Surgeons with Purpose

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Dr. Tali Lando is a pediatric otolaryngologist, storyteller, speaker, breast cancer survivor, mother of 3 girls, and self-proclaimed worker bee.

She has held the same job since finishing fellowship. Sixteen years in one place. In the beginning, she describes running around like a chicken with her head cut off, but the work felt worth doing. Over time, the system became more rigid, and the space to practice medicine on her own terms seemed to shrink. She hadn't changed. The environment around her had. And she is still grappling with what that means for her as an academic surgeon.

Dr. Lando first ventured onto social media ten or eleven years ago to promote a book about her own breast cancer experience, written as a girlfriend's guide. She started with rules: case-based, de-identified, educational content. No dancing. No singing. Eventually, she found her voice and discovered she actually enjoyed bringing humor and fun into her work online. Then came a complaint. After she posted a video dancing with a nurse anesthetist well after hours, someone recognized the room and reported her. The experience gutted her. It also left her looking over her shoulder, wondering who was watching and what might happen next. That fear has come in waves ever since, growing alongside an ever-expanding list of rules about what physicians can say, share, and do.

We spend much of this conversation talking about what happens to physicians after a complication or lawsuit. Dr. Lando walks us through the choreography of second victim syndrome: the adrenaline-fueled calls to risk management and legal, the conversation with a trusted friend or colleague, the self-blame and shame, and eventually the deposition. You ask for an early start so you can get back to work, then spend an hour answering questions from a lawyer who seems to have already decided who you are and why you did what you did. Your intention throughout was to help a patient. The institutional response may be to remind you that therapy is available. Then you get back on the horse, because the patients keep coming. You drive to clinic and see people with the very condition you're being sued over.

There's also the court of public opinion, where physicians have almost no ability to defend themselves. Dr. Lando shares the story of a colleague who was publicly condemned over a case in which he had done nothing wrong, while his own institution prohibited him from explaining what happened. The damage to a physician's reputation can be profound, and there may be very little recourse.

Recently, Dr. Lando was asked to write a chapter on resilience, even as she was struggling to find some of her own. We talk about how familiar that tension is for so many physicians, and about the difference between sharing from a wound and sharing from a scar. Vulnerability has its own timing. Sometimes we can help others most when we've made enough of our way through the experience to become the sherpas guiding someone else up the mountain.

This is a conversation about broken systems, institutional scrutiny, physician autonomy, and second victim system.

Learn more about Dr. Lando on her website here.

Find Dr. Lando on Instagram here.

Get her most recent book, Breathless: Surgical Tales from the Brink here.

If you're in litigation right now: the Physician Support Line (1-888-409-0141) is free, confidential, and staffed by volunteer psychiatrists for physicians and trainees, 8am–1am ET daily.

Join us inside Empowered Surgeons Group here.

Dr. David Canes is a urologist and the CEO of Wellprept. He was born in South Africa to a foreign-language teacher and an actuary, moved to Canada and then New York while he was still very young, and was fascinated by doctors from the time he was a kid. Medical school settled it: he fell in love with anatomy, and from the first day of the course it was obvious he was going to be a surgeon. Eight years into practice he hit a wall, and the way he describes recognizing it is the most useful thing in this episode.

He does not forget a face. He remembers his surgical patients. So when he started opening the drape in the pre-op holding area and not recognizing the person underneath it, that registered as alien. Not a failure of memory so much as evidence that something had gone wrong. The second signal was the sensation of giving a cancer diagnosis while standing slightly outside himself. He had delivered the prostate cancer talk so many times that he was running it the way you drive to work without remembering the drive. He also noticed he had started to resent the moment a patient pulled out a list of questions. He was still fully present in the OR. It was clinic he had come to dread, which he found genuinely shameful in a job he knew he was fortunate to have.

He names the taboo directly: it feels forbidden for a physician to admit they're tired of explaining things from scratch. His position is that there's no shame in knowing which conversations you enjoy and which you don't, and that what makes a conversation enjoyable is unpredictable anyway. That unpredictability is not a defect in the doctor. It's evidence of being a human being rather than a delivery mechanism.

The fix he reached for was simple. The NCCN publishes patient guides in five languages. He asked his staff to email the relevant one ahead of the visit and made a short bit.ly link for it. Among the patients who actually read it, everything changed. Instead of starting at zero, he could pull up the MRI and show someone exactly where the tumor was bulging and why nerve-sparing wasn't on the table. Patients began opening with thank you. He compares it to university prerequisites — the work you finish before the seminar so the seminar can be the seminar. That workaround is how he became, in his words, an accidental entrepreneur: he was trying to fix a broken way of seeing patients, not start a company.

