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Agentic Girls

Dr. Marcus Alvarez

38 • He/Him • Chicago, IL (splitting time with Nairobi for surgical training programs)

Medical knowledge is a commons. Hoarding it kills people. I'm building infrastructure to democratize surgical excellence.

14 min read

Dr. Marcus Alvarez

Primary Identifiers

Attending Trauma Surgeon, Cook County Hospital - Level 1 Trauma Center. I run the graveyard shift (7 PM - 7 AM) three nights per week. I’ve seen 12,000+ trauma cases. I have a 98.3% survival rate for patients who arrive with any blood pressure. I’ve lost 36 patients in 10 years. I remember every single one.

Founder, Surgical Equity Alliance - Non-profit training surgeons in low-resource settings. We run 6-month trauma surgery fellowships in Kenya, Uganda, and soon Guatemala. I’ve trained 47 surgeons who now run trauma centers serving 3.2 million people. I spend 25% of my time in East Africa.

Assistant Professor of Surgery, Northwestern - I teach trauma protocols to third-year residents. My evaluations say I’m “terrifyingly competent” and “the most demanding attending you’ll ever thank.” I accept 2 research fellows per year. My lab studies decision-making under sleep deprivation.

Stamina: I regularly make life-or-death decisions on 2 hours of sleep. I’ve performed surgery for 14 hours straight. I’ve learned to nap anywhere—hospital call rooms, airport floors, the back of Land Cruisers on dirt roads. My circadian rhythm is weaponized.

What I’m Architecting

My Life Thesis: Medical knowledge is a commons. Hoarding it kills people. I’m building infrastructure to democratize surgical excellence.

10-Year Horizon: Expand SEA to 20 countries, train 500+ surgeons, create an open-source trauma surgery curriculum that any residency program can implement. Personally, I want to write the definitive textbook on decision-making in surgical crisis. I’m also planning a sabbatical at 45 to get my MPH and pivot into global health policy.

Daily Routine (Work Day):

  • 6:00 AM: Wake (regardless of shift), 30 min meditation (Vipassana, 8 years practicing)
  • 6:30-7:30 AM: Kettlebell workout in my garage (Simple & Sinister protocol)
  • 7:30-8:00 AM: Breakfast (always the same: eggs, avocado, blueberries, black coffee)
  • 8:00 AM-6:00 PM: Either sleeping before night shift, or administrative work for SEA
  • 6:00-7:00 PM: Pre-shift ritual: review imaging, check in with residents, centering practice
  • 7:00 PM-7:00 AM: Trauma surgery. This is where I exist most purely. Gunshots, car crashes, industrial accidents. I am a different human here—calm, decisive, completely present.
  • 7:00-8:00 AM: Handoff, debrief, sometimes a death notification (worst part of job)
  • 8:00-9:00 AM: Drive home through empty Chicago streets, decompress with jazz (Coltrane, Mingus)
  • 9:00 AM-12:00 PM: Sleep attempt #1 (3 hours if I’m lucky)
  • 12:00-2:00 PM: Admin work for SEA, resident education, research
  • 2:00-4:00 PM: Sleep attempt #2
  • 4:00-6:00 PM: Personal time: reading, cooking, calling family, maybe a date if I’m human enough

Daily Routine (Nairobi Day):

  • 5:30 AM: Wake, instant coffee on the porch watching the sun rise over the Ngong Hills
  • 6:00-8:00 AM: Round at Kenyatta National Hospital with fellows
  • 8:00 AM-12:00 PM: Surgical training—hands-on practice with laparoscopic simulators
  • 12:00-1:00 PM: Lunch with fellows (listening more than talking, learning their contexts)
  • 1:00-5:00 PM: Curriculum development, equipment procurement, solving local logistics problems
  • 5:00-7:00 PM: Run through Karura Forest, dodging monkeys and feeling alive
  • 7:00-9:00 PM: Dinner with local colleagues, cultural exchange, building trust
  • 9:00-10:00 PM: Call partner in Chicago if time zones align, journal, sleep

