Peak Protocols: An Arena Labs Series

Arena Labs
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  • MEDICINE

Arena Labs has spent years bringing experts from high-pressure, high-stakes fields to teach on the frontlines of healthcare. Now, we're capturing the best insights and tools from those experts and making them available beyond the hospitals where we work.

Episodes

  1. When Burnout Becomes Biology: Understanding the Science and Solutions Behind Healthcare Worker Exhaustion

    12/11/2025

    When Burnout Becomes Biology: Understanding the Science and Solutions Behind Healthcare Worker Exhaustion

    In this episode, we sit down with Diane Malaspina, Performance Coach Manager at Arena Labs, psychologist, and yoga and mindfulness teacher, who spent years working directly with healthcare providers navigating unprecedented stress during COVID-19. Her unique integration of psychology, mind-body practices, and frontline coaching experience reveals the hidden patterns that lead talented clinicians to struggle and what actually works to help them recover. Diane walks us through the window of tolerance framework, explaining how healthcare providers cycle between hyperarousal (the inability to sleep, anxious rumination, digestive issues, and irritability) and hypoarousal (the exhaustion phase where motivation disappears and the body shuts down). While working with a University Department of Psychiatry during the pandemic, she witnessed compassion fatigue firsthand as practitioners carried patients' struggles home, unable to separate work from personal life, what she calls "the gray zone." This isn't abstract theory. It's about what happens when brilliant problem-solvers ignore their own symptoms, believing time management will solve what's actually an energy management crisis. Diane explains how high achievers in high-demand environments develop a distorted relationship with time, constantly pushing through strain without pausing to regenerate their nervous systems. We explore: The physiological markers that signal burnout before it becomes severe—and why coaches can't let clinicians skip past symptomsWhy that "break" spent scrolling your phone in the cafeteria isn't actually a break, and what qualifies as genuine nervous system recoveryHow a surgeon working 12-hour procedures manages energy through team structure, strategic mini-breaks, and sleep optimizationThe shift from "I can't" to "what's the minimal doable step?"—and why starting with five deep breaths outside matters more than elaborate wellness programsHow one couple reclaimed 30 minutes of sleep by co-creating bedtime goals, leading to measurable improvements in workplace focusWhy leaders need to hear that "putting in more hours when people are depleted" doesn't produce quality outcomes—and what the alternative looks likeDiane makes the case that investing in clinician well-being isn't soft science—it's directly connected to patient outcomes, turnover, and whether healthcare providers can stay connected to their purpose. She challenges us to get curious about quality of life metrics, not just quantitative dollar analysis, and to recognize that the system can only push for so long before it hits exhaustion. Whether you're experiencing the early signs of burnout, managing teams under relentless pressure, or trying to build a culture where breaks actually restore energy, this conversation offers evidence-based frameworks and practical tools from someone who's guided hundreds of healthcare providers back from the edge. Have thoughts or ideas sparked by this episode? Reach out to the team at Arena Labs. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    28 min
  2. Pressure in Pediatric Surgery with Dr. Danielle Gottlieb Sen

    12/03/2025

    Pressure in Pediatric Surgery with Dr. Danielle Gottlieb Sen

    When Technical Mastery Meets Human Connection: What It Really Takes to Operate on Children's Hearts In this episode, we sit down with Dr. Danielle Gottlieb Sen, a pediatric cardiac surgeon whose unconventional path to the operating room reveals as much about resilience and self-determination as it does about technical excellence. From Sub-Saharan Africa to Harvard training programs, she shares how a drive to serve, combined with incremental decisions and relentless endurance, led her to one of medicine's most demanding specialties. Dr. Danielle Gottlieb Sen opens up about the physical and emotional rigor of surgical training in an era without work-hour restrictions, the humbling experience of holding a living heart in her hands, and why she had to pretend she'd be a general surgeon to survive the journey. We explore how she navigated environments where she didn't fit the archetype, the moment a gruff conversation with her mother changed everything, and what it means to stay present with families when outcomes don't go as planned. This isn't just a story about technical skill. It's about building intuition through repetition, creating psychological safety in high-stakes environments, and leading teams with flat hierarchies and mutual respect. Dr. Danielle Gottlieb Sen walks us through what actually happens in a pediatric cardiac OR, from the choreographed communication with perfusionists to the strategic use of music and storytelling to help families understand what's about to happen to their child. We explore: How incremental decisions can lead to extraordinary outcomes, even when you can't see yourself in the roleWhy physical endurance and emotional processing are as critical as technical masteryThe art of informed consent: turning complex cardiac anatomy into stories families can understandHow operating room culture is cultivated through respect, routinized communication, and shared humanityWhy worrying less about what others think might be the key to accelerating your careerWhat it means to show up for families, especially when things don't go wellWhether you're navigating a demanding training environment, leading teams under pressure, or trying to communicate clearly in moments that matter most, this conversation offers hard-won wisdom from someone who's spent two decades at the intersection of technical precision and profound human care. Have thoughts or ideas sparked by this episode? Reach out to the team at Arena Labs. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    32 min

