Med student suicide

[Zyra]

1) Work hours are self-reported and easily fudged. They also don't take into account travel time or time working at home.

2) The "cap" is 80 hours per week averaged over 4 weeks. Our days off are averaged over 4 weeks too. So people can work 9 days straight, working 14+ hour days and be way over 80 hours for that week, but then have 2 days off the following week and come out even.

Your residency sounds much worse than my relatives'. Also, most jobs' work hours don't account for travel time...

---

Members don't see this ad.

 

[Ismet]

Your residency sounds much worse than my relatives'. Also, most jobs' work hours don't account for travel time...

Does that matter? Every job has "non-accounted" time that still factors into your personal work day. If we're talking about burnout and hours, it's more than just the time that people get paid for.

 

[lymphocyte]

I think students fail to understand this and think that "school" is as hard as it gets...when it might be the easiest time of your life.

You just don't get it.

When a bunch of medical students and doctors are sharing their experiences about how much it sucks in the context of a student's suicide, it's pretty darn annoying to have someone not in the medical profession with zero clue mention how much worse others have it. Medical students are well aware that it probably gets harder, because all of us do clinical rotations where we see what residents routinely put up with (not to mention what we routinely put up with). It's not all bad all the time, but dude, it's hard. And we get to say it's hard regardless of how badly others have it. Everybody is allowed to hurt. What, exactly, do we "fail to understand"?

Medical school has definitely not been the "easiest time of my life." Regardless of what comes ahead, it never will be. I literally just got home after being in the hospital for 30 hours (including patchy sleep in the call room). I enjoyed it--lots of flow-type moments where 4 years of hard education kept coming together--but it was freakin' miserable too. (Just like it was miserable studying for Step 1 during MS2 or spending all those late nights in the library during MS1.) And ultimately the notes I wrote and decisions I made were countersigned by a real doctor who was working a lot harder than I was and who had actual responsibility over decisions that might harm or even kill another human being.

Plus, nobody's even mentioned the sheer inanity intrinsic to all of it. Soooooooooooooo much busy work, bureaucracy, the more-than-occasional odd colleague, contradictory feedback from attendings, broken fax machines, slow elevators, getting lost, frustrating EMR, wanting to pee really badly when you're stuck with a sweet and dying but talkative patient, etc.--sometimes you just have to laugh at it all, if you can manage laughing. Now throw in a high-stakes, litigious, dehumanising, money-driven, work-obsessed culture with a lot of fragile egos (= administrators, nurses, attendings, residents, and medical students) and there's plenty of misery to go around.

I will say this: medical school has certainly been the best time of my life, because I grew tremendously as a person and made some lifelong friends--but all that growth and friendship came at the expense of a whole lot of pain. And it's not all bad. At the end of the day, I feel tremendous gratitude that medicine will be my profession: I get to help people for a living; by and large, my colleagues are interesting, smart, and hard working people; teaching and learning have become a way of life; and I'll eventually be renumerated extremely well for all the toil (better than a lot of people who toil away just as hard doing something else). But exactly none of that matters to a medical student who is contemplating suicide. All that matters is, right now, things hurt more than they can handle, regardless of whether anybody else thinks the suffering is justified.

 

[zeppelinpage4]

You just don't get it.

When a bunch of medical students and doctors are sharing their experiences about how much it sucks in the context of a student's suicide, it's pretty darn annoying to have someone not in the medical profession with zero clue mention how much worse others have it. Medical students are well aware that it probably gets harder, because all of us do clinical rotations where we see what residents routinely put up with (not to mention what we routinely put up with). It's not all bad all the time, but dude, it's hard. And we get to say it's hard regardless of badly others have it. Everybody is allowed to hurt. What, exactly, do we "fail to understand"?

Medical school has definitely not been the "easiest time of my life." Regardless of what comes ahead, it never will be. I literally just got home after being in the hospital for 30 hours (including patchy sleep in the call room). I enjoyed it--lots of flow-type moments where 4 years of hard education kept coming together--but it was freakin' miserable too. (Just like it was miserable studying for Step 1 during MS2 or spending all those late nights in the library during MS1.) And ultimately the notes I wrote and decisions I made were countersigned by a real doctor who was working a lot harder than I was and who had actual responsibility over decisions that might harm or even kill another human being.

