M and M as death ritual

Our fingers, no matter how nimble and graceful, are always tangled up with the fate of our patients, and when one of those patients dies, it is impossible to divest ourselves of that sense of responsibility. We torment ourselves with the what-ifs. Perhaps, if we had put that stitch in just a little differently or removed that cancer a little higher up or worked a little longer, then maybe our patient's course might have been different.

. . . M and M requires a public accounting of loss and, in so requires a public accounting of loss and, in so doing, reconstructs the death into an event that affirms a core value of our professional identity: the need to be infallible in a highly variable world. In this way, M and M is like death rituals in other cultures; it seeks to transform death's loss into an affirmative experience.

. . .

By defining death only as the result of errors, we erase the face of our patients and insert our own fiercely optimistic version of immortality.

Pauline W. Chen, Final Exam: A Surgeon's Reflections on Mortality  (New York: Alfred A. Knopf, 2007), pp. 118-19.