In this powerful episode of Epic Begins With 1 Step Forward, Zander sits down with acute care surgeon and author Dr. Daniel Eiferman to explore the emotional toll of medical mistakes and the extraordinary power of resilience. Daniel shares the devastating surgical complication that changed his career and inspired his mission to help healthcare professionals recover from failure. Together, they discuss physician burnout, self-doubt, the importance of peer support, and why even highly trained professionals struggle with emotional recovery. Drawing from his book, Cut Open: Surgeon Stories of Loss, Resilience and Growth, Daniel reveals how changing our relationship with failure can lead to personal and professional growth. This conversation reminds us that healing requires connection, compassion, and the courage to move forward.
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A Surgeon’s Worst Nightmare: The Mistake That Changed His Life With Dr. Daniel Eiferman
I am joined by Daniel Eiferman. Daniel, welcome. Tell us who you are and what you do.
Thanks so much for having me. I am what is known as an acute care surgeon, as what I do during the day, and then I masqueraded as an author as well. Most people would say don’t quit my day job as a surgeon.
You worked hard to become a surgeon. Perhaps don’t just give up on that 8 or 10-years of work that it took you to become a surgeon.
That is true.
As a multi-time author, I get it. My last name is not King and my first name is not Stephen. I’m not making enough money to survive, but it’s all good. It’s not the reason we wrote the books.
No, that is true. Although, I would have settled for breakeven money. Let alone how much I lost on the book, but you’re right. It was a passion project. Much about I’m sure some of the stuff we’re going to talk about now.
I always love to ask. Growing up, did you know that you wanted to be a doctor, to be a surgeon? Was it more like, “I want to be a cowboy or a fireman or doctor?”
An Unconventional Path to Medicine
It’s a great question. I’m going to tell you a story that I don’t think paints myself in the most flattering light, but it’s the truth. One of the formative things in my life was my parents’ divorce. It took nine years for my parents to get divorced. Unfortunately, my dad was not a nice man. We haven’t spoken since May 25th, 1993, when I made the decision that I didn’t want to be around him because he was just mean, for lack of a better word.
My father was a doctor. I remember in the middle of all the nastiness of my parents’ divorce, I came home one day. There was a gift basket that was taller than I was when I was eleven years old. I’m like, “What is this?” You go and you read it. It was from a patient that was thanking profusely and saying the nicest things about my father. I’m not kidding. I’m eleven years old when this happens. I said, “If you can be that much of A-hole and people think that you’re good, I’m doing that profession.” I’m not kidding you, that’s when I decided to be a doctor. That’s my story. It’s not glamorous.
It’s a good story. Epic does begin with one step forward. We all have multiple stories in our life of stuff that we ended up doing, and it is that one step. It’s what I build this whole show on, which is these big things that we do. The big epic journeys we go on start usually with the decision to do something. Obviously, you were eleven. I dare say your epic journey to become a doctor was at least twelve years for you just to be the doctor. Never mind the surgeon.
It depends on whether you count college or not, but most surgeons will.
College through med school saying you were probably 22 or 23 by the time that you got to be a doctor.
Twenty-five, but you’re right all about being one step. That happened then my parents’ divorce. The word security got to be a very big deal to me.
I can imagine.
I was like, “I want something. I want a job that is secure, that I’m going to be able to provide for my family.” That reinforced. If you’ve ever seen the numbers now, like with the shortage of healthcare providers they’re predicting, especially in surgery. I’m in a pretty secure profession. Now that I’m a dad and have three wonderful kids, I took one step forward when I was eleven, which led to the next step of learning how important security was and making a decision for my future. I was like, “Medicine is a secure future.”
The predictions of lack of doctors and stuff like that is scary thinking about the incredibly large aging population.
A childhood moment inspired Dr. Daniel Eiferman to pursue medicine, proving that unconventional beginnings can lead to impactful careers.
You’re preaching to the choir.
I get you. Everyone thinks about surgery and they think about the specialists, but the fact of the matter is, the general surgeons are the ones who do the majority of the operations. In fact, I had to go find one. Honestly, on September 9th, I had an inguinal repair.
You look pretty good for three weeks pro stop.
It was done with the robot. All of that is good. You’re like, “I need a doctor, but I don’t know. Where do I find one?” I happened to find a good one. At least so far the pain’s gone away. I don’t seem to be having any infections.
