Physician suicide was at the heart of a potent story released by National Public Radio just last week. Although I originally had other intentions for this particular post, life was making plans that I would be wrong to pass up. That story, less than four minutes long, is so compelling and so directly relates to the concerns we explore in this blog and the coaching and speaking that I do that, for now, it has reset the compass.
NPR tells it like it is
One caveat: Before listening, I want you to know that the story is intense. Please pause and use your very best discernment. This is most crucial if you are struggling through a difficult chapter of your own. Yes, the physician community as a whole needs to broach this topic. No, that does not mean that I give this NPR story or my post permission to overwhelm you. And neither should you. If you opt to listen, you will find the NPR story below.
The story centers on a fact which is hot for discussion in the physician community right now -- medical , surgical , and educational -- and one which we have touched upon before. Namely, out of nearly a million physicians in the United States, about 400 take their own lives every year. As many sources have noted, that is a rate more than twice that of the general population.
Factors contributing to the physician suicide risk
Many factors certainly contribute, some of which the NPR story highlights:
Noisy work environments
Disrupted sleep
Long and irregular hours
Technology-related frustration and exhaustion
The depressing effect of too much forced screen time
Encroachment of professional responsibilities on personal, family, and play time
Too little face-to-face time with colleagues
Too little time and opportunity set aside to absorb the human hardships we encounter
A young career begun under a mountain of debt
Too little time to pursue exciting activities which expand the skill set we enjoy
And above all, far too little time spent with the patients we yearn to learn from, to serve, and to heal.
I'm sure you know as well as I do that all play a part.
In the NPR story, we hear the voice of Dr. Pamela Wible, front-runner in the movement to raise awareness of physician and medical student suicide. As in her 2013 TED talk, she decries as abusive the trans-generational forces in the culture of medicine which drive us to hold unsustainable, implausible expectations of our colleagues and ourselves.
Front and center, however, NPR places the damage associated with devastating patient outcomes and the extraordinary stress for physicians of medical malpractice litigation. Rightly so. In fact, stumbling into Dr. Wible’s TED talk right at the height of my own experience with litigation catalyzed my commitment to provide insight, education, and support to my colleagues around bad outcomes and litigation. I knew full well that for every individual healer who dies by suicide, many more have to be contemplating it. I also knew that no life event had ever been as hard for me as the unexpected loss of my patient and a lawsuit.
The NPR journalist interviews an anonymous Ohio emergency physician faced with an unforeseen, tragic patient outcome, who encapsulates the second victim’s experience well. “You don't focus on the 99 you save. You end up focusing on the one that you lose.”
Prior to his own nearly fatal suicide attempt, he says that he did what “all doctors” might do: “You put that Superman cape on. And you think you can get through it.” And I guess, because we physicians and other healers are typically such strong people to begin with, creatures of endurance ready to go into situations many people are not, we can.
That is, until a time comes when we just can’t.
My welfare, my patient's welfare
People have known for a very long time what very recent research from some folks at the Mayo Clinic confirms -- the mental and spiritual well-being of physicians has an inextricable influence on their successfully doing their work. The question which urgently confronts physicians and the community of healers today is how best to pursue, protect, and restore that underlying mind-and-heart health.
Over the next three posts, we’ll begin to scratch the surface of that question in a few ways:
We’ll examine some systemic barriers which stand between us and our addressing our own mental health, and the inspiring story of what certain doctors in Idaho have accomplished on that front for physicians in their state;
We’ll unearth a very old take on stewardship of our professional capacities and personal joy and see how it applies to us today; and
We’ll explore and begin to discard an oft-shared mindset which can block mental well-being and growth in physicians.
Unraveling the problem of physician suicide is a tall order, but we scientists are creative, deeply thoughtful, pragmatic people, accustomed to tall orders.
As we approach the 50th anniversary of the first landing on the moon a mere eight years after President Kennedy issued the call to do it, I hope you'll join me around the table for a great big Morbidity and Mortality conversation. We have the knowledge and we have the power to improve the outcomes for ourselves, our patients, and many generations to come. What do we have to fear? Only fear itself.
Are you looking for support as you traverse a malpractice lawsuit or recover from an unexpected patient outcome? I encourage you to consider Thrive: Insight Coaching; it may be the tool for you.
Are you looking for a speaker for your next conference or summit on physician wellness, burnout, or malpractice litigation? Read more about my public speaking here.