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Two of the most powerful people in AI—Sam Altman and Elon Musk—began their face-off in court in Oakland, California, last week. Musk is suing OpenAI, alleging that the millions he spent to fund it around a decade ago were meant for a nonprofit, not a corporation, and that the company has reneged on that mission since. 

The stakes are high—even a partial win for Musk could set OpenAI back as it reportedly plans to go public this year. But most of the attention comes from the spectacle of a feud on X now playing out in federal court. “Cringey texts, raw diary entries, and endless scheming behind the founding and growth of OpenAI are expected to come to light,” my colleague Michelle Kim wrote before it began. And the trial unfolds as the cultural backlash against AI swells; some of the signs held by protesters outside the courthouse suggest that to a significant number of people, whatever the outcome of Musk v. Altman, we all lose.  

Most of us have had to observe the trial from afar, but Michelle, who also happens to be a lawyer, has been in court each day. I caught up with her to learn what’s unfolded thus far and what might come next.

Can you give us the overview of what this case is actually about? What exactly is being decided, and who is favored right now?

Elon Musk is arguing that Sam Altman and OpenAI president Greg Brockman have breached the company’s charitable trust by effectively converting OpenAI into a for-profit company. Musk alleges that is not what they promised him in the company’s early days. He has asked for several remedies, like a crazy amount of damages and removing Sam Altman. But the main remedy he wants is unwinding OpenAI’s restructuring. [In October 2025 OpenAI struck deals with the attorneys general of California and Delaware that would essentially allow its nonprofit portion to have less day-to-day control of OpenAI. It’s a compromise from what OpenAI originally proposed, but Musk still wants to stop it.] 

OpenAI argues that Elon Musk actually agreed to have the company operate a for-profit arm, because he knew building AI is very expensive. So it’s about proving what Musk knew, what he didn’t know, and whether he really was deceived by Altman and Brockman.

There’s a big debate about when exactly Musk found out about this alleged misconduct. Musk founded OpenAI with Altman and Brockman in 2015, and he brought the suit in 2024. There’s a statute of limitations for charitable trust claims; you need to have brought a claim within three to four years after you find out about the alleged misconduct. So Musk tries to paint a picture that back in the day he was a little suspicious, but that it was really only in 2022 that he realized OpenAI was no longer committed to its original charitable mission, and that he had been scammed. It’s only the first week of trial, but I’m not sure Musk has proved this to the judge and jury.

What were some standout moments thus far?

At one point one of Elon Musk’s lawyers said, “We could all die as a result of AI.” I think a lot of the people in the room were really shaken by this comment, and the judge told Musk’s lawyer: You talk about all these safety risks that OpenAI has when building AI, but Musk is also creating a company that’s in the same exact space. She basically said, I’m sure there’s plenty of people who also don’t want to put the future of humanity in Elon Musk’s hands. 

And then the lawyers just kept going on and on about the catastrophic risks of AI and whether Elon Musk or OpenAI was in the better position to steward AI safety. And the judge sort of snapped. She said very sternly that this trial was not about whether or not artificial intelligence has damaged humanity. And I thought that was a really striking standout moment of the trial that pointed at how even though it is technically just about whether Elon Musk was really deceived by OpenAI, it’s also become a huge discussion about AI safety and some of the practices that the labs are engaging in when building AI. 

Can you give us a look behind the curtain at how getting into this trial works?

There are tons of reporters. This is a very high-profile suit, so I have to wake up around 4:30 a.m. and show up to the Oakland courthouse at 6 a.m. sharp to get in line. And on some days, even 6 a.m. doesn’t get you into the courtroom. There are lots of photographers in front of the courthouse, especially on days when you know Musk or Altman and Brockman are present. And there’s also some concerned citizens who want to watch the trial. I usually have to wait, like, two hours in line to get in to be one of the 30 people who claim the unreserved seats in the courtroom. 

What has it felt like to see Elon Musk testify? How would you describe his demeanor?

He shows up in a crisp black suit. He can be this inflammatory person on X, but in the courtroom, he is calm, cool, collected, and looks very comfortable. He has been in a lot of lawsuits. He knows how to talk to the jury and how to present himself in front of them and the judge. He’s also cracking jokes with his lawyer and even the opposing party’s lawyer and the judge. 

And he can be witty. There was this one moment when OpenAI’s lawyer was asking Musk a question and sort of fed him an answer. And Musk said “That’s not a leading question, that’s a leading answer.” The judge intervened and said, “You’re not a lawyer, Elon.” And then he was like, “Well, I did take Law 101.”

