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.

We are more than our mistakes

The key to leading a resilient life is maintaining a positive energy balance. A chief component to staying energized is the development of self-compassion – the virtue of being kind to oneself in the face of failure. Truly, resilient individuals adopt an attitude that looks at failure as an opportunity. Furthermore, they recognize we all are so much more than our mistakes.

The voices

Everyone has them – the inner critic that is relentless in the face of failure. We all have experienced this to some degree in our surgical careers. We make one bad incision and the "voice" of self-reproach descends upon us. Thoughts such as "I can't believe I did that" or "this never should have happened to someone of my experience" or even "you call yourself a surgeon!" This inner dialogue robs us of self-esteem and only serves to make us feel less worthy. The inner critic may represent a parental figure who tended to criticize or a teacher or coach who always seemed to dwell on the negative. All the negative energy we have absorbed over our lifetimes surfaces during times of stress.

This self-reproaching inner dialogue erodes confidence and feeds on further negativity. A downward spiral in negative thinking can ensue and result in a true "funk."


A gifted therapist years ago instructed me in an effective means of sidestepping negative thinking. First, one must create space between negative thinking and reality. In other words, observe one's thoughts rather than being them. For instance, whenever my inner critic manifests, I develop awareness that my brain is shifting to dysfunctional mode and I merely watch these thoughts come and go. I don't resist them for that only gives them more energy. After I become aware, I breathe and return to the present moment with the realization that negative thoughts are not to be trusted. They contain a lie and when I detach myself from them, they lose power.

Recognize that when you experience a barrage of self-effacing thinking, space between you and your thinking must be created. Otherwise a decline in mood is inevitable.

Look for the gift

Resilient individuals look at mistakes as opportunities for growth. In his classic book, Learned Optimism, Martin Seligman describes how resilient individuals develop a more constructive explanatory style for interpreting their actions. They are not quick to condemn themselves and more accurately ascribe untoward outcomes to conditions rather than overt personal failure. Optimists acknowledge that no mistake is permanent and doesn’t necessarily extend to other areas of their lives – i.e., "I am a total failure."

True optimists also recognize that each misadventure holds a gift – something positive is destined to follow. For example, the wayward incision may be a helpful reminder to slow down and get back to the present moment. The infection may hold the lesson that a 3-hour perfect fracture reduction also exposed the patient to unnecessary wound desiccation and vulnerability to contaminants.

The journey

This most wonderful of vocations is a marathon – not a sprint. Those of us who are kind to ourselves finish the race in good form. A self-compassionate mindset also enables us to serve our patients, friends and families with a "full tank."

Create space with negative thinking. Recognize that when you take “shots” at yourself these thoughts are not from your "source." The inner critic only undermines our ability to care for the next patient.