Cofndr @openbionics, @myometric & @bboxml (0 human employee experiment). @disneyaccel alum. MBE. A bard. Possibly a member of the last thinking generation.
Sunny CA.
Joined January 2009
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Sammy Payne 🧚♀️ retweeted
Can't recommend reading this article enough. Why Clinton is the most qualified person to ever run for office. m.huffpost.com/us/entry/1222…
Sammy Payne 🧚♀️ retweeted
I try not to make political posts. I really do. But I'm watching the @HillaryClinton testimony right now, and it's one of those moments where something just hits you in a way you can't scroll past.
Watching her answer questions, make her points with precision and composure, command the room with the kind of quiet competence that used to be the baseline for public service... it's a painful reminder. This country had a chance to choose a fundamentally different path, and we didn't take it.
You don't have to agree with every policy position she ever held. That's not the point. The point is that we were offered serious, prepared, deeply knowledgeable leadership, and we said no thanks. That's the American tragedy. Not a partisan one. A civic one.
Okay. Back to not making political posts. youtube.com/watch?v=siiAk6WX…
Sammy Payne 🧚♀️ retweeted
we're making @blocks smaller today. here's my note to the company.
####
today we're making one of the hardest decisions in the history of our company: we're reducing our organization by nearly half, from over 10,000 people to just under 6,000. that means over 4,000 of you are being asked to leave or entering into consultation. i'll be straight about what's happening, why, and what it means for everyone.
first off, if you're one of the people affected, you'll receive your salary for 20 weeks + 1 week per year of tenure, equity vested through the end of may, 6 months of health care, your corporate devices, and $5,000 to put toward whatever you need to help you in this transition (if you’re outside the U.S. you’ll receive similar support but exact details are going to vary based on local requirements). i want you to know that before anything else. everyone will be notified today, whether you're being asked to leave, entering consultation, or asked to stay.
we're not making this decision because we're in trouble. our business is strong. gross profit continues to grow, we continue to serve more and more customers, and profitability is improving. but something has changed. we're already seeing that the intelligence tools we’re creating and using, paired with smaller and flatter teams, are enabling a new way of working which fundamentally changes what it means to build and run a company. and that's accelerating rapidly.
i had two options: cut gradually over months or years as this shift plays out, or be honest about where we are and act on it now. i chose the latter. repeated rounds of cuts are destructive to morale, to focus, and to the trust that customers and shareholders place in our ability to lead. i'd rather take a hard, clear action now and build from a position we believe in than manage a slow reduction of people toward the same outcome. a smaller company also gives us the space to grow our business the right way, on our own terms, instead of constantly reacting to market pressures.
a decision at this scale carries risk. but so does standing still. we've done a full review to determine the roles and people we require to reliably grow the business from here, and we've pressure-tested those decisions from multiple angles. i accept that we may have gotten some of them wrong, and we've built in flexibility to account for that, and do the right thing for our customers.
we're not going to just disappear people from slack and email and pretend they were never here. communication channels will stay open through thursday evening (pacific) so everyone can say goodbye properly, and share whatever you wish. i'll also be hosting a live video session to thank everyone at 3:35pm pacific. i know doing it this way might feel awkward. i'd rather it feel awkward and human than efficient and cold.
to those of you leaving…i’m grateful for you, and i’m sorry to put you through this. you built what this company is today. that's a fact that i'll honor forever. this decision is not a reflection of what you contributed. you will be a great contributor to any organization going forward.
to those staying…i made this decision, and i'll own it. what i'm asking of you is to build with me. we're going to build this company with intelligence at the core of everything we do. how we work, how we create, how we serve our customers. our customers will feel this shift too, and we're going to help them navigate it: towards a future where they can build their own features directly, composed of our capabilities and served through our interfaces. that's what i'm focused on now. expect a note from me tomorrow.
jack
Sammy Payne 🧚♀️ retweeted
Psilocybin appears to simultaneously be an anti-depressant / quality of life enhancer, anti-addiction drug, neuroplasticity booster, and a plausible longevity drug.
We can now watch psilocybin grow new brain connections in real time.
Not metaphorically. Not "neuroplasticity" as a vague buzzword. Actual, physical structures — dendritic spines — sprouting from cortical neurons within 24 hours of a single dose.
A team at Yale used chronic two-photon microscopy to image individual dendritic spines on layer 5 pyramidal neurons in the medial frontal cortex of living mice.
Before psilocybin. After psilocybin. Same neurons. Same spines. Day after day.
