Another suicide

[lakeofirefun]

Advertisement - Members don't see this ad

We're hearing rumblings, nothing confirmed yet, of another suicide by a medical resident in NYC a few days ago. As someone in the thick of it, I find this incredibly depressing. The feeling of uncertainty about one's ability to weather residency training is so pervasive and the conclusion that one cannot so understandable. I never before could relate to those that couldn't separate various aspects of their life, e.g. professional identity, spouse, friend, decent human being with intrinsic value. Residency has a way of forging these qualities into a single rigid hunk of material. There is no option to excel in one aspect while struggling in another. You either sink or float, nothing in between.

 

[DrBowtie]

We're hearing rumblings, nothing confirmed yet, of another suicide by a medical resident in NYC a few days ago. As someone in the thick of it, I find this incredibly depressing. The feeling of uncertainty about one's ability to weather residency training is so pervasive and the conclusion that one cannot so understandable. I never before could relate to those that couldn't separate various aspects of their life, e.g. professional identity, spouse, friend, decent human being with intrinsic value. Residency has a way of forging these qualities into a single rigid hunk of material. There is no option to excel in one aspect while struggling in another. You either sink or float, nothing in between.

These suicides seems more prevalent in NYC. Maybe this is just reporting bias, statistical noise, or just by volume of medical residents.

Part of me does wonder if the reported lack of support from ancillary staff due to unionization or added financial stress of living in one of the most expensive cities in the US are contributing factors.

 

[Crayola227]

These suicides seems more prevalent in NYC. Maybe this is just reporting bias, statistical noise, or just by volume of medical residents.

Part of me does wonder if the reported lack of support from ancillary staff due to unionization or added financial stress of living in one of the most expensive cities in the US are contributing factors.

I have consistently heard from PDs and others in academia say that medicine on the East Coast in general has a different, more rigid structure, and that the programs in NYC are sweatshops.

 

[Psai]

Probably has to do with the incredibly ****ty ancillary staff, crappy nursing, poor pay for cost of living and rigid hierarchy of the east coast.

 

[IlDestriero]

Actually it probably had to do with their undiagnosed or untreated mental illness.


--
Il Destriero

 

[DrBowtie]

Actually it probably had to do with their undiagnosed or untreated mental illness.


--
Il Destriero

I think that is obvious, but no doubt adding additional stressors doesn't help an already fragile person

 

[gutonc]

Actually it probably had to do with their undiagnosed or untreated mental illness.

It's way easier to blame the nurses though.

 

[criticalelement]

Actually it probably had to do with their undiagnosed or untreated mental illness.


--
Il Destriero

You are right. Probably has nothing to do with the system of medical training that continues on un-checked.

 

[lakeofirefun]

I think that is obvious, but no doubt adding additional stressors doesn't help an already fragile person

Actually it probably had to do with their undiagnosed or untreated mental illness.

--
Il Destriero

When I'm well beyond hour 100 for the week (yes, I'm sure all major academic centers on the east coast are in full violation of duty hours), struggling to learn a new system, getting hammer paged by everyone and their mother, forgetting to do 3 out of every 10 tasks I set out to do, all while being quizzed on my understanding of the pathophysiology of a disease or the mechanism of action of a drug and invariably stared at like an idiot, which I essentially am at that point because my addled brain can't remember my own last name, I think about how resilient we are. I envision a friend or family member in the same situation. I picture how crazy they would feel, how shocked they would be spending one hour on a busy, sick service. They would say "WTF is going on here?!" They would walk into the elevator and hit Lobby. Trainees, on the other hand, stay for anther 16, 20, 30 hours.

I acknowledge that those residents who killed themselves may have had some underlying mental illness, and that no one, not the program, their family, or sh@tty nursing is to blame. I do not believe, however, that they were fragile. They made it to residency, which already requires a lot of a person, but for some reason they ran out of coping mechanisms. When I think about that fictionalized friend hitting a capped service, unsure of themselves every second of the day, wondering if they'll get fired from the only job that can possibly pay off the 250K they owe, not urinating for 10 hours because they haven't had anything to drink in 15, I wonder what kind of coping skills they would employ. GTFO is most likely, as this would be the rational response to such stress, to escape from harm. But having invested so much time, money, and family sacrifice, we can't do that. So we require additional coping strategies, some healthy, some not so much. Everyone has their limit and medical training remains hell bent on testing those limits.

