Today's Wisdom - Medvi, Franco and Brutalism

Welcome back to A Little Wiser. B.B. King said, 'The beautiful thing about learning is that no one can take it away from you.' As we continue our work to learn and deconstruct the world's moving parts, we’re glad to have you here. Today’s wisdom explores:

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In 2024, Sam Altman made a prediction that most people in the tech industry quietly filed under optimistic fantasy. He told anyone who would listen that artificial intelligence would soon make it possible for a single person to build a billion-dollar company, and placed a bet with a group of fellow tech CEOs over when it would actually happen. In January this year, Altman emailed the New York Times to announce he had won, adding with characteristic understatement that he "would like to meet the guy." The guy is Matthew Gallagher, a 41-year-old entrepreneur who in early 2024 spent $20,000 and approximately two months building a GLP-1 weight-loss telehealth company called Medvi from his living room in Los Angeles, with no staff, no office, and no outside funding whatsoever. Within twelve months his company had generated $401 million in revenue across 250,000 customers. By the end of 2025, Medvi employed two people, Gallagher and his brother, and had turned a net profit of $65 million. It is, by any measure, one of the most astonishing business stories in recent memory, and also, depending on how you look at it, one of the most troubling.

Medvi is not, in any traditional sense, a healthcare company. It is a marketing layer, an exceptionally well-constructed front end that connects customers to rented infrastructure. Two third-party platforms, CareValidate and OpenLoop Health, handle the doctors, prescriptions, pharmacies, shipping, and regulatory compliance. Gallagher controls the brand, the website, the checkout flow, and the advertising, all of it built and operated with AI tools. For $299 a month, a customer can obtain compounded semaglutide, the active weight-loss ingredient in Ozempic, through Medvi's website, compared to a brand-name pharmacy price of $1,300 to $1,500 for the equivalent. The demand was already enormous and Gallagher simply positioned himself in the middle of it and let the numbers do the rest. He holds no proprietary technology, no licensed physician network, and no pharmacy infrastructure. The entire enterprise is, structurally, a checkout page attached to other people's regulated operations, and it generated nearly half a billion dollars in its first year.

The controversy surrounding Medvi has accumulated at a pace that rivals its revenue growth, and it cuts to the heart of a serious debate about what happens when entrepreneurial speed outruns the frameworks meant to protect patients. In November 2025 a class action lawsuit was filed in Delaware against the company. In January 2026 Medvi's clinical partner OpenLoop suffered a data breach that exposed 1.6 million patient records. The following month, Medvi itself received an FDA Warning Letter for misbranding violations. Futurism reported that the company had used AI-generated deepfake before-and-after photos in its marketing materials. Perhaps most strikingly, the company has been linked to over 800 fake doctor accounts on Facebook used to promote compounded GLP-1 medications, a practice that involves inventing medical credentials to push pharmaceutical products at scale to a vulnerable audience. Compounded semaglutide itself occupies a contested legal space. It is produced under an FDA exemption that permitted copies of branded medications while Ozempic remained on the official drug shortage list, a status the FDA revoked in early 2025, triggering immediate legal challenges across the entire sector. Novo Nordisk has filed lawsuits against multiple compounding operations arguing that patients are being misled about what they are receiving. Gallagher's story is genuinely historic, proof that one person armed with the right tools can build something of staggering scale from nothing. What remains an open question is whether what was built should have been, and who is responsible when the infrastructure underneath it fails the people it was supposed to serve.

Spain in the early 1930s was a country pulling itself apart at the seams. The Second Spanish Republic, established in 1931 after the abdication of King Alfonso XIII, had inherited a nation of staggering inequality. A small landowning aristocracy controlled vast estates while millions of rural labourers worked in conditions close to serfdom, a powerful Catholic Church dominated education and public life, and a military officer class regarded itself as the guardian of a Spanish national identity it felt the republic was actively dismantling. The government's attempts at land reform, secularisation of schools, and regional autonomy for Catalonia and the Basque Country inflamed all three simultaneously. On the left, anarchists, communists, and socialists argued the reforms were too timid and too slow. On the right, monarchists, the Church, wealthy landowners, and a new fascist movement called the Falange argued they went far too far. When a Popular Front coalition of left-wing parties won the February 1936 elections, Spain's political climate reached a point where compromise had effectively ceased to be available to anyone. In July 1936, a group of generals launched a coup, expecting to seize power within days. They were wrong, and what followed was nearly three years of some of the most savage fighting Europe had seen since the trenches of the First World War.

