I'm merely balancing out the unduly optimistic powerpoint slides.
He actually devotes a few slides to picking the right company (the part about the company being a burning money pit or whatever). I think you're reading a whole lot of optimism that isn't there.
In the end it's up to you to judge the company for both human and career aspects, and to choose wisely who you work for. In ten years of working in the bay area, I have not regretted working for startups once. In short - mileage will vary.