 

[n618ft]

I don't think any of us know the circumstances surrounding this but I wish the best for his friends and family. At our program, we have to plan time off 3+ months in advance. I assume this is pretty consistent with everyone else out there. Moving, buying/renting a place, having to make new friends, lots of work and assignments... takes a toll on anyone. I personally wish I could take a couple days off at a moment's notice just to sleep in, go to the dentist, maybe get a lipid panel or go by the store for some omeprazole. Some personal care takes a back seat unless you have a significant other or family helping you out in the background. I had several interviews in and around NYC and I don't think I could survive that area for more reasons than I care to write. Props to anyone that can.

 

[Psai]

It's way easier to blame the nurses though.

Try living it before you throw shade

 

[Mass Effect]

Are you sure you're not talking about the medical student (not resident) at Mount Sinai?

 

[Mass Effect]

Actually it probably had to do with their undiagnosed or untreated mental illness.

Why do you think those things are mutually exclusive?

 

[gutonc]

Try living it before you throw shade

I did.

 

[IlDestriero]

Why do you think those things are mutually exclusive?

I don't blame the system when someone's poor coping skills lead them to take their own life. If the nurses were nicer, the physicians lounge stocked k cups, they got a 12k cost of living adjustment, etc. the person would still be seriously mentally ill and find some other reason to end their lives. All you can do is try to put education in place to try to recognize when people are having problems to try to get them help, and try to educate people at risk about treatment options, etc.
This is a high stress job, and some specialties are an order of magnitude higher than others. It's not for everyone. They need to recognize their limitations.
It's a tragedy when someone chooses to end their lives, for any reason, but I'm not really sure how preventable it is.


--
Il Destriero

 

[lakeofirefun]

Are you sure you're not talking about the medical student (not resident) at Mount Sinai?

Honestly, I'm not sure. After hearing the initial buzz I've barely seen any fellow med residents. I'm a nightcrawler for the next couple of weeks.
Either way, it's still very sad and, to respectfully disagree with the poster above, somewhat preventable. Not always, but we could do much better.
My unsolicited advice for those still in med school, realizing I was just there 4 months ago so perhaps take it a grain of salt, is to choose your residency based on the people there. The "I could get a drink with these people" factor should be given more weight, a multiplier of 10 perhaps. This is assuming you have a handful of decent programs lined up, which so many on this forum have. Go where you will like your colleagues and advisors. Go to the program close to your family. This sh$t is isolating and establishing a social network is tough. I'm getting to know my neighborhood bartender better than most of my peers right now...luckily for me he's an interesting dude and the only one free when I get out a 11am.

 

[Donald Juan]

I don't blame the system when someone's poor coping skills lead them to take their own life. If the nurses were nicer, the physicians lounge stocked k cups, they got a 12k cost of living adjustment, etc. the person would still be seriously mentally ill and find some other reason to end their lives. All you can do is try to put education in place to try to recognize when people are having problems to try to get them help, and try to educate people at risk about treatment options, etc.
This is a high stress job, and some specialties are an order of magnitude higher than others. It's not for everyone. They need to recognize their limitations.
It's a tragedy when someone chooses to end their lives, for any reason, but I'm not really sure how preventable it is.


--
Il Destriero

I respectively disagree. You seem to be under the impression that someone is either suicidal or not, when the truth is many people are probably predisposed to suicide without some overt mental illness underlying them and outside factors could either make them much more likely to commit suicide or more likely not to. Would you also say that the high rates of suicide in cancer patients are just because they already have a mental illness and would find some reason to kill themselves whether or not they were diagnosed with cancer? Or maybe some of them were more predisposed to suicide (again, no overt mental illness) and the stress of the situation was enough to push them toward actually going through with it.

 

[WusUpDoc]

Please check out Pamela Wible MD on Facebook or her blog. She is fighting to bring awareness to the physician suicide epidemic. The number of Med students/residents/physicians who die each year due to suicide is astounding (around 400 physicians/year, plus another 100 or so Med students). There is also a documentary in the works regarding the issue called "Do No Harm".


