The Intentional Surgeon with Sharon L. Stein, MD

In rural, underserved areas of Kenya, a lack of access to timely cesarean sections leaves young women vulnerable to the trauma of obstructed labor. Beyond the tragic loss of the child, the resulting prolonged pressure on pelvic organs causes severe tissue necrosis and the formation of vesicovaginal and rectovaginal fistulas. Leaking urine and stool continuously, these women are often heavily stigmatized and ostracized by their communities.In this episode, Dr. Sharon L. Stein sits down with Dr. Anna Spivak, Section Chief of Pelvic Floor Surgery at the Cleveland Clinic, to discuss Campaign 52—an international medical relief initiative providing free, life-altering surgical care to these vulnerable women.Unlike top-down, Western-driven mission trips, Campaign 52 operates at the explicit request and direction of local Kenyan surgeons. Dr. Spivak shares how this collaborative, local-first framework allows a specialized task force of colorectal, gynecologic, and urologic surgeons to tackle an overwhelming backlog of complex pelvic floor conditions, directly target the exact procedural needs of the community, and systematically build lasting hospital infrastructure.Global Surgery Best Practices:For residents, fellows, and surgeons looking to participate in humanitarian work overseas, Dr. Spivak outlines a foundational rulebook:Do not establish a short-term camp without locked-in, long-term, perpetual aftercare. Campaign 52 ensures close, local, long-term clinical checkups, pelvic floor physical therapy tracking, and remote communication via the Fistula Foundation.Front-load your schedule. Round on 100+ triage patients on day one, and position the highly complex, multi-hour operations early in the week so patients have adequate time to recover safely before the traveling team departs.Do not show up to enforce what you think a population needs. Identify local clinical hubs seeking discrete clinical education or structural backlog reduction.Key Takeaway for Listeners:"In the United States, some equipment would be in the garbage a long time ago. Because they have very little, they truly utilize everything they have. Limitation begets creativity. When Dr. Mabeya fixes these complex fistulas, he is truly saving souls. He's giving these women a chance to be alive, to take care of themselves, and to contribute to their society." — Dr. Anna SpivakLearn More and Get Involved:Read the Research: Dive into the three-part series documenting the logistics and outcomes of Campaign 52 published in Diseases of the Colon & Rectum (DC&R).Follow the Work: Connect with the team via @Campaign_52 on Instagram and Facebook to donate unused clinic supplies or join the surgical task force.Explore Global Relief: Learn more about broader international surgical placements through the American College of Surgeons' Operation Giving Back initiative.

Dr. Monique Hassan, a fellowship-trained bariatric surgeon and former Army surgeon, joins the podcast to share the philosophy behind her brand, "Surgery with Soul: Rooted in Purpose, Powered by Compassion."Dr. Hassan details her circuitous path to general surgery, motivated by a dramatic life-saving trauma case that cemented her commitment to becoming comfortable with the uncomfortable. She discusses how this led her to bariatrics, a specialty where she sees immediate, profound transformations.Fighting Stigma and Finding ConnectionDr. Hassan emphasizes that obesity is the only major medical problem carried externally, leading to constant judgment and systemic barriers in healthcare. Patients often take three to five years to seek help. She believes that for success in bariatrics, surgeons must go beyond technical skill and address the social issues that surround a patient's health, offering genuine empathy and support.Leveraging Social Media for ChangeDr. Hassan uses her professional social media to combat the pervasive misinformation about bariatric surgery. She finds that posts that are supportive, speak from the heart, and validate the patient's struggles ("Obesity is a disease; it's not your fault") resonate most strongly, helping patients feel seen and connected.The Power of IntentionalityTo build a reputation outside a major academic center, Dr. Hassan adopted a "Year of Yes" strategy, saying yes to every speaking opportunity to build a quality portfolio.Ultimately, Dr. Hassan would like to see more genuine diversity in surgical culture—in terms of race, ethnicity, and background—to ensure the profession reflects and better serves the patients it treats.Resources:ASMBS (American Society for Metabolic and Bariatric Surgery): Dr. Hassan is involved in the executive council of this national society.

