Surgeons think they listen to their patients , in their various clinical settings , but very rarely do they listen with real understanding, true empathy. All doctors and medical students learn psychological ego defence mechanisms to protect themselves using ' detached concern'. Too little detached concern leaves the surgeon at risk of 'personal emotional injury' from exposure to their patient and too much risks the patient feeling that their surgeon is hardened and unempathic. Chronic over exposure to complicated clinical scenarios will affect surgeons to the extent that it overspills into their private lives. This is another negative factor towards clinical burnout amongst all surgeons. Regular reflective practice with surgeons asking themselves about their feelings can change how they practice and minimise the risk of developing burnout. #manageddetachedconcern www.mentoringmedics.com