• Elephant Sleep Patterns: Wild African elephants in Botswana exhibit an average sleep duration of two hours per day.
• Sleep Deprivation Adaptability: These animals maintain functionality even after skipping an entire night of rest without requiring compensatory napping.
• Species Specificity: Biological constraints inherent to elephants prevent the adoption of these sleep habits by human beings.
• Mammalian Sleep Trends: Observations indicate an inverse correlation between physical body mass and total hours of sleep required.
• Brain Restoration Function: Sleep serves primarily as a specialized biological state dedicated to the repair and reorganization of cerebral tissues.
• Kleiber's Law Application: Metabolic rates scale to the 3/4 power of body mass, dictating the energy consumption patterns of various organisms.
• Cellular Metabolic Demands: Smaller brains experience higher rates of waste production and cellular damage per unit mass compared to larger brains.
• Comparative Biological Efficiency: The divergence in sleep needs across vast differences in animal mass is mathematically consistent with existing metabolic energy theories.

The study was quite the sensation when it was published in March of 2017. Scientists affiliated with University of the Witwatersrand in South Africa tracked African elephants in the wilds of Botswana for a month straight, and found that they only slept for two hours per day on average! What’s more, the animals could skip a night's sleep without needing extra naps the next day. Huh? How? Could we learn to sleep like that?

Alas, elephants' amazingly efficient sleep schedule is likely unique to them, not something humans could adopt through scientific means.

The study further evinced a trend that extends across the mammalian class: the bigger the mammal, the less sleep it needs. 

Some of the tiniest bats routinely sleep 18 hours a day. Cats sleep between 12 and 16. Chimpanzees doze about 10 hours. Cows snooze for about four. Yes, there are exceptions here and there – prey animals sleep less, predators more – but the trend is pretty consistent.

Gravett et al. / PLoS ONE

One of the tidiest theories to explain it was proposed almost two decades ago, and it has held up remarkably well. Scientists Van Savage and Geoffrey West at the Santa Fe Institute speculated that, "the process identified as sleep is a special state of the brain that is devoted primarily to the critical activities of repair and reorganization." Other organs and tissues could be repaired when awake, but not the brain.

Larger mammals thus need fewer hours of sleep because they have slower metabolisms than small mammals. This fact follows a biological law called Kleiber's Law, named for the biologist who discovered it. The law states that for the vast majority of animals, an organism's metabolic rate scales to the 3⁄4 power of its body mass. Pound for pound, smaller animals consume more energy.

This applies to all tissues and organs, even the brain. Each cell in the half-gram brain of a mouse demands more energy than a comparable cell inside a five kilogram elephant brain. Smaller brains thus produce proportionally more waste products and become more 'damaged' during operation per unit mass than large ones, requiring more time asleep to get them back into working order.

"The theory is able to explain sleep times that differ by a factor of seven across organisms that differ in mass by six orders of magnitude," Savage and West wrote.

It also explains why elephants can thrive with just a couple hours of shut eye.

• Documentary Discovery: A podcast episode regarding an HBO film about the identity of Satoshi Nakamoto prompted immediate viewer interest.
• Previous Research: The author previously abandoned a personal project dedicated to uncovering the identity of the Bitcoin creator due to its complexity.
• Industry Impact: Bitcoin functions as a global financial revolution representing a multi-trillion dollar asset class under the control of an anonymous founder.
• Media Consumption: The HBO production titled Money Electric The Bitcoin Mystery presented a specific Canadian developer as the likely identity behind the pseudonym.
• Evidence Evaluation: Viewers of the documentary found the core thesis regarding the individual identified by the filmmakers to be insufficiently supported by facts.
• Cryptographic Figure: Adam Back appears in the program during an interview filmed on location in Riga, Latvia.
• Interview Conduct: The subject exhibited notable physical tension and requested privacy when the topic of his own potential Satoshi identity arose.
• Behavioral Analysis: Observations of non-verbal cues and nervous mannerisms led to personal speculation regarding the veracity of the cryptographer's public statements.