Plus, nobody's even mentioned the sheer inanity intrinsic to all of it. Soooooooooooooo much busy work, bureaucracy, the more-than-occasional odd colleague, contradictory feedback from attendings, broken fax machines, slow elevators, getting lost, frustrating EMR, wanting to pee really badly when you're stuck with a sweet and dying but talkative patient, etc.--sometimes you just have to laugh at it all, if you can manage laughing. Now throw in a high-stakes, litigious, dehumanising, money-driven, work-obsessed culture with a lot of fragile egos (= administrators, nurses, attendings, residents, and medical students) and there's plenty of misery to go around.

I will say this: medical school has certainly been the best time of my life, because I grew tremendously as a person and made some lifelong friends--but all that growth and friendship came at the expense of a whole lot of pain. And it's not all bad. At the end of the day, I feel tremendous gratitude that medicine will be my profession: I get to help people for a living; by and large, my colleagues are interesting, smart, and hard working people; teaching and learning have become a way of life; and that I'll eventually be renumerated extremely well for all the toil (better than a lot of people who toil away just as hard doing something else). But exactly none of that matters to a medical student who is contemplating suicide. All that matters is, right now, things hurt more than they can handle, regardless of whether anybody else thinks the suffering is justified.

I wish I could like this 1000 times.

 

[Psai]

Nah, not just ONE 80-100 hour work week. Unless you're on cocaine/other stimulants, averaging 80-100 hour work weeks for multiple years in a row is pretty impressive. I'm also not talking about just sitting there doing nothing/jacking off for 80-100 hours a week - they're actually working on detail oriented stuff and are required to perform to a high caliber.

Yeah I've only had one 80-100 hour work week in my life and I was just sitting there doing nothing without touching any detail oriented stuff whatsoever. Thanks for telling us about other people's lives though, your perspective as a man of experience in medical school and investment banking is incredibly valuable to all of us in this community.

 

[lymphocyte]

Personality disorders are not treatable conditions- the only one with any accepted form of treatment is BPD, for which cognitive behavioral therapy has modest improvement in some individuals.

MJ, friend, I have to push back a little on this claim.

Personality disorders exist on a spectrum with symptoms of varying severity that often can be treated. That's reflected in the Section III DSM 5 "Alternative Model for Personality Disorders," which went from calling personality disorders categorical entities that are "inflexible," "pervasive," and "enduring patterns" to "impairments in personality functioning along with certain pathological personality traits" that are "relatively stable." Insofar as the impairments of functioning can be treated with cognitive techniques, so too can personality disorders. (The reason why the Alternative Model is the alternative model is because the American Psychiatry Association trustees voted to override the the expert opinion of the personality disorder working group--the politics of which is a rant for another day. But the Alternative Model is purposefully not listed under "Conditions for Further Study," so it truly can be taken as an alternative to the Section II entity).

The insights driving this view of personality have largely been due to the psychodynamic psychiatrists. They unfortunately get short shrift in medicine but have empirical evidence supporting their treatment modality with effect sizes larger than medications for some psychiatric disorders. There are many reasons for their efficacy, but one important reason is that people function on levels that cannot be helpfully explained in biological terms. Sometimes the most therapeutic perspective is the psychological or even sociological one.

For that reason, the literature on narcissistic personality organisation (which is very different from "narcissistic personality disorder" as reified by the DSM) has been a tremendously powerful for me. Why? Think of all the people who trouble with genuine empathy, maintaining healthy long-term relationships, mood that seems to precipitously mirror self-esteem, rejection sensitivity, accurately gauging their importance to other people, perfectionism, setting goals based on gaining approval from others, a life littered with superficial friendships that matter for all the wrong reasons (I think we call them "Facebook Friends" now, and the number of "Happy Birthdays" you get seems reeeeeeally important to some). Now imagine that all of those tendencies could be explained in a self-consistent, conceptually fruitful, and therapeutically useful way. That's pretty powerful.

You mention guidelines, but some guidelines are good (like 2015 ACLS), some guidelines are okay but quickly outdated (like JNC-8 in light of SPRINT), and some guidelines are outright bad and probably dangerous (like Surviving Sepsis). Each one needs to be judged on its own merits. Appeal to authority goes far in medicine, and rightfully so, but sometimes too far.

Even my mentioning the DSM is a little unfortunate, because the DSM often gets conflated with psychiatry, but psychiatry is so much more than the DSM. All the DSM aims to accomplish is statistical reliability and consensus, not necessarily pathological validity. One way of increasing reliability and consensus is making over-broad diagnostic entities that kinda seem to apply to almost everyone. That's a reason why in 2013 the National Institute of Mental Health moved away from using the DSM to "Research Domain Criteria" (RDoC) to guide funding decisions (and funding = everything in academic medicine). RDoC gets at the pathogenic origins of disease, instead of mere consensus-driven classification, and it was IMHO a tremendous foundational leap in psychiatry.

