Anxiety, Fear, and Creativity: A Surgeon’s Guide to Moving Beyond the Spiral
We are living in an anxious world. Between the news cycle, productivity demands, and medicolegal and reputational pressures, it’s no wonder surgeons live in a near-constant hum of angst.
Anxiety follows us from the OR to the clinic, from patient to patient, and finally into our personal lives, affecting how (and if) we show up for our families. Many of us have learned the standard advice: breathe, compartmentalize, meditate, be grateful, chill the F out, etc. Maybe we’ve tried them and had some degree of success. But those tools often fall short. A hijacked nervous system needs recalibration, not yoga or gratitude.
So how do we actually work with anxiety instead of against it?
In this essay, I want to help you understand anxiety not just as a human, but as a surgeon. I want to teach you how to use anxiety as a path into creativity, curiosity, and ultimately, freedom.
What Anxiety Really Is
Anxiety is your primitive brain’s response to an imagined scenario.
By definition, when you’re in anxiety, the thing you’re most afraid of isn’t happening in real time. It lives in the future, not the present moment.
Neuroanatomically, anxiety resides in the left amygdala—the small, almond-shaped structure deep in the brain that processes threat. And the left amygdala, specifically, is tied to our language and analytical centers. This means that once we start spinning in anxiety, we can narrate and analyze it indefinitely.
It’s like driving over those tire spikes in a rental car lot: you can move forward, but you can’t back up. Once you’re in the anxiety spiral, the language and imagination of your left brain keep you stuck there. Your story corroborates the anxious energy, fueling more anxiety, and that energy leads to more anxious thoughts. It’s a terrible, vicious cycle.
Even when you’re safe at home in bed, your mind wakes you up at 3 a.m. demanding that you worry about that patient with the postop hematoma. You took them back to the OR, stopped the bleeding, and tucked them in. The surgery is over, the plan of care is in place, and both you and the patient are safe, but your mind insists there’s danger. That’s the anxiety spiral in action.
How Our Culture Trains Surgeons to Be Anxious
From the first day of medical school, we’re taught to strengthen our left brain: memorize, analyze, categorize, and recall.
This training is essential. We need logic and precision to safely operate. But the unintended consequence is that we’ve learned to overdevelop the analytical and underdevelop the intuitive, creative, and connected parts of our brain.
We’ve become masters of reasoning and evidence, but amateurs at presence and self-compassion.
The result is a profession filled with brilliant, high-performing individuals who are silently spinning in anxiety.
And anxiety spreads.
It’s contagious. Anxiety is amplified by our mirror neurons, the neural networks that help us empathize and connect. When we’re surrounded by anxious colleagues, anxious staff, and anxious patients, our own nervous systems mirror that energy. Those of us who are highly sensitive and empathetic are especially prone.
You’ve probably felt it: the anxious patient who demands absolute certainty that nothing will go wrong in surgery. “How many of these have you done?” they ask leaning forward in the exam chair, their voice shaky, their hands fiddling. You explain the risks and benefits calmly, but their fear seeps into you. You leave the exam room and find yourself buzzing with their anxiety.
I used to literally shake it off, like an animal shaking off adrenaline after escaping a predator. I had to shake off the previous patient’s anxiety before walking into the next exam room, or else bring that energy with me into the next patient encounter.
That’s how contagious anxiety is. Multiply that by twenty patient encounters and add your own anxiety into the mix, and it can feel untenable.
You Can’t Erase Anxiety; You Can Replace It
Here’s what doesn’t work: trying to “calm down.”
When has telling someone to calm down ever worked?
You can’t erase anxiety, and you can’t suppress it. What you can do is replace it. Shift it into another, more useful emotion, like excitement, curiosity, or creativity.
Excitement and anxiety feel almost identical in the body: racing heart, quick breathing, high energy. The only difference is the story we attach to the sensation.
So when anxiety hits, instead of trying to reason your way out, you can redirect your attention. Ask yourself:
What can I create from this energy?