One evening in the fall of 2024, my wife and I were sitting in traffic on the Long Island Expressway when, tired of listening to the jazz-funk station I often played on our drives, she switched to a podcast.

It was “Hard Fork,” the New York Times tech show, and the hosts were discussing a new HBO documentary claiming to have unmasked Bitcoin’s pseudonymous inventor, Satoshi Nakamoto.

I was instantly riveted. I had long considered the question of Satoshi’s true identity one of our age’s great enigmas and had poked at it before without success. Two years earlier, I had even spent several months researching a book on the subject. But I soon realized I was out of my depth and reluctantly gave up.

Hearing that someone else might have finally identified the shadowy figure who had revolutionized finance, spawned a $2.4 trillion industry and amassed one of the world’s biggest fortunes in one stroke of staggering genius aroused in me a mixture of admiration and envy. I couldn’t wait to watch the film. As soon as we got home that night, I logged in to the HBO Max app and pressed play.

In the end, I found the conclusion of “Money Electric: The Bitcoin Mystery” unconvincing: HBO singled out a Canadian software developer based on what seemed like very thin evidence. But as I watched what was an otherwise entertaining romp through the world of crypto, one scene caught my attention.

Adam Back, a British cryptographer and leading figure in the Bitcoin movement, sat on a park bench in Riga, Latvia, his shirt untucked under a brown coat. The filmmaker casually rattled off the names of several Satoshi suspects. At the mention of his own name, Mr. Back tensed up, strenuously denied he was Satoshi and asked that the conversation be kept off the record.

Having encountered my share of liars and developed something of an expertise in their tells, Mr. Back’s demeanor — his shifty eyes, his awkward chuckle, the jerky movement of his left hand — struck me as fishy. When the credits rolled up, I replayed the sequence several times on my TV.

• Professional Background: David Heinemeier Hansson serves as the co-owner and CTO of 37signals.
• Product Development: The leadership role includes the creation of software products such as Basecamp and HEY.
• Technological Contributions: Open-source software development includes frameworks like Ruby on Rails, Hotwire, and Kamal.
• Literary Works: Authorship encompasses business-focused books including REWORK, It Doesn't Have to Be Crazy at Work, and REMOTE.
• Athletic Achievement: Professional experience includes a victory as a driver at the Le Mans race event.
• Investment Activity: Financial backing is provided to various startups based in Denmark.
• Corporate Philosophy: Operations at 37signals focus on providing software solutions for smaller-scale market participants.
• Date Reference: The provided profile snapshot and contextual information are current as of April 6, 2026.

April 6, 2026

Panther Lake is the real deal

About David Heinemeier Hansson

Made Basecamp and HEY for the underdogs as co-owner and CTO of 37signals. Created Ruby on Rails, Hotwire, Kamal, Omarchy. Wrote REWORK, It Doesn't Have to Be Crazy at Work, and REMOTE. Won at Le Mans as a racing driver. Invested in Danish startups.

• Intelligence Sharing: Russian intelligence provided a list of 55 critical energy infrastructure targets in Israel to Iranian authorities.
• Infrastructure Categorization: Targets are classified into three levels of strategic importance, ranging from primary national power stations to regional industrial substations.
• Grid Vulnerability: Analysts identify Israel as an energy island, where the isolation of the national power grid creates a high susceptibility to total collapse from localized damage.
• Strategic Objective: The intelligence transfer intends to facilitate precision missile strikes against key energy facilities to induce prolonged, large-scale blackouts.
• Allied Cooperation: Military and intelligence collaboration between Moscow and Tehran encompasses the reciprocal provision of drone technology and actionable target data.
• Geopolitical Diversion: The transfer of knowledge and assets is viewed as a mechanism to escalate tension in the Middle East, thereby diverting international focus from the conflict in Ukraine.
• Technological Proliferation: Investigations indicate the presence of Russian components in drones utilized within the Middle East, suggesting a domestic expansion of Shahed-style drone production within Russia.
• Official Denials: Russian diplomatic representatives have formally refuted claims regarding the sharing of intelligence data with Iran, emphasizing existing security communication channels with Israel.