Anywho. I have a lot of empathy for patients with personality disorders. They generally live miserable lives and sometimes get shunned in virtue of a "forever" diagnostic label with very questionable validity. They need help too and help really is possible.

http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

Kernberg OF. The almost untreatable narcissistic patient. J Am Psychoanal Assoc. 2007;55(2):503-39.

Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol. 2010;65(2):98-109.

Skodol AE, Morey LC, Bender DS, Oldham JM. The Alternative DSM-5 Model for Personality Disorders: A Clinical Application. Am J Psychiatry. 2015;172(7):606-13.

 

[Mad Jack]

MJ, friend, I have to push back a little on this claim.

Personality disorders exist on a spectrum with symptoms of varying severity that often can be treated. That's reflected in the Section III DSM 5 "Alternative Model for Personality Disorders," which went from calling personality disorders categorical entities that are "inflexible," "pervasive," and "enduring patterns" to "impairments in personality functioning along with certain pathological personality traits" that are "relatively stable." Insofar as the impairments of functioning can be treated with cognitive techniques, so too can personality disorders. (The reason why the Alternative Model is the alternative model has to do with the American Psychiatry Association trustees voting to override the the expert opinion of the personality disorder working group--the politics of which is a rant for another day. But the Alternative Model is purposefully not listed under "Conditions for Further Study," so it truly can be taken as an alternative to the Section II entity).

The insights driving this view of personality have largely been due to the psychodynamic psychiatrists. They unfortunately get short shrift in medicine but have empirical evidence supporting their treatment modality with effect sizes larger than medications for some psychiatric disorders. There are many reasons for their efficacy, but one important reason is that people function on levels that cannot be helpfully explained in biological terms. Sometimes the most therapeutic perspective is the psychological or even sociological one.

For that reason, the literature on narcissistic personality organisation (which is very different from "narcissistic personality disorder" as reified by the DSM) has been a tremendously powerful for me. Why? Think of how many people have trouble with genuine empathy, maintaining healthy long-term relationships, mood that seems to precipitously mirror self-esteem, rejection sensitivity, accurately gauging their importance to other people, perfectionism, setting goals based on gaining approval from others, a life littered with superficial friendships that matter for all the wrong reasons (I think we call them "Facebook Friends" now, and the number of "Happy Birthdays" you get seems really important to some). Now imagine that all of those tendencies could be explained in a self-consistent, conceptually fruitful, and therapeutically useful way. That's pretty powerful.

You mention guidelines, but some guidelines are good (like 2015 ACLS), some guidelines are okay but quickly outdated (like JNC-8 in light of SPRINT), and some guidelines are outright bad and probably dangerous (like Surviving Sepsis). Each one needs to be judged on its own merits. Appeal to authority goes far in medicine, and rightfully so, but sometimes too far.

Even my mentioning the DSM is a little unfortunate, because the DSM often gets conflated with psychiatry, but psychiatry is so much more than the DSM. All the DSM aims to accomplish is statistical reliability and consensus, not necessarily pathological validity. One way of increasing reliability and consensus is making over-broad diagnostic entities that kinda seem to apply to almost everyone. That's a reason why in 2013 the National Institute of Mental Health moved away from using the DSM to "Research Domain Criteria" (RDoC) to guide funding decisions (and funding = everything in academic medicine). RDoC gets at the pathogenic origins of disease, instead of mere consensus-driven classification, and it was IMHO a tremendous foundational leap in psychiatry.

Anywho. I have a lot of empathy for patients with personality disorders. They generally live miserable lives and often get shunned in virtue of "forever" diagnostic labels of very questionable validity. They need help too and help really is possible.

http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

Kernberg OF. The almost untreatable narcissistic patient. J Am Psychoanal Assoc. 2007;55(2):503-39.

Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol. 2010;65(2):98-109.

Skodol AE, Morey LC, Bender DS, Oldham JM. The Alternative DSM-5 Model for Personality Disorders: A Clinical Application. Am J Psychiatry. 2015;172(7):606-13.

I just go by the, "will insurance pay to treat this person" model of whether a treatment is legit. Insurance won't pay to treat personality disorders because there is no proven efficacy outside of BPD, so there is, to me, no widely accepted way if treating personality disorders. Some niche guy doing a particular treatment that has proven effective for him in treating a particular disorder does not an effective widely applicable treatment modality make.