In this powerful episode, we welcome Dr. Brian Williams, a trauma and critical care surgeon, Air Force veteran, and former Congressional healthcare policy advisor. Dr. Williams shares the intensely personal journey that led him to write his critically acclaimed book, The Bodies Keep Coming: Dispatches from a Black Trauma Surgeon on Racism, Violence, and How We Heal.Dr. Williams discusses how the 2016 mass shooting of police officers in Dallas—where he was the trauma surgeon on call—served as a pivot point, driving him to use his expertise to seek broader societal change. He offers deep insights into the unique burdens faced by surgeons of color, the necessity of humility in the operating room, and actionable ways all healthcare professionals can transition from clinical practice to policy advocacy.What You'll LearnThe Pivot Point: How the Dallas mass shooting was the impetus for him to make a serious change, building on years of internal realization that his impact needed to extend beyond the hospital walls.The Surgeon's Conflict: He speaks openly about the duality of a surgeon's psyche: the humility and feeling of "not enough" that drives continuous learning, balanced with the necessary confidence and bravado to perform life-saving procedures. He shares a humbling, early-career story about calling a code on a patient who was simply asleep, highlighting the core lesson of humility and attention to detail.The Weight of Life-and-Death Decisions: Dr. Williams reflects on the enormous responsibility trauma surgeons carry, living with the question of whether a different split-second decision could have changed a patient's outcome during a mass casualty event.The Burden of Black Surgeons: As a Black male physician, he discusses the burden of having to exceed standards to maintain credibility, and the emotional toll of dealing with overt and covert racism daily. He emphasizes that increased diversity in the workforce is essential for a better healthcare system and patient experience.Turning Expertise into Policy: Dr. Williams asserts that every healthcare professional has a voice and perspective needed by policymakers. He offers tangible, actionable ways surgeons can influence healthcare equity and policy, including:Writing Op-Eds based on research for a wider audience.Speaking at local City Council or Commissioners Court meetings about healthcare items on the docket.Getting involved with policy and advocacy groups within professional societies (like the ACS) or external organizations (like Doctors for America).The Head and the Heart of Advocacy: The key to successful policy influence is bringing both evidence (statistics and data) to make them believe you, and stories to make them care. Always offer a concrete solution when voicing a concern.Resources:The Bodies Keep Coming: Dispatches from a Black Trauma Surgeon on Racism, Violence, and How We HealDoctors for America

Malpractice litigation is a universal reality in medicine, yet it remains one of the most isolating and difficult experiences a physician will face. We break the silence with Dr. Gita Pensa, an emergency medicine physician, educator, and the creator of the groundbreaking podcast and resource platform, Doctors and Litigation & LEAP.Drawing on her personal 12-year legal saga that involved two jury trials, Dr. Pensa shares a story of trauma, resilience, and transformation. She challenges the conventional wisdom of "don't talk about it" and offers vital, humane, and strategic advice for surgeons and all physicians on how to survive—and even grow from—the harrowing experience of being sued.Featured:Hard Truths About Litigation: Dr. Pensa stresses: being sued or having an adverse outcome is not a verdict on the quality of your care. She challenges the misconception that the legal system operates based on medical logic and fairness, describing law as a "weapon" where strategy often dictates the outcome.The Danger of Isolation: Why advice to "not talk about it" is neither smart nor humane. She explains that physicians must be able to talk about the fact that they are being sued, their feelings, and the legal process without compromising the details of the medical care.The Process of Recovery and Growth: She shares her journey out of a decade-long crisis, detailing the need for both emotional processing and strategic education. She emphasizes that growth comes from having self-compassion, accepting help, and studying the legal process to become an "empowered defendant."The Surgeon's Struggle: Unique challenges in litigation, dealing with the direct physical cause of harm and their natural desire for control.Contending with Chronic Stress: Litigation is described as a "chronic disease with acute exacerbations" of terrible stress, prolonged by years of delays and uncertainty. She validates the difficulty of relinquishing control and dealing with prolonged stress, which is often compounded by feelings of guilt and responsibility.The Path Forward: Communication and Resolution: Learn about the power of honest and open dialogue with patients after an adverse event.About the GuestDr. Gita Pensa is an emergency medicine physician practicing in Rhode Island and an Adjunct Associate Professor at the Warren Alpert School of Medicine of Brown University.Resources:Doctors and Litigation: The L Word podcast and educational platform.A World of Hurt: How Medical Malpractice Fails Everyone: A 27-minute documentary focusing on the malpractice system and the value of Communication Resolution Programs.Communication Resolution Program (CRP): Models like the Michigan Model for open and honest dialogue with patients after adverse events.