Russian intelligence has provided Iran with a detailed list of 55 critical energy infrastructure targets within Israel, according to information obtained by The Jerusalem Post from a source close to Ukrainian intelligence.

The report, which highlights the deepening military and intelligence cooperation between Moscow and Tehran, suggests that the information that was shared enables Iran to launch precision missile strikes against Israel’s energy grid.

According to the findings, the targeted sites are divided into three categories based on their strategic importance:

Level 1: Critical production facilities. These are sites whose destruction would cripple the national energy system. The report specifically names the Orot Rabin power station as a primary target.

Level 2: Major urban and industrial energy hubs. These facilities are located primarily in central Israel and serve large population centers.

Israeli search and rescue personnel work on the site of a residential building that was destroyed by an Iranian strike in central Israel. (credit: Oren Ziv/picture alliance via Getty Images)

Level 3: Local infrastructure. These targets include regional substations that support industrial zones and smaller power plants.

The Russian assessment regarding Israel’s vulnerability is that “unlike many European nations, Israel’s power grid is characterized by a high degree of isolation”. Because Israel is an “energy island” that does not import electricity from neighboring countries, Russian intelligence reportedly told Iran that damaging even a few central components could trigger a total and prolonged energy collapse, leading to mass blackouts and technical failures that could not be easily mitigated.

Zelensky warns of growing Russia-Iran alliance

Ukrainian President Volodymyr Zelensky has grown increasingly vocal about the Russia-Iran alliance, warning that the “knowledge” Russia has gained on the battlefields of Ukraine is being exported to the Middle East.

“The Russians also helped them, like the Iranians helped [Russia] at the beginning of the war when they gave them Shaheds,” Zelensky told the Post in an interview two weeks ago. “They gained big knowledge on the battlefield and this impacting and will have an impact on other regions.”

Zelensky further claimed that Russia has begun providing Iran with Shahed-style drones manufactured on Russian soil. He alleged in an interview with the Post that “Russian components” were discovered in a drone recently downed in a Middle Eastern country, though he declined to name the specific location for security reasons.

“We saw some components; they had Russian details. We know it because Iranians didn’t produce it,” the President stated.

However, Ukrainian officials maintain that the motive behind the intelligence transfer is twofold: to embolden its primary ally in the region and to create a fresh crisis in the Middle East that would divert international attention and resources away from the war in Ukraine.

Russian ambassador Anatoly Viktorov responded to the allegations, stating, “Russia and Israel established contacts to discuss national security issues long ago. These contacts have been intensively maintained between relevant Russian and Israeli agencies. The most pressing issues have been discussed at the highest level. We value track record which has been accumulated in this area.

“Representatives of the Russian political leadership have repeatedly dissented from the ‘accusations’ that our country allegedly provides intelligence data to Iran,” he added.

• Weapon Accumulation Strategy: Iran has redirected significant national revenue toward the mass production of long-range ballistic missiles and drones rather than essential infrastructure.
• Financial Impact Of Diplomacy: International fund transfers, including those associated with the JCPOA agreements, provided liquid capital that accelerated Iranian military industrial output.
• Strategic Policy Miscalculations: Diplomatic efforts to reduce regional friction inadvertently empowered the Revolutionary Guard by prioritizing ideological objectives over security warnings from neighboring states.
• Nuclear Infrastructure Expansion: Industrial-scale nuclear enrichment facilities and weaponization sites were aggressively developed and expanded following the removal of international export restrictions.
• Internal Economic Neglect: The prioritization of military assets has led to chronic underinvestment in critical civilian utilities, most notably water desalination and power generation.
• Environmental And Humanitarian Crisis: Major population centers, including Tehran and Mashhad, face severe water shortages and potential desertification due to the regime's failure to address basic infrastructure needs.
• Repression And State Control: Internal dissent is effectively stifled through the use of state security forces armed with contemporary weaponry, mirroring historical precedents regarding the suppression of popular uprisings.
• Regional Security Imperatives: Ongoing military operations targeting Iranian missile production facilities are identified as necessary to mitigate direct threats to regional stability and critical infrastructure in neighboring nations.

