Complications in Surgery. Every surgeon has experienced complications from doing a surgical procedure. Dr. James Hardy even wrote an entire book entitled complications in surgery. The question I want to address today is not a specific complication, but how does a surgeon feel when a complication arises following a surgical procedure which he has performed. Generally, it seems to me that most of us surgeons put on our intellectual hats and recognize that complications do occur. Most often we view it as a continuation of the disease process. However, what about those times when it does not seem related to the disease process. What about when those nagging thoughts of doubt come creaping in "did I do something to permit the complication to happen?" Surgeons are not able to function optimally if constantly confronted by self-doubt. The emotional safety net is to simply acknowledge complications as part of the activity of doing surgery. However, when complications do occur, I believe the usual emotional response is to feel angry. Angry that we are not so much in control as we would like to think and that even with meticulous attempts at hemostasis, hematomas occur; even with careful attention to anastamotic technique, leaks occur, etc. The anger arises out of a sense of helplessness to control the ultimate outcomes of our own physical performances. How great was the insight of Ambrose Pare, the father of modern surgery, who so carefully summed up his surgical endeavors = "I only put on the bandages, God does the healing." So often, we tend to forget that the natural and Divine forces with which we contend far exceed our mortal powers. Looking forward to some responses. JTE.