I totally agree. My realization was that I'd rather spend the non-family time on my own ideas. I've edited my post so the focus stays on the questions I've asked.
RE your questions there's one thing I know: non-compete are not enforceable in California. Relax and join a different medical startup if you want.
(I am not a lawyer, so get one to confirm, or get listen to another 10 random folks :))
Unsure about remaining questions:
1) can you do anything to prevent your defamation among recruiters and/or make them pay for it,
2) sign-in bonus tax issues.
But my point was that as far as ethical and personal issues go, I am not on your side. If I was your employer I'd be angry too :)
RE spending time on your own ideas, I think the problem is not strictly time. It's energy. I spend only 40-45 hours a week at work but it's intensive focused time that leaves leave me with barely 15 hours/week of high energy focused time on all of the rest: my hobbies and meaningful time with family combined. In startups there's expectation that you give all of it, not just 40-45 hours.
I would like to correct the above into "In some companies, startup or not, there's expectation that..."
I worked for four years in a startup environment and normal workweek was always sufficient. Of course, I made sure this was the situation before I signed up. Making sure the company culture fits your philosophy of life before signing up is always good (if the economic situation is such that there are plausible alternatives). Becoming hired is not a cost free transaction but incurs severe opportunity costs for the near future. Not getting hired can incur acute fiscal costs on the other. But I would claim the nature of ones employment is not about subjugating ones autonomy unless the employee lets it. Of course, debt and mortgage balances the odds in the favor of the employer more often than not.
Please, telling bright young people that working ones ass of for the benefit of the employer is the only path to a good life is a severe deficit of clear thinking. Some people enjoy doing lots of work for the work's sake and it's a totally fine way to live ones life - but it's not the only good and admirable way available. I'm not saying any other way is better, just that there are usually options available to clever people how to organize ones life.
"non-compete are not enforceable in California. Relax and join a different medical startup if you want."
The way I read the OP (though this may be incorrect) wasn't so much that they were threatening to enforce a non-compete, but rather that they intended to blackball him within the local industry.
As an employee, I have an expectation that my standard salary pays for roughly 40-45 hours a week of work. If these startups are looking to hire and expecting to have all of my free time and energy, they better be giving me something for it.
I don't think joining a startup is a very economical decision as opposed to joining a big company. Startups usually give stock options enough for some equivalent of early retirement after 5 years if there's a successful exit, but the chance is low. Last time I tried to do calc on expected income, corporations were winning.
From my friends I know only one person who went to startup with the idea to (hopefully) make good money after careful risk/reward evaluation. Most people go to a startup for non-material reasons - like do more things with your own hands, more lively/friendly environment, different learning opportunities, flexbility to change roles, etc, etc.
RE working weeks. I haven't worked in a startup myself, but friends told me that generally there's an expectation of hardwork and long hours.
The important part - an expectation of long hours doesn't mean they will necessarily fire someone who works 8 hours per day, but it means you'll likely get medium rewards and medium respect from peers if you used to be top performer in a larger company. Which may be fine.
The fact that the author quit due to long hours after he got performance award indicates a potential for flexibility: e.g. maybe he could work less, say no to some requests or fail on some deadlines, and not get award, but still be good enough to not get fired and get interesting projects.
(I am not a lawyer, so get one to confirm, or get listen to another 10 random folks :))
Unsure about remaining questions: 1) can you do anything to prevent your defamation among recruiters and/or make them pay for it, 2) sign-in bonus tax issues.
But my point was that as far as ethical and personal issues go, I am not on your side. If I was your employer I'd be angry too :)
RE spending time on your own ideas, I think the problem is not strictly time. It's energy. I spend only 40-45 hours a week at work but it's intensive focused time that leaves leave me with barely 15 hours/week of high energy focused time on all of the rest: my hobbies and meaningful time with family combined. In startups there's expectation that you give all of it, not just 40-45 hours.