Surgeons put on a stony, unfeeling mask so that patients' deaths don't destroy them emotionally and they can keep working. It is a form of self-protection against the stresses of the job, and doctors may come to rely on it almost inevitably.
The protective detachment holds until a single death gets through it, and then it can fall apart all at once. A surgeon may even refuse ever to speak of that case again. What the crack reveals is that compassion was never gone, and that cutting skillfully and caring deeply can exist in the same person.
Once the brain is exposed, the patient never fully returns to who they were before, whatever the outcome. Because the self lives in such delicate tissue, entering it is an arrogant act. It means presuming to alter the seat of the person.
When egg and sperm form, chromosomes are shuffled like cards as nature tries to deal the best hand. Some children are simply dealt a losing hand. Their disease comes from chance in that shuffle, not from anything anyone did.
It is not clear that patients facing surgery even want compassion from their surgeon. Mainly they want someone who can get the job done. That expectation helps explain why surgeons can feel free to hide their feelings.