In general, I would predict that the audience reading this blog knows about medicine’s suicide epidemic: Roughly 400 physicians and 150 medical students kill themselves each year in the United States. This means that every year, about a million Americans lose their doctors to suicide. This crisis is a public health issue. The puzzling question is: Why isn’t it publicly known? If one million Americans were affected each year by ...

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When a person gets depressed over their divorce, they are said to have a mental illness. When a person becomes psychotic from a manic episode due to their bipolar disorder, they are also said to have a mental illness. But are both of these illnesses mental illnesses? The definition of mental is that which relates to cerebral, brain, cognitive or intellectual processes. Many disorders occur from problems in the anatomy or ...

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Imagine losing your grip on reality; your only place to turn is the local hospital. Once there, you give up your personal effects, your clothes, and often, your right to leave. You wear paper scrubs in a sparse room, lay on an uncomfortable bed, and have a guard nearby preventing your escape. In seeking help, you have become a prisoner. This is done for your and for the hospital personnel’s ...

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As the audience of medical students decried the experiences that defined their academic lives, my cohort of middle-aged doctors started to squirm. We knew these stories: Doctors mistreating medical students, nurses, and other doctors; learning to cope with brutally long work hours; the struggle to grasp vague and ever-changing expectations while quickly bouncing from one clinical rotation to the next. The four of us had eagerly agreed to participate on the ...

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Pamela Wible MD’s book, Physician Suicide Letters Answered, is a devastating view of raw pain, the pain of young, energetic, highly committed young people motivated to help and heal. These healers themselves have been plunged into the spiritual, physical, emotional, and intellectual hell of suicidal thought and action. Iatrogenic illness in action (iatrogenic illness being that which is caused by medical practitioners). Unfortunately, and tragically, the iatrogenic illness that ...

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Prior to the release of DSM-5 in 2013, I referred at times to the pocket copy of DSM-IV parked in my office bookcase.  The main reason was to enter the right diagnostic codes on insurance forms.  I also sometimes quoted DSM criteria to show a patient that ADHD can’t arise in adulthood, that daily mood swings are not characteristic of bipolar disorder, or that six months of sobriety is still “early” ...

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I was treating John W., a psychiatric patient who was an insurance executive. He was angry about his work situation. He complained bitterly about his supervisor whom he felt singled him out for unfair criticism. Over the course of months, John’s complaints escalated to the point where he said, “I swear … if there was a chance I’d get away with it, I’d love to get rid of the guy.” I ...

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The New York Times and NPR recently published articles related to the Goldwater Rule. In short, a magazine sent a survey to over 12,000 psychiatrists in the U.S. with the single question of whether they thought presidential nominee Mr. Barry Goldwater was fit to serve as president. Few psychiatrists responded. Of those that did, more than half -- still over 1,000 -- said that he was ...

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By the end of my first year of residency, I knew I was in trouble. I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake. My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts. Yet, I came to work ...

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StephanieFired Dear Pamela, You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency program. On this web page, I spoke about the fact that I had become interested in this event during my struggle to ...

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