Physician Suicide
Here is a nice editorial about physician suicide in the NY Times. I blog about this issue often because it saddens me. This is one really is from the young doctor’s perspective. Here are some highlights from the piece that were important to me:
The statistics on physician suicide are frightening: Physicians are more than twice as likely to kill themselves as nonphysicians (and female physicians three times more likely than their male counterparts). Some 400 doctors commit suicide every year. Young physicians at the beginning of their training are particularly vulnerable: In a recent study, 9.4 percent of fourth-year medical students and interns — as first-year residents are called — reported having suicidal thoughts in the previous two weeks.
Some stoics may invoke Osler’s creed to argue that physicians must push aside our personal burdens to care for the sick. But a tired and depressed doctor who is an island of self-doubt simply isn’t as likely to improve the outcomes of his or her patients — or ever truly care for them.
You can read the whole article if you are a young resident and it intrigues you. The truth is that as a young doctor you have more help around you and that is a good thing. Use it because that help unfortunately goes away. Just wait. The burdens are different when you are older, and in many ways life as a doctor is better but it is doesn’t last long. Soon you will find that the bureaucracy of medicine will beat you down and then you find out NO ONE is there to talk to. You also fear being reported to the state board for being an impaired doctor. You are alone on an island that is shrinking in size as others try to bump you off. Yes, I am saddened for my fallen comrades and I only pray that we can one day get off the treadmill. That is our only chance of rescue.
I suffered from depression in residency. When I felt the worst I had no time to see anyone. When I had time to see someone I felt fine. I was angry at my mentors for not seeing how much trouble I was having. After a few years in practice I was able to see that was unrealistic. I wanted to quit many times but my overwhelming debt keep me working.
Hello Douglas. A good day to you sir. Yes, we physician types (including those in training) are a stressed bunch. I have had 2 so called heart attacks and I continue to work at breakneck speed. (zero cardiac risk factors by the way..except the real killer…stress). I know, it’s stupid. We slowly and insidiously keep ratcheting the stress to unsustainable levels. I know I did it and our medical culture encouraged it. We as interns or residents would NEVER call in sick. Why? The wrath of our coverage/call partners would be horrendous. “Suck it up”. We used to say (myself included) you are either dead..or your here working. 24 hour, 36 hour, 72 hour shift..no problem. I can take it. 100 hour week, including 6 fifteen hour overnight shifts on a busy internal medicine service. No problem. Good training! Remember the old saying….”All the good medicine cases happen in the middle of the night”. As a chief resident I would reprimand residents who took time off for legit reasons. Why? The Culture. Somebody has to be there and do the job. You are expendable. Physician suicide is a natural progression from the culture of stress that exists in modern medicine. I think limiting resident hours is a step in the right direction. However, as an attending hospitalist, I felt more stress on my week of service than anytime as a resident. (I actually had my first heart attack right after a stressful hospitalist week).
The point being, stress is killing us. Either the acute MI, cancer from immune suppression, substance abuse, or suicide. Physician heal thyself.