Edward Luttwak

Mar 17 2026 - 12:02am 5 mins

Since October 2023, Iran has launched more than 1,000 ballistic missiles against Israel — and many more against its Gulf Arab neighbors. It has also launched thousands of drones, sending more than 1,500 toward the United Arab Emirates alone. How did the Islamic Republic accumulate such vast inventories of expensive weapons? And expensive they are: drones would only be cheap, as the media keeps claiming, if their number were not so large, while ballistic missiles are necessarily expensive because of their size. Iranian Shahab-3 missiles weigh 16 tons, while Korramshahrs come in at 25.

Just as with any other feat of accumulation, this too is the result of disciplined persistence. In the regime’s case, that meant allocating Iran’s limited foreign-currency earnings to what really mattered: not waterworks against desertification, not gas pipelines to bring cheap gas to the cities, not desalination plants to overcome water shortages even in Tehran, but rather the production of very large numbers of long-range missiles to attack Israel and other countries.

This enormous industrial effort has been underway for years, yet it was greatly accelerated by the transfer of $1.7 billion to Iran by the Obama administration. Officially, this was merely an overdue refund for canceled military orders dating back to the time of the Shah. But the payment’s first installment — $400 million in stacked banknotes — was sent on 17 January, 2016. This just happened to coincide with the release of several Americans from Iranian captivity, and the coming into effect of Obama’s grand diplomatic achievement: the Joint Comprehensive Plan of Action.

In those early weeks of 2016, one would hear the initials “J-C-P-O-A” proudly enunciated by Obama staffers even at lowkey Washington gatherings. Why? Because, its supporters claimed, the deal would definitively end Iran’s efforts to acquire nuclear weapons. It limited Iran’s uranium-235 enrichment to just 3.67%, with dangerous levels only kicking in at 60%. Iran was also permitted a meager 300 kilos of nuclear material.

But for Robert Malley, head of Obama’s Iran team, this technical win was outweighed by a more emotionally satisfying achievement. Having grown up in a household where Algeria’s FLN nationalists were much celebrated, and where traditional Arab rulers and Israel were greatly deplored, Malley hoped the JCPOA would stop US-Iran frictions. That, in turn, would allow Obama to finally sideline both the embarrassing Saudis — with their over-the-top gold-bathtub polygamy — and the insufficiently humble but very demanding Israelis.

Given those tacit but clear preferences, one can understand why Obama disregarded all Saudi warnings about the Revolutionary Guards. This was a Shia supremacist organization, but its long-term plan was nonetheless to become the hero of all Arabs, Sunnis included, by defeating Israel and taking the Temple Mount. Mecca itself was another aim. Meanwhile, US diplomats in Saudi Arabia — who reported that Iranians arriving for the Mecca pilgrimage were seemingly eager to assert themselves by picking quarrels — were dismissed as having gone native.

Israel was worried too. It noted that the Revolutionary Guards were taking a rising proportion of Iran’s oil revenue — itself increased by the JCPOA — to build more missiles, to increase their number of U-235 separation centrifuges, and to expand both their own forces and those of auxiliaries abroad. Those warnings were too well-documented to be dismissed out of hand. Yet nothing was done, for action would have spoiled Obama’s great diplomatic success.

To be fair, Obama was not responsible for what happened next. After the JCPOA removed all export restrictions on Iran, the country’s hard-currency earnings from oil exports rose. The Revolutionary Guards swiftly demanded an even larger share of the total, even after oil prices started to dip.

Mahmoud Ahmadinejad, Iran’s president from 2005 to 2013, and who was famous for his slogan about the sofreh — the traditional tablecloths of modest households, focusing attention on the needs of Iran’s poor — seems to have complained. But Qasem Soleimani and the Revolutionary Guards were in the ascendancy with Ayatollah Khamenei. So while Ahmadinejad was set aside, the Revolutionary Guards claimed an increasing share of Iran’s oil revenues.