Navigating a career in medicine can be a challenging journey, and sometimes, physicians face injustices and workplace conflicts that are isolating and overwhelming. In this episode of The Intentional Surgeon, we sit down with Dr. Pringl Miller and Dr. Andrea Merrill, the founders of Physicians Just Equity (PJE), to discuss their mission to support physicians and surgeons in the United States who experience workplace conflict.Dr. Miller, a board-certified general surgeon, hospice and palliative care medicine, and Dr. Merrill, a board-certified general surgeon and surgical oncologist, practicing breast surgeon, share their personal experiences with workplace injustices and how those challenges inspired them to create PJE. They explain how the organization provides peer support, education, research, and advocacy to help physicians navigate difficult situations without suffering reputational harm or career setbacks.Featured in this Episode:The Hidden Struggle: Discover why so many physicians, despite their training and competence, feel isolated and overwhelmed when faced with workplace conflict. Dr. Miller explains how PJE's mission is to provide a safe space and peer support for those who feel like they're "the frog in the boiling water."Recognizing the Red Flags: Learn to identify the warning signs that indicate you might need help. Dr. Merrill shares key indicators, such as a surprise meeting, a sudden decrease in referrals, or being placed on a performance improvement plan, and offers actionable advice on how to respond.A Guide to Getting Help: Understand the process of reaching out to Physicians Just Equity. Dr. Miller details how the organization provides one-on-one team peer support, Q&A sessions, and a comprehensive intake process to ensure a safe and confidential environment.The Power of Data: Hear how PJE is collecting crucial data on physician injustices to inform advocacy and drive institutional change. The guests discuss alarming trends, including an increase in unjustified dismissals of trainees, and how this impacts the future of the healthcare workforce.Stories of Success: Be inspired by powerful success stories, including that of a cardiothoracic surgery resident who overcame multiple dismissals to complete her training.About the Guests:Dr. Pringl Miller: A board-certified general surgeon, hospice and palliative care medicine with fellowship training in clinical medical ethics. She is the founder of the Surgical Palliative Care Society and Physicians Just Equity.Dr. Andrea Merrill: A board-certified general surgeon and surgical oncologist, practicing breast surgeon, serving as a peer supporter for Physicians Just Equity.

In this episode of The Intentional Surgeon, Dr. Sharon L. Stein speaks with Dr. Geeta Lal about the importance of surgical ergonomics. They discuss Dr. Lal's personal journey with surgical-related injuries, the cultural shifts needed in the surgical community to prioritize surgeon longevity, and practical tips for improving ergonomics in the operating room. Included in this conversation: The role of surgical ergonomics in surgeon wellness.Why surgical culture often minimizes our own physical health.Ergonomics can enhance both physical and cognitive performance.Breaks during surgery have been shown to improve both focus and performance.Tips for residents to use now in advocating for their own surgical longevity.The role of stretching and strengthening in preserving physical wellness.About Dr. Geeta LalDr. Geeta Lal is a board-certified General Surgeon (USA & Canada) with fellowship training in Endocrine Surgical Oncology. A tenured Professor of Surgery with a cross-appointment in Pediatrics, she has over 20 years of experience in thyroid and parathyroid surgery, including pediatric and re-operative cases. Dr. Lal is deeply involved in teaching surgical residents and medical students and has held leadership roles, including Co-Leader of her cancer center’s Endocrine Multidisciplinary Oncology Group and Associate Chief Quality Officer for Adult Inpatient Services. She maintains an active clinical research program with extensive publications on a variety of topics, including Surgical Ergonomics. She is a founder and first president of the Society of Surgical Ergonomics. She speaks, consults, and coaches internationally in the field of Surgical Ergonomics and details of how to engage hercan be found at https://surgicalergonomics.com/.Other resources discussed in the podcast: The Society of Surgical Ergonomics OR Stretch Video

