Go Hit the Hardest Part First — Listening to Medsider on How Ammortal Decided Whether to Build

Contents

1. I used to treat “check whether the market wants it” as the whole of de-risking
2. Six months and 33 prototypes, to buy a reason to stop
3. How I sequence things now, and where I’m still unsure
4. Worth a look
5. One thing to take away

Jian means hardship: the peril lies ahead. To see the peril and be able to halt — that is wisdom.

—— I Ching, Commentary on the Jian Hexagram (pre-Qin, my own translation)

In the Medsider episode released on 26 October 2026, host Scott Nelson interviews Brian Le Gette, co-founder and CEO of Ammortal, about turning a sketch into a $160,000, 700-pound, 600-component chamber. Le Gette says that once he started, the first thing he did was single out the one component in the whole machine that nobody had ever built, then spend six months and 33 prototypes proving it could be manufactured — and if it couldn’t, the product was off. Prototype to pre-production took three and a half years in total, at a third to half the capital this kind of complexity normally takes. His sequence has preconditions: this is his fifth company, he had investors he’d already made money for and could go back to, and the product lands the moment someone tries it. Drop any one of those three and attacking the technical crux first can burn the cash with nobody waiting to buy.

I used to treat “check whether the market wants it” as the whole of de-risking

My own ordering for hardware startups ran like this: confirm somebody wants it, build something that shows the concept, raise on that, and leave the engineering crux until the money is in. The logic sounds defensible — building something nobody buys is the most expensive way to die, so moving demand validation to the front looks like de-risking.

Which made “solve the hardest thing first” sound like a motivational line to me for years. An engineer says it, I nod, and I’m thinking: so what exactly do you take to investors in the meantime?

On pricing I was shallower still. I treated price as an answer the market hands you: build it, go ask, collect a range, come back and adjust the cost. Le Gette’s account inverts that order. He says he enters an industry through the window — never the front door, never the back door. He knows a little about the field but doesn’t live in it, so he isn’t bound by what currently exists. When he came into this one, insiders told him nobody in this industry ever sells anything at $160,000. His reply: good thing I’d already finished designing the product by the time I heard that.

Where I was shallow, plainly: I had collapsed “validate demand” and “reduce risk” into the same act, so the moment somebody said they wanted it, I felt the risk had come down. This episode showed me a different way to run the arithmetic.

Six months and 33 prototypes, to buy a reason to stop

Le Gette’s method is one sentence: ask what the most complicated subsystem, part, whatever it is in the machine actually is; if you can’t do that one, don’t do anything.

There was a component in the Ammortal chamber whose manufacturing had never been done and whose engineering had never been done. He says there were three separate reasons it had never been built (he won’t say which part, because of the patents). So he spent six months hitting it, built 33 prototypes, and it worked — they figured out how to make it. Then he asked the next question: where’s the next biggest fail-fast, fail-cheap?

The value of that ordering sits in the comparison of numbers. The whole design phase was three and a half years; proving that one part took six months. If those six months had failed, he loses six months. If he’d left it to the end and then discovered it couldn’t be made, he loses three and a half years, plus the cash burned along the way, the people hired, the channels signed. Looking back at his first company, he says he and his partner did another 50% of things that simply didn’t matter — and the weight of that line comes from the fact that his first company, One80s, hit number nine on the Inc. 500. That one worked, and half the effort still went into things that weren’t deciding anything.

Scott adds a cross-check here that I think is the most useful minute in the episode. He mentions an interview with Dan Hawkins, co-founder of Shockwave Medical, who described how Fred Moll directed the early engineering team at Intuitive Surgical: identify the single largest technical bottleneck, throw every resource at it, and don’t move on until it’s solved. Two independent people, two medical device companies from different eras, same ordering.

The pricing passage runs the same arithmetic on the commercial side. Le Gette re-ran the numbers for himself: the therapies stacked inside the chamber take about three hours to do serially, and he compressed them into 25 minutes. B2B buyers want turnover; four rooms of tech becomes one room, and they can have four of those rooms. At which point he says: wait a minute, I’m not expensive, I’m reasonably priced. That whole calculation rests on the stack actually working, and he stops himself mid-answer to state the boundary: Ammortal is a wellness product, it is not a medical device, it is not allowed to make those claims, and all he can say is what the individual sub-sciences he combined have been shown to do. Drawing the line that sharply is what made me willing to keep listening to the rest.

One detail I liked. He traces the origin to Buenos Aires — Malbec, steak, watching polo — where a future business partner told him about MMA fighters treated with light therapy and pulsed electromagnetics: knee injuries that were supposed to keep them out for eleven or twelve months, and they were back in the ring winning in six to eight weeks. He asked whether anyone had done it on the whole body. No. He filed it away, woke up one morning and drew the chamber, filed it away again, then woke up another morning deciding he had to do this, sold the company he was running, and came over. He’s equally concrete about the engineering: at 15,000 volts a lot of materials stop insulating and start conducting, plastic included, and data lines flip from zeros to ones when you put huge overlapping fields across them.