It was then that the Natanz complex was hugely expanded to accommodate two immense centrifuge cascades, of 25,000 centrifuges each, while an entire separate centrifuge cascade was installed deep underground at Fordow. Meanwhile, a weaponization facility was established in Isfahan, to go with one at the Parchim base near Tehran.

I have never heard a convincing explanation for these projects: far more than needed even for many bombs, let alone civilian electricity production, and especially in a country with unlimited natural gas. Corruption is hard to prove in a dictatorship with so much oil money sloshing around. But even here, graft cannot always stay hidden. When Mossad killed the chief nuclear scientist of the Revolutionary Guards in November 2020 — using a remote-controlled machine gun placed inside a parked Nissan van — he was being driven on his hour-long twice-daily commute from Tehran to Absard: a fashionable hill town where rich Iranians go to escape the capital’s pollution. Families without personal chauffeurs tend to visit Absard only on weekends, and generally settle for simple lodgings. But this nuclear scientist seems to have been unusually wealthy by Iranian standards.

At the same time, the Revolutionary Guards also spent immense sums on ballistic missile fuel and other components — including the multiple “cluster” warheads now causing much damage in Israel. The sheer scale of Iran’s missile production is itself amazing too, with 3,000 the low estimate for the longer-range types targeting Tel Aviv and other Israeli cities.

All the same, neither Israel nor any other country has been as harmed by the Revolutionary Guards as Iran itself. Because the Islamic Republic has overspent its oil export earnings — not at all huge for a country of 90 million — it has neglected to make investments elsewhere. Especially urgent is water supply, needed for major cities including Tehran, whose 13 million inhabitants now face the possibility of desertification-driven evacuation. Mashhad, with three million inhabitants and Iran’s second-largest city, is in the same predicament. Located near the Afghan border, its problems are aggravated by Taliban dam building, as are many smaller cities, including ancient Yazd with its Zoroastrian eternal flame.

“Neither Israel nor any other country has been as harmed by the Revolutionary Guards as Iran itself.”

What all these places desperately need is a new supply of desalinated seawater, pumped all the way from the Persian Gulf. With three times as much natural gas as the US, Iran could produce all the water it needs, just as Israel is doing — but that would have required vast investments starting decades ago. Iran’s grossly insufficient electrical supply is another victim of Revolutionary Guard overspending, with frequent power cuts whenever temperatures fall and more heating is needed.

We keep being told that Iran’s population cannot liberate itself for the simple reason Trotsky long ago identified: popular insurgency could conquer the Bastille in 1789, but by the Twenties Trotsky’s Red Army had Maxim machine guns that could mow down any number of demonstrators. Iran’s Basij and Revolutionary Guards have done just that, and can do so again.

That being true, the US-Israeli war still has a purpose: to destroy Iran’s missile and drone factories and inventories. For as long as they exist, they will permanently threaten the Gulf states, just as they have already closed the world’s largest airport in Dubai, and which continue to menace water-desalination plants in Qatar and oil-separation facilities in Saudi Arabia.

Whatever their leaders say in public, nobody of consequence on the western side of the Gulf wants Trump or the Israelis to stop undoing the damage that began with Obama’s once-celebrated JCPOA. That deal, it is now clear to see, did not stop nuclear enrichment towards the bomb — and indeed accelerated every other danger emanating from the Islamic Republic.

Professor Edward Luttwak is a strategist and historian known for his works on grand strategy, geoeconomics, military history, and international relations.

ELuttwak

• Technological Optimization: A founder leveraged over a dozen artificial intelligence tools to automate coding, marketing, customer service, and business process analysis.
• Rapid Scaling: The startup Medvi reached high revenue milestones quickly by utilizing existing telehealth infrastructure to facilitate the distribution of prescription medications.
• Capital Efficiency: With only two employees and minimal initial investment, the enterprise reported substantial annual sales and profit margins surpassing traditional competitors.
• Automation Focus: Operations are structured around AI agents and software systems that handle day-to-day business functions, reducing the need for significant human staff.
• External Partnerships: The business model relies on third-party platforms to manage clinical requirements, including interactions with medical doctors and physical product fulfillment.
• Lean Philosophy: The founder deliberately avoids large-scale hiring based on previous experience suggesting that human teams can complicate decision-making and increase fixed costs.
• Agile Iteration: The company continuously expands its product offerings, moving into new categories like men’s health and nutrition through automated operational adjustments.
• Strategic Philanthropy: A portion of generated profits is allocated toward a private foundation intended to support social causes, including homelessness and animal welfare.

