The Journey to Better

Dr. Jasleen Tiwana - Fellowship to Finding Balance

Bill Lombardi welcomes Dr. Jasleen Tiwana, an interventional cardiologist practicing in Alaska who completed her high-risk PCI fellowship at the University of Washington, to discuss her journey from training to building a successful practice while balancing professional excellence and family life. • Dr. Tiwana's drive to become "the best" led her to pursue additional training in complex coronary interventions • The personality type that succeeds in high-risk PCI is one that "can't quite let it go" when faced with difficult cases • Learning to "fail fast" became a valuable principle both in the cath lab and in personal life • The myth that women cannot succeed in interventional cardiology while having children is firmly debunked • Building a community of supportive colleagues helps process challenges and complications • Advocating for personal needs in the workplace (like mini-fridges for breast milk) benefits everyone • Finding grace for yourself and your partner is essential when balancing two demanding careers with family life • Self-motivation techniques include speaking aloud during cases and setting time limits for strategies • Planning for potential complications creates a "safety blanket" that allows for bolder procedural approaches • Continued growth professionally and personally remains Dr. Tiwana's focus for the future @JTiwanaMD Send us Fan Mail

Dr. Greg Witkop - The Neuroscience of Resilience

Dr. Greg Witkop shares his journey from Army ophthalmologist to DARPA researcher, developing innovative approaches to mental health by combining neuroscience, psychology, and sleep medicine to heal trauma-affected brains. The conversation explores how trauma changes neural circuits and how we might reverse those changes to build resilience in military personnel, physicians, and first responders. • Loss of a military godson to suicide prompted Greg's deep dive into brain science and mental health • Military lost 7,057 troops in combat during 20 years of war since 9/11 but 30,000+ to suicide • Physicians are twice as likely to die by suicide than the general population • DARPA takes "home run swings" in research, attempting transformational rather than incremental change • Combining transcranial magnetic stimulation with cognitive behavioral therapy shows promising results • Sleep augmentation and meditation can create lasting improvements in brain function • Breaking down silos between neuroscience, psychology, and psychiatry is essential for progress • Purpose distinguishes pain (inevitable) from suffering (a choice) • The "stop, drop, and roll" approach for managing acute suicidal thoughts: stop making decisions, drop body temperature, roll toward social support • Creating cultures where vulnerability is safe requires true leadership, not just management If you like the show, share it with others. Reviews on Apple and Spotify help us get out to more people. Good luck on your journey and I hope this helps you be a little bit better. **Show Note** Wright Brothers’ first flight was December 17, 1903. https://www.darpa.mil/about/people/greg-witkop Send us Fan Mail

Dr. Primero Ng - Wisdom Beyond Procedures

Primero Ng, a recent high-risk PCI graduate who trained with Bill at UW, shares his experience transitioning back to practice in Australia and the challenges of building a complex cardiac program in a different healthcare system. Their conversation explores the differences between healthcare cultures, the importance of patient-centered care, and the personal growth that comes from stepping outside your comfort zone. • Moving between healthcare systems with different approaches to patient care • Developing a truly patient-centered approach where indications guide decisions rather than angiogram appearances • Building a complex PCI program from scratch requires focusing on culture, relationships, and small wins • The importance of deliberate practice and ongoing coaching even after formal training ends • Creating collaborative relationships with surgeons and the heart team • Finding work-life balance and keeping family priorities in perspective • Setting realistic expectations: building a program takes 3-5 years of consistent effort • The value of vulnerability and open communication in creating cultural change • Measuring success by process improvement rather than outcomes alone Send us Fan Mail

Dr. Rhian Davies - Mental Courage

Dr. Rhian Davies shares her journey from cardiology fellowship to becoming an interventionist specializing in complex high-risk PCIs and CTOs while balancing her passion for competitive horseback jumping. • Meeting Dr. Lombardi at a fellows course in 2018 despite initial intimidation • Transitioning from fellowship to practice and dealing with being the first female interventionist in her practice • Finding balance between professional responsibilities and personal passions • Mental and physical parallels between competitive jumping and performing complex interventions • Navigating a devastating elbow injury that threatened both career and personal identity • Learning to communicate honestly about struggles rather than suppressing emotions • Building genuine relationships with colleagues and creating community support systems • Developing mental preparation techniques for both riding competitions and complex cardiac cases • Recognizing the importance of maintaining passions outside of medicine for mental well-being "To truly enjoy this career, you have to be ready for not every case going as planned. This field is unbelievably rewarding, and the cases that go amazing and save lives are wonderful, but there are those that don't, and being prepared for that is important." Send us Fan Mail