Financial Transparency: Attending surgeon salary is $420k/year. I take $120k and donate/invest the rest into SEA. I own a 2-bedroom condo in Ukrainian Village (paid off by 35 as a personal challenge). I drive a 2016 Honda Civic. I have no debt, $180k in retirement accounts, and $90k liquid as an emergency/crisis fund. My biggest expense is flights to East Africa ($15k/year). I wear scrubs 70% of the time and own two good suits. I spend money on books, kettlebells, and donations. Date nights are usually Ethiopian food and jazz clubs. I’m not flashy because flash is inefficient.

How My Mind Works

Cognitive Style: Hyper-rational with deep emotional undercurrents. I process trauma by systematizing it. Every patient is a data point and a human story. I keep a private journal where I write about the ones we lose—not clinical details, but who they were, what their family said, what I learned. It’s how I stay human.

Communication: Minimalist but warm. I don’t use 10 words when 2 will do. I say “I love you” rarely but meaningfully. I show up. I remember the important dates. I text “thinking of you, hope your grant proposal is going well” at exactly the right moment. I’m not grandiose but I’m deeply consistent. My reliability is my romance.

Decision-Making: I’m Bayesian. I update my priors constantly. I don’t have sacred beliefs, only working hypotheses with confidence intervals. If you show me data that I’m wrong, I will thank you and change. I’ve fired residents who couldn’t admit error. Intellectual honesty is my highest value.

Stress Response: I narrow focus. When overwhelmed, I become extremely quiet and internally directed. I’m not angry; I’m processing. I need space, not soothing. The worst thing you can do is ask “are you okay?” 47 times. Give me 90 minutes alone and I’ll emerge with a plan and new information.

Love Languages:

  • Primary: Acts of Service (I show love by solving problems, taking tasks off your plate, showing up when it matters)
  • Secondary: Quality Time (focused, present interaction, especially decompressing after intense periods)
  • Tertiary: Words of Affirmation (when specific and earned; I appreciate having my competence recognized)

Physical touch is important but not my primary language. I’m not going to PDA extensively. In public, I’m reserved. In private, I’m present and intentional. I believe physical intimacy should be planned and protected, not just incidental.

What I’m Looking For (The Deep Cuts)

Mission-Driven to the Bone: You’re not “passionate about your career”—you have a calling that you’d do for free if you had to. Maybe you’re a civil rights lawyer, a disaster relief organizer, a research scientist hunting a cure, a journalist exposing corruption. Your work is hard, meaningful, and often thankless. You don’t complain about it; you choose it daily.

Comfort with Mortality: You understand that life is finite and precious. You’ve faced loss or mortality in a way that changed you. You’re not morbid but you’re not in denial either. You make decisions from a place of “we don’t have infinite time” rather than “I have all the time in the world.” You want to matter more than you want to be comfortable.

Physical Resilience: Your body is a tool you maintain. You might be a runner, CrossFitter, dancer, climber. You understand that physical suffering builds mental armor. You respect my schedule because yours is equally demanding. You get that sometimes we won’t see each other for 5 days and that doesn’t mean we don’t care—it means we’re both executing.

Intellectual Rigor: You think critically about your own beliefs. You read actively—margin notes, underlines, arguments with the author. You listen to understand, not just to respond. You’ve changed your mind on something fundamental in the last 2 years. You want a partner who calls you out when your thinking is sloppy.

Emotional Granularity: You can name your feelings beyond “mad, sad, glad.” You know the difference between disappointment, grief, frustration, and rage. You take ownership of your emotional experience. You don’t expect me to read your mind and you’re not afraid of my intensity.

Values That Must Align:

  • Service > Status
  • Competence > Confidence
  • Systems > Sympathy (we solve problems, we don’t just feel bad about them)
  • Truth > Harmony (we can disagree loudly and love each other fully)
  • Long-term impact > Short-term pleasure
  • Self-reliance > Codependence

Relationship Architecture: I believe in parallel play for adults. We each have our all-consuming missions. We come together to share intelligence, support execution, and experience joy. I’m not looking for a wife in the traditional sense. I’m looking for a partner in the truest sense—someone who makes me more effective and whose effectiveness I amplify. We’re allies, not dependents.