And here's what they found:
A single dose of psilocybin produced a ~10% increase in spine density and spine size. New spines began forming within 24 hours. Most of these new connections were still there a month later.
That last part matters most.
Psilocybin has a half-life of about 3 hours. The molecule is gone by dinner. But the structural changes it triggers persist for at least 34 days (and likely far longer).
This is the biological explanation for something clinicians have observed for years: a single psilocybin session producing therapeutic benefits that last months. The drug disappears, but the architecture it built does not.
There's a critical mechanistic detail. When researchers pre-treated with ketanserin — a 5-HT2A receptor antagonist — the spine growth was completely blocked. This confirms that structural remodeling depends on activation of the serotonin 2A receptor. The same receptor responsible for the psychedelic experience itself.
A 2025 follow-up from the same lab went further. Using rabies tracing to map brain-wide inputs to these new spines, they discovered psilocybin's rewiring is network-specific. It selectively strengthens inputs from perceptual and default mode network regions, the same networks implicated in self-referential processing, rumination, and depression.
It doesn't just grow connections randomly. It grows the RIGHT ones.
Here's what this means for practitioners:
The window after a psychedelic experience isn't just psychological. It's structural. New dendritic spines form and stabilize in the days and weeks following a session.
Integration practices — therapy, journaling, somatic work, meditation, breathwork — aren't just processing insights. They may be reinforcing which of these new physical connections survive.
You're not just supporting someone's mental model. You're supporting their neural architecture.
Think about what that reframes. The integration period isn't a nice-to-have. It's a biological imperative. Those new spines either stabilize into lasting connections or get pruned. The environment, practices, and support during that window may determine which.
We're not just learning that psilocybin works. We're watching exactly how it works, at the level of individual synapses.
The implications for how we design protocols, structure integration, and time follow-up sessions are enormous.
What do you make of this research? Is psilocybin the miracle drug that science makes it out to be?
Sammy Payne 🧚♀️ retweeted
Yann LeCun says absolutely none of the humanoid companies have any idea how to make those robots smart enough to be useful.
Sammy Payne 🧚♀️ retweeted
If you haven’t made it safe and easy for your friends to give you devastating feedback (on the order of “you completely suck at this skill that’s core to your identity”, you don’t actually want this thing you’ve been pursuing for 4 years”, etc), you’re leaving $ on the table
Sammy Payne 🧚♀️ retweeted
> founder building their second startup:
Sammy Payne 🧚♀️ retweeted
This is a story about how skin substitutes, materials used to improve healing of complex wounds, grew from a niche product in 2019 to scamming taxpayers and patients out of $10 bln/year, not because of a medical breakthrough, but from billing abuse. It’s a case study in how hard it is to cut even waste, fraud, and abuse.
Medicare, run by CMS, reimburses bandages based upon the average sales price (ASP) at which the private sector is transacting. But in the first 6 months of product introduction, CMS doesn't have the data to compute ASP, so it pays whatever price the company sets. You can see the logic of the rule but probably also see the potential problem.
Manufacturers figured out how to game the system. Introduce a new product at an inflated price, which Medicare will pay for the first 6 months. Then, phase it out and introduce an almost identical, but new, product. CMS now covers that product at whatever price the manufacturer set. Five years ago, the most expensive skin substitute was $1,000/sq in. Today it is $21,000/sq in.
Why do medical providers support this scam instead of choosing a cheaper product? First, CMS pays providers a fee that includes a % of the bandage’s price, which rewards higher costs. Second, manufacturers offer steep “bulk” discounts on purchases as small as a few inches, and providers keep the difference. The higher the list price, the more they earn.
This loophole has become a major revenue stream for dishonest manufacturers and providers. Mobile wound care clinics have popped up to generate demand from patients who never needed the product in the first place.
Skin substitutes, unlike drugs, do not need successful randomized controlled trials to come to market. This creates two problems. First, manufacturers have negligible barriers to introduce substitute products every 6 months. And second, there is low quality of evidence on what type of wounds on which these products are effective, leading to overuse.
In 2023, an Inspector General warned about the abuse, but fixing even blatant fraud takes time. CMS announced in 2024 a fix would happen in early 2025. In January, the Trump admin paused all Biden admin policies. Ultimately, the Trump admin finalized a rule reducing the price that will go into effect in 2026. Delays have cost taxpayers and patients billions. More concerning, the industry is making very large political donations in an attempt to delay or kill the changes.
