Physician Suicide Letters

[Muffinho]

Advertisement - Members don't see this ad

http://www.kevinmd.com/blog/2014/04/physician-suicide-letters.html

I read this last night, I think the article came out a few weeks after the article about miserable physicians that was posted on this forum about a month ago. It is certainly a troubling thing to read.

Is there anyway to address an issue like this in medicine?

 

[Womb Raider]

Easy, just make sure you drive a 100k + car, marry a blonde bombshell and have a nice lake house.

 

[amazing tekkers]

This isn't limited to the medicine field, lawyers, millionaires, actors, sports stars all take their life--we never truly know why, the most talented people often have been on journeys that have been tainted with experiences that either haunt them or drive them to the breaking points so they seek solace in other things to escape...suicide is a way for them to end all the pain I guess.

 

[DokterMom]

Inherent in the concept of success is the myth of 'happily ever after'... That if we get into medical school we'll be happy. That once we secure a great residency, we'll be happy. That once we're attendings we'll be happy. That if we get that big part in a movie or show we'll be happy. That if we find our 'Prince Charming' or Beautiful Wife, we'll be happy.

But that's not how life works, and it always seems to surprise some people.

 

[Ismet]

I think more and more med schools are incorporating ways to support mental health, so hopefully that will cause some change down the road. I believe the LCME requires all medical schools to have some form of completely confidential mental health professional to talk to, but many schools are going above and beyond that and trying to proactively help those who may be at risk of depression. But medicine will always be a stressful and challenging profession and it will always push some people to their breaking point. I just hope the stigma keeps decreasing so that more people would seek help.

Easy, just make sure you drive a 100k + car, marry a blonde bombshell and have a nice lake house.

This really isn't something to joke about.

 

[majestic red]

I think that most people who've made it to medical school and beyond aren't really used failing. Most of us were good students in high school, good students in college, applied to medical school and succeeded, etc. etc. We're used to success, we're used to getting what we want, and we're used to getting positive feedback. I think it can sometimes come as a shock when suddenly you're not at the top of the class, or when your patients/superiors are yelling at you.

 

[swolebrah]

I think that most people who've made it to medical school and beyond aren't really used failing. Most of us were good students in high school, good students in college, applied to medical school and succeeded, etc. etc. We're used to success, we're used to getting what we want, and we're used to getting positive feedback. I think it can sometimes come as a shock when suddenly you're not at the top of the class, or when your patients/superiors are yelling at you.

This is very true. So many of my colleagues have not seen the "real world" in terms of how medicine politics works and are just stuck to studying and the occasional volunteering. This is why I suggest to become a nursing assistant or scribe because you get to see first hand how residents are treated, how attending act, how nurses treat others, the surgeon d@#k heads, etc. You get to see the politics between the admitting physicians and the EM physicians and all the drama related with that, etc. You also see how what you vision medicine to be like isn't really what it is. I'd say 80-90% of pt's in the EM are just PCP pt's who don't have a PCP so they come to EM. Before I did scribing though, I thought EM was just trauma's 24/7. It's easy to have a warped view of what medicine is going to be like from textbooks, internet, or TV shows. However until your actually in the hospital watching it being practiced, you never get the full understanding.

 

[mrh125]

Easy, just make sure you drive a 100k + car, marry a blonde bombshell and have a nice lake house.

dont forget to retire early

 

[Lucca]

One: We don't take mental health disorders seriously enough in this country. Free expression, communication and managing your emotions should be something that is considered normal and it shouldn't be reserved only 'if there's something wrong'. We need to look at mental health from a holistic point of view as something that should be monitored and cared for constantly like weight, diet, blood pressure, symptoms, etc.

Two: The prevailing culture of being a 'successful american' places far too much weight on the material value of wealth as a reliable indicator of success. We buy into the narrow definitions of success far too often, especially as pre-meds, and undermine the value of our educations to that end. This combined with the extremely delayed gratification inherent in pursuing medicine causes us to feel expectant or entitled to happiness at some point in life when they have achieved a set number of 'things', as DokterMom has already said. This is inaccurate and extremely unhealthy and especially infectious because of the lack of emotional feedback we receive in school, at home, and in society at large as stated in number One.

