Today, we are joined by Dr. Will Bynum.

Will Bynum, MD, PhD., is an Associate Professor of Family Medicine in the Duke University School of Medicine. Prior to arriving at Duke in October 2017, he served for seven years on Active Duty in the US Air Force. Will's military service included four years of faculty duties in the NCC Family Medicine Residency Program, a deployment to East Africa as the senior medical director of a special operations command, and multiple overseas trips providing medical support to traveling congressional delegations. Will currently serves as the Duke Family Medicine Residency Program Director and Faculty Advisor to the Duke School of Medicine Student Wellness Committee. Will's primary academic interest centers on the role of self-conscious emotions (shame, guilt, and pride) in the medical learning experience. He has conducted some of this research through his PhD work in health professions education at Maastricht University in the Netherlands.

In the conversation, Dr. Bynum shares his journey from a service-oriented upbringing to becoming a leader in addressing shame in healthcare, exploring how authentic human connection forms the foundation of his work as both clinician and educator.

We also cover:

● His experiences in military service and the paradoxical psychological safety he found there compared to healthcare environments

● The personal crisis that led him to study shame in medical education and healthcare

● How storytelling and narrative serve as powerful tools for addressing shame

● The concept of "shame competence" and shame-sensitive practices in healthcare

● His vision for a more connected, authentic healthcare system that integrates humanities and creativity

Dr. Bynum concludes by reflecting on finding joy in his life through connecting with his family, building new experiences with his children, and creating work that feels meaningful enough to blur the line between profession and passion.

Dr. Bynum’s LinkedIn: https://www.linkedin.com/in/william-bynum-698a1889/

Website - Shame Space Consortium: https://www.theshamespace.com/

Chapters:

(00:00) Introduction

(01:45) Dr. Bynum’s Background

(04:00) Dr. Bynum's Path to Medicine

(07:15) Service-Oriented Family Influence

(10:30) Military Service Experience

(16:00) Journey into Medical Education

(18:45) Origin Story of Studying Shame in Medicine

(24:15) Storytelling as a Tool for Addressing Shame

(28:30) Comparing Military and Healthcare Environments

(34:30) Shame Competence and Shame-Sensitive Practices

(38:30) Creativity, Arts, and Humanities in Healthcare

(42:00) Imagining a Transformed Healthcare Future

(47:45) Personal Life and Finding Joy

(50:15) Conclusion

Resources/References:

The Shame Conversation Film: https://www.theshamespace.com/film

Dr. Brene Brown Ted Talks on shame and vulnerability: https://www.youtube.com/watch?v=psN1DORYYV0

https://www.youtube.com/watch?v=iCvmsMzlF7o

Bynum WE 4th, Sukhera J. Perfectionism, Power, and Process: What We Must Address to Dismantle Mental Health Stigma in Medical Education. Acad Med. 2021;96(5):621-623. doi:10.1097/ACM.0000000000004008

Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021;55(2):185-197. doi:10.1111/medu.14354

Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021;96(11S):S23-S30. doi:10.1097/ACM.0000000000004261

Today, we are joined by Charles Pfeffer.

Charles is an organizational consultant and executive coach with over 30 years of experience helping leaders harness their own and their organization's inherent ability to create change through learning and adaptation. He guides partly through his listening skills, honed through a life-long engagement with self-awareness approaches and group dynamics training, guiding his clients to clarify what they want – for their enterprise, their teams, themselves, and the world. Has assisted executives across many varied industries and organizations, including FedEx, Xerox, DuPont, and Medifast, to align teams, develop leaders, communicate rigorously, and produce results, and has coached teams with assignments ranging from bringing the world's first production digital color printer to market to safely closing the NASA Space Shuttle program. Collaborating with Nvolv Partners, Charles worked with Starbucks and Save the Children to align leadership, strategy, and talent, and has teamed with Brimstone Consulting on strategic change initiatives at the New York Times, ExpressScripts, and the State of Maine. Working with the pioneering DEI firm, The Kaleel Jamison Consulting Group, Charles helped to bring the power of inclusion to accelerate strategy deployment at Merck, United Airlines, and EcoLab.

In the conversation, Charles shares insights from his "accidental" journey into personal growth work and executive coaching, highlighting how he helps leaders navigate complexity and change while maintaining authentic purpose.

We also cover:

• The fundamental question he poses to clients: "What do you want?" and how this simple inquiry can unlock deeper purpose
• How organizations navigate change through disruption and the role of leaders in transforming systems
• The parallels between executive leadership challenges and healthcare professionals' experiences
• The connection between oath, authenticity, and purpose in professional identity
• His vision for healthcare environments that provide calm, competent care through better alignment of capacity and demand

Charles concludes by sharing his personal approach to flourishing, which includes time in nature - walking in the woods, kayaking, and skiing - as restorative practices that help him maintain balance while supporting leaders through complex challenges.

