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Invited Critique
January 17, 2011

Failure Is Not a Fate Worse Than Death: Comment on “Special Report: Suicidal Ideation Among American Surgeons”

Author Affiliations

Author Affiliations: Section of Endocrine Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Arch Surg. 2011;146(1):62-63. doi:10.1001/archsurg.2010.283

We applaud this exemplary and timely contribution on a subject too often ignored and for which the findings sadly resonate with experience. Surgeons work hard—in this study, 92% worked 40 hours a week or longer—and their irregular hours and ultimate accountability for immediate life-and-death situations compound job stress. Surgeons care deeply about their patients. Surgeons also exist in a culture that, like it or not, honors self-denial, prizes impervious resilience, and tends to interpret imperfection as failure. Shanafelt and colleagues show for the first time that surgeons with a recent perceived medical failure may react by ideating about taking their own life.

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