Irlau Machado was the CEO of Intermedica from its acquisition by Bain Capital, through eventual IPO until the merger with Hapvida in 2022. We discuss his personal transformation after receiving a cancer diagnosis in his 30s, the career changes that resulted and insights from his subsequent experience running one of the largest healthcare businesses in Brazil. He explains the logic behind the transformation in Brazilian healthcare over the last decade and teaches us about leadership in a service industry where balancing costs and quality can be easily misconstrued.