Three: Medicine is very stressful and it is almost impossible to know if you are truly, really cut out for it until you get there. No matter how informed you are, there might come a day where you just can't anymore. Even the process of getting there is psychologically and physically abusive.

 

[911 Turbo]

-4 years of undergrad where get good gpa+do good on mcat+volunteer+research+shadow+job+possibly no social life
-Get into medical school with excellent LOR+essays+apps+interviews
-4 years of medical school where you need good connections+gpa+board scores+research+volunteer+most likely no social life
-Get into residency with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in residency for 3-7 years while making 50k per year
-Get into fellowship with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in fellowship for 1-2 years while making 50k per year
-Pass all board and licensing exams
-Finally a doctor where u might make between 150k-800k depending on how u did upto this point but u have like 250-400k debt with interest
-work 30-40 years for 40-70 hours per week before u get old and die


from misc

 

[Muffinho]

-4 years of undergrad where get good gpa+do good on mcat+volunteer+research+shadow+job+possibly no social life
-Get into medical school with excellent LOR+essays+apps+interviews
-4 years of medical school where you need good connections+gpa+board scores+research+volunteer+most likely no social life
-Get into residency with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in residency for 3-7 years while making 50k per year
-Get into fellowship with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in fellowship for 1-2 years while making 50k per year
-Pass all board and licensing exams
-Finally a doctor where u might make between 150k-800k depending on how u did upto this point but u have like 250-400k debt with interest
-work 30-40 years for 40-70 hours per week before u get old and die


from misc

Sounds great.

 

[Xenoblade]

The more I interact with physicians outside of clinical settings, the more I realize how mentally unstable/troubled a lot of physicians are.

 

[Planes2Doc]

The entire system should be over-hauled. Since when is torture an effective teaching method? Is it necessary to beat the living hell out of people for ***** and giggles? Medical school is hell. I don't think many people contemplate how horrible medical school really is. If they did, I think many wouldn't apply. I'm amazed with how many people in pre-med think that it will be a fun experience. It's not.

In my opinion, I'd take four years of hell now than being stuck in a corporate dead end job for the rest of my life doing nothing remotely meaningful. I know that there are all too many people who have regretted taking the path to becoming physicians. Sadly, once you've invested so much to start it, it's too difficult to back out. I think the best things to do going forward are to support our colleagues, and to make sure that people do NOT see mental health issues as being taboo.

If anyone is ever feeling completely depressed and burned out. Please seek help! It's not worth suffering alone.

 

[911 Turbo]

The entire system should be over-hauled. Since when is torture an effective teaching method? Is it necessary to beat the living hell out of people for ***** and giggles? Medical school is hell. I don't think many people contemplate how horrible medical school really is. If they did, I think many wouldn't apply. I'm amazed with how many people in pre-med think that it will be a fun experience. It's not.

In my opinion, I'd take four years of hell now than being stuck in a corporate dead end job for the rest of my life doing nothing remotely meaningful. I know that there are all too many people who have regretted taking the path to becoming physicians. Sadly, once you've invested so much to start it, it's too difficult to back out. I think the best things to do going forward are to support our colleagues, and to make sure that people do NOT see mental health issues as being taboo.

If anyone is ever feeling completely depressed and burned out. Please seek help! It's not worth suffering alone.

So if you were a freshman all over again and you could choose between oil/gas engineering and medical school, what would you go with?

 

[Planes2Doc]

So if you were a freshman all over again and you could choose between oil/gas engineering and medical school, what would you go with?

I don't think I could honestly answer this question at this point. I'd like to see where I'm at once I'm done with medical school to give you an intelligent answer. Then maybe I'd wait again until residency is over so I can give you yet another intelligent answer. In my worst moments in medical school, I wish I could have taken everything back and went back to the airlines. Once M1 was over and I had some time off in the summer, I regained some perspective.

But honestly, I hate medical school. I hate medical school with a passion. Medical school ****ing sucks. But I'm not here to be a medical student. I'm here to become a physician.

One of the greatest things I've ever heard on this site was: "You can work hard now and take it easy for the rest of your life... Or... You can take it easy now and work hard for the rest of your life. The choice is yours!" I wrote it down and have it written on poster board in my room. It's next to where my white coat is hanging. When the going gets real tough, I look in that direction for moral support.

