Have you ever felt like you were on a moving sidewalk toward retirement, as if you had committed to a life path long ago and now you’re simply being carried along it? If so, you’re not alone, and you won’t want to miss this episode.

This week I speak with Mark Shrime, MD, PhD - Head and Neck surgeon, researcher, and former Chief of the Harvard Program in Global Surgery - about discernment, vocation, risk, and the search for meaning in medicine. Mark talks candidly about disliking medical school, nearly quitting, and ultimately choosing ENT after spending time with a surgeon who modeled what it means to balance work and play - a theme that never stopped mattering.

We explore how physicians make consequential decisions under uncertainty, how intuition can be trained, and why medicine treats vocation almost like the clergy: you choose young, never leave, and give your whole life to it. Along the way, we discuss administrative bloat, the profit motives of healthcare, the indoctrination of not listening to our inner voice, and the question of whether doctors are truly risk-averse or simply trained to be.

A turning point comes with Mark’s service work on Mercy Ships, where he performed head and neck surgery in a purely service mindset. An epiphany in Monrovia - punctuated by a near-fatal car accident - clarified his path in a way that finally felt aligned rather than obligatory. Conversations in Madagascar later informed his paper Trading Bankruptcy for Health (Value Health, 2018), a study I referenced in my TEDx talk Seeing Beyond the Red Swans.

We talk black swans, white swans, and red swans, and the privilege of being present with people in their deepest truths. Ultimately, we circle back to what humans crave most: to be seen, accepted, safe, and unjudged, even though safety is not incentivized in modern healthcare.

We close with positive psychology, the inner judge and its saboteurs, and the uncomfortable but necessary skill of falling in love with failure, especially in surgery, where complications become harder emotionally even as skill peaks.

Watch Mark's TEDx talk, Putting Purpose Over Path.

Work with him and buy his book here.

Follow him on instagram here.