Physician Suicide 101: Secrets, Lies, and Solutions

Pamela L. Wible, MD

November 13, 2014

Psychological Autopsy #3: Kaitlyn

A sweet, good girl. Kaitlyn never gave her parents any problems (though she cried when she lost at Monopoly). From the time she started preschool, she never needed any help with her homework or anything. At 3 years old, she had to get glasses. Her parents took her to the big medical center where the doctor asked lots of questions. He'd look at the parents for answers, but Kaitlyn answered them all. The doctor was amazed.

Figure 8a. Kaitlyn and her mom; Figure 8b. Kaitlyn in high school; Figure 8c. Kaitlyn in medical school, 23 years old.

In high school, Kaitlyn was a deep thinker, an artist, a poet. I met her extended family in North Carolina. They claim, "Kaitlyn was one of the happiest people on this Earth."

An introvert with social anxiety, Kaitlyn always had a few close friends but none in med school. Everyone was busy studying, and "people just went their own way," she told her mom. She was desperately lonely. Her perfectionism worsened. She went on a strict diet, started running marathons, and lost a lot of weight. She ran like 10-12 miles before class every day and still excelled in med school, acing her Step One exam. Unfortunately she didn’t live to celebrate her results because she completed her suicide—a helium overdose—like a well-planned school project. She left a two-page suicide note in which she claimed lifelong depression but hid it to protect her family and herself.

As an aside, I believe that Kaitlyn suffered less from depression and more from "feeling different and isolated" due to her high intellect. She was raised in the poorest county in North Carolina and was the smartest person around. Maybe she had hoped that when she entered medical school, she would finally be with her tribe—a social circle of more like-minded intellectuals. But medical school rarely creates an environment for students to develop intimate friendships with one another. These young sensitive and brilliant people are left to fend for themselves in survival mode with an overwhelming amount of material to master in a short time with little emotional support.

I can guarantee that many medical students cry themselves to sleep at night in their pillows. That's what I did nearly every night my first year of medical school. I cried so much that one morning my eyelids were sealed shut. I couldn't see anything when I woke up. I had to feel my way to the bathroom. Is this the way a civilized society trains its healers?

Kaitlyn's mother published her daughter's suicide letter in a book[4] she wrote about Kaitlyn. An excerpt:

Figure 9. Kaitlyn's suicide letter.

Kaitlyn's grieving mother—unable to recover from her daughter's death—died by helium overdose 1 year later. I attended her funeral.

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