Botched surgery

[Liemannen]

A tired surgeon can be dangerous.

if the Surgery operation would take the surgeon to negative AP, the surgeon might fall asleep mid operation. Or maybe literally fall asleep, scalpel first against some nice lung / heart pillow.

If the surgery takes surgeon to negative AP, have some % chance that the patient gets hurt instead of healed. More negative, then bigger chances of botching things up.

"Patient Adam" was killed by Doctor Nick with a botched surgery attempt. Or something like that if the patient dies.

[Badziew]

Why should it be limited to only negative AP?
Surgery could in general have a small chance of failure, and tiredness would only increase it.
Other debilitating factors could be the surgeon having non-full HP or suffering from any kind of negative status effect - it is rather hard to concentrate on surgery when you are bleeding, set on fire, or your veins boil from poison, isn't it?

[Kandarin]

Adding realism in this particular area would hurt the player experience more than it helps. Nexus players generally like spending their last AP on big things, and punishing them for this one instance would feel bad.