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What happens when the skills that make you a great surgeon begin pulling you toward a different kind of impact?

In this episode, I sit down with Dr. Ivan Capobianco, who trained as a hepatobiliary and transplant surgeon and whose career journey spans Italy, Germany, global health work in Angola, academic research, AI, entrepreneurship, and medical publishing.

Ivan shares a deeply honest account of how he moved from the operating room into startup life and research, not because he couldn’t handle surgery, but because he began asking a bigger question:

How else can I serve?

We talk about:

-Growing up in Italy in a creative family, and why medicine wasn’t always the obvious path

-Training at the University of Padua, one of the oldest medical faculties in the world

-Key differences between European and U.S. surgical training systems

-How a year “off” before residency led him to Angola and permanently changed how he saw medicine

-Why pediatric surgery culture felt different, and what that revealed about surgical identity

-Burnout that didn’t announce itself until it did

-A pivotal moment during parental leave that forced a reckoning between career, family, and self

-Attrition in surgery, particularly for women

-The unfortunate truth that productivity and profit override patient-centered values in modern surgical systems

-The realization that helping healthcare workers may help more patients than operating alone

Ivan also shares how his love of research, data, and prevention led him to:

-Learn coding and machine learning

-Found the healthcare documentation startup Briefly

-Create STITCHES, a daily newsletter that curates and summarizes the most relevant surgical literature from hundreds of papers published each day

We explore:

-Why most “AI in surgery” papers miss the mark

-The value of small case reports and practical technique papers

-Why knowing open surgery still matters in a robotic era

-The loss of discussion and collaboration in modern academic medicine

-The myth of “I don’t have time”

-How essentialism can reduce cognitive and bureaucratic burden for surgeons

This is a conversation about agency, courage, and redefining service and usefulness in a system that often narrows our sense of who we’re allowed to be.

Dr. Ivan Capobianco leads the Surgical AI anda Digital Phenotyping Group at the Department of General Surgery, University of Tübingen. His research focuses on machine learning and artifical intelligence, Big Data in medicine, with a a particular emphasis on natural language processing methods applied to clinical data. He is the founder of the healthcare startup Breeflee, and creator of the surgical research newsletter STITCHES, which reaches over 5,000 readers daily. His work focuses on improving working conditions for surgeons and other healthcare professionals through better data, automation, and access to meaningful research.

The Pain to Power Workshop is the foundation upon which your self-concept is built. You can't step into the next version of yourself until you heal old wounds and rewrite your past. We start this work Feb 2nd, 2026. You have access to the content until March 2nd, 2026. Sign up here.

If you are catching this episode outside the window, no worries! You can still join us inside Empowered Surgeons group here.

LIMITED OFFER: The Pain to Power 5-day Coaching Program starts Feb 2nd. Sign up here.

In this episode I speak with Dr. Mandy Rice, a dual board–certified General Surgeon and Surgical Intensivist whose path to surgery was anything but traditional. She began her career as a pediatric ICU nurse at 22, carrying the belief that she “wasn’t smart enough to be a doctor” - until a physician challenged that narrative, and she chose to believe him.

Mandy loved medical school: the chaos, the autonomy, and the sense of purpose. Only later did she realize that the chaos she gravitated toward mirrored the chaos of her childhood, and that comfort and disorder had long been paired in her nervous system. After graduating medical school at 36, she entered residency and discovered stark differences between nursing and medicine, mentorship and hierarchy. A strong female role model in medical school contrasted sharply with a toxic training environment in residency, where lack of support - particularly from women in leadership - left her asking, “Why would people who are paid to train me treat me this way?”

We talk openly about the pain and disorientation of being fired from a training program, and the rude awakening that truth, logic, and “first, do no harm” do not always govern surgical culture. From there, Mandy navigated her first job out of training, reimagined the life she wanted, and ultimately designed a practice on her own terms, including direct-care surgery and later, community-based women’s health and hormone therapy.

Along the way we examine burnout, depersonalization, and the subtle spectrum between over-empathizing and dehumanizing patients. The middle ground, we learn, is compassion and skillful empathy. We also explore the gifts of palliative medicine and how it reshaped her ability to have difficult conversations, confront uncertainty, and meet suffering without collapsing into it.

Today, Mandy practices community surgery through a circuitous and self-authored route - proof that there are many ways to practice surgery, many ways to serve, and many ways to live a life in healthcare that is meaningful, humane, and your own.

Learn more about Dr. Mandy Rice here.

Join us inside Empowered Surgeons Group here.

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.