Matthew Gallagher, 41, built his start-up, Medvi, with artificial intelligence and few humans.Credit...Maggie Shannon for The New York Times

Supported by

SKIP ADVERTISEMENT

Listen · 13:09 min

By Erin Griffith

Reporting from Los Angeles

• April 2, 2026

Matthew Gallagher took just two months, $20,000 and more than a dozen artificial intelligence tools to get his start-up off the ground.

From his house in Los Angeles, Mr. Gallagher, 41, used A.I. to write the code for the software that powers his company, produce the website copy, generate the images and videos for ads and handle customer service. He created A.I. systems to analyze his business’s performance. And he outsourced the other stuff he couldn’t do himself.

His start-up, Medvi, a telehealth provider of GLP-1 weight-loss drugs, got 300 customers in its first month. In its second month, it gained 1,000 more. In 2025, Medvi’s first full year in business, the company generated $401 million in sales.

Mr. Gallagher then hired his only employee, his younger brother, Elliot. This year, they are on track to do $1.8 billion in sales.

A $1.8 billion company with just two employees? In the age of A.I., it’s increasingly possible.

Sam Altman, the chief executive of OpenAI, predicted the rise of a new breed of superefficient company in 2024. A one-person business worth $1 billion “would have been unimaginable without A.I.,” he said on a podcast, “and now it will happen.”

Now as A.I. tools spread, entrepreneurs are harnessing the technology to expand their start-ups to an enormous scale at breathtaking speed with very few humans. Big companies, especially in tech, are getting in on the disruption, too. Pinterest, Block and others have cut thousands of workers in recent months, citing efficiencies enabled by A.I.

Mr. Gallagher, who formerly ran a start-up that sold wristwatches, said he thought Mr. Altman’s prophecy of a one-person $1 billion company would be a firm that built A.I. He was excited when he realized he may have done it, taking an old idea — being a middleman for weight-loss drugs — and using A.I. to turbocharge it.

“It’s not an A.I. company, but I did it with A.I.,” he said.

In an email, Mr. Altman said that it appeared he had won a bet with his tech C.E.O. friends over when such a company would appear, and that he “would like to meet the guy” who had done it.

Medvi is technically not a one-person $1 billion company, since Mr. Gallagher hired his brother and has some contractors. The start-up, which has not raised outside funding, also has no official valuation. But many highly valued tech companies can only dream of hitting $1 billion in revenue with so few workers. Medvi is also profitable, Mr. Gallagher said.

The New York Times was given access to Medvi’s financials to verify its revenue and profits and interviewed Mr. Gallagher’s business partners.

On a recent afternoon at the Soho House club in Los Angeles, Mr. Gallagher, sporting unkempt curly hair, a baggy T-shirt and tattoos on his arms and hands, said the last 18 months had been a whirlwind.

He works on Medvi from his house basically anytime he’s not showering, sleeping or spending time with his two children, he said during a two-hour conversation. He even made an A.I. clone of his voice to help manage his personal life, using it to call and schedule appointments so he would have more time to work.

Not everyone can build such an A.I.-enabled company, though many may try. Mr. Gallagher is suited to the moment because he knows marketing and how to use cutting-edge A.I., said Kobie Fuller, an investor at the venture capital firm Upfront Ventures who has advised him.

“Those folks that have those skills, it’s kind of like their superpower,” Mr. Fuller said. “This is an extreme example, but I don’t think it’s going to be the last by any stretch.”

Mr. Gallagher has told hardly anyone about his company, which he said was raking in more than $3 million a day. He was nervous to talk publicly about it, he said.

“I mean, it’s crazy, right?” he asked, before answering himself. “It’s crazy.”