The two sides that crystallised around the coup were uneasy alliances held together by a shared enemy. The Nationalists, as Franco's forces became known as, united the Spanish army, the Catholic Church, the landowning class, the Falangists, and the monarchists under the banner of restoring order, hierarchy, and traditional Catholic Spain. They were a coalition of reaction, but they were a coherent one, and Franco's emergence as their undisputed leader by late 1936 gave them a unity of command the other side never achieved. The Republicans, the government's defenders, were a fractious alliance of liberal democrats, Basque and Catalan nationalists, socialists, communists, and anarchists who agreed on very little beyond their opposition to the coup. The anarchist militias of Catalonia ran their factories as workers' collectives and refused to take orders from anyone. The communists, increasingly funded and directed by Stalin, wanted a conventional military structure and spent considerable energy suppressing their supposed allies on the far left. George Orwell, who arrived in Barcelona in December 1936 and fought with the anarchist POUM militia, watched these internal purges with horror and later wrote about them in Homage to Catalonia. The Spanish Civil War became the ideological laboratory of the twentieth century, the first major battlefield where fascism and communism faced each other directly, and where the great powers of Europe manoeuvred for advantage under the thin cover of a proxy war.

The war produced atrocities on both sides, though not of equal scale or equivalent intent. Franco's forces conducted a systematic campaign of terror in captured territories, executing teachers, trade unionists, and anyone associated with left-wing organisations. When Nationalist forces took Badajoz in August 1936, somewhere between 1,000 and 4,000 residents were herded into the bullring and shot. The bombing of Guernica in April 1937, carried out by Hitler's Condor Legion at Franco's request, killed hundreds of civilians in a Basque market town on a busy market day. It became the defining atrocity of the conflict, immortalised by Picasso in his painting ‘Guernica’. Franco entered Madrid in March 1939 and the war was over, leaving somewhere between 500,000 and one million people dead through combat, execution, and famine. Franco ruled Spain as a dictator for the next 36 years, dying in his bed in 1975 at the age of 82. For Hitler and Mussolini the war had been a place to test weapons, tactics, and the willingness of democratic governments to appease rather than confront. The democratic world had been given the clearest possible view of what fascism intended, and had chosen to look the other way.

The word brutal in brutalism has nothing to do with harshness, though the coincidence has shaped public opinion of the style for sixty years. It derives from the French béton brut, meaning raw concrete, a term the Swiss-French architect Le Corbusier used to describe the unfinished, board-marked concrete he favoured in his postwar buildings. When the British architectural critics Alison and Peter Smithson picked up the term in the early 1950s and began applying it to a new movement they saw emerging in postwar architecture, they were describing the idea that a building should display its materials and its structure without decoration or disguise. A concrete ceiling should look like concrete. A ventilation duct should be seen, not hidden behind a false ceiling. A staircase should announce itself on the exterior rather than being tucked apologetically inside. What brutalism was arguing was that the entire history of decorative architecture had been a habit of dressing buildings in borrowed clothes to disguise what they actually were. The only honest response to the postwar world was to strip all of that away and begin again with raw material and structural truth.

The movement arrived at a specific historical moment that shaped everything about what it became. Europe in the late 1940s and 1950s was rebuilding on a scale and at a speed that had no precedent in peacetime, and brutalism offered architects and governments a style that was simultaneously cheap, fast, and philosophically aligned with the egalitarian ambitions of the postwar welfare state. In Britain, brutalism became the architectural language of the new social contract: the council estate, the university expansion, the civic centre, the NHS hospitals. The Barbican in London, begun in 1965 on a site flattened by the Blitz and completed over the following two decades, is the most complete expression of brutalism's ambitions in Britain. It is a self-contained city within a city, housing 4,000 people alongside arts centres, schools, and a lake. The Barbicans exposed concrete towers and elevated walkways expressed a genuine utopian vision of how urban life could be reorganised.

What happened to brutalism's reputation is a story about the gap between architectural intention and lived experience, and it is a more complicated story than either its defenders or its critics tend to allow. The social housing blocks built in brutalism's image, though often designed with genuine idealism, were systematically underfunded by local authorities who lacked the money for the maintenance the style demanded. The combination of poor upkeep and concentrated deprivation produced environments that became synonymous in the public mind with failure. The concrete itself aged badly in northern European weather staining, cracking, and leaching in ways that made even the finest buildings look neglected within a decade. Robin Hood Gardens in east London, designed by the Smithsons themselves and completed in 1972, was demolished in 2017 despite years of campaigning by architects who considered it a masterpiece. The debate around its demolition captured the central tension in brutalism's legacy precisely. On one side, architects and historians who could see in it a serious and coherent artistic vision. On the other, the people who had actually lived there, whose memories of the place were frequently a great deal less romantic than the critics' appraisals of it.

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Until next time... A Little Wiser Team