The term lean in became part of US vernacular largely because of Sheryl Sandberg’s influential 2013 book1 encouraging women to claim workplace equality and success in the face of ongoing sexism while philosophically letting go of expectations for perfection at work or home. For many female surgeons, this was not a new concept: to secure and maintain a seat at the table, we often use grit and practicality to devote as much or more effort to our work than our male counterparts in training or practice. But at what price?