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Seven realities of working in a start up



The utter chaos of building a start up
The utter chaos of building a start up

It's the dream of many industry veterans, clinicians and engineers - researchers and entrepreneurs. That dream of "Build it and they will come."


Having spent nearly twenty years doing hard core start ups in Medtech across the globe - from cupboards in California to HQs in Goa, from pig sheds in Cambridge to beach huts in Rome - I've seen what the real inside of the machine that makes the sausage is like.


Today's post is the "Reality" check for those seeking the glamour of start ups. Now don't read me wrong - I would not give up doing start ups EVER! It's so awesome. But strap in and be prepared, as it's not all table football machines and free snacks in the brightly coloured open cafeteria.


It's full on 24/7 - never stopping - never relenting

The one thing I realised after I took a break from operationally running start ups is just how much free time I now have. That's because when you're inside the sausage machine - pumping out the sausage - it is all consuming. You and your family will live and breathe your startup 24 hours a day - 7 days a week. prepare them for this.

Calls at the weekend - crisis after crisis while on vacation (if you get a vacation)

If you're not working - your company is not progressing.

You own it - and it owns you.

Be prepared for 10 years (yes that is how long a MedTech Startup will consume you for unless you crash earlier.) it is 10 years of giving everything - every minute of every day.

It is intense like nothing you have ever experienced before.

You will age 20 years in 5 years! You will argue at home! Friends will think you're mad.


It's raising money - running out of money - raising money

Burn baby burn is the mantra of every startup - "You are what you burn."

You will spend most of your time as a CEO or leadership team out with the begging bowl. You will do pitch after pitch after frustrating pitch. Fielding what will seem like an endless stream of near stupid questions from highly uneducated investors that "just don't get it."

That's a big part of your life, because without money you die.

There will be moments of high intensity as you watch your bank balance thunder towards zero - you will cut the spend - and be on vapours right to the point a bridge loan comes in, and then you have the exalted rush of exchanging documents - cash hits the bank - you pay off your debts and backlog of wages - breath a great a sigh of relief and then... get out and get raising the next round as your cash runway is about the 12 months it will take to raise the next round. Raise - Burn - Panic - Raise..... rinse and repeat for a decade.


It's doing anything and everything - get your hands dirty

There is no army of people to book your flights - set up meetings - clean your dishes.

You want the bicycle - get peddling - and get peddling fast. You will be doing everything and anything in the first 12 months. Setting up every system - paying rents - putting stuff on your credit card - seeing vendors - buying hardware tools - getting coffee - making logos ... etc etc etc etc.

If you have any antibodies to doing menial shit - then don't start a startup. You are it! General dog's body and gofer on everything - so get ready to be that person answering the door to UPS at 8:00 am and turning off the office lights at 8:00 pm.


It's chaos on a daily basis when building a start up

Every day is three things to plan and one hundred random and chaotic - fly by the seat of your pants decisions. What can go wrong will go wrong. If Murphy had an office where he write all his laws on what could go wrong - he's sitting in the desk next to you.

It will be random shit coming in from all directions and at all times of the day. And you will be dealing with it - resolving it and spinning those chaotic plates - having to decide which ones will fall. Because they will - and you need to decide which one creates the least havoc when it falls and smashes. It's plan and see those plans disintegrate - plan again and refine - and see them disintegrate.

But through the chaos you will see steady progress.


A start up is like building the 747 around you as you're flying it

A start up is super complex - and requires complex systems to be in place - especially in a Medtech company. But you can't wait until the systems are all in place before you get going - or you'll run out of cash.

It's the equivalent of taking off in a non complete Boeing 747 and trying to build the plane around you at the exact same time of learning how to fly a 747.

It's one of the biggest challenges you will ever face - and especially early on as you are full of turbulence - and have little surety on how to fly it - not really sure you're going in the right direction - and risk running out of fuel every few hundred miles - and or engines falling off.

Oh it's thrilling and invigorating - but it's not surprising why 75% to 90% of startups crash.


It's talking to people that don't get it

It's your baby. It's your idea, and for you it is so clear - simple and easy to understand that world changing thing you are trying to do.

Every time you talk to someone they will screw their face up - shake their head and ask the most stupid questions about the most obvious things. They just won't get it.

You will meet the odd visionary who will see the light and join the quest. But the majority of people are "Stupid" right? They have no vision - right? They just don't know the space - right?

Get used to it! And get used to it fast - and build a very thick skin combined with saintly patience. Because if it was that F'in obvious a hundred other people would have started that company already. How stupid was "Tis Tok" - a friking app where kids do stupid dances to some random music. And no you didn't get it - and yes you thought it was dumb. And many of you still won't have that app.

Most ideas are stupid - then some early adopters get it - then main stream takes it on - then of course it was obvious. How could anyone have not seen it.

People using Nokias and Blackberrys thought the iP{hone was dumb. A music player that can make phone calls.

You live in that world where people won't "get it"- so get used to it!

It is as frustrating as hell.

But a lot of the time your idea is just... stupid. (The fax machine for the bicycle.)


Start ups are about commercialisation not R&D

This is NOT about engineers having that Edison breakthrough moment in the lab. That euphoric breakthrough by the team in white lab coats crowded round the blob of unobtainium.

No - a startup is a commercial business - and pretty soon you'll realise that if you are an R&D engineer you are out of your depth pretty quickly. It's about finance - marketing - sales - commercialisation - strategy - investments - oh and making the best product to drive all that.

But it's that way around. So if you think that start ups are all about R&D BBQs and fuse ball - then get real - because you will be a business manager not a research manager.



Saying all that - for some of you - this is not "oh no" - it's "Hell yes - bring it on!"





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