Bill Ackman: The Biggest Fight of His Life

Bill Ackman (0:00)

So, the thing that you need to think through is the risk of disruption. What AI has done is massively increase the risk of disruptions.

Shane Parrish (0:13)

You've had a challenging year this year with Lucy. What happened?

Bill Ackman (0:16)

You know, otherwise healthy child, what happened was she had, unbeknownst to us, a what's called an arterial venous malformation, which is a kind of structure in the brain where the way the doctors describe it is the arteries, typically blood flows into the arteries and then to the capillaries, and then to the veins. When you go from arteries where there's a huge amount of blood flow to capillaries, the blood flow slows down and then to the veins. So in her case, she had like a bridge that went from the artery directly to the vein. So over time, there was too much pressure going into these veins in her brain and one of those veins burst. And then a large amount of blood filled her brain, which is a confined volume. And so it's a bit like a balloon blowing up inside your brain. And that put pressure on the surrounding brain and the skull, and obviously the skull doesn't move. So the pressure goes downward, it puts pressure on the midbrain. The midbrain is what keeps you breathing, keeps your heart beating. And the really unfortunate thing, we believe this happened around nine in the morning, based on her orry. She lived, young woman, lives alone in Williamsburg. And I texted her at four o'clock that day, I had called her another time that day. Other family members had done the same, but only when she hadn't picked up her luggage.

She was leaving for Abu Dhabi for a wedding. A friend of hers was getting married the following day, and she was picking up her luggage from her mom's house. And she didn't show a couple of, when she was two hours late, and no one could reach her that week.

I was sleeping at the time, but my oldest daughter went to find her, and she found her lying on the floor of her apartment, barely breathing, face down on the right side. So, and she thought she was dead.

Called 911, she could hear her breathing in a very labored way. And then, I don't sleep next to my cell phone, my daughter doesn't know the landline number for my house. So, she was able to call someone in the building, guy in the building knocked on the door, you know, pounded on the door, and handed me the phone with my daughter. And then, hopped in a cab. The EMT didn't know which hospital to take her, because they didn't know what had happened to her. One of the big problems, sometimes, you know, the EMT thinks someone's just drunk, and that's why they fell. And the way you treat a drunk person is you just let time go by, right? Time going by for a person where the brain hemorrhage is very, you know, the more time the brain is under pressure, the more damage that can take place.

Got to the hospital at 1205, and she was just sitting on a gurney there while they were trying to figure out what she had. Eventually, they gave her a CT. They figured out she had a hemorrhage. They called the surgeon.

And what you need to do is you need to release the pressure on the brain as quickly as possible. And the way you do that is you remove about 40 percent of the skull to allow the brain to expand beyond the skull. And we moved her from Elmhurst Hospital, by the way, very pleased with how they cared for her there. City Hospital in Queens. We moved her to Mount Sinai, where Niren and I spent some time helping Mount Sinai. So we knew the team there. And they also have very good neurosurgeons and a neuroscience brain practice. And she was on a breathing tube.

She was wearing some, she had bandages, of course, on her head and it said, no bone, right, to make sure that nurses knew not to be careful. And that's how we started. And so, you know, I basically gave the doctors the, what I call the dare to be great speech. I said, you know, let's see what can be achieved by, you know, whatever you need from us, unlimited resources, you know, let's look at latest and greatest technologies. I mean, they basically told us, you know, look, Bill, we don't know what kind of deficit she's going to have. You know, 19 hours of pressure on the brain, you know, I didn't learn actually until weeks later, they don't normally do the surgery to save someone, when it's been more than five hours because the assumption is brain death basically. So, 19 hours, she's close to death, you know, hours, minutes, I don't know exactly.