Spotting Opportunity

Mr. Gallagher had an itinerant childhood, living out of motels and cars for a time before landing in Cincinnati when he was 12. That was where his uncle gave him a laptop, which he used to teach himself to code so he could make a Weird Al Yankovic fan page.

As a teenager, Mr. Gallagher began building websites for local businesses. He always had a hustle, including selling candles and Samurai swords on eBay. At 18, after building a web hosting business, he sold it for $6,000.

Mr. Gallagher briefly attended the University of Cincinnati and Northern Kentucky University but did not graduate. In 2010, he moved to Los Angeles to become an actor. He eventually returned to coding, bouncing between tech jobs.

In 2016, he built Watch Gang, a start-up that sold wristwatches via subscription. It had fans but never turned a profit, even as Mr. Gallagher chased revenue growth and hired 60 people.

OpenAI’s release of ChatGPT in 2022 inspired Mr. Gallagher to start tinkering with A.I. Two years later, he met Jiten Chhabra, a co-founder of CareValidate, a medical start-up in Atlanta.

CareValidate offers what is essentially a telehealth-in-a-box kit. Companies, employers or retailers that want to sell customers prescription drugs can use CareValidate’s technology and network of online doctors to set up a business. The company’s software connects patients with doctors and pharmacies, which write, fulfill and ship the prescriptions. CareValidate charges fees for its software.

Mr. Gallagher saw an opportunity for his own telehealth business. He could use A.I. to do the branding and marketing and let CareValidate and a similar platform, OpenLoop Health, handle the doctors, pharmacies, shipping and compliance. He planned to start with GLP-1s.

He was entering an established market. For nearly a decade, Hims & Hers Health, Ro and other companies have sold drugs for erectile dysfunction and hair loss online, using an online network of doctors to write the prescriptions. Hims, which went public in 2021, has 2,442 employees and generated $2.4 billion in revenue last year.

Hims and Ro had already expanded into GLP-1 drugs, but Mr. Gallagher thought he could do the same thing faster and more efficiently with A.I. and the doctor-on-demand platforms.

He used many A.I. tools to build Medvi’s website, including ChatGPT, Claude and Grok. He created custom tools, including A.I. agents, or bots that perform tasks on their own, to get his software systems to communicate with one another. He tested A.I. voice tools from ElevenLabs and others for communicating with customers. And he used the image and video generators Midjourney and Runway to create media for his website and ads.

Altogether, he spent $20,000 on the software and the first month of marketing.

Medvi’s initial website featured photos of smiling models who looked A.I.-generated and before-and-after weight-loss photos from around the web with the faces changed. Some of its ads were A.I. slop. A scrolling ticker of mainstream media logos made it look as if Medvi had been featured in Bloomberg and The Times when it had merely advertised there.

But Mr. Gallagher was most concerned with getting Medvi’s checkout to work smoothly and making sure his A.I. customer service system stuck to the task at hand. He tested it by asking the system for lasagna recipes; it took some tweaking to get it to stop supplying them, he said.

Medvi opened for business in September 2024. It was perfectly timed. Americans wanted cheap GLP-1s, delivered without going to a doctor’s office. The start-up charged as little as $179 for the first month’s supply of the drugs, in line with competitors.

Image

To build Medvi, Mr. Gallagher used A.I. tools including ChatGPT, Claude, Grok, Midjourney and Runway.Credit...Maggie Shannon for The New York Times

The Sky’s the Limit?

From the beginning, “growth was insane,” Mr. Gallagher said.

Medvi quickly became one of CareValidate’s and OpenLoop’s top clients. The companies said they were blown away by the start-up's speed and scale.

“You’re like, ‘Do you have an army of people behind you somewhere?’ And he’s like, ‘Nope,’” CareValidate’s Mr. Chhabra said of Mr. Gallagher.

Dr. Jon Lensing, OpenLoop’s chief executive, said Mr. Gallagher had started sharing tech tips with his company. “Matthew’s native tongue seems to be A.I.,” he said.

