It’s Not Balance, It’s Trade-Offs: Lessons in Leadership and Life with Lieutenant General Mary K. Izaguirre

From The Green Notebook

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In this episode, Joe sits down with Lieutenant General Mary Izaguirre, the 46th Surgeon General of the U.S. Army and Commanding General of Army Medical Command, for a wide-ranging conversation on leadership, vulnerability, culture, and purpose. Drawing on over three decades of service, LTG Izaguirre shares hard-earned lessons on how to lead authentically and navigate professional complexity.

Together, they discuss the evolving role of Army Medicine, the power of modeling vulnerability, and how intentionality—not balance—is the key to managing life’s trade-offs. Joe and LTG Izaguirre cover:

• Why vulnerability is a leadership strength, not a weakness
• How leaders can model safety, trust, and curiosity within their teams
• The importance of asking the right questions—and being okay not knowing the answers
• How trade-offs, not balance, define sustainable leadership
• The impact of journaling and reflection in high-responsibility roles
• Breaking down the “us vs. them” mentality in large organizations
• What Army Medicine’s true mission is—and why it matters more than ever

Whether you’re a leader in uniform, a parent navigating a demanding career, or someone wrestling with how to show up fully for both your mission and your people, this episode is packed with wisdom, candor, and practical insights.

Lieutenant General Mary K. Izaguirre is the 46th Surgeon General of the U.S. Army and the Commanding General of Army Medical Command. A board-certified family physician and Fellow of the American Academy of Family Physicians, she brings over three decades of military and medical leadership to her role. LTG Izaguirre has held key command and senior staff positions across the Army and deployed in support of operations in Iraq and Afghanistan. She holds multiple advanced degrees, including a Doctor of Osteopathic Medicine, Master of Public Health, and Master in National Security and Resource Strategy. She and her husband, Joseph, are the proud parents of five children.

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