This too shall pass.

 

[Planes2Doc]

The "letters" post and all the posts on here are extremely depressing 🙁

No one should be abused..where does this abuse usually come from and in what form?

I think abuse comes from attending physicians who like to abuse medical students because they were subject to the same abuse. It's a vicious cycle that needs to end, but it doesn't seem like it's going to because if we did it, then so should you. 🙁

 

[Planes2Doc]

But that quote isn't even true. Docs work hard in med school and for the rest of their lives...

Yeah but have you ever had to work a dead end job, sitting in a cubicle doing a bunch of work that's completely meaningless? If you think it sucks on a daily basis, then imagine doing it for the rest of your life. Sure, I hear a lot of physicians complain about what they do. But at the same time, I see physicians who love what they do. They feel that they are making a difference in peoples' lives each day. Sure medical school may be miserable, but it won't take that last shred of idealism out of me. Also, the hell of medical school and everything after in my opinion is far easier than going through a life of meaningless monotony that you see so many people complaining of on a daily basis.

 

[username456789]

One of the greatest things I've ever heard on this site was: "You can work hard now and take it easy for the rest of your life... Or... You can take it easy now and work hard for the rest of your life. The choice is yours!" I wrote it down and have it written on poster board in my room. It's next to where my white coat is hanging. When the going gets real tough, I look in that direction for moral support.

This is what I try to advocate to people, and why I can't align my thinking with the "P=MD" crowd.

Busting my ass, especially during M1/M2, sucked. But it paid off in spades. Putting some very hard work in up front, for me, has allowed me to reach a point where the rest of my life should be significantly more enjoyable than it otherwise would be.

 

[Planes2Doc]

Do you not know of any physicians who *don't* love what they do? Because I do.

There are plenty out there. If not, maybe they just aren't being 100% honest with you.

Like anything else, it's a job, it wears on you, and yea it even becomes monotonous. It's also emotionally taxing, and frustrating. Some specialties are "worse" than others--but let me ask you this..if your mission in going into medicine was to *help* people...and for whatever reason down the line you repeatedly feel that you cannot do that (either because of certain guidelines you need to abide by, or bc of patient noncompliance alone for example..), do you think you will be satisfied at the end of the day?

I think that's where a lot of the dissatisfaction lies. It's the long hours combined with the lack of change, and docs feeling like they are having less and less of an impact on patient care.

And perhaps that's where the beatings come into play..to desensitize and create strength, and to make docs more capable in handling the future BS that will come their way.

You're right it is a job, and yes, I know plenty of people that are unhappy with it. At the same time, I know people that are happy in the corporate world. To each their own.

The article posted by the OP deals with suicide. Usually people who aren't doing a job they enjoy (which is most people) don't suffer from suicidal ideation. Yet, so many medical students, residents, and attending physicians are being driven into severe depression and some even commit suicide. So no, I don't think that beatings are helping. It doesn't take a rocket scientist to see that they aren't going to love their job so much that they will hate weekends and never want to go home, but that's no reason to abuse people to the point where they kill themselves.

And most importantly I'd like to add that: ANY KIND OF ABUSE, WHETHER EMOTIONAL OR PHYSICAL, IS NEVER OKAY UNDER ANY KIND OF CIRCUMSTANCE!

 

[mrh125]

-4 years of undergrad where get good gpa+do good on mcat+volunteer+research+shadow+job+possibly no social life
-Get into medical school with excellent LOR+essays+apps+interviews
-4 years of medical school where you need good connections+gpa+board scores+research+volunteer+most likely no social life
-Get into residency with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in residency for 3-7 years while making 50k per year
-Get into fellowship with excellent LOR+essays+apps+interviews
-Work 60-80 hours per week in fellowship for 1-2 years while making 50k per year
-Pass all board and licensing exams
-Finally a doctor where u might make between 150k-800k depending on how u did upto this point but u have like 250-400k debt with interest
-work 30-40 years for 40-70 hours per week before u get old and die


from misc

change it to 10 years 40-70+ hrs a week if you get into surgical specialities after longer residencies, then retire in hawaii. TYBG.