You don’t have a hematoma. You can walk all this stuff. This is good. I’m glad.
Exactly. I know one of the things that you talk about for doctors, surgeons is how to recover from what we’ll call the epic unexpected. Those things that happen in your job that shake your confidence. Is there a story for you behind that?
There is.
Maybe you want to share it.
I do, if it’s alright. It will take me about three minutes to get out if you’re okay with it.
It’s fine. We’re here to have a conversation. We all want to hear the story now.
The Devastating Complication That Shifted Everything
It just passed its ten-year anniversary in 2026, but six years into my career, I had the worst complication of my career. It happened when things were going well for me. My career was on an upward trajectory. I had just been promoted with tenure. I was finishing up my Master’s. I was in a good spot. I went to help another surgeon do a pretty difficult re-operative cancer surgery. I walked in and the tumor had gotten caught on one of the major blood vessels down in the pelvis.
I worked on it and I told you I was like, “I don’t think I can get this out.” He’s like, “It’d be good for the cancer if we got it all out.” We pushed on. I kept going. I’m doing every surgical trick I know to get this thing off and I can’t get it. On the very last thing that I do, I get into the artery. It’s like, “This is not good. Now we have to stop the bleeding. For the non-physicians out there tuning in, there’s two major blood vessels down there.
One goes and becomes the blood vessel to your leg. That one you have to protect. The other one goes to your pelvis and you can tie that one off and live without it. I was pretty convinced that I had gotten the one that you can tie off without problems. It was difficult, but I was pretty sure that’s what I was looking at. I got the bleeding to stop. The patient’s stabilized. I was like, “Everybody, we’ve got to be very conscious about this guy’s leg.”
After the surgery was over, I went to the intensive care unit. I was like, “This was abdominal surgery, but I need you to call me if there’s any problems with the left leg.” The night goes by, I go in to see him the next morning. He looks fantastic. He was making jokes with me, and laughing. I’m like, “Thank God.” To be safe, I left him in the ICU for another day. I came back the next morning. To this day, I remember exactly what I said to him. I said, “I’m sorry, sir. You look too good. I’m going to have to throw you out of the intensive care unit,” because he looked great.
That afternoon, I got a call from one of the vascular surgeons that said he was taking the patient to the OR for an amputation because I had not identified the anatomy correctly. That was crushing to me. The bandwagon or the soapbox that I got onto is I trained, as you alluded to before, eleven years after college or fifteen years, I wanted to get this job. Never once did anybody teach me how to deal with these emotions that just overcame me. The sadness and the self-questioning.
Once I was able to get better, I made it my mission that I was going to go out and talk about this stuff. That has been my goal since this happened, to go out and say, “Let’s talk about what it takes to become resilient. How do you stop the negative thought process in your brain? How do you help somebody else?” That was my sentinel event. It was 2016, and that has been my mission.
Accepting mistakes as part of the process gets you closer to mastery than constantly trying to avoid them.
Thank you for doing that. That’s so important because any profession, but especially doctors and stuff, surgeons, have the reputation, perhaps overblown by Hollywood of being total type A personality, go-getter. They’re good at their job but not very good at bedside manner. They’re so good that they will say, “I don’t care.”
You can tell me if you’ve ever seen this movie, but I wrote a lecture that I will give. It’s called There’s No Crying in Surgery based off of a League of Their Own.
I know League of Their Own.
I show some clips there when Tom Hanks is berating his outfielder and making the analogy of what it’s like sometimes to be a surgical trainee. Have you ever seen the movie Malice with Alec Baldwin?
I did.
Do you remember the scene where they talked to him about, “Do you think you’re God?”
Yes.
I put that in the presentation because that is some stereotype of the way surgeons are that if it happened, then we just move on to the next one. There’s nothing else that could have been done. The truth is, unless you have a gross personality disorder, most of us are human.
I talk about this in Epic Begins with One Step Forward, where failure is part of the journey. No one wants to fail. I could perhaps not pick up on something one of my mental health clients is saying, and I’m like, “They were more depressed this week and I could have helped them.” As a surgeon, you can fail, and unfortunately someone could lose a leg, they could die. However, not every surgery is going to be 100%.
I’ve shared this a lot, but a couple of years ago I crashed on my mountain bike. I shattered the head of my humerus.
