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Anxiety can be transformed into resilience and courage, but only when we move toward it, not away from it.

Anxiety is the life-saving fear response misapplied to the imagination.

By definition, anxiety is a lie.

What we fear—killing the patient, facing a lawsuit, losing our reputation, losing everything—is not actually happening in real time.

Fear is intuitive, primitive, and immediately actionable. It comes in a wave, then recedes.

Anxiety, on the other hand, never relents.

The Five Fear Responses

• Fight
• Flight
• Freeze
• Fawn
• Flop

When we close a loop with fight or flight, our brain registers safety and completion.

But when we respond with freeze, fawn, or flop, the event can encode as trauma.

That’s why exercising healthy fight—asserting boundaries instead of people-pleasing—is essential.

In the hierarchical culture of surgical training, this can be especially hard to do.

Managing Anxiety: Before, During, and After SurgeryPre-op

Notice the thoughts your brain offers, often disguised as innocent questions:

“What if I don’t find the nerve?”

Instead of accepting that thought as truth, offer the opposite:

“What if I do?”

Then, shift into a mental state that serves you. I like to remind myself:

“It’s not about me. It never was, and it never will be.”

Finally, create a short ritual, like visualizing the entire case from start to finish at the scrub sink.

Intra-op

When anxiety hits—bleeding, getting lost in a dissection, uncertainty—let the physiologic surge pass through your system for 90 seconds.

Do not believe the story your brain tells you during those 90 seconds.

Once the wave subsides, find certainty:

“What do I know for sure?”

Then move from known to unknown with curiosity and creativity.

Post-op

Download your thoughts.

Speak them into a voice memo or write them down unedited, unfiltered, stream-of-consciousness.

Getting it out of your head helps you process, release, and reset for the next case.

Key takeaway:

Anxiety isn’t the enemy; it’s an invitation.

When you learn to meet it directly, you transform it into the fuel for courage, clarity, and growth.