Do doctors secretly experience happiness when a fellow surgeon encounters a complication, perhaps as confirmation they’re not alone in their fallibility?
You guessed right: I did spend an evening with the eloquent Shashi Tharoor. He graced the 5th International Conference on Complications in Neurosurgery as chief guest. Tharoor, in his characteristically erudite style, regaled us with a gem: “The scariest neurosurgeon from the patient’s point of view is one who manages to nick himself while shaving.” The room erupted in laughter, a sound rarely heard echoing through the hallowed halls of surgical conferences.
It’s a meeting we host every two years in India where neurosurgeons from across the world come together to deliberate their failures rather than talk about their triumphs. They travel to share their experiences on what went wrong, rather than what worked. Instead of addressing the latest advances, we discuss disasters. It’s the only meeting where, as a surgeon, you don’t feel too bad about yourself. “According to The New England Journal of Medicine, a staggering 88% of physicians in America are likely to be sued by the age of 45, and a jaw-dropping 99% of them by the age of 65,” Tharoor went on to enlighten his audience with this sobering statistic, adding that neurosurgery topped the list, and that he was surprised that a set of the most skilled hands and meticulous planning doesn’t always lead to a perfect outcome.
Intrigued by this culture of commiseration, I posed a question to a friend: “As a surgeon, what would your reaction be if another surgeon you knew had a complication with a patient?” “You want me to be honest?” he replied. “Of course,” I retorted, knowing no other way. He told me a story of how he was called to see someone in his building who had an abscess in the spine, for which he recommended a particular procedure. The family took several further opinions from him, didn’t even offer to pay, and eventually scheduled surgery elsewhere without even notifying him. They returned to him after the patient developed a serious complication from the operation, where the procedure was not in keeping with what he’d initially recommended. “Now, am I supposed to feel bad for such a patient?” he rhetorically asked. “I was happy – because I don’t like that other surgeon!” he admitted with a devilish smile.
That’s when the word ‘schadenfreude’ came to mind. It had nothing to do with Shashi Tharoor. It’s a German word that means delighting in another person’s misfortune; (schaden, damage + freude, joy). Sitting in a room filled to the brim with 300 surgeons, I couldn’t help but ponder: Do doctors, in the quiet recesses of their minds, ever experience a twinge of… happiness (dare I say) when a fellow surgeon encounters a complication? Is there a secret, unspoken relief in knowing that they are not alone in their fallibility? Of course, propriety dictates that one should never openly admit to such a sentiment. After all, medicine is hailed as the noblest of professions, and revelling in another surgeon’s misfortune, especially when it comes at the expense of a patient’s well-being, is generally frowned upon.
I must confess that when I was younger and brimming with youthful arrogance, if I advised patients against spine surgery, and they, in their infinite wisdom, went ahead and had it done elsewhere only to return to me with a laundry list of complaints, I experienced a certain… surgical schadenfreude.
“How dare they not heed my sage advice?” I would ask myself smugly, convinced that my word was the ultimate medical decree. But age, as they say, brings wisdom (and less hair). Now that I’m older and (hopefully) wiser, I look at patients with newfound empathy and grace, born from the humbling experience of having navigated my own fair share of complications. Often, patients labour under the misconception that doctors are somehow immune to the consequences of their mistakes. Nothing could be further from the truth. The weight of responsibility in our profession is a heavy burden to bear.
“There is no love of life without despair of life,” wrote Albert Camus, the French philosopher and author. The metamorphosis of despair into love is what we call meaning. And as doctors, we are constantly aiming to make people’s lives more meaningful by picking up fragmented pieces of shattered hopes and dreams and trying to put the puzzle together. So today, nothing gives me more joy than a patient cured, even if it is at the hands of another surgeon. Surgical schadenfreude has been replaced by surgical freudenfreude – the bliss you feel when someone else succeeds, even if it doesn’t directly involve you. Despite its hardships and vicissitudes, the joy of healing and helping is comparable to none.
On a lighter note, I have an adorable friend who abhors the fact that I’m good at what I do and that my entire being is ensconced by how much I love my work. She loves to see me agonize and self-doubt over patients and is filled with glee when I’m having a long, hard day fraught with multiple operations where I don’t have time even to grab a meal. It baffled me till date but now, strangely, I find a sense of perverse amusement in knowing that someone is happy to see me in a state of utter chaos. It’s probably a unique textbook case of reverse schadenfreude.