 

[TheWeeIceMan]

change it to 10 years 40-70+ hrs a week if you get into surgical specialities after longer residencies, then retire in hawaii. TYBG.

10 years post residency and you're probably barely out from under a mountain of debt, with a wife, kids, and a morgage. No way will you be retiring.

 

[mrh125]

10 years post residency and you're probably barely out from under a mountain of debt, with a wife, kids, and a morgage. No way will you be retiring.

some surgeons are able to do that. maybe 15-20, but not 30. there's a reason why the high stress speciality dudes retire earily aside from stress.

 

[Muffinho]

You're right it is a job, and yes, I know plenty of people that are unhappy with it. At the same time, I know people that are happy in the corporate world. To each their own.

The article posted by the OP deals with suicide. Usually people who aren't doing a job they enjoy (which is most people) don't suffer from suicidal ideation. Yet, so many medical students, residents, and attending physicians are being driven into severe depression and some even commit suicide. So no, I don't think that beatings are helping. It doesn't take a rocket scientist to see that they aren't going to love their job so much that they will hate weekends and never want to go home, but that's no reason to abuse people to the point where they kill themselves.

And most importantly I'd like to add that: ANY KIND OF ABUSE, WHETHER EMOTIONAL OR PHYSICAL, IS NEVER OKAY UNDER ANY KIND OF CIRCUMSTANCE!

It is eye-opening to learn about the abuse that goes on. The physician I shadowed is a FM and is generally very happy; I was never exposed to negative sentiments from physicians.

 

[Gauss44]

You can substitute the name of any profession in that title and make a similar argument.

Difficult circumstances have nothing to do with suicide IMO. In my experience (working with mental health patients and growing up around foster kids), suicide attempts are more often linked to emotional issues, mental health issues, or one's personal perception of a situation. That last part about perception explains why different people react differently in similar situations. But I digress, few of us on here are in the mental health field. For most of us, this is out of our purview.

http://www.kevinmd.com/blog/2014/04/physician-suicide-letters.html

I read this last night, I think the article came out a few weeks after the article about miserable physicians that was posted on this forum about a month ago. It is certainly a troubling thing to read.

Is there anyway to address an issue like this in medicine?

 

[amazing tekkers]

What is the abuse though..and does it have a greater purpose perhaps?

Mental abuse from attendings, people say you need thick skin to handle the things they hurl at you, it really shouldn't be that bad,..I hope anyway.

 

[Gauss44]

Being a doctor is NOT the most stressful or brutal occupation. (Examples below, although I think this one's obvious given any creativity.)

 

[amazing tekkers]

change it to 10 years 40-70+ hrs a week if you get into surgical specialities after longer residencies, then retire in hawaii. TYBG.

 

[Ismet]

Oh, I don't buy the argument that doctors have it worse than most other professionals either. I'm sure there are examples of much more stressful occupations.

While every profession has its own challenges and stressors, and while I do not have any personal experience in any other profession, it's pretty fair to say that medicine has some unique stressors that may weigh more heavily on people's emotional, mental, and psychological well-being. Patients dying, either from something you did or something you didn't do or because it wasn't possible to help them. That's a huge burden for someone to bear. We had a talk this past week from a physician who broke down crying while talking about a patient who passed away years and years ago. That stuff stays with you. Some people grow stronger from it, some people break down bit by bit.

Long hours, lack of time with family/friends, the years of studying and being beaten down emotionally in med school (and residency?). I don't know what year @Planes2Doc is in school, but I pretty much agree with everything he's said. There were so many days in my first 2 years of med school that I just wanted to give up. I asked myself what I was doing here and why I was doing this to myself. There are parts of med school that I really enjoyed, but those were mainly social and extracurricular things, as well as our weekly clinical sessions where we got to work with doctors and see/interview patients. The academic side of med school until now has been pretty miserable to say the least, but I think those weekly clinical sessions were what gave me hope that I'll enjoy the job that's at the end of all of this. I'm really looking forward to clerkships, and while I know 3rd year brings its own challenges, I've heard from countless upperclassmen that it's a great time.

 

[Gauss44]

Not sure about brutal, but it has to be up there in terms of day to day stresses. Some people feed off of the stress though.

