It was a precious weekend. I recently spent time with some of my best friends and colleagues at the latest in a long series of strategic retreats we’ve held over the last 20 years. These guys—my “Middle Way Brothers”—have been an incredible source of strength and wisdom through all the ups and downs of a hectic two decades of career and family. I don’t take this peer group for granted; I know how lucky I am. At a recent meeting, even our keynote speaker, the award-winning author Angela Duckworth, remarked on the profound benefits of navigating life with like-minded friends focused on making each other better.
Our agenda covered a host of topics, but the themes of Stoicism and legacy ran deep. We reviewed the works of one of my favorite authors, Ryan Holiday, and shared perspectives on how to integrate the practical lessons from this age-old philosophy into this new phase of our lives.
One of my favorite Stoic mantras is “Amor Fati” (Love of Fate). This is the idea of not just accepting what happens to you, but embracing and even loving it. It means seeing every challenge, obstacle, and setback as an opportunity for growth and a necessary, vital part of your journey. I’ve certainly had my own recent opportunities to practice this.
A Toolkit for Legacy
One of the most practical exercises for setting priorities and accepting change is “negative visualization.” In fact, many high performers habitually visualize their “Last Game.”
This profound sentiment—”playing every game as if it’s your last”—resonates with existential urgency. Its essence is to embrace the impermanence of our situation. This mindset forces us to ask the hard questions, navigate the inevitable uncertainties, and decisively prioritize our efforts and time in a way that guarantees meaningful growth.
The Final Operation
The moment I looked at the MRI, I instantly knew my reality. Years of surgery and paddle tennis had taken their toll; the image of my torn rotator cuff was a clear sign that I needed a break. As a scoliosis surgeon, my summers are a relentless schedule of operations—families eager to get their children’s surgeries done before the new school year begins. So, on August 29th, after operating nearly every single day of the summer, I prepared for one final case. Days later, I would become the patient, with Dr. Ahmad operating on my shoulder, starting a ten-week recovery.
But as I stood in the operating room that day, a different, radical thought struck me: What if this was my last surgery ever?
Here was an immediate opportunity to rehearse that inevitable day, to approach this final operation as if it were the end of my career. As I finished and thanked my team, time seemed to slow down. I was overcome with a profound sense of gratitude—not just for the people in the room, but for every event and opportunity that had led me to that moment. And for the sequence of events that have allowed me to care for so many children over the decades. I grasped the extraordinary privilege of helping so many children and families.
It Was Enough
I looked around the room and knew I was utterly, resolutely at peace. If this had been my last surgery, it would have been enough.
It was all okay. I have helped more than 3,000 kids with complex spine issues, and I realized this next stage could simply be an opportunity to forge other avenues for legacy and impact. That moment—that clear-eyed visualization of the end—did more than just calm my nerves. It cemented my focus on the extraordinary opportunity that is the present and affirmed the vast potential that is ahead.
I didn’t just accept my fate that day; I loved it. And while there may in fact be time to continue to make a difference in kids’ and families’ lives through spine surgery, there is no doubt that a day will come when we need to be prepared to transition from the Strengths that have served us well in the past to a new set of Strengths and priorities. Exercises like this ready us for the transition. Are you ready to think about the seeds that need to be planted for the next stage of your garden? Ryan Holiday can help.