After returning from our inaugural women surgeon's retreat in Cabo, Steph Sheldon and I debrief about the lessons we learned.

Please enjoy this special episode of Surgeons with Purpose.

The "Pain to Power Workshop" will launch on Jan 18th. Get on my email list here to get all the updates about the program.

And if you are ready to join us in Empowered Surgeons Group, click here.

Steph Sheldon is a creative entrepreneur, business coach, website designer, and brand strategist who works primarily with women founders and coaches to help them clarify their voice, build intentional digital spaces, and grow sustainable, aligned businesses. She blends her background in architecture with business strategy and creativity to support her clients in creating meaningful, effective online presences and offerings.

Steph frames business not just as technical work but as creative and personal expression, rooted in clarity, intention, and connection between the founder and their audience. Her content and coaching often explore how inner beliefs, creativity, and somatic experience inform business success.

Follow her on instagram here.

Are you a woman surgeon who wants to retreat with us in Norway in August? Get on my calendar for an interview here.

Join Empowered Surgeons Group here.

In this episode, Dr. Lauren Umstattd shares her journey through otolaryngology training, a painful facial plastics fellowship experience, and the difficult decision to leave a path that no longer aligned with her values. First drawn to ENT as a medical student by its breadth and clinical complexity, Lauren enjoyed the precision of endoscopic and microscopic surgery during residency but found herself emotionally weighed down by head and neck cancer care. A rotation in facial plastic surgery changed everything, offering her clarity, creativity, and a sense of elective choice that resonated deeply.

Fellowship, however, became one of the most difficult chapters of her training. Despite being a strong student, Lauren felt profoundly out of alignment with her fellowship director and increasingly isolated, questioning herself in ways she never had before. As the experience deteriorated, she began simultaneously building her future practice, ultimately making the terrifying decision to resign just ten months in, despite fears about certification and professional identity. Ultimately, she chose her hard.

Lauren goes on to describe building a facial plastic surgery practice rooted in trust, transparency, and psychological safety. She discusses leveraging social media, thinking like an entrepreneur, and learning to separate the certainty required in surgery from the experimentation required in business. Central to her work is reframing perfectionism and failure, setting honest expectations with patients, and acknowledging that neither surgeons nor outcomes are ever perfect.

This conversation explores what it means to design a life and practice on your own terms, build culture intentionally, and fall in love with the hard parts of the work. It’s a powerful reminder that sometimes the bravest move in surgery and life is choosing alignment over approval.

Dr. Lauren Umstattd is a facial plastic surgeon and entrepreneur known for her commitment to autonomy, ethical patient communication, and psychologically safe practice culture. She is passionate about building systems that support excellence without sacrificing humanity. Follow her on instagram here and TikTok here.

Dr. Kat Hudon shares her journey from enthusiastic learner to an employed physician slowly beaten down by a system designed to keep doctors exhausted, constrained, and disconnected from their creativity.

In this convo, we explore how medicine places an impossible mantle of perfection on physicians, why resilience is a finite resource, and how the system punishes anything that falls outside the narrow definition of “excellence.” Dr. Hudon reflects on moral injury, middle management challenges, the growing administrative bloat in healthcare, and how she realized she always had a choice.

This episode is about reclaiming agency through values, connection, collaboration, and the courage to design a life and practice that actually aligns with who you are.

1. Kat describes the arc many physicians experience: entering medicine as a high-achieving, enthusiastic learner and slowly realizing, “I thought this was going to be better.”
2. Residency forges some of her most meaningful, lifelong relationships—even as the system itself begins to erode joy and creativity.
3. As leadership changes in employed medicine, conditions often worsen rather than improve.

1. Medicine demands perfection while punishing anything less.
2. Resilience is not endless—it’s a bucket that must be actively filled and resourced.
3. The dream of post-training life rarely matches reality; the clinical work is often the easiest part of the job.

1. Five years ago, Kat witnessed a dramatic rise in loneliness and anxiety among children without adequate training, resources, or systems to support them.
2. The moral injury of feeling like she was causing harm simply by working within a broken system shook her willingness to participate in it.
3. Healthcare has become an industry of industries, bloated by layers of administration and confusion designed to perpetuate itself.

1. Insurance companies dictate care decisions, limiting physician autonomy and patient-centered care.
2. If given a magic wand, Kat would eliminate the outsized power insurance holds over medical decision-making
3. The growing number—and salaries—of administrators contrasts sharply with the lived experience of clinicians.

