My story starts like most individuals who enter into medical training. I had the dream that being a physician was my life calling to bring physical healing to others. While I did gain medical knowledge and skills, I also unintentionally developed a jaded mentality. I was quickly introduced to the reality of medical culture in which public embarrassment from “pimping” (a series of difficult intentionally unanswerable questions posed to medical students or residents) and condescending attitudes were the norm. In the midst of my training, I found myself caught up in the insidious black hole called depression. For years, I suppressed my negative emotions believing that depression was a sign of weakness. I fought through it and tried to develop a “thick skin” with the hope that things would get better. In doing so, I ultimately let my depression grow until one day it overtook me, and I came to a point where I wanted to end my life. While in that dark place, I realized my desperate need for help regardless of whether it made me look weak or incompetent.
At the start of my journey of emotional healing, I began to learn more about physician depression and suicide. My eyes were opened to the reality that so many others were feeling the same way that I was but were too afraid to tell anyone. Physicians are held to a higher standard because of their role in treating human life. However, this does not mean that doctors are not human and don’t have personal struggles like everyone else.
Physicians are especially at a higher risk for emotional exhaustion, depression, and anxiety due to the work and hours required. Do depression and anxiety indicate weakness and an incapability to be a good physician? I now know that is not true, but unfortunately, there is an unspoken belief among many in the medical field who suggest it is. Depression is an illness that needs proper treatment and checkups just like any other physical ailments. The fact that there is such a stigma on depression and anxiety in medical professionals prevents individuals from admitting to having any type of mental illness and obtaining appropriate treatments.
In realizing that there may be others in my residency struggling with depression, anxiety or just feeling overwhelmed, I became more vocal about my emotional journey to other residents who I sensed were also struggling. I believe this made myself more approachable to talk about the hardships of residency and be a source of encouragement. I was known as the movie character Sadness from Inside Out, but it gave me the opportunity to reach residents who just needed someone who understood. I wasn’t the strongest resident or resident of the year. But if I saw an opportunity to help another resident, I took it. If it was helping with a note when my fellow resident was too exhausted to think straight, helping an intern to put orders with an admission, providing reassurance after a bad evaluation from an attending physician, or even just visiting a resident at the end of a shift — I did it. There was a happiness that I found when I was willing to simply be there for another resident. Through simple acts of kindness and sharing my own insecurities, it gave others the feeling of support and the courage to seek help if they needed.
Am I asking doctors to be best friends and sing kumbaya? No, but I am asking for doctors and medical staff to start thinking about the golden rule. If medical professionals can be kindhearted to patients in the name of patient satisfaction even when a patient is acting terribly, could we also show that same thoughtfulness to our colleagues? Instead of yelling at the resident because they asked a stupid question or did not know the answer to a question, could we be more professional by not losing our temper and just teach in a non-condescending way? Instead of telling the intern that he or she is slow and you don’t know how he or she even made it into residency, could senior residents turn the situation into a learning experience? Could they show how things are done by example instead of just sitting there doing nothing while the intern is crying on the inside losing their confidence with every minute that goes by?
There are exceptions to this, and some actions require a more appropriate disciplinary approach especially when there is danger to a patient. I know we don’t live in a perfect world, but imagine that in addition to patient satisfaction, people strived for staff satisfaction. I know we can’t control the actions of others, but we can control our actions and how we treat others. Nobody is perfect including me, but what if we just tried? Stopping the unnecessary emotional cruelty and instead treating colleagues and medical staff in a professional and mindful manner could possibly create an environment that everyone would want to work in. If there is anything that I learned from my medical training, it is that compassion, respect and camaraderie go a long way.
I suspect that the major reasons for many of these suicides committed by physicians and medical students were connected to work-related struggles and personal emotional suffering that was not properly addressed. I wonder how many of these individuals would still be alive if the culture of medicine wasn’t so patronizing, judgmental, and discouraging but rather considerate, constructive, and understanding instead? How many of them would still be alive, if there wasn’t such a stigma on depression or anxiety and they felt comfortable to get the treatment they needed without fear of judgment?
How many of them would still be alive if someone simply said, “me too?” Kindness and understanding have the power to save those around us and are lights in the darkness. I want to inspire us all to be that light.
Audris Bol is a pediatrician.
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