In their evaluation of a method that assesses surgical workload, Wilson et al. [1] made the assumption that intraoperative stress is necessarily detrimental to surgical performance. However, the Yerkes–Dodson law [2] dictates that increasing levels of stress improve performance up to a point, beyond which further stress causes performance to diminish. Thus, if our objective is to improve outcomes, the important metric is not surgeons’ subjective evaluation of their stress level but an objective evaluation of how different intraoperative conditions impact upon performance, especially given that the stress–performance relationship will differ between surgeons.