Physician Suicide 101: Secrets, Lies, and Solutions

Pamela L. Wible, MD

November 13, 2014

Could the Story Have Had a Different Ending?

Would Greg, Vincent, and Kaitlyn be alive today? Yes. Their deaths were 100% preventable. Every day we don't take action, we lose another Kaitlyn, Vincent, or Greg. (Author’s note: This article posted on November 13, 2014, which is Greg’s 32nd birthday. We miss your sweet soul.)

What Will You Do?

Talk about physician suicide. Will you talk about physician suicide? If you lose a peer, will you hold an M&M conference or perform a psychological autopsy? A group of cyberspace docs recently asked me: "What gives you the right to perform a psychological autopsy? To go through these victims' autopsies and suicide notes?"

Well, these families reached out to me. I didn't go looking for this. I didn't even know I was doing psychological autopsies until I discovered the term in a suicide article. FYI: families with suicided children are eager for someone to take a sincere interest in their kids' deaths. Would you be willing to honor their children? And prevent future deaths among your peers?

Another gang of cyberspace docs wanted to know what kind of training I have that allows me to do these psychological autopsies. Do I have some sort of certificate that gives me the right to do this? I have no training. But my mom's a psychiatrist. My dad's a pathologist. Maybe that means I'm a natural at psychological autopsies.

What training do you really need? Just take an interest in your dead colleagues. The only question you really need to ask is: Why?

Stop bullying and abuse. Will you stop the bullying and abuse? We can all reach out to faculty who use shame-and-blame teaching, call attention to the violence, and offer alternatives. We do not need fear-based teaching to learn how to be healers.

Learn nonviolent communication. Will you learn NVC? Vincent was inserted into violent crime scenes. Why speak violently to one another? NVC can reduce the trauma of our traumatic jobs. Let's learn and then teach NVC. It's easy. I learned in an hour online. Plus my ex-husband's last girlfriend teaches it, and I hired her for a private lesson. Takes about an hour—or at max 2. Every medical school, hospital, and clinic should teach their students, physicians, staff—even administrators and CEOs--how to speak with kindness and compassion.

Incorporate Balint groups. Will you start a Balint group? All medical students and physicians would benefit from a weekly lunchtime case conference, a structured release valve for the trauma they have witnessed. Vincent and his peers could have processed their feelings and eaten.

I teach a biannual physician retreat in which physicians often (spontaneously and without prompting) start crying about cases from years ago. One doc in her late 50s broke down about a miscarriage she witnessed over 20 years ago. She was just so happy that she could finally cry about it! She hadn't been able to cry in years. Really? We're just supposed to just shove all this down day after day, week after week, year after year, with no release valve? You can't tell your spouse. Cases are confidential. Plus you'll wear out your spouse. There's a reason most people don't go into medicine. They can't handle this stuff. We can if we have a way to process our feelings in real time before we start plotting our suicides.

Please (I'm begging you) start a Balint group in your clinic or hospital. You could save lives.

Reach out to troubled colleagues. Will you reach out to troubled colleagues? Doctors like Greg won't just come up to you and say, "I'm suicidal." But he might say, "I had a rough day." (That's doctor-speak for: I need help!) When docs e-mail me their troubles, I call them back immediately. Sometimes 30 seconds after they hit the "send" button on their computers. They're shocked. I respond: "When you're on call, you call patients immediately. Right? Why don't we do that for each other?"

Be a mentor. Will you be a mentor? At the time of Kaitlyn's death, she was dating a man in Michigan who was a 99% match on OkCupid. Kaitlyn needed a matched mentor in her own town—at her own school. Someone to watch over her. Could that have been you?


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