Wellprept grew out of it. The target is the administrative load that encroaches on the minutes between a physician and a patient — digital journeys that drip the right amount of content at the right time, and a single source of truth a team can answer from. For example: "can I swim after ear tubes?" is now a question a staff member can resolve without interrupting the doctor. It gives answers a permanent shelf life. They're in hundreds of practices across the US and Canada.

Learn more about Well Prept here.

Follow Dr. David Canes on Instagram here.

Last 3 spots for the Women Surgeons retreat! Interview for a spot here.

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Dr. Sandra Stinnett is a laryngologist at the University of Pittsburgh and director of its swallowing disorders center. She has always believed the soul lives in the throat, which makes her choice of specialty feel almost inevitable. Laryngology sits at the intersection of her two great loves: music and medicine, art and science, the voice and the person behind it.

Married to a musician, Dr. Stinnett was drawn to the variety of laryngology, the short cases, and the immediate, tangible difference she could make in a patient's life. But the moment she knew she'd found her place came during residency, when she performed a delicate phonomicrosurgery without rupturing the capsule around a mass. Her attending told her she had good hands. Sometimes, you just need someone who knows what they're looking at to see something in you before you fully see it yourself.

Dr. Stinnett's interests have always extended beyond the operating room. Before medicine, she loved journalism and dreamed of becoming a VJ. Today, she's an academic surgeon and content creator, building a public presence alongside her research, publications, and funding. We talk about what it means to create publicly when you know your institution is watching, how to earn the trust and flexibility to speak in your own voice, and why institutional alignment matters. Sandra is deliberate about the issues she speaks on. She's not interested in chasing hot takes. She wants to be a surgeon, a human, and a mom, and she's done pretending those identities need to exist in separate compartments.

As a woman of color in surgery, Dr. Stinnett believes every physician needs three people in their corner: a coach, a mentor, and a sponsor. Her own visibility has become a kind of advertising, opening doors and putting her name in rooms she never imagined she'd enter. But visibility isn't just about career advancement. Some of Dr. Stinnett's most meaningful work involves rebuilding trust between the Black community and medicine. She shares what it's like when a patient makes it clear they don't want her as their doctor, and we explore the role of allyship, including the importance of having a trusted friend and ally within her own department. We also talk about how her faith helps her resist the urge to vilify people, and why genuine curiosity about people whose lives look different from our own matters.

Dr. Stinnett does research on stress and the voice. The larynx is an emotional organ, and our voices can reveal what our bodies have been carrying. Through her work examining allostatic load, the cumulative physiological wear and tear of stress, Dr. Stinnett is exploring how that burden affects the very instrument through which we communicate who we are.

If you've ever wondered how to build a public presence as a surgeon without putting your career at risk, or how to make room for all the parts of yourself in a profession that rarely makes that easy, this conversation is for you.

Learn more about House of Nephesh here. Follow Dr. Sandra Stinnett on instagram here.

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This episode discusses suicidal ideation. Please listen carefully.

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Jeremy Heffner is a trauma and acute care surgeon fifteen years into practice. He ran the COVID response at his institution. Somewhere in there, his compartmentalization strategy stopped working. He would find himself in situations where he couldn't contain his emotions and couldn't locate where any of it was coming from: which part of the past, which patient, which year. He had hypercompartmentalized to the point that he could no longer find the source. He saw therapists. He did EMDR. Eventually he admitted himself to a residential program for a month. Frontline workers, he says, are given almost nothing to process the day-to-day, so they don't.

In surgery we keep running until we hit a wall. He describes a room full of surgeons nudging each other about who is earning more and taking the harder cases, and nobody ever asking the only question that matters: did you ever figure out the work-life balance thing? His own verdict is unsparing: you have to run the race yourself and reach your limits before you'll believe they exist.

After admission to the residential facility, things got worse. Without the normal stressors he felt empty, and there was one night he came very close to dying by suicide. He couldn't work out what defined him anymore. He knew he couldn't go back to being who he had been, because that version hadn't worked. If he wasn't producing ridiculous RVUs, had he failed? For the first time in his life, he didn't know what the path forward looked like. Two realizations moved him. The first was that every single moment of the day is his choice — that the excuses, starting with “if I don't see these patients, then…,” were his own. The second arrived as a willingness to be fired: once he understood he didn't have to prove himself, the rest of the stress fell away. Recognizing your own intrinsic value, he says, is the muscle. And he's blunt about his own part in it; he had been blaming the system for hiding what he was keeping from them.