 

[giantswing]

Late to the party but:

DGAF about investment banking, but I think medicine is hard when you combine long hours with little positive feed back, lots of feed back when you've done it wrong, angry patients, and you're left feeling panicked, inefficient, and behind all the time. Combine this with little time to study and you feel stupid all the time too.

I haven't ever felt suicidal, but I have thought that I was literally going to die of fatigue, hunger, thirst, stupidity, and generally being overwhelmed. Everyone has different thresholds.

 

[lymphocyte]

I just go by the, "will insurance pay to treat this person" model of whether a treatment is legit. Insurance won't pay to treat personality disorders because there is no proven efficacy outside of BPD, so there is, to me, no widely accepted way if treating personality disorders. Some niche guy doing a particular treatment that has proven effective for him in treating a particular disorder does not an effective widely applicable treatment modality make.

What insurance companies are willing to pay for probably isn't a great way to determine if a treatment is legitimate, though it's completely fair from a practical point of view.

And Medicare actually does reimburse for psychotherapy and psychoanalysis; written into the law is a mandate for Medicare to cover "diagnostic and/or therapeutic treatment for mental, psychoneurotic, and personality disorders"; personality disorders are often comorbid with psychiatric disease; and "some niche guy" includes many experts in the field, including a fair few on the DSM Personality Disorder Working Group and many widely-recognised clinics at places like Cornell, NYU, UPitt, Mayo, Mclean, and Baylor. Lots of psychiatrists on the front line too. Kernberg is just one of the more influential ones, and I found that paper he wrote pretty electrifying. I'm only sharing it for students whose interest in psychiatry might be piqued--in the hope that they see psychiatry is just as heterogenous and rife with controversy as any other speciality in medicine, from intensive care to urology.

 

[TedStark]

What insurance companies are willing to pay for probably isn't a great way to determine if a treatment is legitimate, though it's completely fair from a practical point of view.

And Medicare actually does reimburse for psychotherapy and psychoanalysis; written into the law is a mandate for Medicare to cover "diagnostic and/or therapeutic treatment for mental, psychoneurotic, and personality disorders"; personality disorders are often comorbid with psychiatric disease; and "some niche guy" includes many experts in the field, including a fair few on the DSM Personality Disorder Working Group and many widely-recognised clinics at Cornell, NYU, UPitt, Mayo, Mclean, and Baylor. Lots of psychiatrists on the front line too. Kernberg is just one of the more influential ones, and I found that paper he wrote pretty electrifying. I'm only sharing it for students whose interest in psychiatry might be piqued--in the hope that they see psychiatry is just as heterogenous and rife with controversy as any other speciality in medicine, from intensive care to urology.

Yea apparently insurance reimburses for chiropractic whatever as well.

 

[chipwhitley]

Why do I feel compelled to respond? Because we rarely get to openly talk about suicide and mental health, particularly as it affects student doctors. (This is the allopathic forum, right?) Pointing out how others have it worse (and wrongly too)... accomplishes what exactly?

I don't usually agree with what you have to say, but this is completely on point. I am also tired of all these pointless comparisons. Everyone's struggle is their own and everyone is allowed to hurt.

 

[chipwhitley]

You just don't get it.

When a bunch of medical students and doctors are sharing their experiences about how much it sucks in the context of a student's suicide, it's pretty darn annoying to have someone not in the medical profession with zero clue mention how much worse others have it. Medical students are well aware that it probably gets harder, because all of us do clinical rotations where we see what residents routinely put up with (not to mention what we routinely put up with). It's not all bad all the time, but dude, it's hard. And we get to say it's hard regardless of how badly others have it. Everybody is allowed to hurt. What, exactly, do we "fail to understand"?

Medical school has definitely not been the "easiest time of my life." Regardless of what comes ahead, it never will be. I literally just got home after being in the hospital for 30 hours (including patchy sleep in the call room). I enjoyed it--lots of flow-type moments where 4 years of hard education kept coming together--but it was freakin' miserable too. (Just like it was miserable studying for Step 1 during MS2 or spending all those late nights in the library during MS1.) And ultimately the notes I wrote and decisions I made were countersigned by a real doctor who was working a lot harder than I was and who had actual responsibility over decisions that might harm or even kill another human being.

