A year and a half ago, I spent 8 weeks sleeping on a chair next to my five-year-old daughter in a hospital bed. She had broken her femur. The technology I’m writing about today would have cut that stay to 1–2 weeks. I didn’t know about it then. I know about it now — and I own it.
This post covers two new positions in the Sleep Well portfolio: Intuitive Surgical (ISRG) and Pro Medicus (PME.AX). Both are up since purchase — 3% and 50%, respectively. More importantly, both are the kind of businesses I’ve spent years looking for: zero customer churn, near-unassailable competitive moats, and decades of growth runway that have nothing to do with macro noise or interest rate cycles.
After a difficult stretch, this is what a portfolio upgrade looks like. The full thesis, valuation work, and reasoning behind both positions are below — for paid subscribers. If you’ve been on the fence, this is the one to read.
Links to the full deep dive and valuation are provided here for context:
SWI #24: Pro Medicus (PME.AX)
SWI #23: Intuitive Surgical (ISRG)
Intuitive Surgical (ISRG)
A year and a half ago, my family faced the biggest challenge we’d ever been through. My then five-year-old daughter broke her femur and needed either surgery or traction treatment. We were told the clinical outcome would be the same either way. What nobody told us — what I only understood much later, after spending months researching Intuitive Surgical — was how different the road there would look.
We chose traction. What followed was 8 weeks of my daughter lying completely still in a hospital bed. 8 weeks of me sleeping on a chair beside her, 24 hours a day, while my wife was at home alone with our second child, who was 6 months old at the time. I remember begging the nurses to let us recover at home. Not only was the care poor, but our family was fracturing under its weight.
Robotic-assisted surgery would have changed the experience entirely. That 8-week hospital stay: cut to 1–2 weeks. The 5-month full recovery: cut to 2–3 months. The NHS, stretched as it always is, would have freed up a bed worth at least £500 a day. And two parents would have got their lives back months earlier.
I didn’t know any of this then. I know it now. So having robotic-assisted surgery would have helped us return to our normal life much quicker.
Intuitive’s slides summarise the benefits to all stakeholders well:
And so, the firsthand experience and points above form a core thesis for why I wanted to own Intuitive Surgical and Pro Medicus (more on this later).
As a business, it’s incredibly easy to see why a long-term investor would want to own it.
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