That’s painful.
Yes, it was. I broke the shaft of my humerus. I had to have an ORIF because I had a commutated fracture. Now, if I’m doing something, I’m doing it well. Most people do 2-3 pieces. I blew that thing into nine pieces. That was in October. I go in for an appointment, and they’re doing an X-ray to see how I’m healing. It turned out that the shaft fracture hadn’t healed, and I broke the titanium plate that was in my arm.
I had to go in for another.
You had to have a revision?
Yes, and now it looks like I have a centipede. There’s this nice long plate and all these screws. Eventually, I have two shoulder surgeons and my orthopedic trauma surgeon. They’re like, “You will have to have a shoulder replacement at some point. It’s not a question of if, it’s just when.” I’m doing fine. I don’t seem to have pain, but sometimes you have a non-union of a broken bone. That happens. I have to say I didn’t pay particular attention when I was signing the thing. I’m like, “Okay. Whatever.”
Reframing Failure on the Path to Mastery
You bring up something that I try to talk about a lot when it comes to mistakes and gaining mastery. That is, If you change your relationship with failure and you say, “Those who accept that mistakes are part of the process to gaining mastery are more likely to progress to mastery than those who constantly just try to avoid mistakes.” We’re not taught that, I don’t think.
Whatever your job is, you don’t want to make mistakes. There are the jobs, a surgeon being one of them, where mistakes can have big consequences. Sometimes not as big, but yes. As godly as you all think you are, you put your pants on the same way that I put my pants on. You’re still humans. You still have feelings the way that we remember, “Who was your favorite teacher?” We all have one or two people that stand out in our mind of all the teachers that we had. “I like Mrs. Smith.”
I know as a mental health provider, I’ve got that one or two clients that I remember maybe because I saw what was possible. They then discovered it. You as a surgeon may have that. I can’t believe I pulled that off, or the patient that unfortunately loses their leg or something like that. We all have those but hopefully, you learn from those.
That’s the idea that is how we progress. I always tell people one of the best quotes that was told to me while I was in surgical training. “Good judgment comes from experience. Experience comes from bad judgment.”
Healing from a major setback starts when you open up to peers who walk in your shoes and understand the weight you carry.
We were talking before we got on about the lack of doctors. Some of it, the path is hard. One of the things that I believe I’ve seen, I can’t say for sure cause I don’t know. I’m old enough. I don’t have friends who are going through medical school, but it’s like, “We’re no longer going to make you do a 48-hour shift.”
That’s a positive thing. I look at the psychology side of stuff and go, “I can believe that someone who’s been on call for 36 or 48 hours is a heck of a lot more likely, psychologically may not be mentally as not necessarily as sharp, and they may make a mistake. It’s that old fashioned, “We did it. You have to do it.” Maybe that doesn’t work. Medicine has advanced. We’re not using ether anymore.
That is correct, we are not.
We’ve decided that perhaps giving people large doses of opium for painkilling might not be our best choice. There are other options. That may be the reason that people aren’t going into medicine because they’re like, “I don’t want to go through that.”
That’s a whole other subject.
That’s a big ball of wax.
Addressing Burnout and the Mental Strain in Healthcare
What you’re seeing now a lot too is a lot of physician burnout and physicians having a high rate of self-harm and things like that. You’re having a decrease in providers who’ve already had the investment of being trained out there, and that’s not good.
Again, I will draw this parallel, but let’s say I know it’s not exactly the same. I live in California. For me to be able to take the exam to become a licensed professional clinical counselor, I needed 3,000 hours of internship. That’s a long time. There were people that I went through graduate school with who got through or almost all the way through and said, “I don’t want to do this job. It’s not what I want to do.” I know there’s a huge need for mental health providers.
The fact that mental health is getting more talked about is great. What you’re talking about, part of that is the mental health aspect of how do I recover from that? How do I not freeze up in the operating room? How do I face that? I could say from a psychological standpoint. The longer you avoid it, the bigger the phobia becomes. Stuff is going to happen. I saw it with my dad, and this wasn’t even a medical thing. We lived in Boston.
Emotional recovery mirrors wound healing. It hurts during the initial inflammation, but time, tools, and care bring real healing.