Plus, nobody's even mentioned the sheer inanity intrinsic to all of it. Soooooooooooooo much busy work, bureaucracy, the more-than-occasional odd colleague, contradictory feedback from attendings, broken fax machines, slow elevators, getting lost, frustrating EMR, wanting to pee really badly when you're stuck with a sweet and dying but talkative patient, etc.--sometimes you just have to laugh at it all, if you can manage laughing. Now throw in a high-stakes, litigious, dehumanising, money-driven, work-obsessed culture with a lot of fragile egos (= administrators, nurses, attendings, residents, and medical students) and there's plenty of misery to go around.

I will say this: medical school has certainly been the best time of my life, because I grew tremendously as a person and made some lifelong friends--but all that growth and friendship came at the expense of a whole lot of pain. And it's not all bad. At the end of the day, I feel tremendous gratitude that medicine will be my profession: I get to help people for a living; by and large, my colleagues are interesting, smart, and hard working people; teaching and learning have become a way of life; and I'll eventually be renumerated extremely well for all the toil (better than a lot of people who toil away just as hard doing something else). But exactly none of that matters to a medical student who is contemplating suicide. All that matters is, right now, things hurt more than they can handle, regardless of whether anybody else thinks the suffering is justified.

This is so true. I'll be honest here, I've struggled with depression and anxiety during med school and many times I have contemplated suicide myself. I've felt that way again now that I'm in the beginning of intern year too. Things were too much for me to handle. And it didn't help when people who I thought I could trust for support told me I had no right to be depressed because x person has it much worse, or because I'm on a path to make more money than most people will ever see. When someone's depressed to the point of wanting to kill themselves, that sort of stuff does nothing, and often makes it worse.

 

[lymphocyte]

This is so true. I'll be honest here, I've struggled with depression and anxiety during med school and many times I have contemplated suicide myself. I've felt that way again now that I'm in the beginning of intern year too. Things were too much for me to handle. And it didn't help when people who I thought I could trust for support told me I had no right to be depressed because x person has it much worse, or because I'm on a path to make more money than most people will ever see. When someone's depressed to the point of wanting to kill themselves, that sort of stuff does nothing, and often makes it worse.

Thank you so much for sharing this. PM me if you ever want a sympathetic shoulder. You are not alone.

 

[solitarius]

I like the content of medicine, and I enjoy the idea of clinical care.

I've never thought of suicide, but I have mentally checked out quite a few times.

The culture of medicine is driving some people over the edge, and that is sad. I think medical school is very manageable, but becomes overwhelming if you buy into the hype.

Dean: So I heard you were interested in Specialty X (very competitive).
Me: Where did you hear that? I'm actually not interested in X, I'm interested in Y.

The idea of spending 5+ years under the microscope with five extremely neurotic / extremely well-accomplished medical school graduates.... I'll PASS.

 

[njtrimed]

This is so true. I'll be honest here, I've struggled with depression and anxiety during med school and many times I have contemplated suicide myself. I've felt that way again now that I'm in the beginning of intern year too. Things were too much for me to handle. And it didn't help when people who I thought I could trust for support told me I had no right to be depressed because x person has it much worse, or because I'm on a path to make more money than most people will ever see. When someone's depressed to the point of wanting to kill themselves, that sort of stuff does nothing, and often makes it worse.

@Chip Whitley- are you okay? I'm here now if you need to talk.

 

[W19]

This is so true. I'll be honest here, I've struggled with depression and anxiety during med school and many times I have contemplated suicide myself. I've felt that way again now that I'm in the beginning of intern year too. Things were too much for me to handle. And it didn't help when people who I thought I could trust for support told me I had no right to be depressed because x person has it much worse, or because I'm on a path to make more money than most people will ever see. When someone's depressed to the point of wanting to kill themselves, that sort of stuff does nothing, and often makes it worse.

Hey chip... Get the help you need ASAP! PM some of us here if you need to talk.

 

[chipwhitley]

Thank you so much for sharing this. PM me if you ever want a sympathetic shoulder. You are not alone.

@Chip Whitley- are you okay? I'm here now if you need to talk.

Hey, thanks everyone for the support. I appreciate it. I am doing all right now, I just wanted to share my experience which I feel happens a lot but people are ashamed to say so because of the stigma around it. It seems like you and others on this forum definitely don't feel that way and will be there for your fellow classmates when they need it which is really great and may end up saving a life! I am also here for any of you who may find yourself in a dark place in this difficult path, feel free to PM me as well.

 

[Mass Effect]

Not trying to make this a d*** measuring contest, but residents averaging 100+ hour work weeks wasn't uncommon before the 80-hour work week law was implemented

Residents averaging 80+ hour work weeks is uncommon now?