Dr. Jesse Kane - Courage to Evolve

Dr. Jesse Kane shares his journey from interventional cardiology fellow to attending physician at the University of Vermont, exploring how his diverse training experiences shaped his approach to medicine and patient care. • Moving between different institutions exposes physicians to varying approaches and helps identify best practices • Redefining success means focusing on helping patients and being a good teacher rather than case volumes or technical metrics • Physical manifestations of stress during complex procedures can include tension headaches and pain • Building a supportive community of colleagues is essential for managing the psychological challenges of high-risk interventions • Creating clear boundaries between work and home life becomes increasingly important, especially when starting a family • Cultivating a team-oriented culture in medicine promotes innovation and growth • Simple strategies like keeping your phone out of reach at home can improve presence with loved ones • Medicine needs to preserve space for innovation and pushing boundaries, even when success isn't guaranteed If you're interested in joining this conversation or sharing your own journey, please subscribe to the podcast and share it with others who might benefit. Send us Fan Mail

Dr. Amy Cheney - Life After Training

After cardiology fellowship, physicians face critical career decisions balancing technical skills, personal fulfillment, and family demands that shape their professional trajectories. Dr. Amy Cheney shares her journey from UW fellowship to community practice, revealing insights about transitioning from academic to private practice settings. • COVID disruptions during fellowship created uncertainty but built valuable adaptability skills • First job after training wasn't the right fit despite appearing aligned with career goals • Finding practice partners with shared clinical philosophy proved essential for professional satisfaction • Working with another high-risk PCI operator provides both technical collaboration and emotional support • Learning to establish boundaries between work and home life requires intentional practice • Two-physician marriages need structured communication about schedules and childcare responsibilities • Women in interventional cardiology face unique challenges requiring confidence and resilience • Personal tragedy can ultimately enhance professional empathy and perspective • Finding mentors who share similar life circumstances provides crucial guidance • Academic concepts translate differently to community practice but remain valuable foundations We need to maintain work sustainability through proper boundaries and prioritizing family time. The culture of medicine is changing to value physician wellbeing alongside technical excellence. Send us Fan Mail

Dr. Gabe Charbonneau - Medicine Forward

Physicians aren't broken - the healthcare system is. Dr. Gabe Charbonneau joins Bill to discuss physician burnout and the hopeful path forward through solidarity, boundaries, and reclaiming joy in medicine. • Dr. Charbonneau shares his journey from rural Idaho inspiration to experiencing severe burnout in his first post-residency position • Medicine Forward was born from collaboration with Dr. Eric Topol to create a physician organization focused on the doctor-patient relationship and humanity in medicine • Two essential paths exist for tackling burnout: the inner path (personal boundaries and wellness) and system advocacy (changing the broken structures) • Perfectionism in medicine creates isolation and "terminal uniqueness" where physicians suffer alone rather than supporting each other • Physicians must learn to care for each other and model the compassionate behavior they want to see in healthcare • Current Medicine Forward initiatives include a documentary, coaching programs, and building communities of support for physicians • True leadership requires caring about people rather than just managing them - a critical missing element in healthcare systems To learn more or join the movement, visit medicineforward.org where you can become a member for $5 per year and connect with others working to fight burnout and reclaim the joy in medicine. https://x.com/gabrieldane https://www.linkedin.com/in/gabe-charbonneau-md-66978449/ Send us Fan Mail

100th Perspective - Dr. Aaron Grantham and Dr. Jarrod Frizzell

Dr. Bill Lombardi celebrates his 100th podcast episode by reversing roles, allowing his early guests Dr. Aaron Grantham and Dr. Jared Frizzell to interview him about his personal transformation and journey to better. • Discussing the "two steps forward, one step back" reality of personal growth and how to prevent falling all the way back • Recognizing physiological triggers when slipping into old patterns and using mantras like "I'm a good and worthy man" to reset • Moving from external validation to intrinsic worth by developing radical acceptance and forgiveness • Confronting past trauma, particularly from his relationship with his perfectionist father • Changing his approach to parenting by no longer defining success through academic achievement and finances • Evolution of the CTO space in interventional cardiology and recognizing the importance of psychological well-being • Finding purpose in serving others rather than in technical achievements • The importance of vulnerability and having supportive relationships when facing life's challenges • Recognizing that worthiness comes from within rather than external achievements I hope this episode helps you get a little bit better and I look forward to seeing you for episode 101. Good luck this week on your journey to better. Send us Fan Mail

