You Can “Bleeding Heart” Your Way Out of Business

What happens when a Wharton MBA who spent two decades marketing pacemakers decides his work isn't meaningful enough? Andrew Rosen turned 40, had three kids in quick succession, and realized he was spending his days in PowerPoint trying to win over the next layer of management. So he made an abrupt break from corporate life. Nearly 20 years later, he calls it the best decision he's ever made. Today Andrew leads the National Ataxia Foundation, the largest U.S. patient advocacy organization for ataxia. Ataxia is a rare, often inherited brain disease that affects balance, walking, and speech. Many patients are misdiagnosed for years, and some are even accused of being drunk. Since joining as employee #8 in 2019, Andrew has helped grow the organization from about $2M to a 30-person team, and he's aiming much higher. In this conversation with host Efrain, Andrew shares why running a nonprofit is no different from running a small business, and why passion alone won't keep the doors open. "Caring about the cause is required, but it's not sufficient. You've also got to have business skills and make tough decisions." — Andrew Rosen WHAT YOU'LL LEARN → Why business discipline is essential for mission-driven organizations → The balance habits that keep a CEO energized after decades of mission work → What the dot-com crash taught him about today's AI boom → How AI could accelerate treatments for rare neurological diseases → Why rare diseases need a different path to drug approval → How a celebrity partnership reached tens of millions of people → Advice for leaders who are questioning their "why" TIMESTAMPS 00:00 Intro 00:16 Welcome Andrew Rosen 01:51 What is ataxia? 03:28 Leaving corporate at 40 for nonprofit work 05:20 A nonprofit is a small business 07:01 Balance, workouts, and staying grounded 09:47 Don't miss the time with your kids 11:10 Dot-com lessons vs. today's AI moment 12:06 AI and rare disease drug discovery 14:48 How the team uses AI day to day 16:22 The research funding challenge 18:06 Programs: research and patient support 20:32 Growing from 8 employees to 30 23:46 The 3–5 year goal: getting treatments approved 27:16 How patients finally get diagnosed 28:57 Bill Nye and the power of awareness 31:42 How to get involved 33:28 Advice for leaders rethinking their why GET INVOLVED Learn about ataxia, donate, join a local Walk n' Roll, or connect with one of 60+ support groups nationwide: 👉 https://ataxia.org ABOUT HART & HUSTLE Hart & Hustle features honest conversations with leaders building mission-driven organizations across nonprofits, healthcare, and community services. Presented by FRANSiS™, which helps mission-based organizations extend their team's capacity with 24/7 SMS-powered AI. 👉 https://fransis.us If this conversation resonated, like, subscribe, and share it with a leader who needs the reminder that purpose and good business go hand in hand. #HartAndHustle #NonprofitLeadership #MissionDriven #RareDisease #CareerChange