That said, he does get flustered and uncomfortable when OpenAI’s lawyer asks tough, piercing questions. Which he’s been doing.

What are the biggest things we’ve learned that weren’t clear in the earlier phases of this case?

On the fourth day of the trial, Musk admitted during cross-examination that xAI distills OpenAI’s models to train its own models, which was shocking. Musk followed up by saying that this is standard practice among all the labs now and that xAI wasn’t doing anything beyond what others were already doing. But a lot of the journalists started typing away at their laptops as soon as Musk made this comment. 

I also learned that there’s just so much scheming among Big Tech executives. You know about it vaguely, but to hear firsthand accounts and read their emails and text messages is fascinating. 

For example, there was a text message between Musk and Mark Zuckerberg of Meta, where they’re kind of teaming up to stop OpenAI’s restructuring. They’re even trying to make a bid to buy all the assets of OpenAI’s nonprofit. The level of scheming that goes on among these executives is mind-blowing.

What happens next?

OpenAI’s president, Greg Brockman, who was meticulously taking notes during some of Elon Musk’s testimony, is expected to testify next week. And Stuart Russell, a computer scientist at UC Berkeley, will testify about AI safety. I’m expecting that to open the floodgates to this crazy discussion about who can be trusted to build AI. 

A bunch of other high-profile people are expected to testify, like former OpenAI chief scientist Ilya Sutskever, former CTO Mira Murati, and Microsoft CEO Satya Nadella. 

The trial is supposed to last around three weeks. The nine jurors will deliver an advisory verdict that guides the judge on how to decide Musk’s claims against OpenAI. The judge doesn’t have to listen to the jury and can decide however she wants. If she decides OpenAI is liable, then she’ll decide what sort of remedies are appropriate. 

MIT Technology Review will have ongoing coverage of Musk v. Altman until its conclusion. Follow @techreview or @michelletomkim on X for up-to-the-minute reporting.

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The AI market is full of big promises of grand transformation. Health care is a prime target for those promises, beset as it is by financial pressures, labor shortages, and the growing burden of caring for an aging population. AI developers are targeting functions that vary widely, from curing cancer and performing surgery to streamlining routine administrative tasks.

The opportunity is genuine, but execution can be difficult. Numerous software vendors have tried to “fix” health care challenges but failed because they misunderstood the environment. “Health care is very complex,” says Steve Bethke, vice president of the solution developer market for Mayo Clinic Platform, which supports the buildout and deployment of digital solutions for health care companies through data-based insights and expert validation. “Solution developers must have a deep focus on clinical and technical capabilities, and then align their solutions to the relevant business impacts. If they miss any dimension, the solution will not be adopted or drive value.”

AI applications for health care are proliferating rapidly. The U.S. Food and Drug Administration has approved more than 1,300 AI-enabled medical devices, mostly for interpreting diagnostic images. More than half of these were approved in the past three years, with the earliest dating as far back as 1995. Non-radiological applications carry out tasks as diverse as tracking sleep apnea, analyzing heart rhythms, and planning orthopedic surgeries.

AI applications that do not count as medical devices— for example, those that handle scheduling and administrative tasks—are more difficult to track but are also rapidly increasing. AI can help coordinate complex tasks and workflows that are often conventionally managed by whiteboards and sticky notes. Such functions may well outstrip clinical uses in their impact on health systems. A recent survey of technology leaders found that 72% said their top priority for AI was reducing caregiver burden and improving caregiver satisfaction, while over half (53%) cited workflow efficiency and productivity.

Any health care-related application can potentially impact patient care, whether directly or indirectly, and AI apps that are poorly designed or inadequately trained and validated can put patients at risk. Providers recognize that risk: In the same survey, 77% said immature AI tools are a significant barrier to adoption. Regulators and lawmakers are also keeping an eye on the risks as development and adoption burgeon, though the U.S. regulatory picture is still in flux, as a 2024 report to Congress on AI in health care observes.

To tackle some of the technical challenges, many health care providers are partnering with application developers to build AI solutions. In a recent study, McKinsey found that 61% of health care organizations intend to pursue partnerships with third-party vendors to develop customized generative AI solutions as a primary strategy as opposed to building them in-house or buying off-the-shelf products.

But health care-specific AI applications must also be tailored to the nuanced clinical needs of medical providers as well as the complex business and regulatory considerations of the wider sector. This is where developers can benefit from working with a partner with a deep understanding of the health care environment to tailor applications to what providers want and need most. Doing so helps to position AI products for maximum impact and value, avoiding the pitfalls unique to the health care environment.

Download the report.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

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