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

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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

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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

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