There’s a constant cat and mouse game between regulators who set healthcare reimbursement rules and companies looking to exploit them. The IG and CMS have done their job. Now they need political support to identify and stop this sort of fraud broadly. Congress must resist industry lobbying to undo the pricing change. Politicians say they’re furious about rising healthcare costs. The real test is whether they’ll address even blatant abuse to actually bring them down.
Sammy Payne 🧚♀️ retweeted
“Mitochondrially challenged” has entered the lexicon.
Sammy Payne 🧚♀️ retweeted
“Well, stressful is the point. You don't adapt to anything unless it poses a challenge. Challenges are healthy. You can handle them.” 🎯
I've seen people scared to exercise because it's "stressful." Well, stressful is the point. You don't adapt to anything unless it poses a challenge. Challenges are healthy. You can handle them.
Humans are very good at achieving homeostasis. At getting used to situations and even stressors to the point that they're no longer actually stressful. A recent study looked at hard HIIT and resistance training in supposedly the most fragile population around: the untrained elderly.
Everything improved with training. Blood lipids, muscle mass, endurance.
Initial bouts were stressful and raised cortisol, heart rate, lactate. But then the training effect occurred. Turns out that over time, the more fit you get the less stressful exercise-induced stress actually is. The cortisol rise is blunted. Heart rate doesn't get so high. Lactate lowers.
So many young people are totally dialed in on supplementation, nutrition, sunlight, sleep, but instead of doing some hard physical things once in a while they languish under chicken lamps and put weird research chemicals in their belly buttons.
Sammy Payne 🧚♀️ retweeted
It seems like there is not enough of a policy response to the fact that, with 57M miles of data, Waymo’s autonomous vehicles experience 85% less serious injuries & 79% less injuries overall than cars with human drivers.
2.4 million are injured & 40k killed in US accidents a year
Sammy Payne 🧚♀️ retweeted
Leadville 100 Mile Nutrition, by the numbers ⬇️
1: Time I accidentally made potato hands at the finish. Heart hands are out. Carb hands are in 🥔
150: grams of carbs per hour for the first 10 hours. After dialing back fueling during my hilarious implosion at Western States, I fully understood that whatever ultra powers I have come from carbs. I kept it simple with a Science in Sport Beta Fuel gel every 20 minutes, with every 6th gel being a Precision 100 mg caffeine gel. In my bottles, I averaged 1.5 x 0.5 L per hour with 1.25x concentrated Skratch. All from The Feed 🙏
90-100: grams of carbs per hour for the final 5 hours. Leadville is a battle against the GI demons, and my burps were coming from the depths of Hades
4.5: grams of Maurten sodium bicarbonate 90 minutes before the start. Bicarb is driving performance in track and road running, but it’s not researched in ultras. A 2022 case study on GOAT Kilian found very high lactate levels during UTMB, and my theory is that the body enters stressed states that mimic high intensity events in hard ultras
24: ounces of fluid per hour for the first 10 hours. My sweat rate has gone down this year, and the failure to understand that contributed to disaster at Western States (along with a mental shart that could be seen from space)
12-16: ounces of fluid per hour for the final few hours. The body has compensatory mechanisms to reduce sweat rate in fatigued states, but we can’t really study how severe that drop might be. My theory is that lots of GI issues are caused by optimizing hydration for a fresh state, and applying that when fatigued
0.75: quantity of a Gatorade Protein Bar when I woke up. They taste like a Snickers went to a 24-Hour Fitness to take a selfie and then leave
4: bacon cheeseburger dinners in the 5 days before the race (and on the 5th day, he ate a $22 plate of enchiladas)
30-60: minutes I told Megan to add to last year’s projections in the 2024 spreadsheet
15:12: time that Megan predicted in pre-race crew texts, which would beat my previous record by 14 minutes
15:12:30: finishing time
1 in 10,000: odds I would have given that time before the start
Love you all 🧡💜♥️
Sammy Payne 🧚♀️ retweeted
Jane is a force to be reckoned with!!💥 From the joyous events she has organised, seeing hundreds of limb different families come together yearly - to her endless hours of selfless campaigning. She has been recognised with a Paul Harris award!🏆
Well done Jane!❤️@LBofoundation
Sammy Payne 🧚♀️ retweeted
LEADVILLE MEN’S COURSE RECORD: @MountainRoche resets his own course record, lowering it by over 14 minutes from his performance last year, in a new CR time of 15:12:30! Back-to-back champ! @LTRaceSeries #Leadville100 #LT100
Sammy Payne 🧚♀️ retweeted
A noble person is kind to a stranger he will never meet again, when nobody is watching, & when he has nothing to gain. The rest is self-promotion, social climbing, or profit seeking.