When you’re a resident, you don’t worry about complications, not in any meaningful way, because they aren’t your patients. When you’re an attending you question your decisions a lot. Fortunately in trauma, there isn’t much in terms of agonizing...unlike elective stuff. That’s part of why i did trauma. I didn’t want the mental anguish of wondering “should I have really done that total knee/spine/etc case” if the patient got a complication.
I think complications keep you humble, and teach you that no matter how skilled you are, you still make mistakes. Or even if you don’t make any mistakes, patients still get complications, as a result of being old or ill or diabetic or smokers and that affects outcomes. The only thing the surgeon can control is their own hands. That’s very sobering.
When you have a complication and are working through it, do your best to understand why it happened, and modify the factors in your control to prevent it from happening in the future. Also be honest with your patients...the vast majority of the time, they will appreciate it, as long as you show that you care. Some of the families who love me the most are those who had nonunions or other problems, or infections where my fixation failed. If you show concern, talk to family, call them to ask how the patient is doing, accommodate them, it will go a long way...as long as you do it out of genuine concern and they don’t feel like you’re just trying to cover your ass. You can do that without placing blame on yourself—I often say, “I’m sorry this happened. It is upsetting to you obviously and also upsetting to me, because i wanted you to have a successful outcome. I wish it had not, we did x y and z to try and prevent it, but because of a b and c factors, it happened. Here is how we try to solve it.” It is concern that has to come through, not fear or blame or pride that your magic hands somehow didn’t work.
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