A job without stress equates to a job without challenge.

I don't think that ALL doctors experience their work as being "stressful" most of the time. There must be a survey about that somewhere.

I do know that different people have different experiences of the same situations. For example, if there's an incident of some sort and 10 people are present, a few of them might describe that incident as "stressful," etc. while the others didn't think so at all. I think a lot of this is individual perception. And I hate to be the devil's advocate, but I don't think that all challenges are stressful either.

 

[sobored]

Being a doctor is NOT the most stressful or brutal occupation.

I'd love to know how you can speak with such resounding certainty about this issue. Please share.

 

[Gauss44]

While every profession has its own challenges and stressors, and while I do not have any personal experience in any other profession, it's pretty fair to say that medicine has some unique stressors that may weigh more heavily on people's emotional, mental, and psychological well-being. Patients dying, either from something you did or something you didn't do or because it wasn't possible to help them. That's a huge burden for someone to bear. We had a talk this past week from a physician who broke down crying while talking about a patient who passed away years and years ago. That stuff stays with you. Some people grow stronger from it, some people break down bit by bit.

Long hours, lack of time with family/friends, the years of studying and being beaten down emotionally in med school (and residency?). I don't know what year @Planes2Doc is in school, but I pretty much agree with everything he's said. There were so many days in my first 2 years of med school that I just wanted to give up. I asked myself what I was doing here and why I was doing this to myself. There are parts of med school that I really enjoyed, but those were mainly social and extracurricular things, as well as our weekly clinical sessions where we got to work with doctors and see/interview patients. The academic side of med school until now has been pretty miserable to say the least, but I think those weekly clinical sessions were what gave me hope that I'll enjoy the job that's at the end of all of this. I'm really looking forward to clerkships, and while I know 3rd year brings its own challenges, I've heard from countless upperclassmen that it's a great time.

Well, lets consider some other examples of career stress (get the violins out/blues guitars ready):

Attorney/Judge/Police: You fail at keeping a bad guy off the street and he kills someone, perhaps a child, who asked you for protection. You fail at keeping an innocent person safe and he get's executed or raped in prison. A crazy person or powerful criminal is angry at you for doing your job and goes after your family.

Poor unskilled worker/non-citizen worker: You have an abusive boss but cannot afford to leave your job or your family will become homeless. (Use your imagination for the abuse part and don't limit it to only words.)

etc.

 

[Gauss44]

I'd love to know how you can speak with such resounding certainty about this issue. Please share.

How could you overlook active military duty? Or any number of professions that are less in demand where people get "stuck" working under abusive conditions and cannot afford to leave?

 

[sobored]

How could you overlook active military duty? Or any number of professions that are less in demand where people get "stuck" working under abusive conditions and cannot afford to leave?

Interesting. So, in your expert opinion, how would you quantify the relative stresses? Would you say a sweat shop worker's job is about 28% more stressful than a physician's job? Maybe 11%, adjusting for specialty? I'd love to hear more about your opinion, since it seems like you've been intimately involved with the challenges of so many different professions. Feel free to keep sharing.

 

[Gauss44]

Interesting. So, in your expert opinion, how would you quantify the relative stresses? Would you say a sweat shop worker's job is about 28% more stressful than a physician's job? Maybe 11%, adjusting for specialty? I'd love to hear more about your opinion, since it seems like you've been intimately involved with the challenges of so many different professions. Feel free to keep sharing.

Instead of wasting your time writing disrespectful replies here, why don't you do your own research? There may or may not be a study on that somewhere.

 

[Gauss44]

Yea yea yea. Did you just google that right now..because that's exactly what comes up on the forbes most stressful job list lol.

Here's the thing, name a profession in which people get sued day in and day out..for attempting to HELP people.

Name a profession in which the general public expects you to perform miracles, and practically be god himself. If you make any mistakes (or perceived mistakes), you get sued and your entire livelihood can be stripped away from you just like that.

Name a profession that takes 14+ years to achieve, before you can actually start working within that capacity. .

Well if it's so bad, maybe you should change careers? Make room for someone who wants to be a doctor?

