'I Wish I Had Listened': Fidji Simo Steps Down From OpenAI After Health Battle

Big shakeup at OpenAI. Fidji Simo, one of the company's most senior leaders, is stepping away from her full-time job after months of dealing with a health condition that turned out to be far tougher to manage than she first expected.

Simo shared the news herself, first in a note to OpenAI staff and then publicly on X. She explained that she went on medical leave back in April after a serious flare-up of a chronic illness she's actually been living with for seven years,  Postural Orthostatic Tachycardia Syndrome, or POTS for short. It's a condition that messes with your nervous system and can cause dizziness, fainting, and a racing heart, and right now, there's no cure for it.

Three months later, Simo says it's become clear that getting better is going to take longer than she hoped. So instead of trying to push through a full-time leadership job, she's choosing to step back and become a part-time advisor to the company instead.

In her post, she was refreshingly honest about it too. She said people called her "courageous" for going on leave in the first place, but she pushed back on that framing admitting she'd actually ignored warning signs for years before finally making this call. She even brought up a moment from her Facebook days, when Mark Zuckerberg once told her to "play the long game" and offered her a year off. She turned it down back then. Looking back now, she says she wishes she hadn't.

“When I went on leave, many people told me I was courageous for prioritizing my health. The truth is that I am only making this decision now because I failed to make it many times before,” she wrote on X. 

Who is Fidji Simo?

For those who don't follow OpenAI closely, Simo was widely seen as Sam Altman's right hand. She joined OpenAI's board in 2024, then came on board full-time in May 2025 as CEO of Applications (a title later updated to CEO of AGI Deployment), leaving her job running Instacart, where she'd led the company through its IPO. Before that, she spent over a decade at Meta, where she ran the Facebook app itself.

At OpenAI, her job was to run the business side of the company: consumer products, commercial deals, and day-to-day operations, while Altman focused more on research, safety, and computing power. Three heavy-hitters- COO Brad Lightcap, CFO Sarah Friar, and former CPO Kevin Weil, all reported directly to her.

Not the only recent exit

Simo's departure isn't happening in isolation. OpenAI's leadership bench has been thinning out quite a bit lately. Back in April, when Simo first announced her medical leave, the company also revealed that Chief Marketing Officer Kate Rouch was leaving to focus on her own cancer recovery. Around the same time, Brad Lightcap shifted into a lower-profile "special projects" role. And Kevin Weil, the company's product chief, has since exited altogether too.

Add Simo's news to that list, and it paints a picture of an executive team that's been through a lot of turnover in a very short window especially notable for a company currently valued at a jaw-dropping $852 billion and reportedly gearing up for a future IPO.

According to reports, Simo's duties won't go to one single successor. Instead, they're being split across three people: OpenAI President Greg Brockman who'd already been covering product duties during her leave, CFO Sarah Friar, and one other chief exec. It's a temporary patchwork solution for now, though it does raise the question of whether Altman will eventually need to find one clear No. 2 again especially with IPO plans reportedly on the horizon, even if not imminent.

Altman's response

Altman didn't hold back his feelings either. Reacting to the news on X, he wrote that he was "really sad" about Simo's decision, calling her a close friend as much as a colleague, and wishing her a speedy recovery. Short and simple, but it was clear this one hit differently than a typical executive exit.

Simo says her focus is to get better. But she's made it clear she's not stepping away from the mission entirely, she says she still believes deeply in AI's potential to help solve real health problems, and plans to keep contributing in whatever way her health allows.

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