Adverse events for surgeons

How do you manage adverse events?

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Lilli Cooper’s no fluff newsletter.

Helping surgeons perform, and feel, better.

Lilli Cooper’s no fluff newsletter.

Helping surgeons perform, and feel, better.

Lilli Cooper’s no fluff newsletter.

Helping surgeons perform, and feel, better.

Adverse events for surgeons

Adverse events (errors and complications) happen to all surgeons, yet there is no formal preparation for them, in contrast to other "softer" skills, like breaking bad news.

Surgeons feel underprepared to deal with them, struggle when they happen, and have been referred to as the 'second casualty'.

Adverse events for surgeons

Adverse events (errors and complications) happen to all surgeons, yet there is no formal preparation for them, in contrast to other "softer" skills, like breaking bad news.

Surgeons feel underprepared to deal with them, struggle when they happen, and have been referred to as the 'second casualty'.

Adverse events for surgeons

Adverse events (errors and complications) happen to all surgeons, yet there is no formal preparation for them, in contrast to other "softer" skills, like breaking bad news.

Surgeons feel underprepared to deal with them, struggle when they happen, and have been referred to as the 'second casualty'.

Core Insights

80% of surgeons experienced an adverse event (AE) in the last year.

AEs are difficult to deal with.

  • 48% of surgeons experience increased anxiety

  • 43% struggle with sleep

  • 11% increase alcohol use

  • 13% have affected relationships

  • 38% experience symptoms of PTS

(For reference, PTS affects up to about 8% in the UK serving military).

Common emotions, feelings and behaviours include: sadness, anxiety, shame, flashbacks, nausea, numbing, (e.g. through alcohol) and avoidance (e.g. physically or through overwork).

The impact of an AE varies depending on its subjective meaning to you. It can be worse at vulnerable career points, with certain patients, and when perceived as an error rather than complication.

43% of surgeons don't speak to anyone after an AE, not even a friend or colleague, though most surgeons want to be supported. More open communication could help reduce shame, process emotion, and enhance reporting and learning from AEs.

Other important ways to increase our individual shame competency are compassion to ourselves and others, and connecting with what is important to you within, and outside, medicine.

References:

  • Turner K, Bolderston H, Thomas K, Greville-Harris M, Withers C, McDougall S. The impact of adverse events on surgeons. BJS 2022;109:308-10

  • Juskaite S, Stone J, Greenberg N, Dyball D, Fear NT. Current perspectives on the mental health of UK military personnel and veterals. Brit Med Bull. 2025;154:1-9

  • Brown, B. (2021). Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience. Random House Pp 135-145

  • Neff K, Germer C. (2018). The Mindful Self-Compassion Workbook. The Guilford Press. Pp.34-36

Core Insights

80% of surgeons experienced an adverse event (AE) in the last year.

AEs are difficult to deal with.

  • 48% of surgeons experience increased anxiety

  • 43% struggle with sleep

  • 11% increase alcohol use

  • 13% have affected relationships

  • 38% experience symptoms of PTS

(For reference, PTS affects up to about 8% in the UK serving military).

Common emotions, feelings and behaviours include: sadness, anxiety, shame, flashbacks, nausea, numbing, (e.g. through alcohol) and avoidance (e.g. physically or through overwork).

The impact of an AE varies depending on its subjective meaning to you. It can be worse at vulnerable career points, with certain patients, and when perceived as an error rather than complication.

43% of surgeons don't speak to anyone after an AE, not even a friend or colleague, though most surgeons want to be supported. More open communication could help reduce shame, process emotion, and enhance reporting and learning from AEs.

Other important ways to increase our individual shame competency are compassion to ourselves and others, and connecting with what is important to you within, and outside, medicine.

References:

  • Turner K, Bolderston H, Thomas K, Greville-Harris M, Withers C, McDougall S. The impact of adverse events on surgeons. BJS 2022;109:308-10

  • Juskaite S, Stone J, Greenberg N, Dyball D, Fear NT. Current perspectives on the mental health of UK military personnel and veterals. Brit Med Bull. 2025;154:1-9

  • Brown, B. (2021). Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience. Random House Pp 135-145

  • Neff K, Germer C. (2018). The Mindful Self-Compassion Workbook. The Guilford Press. Pp.34-36

Core Insights

80% of surgeons experienced an adverse event (AE) in the last year.

AEs are difficult to deal with.

  • 48% of surgeons experience increased anxiety

  • 43% struggle with sleep

  • 11% increase alcohol use

  • 13% have affected relationships

  • 38% experience symptoms of PTS

(For reference, PTS affects up to about 8% in the UK serving military).

Common emotions, feelings and behaviours include: sadness, anxiety, shame, flashbacks, nausea, numbing, (e.g. through alcohol) and avoidance (e.g. physically or through overwork).

The impact of an AE varies depending on its subjective meaning to you. It can be worse at vulnerable career points, with certain patients, and when perceived as an error rather than complication.

