Becoming a first-time founder is not easy. For months you feel as though you’re stumbling around in the dark.
Meanwhile, my LinkedIn feed is full of founders reciting the same tips and tricks for fundraising and scaling – the glamorous side of the business.
The reality is messier. Most founders are wrestling with the nitty-gritty, the grunt work no one posts about.
Having founded 01Health in 2022 and recently led the company through a $15 million Series A, I’ve learned a few things the hard way. Here’s what I wish someone had told me.
Most startups fail
When you start out with a dream, you rarely stop to ask ‘what if this fails’. You learn to ask it fast.
The uncomfortable truth is that most startups don’t make it. And once you’re in it, you see the evidence everywhere – in the businesses quietly crumbling around you and the founder friends who dissolve their companies and quietly go back to their old jobs.
I remember sitting across from a founder friend at a coffee shop while they told me, almost matter-of-factly, that they were winding their company down. Same stage as us. Same conviction.
That’s the lesson: you are not invincible. Someone, somewhere, is probably already building your idea. Stand still, and your business will fail. It’s that simple.
I wouldn’t tell founders to fear failure. But I don’t think you can build a robust product, or a scalable business, without accepting that you’re operating on borrowed time.
Change is everywhere
No business stays the same. Ideas evolve. In startups, that evolution just happens faster.
The idea you start with won’t be the idea you end up with – and it shouldn’t be. You have investors to satisfy, markets that shift under your feet, and expectations that need constant recalibrating against what’s actually possible.
One of the hardest balances in company building is knowing when to create a new reality versus when to solve a problem customers already know they have. Sometimes you’re pushing on a closed door – the world doesn’t want the thing you’re convinced it needs. And sometimes the opposite is true, and the job is to invent something people wouldn’t have imagined was possible.
For us it leans heavily toward the latter. We’re building new models of care – things that haven’t been done before – so being brave and ambitious isn’t optional. But ambition has to be paired with realism about how quickly a market can absorb change, even when everyone agrees the change is a good idea.
The same goes for how you picture the founder’s role itself – within a given day you wear many hats, and the skills you need change significantly as the business grows.
There’s a particular skill you build in the early days that nobody warns you about: context switching, at speed, without dropping the depth. In the space of one day I’d go deep on a product decision – really in the weeds, the kind of detail that decides whether a feature works – then close the laptop on that and switch fully into a hiring conversation, then again into something on fundraising.
Over time it becomes a muscle. You learn to cram a lot into a day and still be fully present in each thing while you’re in it.
The takeaway: in the startup world, you have to be agile. Your company – and your role within it – will evolve, sometimes hour by hour.
Time not money
Founders obsess over capital. And it’s easy to see why. Money looks like the answer to everything. Hire faster. Market louder. Build more. And yes, capital matters. Our Series A bought us room to breathe we didn’t have before.
But money was never the thing I was short of. Time was.
You cannot buy back the six months you spent building the wrong feature. You cannot buy back the year you spent hiring the wrong people because you didn’t trust your gut. Capital can paper over some mistakes, but it can’t reverse the clock.
The founders I admire most aren’t the ones who raised the biggest rounds. They’re the ones who treated time as the scarcer resource – who made faster decisions, who killed bad ideas quickly instead of nursing them, who understood that a slow ‘yes’ can be more costly than a fast ‘no’.
If I could go back and tell myself one thing in 2022, it would be this: stop asking ‘can we afford this?’ and start asking ‘can we afford the time this will take?’
Nobody has it figured out
Here’s the thing nobody tells you: the founders who look like they’ve got it all figured out on LinkedIn are stumbling through the same fog as you.
I still don’t have all the answers. I doubt I ever will. What’s changed is that I’ve stopped expecting to.
Building 01Health – and watching 32Co and Aerox Health grow alongside it – has taught me that founding a company isn’t a single decision you make once and then execute perfectly. It’s thousands of small, imperfect decisions, made under pressure, with incomplete information, at a pace that never quite feels comfortable.
So if you’re a first-time founder reading this, stumbling around in the dark exactly as I once did: that’s not a sign you’re doing it wrong. That’s just what it looks like from the inside. The confidence comes later. What matters is that you keep moving anyway.