Physicians all around us are dying from suicide. For me personally, some deceased colleagues I knew more closely, others were just faces that you would pass on the wards. Even two physicians that I knew peripherally died just this past week.
The issue of physician suicide is in the news now, and facts are available. At least a whole medical school class worth of physicians dies by suicide each year. The suicide rate for female physicians is 2.27x greater than the general female population.
I am one of many physicians struggling with depression and suicidal thoughts and ideation. For me, this new low is complicated by the fact that I was betrayed by a prior physician, having engaged in a sexual relationship with my prior psychiatrist during the course of my treatment.
I have tried to seek help for myself, but I feel that “help” although often marketed, is not really so readily available. I’ve seen a couple additional psychiatrists and therapists. I’ve tried medications. I’ve tried newer treatments for depression, like TMS. I’ve been in the hospital. I’m in the hospital right now.
I’ve struggled with opening up to anyone here while inpatient and have shut down and am saying all the correct things so that I can go home. I feel more alone and isolated here than I did at home. The attending psychiatrist here said it is very common for physicians to feel this uncomfortable in the hospital. When someone is used to being in control and writing orders for their own patients, to be woken up for vitals or medicine or blood work or disturbed for ‘check-ins’ is humiliating and for me, greatly contributes to worsening feelings of self esteem. The contrast/contradiction between trying to return work emails while here and answer complex clinical questions for my own patients and colleagues, while at the same time, not being able to leave this inpatient unit to go on a “group walk” because I do not have grounds privileges is absurd and impossible to deal with. I just keep considering how could I have fallen so, so, so low.
Thus, do I continue to have suicidal thoughts? Yes. When the treaters/staff ask, do I admit to these thoughts? No. I want more than anything to escape this so-called help and go back to where I have some modicum of control, particularly of my own environment.
While here, I have been re-reading a particular medical classic- “The House of God” by Samuel Shem. My attempt to seek psychiatric help as a physician seems straight out of this satire. A quote from this book that particularly struck me today:
“Nope. I’m saying women like Jo make lousy people because they’re doctors, just like some men do. The profession is a disease. It doesn’t care what sex you are. It can trap us, any of us, and it’s pretty clear that it’s trapped Jo. It’s awful. You should see her apartment- it’s like no one lives there. She’s been there over a year, and she still hasn’t unpacked her stereo.”
I’m hoping to be discharged from this place soon so that I can return to my small apartment with stacks of unpacked boxes, and go back to fighting these demons alone, but on my terms. I may not make it, but I’ve tried my best. To me, the idea of “help” for struggling physicians is an illusion, and just plain does not exist at this current time.
The author is an attending physician at an academic hospital in New York City.
Editor’s Note: If you are a clinician struggling with burnout, depression, or suicidal thoughts, click here for resources for healthcare professionals from the American Foundation for Suicide Prevention. To reach the National Suicide Prevention Lifeline, call 1–800–273-TALK (8255).