Sent from my iPhone using SDN mobile

 

[Mass Effect]

I don't blame the system when someone's poor coping skills lead them to take their own life. If the nurses were nicer, the physicians lounge stocked k cups, they got a 12k cost of living adjustment, etc. the person would still be seriously mentally ill and find some other reason to end their lives. All you can do is try to put education in place to try to recognize when people are having problems to try to get them help, and try to educate people at risk about treatment options, etc.
This is a high stress job, and some specialties are an order of magnitude higher than others. It's not for everyone. They need to recognize their limitations.
It's a tragedy when someone chooses to end their lives, for any reason, but I'm not really sure how preventable it is.

So then I guess you think anyone who commits suicide does so because of problems within themselves and nothing should ever be done about the reasons surrounding why. It was their own "limitation" after all. How does that work when it comes to school bullying, gay harassment, and a host of other socially unacceptable practices that have caused others to take their own life?

 

[hallowmann]

I don't blame the system when someone's poor coping skills lead them to take their own life. If the nurses were nicer, the physicians lounge stocked k cups, they got a 12k cost of living adjustment, etc. the person would still be seriously mentally ill and find some other reason to end their lives. All you can do is try to put education in place to try to recognize when people are having problems to try to get them help, and try to educate people at risk about treatment options, etc.
This is a high stress job, and some specialties are an order of magnitude higher than others. It's not for everyone. They need to recognize their limitations.
It's a tragedy when someone chooses to end their lives, for any reason, but I'm not really sure how preventable it is.


--
Il Destriero

Yeah, I hate to jump on top of you with everyone else, but I really disagree with this. While I don't know how big an effect "the nursing staff" has on docs committing suicide, many many studies have shown that modifying even small things in an individual's life significantly reduces the likelihood that they will attempt suicide. I agree that there is a population that suffers from serious and chronic mental illness that makes up a sizable (if not majority) of the cases of suicides, there is also a very non-insignificant population that commits suicides due to a spur of the moment decision, sometimes after brief and sudden life events, and under the influence of illicit substances and alcohol (I'm even talking people that got drunk and came home from the bar and never exhibited suicidal red flags). I mean even the fact that financial insecurity is a common factor in cases of suicide is a testament to that. Having an accessible firearm in the home makes an individual in that home 3 times more likely to commit suicide. Studies have even shown that making access to the side of bridge more difficult actually reduces the incidence of suicide in an area, even when there's another bridge a few miles further down the road.

We're talking real modifiable risks. Many people go through transient depression that may feel insurmountable at the time. That combined with say inebriation and/or access to a loaded gun is a pretty good recipe for suicide in people with even decent coping skills. In other words, its not as black and white as you make it seem.

 

[epsilonprodigy]

As a resident who struggles at a program with very poor ancillary staff support, I would bet that the quality of nursing care has a LOT to do with residents' professional satisfaction and feelings of self worth. We're in a profession where it's considered noble to take the blame for others' mistakes/laziness, and after awhile, some people really start to believe that it's their fault that the x-Ray tech took an extended lunch instead of getting that stat CXR. This is a culture problem that has to change-most of us are hard on ourselves already, so mis-laying blame not only dodges the true issue, it propagates the "everything is my fault" mentality. Throw in sleep deprivation and prolonged removal from loved ones, and you've got the perfect storm for mental illness and suicidality to ensue. The magnitude of having to deal with people who suck at/don't care about their jobs shouldn't be discounted.


Sent from my iPhone using SDN mobile

 

[WholeLottaGame7]

Yeah, I hate to jump on top of you with everyone else, but I really disagree with this. While I don't know how big an effect "the nursing staff" has on docs committing suicide, many many studies have shown that modifying even small things in an individual's life significantly reduces the likelihood that they will attempt suicide. I agree that there is a population that suffers from serious and chronic mental illness that makes up a sizable (if not majority) of the cases of suicides, there is also a very non-insignificant population that commits suicides due to a spur of the moment decision, sometimes after brief and sudden life events, and under the influence of illicit substances and alcohol (I'm even talking people that got drunk and came home from the bar and never exhibited suicidal red flags). I mean even the fact that financial insecurity is a common factor in cases of suicide is a testament to that. Having an accessible firearm in the home makes an individual in that home 3 times more likely to commit suicide. Studies have even shown that making access to the side of bridge more difficult actually reduces the incidence of suicide in an area, even when there's another bridge a few miles further down the road.

We're talking real modifiable risks. Many people go through transient depression that may feel insurmountable at the time. That combined with say inebriation and/or access to a loaded gun is a pretty good recipe for suicide in people with even decent coping skills. In other words, its not as black and white as you make it seem.

