I was non-founding, so while the author mentions fleeting bouts of imposter syndrome (which he leans into by trusting his instincts) I have a little less of that thankfully.
However, what I struggle with a lot is that there's absolutely no manual for this role. Everything is my problem, yet nothing is my problem.
I have had several conflicts with founders because I act outside of my scope (I.E, I do things they think is a waste of my time: like budget forecasts, headcount plans, retrospectives of milestones and previously I was doing the product roadmap- which I definitely agree is out of scope).
I think it's an unfortunate case that since there's not a really solid role definition, it's not even possible to talk about what should and shouldn't be included. For example I was acting as IT for a really long time because justifying a person for such a role was really difficult, and we spent even more time dealing with our IT service provider than if I was doing it by myself- so I did.
As for being hands on, that's dead. I still get my little joy from shipping toy code (little bots that automate stuff for example) but I've hired people who are better programmers than me and do it daily, and I have to trust them.
Aside from what I mentioned about the role, the absolute hardest thing for me to come to terms with is that I no longer get a dopamine hit when I fix/build something. Failures are concentrated (blameless post-mortems mean that it's the culture or environment that's wrong, guess who is responsible for the environment!) and successes are amortised (credit should go to the team who are hands on, of course).
It's a very thankless, extremely stressful job, where there is little direct joy from accomplishing something. And worse: people will rarely give you critical feedback to improve should you be doing anything wrong, so you're constantly second-guessing yourself because you know the power dynamic stifles feedback loops. Nobody will ever thank you, and I find that people treat you like you're part of a system and not a human.
I'm not sure I'll make it to year 7, and I wonder if I'll change my tune by then; but I wonder more how the author feels about these points.