The Surgeon’s Response to a Patient Death

As both a function of the disease processes that they treat and the fact that surgeons operate on vital organs, surgeons often experience patient mortality more frequently than other specialties. Guilt and depression may be a particular problem, especially as surgeons can feel that we are directly responsible for the patient’s death through their (well-intentioned) actions. This can have emotional consequences that if left unchecked can affect both the surgeon’s medical performance as well as increase their tendency for stress and maladaptive responses such as anger, depression, or even substance abuse. Recognition that we are at risk for problems is the first step to understanding that the surgeon is also in jeopardy of suffering what has been called “second victim syndrome.” Self-awareness and the ability of the surgeon to be open about their feelings may be key to coping with this untoward outcome of surgical practice. Multiple coping strategies exist, but there is increasing awareness that a formalized peer support network can be very helpful, presuming the surgeon has the insight to ask for help when they need it. Family support is also often crucial in these difficult times. Burnout is finally being talked about more openly as more and more organizations recognize the issues with work-life balance and compassion fatigue, although systematic programmatic resources to provide support are still lagging behind.