I think the thing I was most struck by today was that there was so much discussion around surgery but not a whole lot of representation from the field itself. The Lewis Blackman case (which prominently featured the postoperative course of a young boy), the teaching case about the retained lap in the liver transplant, and some of the slides about the communication styles of physicians all centered around surgical cases/ issues. A bad outcome in a surgical case is often very dramatic (unexpected death in an otherwise healthy child, retained foreign body requiring an additional operation). It’s easy to criticize surgeons as overly confident, arrogant, and/ or reckless- especially when things go badly. However, I think what people forget is that it takes a certain amount of confidence and arrogance to be able to cut into another person’s body. This tension between confidence and humility is what makes surgery (and quality and safety within surgical subspecialties) so complicated. Until we engage more surgeons in this process it will be difficult to affect real change.