How to be an Authentic Doctor #5: Don’t Kill Yourself

asssss

don’t mean this figuratively. This is a literal recommendation.  Do not commit suicide. There I said it.  No one else seems to want to talk about it but doctors do kill themselves.  A lot.  In fact, our suicide rate is much higher than the rest of the general population.  This is more than troubling.  This is mind blowing.  I have known about a half dozen physicians who have taken their own lives over the years.  One hung himself from a tree outside his house.   One performed hari-kari with a knife in his car.  Another one put a bullet in his head.  Seems like a lot, doesn’t it?  Do you know why? Because it is!

How could someone who spent 4 years in college, 4 years in medical school and 3 to 7 years in residency decide to take his or her own life?   Because we can.   And because we don’t take care of each other.

There are a ton of theories out there on why doctors commit suicide.   Honestly, this isn’t much of a mystery.  The pressure is tremendous.  The lack of gratitude by patients and employers is painful.   The feeling of “is this all there is?” is overwhelming.  We are working harder, getting paid less and with more and more mandates put upon us. The list goes on and on.  Here is a little secret.   The job has sucked the life out of us.  Doctors are getting more and more depressed and the number of us that suffer with depression are growing in epidemic proportions.

But don’t doctors have the world by the balls?  Not quite.  We have sold our souls and youth and health and relationships to get here, and now that we are here, we feel alone in our misery.   Add that loneliness to the other factors mentioned above, which results in, ta da, depression.  So why don’t we tell anyone about it?  Because that makes you unfit to be a doctor and anyone you tell is liable for not reporting you.  How unbelievable is that?  No doctor wants that stigma.  And we all want to keep our job.

It is also a pride issue.   Many of my medical partners (including myself) probably needed, but did not take, antidepressants in the past. We were too strong for that.  Some got counseling but that was rare.  Instead, we suffered in silence just like so many other doctors do out there.

So what’s the answer?  That isn’t easy, and I will point out some other recommendations as this series goes on, but first we need anonymity.  We need to feel secure that our jobs are not threatened when we spill our guts.  That is a long way from happening since we have lost control of this profession.   So let me give you one more recommendation – foster, build and maintain your friendships especially with other doctors. We need to stop being loners.  We need to hang out with each other more.  We need to fight this loneliness and realize others are walking in the same footsteps as we are.  We need to be able to trust each other, talk to each other and hang out with each other.  This decreases after college, gets worse after medical school, tapers to a dribble during residency and then gets cut off once you enter the medical world.  That is when we start to isolate ourselves and then we kill ourselves.  We need to be able to commiserate with each other.  No man or woman is an island.  Not even a doctor.

 

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  12 comments for “How to be an Authentic Doctor #5: Don’t Kill Yourself

  1. Terry Nugent
    March 26, 2014 at 2:15 pm

    Back in the mid 20th century, the county medical society served as a gathering place for physicians to get together. Over time, membership fell for various reasons, but judging by your post nothing has arisen to take the place of what may be a necessary socialization function for doctors. Perhaps it is time for a renaissance.

  2. Katherine
    March 26, 2014 at 8:22 am

    Not to make light of a very serious issue (I have lost friends and family to suicide), but the workload and expectations of physicians is ridiculous. I guess is my little small town bubble we are lucky, the MDs I know actually seem to respect and value what each other does, but, when you have one choice of an ENT in a 1.5 hour radius I guess one has to…. OK I digress.

    My point was supposed to be that I have seen a lot of physicians regain quality of life and time to actually relax if they are willing to hire a (non militant) midlevel that has a good head on their shoulders.

    • Doug Farrago
      March 26, 2014 at 9:22 am

      And that was how it started, with good intentions, to be collaborative. And then the number of militant midlevels grew and now no one gets along

  3. DrPhil
    March 23, 2014 at 2:53 am

    As a survivor also, here is how the Medical board helped me:

    One of many conditions allowing me to be a practicing registered medical practitioner:

    The Practitioner will only practice in a group practice approved by the Board or its delegate.

    For the purposes of these conditions, the practice of medicine means any role, whether remunerated or not, in which the individual uses their skill and knowledge as a medical practitioner. It is not limited to the provision of direct clinical care and extends to remunerated or unremunerated consultations or procedures, prescribing, referring and signing documents requiring the exercise of knowledge and skills of a medical practitioner.

