've earned it, but we didn't come this far to stop now. We came here to become world champions."

"He's an exceptional talent with a huge future ahead of him, but tomorrow there will be no gifts. We'll compete, we'll fight for every ball, and we'll do everything possible to beat Spain. That's our responsibility to the French people."

"If they win, they'll deserve to celebrate. But if we win, I'll look at Lamine, shake his hand, smile, and remind him that football has a funny way of answering bold predictions. Now it's time to stop talking and decide everything on the pitch."

[Hidden History @HiddenHistoryYT]

In 1945 the USS Indianapolis secretly delivered the parts for the atomic bomb that would hit Hiroshima.

Days later, mission done, a Japanese submarine put two torpedoes into her. She sank in 12 minutes.

Nearly 900 men made it off the ship alive and into the open ocean. Then it got worse.

No one knew they were missing. Three separate Navy stations picked up the distress signals and every one of them ignored it. One officer thought it was a Japanese trap. Another had ordered not to be disturbed.

So the men floated. For almost five days. No food, no fresh water, burning by day and freezing at night. Some drank seawater and went insane. And the whole time, the sharks were circling and feeding. It is considered the worst shark attack in human history.

When rescue finally came by accident, only 316 of the nearly 1,200 crew were still alive.

The Navy needed someone to blame for the disaster. They chose Captain Charles McVay, one of the men who survived it. He became the only U.S. captain in the entire war to be court-martialed for losing his ship to the enemy.

At his trial the Navy did something almost unheard of. They brought in the Japanese commander who sank the ship to testify against him. Instead, the enemy captain told the court that zigzagging would have made no difference and that McVay did nothing wrong.

They convicted him anyway.

For years afterward McVay got hate mail from the families of the dead. Some sent letters every Christmas telling him he murdered their sons. In 1968 he walked onto his front lawn and shot himself, holding a toy sailor he had kept since he was a boy.

Case closed. For fifty years.

Then in 1996 an 11-year-old named Hunter Scott watched Jaws with his dad and got hooked on the 30 second speech about the Indianapolis. He made it his sixth grade history project.

He tracked down and interviewed nearly 150 survivors. He dug through more than 800 documents. And buried in there he found what the Navy had left out, including that they knew enemy subs were operating right on the ship's route and never warned McVay.

A kid's school project turned into a national story. It reached Congress. In 2000 lawmakers passed a resolution clearing McVay's name and President Clinton signed it. The Navy officially cleared his record in 2001.

The captain the Navy spent decades blaming was finally exonerated by a sixth grader.

Hunter Scott grew up and became a naval flight officer.

[Collin Rugg @CollinRugg]

NEW: President Trump personally called FIFA President Gianni Infantino to ask him to review the suspension of U.S. player Folarin Balogun, according to the NYT.

Balogun was given a red card against Bosnia and Herzegovina on Wednesday and was suspended for the next game.

FIFA has now announced that Balogun will be eligible to play on Monday against Belgium.

“Thank you to FIFA for doing what was right and reversing a great injustice,” President Trump said on Truth Social.

Good. Everyone knows that call was ridiculous.

[Marc Andreessen 🇺🇸 @pmarca]

God bless America.

[Nick shirley @nickshirleyy]

🚨 Today the California Senate Committee held a hearing on the “Stop Nick Shirley Act,” known as AB 2624. This bill will criminalize and punish anyone from looking into fraud inside immigrant communities in California.

This bill was created only after I exposed billions of dollars in fraud throughout immigrant communities in the US. “Immigration support services” have become a billion dollar industry in California, and now that the fraud has been exposed, they are trying to criminalize those who look into the fraud.

The bill has passed through the California Assembly and is set to pass through the Senate and then to Governor Newsom’s desk. This bill was created by the Attorney Generals WIFE and will allow him to go after citizens if they film nonprofits and “immigration support services providers”.

Welcome to Califraudia.

[Melissa Chen @MsMelChen]

NORWAY🇳🇴 advances to the round of 16!

Jacobin Magazine credited socialism for Haaland's success which is so laughable because it's actually the complete opposite. Haaland is not a glorious product of Norway's "inclusive, publicly funded model."

Haaland's dad was actually a Premier League and national team player. So were the fathers of Sørloth and Thorstvedt. These aren't scrappy kids from the council pitches who pulled themselves up by their bootstraps thanks to the People's football utopia.

They're hereditary football aristocracy, families with the cash, connections, and know-how to pay for every fancy facility, private course, and elite pathway that actually matters.

It takes some Olympic-level mental gymnastics to pretend Erling Haaland is just "ordinary Norwegian football culture" when the lad has been micromanaged into superstardom by his dad-manager since he could walk. He's basically a walking billboard for inherited advantage dressed up in Viking helmets.

(Btw Haaland's family lives in Switzerland to dodge the crazy high Norwegian taxes and hangs with billionaire tax refugees)

Anyway, congratulations to NORWAY🇳🇴

[Paul Graham @paulg]

College students use AI to do most of their writing. An increasing number of professors secretly use it for grading. In the limit case, AIs do all the work, and all the humans do is transmit what they create. A good compiler would recognize this as dead code and remove it.