Founder Alex Marechniak stepped down as CEO not from a lack of skill, but because personal crises and burnout depleted his capacity. He recognized that leadership requires being "fully in the game," and transparently told his board he wasn't, prioritizing the company's health over his ego.

A CEO's primary role differs fundamentally based on company type. In an asset-centric biotech, the CEO must act as a hands-on program manager, micromanaging execution. In a platform company, the CEO must be deeply embedded in the science to predict and leverage the technology's long-term trajectory.

Companies typically fail from poor execution, not poor vision. Success depends on navigating a handful of pivotal 'moments of truth' over a lifetime. The most critical leadership skill isn't just making the right choice, but first identifying that a rare, critical decision point has arrived.

The most paralyzing decisions for a leader aren't clear-cut choices but dilemmas where every path is painful. Ben Horowitz's decision to take his company public with minimal revenue was a bad idea, but the alternative—bankruptcy—was worse. The key skill is choosing the 'slightly better' path in the abyss, despite the guaranteed negative feedback.

Many leaders enter QBRs seeking praise for their team's activities. The crucial mindset shift is from seeking validation to taking responsibility for the business's health. This means having the courage to present uncomfortable truths revealed by data, even if it challenges the status quo.

Many founders become too attached to what they've built. The ability to unemotionally kill products that aren't working—even core parts of the business—is a superpower. This prevents wasting resources and allows for the rapid pivots necessary to find true product-market fit.

Corporate leaders are incentivized and wired to pursue growth through acquisition, constantly getting bigger. However, they consistently fail at the strategically crucial, but less glamorous, task of divesting assets at the right time, often holding on until value has significantly eroded.

High-performing CEOs don't hesitate on talent decisions. One mentor's advice was to act immediately the first time you consider firing someone, as indecision only prolongs the inevitable and harms value creation. This counteracts the common tendency for CEOs to be overly loyal or fear disruption.

During a routine roadmap review, Nvidia's CEO unexpectedly abolished a major product line and reassigned a third of the company's engineers. This exemplifies the fearless, rapid, and decisive leadership required to navigate fast-moving tech markets.