John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

Value of learned optimism is to cultivate self-compassion and gentleness

I was in the operating room doing a routine hip scope, like I have done hundreds of time before, showing the fellow “how it is done.” After placing an anchor in the acetabulum, the fellow tactfully and kindly indicated that the anchor had penetrated the joint.

Years ago, in a previously less enlightened state, I used to handle such mishaps with a barrage of negative self-talk with mental “tapes” from parents, teachers or coaches along the lines of “you are incompetent,” “how could you,” “this is inexcusable,” and “you call yourself a surgeon.”

Now after years of therapy and self-healing, I have learned to be kinder and gentler to myself.

Mistakes always happen. They are part of the human condition. Our response to mistakes determines our character and happiness. We can look at mistakes as a justification for self-condemnation or as an opportunity for growth.

Learned optimism

Martin Seligman, the “godfather” of learned optimism, has written extensively on how optimism can be developed and cultivated. Optimists are more successful, healthier and more resilient. Optimists also have a healthy perspective on mistakes.

Seligman elaborates that optimists and pessimists differ in how they explain mistakes or negative events with respect to permanence, pervasiveness and personalization.

Optimists view mistakes or bad events as temporary and do not view them as a consistent pattern. Pessimists generalize negative events and frequently use words such as “always” or “never.” Pessimistic surgeons may say to themselves “I am always making the wrong portal.”

Optimists view failure in one area as being distinct from the rest of their lives, whereas pessimists tend to view a negative occurrence as permeating the rest of their lives. Optimists ascribe failure to causes outside of themselves, whereas pessimists blame only themselves.

For the hip scope misadventure, I reasoned this happened only rarely in my hands and I have, in fact, helped countless other patients despite this occurrence. I also recognized the patient had a rather large habitus, which forced me to change my portal placement. My lesson was to be more mindful of drilling when dealing with a larger body mass.

Cultivate self-compassion

I believe the real value of learned optimism is cultivating self-compassion and gentleness with oneself. In my estimation, this vocation which we have chosen is the most gratifying and fulfilling on the planet. Yet, it is a marathon replete with its challenges. If we are to negotiate the journey, then we must cultivate self-compassion and recognize that mistakes hold value. There is always a gift or lesson in every mistake and resilient surgeons learn, improve and move on. The resilient surgeon is optimistic that any failure holds real value.

After my hip mistake, I had three additional challenging cases to follow. In order to bring my “A game” to the next case, I acknowledged my lesson or gift, was kind to myself and moved on. After all, failure is a great teacher.

So be kind to yourself. Your patients, families and friends deserve all of you.