He also turned to AI during that stretch, in a state of high vulnerability and shame. It helped him, he says, by forcing his mind onto a new problem. But it also showed him what the models actually do. He argues the models can induce psychosis in vulnerable people, and he lays out three places this could land — we believe we're steering when we aren't; too many destabilizing ideas arrive at once; or we learn to work alongside these systems as neither boss nor slave, which he calls the real threading of the needle. His warning for medicine is sharp: whatever efficiency AI creates does not entitle administrators to more of a physician's time.

What got him through PTSD was his wife, and a life rebalanced around something other than output. He is worried about the surgeons being trained right now on a model that no longer matches the world, sent out like deer to the slaughter by leaders who haven't noticed the game changed, World War One generals all over again. His closing thought is about leverage: once you genuinely believe in your own worth, you simply stop accepting the terms. You are not an easily replaced part.

Follow Jeremy on LinkedIn here.

Join SurgeON here.

Get his book, Proof of the Impossible here.

If you're struggling: the Physician Support Line (1-888-409-0141) is free, confidential, and staffed by volunteer psychiatrists for U.S. physicians, residents, and medical students, 8am–1am ET every day and nothing is recorded. The 988 Suicide & Crisis Lifeline is available any time by call or text.

Interested in the Cabo retreat? Learn more about it here. And interview for a spot here.

Join us inside Empowered Surgeons Group here.

Gopi Shah and Ashley Agan met when Ashley was a PGY-3 and Gopi was a fellow. They’ve been friends ever since.

Both went on to spend about eight years in academic medicine. Ashley made associate professor at UT Southwestern and was the first physician in her family. Gopi built her own academic career. And eventually, they both hit a wall.

They describe that wall differently.

For Gopi, it was the realization that what she thought her career would feel like was not what it actually felt like. For Ashley, it looked more like a seven-year itch, coupled with a vision she’d carried for years of running a small practice of her own.

What I love about their story is that they didn’t leave in the same direction.

Gopi and her family moved to Paris on what she calls a pipe dream: the chance to live abroad. She put her professional life completely on hold. She needed the reset, not just professionally, but for her mind, body, and overall wellbeing. At one point, she genuinely wasn’t sure she wanted to keep practicing medicine.

Eventually, she tried locums.

It was supposed to be a try-it-and-see experiment. Instead, she found a way of practicing that she loves. Every new institution requires her to read the room, understand the system, and figure out how to work within it. She loves the variety, the call, and the hospital medicine.

And as a pediatric ENT, she has a pretty good explanation for why she likes working with kids: they keep you honest. They see right through the ego.

Ashley watched Gopi do all of this and describes her, in some ways, as a vision board.

Two years ago, Ashley left her salaried academic position and opened a direct-care, cash-pay practice, despite being told it wouldn’t work.

Her take on cash pay is refreshingly nuanced: it’s harder in some ways and easier in others. Building the practice is harder. Actually practicing medicine without the insurance model hanging over every decision is much simpler.

She figured insurance would always be there if she needed it.

She hasn’t needed it.

What Ashley really wanted was control of her time. Her old life had become two daily frenzies, one in the morning and one in the evening, with a packed clinical day sandwiched between them. Somewhere along the way, she started to feel like she was missing the point of her own life.

She understood why the system was built the way it was.

She also understood that she could not build the life she wanted inside it.

And then there’s BackTable ENT.

That started almost by accident.

Gopi’s husband had launched BackTable IR as part of a startup building an app that allowed proceduralists to rate devices. The app needed physician engagement, so they started a podcast to drive people toward it.

The podcast ended up being the thing of value.

Gopi and Ashley first shared a microphone while talking about nosebleeds. In 2020, they decided to make an ENT podcast together. They recorded five episodes, mostly with people they already knew.

Ashley’s summary of those early days is basically perfect: it was so fun, even if nobody listened.

They weren’t initially thinking about it as education. That came later, when they started talking about all the things that weren’t making it onto the academic agenda.

Their first episode in that series was about the idea that you can’t pour from an empty cup. From there, the conversations expanded into practice building, professionalism, personal development, mentorship, coaching, and all of the other things they wish someone had taught them when they were younger.

Some of those topics, like the difference between mentorship and coaching, were still genuinely unfamiliar territory when they recorded them.

And doing it together mattered.

There’s something about having another person beside you that makes it much less terrifying to ask the question that might sound stupid, hear your own voice coming out of a microphone, get in front of a camera, or put an opinion into the world where someone might judge you for it.

Their goal is honest conversation.

Even with sponsorships, they want to be able to say what they actually think. If there’s something their colleagues should know about a device, they want to say it.

These are the conversations that happen on the sidelines at conferences. The conversations that don’t always make it onto the Academy podium.