What I'm hearing right now is whining. I would love to be a doctor and having shadowed, I don't believe it will be very stressful.

 

[sobored]

Instead of wasting your time writing disrespectful replies here, why don't you do your own research? There may or may not be a study on that somewhere.

Let me know how I can research something as subjective as job stresses and I will gladly do it.

And if you think I was being disrespectful, wait until you start your medical training.

 

[TheWeeIceMan]

Well if it's so bad, maybe you should change careers? Make room for someone who wants to be a doctor?

What I'm hearing right now is whining. I would love to be a doctor and having shadowed, I don't believe it will be very stressful.

🙄

 

[Gauss44]

Let me know how I can research something as subjective as job stresses and I will gladly do it.

And if you think I was being disrespectful, wait until you start your medical training.

My point exactly: This is subjective, yet somewhat predictable, and based on individual experience, perception, etc.

Regardless of medical training, hecklers, rude people, etc. Your previous post will remain among those that are disrespectful and unpleasant.

 

[lumpyduster]

Not "Thank you boys and girls?"

 

[Muffinho]

Well if it's so bad, maybe you should change careers? Make room for someone who wants to be a doctor?

What I'm hearing right now is whining. I would love to be a doctor and having shadowed, I don't believe it will be very stressful.

I'm a pre-med so take this with the requisite grain of salt:

You have a thread full of residents and Med Students telling you it's not all butterflies and bubblegum. You may want to consider their experiences. There was another thread like this one with posts from current attendings and their posts were full of valuable information that most of the other pre-meds dismissed or ignored.

 

[911 Turbo]

Not "Thank you boys and girls?"

.........no

 

[sobored]

My point exactly: This is subjective, yet somewhat predictable, and based on individual experience, perception, etc.

Regardless of medical training, hecklers, rude people, etc. Your previous post will remain among those that are disrespectful and unpleasant.

Better disrespectful than ignorant.

 

[Ismet]

I would love to be a doctor and having shadowed, I don't believe it will be very stressful.

I would love to be a doctor and having only gone through half of medical school, you should take my word for it that it will be stressful.

If you think you can gain a sense of the personal stress that someone experiences from following them around for a few hours, you're in for a surprise.

 

[Gauss44]

I'm a pre-med so take this with the requisite grain of salt:

You have a thread full of residents and Med Students telling you it's not all butterflies and bubblegum. You may want to consider their experiences. There was another thread like this one with posts from current attendings and their posts were full of valuable information that most of the other pre-meds dismissed or ignored.

There's a lot of room between butterflies and bubblegum and a terrible stressful nightmare.

 

[911 Turbo]

Instead of shadowing, premeds should be required to live two weeks like an intern

 

[Muffinho]

There's a lot of room between butterflies and bubblegum and a terrible stressful nightmare.

My intuitions tell me that experiences are probably closer to stressful nightmares than they are to unicorns and rainbows.

 

[Gauss44]

Better disrespectful than ignorant.

Better yet, neither.

 

[Ismet]

Instead of shadowing, premeds should be required to live two weeks like an intern

That would crash and burn in all of 2 minutes. Heck I would probably crash and burn in all of 2 minutes.

 

[sobored]

My intuitions tell me that experiences are probably closer to stressful nightmares than they are to unicorns and rainbows.

There have been some truly horrendous moments in med school so far. Thankfully I can see the light at the end of the tunnel. But I think you can take some solace in the fact that it is still an incredible profession, once you sift through all the administrative/bureaucratic BS so prevalent in this field. It's pretty cool to have knowledge that most people will never have. But, as Ismet and others have said, it is certainly stressful, and the life of a physician, overall, is also pretty stressful. And with stress being so subjective, I would never be so arrogant to speak in absolutes about what is or isn't more stressful. Life is full of gray.

 

[Gauss44]

I would love to be a doctor and having only gone through half of medical school, you should take my word for it that it will be stressful.

If you think you can gain a sense of the personal stress that someone experiences from following them around for a few hours, you're in for a surprise.

With all do respect, you didn't mention what your "word" is based on. I wouldn't automatically assume that you experience things exactly the same way as everyone around you. Few things, if any, in life have zero stress for everyone at all times. And a little stress isn't bad anyway.