Redefining the Corner Office
Why 45 is the Perfect Time to Design Work Around Life
I turned 45 last week, and honestly, nothing about my career looks like I thought it would at this age. Turns out, that's the best thing that ever happened to me.
At 40, I was too deep in the startup grind to have this kind of clarity. COVID had just shut down the world, I'd recently become CEO of Evren, and reflection felt like a luxury I couldn't afford. Five years later, I'm grateful for the perspective that only comes with experience and honestly, with burnout.
When Your Body Becomes Your Best Teacher
For those of you who don't know me well, a quick overview of my work background: I'm a biomedical engineer and operator with 20+ years of experience driving strategy, product development, and go-to-market execution across startups and global MedTech firms. As a former startup co-founder and Fortune 500 operator, I now serve as a fractional executive and advisor to growth-stage companies and investors on execution, evidence strategy, and market entry.
OK, now that that's out of the way…
My scientific background trained me to dig deep into problems, but I never expected to need to apply that same analytical rigor to my own body. However, when I left my CEO role and was finally diagnosed with a rheumatological condition called Ankylosing Spondylitis (or, as my dad calls it "Sponge Bob Squarepants") I finally connected dots I'd been trying to make sense of for SEVEN years, ever since I ended up with chronic fatigue back in my Boston Scientific days.
Side note: Having a rheumatological condition is unfortunately becoming all too common, with 8.4% of women and 5.1% of men in the US. And here's something I learned from my functional medicine doctor: when you're diagnosed with one rheumatological condition, you're more likely to have up to four rheumatological conditions than none at all. This means its even more important to deal with it as a whole body issue and not just trying to treat the symptoms. It also means I have had to learn to give myself a lot of grace for the times when I need more rest and can't be as social as I would like, or when I've injured myself (AGAIN) playing tennis or trying to do the higher impact workouts I love at the gym and end up throwing out my back and being forced to walk in the pool next to the octogenarians doing water aerobics for three months while my tennis team captain impatiently waits for me to be back to fighting condition.
But really this isn't meant to be a sob story, it's just a data point that changed my entire approach to work and life.
Since that time, I now understand why I kept injuring myself, having random inflammatory issues, or getting easily fatigued when I don't stay healthy AND I now understand and am working on being the healthiest version of myself so that I can avoid these issues. And a lot of that has to do with keeping a good balance in regular life and in work.
Wrapping up 2025, we are delving into some strategic topics that The Karow Advisory Group has significant experience in. If you need any support with your company - from startup to Fortune 50 - reach out here.
How I Accidentally Built a Better Career
I didn't set out to become a fractional executive. I was actively looking for traditional full-time roles while taking on advisory projects to stay engaged. Then I realized something: the advisory work was energizing me in ways that the traditional interview process wasn't and leaving me with the flexibility to recover or remove myself from unhealthy work situations if needed.
And here's the kicker: I can now work with top-tier companies while staying in Florida with my family. No more agonizing over whether a career move means uprooting everyone. Geography used to be destiny in executive roles. Not anymore.
Here's what my ideal day looks like now: I wake up and enjoy my coffee without having to immediately hit the road and sit in rush hour traffic. I work intensely for two hours, then take a break to hit the gym and spend time outside with my dog, getting morning sun and doing some grounding for vitamin D and nervous system regulation. Back to work, healthy lunch, maybe run an errand before rush hour hits.
The surprising result? I often find myself inspired to dive back into work in the evening with fresh energy and new ideas. When you're not operating from a depleted state, your thinking becomes sharper, not softer.
I hate that I can't support my doubles tennis team this season like I used to. Instead, I'm walking laps in the pool next to my mom, who also has AS and struggles with it more than I do. But here's what I've learned: adaptation isn't defeat. It's strategic intelligence. When you understand your body's signals and work with them rather than against them, you can sustain higher-level performance longer.
Why Companies Are Catching On
Here's what I've discovered: fractional work hasn't just made me happier, it's made me a better executive.
Over the past three years I've discovered just how much can be accomplished when you drop the title-chasing mindset and focus on the work that truly moves the needle. As a fractional executive I'm pulled into launch-critical moments: tightening a go-to-market plan days before a board presentation, rebuilding a product roadmap so it actually meshes with FDA milestones, or shaping the diligence story that unlocks the next round of capital. In each case the mandate is the same: steady the strategy, align the team, and create momentum fast. The results have ranged from six-figure cost saves on a product portfolio to over $2M in funding. That kind of impact is possible because I arrive without internal politics or a long onboarding curve; I can zero-in on the blocker, solve it, and leave the team stronger than when I found it.
What hasn't changed is my love of getting shoulder-to-shoulder with founders and leaders, whether that's white-boarding a clinical-evidence strategy or walking a trade-show floor to pressure-test messaging. I still hit the big conferences, but I've traded the shop-'til-you-drop marathon for targeted, purposeful sprints: meet the two partners who matter, absorb the market signals, then get back to execution. The flexibility to manage my energy means I'm sharper when it counts, and it shows in the outcomes.
This is executive-level work. I'm not doing less, I'm doing it more strategically. I'm building systems that let me contribute at my highest level while managing my energy as the finite resource it is.
And here's what companies are figuring out: fractional executives often deliver faster results because we're not spending months learning the coffee preferences and political landmines. We show up, solve the problem, and move on. It's refreshingly efficient.
Redefining Success at 45
At 45, I'm finally understanding what success actually looks like: it's not about grinding harder or longer. It's about designing a life that lets you do your best work sustainably. It's about choosing projects that energize you rather than drain you. It's about working with your body, not against it.
I'm not just surviving this transition, I'm thriving. And so are the companies I work with.
What does your ideal work structure look like? I'd love to hear how you're redefining success in your own field.
