More than $1 trillion of power in the health care world, as measured by market cap, gathered in December in New York at the Forbes Healthcare Summit. The CEOs of Pfizer and Merck. The billionaire founder of Regeneron. The heads of GlaxoSmithKline and Celgene. But the hottest guest–the one many thought would be a no-show, even though he’d personally messaged that he was “100% coming”–was a 32-year-old in a hoodie.