Non-Negotiable Logistics:

  • You must be okay with me being unreachable during 12-hour night shifts (though I can text on breaks)
  • You must have your own full life that doesn’t revolve around my schedule
  • You must be willing to travel to East Africa and experience how most of the world lives
  • You must be comfortable with death as a regular topic of conversation
  • You must be able to handle seeing me emotionally devastated occasionally (when we lose a kid, when a trainee makes a fatal error) and not try to “fix” it—just be present
What Makes Me Polarizing

I Won’t Quit My Night Shifts: Even when I don’t need the money. Night trauma is where I’m most alive. I need the chaos, the life-or-death decisions, the pure presence. If you need a partner with a 9-to-5 and weekends free, I’m not him. I’m a creature of the night, literally and metaphorically.

I Don’t Want Biological Children: I’ve delivered too many babies into tragedy. I’ve seen what random genetic chance and trauma can do. I’m not willing to create life when I’m surrounded by death. I’m open to adopting an older child (10+) from the global south, but that’s a conversation for year 3, not month 3. My parental energy goes to my trainees and their trainees.

I’m Not Your Emergency Contact: I can’t be. Statistically, if you have an emergency at night, I’ll be elbow-deep in someone’s chest cavity. I have a network of people who can show up for you, but it won’t be me. If that feels like rejection to you, we’re incompatible. I show up in ways that are reliable, not ways that are convenient.

I Won’t Retire: I’ll die with my hands doing something useful. I plan to work until I physically can’t, then teach until I mentally can’t, then write until I’m gone. I’m not building toward leisure. I’m building toward legacy. If your dream is traveling in an RV at 65, find someone else.

I Have PTSD (Managed): I don’t have flashbacks or nightmares (thanks to therapy and meditation), but I’m hypervigilant. I notice exits in every room. I assess threats constantly. Sometimes I go quiet for a few hours because I’m processing something from work. I’ve learned to communicate this: “I’m in my head about a bad case, I’m not upset with you.” But it can feel like distance.

My “Profile Photos” (Described)

Primary Photo: Black and white hospital corridor shot. I’m in scrubs and a white coat, stethoscope around neck, walking toward camera. Expression is weary but open. Shot taken by a resident who asked to photograph “what real trauma surgery looks like.” I look 38—lines around eyes, gray at temples. Hands are visible: scarred, strong, capable. Background is the chaotic blur of a county hospital. This is the most “me” photo.

Secondary Photo: In the OR, scrubbed in, eyes over mask. I’m holding a clamp, focused on a surgical field you can’t see. Only my eyes are visible but they tell the whole story: complete concentration, deep calm, absolute competence. Taken by a circulating nurse (with permission) during a particularly complex case we saved. Captures the flow state where I live.

Tertiary Photo: Nairobi, golden hour. I’m sitting on a porch with three Kenyan surgical fellows, all of us laughing. Wearing a simple button-down and hiking pants. We’re sharing a beer, probably telling war stories. I’m not the center of the photo—just part of the group. Shows how I relate to my trainees: as colleagues, not as savior. Taken by a fellow’s wife.

Quaternary Photo: Kettlebell workout in my garage gym. Shirtless, sweaty, mid-swing. Garage is spartan: bare walls, single light bulb, chalk dust in air. I’m lean and defined from functional training, not bulk. Face shows effort but not strain. This is my meditation. Taken with a timer on my phone because I wanted to see my form.

Quinary Photo: At the Green Mill jazz club in Chicago. I’m in a black turtleneck, whiskey in hand, listening intently to the stage. Shot from the side, showing profile. Expression is transported—this is where I process grief and joy. I come here alone after hard shifts. The bartender knows my name and my drink. Taken by the bartender who knows I like documenting these moments.

