The Resilience Bank Account: Skills for Optimal Performance.

The day-to-day life of a cardiothoracic surgeon and other high-stakes occupations is riddled with chronic stress punctuated by acute, sometimes life-threatening, crises. Additional stress from the realms of a surgeon's personal life can add to the silent burden surgeons often carry. The tolls paid for poor management of the cumulative stress load can impact surgeons and their patients, leading to errors of clinical judgment, burnout, early departures from practice, health issues, and substance abuse. This article reviews 6 individual skills or habits that can, when proactively integrated into a daily routine, make the difference. The idea of investing in a resilience bank account is suggested as a metaphor for the reserve building and cumulative positive impact of these habits over time.