Physician Suicide 101: Secrets, Lies, and Solutions

Pamela L. Wible, MD

November 13, 2014

Are These Cases Isolated?

Our cases are not isolated. All brilliant, sensitive people who felt alone in a highly competitive and inhumane environment. All sleep-deprived, working or studying over 80 hours week. All hid their depression and appeared highly functional until their suicides, and all left notes because we're trained to and we're so darn responsible!

Tiers of Secrets

The secrets start with victims who are ashamed. Families remain silent to safeguard their reputations. Physicians hide suicides from patients who never find out why they can't get a follow-up appointment with their doctor who left the clinic so suddenly. Physician suicide is medicine's darkest secret, and our code of silence is maintained by layers of lies.

Layers of Lies

Reductionist medicine. Reductionism is the opposite of holism. Reductionism leads to body-mind-spirit disintegration. While reductionist medicine has led to scientific advances, it's fatally flawed. It separates us from our hearts and souls, which is what gives our lives meaning and keeps up wanting to live here on Earth.

Professional distance. Professional distance is far from protective. Vulnerability is strength. When we're authentic with our patients and ourselves, we build resilience and connections with other people here on Earth.

Suicide cover-ups. And the suicide cover-ups...It's a medical game of truths and lies. Death certificates are miscoded even when there's a suicide note! A suicidal hanging becomes asphyxia, a suicidal overdose is suddenly an accidental overdose, a self-inflicted gunshot wound is officially an accidental gunshot wound, a suicidal motor vehicle accident is just another motor vehicle accident.

Figure 12. Suicide miscoding.

Blame the Victim

Meanwhile, those in the know whisper blame-the-victim questions:

Was he not doing well academically?

Did she get a low board score?

Did she have a history of depression?

Are we selecting the wrong people?

Was he having trouble at home?

These questions focus blame on the victim, and they deflect blame from the medical school, residency, clinic, hospital, and healthcare system.

So what are the solutions?

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