How I sequence things now, and where I’m still unsure

If you’ve got something in front of you that nobody has done — a new feature, a new service, a customer nobody has ever closed — you may be carrying my old assumption too: build the visible part first, so you have something to show. What I do now is stop and ask one question: which piece of this, if it can’t be done, makes the whole thing moot? Then ask how long it takes to find out. Answer those two and the ordering usually falls out by itself.

There’s a passage that runs the same move on the sales channel, and that’s the part I want to keep. A lot of people have this exact pain: the customer clearly loves it, the meeting goes beautifully, and then nothing happens. Early on Ammortal went to a trade show built around insurance reimbursement. Le Gette says the meetings were incredible, the sessions were incredible, and nothing came of it. They pulled out the common denominator and found it was the payment structure — those buyers would love it and want it, but the economics of the room couldn’t carry it. From then on, when they met someone used to earning through the insurance system, they walked away. His own words: that was their biggest early time burn.

So the piece to hit first on a channel is how the money arrives; whether they like it comes later. All four of his verticals pay cash: professional teams (he says they have most of MLB and most of the NFL), high-end hotels and spas (Four Seasons, Ritz, St. Regis, Canyon Ranch), four-walled fitness and longevity clinics, and high-net-worth homes. He singles out what makes the home channel distinct — the sales cycle. Someone who can buy an extra car on a whim can decide today and pay today; a hotel chain takes twelve to eighteen months from first contact. For a cash-hungry hardware startup, those two channels do different jobs on the balance sheet.

Scott turns this into a column I hadn’t been tracking. We’re used to inventorying clinical risk, technical risk, payment risk — and there’s also workflow risk. However good the product, if it creates friction inside that clinic, it doesn’t get adopted. Le Gette’s answer was to drive the front desk’s required knowledge to zero: you can put a person in the room with the chamber knowing nothing, they touch the screen, and the screen walks them through everything from what to take off to how to fit the cannula to what to do when the session ends. They also built the 15-minute session for people who show up late — “you’re late, I can still give you a 15-minute session” — so the schedule doesn’t collapse. Scott mentions a friend who did a session recently at a Florida clinic he doesn’t normally visit, and what he came back talking about was how well the staff knew the machine, no fumbling at all. Clinic staff turnover is high, which makes that matter more than it sounds.

Three things I’m still unsure about. First, this ordering leans hard on “they try it and they want it.” He says athletes kept asking him to explain the science, and his answer was go use the chamber; they came out hoping it was true, with no convincing required from him. If your product takes three months before anyone can see an effect, that snowball never starts rolling, and attacking the technical crux first gets considerably riskier. Second, with no clinical data as the ticket, the endorsement has to come from felt experience plus usage records at the venues — and on the day that felt experience varies person to person, the same snowball rolls backwards. The episode doesn’t cover how that risk gets managed. Third, there’s a claim in the fundraising section I can’t verify from one interview: he says Ammortal is a data platform company that looks like a hardware company at launch, so institutional investors apply the hardware formula, it doesn’t fit, and he spends the whole meeting arguing uphill — which is why he turned to self-made family offices, professional athletes, a few celebrities he can’t name, and a haute couture brand. I’ve heard that “we’re really a different kind of company” narrative in plenty of fundraising stories and can’t tell insight from pitch from the outside. What does have a concrete shape is the mechanism he describes: the first person you meet gets it and puts in the time, then the file goes to the fund’s managing partner, who was in none of those conversations, pulls out the old formula, and it’s over. That shape I’ve seen elsewhere.

Worth a look

• The Medsider episode released 26 October 2026, host Scott Nelson with Ammortal co-founder and CEO Brian Le Gette
• Ammortal’s site, ammortal.com, where the session lengths and channel mix mentioned in the episode can be checked
• The comparison raised in the episode: Shockwave Medical co-founder Dan Hawkins on how Intuitive Surgical concentrated early resources on a single technical bottleneck
• The long fundraising piece by Beehiiv CEO Tyler Denk, mentioned late in the episode, as a counterweight to the anxiety that you must land a brand-name lead investor
• The Jian hexagram in the I Ching (pre-Qin, public domain)

One thing to take away

One idea: go hit the rock that, if it won’t move, means the whole thing is off — what you buy there is a cheap reason to stop. Most of us put our energy into the pieces that produce visible output, because that’s where progress lives and where you get something to show. The piece that decides whether this works at all tends to be the one you least want to touch and feel least confident about. The later you touch it, the more expensive stopping gets — that’s the entire difference between six months and three and a half years.

Something I’ve tried, and you can run it on anything you’re currently putting off: moving house, changing jobs, whether to have a kid, learning a language, having the conversation you’ve been avoiding with someone. Write the thing out as a list of parts, then circle one — “if this one can’t be done, the whole thing is off.” Spend the next week testing only that part, nothing else on the list. Someone opening a small shop can spend three happy months on the menu, while the thing that actually calls it off is usually the rent and the foot traffic at that address; someone changing careers can spend the same months on a résumé when the real piece is whether the fixed costs at home can come down. Circle it, go test it, come back in a week, and you’ll know whether you’ve been moving forward or circling the comfortable parts.

Raw Markdown

This article is an educational discussion of investment method. It is not advice to buy or sell any individual security, offers no target prices, and does not analyze any current holding. Investing carries risk; make your own decisions or consult a qualified professional.