Why 'Happy' Doctors Die by Suicide

Pamela L. Wible, MD

Disclosures

September 05, 2018

In This Article

Hiding Chronic Anxiety

I feel a kinship with Ben, partly because I used to suffer from chronic anxiety that I hid under academic achievements, but mostly because I'm a cheerful doctor who was once a suicidal physician, too. In 2004 I thought I was the only suicidal physician in the world—until 2012, when I found myself at the memorial for our third doctor suicide in my small town. Despite his very public death, nobody uttered the word "suicide" aloud. Yet everyone kept whispering, "Why?" I wanted to know why. So I started counting doctor suicides. Within a few minutes, I counted 10. Five years later, I had a list of 547. By January 2018, I had 757 cases on my registry. As of today, that number is 1013.

High doctor suicide rates have been reported since 1858.[1] Yet 160 years later, the root causes of these suicides remain unaddressed. Physician suicide is a global public health crisis. More than 1 million Americans lose their doctors each year to suicide—just in the United States.[2] Many doctors have lost several colleagues to suicide. One doctor told me that he lost eight physicians during his career, with no chance to grieve.

Public perception maintains that doctors are successful, intelligent, wealthy, and immune from the problems of the masses.

Of these 1013 suicides, 888 are physicians and 125 are medical students. The majority (867) are in the US and 146 are international. On my registry, surgeons have the greatest number of suicides, followed by anesthesiologists.[3]

However, when accounting for numbers of active physicians per specialty, anesthesiologists are more than twice as likely to die by suicide than any other physician. Surgeons are number two, then emergency medicine physicians, obstetrician/gynecologists, and psychiatrists.[4]

On my registry, for every woman who dies by suicide, we lose four men. Suicide methods vary by specialty, region, and gender. Women prefer overdose. In the US, men use firearms. Jumping is popular in New York City. In India, doctors are found hanging from ceiling fans. Male anesthesiologists are at highest risk among all physicians. Most anesthesiologists overdose. Many are found dead inside hospital call rooms.

Doctor suicides on the registry were submitted to me during a 6-year period (2012-2018) by families, friends, and colleagues who knew the deceased. After speaking to thousands of suicidal physicians since 2012 on my informal doctor suicide hotline and analyzing registry data, I discovered surprising themes—many unique to physicians.

Public perception maintains that doctors are successful, intelligent, wealthy, and immune from the problems of the masses. To patients, it is inconceivable that doctors would have the highest suicide rate of any profession.

Even more baffling, "happy" doctors are dying by suicide. Many doctors who kill themselves appear to be the most optimistic, upbeat, and confident people. Just back from Disneyland, just bought tickets for a family cruise, just gave a thumbs-up to the team after a successful surgery—and hours later they shoot themselves in the head.

Doctors are masters of disguise and compartmentalization.

Turns out that some of the happiest people—especially those who spend their days making other people happy—may be masking their own despair. Reading this excerpt from the 1858 Manual of Psychological Medicine, I'm reminded of so many brilliant doctors I've lost to suicide[1]:

Carlini, a French actor of reputation, consulted a physician to whom he was unknown, on account of the attacks of profound melancholy to which he was subject. The doctor, among other things, recommended the diversion of the Italian comedy; 'for,' said he, 'your distemper must be rooted indeed, if the acting of the lively Carlini does not remove it.' 'Alas!' ejaculated the miserable patient, 'I am the very Carlini whom you recommend me to see; and, while I am capable of filling Paris with mirth and laughter, I am myself the dejected victim of melancholy and chagrin.'

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