Why 'Happy' Doctors Die by Suicide

Pamela L. Wible, MD

Disclosures

September 05, 2018

In This Article

The Consequences for Physicians of Acknowledging Mental Illness

Many of our most inspiring and visionary leaders—artists, actors, even doctors—suffer from mental illness.

Blaming doctors increases suicides. Words like 'burnout' and 'resilience' are employed by medical institutions to blame and shame doctors while deflecting their own accountability.

Yet, students enter medical school with their mental health on par with or better than their peers'. Suicide is an occupational hazard in medicine. Doctors develop on-the-job PTSD—especially in emergency medicine. Patient deaths—even with no medical error—may lead to self-loathing. Suicide is the ultimate self-punishment. Humans make mistakes. When doctors make mistakes, they are publicly shamed in court, on television, and in newspapers (that live online forever). As doctors, we suffer the agony of harming someone else—unintentionally—for the rest of our lives.

Blaming doctors increases suicides. Medical institutions employ words like "burnout" and "resilience" to blame and shame doctors while deflecting their own accountability for inhumane working conditions in failing health systems. When doctors are punished for occupationally induced mental health wounds, they become even more desperate.

If physicians do seek help, they risk being disciplined. Doctors rightfully fear lack of confidentiality when receiving mental health care, as private conversations with therapists could be turned over to medical boards and illegally accessed by their supervisors via electronic medical records at their institutions. So physicians drive out of town, pay cash, and use fake names in paper charts to hide from state boards, hospitals, and insurance plans that interrogate doctors about their mental health and may prevent or delay state licensure, hospital privileges, and health plan participation.

With a great work ethic until their last breath, doctors are often checking in on patients, reviewing test results, and dictating charts minutes before orchestrating their own suicides. Many leave apologetic, heartfelt letters for friends, family, and staff, detailing the reasons for their suicide. One orthopedic surgeon simply wrote: "I'm sorry I couldn't fix everyone."

Doctors choose suicide to end their pain (not because they want to die). Suicide is preventable if we stop the secrecy, stigma, and punishment. In absence of support, doctors make impulsive decisions to end their pain permanently. I asked several male physicians who survived their suicides, "How long after you decided to kill yourself did you take action—overdose on pills or pull the trigger?" The answer: 3 to 5 minutes.

Ignoring doctor suicides leads to more doctor suicides. Let's not wait until the last few minutes of a doctor's life when heroic interventions are required. Most physician suicides are multifactorial, involving a cascade of events that unfold months to years prior. So reach out to "happy" doctors today—especially male anesthesiologists and surgeons, who are least likely to cry or ask for help.

Do No Harm

In honor of Suicide Awareness Month, there will be a special medical community sneak-preview screening of the groundbreaking documentary film Do No Harm. Two-time Emmy-winning filmmaker Robyn Symon follows four people bonded by tragedy on a mission to expose a toxic medical culture that puts the lives of doctors and patients at risk. Showings will be on September 12 and 13 in New York City.

A live panel discussion will follow the movie with filmmaker Robyn Symon and Dr Pamela Wible.

Click here to order a ticket.

Follow Pamela Wible on Twitter.

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