During the summer of 2018, Ethan Stonerook and his family were visiting Clearwater Beach, Florida. This was the first vacation he had been on in a while, and it followed an arduous year of juggling being a Physician Assistant (PA), a foster parent, and raising his own four children with his wife.

Stonerook was a member of a bone marrow transplant team in Gainesville at the time. After seven years, the work had become taxing. He’d been picking up extra shifts for months so his colleagues wouldn’t fall under pressure from radical changes in their work schedules. “That was a tremendous job. I love those patients. I love the people that I was working with,” he says. “But caring for those with leukemia or other blood cancers can take an emotional and sort of metaphysical or existential toll on the folks providing that care day in and day out.” Once the vacation began, Stonerook was able to breathe and accept that things were not sustainable.

On their way back home, his wife started scrolling through a PA job board when she found an opening for a job at Wake Forest Baptist Hospital. When she told Stonerook, an alum of the PA program at Wake Forest, he was very interested. He remembered being inspired to teach when he was a student and hoped to turn his experience into a lesson he could teach to PA students. He wanted to equip them with the tools and coping mechanisms that can keep them hopeful and engaged in their work. “Learning starts from infancy, and we’re just exploring the space around us. We’re also probing it to make sure we’re safe,” he says. “I think for medical trainees, the place is not safe to learn in a playful way, or a way that induces wonder.”

“I think that those opportunities to co-reflect with patients about our own experiences and their experiences do something to develop us as not just providers, but as humans who live in a complex, beautiful world.”

Stonerook began by giving lectures here and there, but soon after, he was given an opportunity to do more. He was hired to direct and design a course on Bioethics and Medical Humanities, which linked the humanities to medicine. It taught students how to build an individual and personal ecosystem around their professional identities, how to increase patient comfort and trust, and how to develop methods of expressing and experiencing catharsis through art.

One of Stonerook’s exercises is called Parallel Charts. In it, clinical students chart the facts of an appointment on a normal medical report. Then they create a piece of art that relates to an impactful experience they had with that patient. One student described working with a young patient who had extreme social anxiety. The student saw himself in the patient; he related to him having been a socially anxious kid himself. He spoke alone with the patient and was moved by how complex the boy was. His parallel chart became a profile painting of the patient. “I think that those opportunities to co-reflect with patients about our own experiences and their experiences do something to develop us as not just providers, but as humans who live in a complex, beautiful world,” says Stonerook.

Around this time, Dr. Ryan Antiel of Duke University’s School of Medicine was developing “The Good Surgeon Project,” an extra-curricular program designed to help surgery residents think about the value of their work, who they’re becoming, and what it means to flourish both in the hospital and outside of it. Antiel pulled in experts in philosophy, medical humanities, ethics, and theology to help brainstorm and develop the curriculum. After some time planning and looking at potential schools to partner with on facilitating the curriculum, Dr. Antiel decided to share it with Wake Forest, and his colleagues in the Wake Forest Department of Surgery suggested that he reach out to Stonerook. “We first met in Winston-Salem for breakfast and immediately hit it off,” Antiel says. “It was clear that our passions overlapped.”

Once the curriculum was set, the program took off. The Good Surgeon Project involves two cohorts of surgical residents, one at Duke and one at Wake Forest, that meet at a facilitator’s home once a month for six months to discuss assigned readings in the humanities, typically accompanied by a related piece of art over dinner. The art would connect to the session topic, and residents would relate it to their experiences. The program at Duke is facilitated by Dr. Antiel and Dr. Brewer Eberly, while the program at Wake Forest is facilitated by Stonerook, Dr. Lucas Neff, and Dr. Kristen Zeller. “I think both of the groups, who are all training surgeons, were really encouraged and inspired by Brewer Eberly, a family physician, and Ethan, a physician assistant, being willing to enter into that space,” says Antiel. “It could be an intimidating setting for a non-surgeon to walk into, and both Brewer and Ethan did so willingly and graciously. They both have just a kind of humility and such attractive personalities that the trainees just immediately took to them.”

The students were independently interviewed at the beginning, middle, and end of the program. “What we learned was that before [the residents] ever started The Good Surgeon, they did not feel comfortable being themselves at work,” says Stonerook. “Everybody had this sort of imposter syndrome. They shared this experience of being a different person when they walked into the hospital than the person who drove there. There were core parts of themselves that they felt like they needed to leave out. And that began to change pretty quickly as they recognized each other across the room in these sessions.”

After the first year of The Good Surgeon, Stonerook worked with others in the PA program to create “Planting Sequoias.” The name derives from a poem by Wendell Berry named “Manifesto: The Mad Farmer Liberation Front.” In the poem, Berry asks readers to “do something that won’t compute” as a form of rebellion. Stonerook likened the acts of investing in a small community, having earnest conversations, and developing faculties for imagining a better way to Berry’s planting sequoias in rebellion to the emotionally and physically strenuous work of medicine. Through funding from the Program for Leadership and Character, he was able to launch Planting Sequoias in 2024.

Much like The Good Surgeon, Planting Sequoias happens over dinner at Stonerook’s and other faculty members’ homes. PA students read assigned stories, poems, and essays in the humanities and arts, then meet to discuss these alongside curated pieces of art or writing in order to make sense of the lessons they’re learning and the experiences they were having as Physician Assistants in training.

Stonerook’s journey as a medical professional has now come full circle. Having found rest in the arts and humanities, he began to imagine a better way to form medical learners for long term resilience, leadership, and flourishing. He hopes to share the curriculum with several other programs in the Wake Forest School of Medicine. “Every day I am just so grateful to walk through the door,” he says. “I get to read poems, watch films, and imagine ways that I can bring wonder and perplexity to students in safe ways that allow them to sort of find a playfulness in their development and in their learning that they haven’t had in a long time.”

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Learn more about The Good Surgeon and Planting Sequoias.