Brian Pridgen, MD

Thrilled to be one of the 4 Voice Hack Night finalists with Surgical Triage! I built a voice-first AI workflow that handles emergency hand surgery transfer requests, patient details, images, and next steps in one conversation. As a hand & microsurgeon, I look forward to having this agent available one day! Huge thanks to @OpenAIDevs and @cerebral_valley Vote for Surgical Triage → cerebralvalley.ai/e/openai-voice… What’s one way voice AI could transform your clinical workflow?

@jxnlco @thsottiaux I've been trying to squeeze out every last token before I lose my 200x abundance, but I didn't think I was pushing it that hard! Good to know I'm not the only one. Any chance we can get an extension on the 6/5 cutoff for the 10x boost?? 😂

Did something happen with Codex usage limits? I went from ~80% weekly usage a couple hours ago to 0%. I'm on a 20x plan with the 10x boost from the 5/5 event. @jxnlco @thsottiaux

@MaziyarPanahi It's amazing how low key they and their documentation are about promoting it! Such a powerful unlock to let users bring their own tokens!

so far, "Sign in with ChatGPT" seems to be the most shocking part to most people! 😂

Frontier medical reasoning on your iPhone, with GPT-5.5, and zero identifiers ever leaving the device. OpenMed Agent reads your Apple Health, wearable trends, and any medical report you scan, redacts on-device, then asks GPT-5.5 via your own ChatGPT account. App Store next. 👇

@_julianschiavo @OpenAIDevs I'm getting the same x.com/HandEManAI/sta…

Is Codex falling down right now or is it just me? @OpenAIDevs

Is there a bug in the latest Codex app release? I'm getting this 'gpt-image-2' error on numerous threads, none of which should have anything to do with images. This blocks the thread from progressing or doing anything else. @thsottiaux @jxnlco

Totally agree. The voice interaction is just the interface that fits an existing workflow. The unlock is the not only the structured packet but the ability to reason over it in real time at a latency acceptable for a voice interaction. And not only does it fill the packet, but this tool ensures that it: 1) is accurate -- e.g. resolves discrepancies between the verbal description of the injury and the photo representation of the injury 2) fits my preferences -- dynamic calling of my custom skills library (Thanks, @beknabdik. Good luck at YC!)

@cerebral_valley @HandEManAI the structured packet is the real unlock here, not the voice. human transfer calls fail because the surgeon gets half the story and has to call back. an agent that won't close the packet until the required fields are filled kills that loop.

The future of voice starts with Chat. Last week, we partnered with @OpenAI to bring builders together at OpenAI's SF HQ to showcase what's possible with the latest realtime voice models. From AI companions and sales agents to translation and education tools, teams pushed the boundaries of voice-first experiences – with winners decided by a community vote. Voice is becoming one of AI's most exciting frontiers. What got built:

Not-roboticist hand surgeon here trying to better understand the robotics hand space... I have a few observations. Curious if there are explanations: Intrinsic muscle function The demonstrated finger flexion at the beginning of the video is more of an intrinsic minus hand posturing where there is flexion through the IP joints with more limited composite flexion through the MP joints. Initiation of grasp in humans is typically a synergistic combination of MP joint flexion + IP joint extension before then flexing the IP joints around the object of interest. This is a complex coordination of movement facilitated by our intrinsic muscles. Thumb palmar abduction and opposition The thumb movement primarily demonstrated here is simply flexing/extending in the plane of the palm, which isn't a particularly functional motion. The more critical palmar abduction / opposition movement shown in the video is a one time movement to the flexed middle finger. I'd instead love to see the thumb opposing to the fingertip of each finger and then dragging the thumb down the length of each finger and into the palm. Tenodesis effect The repeated combined wrist flexion + finger flexion is an antagonistic movement in humans. Typically, we perform synergistic finger extension with wrist flexion. This is enabled by the tenodesis effect. I suspect in a robotic hand that it is easier to pull on palmar tendons to perform composite wrist flexion and finger flexion in a robotic hand, while achieving the more human-like synergistic motion I described is a more complex and coordinated activity. Would love any explanation or discussion if there are good explanations for these missing functions. As I said, I'm trying to learn the space.