Joe Green - Finding Purpose Beyond Performance

Joe Green, a former Olympic pole vault hopeful, shares how his journey from ambitious athlete to purpose-driven entrepreneur taught him valuable life lessons about failure, faith, and finding peace. • Growing up in a small mountain town, Joe developed an "aggressive curiosity" that fueled his various pursuits • Joe describes how witnessing a customer die from a heart attack at 24 sparked his realization that a job isn't everything in life • "You always end on a failure" – a pole vaulting lesson that taught Joe resilience and quick recovery from setbacks • "Full speed is safest" – why halfhearted commitment is more dangerous than full commitment in both sports and life • Finding peace at 28 when retiring from Olympic training to align with his evolving values and purpose • Joe outlines his "four tethers" theory for stability: physical health (downward), relationships (side-to-side), career (forward), and spiritual (upward) • The suicide epidemic among youth stems from lack of purpose and self-worth – how to help others find meaning • Joe and his wife's businesses focus on free enterprise and business ownership as vehicles for positive change • The importance of creating spaces for civil discourse where people can disagree respectfully and learn from each other "Whatever you're about to do, you have to be all in." Send us Fan Mail

Lisa Hunt - Walking Away From Shame

Lisa Hunt shares her transformative journey on the Camino de Santiago, a 500-mile pilgrimage across Spain that helped her shed lifelong burdens of shame and rediscover her authentic self. Her story illustrates how stepping away from modern life's shallowness and embracing vulnerability can lead to profound spiritual freedom. • Flight attendant Lisa felt called to do something deeper as she approached the age her mother was when diagnosed with cancer • A spontaneous trip to Barcelona and reflective journaling sparked healing and self-discovery • At the Cross of Montserrat, Lisa experienced a spiritual moment that called her to walk the Camino • The pilgrimage began mentally a year before her feet touched the path • Fellow pilgrims shared remarkably deep conversations without the "masks" people typically wear • At the Iron Cross, Lisa left a rock symbolizing childhood shame and limitations • A profound sense of lightness and freedom followed her surrender, symbolized by a rainbow appearing on her path • Lisa reclaimed her authentic self by confronting childhood shame, including a painful memory of being punished for her dress length • The journey transformed her approach to life, allowing her to live with boldness and authenticity • Lisa now strives to be a safe space for others to share their true selves Send us Fan Mail

Dr. Chris Burke - Surgical Collaboration: Breaking Down Siloes

Two cardiac specialists explore the transformative power of medical collaboration, discussing how cross-specialty partnerships are revolutionizing patient care and creating space for innovation. They examine how breaking down traditional silos between cardiac surgery, vascular surgery, and interventional cardiology leads to better outcomes and professional growth. • The evolution of cardiac surgery from siloed approaches with arbitrary anatomic boundaries to collaborative, technology-driven care models • How Dr. Chris Burke revitalized the Ross Procedure program by partnering with a pediatric surgeon, creating a program that has now completed over 140 procedures • Building institutional cultures that support innovation while managing the inherent risks of pushing medical boundaries • The emotional toll of high-stakes surgery and strategies for maintaining equilibrium when facing poor outcomes • Why medical professionals need formalized emotional support and coaching throughout their careers, not just during crises • The importance of separating decision-making quality from outcomes when evaluating surgical performance • How collaboration across institutions through registries and consortiums accelerates learning and improves care Share this episode with others who might benefit. Leave us a review on Apple and Spotify, or reach out with questions or comments via email, text, or DM. Good luck on your journey to getting better. https://sites.uw.edu/uwmtap Send us Fan Mail

Dr. Sarah Samaan - Boundaries

Sarah Samaan Sarah, MD, FACC, FACP, FASE, a retired cardiologist turned physician coach and art educator, explores how visual thinking strategies and leadership coaching can transform healthcare culture and combat physician burnout. • Completed Harvard's visual thinking strategies program using art to develop communication, collaboration, and comfort with ambiguity in healthcare • Visual thinking involves group art observation with two key questions: "What's going on in this picture?" and "What do you see that makes you say that?" • Art-based approaches help physicians develop emotional intelligence and openness to multiple perspectives • Many physicians struggle with time management, EHR burdens, and leadership issues that contribute to burnout • Leadership in medicine often lacks proper training, with many promoted for technical skills rather than leadership abilities • Facing dilemmas (choices with no perfect solution) requires different skills than solving problems with clear answers • Competition, volume metrics, and ego-driven incentives are destroying medicine's culture • Setting boundaries is crucial - integrating personal values with professional values prevents saying yes to work while saying no to family • Create a personal mission statement to guide decision-making aligned with your true priorities • Free values workbook available at mindfulphysiciancoaching.com Send us Fan Mail

