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The need for a medical consultation always generates an unpleasant sensation, which becomes more accentuated, when the doctor is a surgeon. The surgeon is next to the dentist, gynecologist and psychiatrist, the doctor to whom the patient turns with the greatest fear. The operative indication and the discussion of therapeutic perspectives can trigger a psycho-emotional imbalance, leading to tomophobia. In fact, it is a complex psychological reaction, including odynophobia (fear of pain), dysmorphophobia (fear of postoperative bodily sequelae), hypnophobia (fear of anesthetic sleep, from which one could not wake up), trypanophobia (fear of injections, needles, scalpel), pantophobia (fear of everything that happens around, in this case, in the hospital environment) and above all, thanatophobia (fear of death). Therefore, it can be stated that the surgical intervention is a test of the psychoaffective capacity. The paper presents the authors' experience in 20 years (2002-2021), related to the psychological management of surgical patients, subjected to medium or large-scale surgical interventions (75% performed in emergency mode), in 958 patients. Mental stress can have consequences, both on the reactivity of the surgical patient and on his postoperative evolution. In the time crunch and in the absence of a psychologist, available to offer specific advice on medical objectives, the management of perioperative anxiety rests with the surgeon and the nursing staff. The paper discusses and underlines some elements related to the psychology of the surgical patient and insists on the importance and role of the psychologist, in the prophylaxis and treatment of what can be called operative disease. [ABSTRACT FROM AUTHOR]