New dexterous hands from Xynova #icra2026

The primitives are there within the Codex app's requestUserInput tool, but I agree that I never see this exposed in Codex. I've built a medical knowledge retrieval tool on top of the open source Codex app server with interactive question functionality so it's clearly possible. Hoping @OpenAIDevs choose to more prominently surface this feature, as I REALLY like the equivalent AskUserQuestion tool in Claude Code and Claude's willingness to use it.

I wish codex had interactive questionnaires.

@fishbotics I’m a hand and microsurgeon in SF. If you’re working on robotic hands, would love to connect. I suspect there are human anatomy-inspired opportunities that aren’t yet being utilized.

Come pursue your wildest ideas at OpenAI robotics! Our team is full-stack, high execution, and aiming to solve some of the biggest, most exciting technical problems of our era

Would love to hear his vision for Foundry Local as a platform for domain expert builders, not just enterprise developers. On-prem inference could be a game changer for solo physician-builders like me trying to move from agentically coded prototypes to responsibly deployed tools in heavily regulated settings.

Really excited to interview @satyanadella tomorrow at @Microsoft Build, in a special live @NoPriorsPod. Questions?

@gpt_alex @vasuman (Credit to and inspired by @vasuman of course in case it wasn't obvious being on his thread... don't want to steal credit)

@gpt_alex @vasuman In short…. I burned billions of tokens Refactored my whole harness Nothing changed But boy was it beautiful

/goal has been running for 16 hours and we're in that sweet spot where I don't want to stop it because it could be cooking but I also seriously doubt it. Please advise

@OpenAIDevs @isausmanov @iamstevesuarez @anshchopra_ @cerebral_valley Thanks, @cerebral_valley and @OpenAIDevs for the opportunity to present! Congrats, @isausmanov!! I look forward to you agentifying our phones!

Congratulations to all the finalists: 🥇Agentic OS for a Phone – @isausmanov 🥈Wagner – @iamstevesuarez 🥉 Surgical Triage – @HandEManAI 🏅 Curo – @anshchopra_ Thanks to @cerebral_valley for co-hosting Voice Hack Night with us. cerebralvalley.ai/e/openai-voice…

The votes are in. @isausmanov’s Agentic OS for a Phone is the Voice Hack Night People’s Choice winner. A voice-first mobile OS. Users talk, agents answer and take action across the phone. Congrats to the team on taking home $50,000 in API credits.

No performance gain on my eval. It kept promising one more great thing to try, but it never moved the needle. Each loop ended up being a minimal tweak, and nothing changed. It was probably a skill issue with my goal prompting but…. I started over and: 1) used an orchestrator thread and told it to use the new codex feature to spin up child threads 2) hyped it up with language like “use first principles clinical reasoning”, “be high agency”, and “make bold decisions with conviction” (inspired by @conviction!!) And within an hour, I got a 10 point gain on the eval (100 point scale). I do suspect there’s some value with the orchestrator maintaining coherence, but that’s just vibes for now.

@TheOneAndArjun Thanks, Arjun! It’s empowering what these tools now enable. If you’re non-technical and have domain expertise in anything, try building something!!

Vote for Brian!!

@model_mechanic I’m a hand and microsurgeon in SF. If you’re working on robotic hands, would love to connect. I suspect there are human anatomy-inspired opportunities that aren’t yet being utilized.

We've created a really unique environment to execute on the scope and ambitions of our program. If you're passionate about working full-stack on robotics, please building with us!

This is incredible and already have found great use cases!!! However, there's a bug that's really breaking the workflow... I've had several instances where a main orchestrator agent spawns another thread. However, the child thread never gets started and hangs at the prompt. The orchestrator doesn't realize the child thread is stuck. It continues to check on this hung thread, views it as ongoing, and won't kill it. I, of course, can manually insert myself, but the goal here is to remove myself as the bottleneck and let the model cook. Any chance this can be improved? (As a related note, I have this issue with probably ~5% of the prompts I launch where I'll launch a prompt, but it's never picked up and just hangs without the job starting. I've updated, restarted, etc to no avail.) @OpenAIDevs

If you ever get tired of managing your Codex threads, just let Codex manage itself! Codex can now create threads, search them, organize them, pin the important ones, and spin up worktrees for parallel tasks.

@kenwarner I’m right there with you as soon as they enable dictation across iPhone, too!

got rid of wisprflow, superwhisper and handy cmd+shift+Y = YAP