15 thoughts on “The surgical schadenfreude”
Now we will need not only English but other dictionsties as well to read you. Very difficult topic beutifully illustrated. Putting self in discussion is difficult but done well
Well written piece as usual.also learnt a new word .schadenfreude.😁
It’s to your credit to deal with this topic in such an honest and candid manner. Your research into a topic is incredible. And you’ve taught us a new word…thanks!! A pinch of humour adds the cherry on top. Great going Dr mazda.
Brilliantly penned. Your reflection captures an uncomfortable truth we rarely voice: the flicker of relief that our own fallibility is shared. In our own mortality & morbiditiy meetings, I’ve sensed that “surgical schadenfreude” is less malice than a maladaptive coping strategy, an anxious reassurance that our personal nightmare is, in fact, part of the collective risk curve. Yet, as you note, that reflex dissolves once we have truly inhabited the consequences of our own complications.
What I find most valuable about forums like ICCN is that they transmute that reflex into something constructive: psychological safety to disclose, rigorous analysis to improve, and ultimately a culture where another surgeon’s misstep becomes everyone’s lesson. Perhaps the next evolution is to formalize this ethos, shared registries of adverse events and peer‑protected debriefs; so we can convert private Schadenfreude into public quality data, and, as you eloquently put it, into “surgical freudenfreude.”
Thank you for reminding us that the real metric is not complication‑free practice, but complication‑informed progress.
Brilliantly penned. Your reflection captures an uncomfortable truth we rarely voice: the flicker of relief that our own fallibility is shared. In our own mortality & morbiditiy meetings, I’ve sensed that “surgical schadenfreude” is less malice than a maladaptive coping strategy, an anxious reassurance that our personal nightmare is, in fact, part of the collective risk curve. Yet, as you note, that reflex dissolves once we have truly inhabited the consequences of our own complications.
What I find most valuable about forums like ICCN is that they transmute that reflex into something constructive: psychological safety to disclose, rigorous analysis to improve, and ultimately a culture where another surgeon’s misstep becomes everyone’s lesson. Perhaps the next evolution is to formalize this ethos, shared registries of adverse events and peer‑protected debriefs; so we can convert private Schadenfreude into public quality data, and, as you eloquently put it, into “surgical freudenfreude.”
Thank you for reminding us that the real metric is not complication‑free practice, but complication‑informed progress.
Superb
Another gem Mazda!
Of course lessons learned is an industry standard and I am glad that surgeons do it in such a massive scale.
One just has to read your articles to see how much humility and compassion our favourite neurosurgeon puts into it.
Another interesting subject I look forward to discussing with you. Would that fall under freudenfreude??
You are great Dr. Mazda. 👍
Very well written about society ‘s most respected people ‘s negative innermost feelings. Usually no one talks about such evil traits in their character. But thanks to u for touching everything and every emotion under the sun.
Neurosurgery still is a surgical science where most of you think along similar lines. Some may be a bit conservative abd some a bit adventurous. But spare a thought about my speciality, Plastic Surgery; every surgeon has a different plan and is prepared to vouch for it. What is even worse is they all are correct, all the plans are workable. Only personal experience and available circumstances differ and so do the plans! I often come across patients who are thoroughly confused, and what is worse is, they think we are a confused lot!
It’s a very frank admission of reality in surgical realms which all surgeons experience but is rarely spoken or discussed in open forums albeit , the fact remains that with multitude of surgeries happening in all fields the complications have also increased
A holistic approach from senior surgeons and other team can alleviate a lot of pain which an operating surgeon may be going through at times
You tread on a path where rarely surgeons want to tread
Well written dr turel !!!
Neurosurgery still is a surgical science where most of you think along similar lines. Some may be a bit conservative and some a bit adventurous. But spare a thought about my speciality, Plastic Surgery; every surgeon has a different plan and is prepared to vouch for it. What is even worse is they all are correct, all the plans are workable. Only personal experience and available circumstances differ and so do the plans! I often come across patients who are thoroughly confused, and what is worse is, they think we are a confused lot!
Very well constructed and articulated writeup..Deeply impressed by the clarity of thought and self observation, and ofcourse the truthfulness of the entire concept makes it so relatable to most of us , if not all..Physicians also harbour similar emotions and as they mature and grow older in their own practices, tend to develop the positive side to it..The
2 new wonderful German words are also a very valuable additional takeaway from this .👏👏👏👌👌👍
Always love reading your articles, Mr Mazda Tharoor. Only you could wrap surgical humility, linguistic flair, and borderline sadism into one beautifully stitched article.
Remind me never to ignore your advice… or borrow your razor 🪒
A very interesting and informative read! This site consistently
shares high-quality and useful articles.