Also, Zyra is clueless.

 

[nih15hopeful]

I have not read everything posted since the OP, and this may fall more under the purview of philosophy than public health (what seems to be the focus here), but I wonder if there's such a stigma around suicide because most of society labels it as "wrong," fostering a culture of hushed whispers and finger pointing. And conversely, as long as it remains a taboo subject, most people will continue to consider it a "problem." We're of multiple minds attempting to navigate a single strait.

I'm not advocating self-immolation, but who's to say what's "best" for a person enduring seemingly perpetual suffering (I'm particularly thinking about those with chronic existential dread and depression who must legitimately convince themselves to wake up and breathe-- much less participate--every day, and who have found no recourse anywhere at all over the course of years of varied efforts)? What makes suicide "wrong" and why must there exist so much societal pressure to find a way to live contently? Under what circumstances is it not "wrong"? I certainly don't have the answers, nor will I pretend to have them. But, I am interested in ideas and discourse.

 

[lymphocyte]

I have not read everything posted since the OP, and this may fall more under the purview of philosophy than public health (what seems to be the focus here), but I wonder if there's such a stigma around suicide because most of society labels it as "wrong," fostering a culture of hushed whispers and finger pointing. And conversely, as long as it remains a taboo subject, most people will continue to consider it a "problem." We're of multiple minds attempting to navigate a single strait.

I'm not advocating self-immolation, but who's to say what's "best" for a person enduring seemingly perpetual suffering (I'm particularly thinking about those with chronic existential dread and depression who must legitimately convince themselves to wake up and breathe-- much less participate--every day, and who have found no recourse anywhere at all over the course of years of varied efforts)? What makes suicide "wrong" and why must there exist so much societal pressure to find a way to live contently? Under what circumstances is it not "wrong"? I certainly don't have the answers, nor will I pretend to have them. But, I am interested in ideas and discourse.

Friend, that's a lot of quotation marks.

I actually think we should do more to stigmatise suicide. It is, in fact, wrong to impulsively kill yourself. What's not wrong is openly talking about suicide, being depressed, getting help, feeling suicidal, etc. Why do I believe this? Because the literature on "suicidal contagion" is incredible and largely points to one fact: the more suicide is seen as a socially acceptable behaviour, or as a tool for accomplishing certain ends (like coping emotionally), the more people commit suicide, especially young people. Not good.

The most infamous example is Goethe's 18th century book "The Sorrows of Young Werther." It portrayed a lovelorn young man who shot himself over a woman. It was an instant best-seller, and quickly became the impetus for a spate of suicides. Young men were found dead by gunshot wearing blue frock coats and yellow waistcoats--just like Werther--with a copy of the book invariably nearby. In fact, there were so many suicides, the book went on to be banned in Italy, Germany, and Denmark. This was the basis for David Phillips' famous phrase "the Werther effect" to describe suicidal contagion. And there are many, many, many more historical examples. In fact, the CDC even issued guidelines for how the Media should report suicide to minimise "suicide clustering," another well-recognised phenomenon. (This story is shamelessly paraphrased from Kay Redfield Jamison's "Night Falls Fast.")

But you bring up an interesting point about euthanasia. You might like this New Yorker article on euthanasia in Belgium and the Netherlands, two countries where it's legal with surprisingly broad indications. It turns out the slippery slope is pretty darn slippery: http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

 

[badasshairday]

Residents averaging 80+ hour work weeks is uncommon now?

Also, Zyra is clueless.

Zyra is in over his head. Part of the stress of being a physician is that you are literally dealing with people's lives. We have all seen people die in front I feel our eyes. Anguish in families. Giving people terminal diagnoses. Second guessing ourselves asking "what if." Stress of malpractice, getting sued when you did nothing wrong.

It isn't just about work hours or trying to make as much money as possible as our wall street friends.

 

[digidesign]

Please add any missing students here. Suicide among doctors - Wikipedia

 

[EleanorAbernathyMD]

Please add any missing students here. Suicide among doctors - Wikipedia

Add any missing students dating back to 1980. Seriously? There is one medical student listed currently (who's case was quite publicized). Please try to convince me what good is going to come of listing names on a Wikipedia page. Or should we get to the bottom line: this page was created as raise hype about the new documentary coming out which is not-so-subtly alluded to in the "In Popular Culture" section. If you really want to put the documentary out there, start a new thread and conversation surrounding the film and its aims rather than unearthing old threads.