Physicians are people too

‘Tis the season to be merry and bright. But sadly, statistics show higher risks and rates of suicide around the holidays. And when you’re having trouble feeling happy, it makes it doubly difficult, especially when you’re surrounded by all the “merry, merry,” and “jolly, jolly.”

And with that in mind, it’s important to remember that your healthcare givers are people too. Many stay on duty all through the holidays, days and nights, weekdays and weekends. Meanwhile, it seems the rest of the world shuts down to celebrate — or just rest and reflect — with family and friends.

Of course, in my day, even if I was on-call over the holidays, I could retreat to the “physicians’ lounge” to rest and relax. It was also a place to find companionship, whenever I had a moment away from the hospital floor.

Sadly, it’s now mostly a thing of the past in most modern hospital environments.

The loss of the physician lounges reflects a sorry change in the culture of medicine, which is now subservient to corporate and government burdens and controls.

The loss represents very minor savings in the hospital systems’ billion-dollar budgets. But it’s a monumental loss to physicians, in terms of professional autonomy, respect and prestige.

Members of this once-proud profession — who sacrificed their youth and assumed thousands of dollars of debt — have been reduced to a pack of bureaucrats, controlled and regulated by non-professional, crony capitalist cretins.

No wonder so many physicians are burned out, stressed and depressed…

In fact, according to a new study from University of California, San Francisco, seven out of 10 surgeons in training experience burnout driven by emotional exhaustion, doubts about the effectiveness of their work, and “depersonalization.” This professional burnout impacts their wellbeing and performance. It also potentially harms patient health.

It’s sad to say, but the surgeons’ doubts about the effectiveness of their work may simply be a rational conclusion. Indeed, scientific evidence shows most surgical procedures are useless or harmful — especially when it comes to heart surgery, orthopedic surgery, and certain other kinds of surgical procedures. But the surgeons are just cogs in the great wheels of the crony capitalist medical system.

For this new study, the UCSF researchers analyzed responses from 566 surgical residents in hospitals throughout the U.S. They found that 69 percent experience high burnout and 53 percent experience perceived high stress.

Furthermore, 20 percent of residents reported experiencing moderate to severe depression, which is double the rate in the general population for a similar age range. In addition, 49 percent suffered from alcohol abuse or misuse, which is five times higher than the general population. And 11 percent of them had suicidal ideation, which is more than three times higher than the general population.

So, this disaster in the making ultimately contributes to a high rate of physician suicide.

But that’s nothing new.

High doctor suicide rates have been reported since 1858. Now, 150 years later, the root causes remain unaddressed.

Every year, one million patients lose their physicians to suicide. That statistic means the majority of doctors have lost a classmate or colleague to suicide — with no real opportunity to grieve.

The suicide rate is seven times higher in male doctors (typically gun shots) than female doctors (typically overdosing).

Furthermore, male anesthesiologists run the highest risk. And most of them die by overdosing, many in-hospital call rooms.

I remember in medical school, we often described the practice of anesthesiology as comprised of hours of utter boredom, punctuated by unpredictable seconds of sheer terror…until it all becomes too much.

As I learned from investigating nearly a thousand suicides as a Medical Examiner, there is no way to predict or explain most suicides. Many appear happy and well-adjusted on the outside — even on the day of death.

They may be masters of disguise, making colleagues and patients laugh all day long, while suffering in silence on the inside. It reminds me of the poignant story of Pagliacci in Leoncavallo’s Opera, or Smoky Robinson’s Tears of a Clown.

Suicide may also be contagious. People who lose a family member to suicide run a high risk of suicide themselves, often by the same methods.

Here is a personal story I have never shared before in writing…

Wide-reaching effects of suicide

While I was away doing fieldwork in Southeast Asia for my M.D./Ph.D. program at the University of Pennsylvania, a classmate committed suicide back in Philadelphia. He laid down on a gurney in a hospital corridor, hooked himself up to an IV, and infused a deadly dose of poison.

He was the oldest son of a world-famous brain surgeon and senior faculty leader at our university. (The second, surviving son is now an accomplished foreign correspondent for NPR. I hear him regularly on the radio reporting from places all over the world, very far from home.)

When I returned from Asia, I was having some trouble adjusting from a jungle “bamboo hospital” back to the high-rise ivory tower of modern medicine. This famous brain surgeon, suffering the loss of his son, took me aside and showed me concern and kindness, which meant all the world to me at the time.

His deceased son had been interested in acupuncture and “alternative” medicine, which I had learned about in Asia, so we eventually organized a memorial symposium in his honor, presenting early research from the 1970s on the effectiveness of natural, non-drug approaches.

Fast forward 20 years…

I was back in Philadelphia in a senior position myself. This grieving father who had once showed me kind concern had become a “monster.” I will share only this last piece of the story, from an even longer story, before moving on…

The one time I was invited to the father’s house, surrounded by the cultural and scientific elite of Philadelphia, my spouse escaped the atmosphere for a moment into a dark, quiet, private study. There, hanging on the wall, was life-sized portrait of his deceased son, my former classmate.

My wife suddenly felt a cold wind blowing through the room. (It was a warm, sunny spring day outside.) She insisted we leave the house immediately. And within two months of persistently trying to work with this troubled man, I left Philadelphia and all its ghosts too — for good.

I suppose Charles Dickens isn’t the only author prone to writing a ghost story at Christmastime. So, as we look ahead to 2018, remember these encouraging words from Dickens, “Reflect upon your present blessings — of which every man has many — not on your past misfortunes, of which all men have some.”

And remember, no one authentically feels happy-go-lucky 24/7. It’s normal to feel down in the dumps sometimes and it’s alright to seek help. Speaking of treatment, if an antidepressant “merry-go-round” has made you feel like you’re going around in circles, try these four natural approaches.

Above all else, if you or a loved one struggles with suicidal thoughts, please don’t wait. Help is available now. Call the National Suicide Prevention Lifeline: 1-800-273-TALK.



“Burned Out Trainee Surgeons at High Risk for Alcohol Abuse, Depression, Suicidal Thoughts,” UCSF News Center ( 10/26/2017