To perform surgery is to experience adverse surgical events. The frequency of such events is so high that no surgeon can avoid them—it will happen.1 Surgeons generally prepare well for things that might happen: scenarios are anticipated and contingencies are rehearsed. Lack of preparation for something that will happen is, therefore, all the more surprising—not least because of the potential for adverse events to cause harm. Such harm is likely to be most pertinent, most profound, and most prolonged for the affected patient, or for their loved ones. Any discussion of the impact of adverse events must recognize this. But health care providers are affected, too. Wu articulated this in coining the term “second victim” in 2000.2 The term has become controversial.3 On reflection, perhaps “second casualty” is better—it’s free of any implication of intent to harm and perhaps of an individual perpetrator. Whatever the terminology, evaluation of this harm in the existing literature often groups doctors together. Yet surgeons are worthy of particular focus: the link between an individual’s action or inaction is perceived by patient, press, and practitioners (quite reasonably so) as more direct in surgery than in other branches of medicine.
Kevin J. Turner
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Department of Urology, University Hospitals Dorset Bournemouth, UK
NSTL