So just out of curiousity, how would you modify these risks? None of the things you specifically mentioned have easy solutions. Make it illegal for physicians to own guns? Or drink alcohol? Eliminate brief and sudden life events? Slip prozac in all the ancillary staff's water supply?

I think @IlDestriero's point was that medicine is inherently a stressful field, and it may not be realistic to expect the suicide rate to ever be in line with the national average. Same with other fields (law enforcement, air traffic controllers, etc). I mean, look how much medicine has changed in the last 20 years. Work hours are way down, medicine is overall nicer (less overt behavioral disorders), wider recognition and acceptance of mental health issues (though obviously not perfect), salaries are still high (though not as high as previous, maybe). And has the suicide rate gone down? I honestly don't know but doubt it has meaningfully decreased.

The best things we can do right now are education and recognizing at-risk individuals and getting them help, but it's an imperfect system. I think you are far more likely to have success modifying the personal risk factors than the system ones. Going somewhere you have a support system, making good financial decisions, learning how to play well with others, exercising and eating well. You actually have a shot at pulling those off, compared to making all the nurses helpful and friendly, or decreasing the amount of bureaucracy to go through to discharge a patient, or making patients more appreciative.

One systems thing I would like to see change is more administrative-level recognition of the issue. My residency hospital has had at least 2 residents commit suicide in the past 5 years, 1 in the department. And it may be my department specifically (but I suspect other departments as well) give off the general vibe of "if we don't talk about it, people will just forget about it and move on." I get that no one wants to advertise that there was a suicide in their department. It looks bad for the hospital to the public and to future applicants. But pretending like it never happened isn't going to solve the issue, either, and is bad for morale.

 

[hallowmann]

So just out of curiousity, how would you modify these risks? None of the things you specifically mentioned have easy solutions. Make it illegal for physicians to own guns? Or drink alcohol? Eliminate brief and sudden life events? Slip prozac in all the ancillary staff's water supply?

I think @IlDestriero's point was that medicine is inherently a stressful field, and it may not be realistic to expect the suicide rate to ever be in line with the national average. Same with other fields (law enforcement, air traffic controllers, etc). I mean, look how much medicine has changed in the last 20 years. Work hours are way down, medicine is overall nicer (less overt behavioral disorders), wider recognition and acceptance of mental health issues (though obviously not perfect), salaries are still high (though not as high as previous, maybe). And has the suicide rate gone down? I honestly don't know but doubt it has meaningfully decreased.

The best things we can do right now are education and recognizing at-risk individuals and getting them help, but it's an imperfect system. I think you are far more likely to have success modifying the personal risk factors than the system ones. Going somewhere you have a support system, making good financial decisions, learning how to play well with others, exercising and eating well. You actually have a shot at pulling those off, compared to making all the nurses helpful and friendly, or decreasing the amount of bureaucracy to go through to discharge a patient, or making patients more appreciative.

One systems thing I would like to see change is more administrative-level recognition of the issue. My residency hospital has had at least 2 residents commit suicide in the past 5 years, 1 in the department. And it may be my department specifically (but I suspect other departments as well) give off the general vibe of "if we don't talk about it, people will just forget about it and move on." I get that no one wants to advertise that there was a suicide in their department. It looks bad for the hospital to the public and to future applicants. But pretending like it never happened isn't going to solve the issue, either, and is bad for morale.

Greater gun safety education (don't want to get into the whole gun debate, but just from a suicide standpoint common sense gun laws/enforcement would do a lot), netting or fencing around bridges, limited access to the roofs of buildings, etc. In terms of physicians specifically, the real issue is support system and better access to help, especially during trauma, which are definitely things we could implement (which is something you clearly agree with).

His post stated there was little that could be done, because a suicidal person will "find a way" and the issue is really with their "limitations". My post was meant to demonstrate that that doesn't really play out in the research. The process of actually having to "find a way" might be enough to deter some people on the edge.

 

[IlDestriero]

No I said if the work stresses noted earlier (nurses, etc) were improved that they'd find another reason to kill themselves and the issue is with their untreated mental illness. Though not recognizing that certain careers are extraordinarily bad choices for them is also a problem.
Why do people do this. They're mentally ill. Not pissed at the nurses for being lazy Union bitches.