He was walking, slipped, fell, and bruised his hip. He did not break his hip and did not do anything but then his fear of falling again. I kept going, “Dad, you got to just get out. Get back up on the horse. Get out there.” He never did it. I just watched how it grew and grew. I’m like, “That didn’t need to happen, Dad. You’re right, you could slip and fall. That does happen.” As a bike rider, there’s two kinds of bike riders. Those who have crashed and those who will crash. Once you crash, you go back into those who will crash.
I’ve heard that a lot. There’s two types of doctors. Those who have been sued and those who haven’t been sued yet. There’s also, the only surgeon who doesn’t have complications is the one who doesn’t operate. That’s life. How we bounce back from those is now what the differentiator is and plays into a little bit more.
My training was on how to cut, sew, read a cat scan, make a diagnosis, and things like that. We need a little bit more of your training in understanding our psychology, how to build trust with people, how to be listeners, and how to talk positively to yourself. Those are things that we are not great at traditionally teaching.
Sadly, that is true. Maybe that’s coming around. It’s hard to say how much personal mental health training is going on in medical schools, but just say it is important. If they have a heavy caseload, they’ll have a therapist just to have someone to talk to. When I was going through my internship, I did that because I’m like, “I don’t know what’s going to happen,” but literally every single course I took, didn’t matter what it was, about self-care.
I was an older graduate student. I didn’t go to grad school till I was 45. Perhaps, life experience said, “I understand that’s not like, ‘Once I got my license.’ The practice of self-care starts now,” and then you just continue it on. I was talking to my cohort when we started our practicum and our internships. I’m like, “If you’re struggling because you have to hold a lot of stuff.” You’re like, “I need someone to talk to.”
That allows me to get in one of the biggest things to stand on my soapbox, bang the drum or whatever it is. The number one thing that helps people get over a bad outcome. I’m speaking to you from a medical and surgical perspective, but it’s true from all of them. I’ll give the answer and I’ll give the explanation. It’s talking to somebody who does what you do. I always tell people at the time that awful complications that I explained to you happened. I’ve been married for sixteen years at that time.
The Healing Power of Talking to Peers
I have my beautiful wife, mom of the kids, best friend in life. Melissa’s not in healthcare. She’s not a doctor. She knew her husband was sad, but explaining to her the whole thing about how I misidentified the anatomy and all that stuff. My wife’s never been in the OR, minus her C-section to have our kids, but she’s never been on my side of the table. When I started healing, when I started healing is when other surgeons who did what I do picked me up. That is the drum that I want to beat. That we have to be there for each other. Somebody who does what you do, that’s who can support you.
I will dovetail off that. Another side of the work I do is with sibling survivors. People who’ve lost their siblings. Many years ago, I lost my older sister to murder. It’s a very lonely experience because we’re everywhere and we’re nowhere. No one’s acknowledging us. When I discovered a great organization, I sat on the board of the Compassionate Friends, which helps families that have lost a child or a sibling.
It’s exactly what you’re saying. When I get to talk to another sibling survivor or they get to talk to me, we get to have the conversations that we want to have. No matter how awesome my family is, my girlfriend, if you don’t know, and frankly, you don’t want to spend fifteen minutes trying to explain to someone about the thing that you want to talk about.
Versus, going in and going, “I misidentified this thing. I feel terrible.” That person goes, “I got you.” There’s so much power in, “Let me talk about the thing I want to talk about with someone who gets it.” Frankly, they may have some words of wisdom, but even if they don’t, acknowledging that they too have had those feelings of inadequacy, failure, self-doubt, or whatever. I’ve got to believe there’s surgeons get in and all of a sudden, stuff isn’t quite going the way you thought. It happens.
My favorite line when people say, “I wouldn’t know what to say when I reach out,” or something like that. You hit it on the head that this other person has the same experience, the same emotions. I always say, “You don’t have to say anything.” I say my favorite line is, “Don’t just say something. Stand there.” Being there and acknowledging you, being curious and asking questions, that alone makes a difference.
This is what I say to people when I’m talking about grief and stuff is, there is no miracle sentence that will make it better for me. I don’t have a miracle sentence for you, but that’s okay. Sometimes, even though it feels inadequate, I’m so sorry for your loss. I’m so sorry that didn’t go well. Honestly, that’s the best thing. We don’t have to have some huge platitude. You’re right, holding the space for you. It may not be comfortable for me, but if I can hold that space, there is so much more healing for you than me trying to come up with some platitudes.
