Let’s Talk About it: Dr. Leigh Sundem Dies by Suicide
Here is the reference article for this quote:
Even though she had 16 academic awards, 6 professional leadership positions, 5 research projects, 8 scientific publications, 9 scientific presentations, 10 years of teaching experience, and membership in 12 professional organizations, Leigh was left unemployable due to discrimination WITHIN medicine…………
Wow!! To be unmatched for 3 years in a row. I can’t imagine the pain and strife she felt. Moreover, the letdown from a system she dedicated her life too. Imagine going through all the hurdles in the face of adversity only to be slapped in the face 3 years in a row. She was by all accounts a stellar candidate and would have made a great physician. The discrimination she faced was from a drug addiction from her teenage years. Really?? Show me anyone who is the same person they were as a teen. The very experts in medicine that are supposed understand human development are the very ones who discriminated against her for past juvenile behavior. That her past was an obstacle to her future shows the hypocrisy in medicine. Now, I do see that she had some responsibility especially as an MD to recognize she needed help, but I suspect her fear for further alienation kept her from reaching out for help. This raises the concept of stigma for both substance abuse and mental health within our own medical community. I wrote about stigma before in a prior blog (https://authenticmedicine.com/2019/07/who-farted-stigma-stinks-diagnostic-clarity-needed-to-distinguish-physician-burnout-depression/). It’s this very stigma that I believed killed Dr. Sundem.
In addition to the stigma concept, her suicide also raises questions in the whole Match process. The process itself, the issues of shortage of residency slots, and the inherent discrimination within the process itself. We all know there are not enough residency slots for the number of physicians applying for residencies. It makes the process very competitive such that anything in people’s pasts is used against them. It was like back in my Army days, there was this ‘Zero Defect’ mentality, such that any infraction, discord, or blemish on the record was used against the Soldier. It makes me worried about what will happen to me this fall as I apply for residency? As a 2nd career MD, will my age be a discriminator? Like Dr. Sundem, I have a good resume, passed all my USMLE exams with good scores on the 1st attempts, and I have a ton of US clinical experience, but like Dr. Sundem, will this be overlooked. Will I face discrimination too? I’m also a disabled Combat Veteran; will this be held against me too? We’ll see. It just brings up the discussion about the shortage of residency slots that has made the Match process so cutthroat. Many qualified applicants such as Dr. Sundem go unmatched every year, and the expectation is that no one who is unmatched gets disturbed about this. If they are disturbed, and seek mental health help, this will be a discriminator? See the dilemma? It seems obvious that we need more residency slots, and petition after petition is sent forward regarding this. I don’t know what the solution is. We know what the problem is, but solutions seem to elude us as a medical community. It’s probably a hugely complex issue requiring complex solutions that this simple blog won’t be able to solve. But maybe Dr. Sundem’s suicide won’t be in vain. Maybe the discussion needs to start by talking about the sequela of being an unmatched physician. The pain of being unmatched, yet the burden of having to stuff the feelings as such. For Dr. Sundem to bear this burden for 3 years straight, one can only imagine the pain she went through.
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And a tip o’the hat to the inventor of the Good Cop/Bad Cop interrogation routine, as much a part of our modern occupational/behavioral plumbing as the write-up, the Counseling and the Progressive Disciplinary Action plan.
It weeds out those intellectually unsuited for leadership. This sort will blurt out the truth when asked, always the same to everyone. True sophistication requires mental effort. Facts are merely mindless observations. The act of raticionation – that what matters is not the truth but its conclusion. One doesn’t want a jury, for instance, hung up on the facts implying that you’ve committed a murder; one wants them convinced that you’re not the murdering type.
In the same way, a sophisticated psychological evaluation panel at a medical board can be divided into the Good Cops, who wheedle to target to blurt out the Truth under the reassurance that the committee is there to help them become a better physician; and then the Bad Cops, who replay their unprejudiced audio confessions that they are Whacky F_cks who shouldn’t be within a straitjacket’s range of a patient, at least not the modern straitjacket embroidered “MD”
If we could only mandate a psychological education and evaluation panel – call it a PEEP – we could select for physicians who are not crippled by conscience and self-doubt as Dr. Lindsay Sundman clearly was; and bring together a group with more solid foundation on the utility of others and less concern about the incompleteness of self.
Doctors who ultimately plan their lives around how they look to the world, and whether people like them or not, are very low suicide risks – for what is the benefit they might gain? It is the ones with psychological complexity, spiritual depth, mental illness – take your pick – who are the ones likely to burn out, yadda yadda etc.
Obviously this sad individual had far deeper, unresolved problems beyond simply not matching, and it’s ridiculous to blame her suicide primarily on that fact.
That said, this business is unhealthy on a physical, emotional, economic, and spiritual level, on a good day; may God truly help anyone whose identity is solely bound up in this job, to escape this often fatal trap.
And again, hear, hear! Since physicians have over twice the suicide rate that non-physicians do, there are over 50% of physicians whom, by their own unkindest cut, shouldn’t be physicians after all.
If we could review physicians’ psychiatric health on a regular basis – say every cycle of license renewal – and make them pass a psychological profile given by psychological experts such as PhD’s, social workers, and such – and target a pass rate of, say, 90% or less – we could easily clear out such weak reeds as Dr. What’s Her Name above. Or at least she could eat lead on her own time, and not foul up our HR, insurance, etc., systems that we in the armchair agree are designed for the EXCEPTIONALLY mentally healthy like us.
Gosh I hope this is sarcasm
Her suicide speaks for her. Not good. justifies not accepting her.She gave up on herself and betrayed all those who had believed in her. What was it that they did not accept her. Did she go ask them.Did she contact an attorney to see if it was discrimination..
She failed herself and all those who loved her and cared about her.. A terrible waste. Evrryone has a path to walk. Everyone makes choices. There is no one to blame but her.Evrrything is COMPETITION. EVERYTHING IS A BUSINESS MODEL.There are thousands of brilliant people who Never Do Anything,never make their potential. Drugs alcohol, just some of the paths. Suicide a permanent solution to a temporary problem…If you want it you have got to FIGHT FOR IT. EVERY DAY. Never QUIT. SHE QUIT..
Hear, hear. What’s-her-name’s suicide is testimony to the Truth that resides within the Algorithm. The Algorithm said she was at increased statistical risk of suicide, and she did, in fact, commit suicide.
We face all our choices in medicine for achievement by knowing how to weigh our collection of Data, which are like electrons whirling about the tiny nucleus of personal identity. We use the same manner of judgment as do the harried “deciders” who are far too busy, far too overwhelmed, far too incapable of independent thought to attempt to distinguish between Candidate A and Candidate B, 4.0 GPA and members of all the right societies and extracurriculars. The reality is there is nothing “outside the box” but perhaps a wildland of infernal beasties a la Zamyatin We judge by the perfection of the cookie that is cut by the cookie cutter, and despair about their similarity. Only the God Algorithm can save us from the exhausting work of human judgment, insight, emotion, the shock of recognition of another, the fatigue of using insight over the Jacobean algorithm. The algorithm said that what’s-her-name was frail meat, and the Algorithm did not fail; the person failed, as the dogma of the Algorithm lovingly reminds us. So what next? How about those beach parties in the days of Covid-19? Did you see Tom Brady’s wowser golf shot? Let’s remember that the fight for the summit of the Bell Curve is the attainment of Absolute Mediocrity = Absolute Conformity.
It seems we need to create an educational curriculum that allows private medicine physicians supervise and complete residency requirements for unmatched slots.
The corollary is we need the profession to fund such a proposal.