COMMENTARY

'On a Roof Looking Over the Edge': Why Physicians Commit Suicide

Brandon Cohen

Disclosures

December 11, 2014

According to a recent article on Medscape, more than 400 physicians in this country committed suicide last year. The piece presented wrenching portraits of some of those lost lives and delved into the causes and potential solutions to this grim problem. In response, medical professionals engaged in a wide-ranging and impassioned discussion, taking on the issue from a remarkable variety of vantage points.

Most responses praised the article and found the heartbreaking accounts of overwhelmed physicians too familiar. Quite a few respondents reported being unable to make it through the entire article, which included childhood photos and suicide notes of deceased doctors. Many physicians described their darkest moments, when they had considered or even attempted suicide. Several felt that they were not completely past these feelings.

One current medical student wrote:

I came perilously close to ending it all recently. I was on a roof looking over the edge which looked rather enticing, and what stopped me from stepping over was a text message from an acquaintance miles away. How do I prevent such a scene from recurring?

Colleagues quickly offered words of support, links to professional help, and even personal phone numbers.

The discussion then sifted through the reasons for the high incidence of suicide. For many, the stressors began in training. Wrote one neurosurgery resident (who spoke for many):

I . . . experienced 55 hours of work with two hours of sleep, not being able to eat, drink or even go to the bathroom for 23 hours straight.

Another healthcare professional offered further perspective on the deficiencies of training:

One thing strikes me as being overlooked by medical schools [and that] is adequate preparation for the shock of transitioning to the very real world of human suffering.

A colleague had a vivid recollection of her first year in med school:

I will never forget the shock to my system of having to ride with EMS on a rotation to a suicide by rifle of a college student . . . [I had a] hard time sleeping [and questioned] things about myself and my purpose. Never got de-briefed. We were just kids who, by getting into med school, automatically were assumed to have superhuman powers to deal with things of this nature. Mental health is so important for med students.

Another physician added:

They make us live perfectionism. We are prepped in med school never to be wrong, brainwashed into thinking doctors are above normal humans. My residency taught me [that] if I did not like or want to help a patient, as a psychiatrist, it was my issue.

Another physician offered an idea:

Every school and every residency should have a Tap out bell . . . Medicine is an inherently stressful occupation, for which not all accepted into programs will be well-suited.

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