There were snags. Medvi’s customer service chatbot sometimes made up prices for the drugs. (Mr. Gallagher honored those.) Or it hallucinated, claiming Medvi sold hair-loss drugs when it didn’t.

If customers wanted to talk to a person, Medvi’s customer service chatbot had been trained to transfer them to Mr. Gallagher’s cellphone. That led to more than 1,000 customer service calls, he recalled.

To manage the onslaught, he integrated programs from OpenLoop and CareValidate that fielded customer service calls. Mr. Gallagher soon graduated from using the online legal site LegalZoom to using a law firm, and from using A.I. accounting tools to using an accounting firm. He also hired media agencies to help buy ads to entice customers.

As sales took off, Mr. Gallagher asked Mr. Fuller, the venture capital investor, if he should raise venture funding. Mr. Fuller told him that if he didn’t need the money, he shouldn’t raise it.

“You should just keep building,” Mr. Fuller said he had told Mr. Gallagher. Mr. Gallagher later thanked him for the advice.

In March last year, Mr. Gallagher changed something minor on Medvi’s website and then went on a hike. From the trail, he got a call from one of his media agencies asking whether it was odd that there had been no orders for the last hour.

Mr. Gallagher realized that his update must have broken something. With no one to fix it, he sprinted home. The downtime lost him around 200 potential customers, he said.

Still, he was hesitant to hire anybody. At Watch Gang, having 60 employees had not helped the company grow.

“It just increased my costs, and then it delayed my decision-making because I had more people to deal with,” he said. Medvi’s biggest advantage was his ability to move quickly, he said.

Mr. Gallagher added two engineers on contract and decided to hire only Elliot, his 36-year-old brother in Cincinnati in April. Elliot’s job includes intercepting and filtering communication so Matthew can focus on his priorities.

“I just helped take a lot of the weight off of him,” Elliot Gallagher said in an interview.

That gave Matthew Gallagher breathing room to fix some shortcuts he had initially taken, like swapping out the before-and-after weight-loss photos for ones from real customers. Some photos on Medvi’s homepage remain A.I.-generated.

By the end of last year, Medvi had reached $401 million in annual sales and amassed 250,000 customers. It produced 16.2 percent in net profit, or $65 million, with spending going to the fees for telehealth platforms, marketing and then software. Hims, by contrast, had a net profit of 5.5 percent last year.

Mr. Gallagher is reinvesting some of Medvi’s profits into expansion. He considered buying companies that provide other health products, but decided it was just as easy to build himself.

In February, Medvi started selling men’s health products, including erectile dysfunction drugs. That business hit 50,000 customers in the first month and is on track to eclipse the GLP-1 business in four months, Mr. Gallagher said.

Last month, Medvi added healthy meal delivery plans, which OpenLoop handles. Next up is women’s health, including hormone therapy drugs. Hair-growth drugs, supplements and skin care products are also on the agenda.

Medvi’s total profit of $70 million to $80 million so far has made Mr. Gallagher emotional, given his upbringing.

“For the first time, I’m not in survival mode,” he said.

Last year, he set up a foundation with $1 million and donated to a Los Angeles cat rescue organization, with plans to also donate to a nonprofit that helps young people experiencing homelessness. His goal is to run most of Medvi’s profits through the foundation. For fun, he invests in films and buys historical items, including a pocket watch from the 1700s.

Mr. Gallagher does not anticipate hiring more people. He said he just didn’t see how it would help Medvi, though he misses the camaraderie of colleagues.

“At this point, I kind of want to hire people because I’m lonely,” he said.

But some human touch is still needed.

In September, Medvi began assigning human account managers to a subset of customers. When those customers call, text or email with a question, they connect to the same account manager. The idea is that the account managers will get to know clients and remember details like birthdays or children’s names, creating higher customer satisfaction.

Medvi’s seven account managers, all hired on contract, now have several hundred clients each. To manage that many relationships, they are using A.I.

Erin Griffith covers tech companies, start-ups and the culture of Silicon Valley from San Francisco.

Related Content

Advertisement

SKIP ADVERTISEMENT