In this episode, Dr. Sharon L. Stein is joined by Dr. Edward Barksdale, a renowned pediatric surgeon and mentor. Together, they explore the powerful concept of hope—how it influences both our personal and professional lives, especially for surgeons.Key Discussion Points:The relationship between vulnerability and resilience in surgery—why hope is not "soft" but an essential discipline that drives our actions, even in tough times.Dr. Barksdale and Dr. Stein discuss that hope is not a wish, but an active pursuit in which you maintain a positive orientation to develop the skill set to move in a direction toward goals.Dr. Barksdale reflects on a transformative trip to Nicaragua in 2007 that reinforced his belief in the power of hope as a strategic tool for creating positive change, both in surgery and in society.The importance of relationships—faith, family, and friends—as vital components in rekindling hope and helping us overcome challenges, both personal and professional.Hope as an active, intentional force that requires action and vision, particularly in times of crisis or despair.How small, meaningful actions—like reaching out to a friend or colleague—can have a profound impact on someone struggling with hopelessness.Highlights:Dr. Barksdale’s story of a young boy from Nicaragua illustrating how hope can move mountains when paired with action.The "Barksdale F’s": faith, family, and friends, as guiding principles for maintaining hope in the face of adversity.The concept of "antifragility," or how we grow stronger from adversity, and the role hope plays in fostering resilience.Dr. Barksdale’s involvement in the International Foundation for Education and Research on Depression (iFred) and his advocacy for recognizing the International Day of Hope on July 12th.Special Note on Mental Health:As part of the conversation on hope, Dr. Barksdale highlights the growing mental health crisis among healthcare professionals, particularly surgeons, and the importance of supporting each other. The episode includes a discussion on the need for better mental health care for surgeons, as well as practical steps to support one another during tough times.Resources:National Suicide Prevention Lifeline: If you or someone you know is struggling with thoughts of suicide, please reach out for help. Call or text 988 or visit 988lifeline.org.International Foundation for Education and Research on Depression (iFred): ifred.orgAbout Dr. Edward Barksdale:Dr. Edward Barksdale is a professor of surgery at the University of Chicago and serves as the Chief Surgical Officer of the Chicagoland Children's Health Alliance, which includes Advocate Children’s Hospital, Comer Children’s Hospital, and Endeavor Health. He is the second vice president-elect of the American College of Surgeons and the Executive Director for the Society of Black Academic Surgeons. With years of experience, Dr. Barksdale has been a mentor and leader, supporting others in navigating the challenges of surgery and life.Stay tuned for future episodes of The Intentional Surgeon as we continue to explore the culture of surgery and how we can change it—one intentional decision at a time.

In this deeply moving episode of The Intentional Surgeon, Dr. Sharon Stein welcomes Dr. Melissa Red Hoffman — trauma surgeon, hospice and palliative care director, writer, and former naturopathic doctor — for a conversation about the culture of surgery, vulnerability, and the power of integrated identity in medicine. Dr. Hoffman opens up about her nontraditional path, surviving violent loss, and how her experience in palliative care, trauma surgery, and chronic illness has reshaped her understanding of what it means to be fully present with patients — and with herself.Together, they explore the ego, the myth of perfection, mental wellness in medicine, and what it truly means to show up as a full human being in the operating room, in the ICU, and in life.Key Themes:The myth of perfection in surgical cultureEgo, excellence, and the quiet cost of strivingHow personal grief and professional identity intertwineVulnerability and safety among surgical colleaguesIntegration vs. balance: bringing your full self into your workCaretaking for loved ones as a physicianChronic illness and redefining what it means to thriveQuotable Moments:"We really are just human beings doing a very important, amazing, life-changing job.""Vulnerability isn't weakness — it's how we learn, grow, and lead.""Sometimes taking care of ourselves is not happy or easy... but it’s necessary."About Dr. Red Hoffman: Dr. Melissa Red Hoffman is a trauma surgeon, Associate Medical Director of Palliative Care, and Hospice Medical Director in Asheville, North Carolina. With a background in naturopathic medicine and yoga, she brings an integrative, human-centered approach to care. A powerful voice in the intersection of trauma, grief, and healing, Dr. Hoffman is also a published writer and speaker known for her honesty, compassion, and commitment to reshaping surgical culture.Resources:Making Meaning After Violent Death | Melissa Red Hoffman, MD, NDIn Shock: My Journey from Death to Recovery and the Redemptive Power of Hope | Awdish Rana