  3. 11/13/2025

    From Olympics to Healthcare with Naya Tapper, OLY

    What Can Elite Athletes Teach Us About Building Stronger Medical Teams? More Than You’d Think. In this episode, we sit down with a two-time Olympian, World Cup competitor, and former co-captain of the U.S. Women’s Rugby Sevens team to explore what high-performance sport can teach medicine about culture, resilience, and sustaining excellence under pressure. From her unlikely entry into rugby to winning an Olympic bronze medal in Paris, she shares how elite teams build identity, maintain standards, and navigate the emotional weight of leadership. We dig into the power of predictive culture design, the role of sports psychology in performance, and how accountability can transform a team’s trajectory. She opens up about the burnout that comes with leadership, the moments that nearly broke her, and the breakthrough coaching that reshaped not just her performance, but her mindset. And she offers a rare behind-the-scenes look at how world-class teams recover, communicate, and rebound from setbacks—lessons that map directly onto clinical environments where pressure, fatigue, and rapid decision-making are part of daily life. We explore: Why relationship-driven culture beats skill alone in high-stakes environmentsHow routines and feedback loops keep teams anchored—even in low momentsThe mental shift from emotion to action that unlocked new levels of performanceWhy recovery isn’t optional and what medicine can adopt from elite sport tomorrowHow leaders can hold standards without breaking themselves in the processWhether you’re leading a clinical team, working in a high-acuity unit, or striving to foster a culture where individuals can flourish and endure, this conversation offers a roadmap rooted in the lived experiences of elite athletes. Have thoughts or ideas sparked by this episode? Reach out to the team at Arena Labs. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    31 min

  4. 07/24/2025

    Fail, Reflect, Master: A Seal's Guide for Clinicians w/ Matt Cumbee

    What if your worst professional failure became your greatest clinical asset? In this episode, Matt Cumbee—former Navy SEAL and Arena Labs performance coach—joins us to unpack how “catastrophic” failures forge the grit and capacity every healthcare worker needs. Drawing on his time as a SEAL and years spent helping physicians, nurses, and surgeons translate elite tactics into everyday care, Matt reveals why embracing missteps is the fastest path to true mastery in high-stakes environments. He breaks down the fail–reflect–master cycle, explains why the hardest lessons often come wrapped in sleepless nights, and shares the go-to strategies he delivers when clinicians need them most. Whether you’re leading the OR or simply aiming to turn your next mistake into your greatest lesson, this episode is packed with actionable insights on how to fail faster, learn deeper, and ultimately raise the bar on patient care. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    28 min

  5. 07/10/2025

    What Makes a Leader Last w/ Mike Mears

    What can the CIA teach us about building better hospitals? More than you’d expect. In this episode, Mike Mears—former CIA Chief of Human Capital and the founder of the CIA Leadership Academy—joins us to explore what medicine can learn from intelligence operations and high-stakes organizational design. After decades in the clandestine world, Mike has spent the past 20 years decoding what makes great leaders tick and how elite teams sustain performance under pressure. We dig into the origins of psychological assessments (spoiler: the CIA invented many of them), how predictive hiring can prevent cultural collapse, and why emotional safety is the hidden variable behind high-performing medical units. Mike also shares powerful stories from his time in intelligence and his own personal experience in a hospital that changed his thinking on leadership forever. Whether you're leading a clinical team, running a health system, or just trying to create a culture where people can thrive and last—you won’t want to miss this one. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    37 min

  6. 06/26/2025

    Performing Under Pressure in the ICU with Jessica B. Williams

    What does it take to not only survive, but lead, in one of the most intense environments in healthcare? In this episode of Peak Protocols, we’re joined by Jessica B. Williams, MSN, APRN, ACCNS-AG, CCRN, a Clinical Nurse Specialist in the CVICU with over 17 years of frontline experience. Jess opens up about the physical and emotional toll of ICU medicine, and the turning point that forced her to reevaluate how she prepared for work. From managing life-or-death ECMO scenarios to recovering from the hidden stress that built beneath the surface, Jess shares the internal practices that allowed her to return to high-stakes care with greater clarity, longevity, and leadership. Whether you're early in your clinical career or leading a team through complex care, this conversation offers a powerful reminder: longevity isn’t just about knowledge, it’s about knowing yourself. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    29 min

  7. 06/15/2025

    FBI Lessons for Frontline Medicine with Sarah Draper

    What can the FBI teach us about performance in healthcare? A lot more than you might think. In this episode, Sarah Draper, a West Point graduate, Army veteran, and former FBI Special Agent, joins us to unpack what it takes to lead and last in high-stakes, high-consequence environments. After a 20-year career investigating national security threats and training the world’s top law enforcement leaders, Sarah turned her focus to medicine, coaching hundreds of physicians and nurses on sustainable performance. We explore how disciplines used in tactical environments—like mental rehearsal, mission clarity, physiological readiness, and post-critical event recovery—translate directly to clinical settings such as trauma bays, ICUs, and ORs. Sarah also shares what she’s learned from years of coaching frontline medical teams: the patterns of burnout, the practices that build resilience, and the small habits that sustain long-term effectiveness. If you’re in the arena of high-stakes care, or leading those who are, this conversation will leave you thinking differently about how to prepare, perform, and recover. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    33 min

  8. 06/14/2025

    Coaching the Frontlines of Medicine with Jackie Pen

    In the premiere episode of Peak Protocols, we sit down with Jackie Pen — an elite performance coach whose journey has taken her from training world-class athletes at Exos and Future to leading clinician performance at Arena Labs. Jackie isn’t just coaching the frontline of medicine, she’s redefining it. Her team translates the tools and frameworks used by Olympic athletes and special operations forces into practical, science-backed protocols for healthcare’s most demanding environments. Whether it’s a 24-hour shift, a trauma bay at 3AM, or the quiet toll of burnout, Jackie’s coaches meet clinicians where they are, delivering strategies for readiness, recovery, and resilience. This episode is a deep dive into what it truly takes to coach those who never get to stop. Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

    28 min
  • 8 Episodes

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Arena Labs has spent years bringing experts from high-pressure, high-stakes fields to teach on the frontlines of healthcare. Now, we're capturing the best insights and tools from those experts and making them available beyond the hospitals where we work.

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