Yesterday, another valued, esteemed physician died. I suspect every physician knows of at least one physician who died prematurely. Lots of times its for “natural” causes… I say “natural” because crashing your car while driving mostly asleep is kinda natural (but not really); because cancer in a person who hasn’t properly slept, eaten, or exercised in 10+ years is kinda natural; because so many causes of premature death that are natural are also preventable, but require the time, energy and investment in yourself to prevent them… And then sometimes their premature death is not natural…. But we don’t want to talk about that. We don’t want to dishonor their memory. Maybe we don’t want to accept that it’s preventable… That it could happen to you, or me, or a friend or colleague or spouse…
I want us, as physicians and as a society, to acknowledge that there is a problem. I want us to acknowledge that we are losing more than one physician a day to suicide… in their homes, in their workplaces, in their call rooms. I want us to recognize that physicians are more likely than others to suffer from depression, drug abuse, alcohol abuse and ultimately commit suicide- intentionally or unintentionally. We need to be aware that as physicians we have excess stress leading to medical conditions that result in our early demise. In women physicians, suicide is 250-400% more common than in non- physician women.
What the hell?? We are bright, energetic, intelligent and successful women! Why are we killing ourselves?
It isn’t just the career, and it isn’t just this career. It’s with any high powered profession and it starts young. We are not prepared for the cold, cruel reality of medicine or business or law, or even life. We are told from when we are small that we are the best. We are so smart, so talented. We can do anything. We are the valedictorians, the varsity athletes, the small town success stories and inner city kids who make it big. Our parents told us how wonderful we are, our teachers told us how smart we are, our coaches told us how talented we are… And then one day… We are just not good enough.
That’s right. We are not good enough. That person you’ve been charged with taking care of dies. What happened to “I can do anything?” What happened to “I’m the best.”
Well, sometimes our best isn’t good enough, and even worse, sometimes we make mistakes. We fail.
So, there you are…. Feet planted to the goddamn OR floor in pure protest of surrender and you can’t fix it….fingers grasping your ICU patient’s bedside table and you can’t prevent it.… Arms pumping the chest of the toddler in the ER and you can’t get him back.…”no one dies on my watch”, but they do….and you can’t handle it.
But in any full time, intense high power career where years are spent in preparation and excessive hours are spent at work, it happens. Failure happens.
Your boss or attending screams at you about what an idiot you are. You repeatedly come home late to a failing marriage, perhaps you succumb to the temptations within the workplace with no real accountability due to “long hours”, call, and overtime. You miss another of your kid’s events… They start acting out…
You begin to unravel. Failure… You have no coping skills for failure. You never expected failure…. Not me…
More stress, more unraveling…. Access, money… It’s a recipe for disaster.
Physicians turn to drugs, alcohol, dysfunctional behavior, destructive relationships, depression. They claim “no time” for more healthy releases like exercise, me time, mindful awareness or meditation.
Well guess what?
I want a pledge. I want you to pledge to not let this happen to you. I want a pledge that you will keep this in mind when dealing with your colleague and friends and even students.
We are smart. We are good. We need to take care of ourselves! Learn to accept failure. You don’t have to like it. But learn from it. Don’t fail yourself. Take a yoga class. Try out mindful awareness. Speak up if you are concerned about yourself or someone else.
There may not be second chance.
Patricia Alcala
Thank you for putting it into words for me. This is the worst part of being in the medical field. I am a Physician Assistant and experienced the same. I went into a field that I knew that I wanted because I was a hospital volunteer as a teenager and realized that helping people was my life. It never occurred to me that all of the abuse that we accept on a daily basis would never be accepted in our private life.
I also lost a fellow P.A. student in her last year to suicide.
Elizabeth Faraone
Is it possible so many physicians kill themselves because they are required to commit malpractice? If I were a person who had no compassion, I would have filed lawsuits a long time ago. I understand the pressure doctors are under to conform.
JBollen
Suicide is the 10th leading cause of death in the US and #2 or #3 in some age groups.
Almost 43,000 people die from suicide each year and yes it is sad that we lose about 350 doctors this way each year but it is only a tiny 1 % of the total. What is missing from that stat is how old are they? Are they working professionals or retired? (the average practicing doctor in the US is 58)
It is thought (Joiner, Jobes work) that one reason they have higher rates of death by suicide is because they have knowledge and access to the means and have built up familiarity with death
The larger problem is that if physicians are in denial about their own depression and refuse to get treatment how can we expect them to identify and treat it in their patients.