An excerpt from Please Don’t Die.
While I was still writing this book, a local doctor killed himself. This was a younger psychiatrist with a successful practice, leaving three children after shooting himself in the head. What do you imagine his patients are thinking right now, especially if they are struggling with depression or suicidal thoughts? I didn’t know him but thinking about this makes me want to cry.
Did you know that doctors actually have higher rates of suicide than Veterans? Their suicide rate is twice as high as the general population. The number of doctor suicides is estimated to occur at 40 per 100,000. This is more than double what is seen among the American general public, which is thought to be around 13 per 100,000. That works out at between 300 and 400 medical practitioners taking their own lives every single year. In the U.S., health professionals are well compensated and well educated. It is a career choice many wish for but few achieve.
How can you explain suicides among this group? They are smart, educated, and by most standards, successful. They have access to resources. What possible reason could they have for ending their lives? We tend to think of this group as success stories. But there are significant stressors in the training and in these careers.
Doctors endure extended training which is extremely competitive. The training itself is taxing intellectually, emotionally and financially. They usually enter the medical field because they want to help others. While training involves intensive and prolonged exposure to almost intolerable stress, being responsible for another’s life is overwhelming.
Because the exposure to stress is so prolonged, talented and compassionate people reach their breaking point. They give up. Doctors tend to feel they should be stronger, and think they’re alone in their despair. They don’t turn to each other, and they don’t talk about how they feel, or how afraid they are of failure. They often internalize their despair and end their lives. As humans, doctors are exposed to the same kind of life stressors as others, and deal with it the same way others do, with drugs and alcohol. Their suicide means is usually drug overdose. They have access to drugs and know how much to take.
The loss of physicians yearly to suicide is a tragic loss of resources because we need compassionate people to provide our health care. The process of medical training has been inhumane for some time, based on an archaic notion that the quality of the ability to provide treatment is based on one’s ability to tolerate extreme stress over long periods of time.
Doctors and nurses are made to suffer, and are stressed to their emotional and physical tolerance as part of training in the belief that this trait is necessary to be successful in the field. That exposure to prolonged sleep deprivation and emotional and physical stress becomes more than some can bear. Students graduate with high student loan amounts.
Adjusting to the work environment coupled with insurance restrictions further frustrates those whose goal it is to help others as it impairs their ability to help those they seek to help. Normal life stressors add to the mix. Relationships suffer from the amount of time lost to studying and working, more so than with a number of other types of employment. Varying work shifts and the need to be “on call” may cause interference with emotional intimacy. The scales can tip to overwhelming. Approximately one million people lose their health provider each year to suicide.
Rhonda Fried is a psychiatric clinical nurse specialist. She is the author of Please Don’t Die.
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