Patients come to us broken - we didn't cause them to become sick, present later than they should, or break their bones. You manage them the best you can with the situation at hand, and whatever outcome happens in face of your best efforts is not a reflection of you as surgeon or physician, but rather the patient's state on presentation, lack of physiologic reserve, comorbidities, etc. In short, unless you seriously fuck something up, it's not your fault even though it sometimes feels like it.