The Scars We Carry

by Dr Fiza Ab. Rahman

In one of the episodes of Hospital Playlist (my favourite K-drama), Dr Ahn Jeong-won, a paediatric surgeon, was seen crying and wanting to quit after losing one of his patients. In reality, I believe there are many Ahn Jeong-wons among us. We just don’t talk about it enough.

We lost a patient yesterday.

After more than 10 years in paediatric surgery, I have lost count of how many parents’ hearts I have broken by telling them that their child was seriously ill, had cancer, needed surgery, was dying or had died. One should never get used to this. No matter how many years we have been doing this or how many patients we have seen, some stay with us forever and we are never the same afterwards.

I hope I will never forget the quiet hospital corridors in the early hours of the morning when I had to tell parents that their child was dying. I hope I will never forget the parents who cried out for us to save their children. I hope I will never forget having to tell parents that their child had died, sometimes when everything had seemed to be going well just hours earlier. I hope I will never forget the children whom I had known since the beginning of their journey, only to watch their conditions deteriorate with their helpless parents by their side. No matter how difficult these moments were, I hope I will never forget them, because they are part of what makes me human. A human first, a surgeon only later. Imagine the parents who are called to the operating theatre because things have not gone as planned, or those who receive an urgent phone call from the hospital, asking them to come immediately without knowing what has happened to their child. Can we imagine how they must feel?

Somehow, for us surgeons, life goes on afterwards. We return to work, attend to other patients, perform the next surgery and carry on with our responsibilities as though nothing has happened. There is rarely time to stop, let alone grieve. The hospital remains busy, and there are other children who still need us.

But has nothing really happened? An invisible wound has been left behind, one that may heal with time but often leaves a permanent, sometimes painful keloid scar. I often find myself replaying those moments, questioning my decisions, wondering whether I could have done things differently, spoken to the parents better or whether I even deserve to be doing this. I want to believe many of us do the same. We reflect, hoping to learn, and promise ourselves that we will keep trying to do better.

Perhaps one of the most difficult parts of our job is facing parents and delivering news that no parent should ever have to hear. Unfortunately, we receive surprisingly little formal training in doing this – Breaking bad news. I have always tried my best to be mindful of how I deliver such news, reminding myself that no matter how busy or exhausted I may be, I must never take these moments for granted. I hope my trainees can see this and learn to do the same. For us, it may be one of several things on our to-do list, but for those parents, it is often a conversation that changes their lives forever, one they will replay in their minds for years to come. It takes more than medical knowledge to deliver bad news. It requires a lot of common sense and empathy. We may know the diagnosis, understand the prognosis and have a management plan, but communicating all this to frightened or overwhelmed parents is an entirely different challenge.

But how do we know when we have done enough? And what about the children themselves? They too, have the right to know what is happening to them. Even young children have some understanding of their bodies and their illness. But are we doing enough justice to them? Are we protecting them by keeping difficult truths and pretending that everything is fine? Are we giving them hope or unintentionally giving them false hope?

I am not even sure how well I have been doing this unpopular part of our job. I wonder whether we could learn from one another if we talked about these experiences more openly. Should breaking bad news be part of our formal surgical training? And if so, who should be teaching us? Perhaps senior surgeons, psychologists, social workers, palliative care physicians or even parents who have been on the receiving end of these conversations? And just as importantly, who looks after the surgeons who have to deliver these messages? We are trained to diagnose, manage, operate and hopefully, save lives. But we are not taught how to deal with the grief that comes when we cannot save a child, or the nightmares in which we repeatedly see images of the children and their parents. We are expected to remain professional, composed and capable of making the next clinical decision, even when we are still grieving ourselves.

Perhaps these are the scars we carry as surgeons. They may not be visible to others, but they remind us of the children we have cared for and lost, the families whose hearts we have broken and the responsibility we continue to carry. I hope these scars will never make us sensitised to suffering, but instead remind us to remain compassionate, to keep learning and to keep trying our best every day.

To our little patients, especially our children in heaven, I pray that Allah grants your parents strength, patience and comfort as they navigate a loss that no parent should ever have to endure. May you all be reunited one day, in a place where there is no more pain, no more suffering and no more goodbyes.

And to the children we could not save, I hope you forgive me for my shortcomings. I promise to keep learning, to keep trying and to do better for the children and their parents who come after you.

A grieving surgeon,

Fiza Ab. Rahman
24 October 2026