I was honored to be invited to speak to my neurosurgical residency "alma mater" as a part of their popular Fridays With Friedlander lecture series. The topic "How a Neurosurgeon Deals With Fear" is an important one for surgeons, and it permitted me to discuss in detail some of the ideas contained within my book "Cognitive Dominance: A Brain Surgeon's Quest to Out-Think Fear".

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Thank you. It's great to be here. As I began to prepare for this talk I had three thoughts in mind…, one was  excitement, then gratitude and fear and excitement because this is a reunion for me. It's really special to be back. I feel like I'm in the conference room talking to you and to know that Dade  and John and Ian and Jeff Balzer…, all of my mentors are there and to think Joe Maroon and Ed Dixon are  there as well as maybe my my co-resident Peter Gersten whose father taught me in medical school  and pathology and Mike Ortigliano. If you're out in Westmoreland county, a  big hello, but also the staff. It was really special to hear that Melissa is still there and she's helping. She was there when I was there as a resident and Wendy Fellows, so  this is good.

Good to see Wendy and Darla and Ava Lois Desiree. It's remarkable that you've committed so much to the department… so much time and energy, so it was excitement and then also is gratitude…, truly gratitude.

It's an honor to speak to you today; to pay homage to the department and to Dr Jannetta and it's really a special day in my  career and I thank you for that opportunity.

And then lastly fear. I give a lot of talks uh but this one I had a higher level of fear for, and it was different because to me you are all the experts. I'm a  generalist, so I had this extra dollop of fear, but I also thought it was appropriate because this talk is about fear, and how can we metabolize it.

So I thought I'd start with a quote from another Pittsburgh surgeon. You may  have heard of this person. I'll read the quote and then I'll see if the audience can come up with the person.

“For the past six years I had honed my  surgical abilities at the same time I harbored anxieties which I was unable to discuss  openly until more than three decades later after I had stopped operating. I had an  intense fear of failing the patients who had placed their life and health in my hands. Far from being relieved by each new layer of skill or experience, the anxieties grew worse. Even for simple operations I would review books to be sure that no mistakes were made or old lessons forgotten, and then sick with apprehension I would go to the operating room almost unable to function until the case began."

Can anyone guess who that might be?

Tom Starzl father of transplant  surgery. So since Dr Starzl's quote is really  about when he was a resident and it's in his book called “The Puzzle People” which is a wonderful book that I suggest you read I'd like to dedicate and focus this talk to the residents.