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First Do No Self HarmUnderstanding and Promoting Physician Stress Resilience$
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Charles Figley, Peter Huggard, and Charlotte Rees

Print publication date: 2013

Print ISBN-13: 9780195383263

Published to Oxford Scholarship Online: January 2014

DOI: 10.1093/acprof:oso/9780195383263.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 18 January 2021



(p.300) (p.301) 17 Surgery
First Do No Self Harm

Patrick Alley

Oxford University Press

This chapter discusses the difficulties of surgery by presenting case studies. One was of Miriam who died unexpectedly following surgery and another, Jack, who suddenly showed up after ten years following is surgery, healthy and happy and appreciative. Alley asks: “How is it then that you can remember the Miriams of this world but not the Jacks?” After 40 years of practice, the author suggests he knows why: The Miriams of patient care are “bolts from the blue” for an important lesson in humility; despite the use of best practices and facilities and expertise, patients can still die. Both types of cases are important and always should be considered together. This chapter emphasizes the importance of finding a balance in your practice, being realistic about complication rates while realizing that most cases go well and the outcomes are near perfect, and forming and maintaining good collegial relationships to share the good times and the bad times.

Keywords:   physician competence, professional “failures”, acceptance of complications, professional support, reflective practice

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