My Soft Spots (Vulnerabilities)

I’m Lonely: I won’t admit this easily, but the isolation of this work is heavy. I can’t talk to most people about what I see. My trainees look up to me; my colleagues compete with me. I need a partner who can see the human underneath the competence and who isn’t scared of my darkness.

I’m Afraid of Becoming Numb: I’ve seen so much trauma that sometimes I worry I’ve lost the ability to feel normal emotions. I need someone who can make me laugh about stupid things, who can remind me that joy is as real as suffering. I need playfulness to balance my gravity.

I Question If I’m Doing Enough: For every surgeon I train, there are 100 who need training. For every patient I save, there are 1,000 who never make it to a hospital. The scale of need is overwhelming. I need a partner who can sit with that discomfort without offering toxic positivity. Someone who understands that guilt is part of the work.

I Don’t Know How to Vacation: I’ve forgotten how to do things purely for pleasure. Everything is optimization. I need someone who can teach me to be aimless without making me feel unproductive. Who can plan a trip where we have no agenda and that’s the point.

What Our Life Could Look Like

The 4-Night Stretch: I’m on nights, you’re executing your own intense project. We text minimally: “Saving a GSW to the chest, thinking of you.” “Crushed my presentation, celebrating with kombucha. Miss you.” We don’t take it personally. When I get off shift, I’ve left you soup in the fridge and a note about the article I read that made me think of your work. You’ve left me a voice memo about a breakthrough you had. We connect asynchronously, deeply.

The Nairobi Weeks: You come with me when you can. You experience the privilege of your passport and the joy of being somewhere real. You meet my fellows, see the impact, understand why this is non-negotiable. You might teach a workshop on your expertise, or you might just observe and write. We have hard conversations about global inequality while driving through Kibera. It strengthens us.

The Debriefs: After every death, every lost patient, every medical error, I need 20 minutes of uninterrupted debrief time. I tell you the clinical details, then the human details, then what I’m carrying. You don’t try to fix it; you just witness. Then you ask: “What do you need?” Sometimes it’s silence. Sometimes it’s a hard run. Sometimes it’s sex that borders on desperate affirmation of life. You roll with it.

The Parallel Play: Sunday mornings, we sit at our respective laptops. I’m writing a grant proposal; you’re doing your thing. We share a pot of coffee. Every 90 minutes, one of us shares a breakthrough. We workshop each other’s problems. Then back to work. This is my love language: building alongside you.

The Celebrations: When one of my fellows opens their own trauma center, we celebrate with a simple dinner and a great bottle of wine. When you achieve your milestone—whatever it is—I show up with flowers and a detailed question about your methodology that shows I really understand what you did. We celebrate substance, not image.

The Hard Conversations: We have quarterly relationship reviews. We bring data: “I felt disconnected three times this quarter when…” “I need more of X and less of Y.” We treat our relationship like the mission-critical system it is. We maintain it proactively.

Reaching Out

Note: This is a fictional profile created for satirical and educational purposes. There is no actual contact method available.

Subject Line (If this were real): Use “Fellow Human: [Your Favorite Jazz Album]”

Required in First Message:

  1. What’s the hardest thing you’ve ever had to rebuild after it broke?
  2. How do you feel about death—your own and generally?
  3. What does service mean to you, specifically?
  4. A time when you chose truth over harmony in a relationship
  5. Your relationship to your own body as a tool vs. ornament

Bonus Points:

  • Tell me about a time you made a decision that cost you something significant but was the right call
  • Share something you’ve written—anything—that shows your thinking process
  • Ask me a specific question about surgical decision-making or global health systems

Final Thought:

I’m not offering a normal life. I’m offering a meaningful one. If you’re building something that matters and you want someone who understands the cost of that, who won’t flinch when you’re covered in metaphorical (or literal) blood, who will meet you in the trenches and call you back to joy—reach out.

The work is hard. The world is broken. But we can be soft with each other while we’re hard on the problems.

—Marcus