The Weight of Perfection: How Surgeons Can Give Themselves Grace

We worry ourselves to death.

As surgeons, we are perfectionists by nature; consequently, we worry and perseverate when we don’t perform perfectly. It is especially true when it comes to rendering the correct diagnosis and treatment plan, when performing an operation, and while caring for patients postoperatively. Unless one is a surgeon, it’s impossible to understand the weight of responsibility we carry when we care for our patients and perform an operation. The patient and their family entrust us with their care, often at some of the most vulnerable moments of their lives.  Even when we have thoroughly discussed the risks, complications, and potential outcomes, we still feel a profound obligation to achieve a perfect result. We have all experienced surgical complications, as it is impossible to avoid them, unfortunately.  As I like to point out to surgical trainees and medical students, no one else on the team in the OR bears the same long-term obligations toward the patient as the responsible surgeon.  The patient’s outcome is lifelong, and so is our responsibility to them.

So how do we best cope with these pressures and responsibilities?

First, we must accept that perfection is unattainable. Despite our training, preparation, and dedication, errors in judgment, technical challenges, and unforeseen complications can and do occur. They are an inevitable part of practicing surgery. Second, remember the extraordinary investment you have made in mastering your craft; thousands of hours spent studying, training, operating, and caring for patients.

Our perfectionism often spreads to critiquing our knowledge base, our professionalism, our relationships, our work-life balance, our parenting style, our friendships, and our golf game! Addressing and cutting ourselves some slack when we are not perfect (and none of us ever are), accepting that we have performed to the best of our abilities, that we are not alone in our failures, that we support one another, that no one in life is perfect; that is what we should focus on. We must learn to grant ourselves the same grace we offer others.

As many sage surgeons have said, “If you never have a complication, then you have not performed enough operations”. They happen. Like all things in life, stuff happens even though we all try our best to avoid it.

I’ll leave you with one of life’s lessons we are taught in the operating room when we are attempting to create the perfect anastomosis, or create that ideal flap, or perfection of any of the myriad things we do in the operating room: “The enemy of good is better”. In other words, if the anastomosis you performed is solid, do not try to perfect it.

Know that making mistakes is a universal human experience.