Nguyen S, et al. - Nationally indemnity payments and legal expenses cost $10 billion annually. Every year, a malpractice claim is faced by 15% to 20% of US surgeons and nearly 2 years are required to resolve each claim. A malpractice claim is more likely when the error is severe and undisclosed and when the surgeon displays little empathy. Neurobiological research evidence suggests sleep loss as a crucial overlooked factor. Sleep loss not only hinders recovery but also increases emotional reactions and triggers impulsive behaviors.