--
Il Destriero

 

[Arcan57]

No I said if the work stresses noted earlier (nurses, etc) were improved that they'd find another reason to kill themselves and the issue is with their untreated mental illness. Though not recognizing that certain careers are extraordinarily bad choices for them is also a problem.
Why do people do this. They're mentally ill. Not pissed at the nurses for being lazy Union bitches.


--
Il Destriero

I think you're ignoring critical incident stress as a potential risk factor. It's incredibly rare for most people's mistakes to end up in the morgue. Other fields that have this potential have built-in processes for dealing with these issues with varying success. A cop shoots someone they go on paid leave regardless of righteousness of shooting. We have a patient die and we get maybe a minute or two to try and process before we see the next patient, often within earshot of the wailing family. If there is even the perception that a mistake in our care led to the patient's death then we will have to recount every detail numerous times to people that don't give a damn about how it's effected us. There's also a common belief that only bad doctors make mistakes which keeps us from being able to empathize with our peers when something goes bad. All of this contributes to a suicide risk that's not exclusively based on pre-existing mental illness.

 

[EverybodyLies99]

We had a student from my med school commit suicide. The higher ups never sent out any emails or disclosed it. It was kept hush hush and nobody wanted to talk about it. This was a student I knew fairly well too. Found out about it through another student. I think it's more common than what we get on the news. A few who jump out of buildings or rooftops or their parents/friends who make it public slip through the cracks and end up on the news...then we hear about them.

 

[criticalelement]

No I said if the work stresses noted earlier (nurses, etc) were improved that they'd find another reason to kill themselves and the issue is with their untreated mental illness. Though not recognizing that certain careers are extraordinarily bad choices for them is also a problem.
Why do people do this. They're mentally ill. Not pissed at the nurses for being lazy Union bitches.


--
Il Destriero

I have yet to find a post as misguided as this one in all of sdn.

 

[IlDestriero]

I have yet to find a post as misguided as this one in all of sdn.

No exaggeration there...
We'll have to agree to disagree. I cannot imagine any situation where I would say, yes time to kill myself because my hours were too high, stress a little too much , nurses weren't that nice, didn't make enough, etc. Bad things happen, tragedies, every day. That's medicine. I didn't make little Johnnie's cancer come back, or make the teen jump into the shallow end of the pool and have a cervical burst fracture. If I went on a bender and drove drunk and high and wiped out a family, maybe that's guilt I'd have trouble sleeping with. The rest is the nature of the business.
My biggest concern is how to get to where I want to retire. And the biggest threat to that is the government takeover of medicine. But even that will only cause a lifestyle change. I can live without my ocean view house in Pacific Palisades.
I disagree that there is much of anything that we could change in medicine to decrease suicide risk, excepting what I noted above. Which was aiding in recognition of people at risk, and providing easy access to resources for those struggling. You could make a 60 hour work week and have mandatory weekends off, but you'll have to add a year or two to training. So factor in that lost time, lost income, increased debt obligations, etc.
Locking the roof, fencing bridges and putting up hotline signs are fine ideas, but they don't really apply specifically to medicine. I thought that's what we were talking about here. Access to powerful medications may be a risk factor for physician suicide, but that's already regulated to some degree and I don't see how to keep needed access for the well, but monitor access to the at risk physician population.
I'm not sure what physicians use to kill themselves vs the military or the general population.
The military has done a lot to try to decrease active duty and vet suicide. But what have they actually done?
Acknowledged there's a problem.
Identified at risk people.
Put resources in place for them to get help and treatment.
You can't change that job much either. It's very high stress and has a lot of people at risk with limited coping skills.

--
Il Destriero

 

[WheezyBaby]

