How to make money in rare diseases
Lessons from a classical pianist from Donetsk
I’m Danny—former pharma-tech founder who bootstrapped to exit, now host of Life Sciences Today. I help techbio and digital health CEOs make money.
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This week, I write abour rare diseases and classical music.
In the latest episode, I spoke with Dr. George Magrath, CEO of Opus Genetics. He’s developing gene therapies for ultra-rare inherited retinal diseases—including one that recently gave a 39-year-old man the ability to see for the first time.
Opus is laser-focused: 1000 confirmed RDH12 cases globally, and yet they’re running fast trials, using AI to predict outcomes, and capturing value in a space where others drown in burn and bureaucracy.
See the episode with Opus Genetics here:
🎧 See Gene Therapy for Inherited Retinal Diseases – Life Sciences Today Podcast
This week, I had coffee with someone else who understands rare, focused excellence.
The pianist who doesn’t play for peanuts
I met Irena Friedland by accident. A professional classical pianist from Donetsk, she came to Israel in 1991 with $200 and two phrases in Hebrew: I want, I need.
Shortly after arriving, she passed a Tel Aviv café, saw a piano, walked in, played, and pitched the owner.
“I need Israeli pop,” he told her.
“No problem,” she said—and came back the next day sight-reading Israeli standards.
She played for 3 hours. He paid $5.
“But people started tipping,” she told me. “He said he’d deduct the $5 from the tips. I said—no problem. That works for me.”
Now? She only plays when it’s worth her time.
Irena’s Rules (that every founder should steal)
Don’t chase the rush
“Classical musicians have a very small market.
They suffer from a chronic mental condition: addiction to the stage.”
They’ll perform for peanuts just to get in front of a live audience.
Irena told me, “I love performing because I love what I do—not because I need the dopamine rush.”
Musicians get addicted to the stage. Founders get addicted to novelty—new features, new partnerships, new pilots.
But the rush rarely pays.
If you want it to pay, you need to charge as much as possible for your product—or your performance.
Don’t sell low
Over coffee, Irena picked apart a large yeast cake with her fingers. I was captivated by her energy.
“My rule is simple: I need to be paid as much as possible for my performance.
I don’t perform for $200.”
She’s right.
I told her the story of how I learned the importance of selling high.
When our FinTech startup crashed in 2003, I became an independent security consultant. I bought a book and 30 days of coaching from the legendary Paul DiModica: How to Sell Technology™ – featuring The Rhino Sales Method.
One of the first lessons? Don’t sell low.
"Classical musicians performing for peanuts" is the perfect metaphor for a classic anti-pattern in tech: Selling Low.
Tech startups do it all the time:
They enter at a low level in the organization—grabbing the first chance to get in.
They create value for people who can’t sign checks.
I told Irena, “We sold cyber solutions in Poland. We always cold-called the CEO. Our contact in PZU, the largest insurance company in Central Europe, was the CSO—a direct report to the CEO, with a corner office on the 35th floor.
If the CEO tells his manager to talk to you—they’ll call you.”
In a world where politics flourish even in small organizations, knowing who authorizes the order is everything. And PZU is a huge organization.
Don’t stop practicing
By now, I saw the analogies between Irena’s philosophy and business.
Yehuda Zisapel, of blessed memory—my lead investor in two startups—used to say:
“Sales requires constant practice. If Michael Jordan can work two hours a day on free throws, your salespeople can practice sales techniques two hours a day.”
Maybe that’s how Yehuda became a billionaire.
Professional musicians practice a lot. Early-career classical musicians typically average 4–6 hours of deliberate practice per day.
I said, “Irena, I don’t know if this is true for piano, but in woodwinds like clarinet and saxophone, daily practice is essential for maintaining tone, technique, and interpretation.
There’s a saying among woodwind players:
‘If you don’t practice one day, your brain notices.
Two days, your body notices.
Three days, your audience notices.’”
She smiled. “Of course it’s true for piano. Exactly the same.”
I told her I had practiced two hours the day before for big band rehearsal—but it wasn’t enough. There were still passages I feared.
“Even a professional like me struggles with difficult fingering,” she said. “But there’s a simple solution.”
I raised an eyebrow. “And that is?”
“When I make a mistake, I just turn to the audience and smile.
Most of them, most of the time, don’t notice anyway.”
I laughed. “I love it.
Miles Davis said there are no wrong notes—only preludes to the next one.”
She grinned. “I love that quote from Miles.”
Outro
Irena and George taught me the same thing in very different ways.
Their love of life—and of their craft—energized me.
Don’t succumb to creative rush. Trade novelty for loyalty to yourself, your mission, and your business.
Don’t sell yourself cheap.
Don’t stop practicing—and don’t forget to smile when you screw up.
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About Me
I’m a former pharma-tech founder who bootstrapped to exit.
Now I help TechBio and digital health CEOs grow revenue—by solving the tech, team, and GTM problems that stall progress.
If you want a warrior to work by your side, DM me on substack, LinkedIn or X
About Opus Genetics
Opus is building a new future for patients with inherited retinal diseases. Visit their web site here.