And underneath so much of what they do is a challenge to one of the most deeply ingrained ideas in medicine: that there is only one right way to be a surgeon.

Both Gopi and Ashley have learned what happens when you’re willing to fail forward, especially when the risk is one you chose for yourself.

That, to me, is the real story here.

Not that they left academic medicine.

Not that one built a locums career and the other built a cash-pay practice.

It’s that they stopped assuming the career they had been handed was the only career available to them.

Learn more about Back Table ENT podcast here. Learn more about Ashley's practice, Scottie ENT, here.

Empowered Surgeons Group is going to Cabo January 6th-10th, 2027 for a mindset coaching intensive. Learn more about the retreat here. Interview for a spot at the retreat here.

You know that old adage: when life gives you lemons, make lemonade? What that means is solving for a result we want as opposed to indulging in our own mind drama. That's what this episode is all about. When you learn how to process through mind drama, you reach your goals faster and raise your self-concept to someone who can solve any problem.

Easier said than done. This is where a coaching relationship helps: to pick you up in your failures. If you are ready to jumpstart your personal development, the Women Surgeons' Retreat is the ideal place to do that.

Get on my calendar today to interview for a spot.

And join Empowered Surgeons Group to get started on this process right away.

My TEDx journey started while I was pooping on a very fancy toilet in NYC. But before I say more about that...

First things first, get Cesar's book, Great Speech, here.

Then book a call with him here.

And finally, join us for the Women Surgeons' Retreat in Cabo Jan 6-10, 2027. Calling all women surgeons who want to uplevel their lives and mastermind with colleagues. Get on my calendar here to interview for a spot in this mindset coaching intensive.

Back to that fancy toilet in NYC…

I was with my family on spring break, and an email from Cesar somehow showed up in my inbox. Next thing I knew, I had the thought, "I can do a TEDx talk." I booked a call with Cesar, and that same year I landed my first talk. Then I landed a second talk, which was selected for the coveted Editor's Pick (an honor reserved for less than 0.1% of TEDx talks). You can watch my first talk, How to save lives with two minutes of listening here and my second talk, Can we end fear-driven healthcare? here.

Cesar Cervantes was the kind of child whose parents concluded early that he was going to need a stage: theater camps, commercials, and a father he first learned to be funny with. He started doing stand-up and was touring by nineteen, work that eventually took him into war zones, performing at lunchtime on forward operating bases to service members. He calls it the worst possible setup for comedy and the most fulfilling work he has ever done.

What he ran into was the limit of the medium. He wanted to create transformation, not just laughter, so he went to graduate school and began teaching comedy inside a theater department. The keynote he built out of those classes drew a different question from other speakers: how do I get on a stage like that? And Top Talks grew out of answering it.

His case for humor is more serious than you might expect. Humor is catharsis. Pain and joy are both part of being a person, and comedy is where we metabolize the overlap; it is a celebration of the flawed human state. Pain plus time equals comedy, which also means a story told too soon is not ready for a stage. We also get into how badly a story suffers when the teller makes themselves the hero of it, a habit that feels like confidence and lands like distance, and one accomplished people fall into without noticing.

On TEDx, Cesar talks about how the stage is for ideas and how ideas change things, rather than motivational speaking or a personal story of overcoming. Ten to twelve minutes is the sweet spot, and the goal is a talk your audience can leave holding in one sentence. Getting there takes laser focus on your throughline, a clear sense of where the audience starts and where you intend to move them, a refusal to get precious about everything you write, and what he calls an "Oh My Gift" moment.

The structure runs in eight beats: an attention getter, an unequivocal reveal of the problem, the throughline, the solution stated plainly, then building the problem out, revealing the solution, the Oh My Gift moment, and a call to action. TED, he notes, loves reason-based thinking that arrives somewhere.

His advice on getting selected is unglamorous and correct. Land the idea, learn to communicate it, submit to events you would genuinely travel to, and separate the outcome from the process. Once selected, get a coach. TED is its own form. As a two-time TEDx speaker, I can vouch for this.

Join us inside Empowered Surgeons Group here.

Follow Cesar on LinkedIn here.

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This episode discusses a recent suicide. Please listen carefully, or if this is particularly triggering for you, forgo listening completely.

On July 23, 2025, Vaibhav Duggal turned 24. He spent the morning of his birthday in a women's health clinic in El Paso, on his OB/GYN rotation as a third-year medical student at Texas Tech University Health Sciences Center. Six days later he was dead.

In this episode, I share more details that have come to light about this case, including the processes the institution followed to address the complaint against Vaibhav, what the culture was like inside the institution, and the conversation between the Dean of the school and Vaibhav's parents.

