As a surgical intern, he feared making mistakes. Now, this resident understands the need to accept failure. | Expert Opinion

Greatness is the sum, and not the absence, of mistakes.

When I was an intern learning to place a chest tube, which is a common bedside procedure to evacuate air or fluid around the lungs, I remember being told to make an incision at a specific spot.

Nervous about not creating enough space to insert the tube, I kept extending the incision until it was about the length of my pinky.

Suddenly, I heard the senior resident gasp from behind me, shouting, “Wow, that is the biggest chest tube incision I have ever seen!”

In retrospect, he was exaggerating, the patient was in a medically induced coma, and we were able to carry out the rest of the procedure safely. But I still remember the nurse giggling at this comment and wishing that scalpels had an undo function.

Similarly, I remember as an intern being called into the operating room by one of the senior surgeons. He asked me how they were doing in the other room. I told him that they were doing something I had never seen before and asked him why that would be.

Then he looked at me with this perplexed expression, and said, “What do you mean? That’s how we do that procedure every time. Didn’t you know?”

I regretted that moment immediately as I had essentially admitted I knew nothing about one of our major operations. But it was too late.

In looking back on the last four years of training, I can recall nothing more distinctly than my mistakes and failures. Context or severity make little difference. The feeling of having potentially harmed someone or the terrible fear of being labeled as incompetent have been some of the most potent building blocks of my growth as a surgeon.

When I was an intern, I wished for the day when I would not feel like an intern ever again, never making the wrong choice, or seeming uncertain. I envisioned that training and rising in the ranks would help me grow beyond that gnawing feeling of doubting whether I had done the right thing.

But now I can see that we do not become immune to the threat of failure even as we become more competent. If anything, the weight of our responsibilities — and the opportunity to fail — only increases.

The senior resident who supervised me placing a chest tube was responsible for safely guiding a junior resident through an invasive procedure. I know now what that feels like, and it can be more anxiety-provoking than doing the procedure myself.

The attending surgeons and clinicians, of course, carry the heaviest duty. I do not yet know how I will cope with that level of responsibility one day.

What I do know is that we cannot hope to prevent mistakes by running away from them. When we feel humiliated, our natural impulse is to withdraw from anything that may make us feel that way again. It is not easy to put yourself out there, question after question, case after case, day after day, knowing that the next one can reveal something unflattering about us.

But making mistakes is a natural part of growth that necessarily requires accepting failure as the first step. This realization may not prevent mistakes from ever happening again, but it will prepare us, humble us, and strengthen us so that we may rise to challenges that have far heavier consequences.

Looking back, my early missteps seem relatively minor, but only because I have since experienced far greater failures. The ones to come will surely be even greater.

Jason Han is a cardiac surgery resident at a Philadelphia hospital.