43% of surgeons don't speak to anyone after an AE, not even a friend or colleague, though most surgeons want to be supported. More open communication could help reduce shame, process emotion, and enhance reporting and learning from AEs.

Other important ways to increase our individual shame competency are compassion to ourselves and others, and connecting with what is important to you within, and outside, medicine.

References:

  • Turner K, Bolderston H, Thomas K, Greville-Harris M, Withers C, McDougall S. The impact of adverse events on surgeons. BJS 2022;109:308-10

  • Juskaite S, Stone J, Greenberg N, Dyball D, Fear NT. Current perspectives on the mental health of UK military personnel and veterals. Brit Med Bull. 2025;154:1-9

  • Brown, B. (2021). Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience. Random House Pp 135-145

  • Neff K, Germer C. (2018). The Mindful Self-Compassion Workbook. The Guilford Press. Pp.34-36

Read more

Find an article I wrote on the subject for the Royal College of Surgeons (Engl.), below

Read Bulletin article here

Read more

Find an article I wrote on the subject for the Royal College of Surgeons (Engl.), below

Read Bulletin article here

Read more

Find an article I wrote on the subject for the Royal College of Surgeons (Engl.), below

Read Bulletin article here

Did you knowse...

43% of surgeons don't speak to anyone after an adverse event, and <3% to a professional.

Did you
knowse...

43% of surgeons don't speak to anyone after an adverse event, and <3% to a professional.

Did you knowse...

43% of surgeons don't speak to anyone after an adverse event, and <3% to a professional.

Good Thinking

If you have a bang on the head in a rugby match, you get checked over. If all is well you get back on the pitch. Maybe we should have the same opt out rather than opt in approach to peer or professional support after AEs?

Good Thinking

If you have a bang on the head in a rugby match, you get checked over. If all is well you get back on the pitch. Maybe we should have the same opt out rather than opt in approach to peer or professional support after AEs?

Good Thinking

If you have a bang on the head in a rugby match, you get checked over. If all is well you get back on the pitch. Maybe we should have the same opt out rather than opt in approach to peer or professional support after AEs?

Got 5 minutes?

Try a compassionate flow exercise.

Take a breath or two to settle.

From you to others: Bring to mind someone at work who is having a tough time and on each exhale offer a phrase, e.g. "May you get what you need". Imagine that flowing towards them.

From others to you: Imagine a wise, steady other (mentor, friend or ideal imagined consultant) who wishes you well. Imagine their support, e.g. "You're doing your best" or "I've got your back", flowing to you on each exhale.

From you to yourself: Acknowledge what is hard right now, and on each exhale, offer yourself a phrase or intention, e.g.: "May I bring kindness and clarity to the next case."

Got 5 minutes?

Try a compassionate flow exercise.

Take a breath or two to settle.

From you to others: Bring to mind someone at work who is having a tough time and on each exhale offer a phrase, e.g. "May you get what you need". Imagine that flowing towards them.

From others to you: Imagine a wise, steady other (mentor, friend or ideal imagined consultant) who wishes you well. Imagine their support, e.g. "You're doing your best" or "I've got your back", flowing to you on each exhale.

From you to yourself: Acknowledge what is hard right now, and on each exhale, offer yourself a phrase or intention, e.g.: "May I bring kindness and clarity to the next case."

Got 5 minutes?

Try a compassionate flow exercise.

Take a breath or two to settle.

From you to others: Bring to mind someone at work who is having a tough time and on each exhale offer a phrase, e.g. "May you get what you need". Imagine that flowing towards them.

From others to you: Imagine a wise, steady other (mentor, friend or ideal imagined consultant) who wishes you well. Imagine their support, e.g. "You're doing your best" or "I've got your back", flowing to you on each exhale.

From you to yourself: Acknowledge what is hard right now, and on each exhale, offer yourself a phrase or intention, e.g.: "May I bring kindness and clarity to the next case."

Low hanging fruit:

Do try this at home
Put regular time aside at the end of the day or week to revisit experiences, alone (e.g. journalling) or with a trusted other (e.g. a coach/therapist).

Low hanging fruit:

Do try this at home
Put regular time aside at the end of the day or week to revisit experiences, alone (e.g. journalling) or with a trusted other (e.g. a coach/therapist).

Low hanging fruit:

Do try this at home
Put regular time aside at the end of the day or week to revisit experiences, alone (e.g. journalling) or with a trusted other (e.g. a coach/therapist).

Featured resources

Below are a few (affiliation-free) resources that might help you manage adverse events.

Journaling can help to reflect on, and process, experiences in a safe and tolerable way. Keen to try it? Here are some resources to get you going.

Try it now

If you find it hard to name emotions, try noticing where they show up in your body, or using an emotion wheel, here (from the FMHA).

Sounds great

Not sure what to do to support yourself or a colleague? Find the RCS (Engl.) guide to Supporting Surgeons After Adverse Events, here.

Read here

Featured resources

Below are a few (affiliation-free) resources that might help you manage adverse events.