Please go back and listen to the first episode #111, Vaibhav's Story, before listening to this one.

If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text in the U.S. Medical students and physicians can also reach the Physician Support Line at 1-888-409-0141, staffed by volunteer psychiatrists.

Join us inside Empowered Surgeons Group here.

Join us inside Empowered Surgeons Group here.

Interested in the Women Surgeons' Cabo retreat Jan 6-10, 2027? Get on my calendar here.

Dr. Erik Pearson grew up the son of an X-ray tech, trained in Dublin, and matched in Utah, where watching the pediatric surgeons at work made the decision for him. It wasn't only the operations. It was the weight of being trusted with someone's child.

After fetal intervention research at Children's Hospital of Philadelphia and pediatric surgery training at Emory, he found a growing practice in Las Vegas looking to build out its ECMO program. Ten years later, he joins us to talk about what that work actually asks of a person.

We get into the parts of pediatric surgery that don't make it into the training curriculum: the driveway moments after a hard case and learning to compartmentalize without going numb. Erik describes the mental shift that let him keep doing this work: I get to be there to help. Not so much be the hero.

The second half of the conversation turns to October 1, 2017. Erik was on call at Sunrise Hospital when victims of the Las Vegas mass shooting began arriving. He walks us through the organized chaos of the ER, the improvised triage bay in the ambulance parking lot, the color category the team invented on the spot because the standard system didn't fit, and the five hours he spent with a single gunshot patient alongside a scrub tech he had never met. He also describes the leadership he saw that night: a CEO in a purple polo whose entire job became removing barriers so clinicians could work.

It's a conversation about competence, grief, transparency with families, and what every hospital and every physician should be asking themselves before the worst night of their career arrives.

• 124 patients with gunshot wounds requiring treatment
• 129 patients admitted that night
• 16 mortalities, 14 of them dead on arrival
• 58 surgeries in the first 24 hours
• 516 blood products used

A model first identified in the response to the Boston Marathon bombing (observed in flocking birds) that Erik saw play out in real time:

1. Unity of mission
2. Generosity of spirit in action
3. Staying in your lane
4. No ego, no blame
5. Trust-based relationships

Dr. Erik Pearson is a pediatric surgeon in Las Vegas, where he has practiced for the past ten years as part of a physician-owned group. He is known as Citizen Surgeon on Instagram. Follow him here. Check out his website here.

Interested in the Cabo retreat? Click here to schedule a 15-min interview.

Learn more about the powerful coaching community & mindset course, Empowered Surgeons Group, here.

Decades of research point to the same conclusion: social support is one of the strongest protective factors in the face of trauma. But what happens when the way we've learned to relate to others gets in the way of that connection, especially in a profession where repeated trauma exposure is routine?

In this episode, Dr. Sacha McBain joins me to talk about the intersection of attachment, community, and trauma-informed care in medical settings. We start with the research: Australian psychologist Richard Bryant's work following the Black Saturday bushfires showed that it wasn't just individual relationships that predicted recovery; it was the shape of a person's whole social network. People who were diversely connected, and whose connections were also connected to each other, fared better. The overlapping network itself served as a buffer.

From there we turn to what happens inside hospitals. Sacha describes sitting in on resident onboarding and hearing the scare tactics used to keep new physicians in line: it's not if you'll be sued, it's when. Patients will find you in parking garages. Never admit you were wrong. The message underneath is essentially "be perfect, or a patient could destroy you.” And it makes co-regulation almost impossible with the very person you've been taught to fear.

What shifts when you see a distressed patient as a frightened, vulnerable human rather than a threat to your livelihood? What do you do when you can't find any empathy left and you're already overwhelmed? Sacha shares a piece of advice from a mentor that reframes curiosity as the thing you reach for when compassion isn't available. And we close on trauma-informed care as something fundamentally pragmatic, not a soft add-on, but a working set of practices around safety, transparency, power, collaboration, and cultural humility.

Sacha McBain, PhD, is a clinical psychologist and associate professor at Rush University System for Health in Chicago. A national leader in medical traumatic stress, she has published peer-reviewed research on the conceptualization and treatment of medical trauma, led national clinical trainings, and helped shape best practices for mental health screening and intervention after traumatic injury.

Previously at the University of Arkansas for Medical Sciences, she developed and led the Trauma Surgery Psychology Consult Service at Arkansas's only Level 1 Trauma Center and served as associate director of the Center for Trauma Prevention, Recovery, and Innovation. She contributed to the American College of Surgeons Mental Health and Substance Use Disorder Best Practice Guidelines Work Group and is an active member of the International Society for Traumatic Stress Studies.

Learn more about Sacha here.