As a superior candidate for medical school, John Caruso was rewarded with ten interviews for medical school and was a no-show for nine of them. John wanted to go to medical school in Bologna, Italy. He was accepted and made the school’s 6-year program into an 8-year program. His family had an enormous flatware and cutlery business based in Bologna with 20 stores in Western Europe, and John wanted in. It was never clear why he wanted to be a physician and, similarly, an anesthesiologist. John was a great resident, but his head was in a different place. He was raised to be an entrepreneur. By practicing pain management, his business needs were met. Dr. Caruso designed a comprehensive entrepreneurial pain center.