Journaling can help to reflect on, and process, experiences in a safe and tolerable way. Keen to try it? Here are some resources to get you going.

Try it now

If you find it hard to name emotions, try noticing where they show up in your body, or using an emotion wheel, here (from the FMHA).

Sounds great

Not sure what to do to support yourself or a colleague? Find the RCS (Engl.) guide to Supporting Surgeons After Adverse Events, here.

Read here

Featured resources

Below are a few (affiliation-free) resources that might help you manage adverse events.

Journaling can help to reflect on, and process, experiences in a safe and tolerable way. Keen to try it? Here are some resources to get you going.

Try it now

If you find it hard to name emotions, try noticing where they show up in your body, or using an emotion wheel, here (from the FMHA).

Sounds great

Not sure what to do to support yourself or a colleague? Find the RCS (Engl.) guide to Supporting Surgeons After Adverse Events, here.

Read here

If you or a colleague are struggling, find the RCS England support line for professionals or peer support below

Find support here

If you or a colleague are struggling, find the RCS England support line for professionals or peer support below

Find support here

If you or a colleague are struggling, find the RCS England support line for professionals or peer support below

Find support here

Fancy a takeaway?

Download a home exercise

Fancy a takeaway?

Download a home exercise

Fancy a takeaway?

Download a home exercise

Wise words

"The difference between triumph and defeat... isn't about willingness to take risks. It's about mastery of rescue"

 Atul Gawande

Wise words

"The difference between triumph and defeat... isn't about willingness to take risks. It's about mastery of rescue"

 Atul Gawande

Wise words

"The difference between triumph and defeat... isn't about willingness to take risks. It's about mastery of rescue"

 Atul Gawande

Join exclusive surgical membership

This is currently free, and includes small group and individual opportunities and workshops.

Join exclusive surgical membership

This is currently free, and includes small group and individual opportunities and workshops.

Join exclusive surgical membership

This is currently free, and includes small group and individual opportunities and workshops.

This event has now passed – subscribe to the newsletter to catch the next one.

Live Mindfulness Workshop

Monday 16th March 7-8pm on Zoom

Join Neil Truncik for a mindfulness workshop designed to help surgeons develop greater awareness, and calm in the midst of a demanding profession.

Click here to register

This event has now passed – subscribe to the newsletter to catch the next one.

Live Mindfulness Workshop

Monday 16th March 7-8pm on Zoom

Join Neil Truncik for a mindfulness workshop designed to help surgeons develop greater awareness, and calm in the midst of a demanding profession.

Click here to register

This event has now passed – subscribe to the newsletter to catch the next one.

Live Mindfulness Workshop

Monday 16th March 7-8pm on Zoom

Join Neil Truncik for a mindfulness workshop designed to help surgeons develop greater awareness, and calm in the midst of a demanding profession.

Click here to register

Book one-to-one coaching here

Book one-to-one coaching here

Book one-to-one coaching here

The next newsletter will be about the Inner Critic

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Hear me out

The next newsletter will be about the Inner Critic

Are there any subjects you would like to see covered?

Hear me out

The next newsletter will be about the Inner Critic

Are there any subjects you would like to see covered?

Hear me out

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Forward it on

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Who is Lilli?

A surgeon by background and also a professional coach

This newsletter aims to share relevant, concise tips to help surgeons perform, and feel, better.

Thanks for being here — feel free to message with thoughts, suggestions, or just to say hi.

Who is Lilli?

A surgeon by background and also a professional coach

This newsletter aims to share relevant, concise tips to help surgeons perform, and feel, better.

Thanks for being here — feel free to message with thoughts, suggestions, or just to say hi.

Who is Lilli?

A surgeon by background and also a professional coach

This newsletter aims to share relevant, concise tips to help surgeons perform, and feel, better.

Thanks for being here — feel free to message with thoughts, suggestions, or just to say hi.

Disclaimer: This newsletter is provided for educational and informational purposes only and does not constitute medical advice or professional services. The information shared should not be used for diagnosing or treating any health conditions. For personalised medical advice, please consult with a licensed healthcare professional.

Disclaimer: This newsletter is provided for educational and informational purposes only and does not constitute medical advice or professional services. The information shared should not be used for diagnosing or treating any health conditions. For personalised medical advice, please consult with a licensed healthcare professional.

Disclaimer: This newsletter is provided for educational and informational purposes only and does not constitute medical advice or professional services. The information shared should not be used for diagnosing or treating any health conditions. For personalised medical advice, please consult with a licensed healthcare professional.

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A monthly letter sharing insights, reflections, and resources for clinicians and high stakes professionals who want to perform or feel better, or both!

Thoughtful content, no spam. Unsubscribe anytime.

Sign up for Lilli's Newsletter

A monthly letter sharing insights, reflections, and resources for clinicians and high stakes professionals who want to perform or feel better, or both!

Thoughtful content, no spam. Unsubscribe anytime.

Supporting healthcare professionals to thrive through evidence-based resources, coaching, and community.

lilli@lillicooper.co.uk

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