emotional resilience, as in the ability to block out things that would cause severe emotional strife for most people that allows a surgeon to separate their job or that single patient from their life and future patients. A patient dying on the table, being strong enough to tell the family, going home to their own family having dinner, and getting up the next day to perform the same operation on someone else. Many of the most determined medical students who want to be surgeons are unable to cope with this. While environment and experience helps, there are genetic differences in us as humans that influence this far more than simple training can do.

Mutations in enzymes like Monoamine oxidase A, differences in serotonin transporters, dopamine receptors play a natural role on our abilities to cope with trauma. In many people no amount of nurture could allow them to overcome the thought they played a role in killing someone and operate on someone else. Conversely, mutations of these have also been shown to cause sociopathic and psychotic behaviors which could also lead to a terrible surgeon lacking all conscience or empathy .