In this episode, I sit down again with my friend and what may soon be our “periodic co-host,” Dr. Rob Orman. Rob is a physician, coach, and host of the Stimulus Podcast, and he works extensively with physicians facing burnout, behavioral challenges, and high-stakes pressure.

We focus on one central idea: how to expand the space between stimulus and response. So many talented clinicians and leaders aren’t struggling with competence, they’re struggling with reactivity. Rob walks us through practical, research-backed tools for regaining control under pressure, including objective self-observation instead of forced positive affirmations, performance-based visualization that improves technical precision, and the intentional use of cue words to anchor calm focus.

We also explore what Rob calls “state gratitude”. Not a personality trait, but a deliberate shift in the moment that reduces limbic activation and lowers stress response. For leaders in healthcare, especially those operating in emotionally intense environments, this is not soft thinking; it is physiology.

We close by discussing breathwork. Specifically, the one-to-two inhale/exhale ratio through the nose, as a direct way to downregulate the nervous system when thinking alone isn’t enough. This conversation is about maturity under pressure, about responding rather than reacting, and about building the internal discipline that high-stakes leadership demands.

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