On June 30th, a physician entered a hospital in New York City with an assault rifle. He killed one person, a physician, and wounded six others. He then set himself on fire and shot himself in the chest, dying by suicide. I, nor anybody else, knows this man’s motives or what was going on in his head. But one detail in the story stuck out to me. According to CNN, ...

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Recently, I attended a conference where a recognized expert in physician burnout was a keynote speaker. As I sat through this lecture on physician burnout, it struck me that we may be approaching burnout in an entirely wrong way. We either look at it from a disease standpoint along the lines of PTSD or depression. Alternatively, we view it as Read more...

A long time ago, when I was interning in an emergency department, several ambulances arrived at once from the site of a bombing. They unloaded three victims plus a mass of assorted limbs. As I placed an endotracheal tube in one patient, the awfulness suddenly hit me: These people had probably been sitting peacefully at home only a half-hour earlier, and now they were a mass of gore. Overwhelmed, I ...

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Imagine that you come home to find your daughter in tears. She’s been acting strangely for the past year, but she never tells you what’s going on. This time she finally tells you: She can’t stop thinking about killing herself with a knife in the kitchen. After an hour of talking, you realize that she doesn’t want to die, but she has obsessive thoughts about hurting herself. She’s overwhelmed, and ...

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Dear Dr. Wible, I lost my beautiful son Evan to suicide four weeks ago. He was a second year internal medicine resident -- a very smart, loving and funny man! He left a lengthy letter and in it he stated, “I do not want any attention drawn to this.” I have been crying all day reading your book and blog and I’ve seen ...

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Why can’t doctors be depressed? They encounter challenging and emotional situations every day, and they are robbed of the emotional intelligence training necessary to handle them properly. The 32-year-old single mother of two who was recently diagnosed with metastatic breast cancer and given a prognosis of four months to live. The 13-year-old daughter who suffered her first seizure while swimming alone in her home pool and now lies paralyzed in the ...

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I am not an employee. Maybe I should have said this four years ago when I was an employee. When I opened my private practice in 2014, I was running away from something as much as I was running to something new. I’ve been out of training for over a decade. Early in my career, I envisioned myself as an employee of either a non-profit organization working with underserved communities ...

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It started with nightmares. I would wake up frightened, covered in sweat and searching my empty room for an intruder. It progressed. I started setting traps on my doors to see if anyone was coming into my apartment when I wasn’t there. I didn’t open my blinds often. And when I did, I ensured no one would be able to see inside. I meticulously planned movements outside my apartment — ...

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I had an interesting conversation with a patient in the office some time ago. He was sent to me to evaluate abnormal liver blood tests, a common issue for gastroenterologists to unravel. I did not think that these laboratory abnormalities portended an unfavorable medical outcome. Beyond the medical issue, he confided to me a harrowing personal tribulation. Often, I find that a person’s personal story is more interesting and significant than ...

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December 2012, three days before Christmas. It started as an ordinary day, but soon it would become the turning point of my career. As I entered my office, I noticed a different energy in the room. The receptionist looked at me and said, “Doc, one of your patients died last night.” As a psychiatrist, I am not used to the feelings generated when someone you cared for, passes in the ...

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