No exaggeration there...
We'll have to agree to disagree. I cannot imagine any situation where I would say, yes time to kill myself because my hours were too high, stress a little too much , nurses weren't that nice, didn't make enough, etc. Bad things happen, tragedies, every day. That's medicine. I didn't make little Johnnie's cancer come back, or make the teen jump into the shallow end of the pool and have a cervical burst fracture. If I went on a bender and drove drunk and high and wiped out a family, maybe that's guilt I'd have trouble sleeping with. The rest is the nature of the business.
My biggest concern is how to get to where I want to retire. And the biggest threat to that is the government takeover of medicine. But even that will only cause a lifestyle change. I can live without my ocean view house in Pacific Palisades.
I disagree that there is much of anything that we could change in medicine to decrease suicide risk, excepting what I noted above. Which was aiding in recognition of people at risk, and providing easy access to resources for those struggling. You could make a 60 hour work week and have mandatory weekends off, but you'll have to add a year or two to training. So factor in that lost time, lost income, increased debt obligations, etc.
Locking the roof, fencing bridges and putting up hotline signs are fine ideas, but they don't really apply specifically to medicine. I thought that's what we were talking about here. Access to powerful medications may be a risk factor for physician suicide, but that's already regulated to some degree and I don't see how to keep needed access for the well, but monitor access to the at risk physician population.
I'm not sure what physicians use to kill themselves vs the military or the general population.
The military has done a lot to try to decrease active duty and vet suicide. But what have they actually done?
Acknowledged there's a problem.
Identified at risk people.
Put resources in place for them to get help and treatment.
You can't change that job much either. It's very high stress and has a lot of people at risk with limited coping skills.

--
Il Destriero

I think culture of an institution makes a significant impact on how trainees process their experience. For example, we've all done things that have led to patient harm in one way or another, with varying degree of fault in those actions. Residency is the first experience a lot of us have in being the individual truly responsible for these events. The extent to which an institution supports individuals in these circumstances likely plays a large role in how a resident is able to process this and either be led down a road of self doubt and blame vs a road where you accept these outcomes as part of the profession and develop healthy behaviors to minimize the likelihood of their happening. It isn't all about cutting hours, avoiding difficult situations, etc

 

[asdf0987]

Just horrible. There have been many, sadly: http://www.nydailynews.com/new-york/woman-found-dead-midtown-scaffolding-suicide-article-1.2558416

 

[Mass Effect]

No I said if the work stresses noted earlier (nurses, etc) were improved that they'd find another reason to kill themselves and the issue is with their untreated mental illness. Though not recognizing that certain careers are extraordinarily bad choices for them is also a problem.
Why do people do this. They're mentally ill. Not pissed at the nurses for being lazy Union bitches.

I'm sorry, but this is an incredibly ignorant post.

 

[sugarx]

mentally stable resident chiming in.

yes, intern year sucked balls. yes, fantasized about killing myself just to imagine the look on my c*** seniors' faces when the list wasn't done in the morning or orders weren't placed.

never actually seriously considered suicide until my in training scores came back and i placed last.

made me question my ability as a physician. nothing sucks worse than dedicating 10+ years of higher education to achieve a goal just to find out you suck at it.

also i believe this is referring to the med student from mt sinai. i believe she took a few years off in the middle of med school and was an m4 now applying to orthopaedics.

edit: posted this to say that yes there are EXTRINSIC factors within the medical/residency training program that affect one's outlook on life and on their self worth. in medical school i was an adrenaline junkie and would do anything to cut a patient open. now that there are actual risks involved, nothing freaks me out more than a simple procedure.

 

[Shorin-Ryu]

So then I guess you think anyone who commits suicide does so because of problems within themselves and nothing should ever be done about the reasons surrounding why. It was their own "limitation" after all. How does that work when it comes to school bullying, gay harassment, and a host of other socially unacceptable practices that have caused others to take their own life?

Agree.

 

[Mad Jack]

No exaggeration there...
We'll have to agree to disagree. I cannot imagine any situation where I would say, yes time to kill myself because my hours were too high, stress a little too much , nurses weren't that nice, didn't make enough, etc. Bad things happen, tragedies, every day. That's medicine. I didn't make little Johnnie's cancer come back, or make the teen jump into the shallow end of the pool and have a cervical burst fracture. If I went on a bender and drove drunk and high and wiped out a family, maybe that's guilt I'd have trouble sleeping with. The rest is the nature of the business.
My biggest concern is how to get to where I want to retire. And the biggest threat to that is the government takeover of medicine. But even that will only cause a lifestyle change. I can live without my ocean view house in Pacific Palisades.
I disagree that there is much of anything that we could change in medicine to decrease suicide risk, excepting what I noted above. Which was aiding in recognition of people at risk, and providing easy access to resources for those struggling. You could make a 60 hour work week and have mandatory weekends off, but you'll have to add a year or two to training. So factor in that lost time, lost income, increased debt obligations, etc.
Locking the roof, fencing bridges and putting up hotline signs are fine ideas, but they don't really apply specifically to medicine. I thought that's what we were talking about here. Access to powerful medications may be a risk factor for physician suicide, but that's already regulated to some degree and I don't see how to keep needed access for the well, but monitor access to the at risk physician population.
I'm not sure what physicians use to kill themselves vs the military or the general population.
The military has done a lot to try to decrease active duty and vet suicide. But what have they actually done?
Acknowledged there's a problem.
Identified at risk people.
Put resources in place for them to get help and treatment.
You can't change that job much either. It's very high stress and has a lot of people at risk with limited coping skills.

