Transformations in self-understanding in surgeons whose treatment efforts were not successful.

This study, dealing with cardiac and cancer surgeons' reactions to treatment failure (i.e., situations where surgeons despite their best efforts were unable to successfully treat their patients) found changes in the surgeons that bore striking resemblance to certain changes in people undergoing psychotherapy. Twenty surgeons participated. Each reported on two of his patients, all of whom had undergone surgery that failed to stem the progress of their disease. The life expectancy of these patients was approximately one year. Each surgeon saw one of his patients only until completion of the customary postoperative care and then referred him/her back to the original physician. The other patient was seen by the surgeon on a once-monthly basis even after postoperative care had been completed. While the surgeons had decided to be part of the study "for the possible good of the patients," many reported experiences of transformations in their own self-understanding. The particular elements of healing and self-understanding included a sense of self-forgiveness and acceptance, a strengthened feeling of human connectedness, an enhanced sense of meaning about what they were doing, and a sense of openness and hope for the future. Perhaps this self-transformative process and the possible mechanisms for change discussed mimic what happens in psychotherapy patients.