Website: https://www.charlespfeffer.com/

LinkedIn Page: https://www.linkedin.com/in/charlespfeffer/

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Chapters:

(00:00) Introduction

(01:15) Charles Pfeffer’s Background

(04:15) Charles' Journey into Personal Growth and Coaching

(08:00) Early Influences and Moving Beyond Blame

(10:30) The Concept of Polarities: Freedom and Responsibility

(13:00) How Executive Coaching Works

(17:00) Understanding Leadership and Organizational Complexity

(22:45) The Challenge of Integration in Healthcare Systems

(26:45) Complexity, Disruption, and Organizational Change

(33:45) Flourishing Through Authentic Purpose

(37:30) What Allows Charles to Flourish in His Work

(41:00) Imagining a Better Healthcare Future

(45:15) Personal Wellness Practices

(46:15) Conclusion

Today, we are joined by Dr. Carter Lebares.

Dr. Lebares is an Associate Professor of Surgery in the Division of General Surgery and the Director of the Center for Mindfulness in Surgery at the University of California, San Francisco. She is a gastrointestinal and bariatric surgeon who specializes in treating gastrointestinal disease, using minimally invasive surgery, such as robotics and surgical endoscopy. Her expertise includes treatments for reflux disease, obesity, early esophageal or gastric cancer, esophageal motility disorders, hernias, gallbladder disease and some kinds of biliary disease.

Lebares' research interests include resilience and mindfulness in surgery, mindfulness and nutrition in metabolic syndrome and obesity, the neuroendocrine and cognitive effects of stress on learning and performance. She has developed and studied a customized curriculum specifically designed for surgeons, the Enhanced Stress Resilience Training (ESRT), which has been demonstrated to improve burnout and global executive function.

In the conversation, Dr. Lebares shares her journey from biochemistry to academic surgery, driven by a deep commitment to advocacy and empowering others through resilience-building approaches.

We also cover:

• Her early experiences advocating for disadvantaged youth that ultimately led her to medicine
• The evolution of surgical training environments and challenges to physician wellbeing
• Development of the Enhanced Stress Resilience Training (ESRT) specifically designed for surgeons
• Her vision for systemic changes in healthcare to preserve medicine as a "pillar of civilization"

Dr. Lebares concludes by reflecting on finding joy in the simplicity of everyday life - being outdoors, connecting with people outside medicine, and appreciating ordinary moments that meditation helps bring into focus.

Guest: Carter Lebares, MD

Associate Professor of Surgery, Division of General Surgery

Director, Center for Mindfulness in Surgery

Principal Investigator, The Lebares Resilience Lab

University of California, San Francisco

Faculty webpage: https://generalsurgery.ucsf.edu/faculty/acute-care-surgery/carter-lebares,-md.aspx

Lebares Resilience Lab Website: https://carterlebares.org/

LinkedIn Page: https://www.linkedin.com/in/carter-lebares-a3970b8/

Selected Resources/References:

About Ann Masten PhD: https://en.wikipedia.org/wiki/Ann_Masten

Libby Zion Law: https://en.wikipedia.org/wiki/Libby_Zion_Law

Luton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Barlow E, Lebares CC, Lewis WG, Egan RJ; Welsh Surgical Research Initiative (WSRI) Collaborative. Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated. J Surg Educ. 2023 Oct;80(10):1395-1402. doi: 10.1016/j.jsurg.2023.07.017. Epub 2023 Aug 9. PMID: 37567800.

Luton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Lebares CC, Powell AGMT, Lewis WG, Egan RJ. Enhanced stress-resilience training for surgical trainees. BJS Open. 2021 Jul 6;5(4):zrab054. doi: 10.1093/bjsopen/zrab054. PMID: 34323917; PMCID: PMC8320339.

Lebares CC, Coaston TN, Delucchi KL, Guvva EV, Shen WT, Staffaroni AM, Kramer JH, Epel ES, Hecht FM, Ascher NL, Harris HW, Cole SW. Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials. Ann Surg. 2021 Mar 1;273(3):424-432. doi: 10.1097/SLA.0000000000004145. PMID: 32773637; PMCID: PMC7863698.

Lebares CC, Guvva EV, Ascher NL, O'Sullivan PS, Harris HW, Epel ES. Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience. J Am Coll Surg. 2018 Jan;226(1):80-90. doi: 10.1016/j.jamcollsurg.2017.10.010. Epub 2017 Oct 26. PMID: 29107117.