Joy Glasser - The Art of Self-Awareness

Joy Glasser, a certified leadership coach with over two decades of experience, shares insights on how coaching differs from therapy and addresses the unique challenges physicians face in their professional lives. She illuminates pathways to self-awareness, better leadership, and finding balance in a demanding healthcare system. • Coaching fundamentally differs from therapy—coaches believe clients aren't broken and need no fixing • Physicians typically struggle with being "fixers" while lacking self-awareness about their own needs • System pressures create burnout with physicians feeling pushed to perform without adequate support • Self-leadership starts with being present and making intentional choices rather than reactive decisions • Building trust requires vulnerability and honesty, both with oneself and with colleagues • Finding time for self-reflection isn't about having more hours but prioritizing meaningful presence • Dealing with uncertainty means shifting from hope (expectations) to wonder (curiosity) • Putting your phone in airplane mode creates space for genuine connection and self-awareness If you're looking for a coach to help you get to the next level, contact Joy Glasser at Glasser Group. https://www.glassergroup.net/ Send us Fan Mail

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Samantha Propper - Beyond Technique: The Human Side of Procedures

Samantha Propper, founder of "Don't Miss a Beat" joins Bill to discuss the challenges and solutions for creating better cath lab environments through improved communication, education, and psychological safety. • Sam's journey from cardiovascular technologist to educator and founder of educational resources for cath lab professionals • Creating visual educational resources that bridge knowledge gaps for staff at all experience levels • How understaffing and lack of structured orientation contributes to high turnover in cath labs • The psychology of fear that affects both physicians and staff during procedures • Why learning happens best through failure, not success • The importance of practicing complication management, not just routine procedures • How physicians can create psychological safety by inviting questions and feedback • Practical strategies for preventing burnout among experienced staff • Teaching outside the procedure room to build skills in a low-stress environment • The value of curiosity and compassion as foundational qualities for team members If you're feeling unvalued in your lab, consider what specifically makes you feel valued – each person's needs are different. If you're a leader, ask your team members directly what makes them feel appreciated rather than assuming you know. Don't Miss a Beat on X - https://x.com/dontmissabeat_x https://www.linkedin.com/in/samanthapropper183/ https://dontmissabeat.store/ Send us Fan Mail

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Robert Ricker - The Team Leadership Paradox

Robert Ricker shares his transformative journey from competitive, achievement-driven professional to a leader focused on building meaningful connections through vulnerability, reflection, and authentic listening. His story illustrates how personal growth requires challenging your identity and developing new skills to create environments where others can thrive. • Transitioning from going fast alone (competitive individual contribution) to going far together (collaborative leadership) • Recognizing when achievement-focused behavior limits connection with colleagues and loved ones • Developing practices for self-reflection including meditation, faith, and deliberate communication changes • Creating a "three-second rule" before responding to allow others space to share • Understanding the difference between listening (hearing words) and truly hearing (comprehending meaning) • Building vulnerability as a leadership strength that fosters trust and psychological safety • Recognizing that "none of us will ever be as smart as all of us" in team environments • Measuring growth by how people feel after interactions and if they reach out spontaneously • Using mirroring techniques from negotiation practices to demonstrate genuine curiosity • Finding balance between execution and relationship-building in professional settings None of us are perfect, but by practicing vulnerability, active listening, and creating safe environments, we can build stronger connections with those around us and achieve more together than we ever could alone. Send us Fan Mail

Dr. Odayme Quesada - Breaking Barriers

Bringing to light the incredible journey of Odayme Quesada, MD, MHS, FACC FAHA, FESC, Endowed Chair in Women’s Cardiovascular Health, Board-Certified Cardiologist, Medical Director of The Women’s Heart Center, Physician Scientist, Assistant Professor University of Cincinnati, this episode offers a unique perspective on women's heart health and the challenges professionals face in the medical field. We discuss key moments in her life that have shaped her career, emphasizing the importance of mentorship and representation. - Dr. Quesada's childhood in Cuba and the transition to Miami - The pivotal role of mentorship in shaping a medical career - Insights from the summer programs at Yale for underrepresented minorities - Challenges women face in receiving proper cardiac care - The importance of collaborative approaches in cardiology - Addressing systemic biases in diagnosing women with heart conditions - Future opportunities in cardiology and empowerment through education - Inspiration for aspiring medical professionals to embrace their unique journey Thank you for listening! Please share this episode and leave us a review. https://x.com/OdaymeMD https://www.linkedin.com/in/odayme-quesada-md-mhs-facc-faha-fesc-2021605a/ Send us Fan Mail