    So – unless you are a registered patient who is seeing me as a patient,
    and are not in any way shape or form a personal friend, a relative, or a relative of a personal friend
    or in any way a relative or a close personal friend to a relative of mine, do not expect me to mention anything about medicine to you ever, except maybe “See your doctor”.

  4. politovski
    March 21, 2014 at 10:28 pm

    well, i would agree and disagree with lance. many of us fixate on work and are as boring as whale-shit to talk to. a buddy of mine from residency and I noticed that our significant others would roll their eyes and make fun of us when we got together. so, we deliberately would avoid talking about work when we got together. sports, politics, kids, beer, tom petty… now that i am out in practice, i would agree with the isolation. so, i invite my partners over for homebrew. there are several local docs who are in my bible study group, and we talk about work abit, but focus more on our bible study instead. it’s much like marriage, you get what you put into it. relationships that you cultivate and nuture will bear fruit.

  5. Sir-Lance-a-Lot
    March 21, 2014 at 10:34 am

    All very true, Doug. Well, except for this: “We need to hang out with each other more.”
    Sorry, but if I were to hang out with other doctors, THAT would probably make me kill myself. Hell, I’ve come close to gnawing off my own arm at “mandatory” staff functions.

    Seriously, you gloss right past this, but I think it’s a real part of the problem. Present company excepted, most doctors can’t stand one another, all doctors feel misunderstood by non-doctors, and most non-doctors utterly despise doctors (which is why I never tell anyone whom meet socially what I do), so most of us really do have nobody we can talk to with any degree of honesty or openness.

    I’m afraid I can’t help by offering some brillant way around this one. The plain fact is that most doctors are assholes, and the few that aren’t are distributed too sparsely to find each other and form real social connections. Trust is also important, because very few human beings are perfect, and most of us have a thing or two we’ve done wrong or inadequately over the years, that we cannot breathe a word about to other doctors, because there is nobody who will leave you swinging in the wind faster than a doctor. In any other occupation, your coworkers will back you up if you get into a jam, but doctors will hang you out to dry every time. Who would want to spend time with someone who may (or may not) rat them out if they say one wrong word?

    Anyway, yeah, I can’t think of five doctors I’ve known who’ve killed themselves, but I can think of two immediately: One, and ER doc, “nicest guy in the world,” always willing to help or talk, went home and set up a well-thought-out IV cocktail one night, without ever giving a clear reason. Another, a very well respected specialist and also a nice, approachable guy, cut his own throat with a kitchen knife and bled out in front of his ex-wife (“issues”?).
    I figure I myself have a fifty-fifty chance of dying of old age, partly because I’m one of those docs that everybody likes, which I see a huge suicide risk factor, and partly because I can’t remember a day when I haven’t thought of doing it, and I’m talking going back over thirty years. I’ve spent years being “fearless” in life, because I really don’t care if I get killed, but so far my number hasn’t come up. Am I planning to do anything? No, because I’m not the kind of jerk who messes up other people’s heads like that. But who knows what thing or things it takes to one day make a person decide that “today is the day”?

    Personally, I think that the healthiest thing I could do would be to get out of medicine, but I can’t afford to yet.

    • Doug Farrago
      March 21, 2014 at 11:06 am

      Great comments and feedback. Thank you for that.

    • Pat
      March 21, 2014 at 8:40 pm

      Kudos Lance, I admire your honesty.

    • Kurt
      March 26, 2014 at 8:43 pm

      “Personally, I think that the healthiest thing I could do would be to get out of medicine, but I can’t afford to yet.”

      Yup. I suspect the death rates among the the R.O.A.D. Docs (Doug’s excellent anagram for Radiology, Opthalmology, Anesthesia and Dermatology) is quite a bit less than FP, IM, ER and Surgery. Ob’s usually
      screw around alot and Anesthesia folks become druggies. Hell they get access to the good stuff but can usually be very successfully rehab’ed if caught ’cause they realize how much money they’ll miss out on.

      Kurt

  6. Pat
    March 21, 2014 at 9:53 am

    Hear, hear… Added to this all is the realization in the word of “Scrubs”‘s Perry Cox, the growing realization that “everything we do is just a stall.”

  7. Josh
    March 21, 2014 at 8:43 am

    Great post and thanks for shedding light on this. To many people think doctors have it perfect and don’t appreciate just how difficult it can be.

  8. March 21, 2014 at 7:56 am

    yupper
    a survivor
    can’t get everything right

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