Table 2:

Internal Strategies that Facilitated Coping

Inevitability	“You can do the best that you can every single day, and you’re still going to have people that don’t do well, whether it’s the system or their disease process, or something that you did, not maliciously, but you know, because you’re a human being and you’re fallible.” (ID16)
	“I better recognize now that there’s only so much that you can control and that there’s a certain component of all surgeries that, regardless of how much you try, just can’t control all the variables, necessarily always have that good outcome…maybe now I’m a little bit more accepting that it’s not always a personal mistake or not always a true technical problem that led to the complication, that there’s a whole host of things that you can’t necessarily make perfect, and that complications are a normal part of doing big surgeries on people, especially people who aren’t healthy to begin with.” (ID7)
	“As a senior resident, I’ve kind of come to terms with the fact that like bad things happen. You can do your best and be a good surgeon, and bad things will still happen. You can do your best and be a good surgeon and still make mistakes sometimes.” (ID6)
Compartmentalization	“I’m pretty good at compartmentalizing, and so I think, you know, that has helped me personally just be able to continue with other things in my life without letting it affect me too much.” (ID25)
	“I don’t really know why or how, but I think I try and compartmentalize what’s going on at work and what’s going on at home in some way.” (ID7)
	“I think in, it could make you really sad over time and really kind of burned-out. And it can also make you stop caring, just become desensitized to it, which also isn’t good.” (ID2)
Forgiveness	“You’ve got to be able to forgive yourself in these kinds of situations…So that kind of helps me move forward in these situations and allows me to forgive myself and not have crippling guilt or remorse or things like that that would preclude me from continuing to take care of people.” (ID1)
	“So I, the thing that I think makes me feel the best is when I actually just talk with the patient and their family about these things.” (ID4)
Emotional Resilience	“I think in general people who go into medicine, we’re thought of and we think of ourselves as these strong people who are hard workers and can get through things, and that’s why we’ve, we’re in the profession that we are. And the thing is, is that, you know, we’re not superheroes, and there’s only so much that one person can take in and deal with. So I think that’s just, it’s part of the pride of, you know, doctors in general.” (ID14)
	“It was really kind of hard to come back from that, although I, you know, essentially did the next day and did the same procedure multiple times again. And I think that’s kind of what you have to do as surgeons, but also I think it was hard for me to kind of, you know, maintain your sense of self-confidence when you have an outcome like that. “ (ID26)
	“I think the idea of resilience is, you know, exceptionally important within surgeon culture, because it’s just open to the nature of the profession. You know what I mean? It’s a pretty grueling residency, you know. You go to high school. You go to college, have to do what you take in college, go to medical school, go to medical school, and then after that, oh, wait, you’re going to get basically, you know, worked to the bone for a period of five to seven years. You know, some of us are doing academic things. So that’s, you know, resilience is, just by nature of the training paradigm, it sort of helps a lot for those who are resilient as people. Because if you have kind of a woe-is-me kind of give-up-ism attitude, you’re just not going to make it. You know, so I think it’s a profession that’s very demanding, that kind of self-selects for those who are able to handle these things because they’ve gone through, what, 13 minimum years of schooling after high school to be able to have the privilege of operating on somebody to help save their life.” (ID1)