Be an astronaut

August 24, 2022

Orchestra health has one value: Be an Astronaut. We understand that this is rather vague so we break it down further.


No astronaut launches for space with their fingers crossed; that’s not how we deal with risk.
— Chris Hadfield, astronaut

Orchestra health is a healthcare service improving care coordination for outpatient surgeries. Before we began to scale our team full tilt we needed to think through, what sort of person would be best suited to help us achieve our aim. After thinking through it we decided that who we needed were astronauts.

More specifically, We need the type of person that would make a good astronaut. A startup needs to be competitive and fast moving; healthcare, by contrast, is sensitive and high stakes.

Why astronauts? Unlike most competitive industries where successful hinges on mastery of a narrow set of skills, astronauts must master a wide set of dissimilar skills, astronauts must be:

  1. Precise
  1. Innovative
  1. Empathetic


When the distances are vast, and the targets small every little bit counts. Close enough and mostly there don’t cut it.

That’s how we feel at Orchestra. When dealing with someone’s health, particularly in proximity to surgery, close enough simply doesn’t cut it. Why is simple enough, mistakes made within healthcare are amplified due to the effort required to correct them and the irrevocable damage that can be caused by them.

The James Webb Space Telescope (JWST) launched Christmas Day, 2021. A culmination of more than 20 years of work for NASA — Which had initially started planning for a follow-on to Hubble in the ‘90s, which famously launched defected and needed to be repaired in space. Overtime & over-budget, The JWST tardiness was partially from the gun shy behavior that NASA felt after their Hubble debacle. JWST going further than earth’s orbit precluded any such bail out post-launch corrections. The answer for this was simply to take their time and test, and then test again. Take measurements whenever possible and move deliberately, not slowly, but deliberately towards their goal. Taking their time to cross their T’s, not their fingers.

At Orchestra, we’re tasked with shepherding the patient through a complex maze of being prepared for surgery and delivering them safely on the other side. When we make mistakes, care becomes more expensive, time is lost, and outcomes are complicated.

So precision is key and worth calling out because as a startup, the notion that our mental state is of a move fast and break things, yippee-ki-yay motherfucker sensibility is worth nipping in the bud.


Space exploration is littered with examples of astronauts needing to think on their feet. Neil Armstrong had his fateful Gemini 8 moment as well as needing to adjust the landing of the LEM on Apollo 11, Apollo 12 needed think quickly after a lightning struck their Saturn V on takeoff, Apollo 13 … just in general.

Astronauts get a lot of the glory for these nail biting incidents, but in many senses astronauts are just the tip of the spear when it comes to execution in space exploration and really do rely on an extensive team to be successful. For example, during the Apollo 13 incident when the carbon dioxide filters were becoming saturated and the command modules extra carbon dioxide filters wouldn’t fit naturally. They needed to make a converter, with Lovell, Haise, and Swigert otherwise occupied they relied on a team on the ground to develop the converter and its instructions under an immense time pressure.

The reason they were able to accomplish this, communicate it to the astronauts, have them reassemble it in space, all while working with the time constraints is not luck (it’s maybe a little luck), but instead an intentionally prepared balance between an intricate understanding of what is and what can be.

That is how we define Innovative. Someone with deep understanding of how things work today combined with a firm grasp of the adjacent possible: An understanding of how to stretch and mold the present in order to shape the future. It’s not wishful thinking or day dreaming, but imagination rooted within expertise and experience.


Astronauts are required to work as a team in precarious environments for long durations far from home. Their team back on earth is required to advise and guide them thousands of miles away without ever having felt the conditions their astronauts are experiencing. Such conditions require high EQ and conflict resolution skills in order to guarantee that missions are not destroyed from within.

For example, I think of the type of person that is driven enough to become an astronaut: undergo the training, experience the discomfort, navigate the bureaucracy that is NASA, cope with the effect this time has on their relationships, get chosen for the crew of Apollo 11 and then be told that you will be the second person to step foot on the moon 😶. I imagine that’s something that can eat away at you, particularly over time when you’re training, prepping, en route. It certainly eats at F1 drivers when they are asked to let their teammate pass them. Time has a curious ability to fester and erode the rational part of someone’s mind. Rational thought like _“Someone has to be first and it’s probably best that we pick that person early and prep and train for that just that there’s not a mad dash for the LEM door after landing.” _

But not everyone can do it, history is littered with deals, alliances, companies that have ended because both people needed to be top chicken. At the core of empathy is an understanding of the bigger picture, and a willingness to leave your ego at the door and put yourself in someone else’s shoes.

Most people who work for or with Orchestra will never undergo the same procedures as our patients. Many will not have had much exposure to the healthcare system beyond their PCP or dentist. They won’t have been put under anesthesia, experienced long hospital stays, or extended recovery treatments. All else being equal, it probably would help if everyone we hired had personal experience with this, but that’s not realistic. The next best option is to find people with empathy who understand the bigger picture, and can work towards it with their team, without ego.

Astronauts are precise, innovative, and empathetic, and so are we. We understand the trust that people place with us and the responsibility that it carries.