1. Disillusionment with healthcare helped catalyze Kat’s move toward building a direct care clinic focused on longevity and age management.
2. Starting a business required clarity around core values and identity.
3. Physicians have highly transferable skills and more freedom than they are often led to believe.

1. One of medicine’s most powerful skills: building trust within minutes.
2. Relating well to patients—rather than using fear or authority—creates better outcomes.
3. Kat shares how relationship-centered conversations led to a 95% success rate with vitamin K acceptance, compared to 10% when scare tactics were used.

1. Kat describes her current practice model, including hour-long initial consultations followed by a membership structure.
2. Diversifying income streams and designing life intentionally creates capacity for empathy, connection, and meaningful discourse, even in challenging conversations.

1. Drawing on David Brooks’ concept of The Second Mountain, Kat reflects on moving from achievement-driven success to purpose, service, and community.

Kat offers practical first steps for physicians who feel trapped:

1. Pause and reflect: Identify what’s working and what isn’t. This isn’t quitting; it’s pruning.
2. Assess probability: What are the chances you’ll be happy if you stay? What are the chances you’d be happy doing something else?
3. Remember: You always have a choice.

Dr. Kat Hudon isn’t just another voice in the crowd; she’s a dedicated advocate for a new era of medicine–one that values integrity over profit, compassion over convention, and authenticity over everything.

Her voice rises above the noise, guiding both practitioners and patients toward a more holistic, honest approach to healthcare. Because real medicine isn’t just about treatment; it’s about trust, and Dr. Hudon is here to redefine what it means to truly care. Dr. Hudon is on a mission to educate, inspire, and advocate for a system where patients and practitioners are empowered to pursue health and healing with more humanity.

Follow her on instagram here.

Join Empowered Surgeons Group here.

See you all in 2026!

Click here to join us in Empowered Surgeons group.

Check out my latest TEDx talk, "Seeing Beyond the Red Swans", here.

In this conversation, I’m joined by author and human performance expert Brad Stulberg to explore identity diversity, mastery, and what it really means to build a sustainable, meaningful career. We discuss the concept of the identity house, what it means to feel one's way to skill attunement, core values, process vs product, and how presence and flow are at the heart of mastery.

This episode is especially relevant for surgeons and high-achievers who have poured everything into one role and are wondering how to prevent burnout without giving up ambition.

1. The idea that we all live in an identity house with multiple rooms (e.g., surgeon, parent, artist, athlete, writer)
2. Why having multiple rooms matters: if one room floods or burns down, the entire house doesn’t collapse
3. Not all identity rooms are the same size, and we don’t need to spend equal time in each
4. You can spend most of your day in one “room”—the key is not letting the others get moldy
5. The concept of minimum effective dosing for neglected parts of identity
6. Why it’s never too late to renovate your identity home, even if you’ve lived only in the “surgeon room” for years

1. Why defining core values is the first step in preventing burnout and moral injury
2. Research-backed values associated with long-term well-being: Autonomy, mastery, belonging
3. Two distinct types of burnout:

1. The danger of optimizing for a “successful week” instead of a successful career
2. How ego convinces us we’re more indispensable than we are
3. The liberating truth: the world keeps turning without us

1. “Feeling our way to excellence” and how it intersects with see one, do one, teach one
2. The universal mastery trajectory:
3. Simple → Complex → Simple
4. Why what looks “simple” is actually hundreds of unconscious micro-steps
5. The four stages of competence:: unconscious incompetence, conscious incompetence, conscious competence, unconscious competence (the apex of excellence)
6. Why many high-achievers get stuck in conscious competence (or try to skip steps)
7. Presence, intimacy with craft, and why the best moments (like a first kiss) are thoughtless

1. Seeing your work as a craft, not just a job
2. Identifying the right goals without obsessing over them
3. The danger of outcome fixation
4. Why process is what sustains excellence over time

1. The nuance of “going all in” without “going all the time”
2. Stimulus + rest = recovery
3. How intensity and joy are not opposites, but partners

Join Empowered Surgeons Group here.

Find Brad Stulberg and his incredible books here.

Trauma is more common than we think, especially in high-stakes professions like surgery. In this episode, I define trauma, PTSD, and post-traumatic growth and explore how these experiences can show up in the body, the nervous system, and everyday life.

Drawing from my own experience with complex PTSD and panic attacks, I walk you through a practical, humane process for moving through trauma rather than around it. This isn’t about fixing yourself or returning to who you were before. It’s about learning how to metabolize difficult experiences and create something meaningful from them.

If you need support, you can get on my calendar for a free consult here.

Join us in Empowered Surgeons Group here.