The stresses of modern medicine place neurosurgeons at substantial risk of emotional and psychological distress. They function in a high-end, high stakes, rapidly changing, multi-tasked environment, fraught with inescapably poor outcomes, human tragedies, risk of litigation, unrelenting demands, and so much more. Neurosurgical residents are particularly vulnerable. Neurosurgical residency is a crucible from which few escape unscathed. The interplay of tremendous daily physical, intellectual, and emotional challenges with a resident's personality type and coping style determines (for better or worse) his or her functionality, fulfillment, and emotional tone; and greatly affects his or her growth and development as a physician and neurosurgeon. Coping patterns learned during residency may impact and permeate a surgeon's entire professional life, their personal life, and their ability to care for desperately ill patients. The purpose of this podcast is to offer insights and details from our experience, with the hope of encouraging a greater focus on the psychological well being of neurosurgical trainees. For the non-neurosurgeon, this podcast offers a rare and fascinating glimpse “behind the curtain” of the psychology behind the development of surgeons willing and able to face and transgress the most complex and unforgiving organ system of the body.