Why There Is No Miracle Sentence for Pain
I would like your permission to use that. I like that. There’s no miracle because you’re right. There’s zero that I’m going to say that’s going to make you feel better at this moment. I’m here to help you heal, but I am not going to say something. All of a sudden, the complication and the emotion that you experienced or are experiencing is going to vanish. That is not realistic. The miracle sentence. Thank you for that.
You’re welcome. I’m trying to get it out there because it’s an important concept that you’re acknowledging that you don’t know what to say. There isn’t anything.
There isn’t anything that’s going to work but me standing by you. I will help you in the long run. We will get through this but you’re still going to grieve this. We’re still going to go through the grieving process of the complication, the grieving process of maybe how you felt about yourself as a surgeon and all that stuff. We’re going to have to go through all those stages together. We will get better. It takes time, but we will get better.
Here’s the other thing perhaps you could share with your fellow surgeons and stuff. Which is not that time heals. It’s just that we acquire more tools to know how to deal with those feelings that are coming up. That’s 30 years of me going through losing my sister that I can say, “It’s much better, but it’s because I have more tools.”
If something triggers me, I’m like, “I know what that trigger is.” Going back to the experience that you were talking about earlier. Experience tells us, “I know what that is.” You could walk into a surgical suite and there could just be a smell that, all of a sudden, triggers and then you’re right back there. Sometimes you can stop the train coming off the tracks or at least not have the derailment be the whole entire train.
Understanding the Emotional Stages of Wound Healing
In a lecture that I’ve always wanted to write but haven’t written yet, and you can tell me if you like this or not. It’s not just the act of time, but what happens in that time and wound healing. If I were to just cut you, we have a very good understanding of the wound healing process. In general, we talk about it being in three phases. Phase one, the inflammatory phase. If you take that in terms of like, “This just happened. I’m shocked. I can’t believe it.” That inflammatory response goes on.
We say it’s maximum around 3 to 5 days, and then it comes down on a phase one, then you go into phase two. We say that phase two goes to about you’re 6 weeks out, then it’s 6 weeks out, it tends to plateau out. The feelings and the emotions to me are the equivalent of that wound healing process. The area is no miracle cure or, in your world, miracle sentence that during that inflammatory phase is going to stop. It’s going to hurt. I’ve always told people, I went to the lab to work on painless surgery. All the experiments failed. This is the cost of doing business. If you have this bad outcome, it’s going to hurt for a little while. That pain will get better as that inflammation subsides and we begin to heal.
Daniel, you and I could sit here and talk for hours on end and still have more to talk about but I want to thank you so much for joining me. Where can people find you? Where can they find your book?
I appreciate you asking. I refuse to do all social media, but the people that I publish the book with maybe do LinkedIn. Maybe this is why my book isn’t selling as much as I wanted it to, but I am on LinkedIn. My book called Cut Open: A Surgeon’s Stories of Loss, Resilience, and Growth is on Amazon and all that stuff. Other ways to get in touch with me, I do have a website called IntegritySurgery.org. That’ll have how to contact me, some of the talks that I give, and then also links to buy the book. Again, I didn’t buy the book to make money, but I’d like to think there’s some pearls in there that may help bring about professional and personal satisfaction. That’s why the book’s out there.
I want to remind everyone that if you’re ready to begin your epic journey, go to EpicBegins.com. As always, remember, epic choices lead to the epic life that you want.
Important Links
- Dr. Daniel Eiferman on LinkedIn
- Compassionate Friends
- Cut Open: A Surgeon’s Stories of Loss, Resilience, and Growth
- Integrity Surgery
About Dr. Daniel Eiferman
Dr. Daniel Eiferman is a trauma surgeon, educator, and healthcare leader who has spent his career operating at the intersection of high-stakes medicine and human resilience.
In his new book, Cut Open: A Surgeon’s Stories of Loss, Resilience, and Growth, he pulls back the curtain on the emotional realities of surgical practice, from complications and difficult decisions to the leadership and mindset required to keep moving forward.
Drawing on decades in the operating room and academic medicine, Dr. Eiferman offers rare insight into how clinicians process failure, rebuild confidence, and support one another in one of the most demanding professions in the world.