How a near-death experience reshaped one founder's relationship with fear

Executive overview

Matthew Poulsen, founder and CEO of Omaze, flatlined for four and a half minutes during emergency surgery — and came back with a fundamentally different relationship to fear. He had built the company on celebrity charity experiences; after his recovery, he led two major pivots that most of his board opposed.

The core shift: decisions made from fear look identical to decisions made from love, but produce different outcomes. Moving faster through fear — not avoiding it — is the lever.

Fear-driven boldness and love-driven boldness produce the same action; only the quality and resilience of the outcome differs.

From celebrity auctions to subscription prizes

• Omaze began when Poulsen noticed a Magic Johnson charity auction was limited to high-net-worth bidders; democratising access via $10 entries unlocked far more total donations.
• First campaign raised $784 over six months; the same mechanic later raised $302,000 for a Breaking Bad experience.
• Celebrity model hit a ceiling: talent was unreliable (Schwarzenegger cancelled to get a haircut with Stallone) and Omaze couldn't control its own pipeline.
• A pre-hospitalisation McLaren experiment — buying a $250k car with only $900k in the bank — raised $1.9m with no celebrity, proving prizes alone could drive scale.
• Poulsen returned from hospital to learn the McLaren result; he pivoted the company immediately, despite the whole team and board being organised around celebrity experiences.
• He credits storytelling as the tool that got stakeholders across the line: "Valuation is just metrics plus storytelling."

The UK-only focus decision

• After validating cars, the team identified houses as the highest-leverage prize category: "A car changes someone's lifestyle. A house changes someone's life."
• Tested the model in the UK because of smaller market size, high population density, a strong local operator, and a clear regulatory environment.
• A 20-person UK team exceeded the sales of a 180-person US operation within 15 months.
• Subscription mechanic (£10/month for automatic monthly house entry) produced Netflix/Spotify-level retention rates.
• To focus fully on UK, Poulsen shut down US operations and let go of 180 people — a decision he says he could not have made before the near-death experience.
• Business now runs past a £400m annual run rate.

The near-death experience

• Scar tissue from a childhood surgery caused a bowel obstruction 40 years later; Poulsen's abdomen swelled progressively over two days.
• His COO Helen turned back to the hospital on instinct at 11pm; minutes later his blood pressure crashed and a crash team was called.
• He flatlined for four and a half minutes. The lead doctor signalled the resuscitation was over; his mother intervened and persuaded them to continue.
• The hospital lacked an ECMO machine (a device that takes over heart and lung function). The only viable machine was 20 minutes away at a different UCLA campus — never before transported.
• A friend at a bachelor party in Las Vegas happened to be sitting next to the head of cardiology at UCLA; that connection unlocked the CEO's sign-off to transport the ECMO.
• Poulsen survived with full cognitive function; the attending doctor called it the most extraordinary case of his 30-year career, attributing the outcome to "larger forces — love."

Fear, love, and decision-making

• Post-recovery, Poulsen experienced elation then depression before arriving at a more durable mindset: the opposite of love is not hate, it is fear.
• His previous bold decisions were fear-driven — fear of inadequacy, of comparison, of not being loved.
• The near-death experience demonstrated that "nothing is as bad as the fear of the thing."
• He now processes fear faster; the quality of decisions improved even when the decisions themselves looked identical from the outside.
• Firing someone, pivoting a business, cutting a market — all can be done from fear or from love; the internal state changes durability and execution.

Storytelling as a core operating principle

• Poulsen teaches storytelling to every employee regardless of role, grounded in neuroscience of narrative and the principle of making the customer the hero.
• He applies it to fundraising, hiring, product development, and vision-setting.
• Storytelling is how he brought the board along on both pivots: painting a vivid picture of the other side was more effective than data alone.

Charity selection and tangible impact

• Omaze uses an RFP process; preference is for projects with concrete, visible outcomes.
• London Air Ambulance example: the charity needed £4m to replace retired helicopters or the programme (serving 3,000 people per year) would end. Omaze's community raised £5m.
• The replacement helicopters carried the first mobile ECMO units in the UK — the same type of machine that saved Poulsen's life, which was itself the first mobile ECMO unit ever used.