Training the "Fine Motor" Brain
Why 10,000 surgeries make you a better CEO, not just a better surgeon
We have a misconception about expertise. We treat “dexterity” and “leadership” as two different skill sets—one belonging to the craftsman, the other to the executive.
But as an engineer who has performed over 10,000 surgeries, I don’t see a difference. I see a single, neurological system of control.
I’ve learned that the same fine motor precision required to save a life is exactly what’s required to scale a $35M company. If you can’t control your hands in a crisis, you cannot control a boardroom.
The “White-Out” Scenario
Every surgeon has been there.
You’re deep into a revision total hip—a case where the bone is thin and the scar tissue is dense. Suddenly, the field turns red. An artery has been nicked. In seconds, the “Human Machine” transitions from a controlled repair to a life-threatening failure.
In that moment, your biology screams at you to panic. Your heart rate spikes. Your peripheral vision narrows. Your adrenaline tries to take over. This is the “White-Out”—the moment where “average” operators lose their composure.
When an operator panics, their hands shake. In surgery, a 1-millimeter tremor is the difference between a controlled repair and a catastrophe. To save the patient, you have to perform a neurological override. You have to “still your hands.” You must force your mind to become a stabilizer for the machine.
The $35M Tremor
I saw the exact same “White-Out” when I decided to leave the safety of a large hospital system to found the Indiana Orthopedic Institute.
I was staring down a two-year non-compete. I was building a $35M facility in Noblesville’s Innovation Mile while the healthcare economy was “shaking underneath us.” The stakeholders were nervous. The administrators were whispering about failure.
Structurally, this was a high-stakes surgical revision of my entire career.
Most leaders, when faced with that level of financial “bleeding,” start to shake. They make “tremor decisions”—hasty pivots, fear-based cuts, and defensive posturing. They lose their fine motor control over the business because they haven’t trained their mental composure.
I didn’t view that gamble as a business risk. I viewed it as a 12-month surgical procedure. I stilled my hands, ignored the “noise” of the market, and executed the plan with the same precision I use to seat a taper-wedge stem in a Grade C femur.
The Composure Protocol
Composure isn’t a personality trait. It’s a muscle. If you want to lead at an elite level, you have to train your brain to override your biological fear response. Here is how I train the “Fine Motor” brain:
1. Still the Hands First When a crisis hits—a lawsuit, a failed product launch, or a surgical complication—the physical comes before the mental. Take a breath. Relax your grip. If you can force your body to remain still, your mind will eventually follow the lead of the machine.
2. Isolate the Variable In a “bleeder,” you don’t try to fix everything at once. You find the source, apply pressure, and isolate the variable. In business, do the same. Stop trying to solve the “entire crisis.” Find the 1% of the problem that is causing the bleed and fix it with surgical focus.
3. Practice under “High-Thermal” Load You don’t learn composure in a calm room. You learn it at the redline. I’ve mentored 166 learners, and the ones who succeed are those who seek out the hardest cases—the ones where the “thermal load” of the crisis is highest. Don’t avoid stress; use it as the weight room for your composure muscle.
4. The Engineering Perspective View every crisis as a mechanical failure, not a personal tragedy. A machine doesn’t care about your feelings; it cares about the torque, the fit, and the alignment. When you remove emotion from the equation, the tremor disappears.
The Bottom Line
10,000 surgeries haven’t just made me a better doctor; they have engineered a brain that thrives when the field turns red.
Leadership is just surgery on a larger scale. Whether it’s a $35M investment or a modular dual-mobility revision, the requirement is the same: A steady hand and a stilled mind.
Are your decisions based on precision, or are you suffering from a tremor?
R. Michael Meneghini, MD
If you found this helpful, share it with a leader who is currently navigating a “White-Out.” Next week, we are diving into “The 9-to-67 Ratio”… how to lead an organization without the administrative rot.