Hard Lessons And Curveballs

In every surgical specialty, there exists a quiet mythology about resilience: the unspoken belief that surgeons stand firm in storms, compartmentalize discomfort, and push forward with unbreakable focus. But behind that mythology lies the real work—human beings navigating hardship, heartbreak, self-doubt, and the weight of responsibility for the lives of others. At our recent American Society for Metabolic and Bariatric Surgery (ASMBS) Weekend meeting in November in Louisville, Kentucky, a session titled “Hard Lessons and Curveballs: The Tough Moments in Bariatric Surgery” peeled back that veneer and revealed something far more profound than any of us anticipated.

The concept was simple but bold: Invite some of the most experienced and respected leaders in metabolic and bariatric surgery to step onto the stage without slides, without data, and without the safety of academic detachment. Ask them instead to speak from the heart. To recount personal stories—not just of clinical complications, but of life’s complications. To let the audience see not the polished professional, but the human being who grew, adapted, and persevered.

This shift in focus was deliberate. All too often, surgeons are asked to speak about a disease, a procedure, or a technical nuance, but rarely about resilience, adversity, or the deeply human work of overcoming hardship. “Hard Lessons and Curveballs” was designed to make space for precisely those conversations.

What unfolded was unlike anything our society had witnessed in years.

I was very worried, admittedly, about how it would be received. Surgeons are conditioned early on to hide their tremors, silence their doubts, and tuck away their grief. But the room filled quietly at first, then rapidly. Chairs were added. Walls lined with people. Within minutes it became clear that this session—intentionally vulnerable, intentionally raw—was striking a nerve. It was soon standing room only, and by the end, it was the most talked-about course of the entire meeting.

Image: Adobe Stock

The emotions came in waves. Loud laughter in one moment, a deafening hush in the next. There were points when boxes of tissues appeared spontaneously, passed around as if the audience had silently agreed to set down their armor together. This was not a lecture; it was a collective exhale.

The stories themselves spanned the breadth of the human condition. There were narratives of immigration, of leaving behind countries, families, languages, and safety nets to pursue the improbable dream of becoming a surgeon in the United States. There were tales of illness, divorce, heartbreak, and the challenge of reconciling personal loss with the need to show up in the operating room the next morning with unwavering steadiness. There were accounts of domestic abuse, healthcare crises, financial instability, and professional setbacks that threatened to shake careers off their foundations.

But woven through each story was a lesson—something that linked these personal storms back to who the speaker became as a surgeon. Many spoke of the hubris that can accompany early surgical success, and the danger of believing that grit alone is enough. Others emphasized the moments when they waited too long to ask for help, both in life and in the operating room, and how humility became one of the most sacred tools they learned to cultivate. Several talked about the cases that haunt them still—patients who suffered complications despite the best intentions, patients whose names remain etched on the psyche.

It was here that a recurring quote by French surgeon and philosopher Rene Leriche echoed across the session:

“Every surgeon carries within themself a small cemetery, where from time to time they go to pray – a place of bitterness and regret, where they must look for an explanation for their failures.”

It is a sentiment that every seasoned surgeon understands instinctively. Our training teaches us to analyze, to deconstruct, to prevent mistakes—but not always to grieve. And yet, the “cemetery” is real: a quiet place in our minds where we visit the memory of patients who endured unexpected complications or outcomes that shook us. What this session made clear was that honoring that cemetery does not weaken the surgeon; it strengthens the human being behind the scalpel.

Audience members later described the session as cathartic, overdue, even transformative. One text message read simply, “That’s the best segment I’ve attended in any conference, Thanks!!!!” Another wrote that they had spent years suppressing difficult memories and suddenly felt permission to acknowledge them. Another expressed that they no longer felt alone in struggling with personal hardships. The session validated something deeply felt but rarely spoken: that the personal and professional selves of a surgeon are not separate strands, but a woven rope—each strengthened or frayed by the other.

The courage on that stage was astounding. These were respected leaders—people who have led societies, chaired departments, authored landmark papers, shaped guidelines, mentored hundreds of surgeons—openly discussing fear, doubt, mistakes, and life’s most fragile moments. In doing so, they modeled a different kind of leadership: one rooted not in perfection, but in authenticity.

“Hard Lessons and Curveballs” became more than a session. It became a mirror. It showed us that resilience is not forged by pretending to be invulnerable, but by acknowledging what has tried to break us and choosing to stand anyway. And in a specialty defined by technical excellence and outcomes metrics, it reminded us that the heart of surgery still beats strongest when surgeons allow themselves to be human.

If anything, this session revealed an unmet need in our surgical society. Surgeons hunger not only for new techniques, innovations, and data—they hunger for connection. They hunger for spaces where the complexities of this profession can be acknowledged without judgment. They hunger for reassurance that resilience is not the absence of hardship, but the alchemy by which hardship is transformed into wisdom.

In the end, the success of this course was not about attendance numbers or reviews. It was about the realization that behind every surgeon is a story, often untold, that shaped them far more powerfully than any textbook ever could.

And for one unforgettable 90-minute session, those stories finally had a home.

Dr. Dan is a professor of surgery at Northeast Ohio Medical University – Summa Health System, in Akron, Ohio. He is the program chair for the ASMBS Weekend 2025 and the ASMBS national annual meeting 2026, and he serves on the ASMBS board of directors.