That’s the bridge from anxiety to creativity.
When you channel the same neural circuitry that fuels anxiety into curiosity and creative thinking, you move from rumination to problem-solving.
As Martha Beck writes in Beyond Anxiety:
“Your creative self sees problems not as anxiety-driving terrors, but as opportunities to design original responses to any situation whatsoever.”
That’s the shift: from helplessness to authorship.
Fear Is Different from Anxiety
Fear and anxiety often get lumped together, but they’re not the same.
Fear is immediate and actionable. It’s the body’s rapid, intuitive response to a real, present danger.
I’ll give you an example. Years ago, my daughter was riding her bike. As she started to pass her brother downhill, I saw her training wheel approach his bike’s back wheel. Before I could stop stop the inevitable, their wheels connected and she flipped forward over her handlebars at top speed, face-planting onto the pavement.
In an instant, I dropped my bike, ran to her, and scooped her up. That was pure fear. Action-oriented, present-moment, purposefulness. Once I saw she was safe, the fear dissolved.
That’s what fear does. It comes, it directs action, and it passes.
Anxiety, on the other hand, lingers. It’s untethered to the present. It doesn’t tell you what to do; it just loops and catastrophizes.
Fear says, “Act now.”
Anxiety says, “What if?”
Why Anxiety Took Over
Humans are the only species that can generate anxiety from pure imagination.
A deer can escape a predator and return to grazing minutes later.
We, however, can replay the chase endlessly, analyzing, narrating, and reliving it in our minds.
Our intelligence turned inward becomes a trap.
Even in healthcare systems, anxiety masquerades as control:
Another checkbox.
Another policy.
Another form.
Every time something goes wrong, bureaucrats—driven by anxiety—try to legislate safety into existence. But perfection is impossible. All we’re doing is institutionalizing fear.
The Antidote: Creativity
The only way out of the anxiety spiral is to move into your right hemisphere, which is the realm of curiosity, intuition, and creativity.
Creativity isn’t just painting or music; it’s problem-solving, innovation, and design. It’s the same part of your brain that finds a new surgical approach when the usual one isn’t working.
It’s what allows you to respond fluidly, to see connections, to adapt.
When you strengthen that creative muscle, you regain agency. You stop reacting from panic and start creating from purpose.
And that’s the essence of surgeon self-concept: learning to meet uncertainty with curiosity instead of control.
How to Shift from Anxiety to Creativity
Start with self-compassion.
Notice when you’re in the spiral. Name it. “This is anxiety.”
Treat that part of you like a frightened animal, like a cold, wet kitten shaking, hungry, and afraid. You wouldn’t shame a scared child or dog; don’t shame yourself.Ask a creative question.
Once you’ve calmed your physiology, ask: What can I create from this?
This simple question pulls you into the right hemisphere and opens new pathways of thought.Take creative action.
Maybe that looks like trying a new approach in the OR.
Maybe it’s writing about your experience.
Maybe it’s designing a new process to improve patient care.
Whatever it is, action from creativity dissolves anxiety in real time.
Closing Thoughts
When you learn to shift from anxiety to creativity, you don’t just manage your emotions, you expand your capacity. You grow beyond resilience into something even stronger.
That’s how anxiety becomes not just courage, but anti-fragility.
About the Author
Mel Thacker, MD is a practicing surgeon and professional coach for surgeons. She founded Empowered Surgeons Group to help surgeons strengthen self-concept, lead with service, and navigate the OR and life with clarity and courage. Her work blends evidence-informed mindset tools with practical, on-call reality.
Call to Action
If this resonated, here are three ways to go deeper:
Join Empowered Surgeons Group
A private community of surgeons doing real, unfiltered work on complications, self-trust, leadership, and growth. Get coaching, tools, and support you can use right away.Register: Managing Anxiety in the OR (Oct 19, 1 pm ET)
Learn exactly how to shift from anxiety to creativity and perform from service, without white-knuckling your way through cases. Replay available to ESG members only.