Dr. Larry Sperling - Navigating Moral Injury

We sat down with the esteemed Dr. Larry Sperling from Emory University to uncover the fascinating intersections of personal stories and professional insights in medicine. Larry's journey from his Northeast upbringing to his pivotal role in preventive cardiology at Emory is a tapestry woven with global health initiatives and familial roots tracing back to Lithuania and Ukraine. Through his narrative, we explore the profound impact of personal history on professional paths, all while addressing the pressing issue of moral injuries within the medical field. Our discussion with Larry highlights the critical need for cultural evolution in healthcare. We examine the daunting challenge of burnout, advocating for systemic changes that go beyond individual resilience. The conversation reveals the importance of supportive microcultures in clinical settings and the shift towards acknowledging burnout as a significant issue. By advocating for servant leadership and collaborative teamwork, we emphasize the role of a nurturing environment in enhancing physician well-being and improving patient care. As we round out the episode, we delve into the essence of teamwork, collaboration, and the celebration of every role within the medical profession. From fostering mentorship to addressing institutional silos, we discuss strategies for sustainable growth and workplace harmony. Larry and I reflect on the importance of spreading grace and compassion in our professional lives, encouraging a culture where each member's contributions are valued. Join us in this enlightening episode as we advocate for a more humane and equitable healthcare system, where both personal and professional lives can truly flourish. https://providers.emoryhealthcare.org/provider/laurence-s-sperling/777032 https://familyheart.org/dr-larry-sperling-appointed-as-chief-medical-officer Send us Fan Mail

Jesse & Rebecca Gibson - Turning the Tables

This episode delves into the intersection of healthcare professional experiences and patient care, as Jesse Gibson and Rebecca Gibson, PA-C share their own stories of vulnerability amidst health crises. The conversation emphasizes the need for empathy, open communication, and emotional understanding in creating a more compassionate healthcare environment, inviting listeners to reflect on their own experiences in fostering human connections within medical practice. • Jesse recounts his experience with chest pain and vulnerability as a healthcare provider • Rebecca discusses the emotional toll on healthcare professionals when facing patient crises • The importance of empathy and compassion in patient interactions is highlighted • Tackling compassion fatigue and maintaining a sense of human connection in healthcare • The call for open communication regarding uncertainties in healthcare is emphasized • Encouraging vulnerability among healthcare providers to strengthen patient relationships • The role of patients and providers in shaping a more empathetic healthcare culture • A shared responsibility in improving the emotional well-being of both patients and providers is proposed https://www.hmpgloballearningnetwork.com/site/cathlab/content/my-experience-other-side-our-job https://doctors.premierhealth.com/provider/jacob-b-gibson/1779782 Send us Fan Mail

Drs. Najah Khan and Merna Abdou - The Impacts of Covid on Medical Training

This episode dives deep into the experiences of Dr. Najah Khan and Dr. Merna Abdou, two cardiology fellows, as they discuss the impact of COVID-19 on their training and patient care. They share personal stories of trauma, the importance of spirituality in healing, and the necessity of compassion in modern medicine, urging the healthcare community to reconnect with humanity and prioritizing quality of life for their patients. • Insights on how COVID-19 reshaped their medical practice • The role of spirituality in patient care discussions • Moving from treating numbers to prioritizing quality of life • Building supportive environments in medical training • The necessity of vulnerability and empathy in healthcare https://x.com/najahakhan https://x.com/MernaAbdou28 Send us Fan Mail

Matt Bowen - Carrying the Flag

Matt Bowen shares his inspiring journey of transforming his health and channeling it into honoring Gold Star families through running. He discusses the emotional ties with veterans, highlights his experiences with Operation 300, and encourages listeners to actively show compassion. • Matt's transformation from military service to medical sales • The power of fitness in regaining control over personal health • The significance and emotional weight of carrying the American flag • Overview of Operation 300's mission for Gold Star children • Engaging stories of empathy and connection on the race course • The importance of simple acts of kindness in supporting veterans https://operation300.app.neoncrm.com/forms/matt-bowen-marathons Send us Fan Mail