--
Il Destriero

The thing about medicine is that it's a trap- you sink in 4-8 years of your life and many people are often horribly in debt (300-400k or more) before they realize they hate it. This creates a situation similar to that in the military, where one can never truly know what they are signing up for, and by the time they do, it's too late and there is no way out that won't bring them as much, or more, suffering than staying in. So they end up stuck in a job they hate, that works them like a dog in ways they didn't even know were possible, in some of the most stressful situations a person can have to endure, and they're stuck there because of decisions they made years prior for poorly conceived reasons with no way out.

A doctor once told me that people that attempt suicide don't want to stop living, they just want to stop living the life they're living now and they don't see a way out of it. For many in medicine, there is no reasonable way to just stop living the life of a resident and be the person they actually want to be. And then once they're done, they are often stuck starting down what looks like an endless barrel of time spent as an attending in a job they despise just to get to a point where they can walk away. If only it were easier to get out of this mess, I bet many physicians would choose to walk instead of ending their lives. Because medicine is, to many, a prison, and much like many ordinary people that end up trapped in the prison system, the environment and living conditions are just too much for them to bear so they take the only way out they can see.

 

[ordersol7]

Personally I think a lot of these issues would go away or at least not be as prevalent if there was a way for people to leave or even take a break without their entire career and financial future being placed at risk.

 

[criticalelement]

The thing about medicine is that it's a trap- you sink in 4-8 years of your life and many people are often horribly in debt (300-400k or more) before they realize they hate it. This creates a situation similar to that in the military, where one can never truly know what they are signing up for, and by the time they do, it's too late and there is no way out that won't bring them as much, or more, suffering than staying in. So they end up stuck in a job they hate, that works them like a dog in ways they didn't even know were possible, in some of the most stressful situations a person can have to endure, and they're stuck there because of decisions they made years prior for poorly conceived reasons with no way out.

A doctor once told me that people that attempt suicide don't want to stop living, they just want to stop living the life they're living now and they don't see a way out of it. For many in medicine, there is no reasonable way to just stop living the life of a resident and be the person they actually want to be. And then once they're done, they are often stuck starting down what looks like an endless barrel of time spent as an attending in a job they despise just to get to a point where they can walk away. If only it were easier to get out of this mess, I bet many physicians would choose to walk instead of ending their lives. Because medicine is, to many, a prison, and much like many ordinary people that end up trapped in the prison system, the environment and living conditions are just too much for them to bear so they take the only way out they can see.

YOur post is a decent one.

If you are the type of person who needs to be in control over everything and you want order in your life and want people to tell you exactly what is needed to succeed and survive medicine will eat you alive on a daily basis and you will think of offing yourself.

The way you approach medicine and medical care is that you have to be cool with knowing 1/2 the story most of the time, at best. Deal with it. Guess the other half and make a decision. If you want people and patients to tell you everything for your benefit, you will wear yourself out. I can guarantee you that. Dont torture yourself.

 

[Mad Jack]

YOur post is a decent one.

If you are the type of person who needs to be in control over everything and you want order in your life and want people to tell you exactly what is needed to succeed and survive medicine will eat you alive on a daily basis and you will think of offing yourself.

The way you approach medicine and medical care is that you have to be cool with knowing 1/2 the story most of the time, at best. Deal with it. Guess the other half and make a decision. If you want people and patients to tell you everything for your benefit, you will wear yourself out. I can guarantee you that. Dont torture yourself.

It's not just that though. Like, if you value freedom to any degree aside from "not at all," if you value your youth, your relationships, or any number of other things to a great degree, if you've got one of a million different things that medicine isn't compatible with, the field will steamroll you into bits. I'm dead inside and basically apathy taken human form, so I'm fine with everything, but my god, younger me? I'd have lost my damn mind, and I can see why so many people in medicine do.