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The Emotional Labour of being a Surgeon

Stewart scored his job as 3-10/10 depending on the day (with ten being the most fantastic job imaginable).

by Laura Fruhen

A team consisting of surgeons, anaesthetists and nurses has come together to operate on several patients. Each case is different and complex. Each operation has the potential to change someone’s life. The team has a huge responsibility.

Stewart is the lead surgeon today. He discusses what aspects of his work are the most difficult. One might expect that the biggest challenge are technical. After all, Stewart has to choose the exact right surgical technique, and then execute this technique with amazing precision, under time pressure, and with a huge cost of error.

In fact, Stewart talks about emotions and his work. He reflects that:


There is this image of the surgeon as cold and uncaring. What people don’t realise is that most of us see things and deal with situations that are difficult, like where someone is terminally ill. Most people don’t face such things regularly. You must deal with this dispassionately in order to diagnose and treat but later it is vital to consider things from the patient’s point of view and engage with what they are feeling.

What Stewart describes is an aspect of work that has been labelled as emotional labour. Some jobs require us to show emotions that we don’t feel, or to hide some of our real feelings [1]. These can be customer-facing professions, such a retail. Healthcare is a classic example of a job that requires emotional labour. Emotional labour takes a toll, and indeed can impair well-being.

In Stewart’s case, what is especially difficult is switching. Sometimes, emotions can get in the way and hinder him from doing a good job, and so he must engage in emotional labour. But at other times, emotions are critical for his work: “The difficult bit is then to re-engage with the patient and to understand what they are going through emotionally. Compassion is vital for the patient and for the surgeon as, for both, it directs the empathy towards providing support either directly or through others. It is this switching from distancing himself emotionally, to really caring about his patients, that is challenging."

Emotions are a core theme for Stewart. In his view, there are “three things make a great surgeon: vulnerability, compassion and humility.” These aspects are all very personal, and require courage and emotional strength to develop. For example, vulnerability means:


you are trained to make decisions, to be certain and in charge. But sometimes it is hard when you are not quite sure what to do for the best. Taking yourself out of the situation, taking a moment, sticking your hand up to ask for help is hard, but it becomes easier the more often you do it. There are times when even experienced surgeons don’t know the answers. Being able to feel vulnerable (even if in truth you are not) but at the same time not react to it, or at least understand your reactions to it and modify your behaviour is an important skill to master.

For Stewart, one of the best things about his job is that “you can see the outcomes of what you have done really quickly.“  He explains that how much he enjoys his job can actually vary quite a bit: “Most days, it's a10. Sometimes it is a 3.” He identifies key factors that sometimes make his job harder: “What makes it a 3? It is your own failures, when things don’t go go as well as you had hoped or when errors occur. Also other hassles, when management are after you, or communication with the patient is causing problems.

What he highlights in particular is an aspect of work that psychologists label as error cost responsibility. The consequences of mistakes that we make at work can be a key stressor, and this is clearly affecting Stewart. When this causes the surgeon to feel vulnerable it may push them towards trying to numb the pain.  This may take a variety of forms; for Stewart it takes the form of snacking. “When I am stressed, I head for the biscuit tin,” he says, patting his stomach.

A little more..

What an anaesthetist said about his job

“The main hassles of being an anaesthetist are funding and bureaucracy”

“My job is a 10.”

“My work starts and stops in theatre. It is great that I get to concentrate on one person at a time, rather than having to focus on 20-30 patients throughout the day.”

“My hours are good, I can see my daughter before I head into work and afterwards.”

“My job wouldn’t happen without technology. Anaesthesia is only 150 years old, but technology has developed rapidly.“

What a nurse said about her job

“My job is a 10.”

“Helping people and the people you work with is what makes this job great.”

“The best thing about working in theatre is that you know each other as a team.”

“I am here because I love my job. It is the joy of helping people.”

“The variety of tasks and operations is great.”

“The worst things about my job are equipment issues. When a machine doesn’t work you go into problem solving mode, you know, when you have to run around.


[1] Ashforth, B. E., & Humphrey, R. H. (1993). Emotional labor in service roles: The influence of identity. Academy of management review, 18(1), 88-115

[2] Martin, R., & Wall, T. D. (1989). Attentional demand and cost responsibility as stressors in shopfloor jobs. Academy of Management Journal, 32(1), 69-86. (Raine study)

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