On the eve of surgery, a burden lightened


Not long ago, I underwent vascular surgery to bypass a kinked artery in my upper abdomen. This was a major intervention requiring an incision more than a foot long below my ribcage. Facing such an invasive and dangerous procedure, my heart grew desperate to clear its conscience.

My own work as a surgeon had helped many people. Even so, as I prepared to undergo a big operation, I looked back with dismay at my short-lived career as an ophthalmologist specializing in facial reconstruction. I felt haunted by the small but significant number of patients harmed by my mistakes. Although my hands had removed hundreds of eyelid cancers leaving minimal blemish and effected thousands of other positive outcomes, the successes did not erase the failures.

Nearly a decade and a half since neck problems ended my surgical work, I still felt spasms of shame about every patient who suffered through my deficiencies. Although I didn't believe my error rate had been any higher than the average physician's, I found no comfort in that rationalization. I'd known rare surgeons who almost never made mistakes, and I could not help but measure myself against those most gifted. And I knew that during training, under the pressure of competition, I had often undertaken procedures that were beyond my budding skill; in a few cases, the results had been disastrous.

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