An excerpt from Finding Purpose: A Neurosurgeon’s Journey of Hope and Healing.
Each year, almost 400 physicians die by suicide. Reading that sentence should be enough to give anyone who has dedicated their life to helping and saving others cause for concern.
From the perspective of family, friends, and colleagues, I present as a 54-year-old pediatric neurosurgeon, endurance ultra-runner, husband, father, and friend. Yet, I have battled with the inner demons of depression, obsessive-compulsive tendencies, and stuttering for as long as I can remember.
In becoming a neurosurgeon, I sought to live my life bringing healing to those with neurological disease. After completing my training, I felt a tremendous sense of pride knowing that I was prepared to have a great impact on patients and families in their time of greatest need and hopelessness. I entered and ended each day with the knowledge that I had given my all. I, like many of my colleagues, ignored fatigue and underestimated the accumulated trauma and stress until suddenly, I became one of the statistics—burned out, depressed, and suicidal. The administrative, clinical, and personal stressors had struck down my physical and mental health.
On September 12, 2009, I attempted suicide. In that particular moment, my resolve was gone, replaced by fear, hopelessness, and a sense of inadequacy. I lacked the skills to respond and was overwhelmed by emotions I had never known. I felt that I was trapped and could not turn to loved ones for support, lest I lose their respect.
I found my way out. My blessing was my family, my resolve, and my mission. I know recovery is possible, because I have recovered through family, friends, and ultra-running. Expressing and acknowledging our insecurities is vital, but it is how we deal with them and find inner peace that is key. Showing compassion and kindness to ourselves and the members of the high functioning teams we lead is vital.
My work in neurosurgery involves the brain health of our patients, and part of maintaining their brain health is taking care of themselves and ourselves while sustaining a work-life balance. We need to raise awareness about physician wellness and remove the stigma and the tendency to keep physician burnout a secret. Burnout can lead to anxiety, depression, suicidal thoughts, marital and family stress, anger issues, addiction, and substance abuse, any of which can lead to dissatisfaction, and ultimately, physicians ending their careers.
Physicians are twice as likely to be dissatisfied with their work-life balance than the average working adult. In 2015, almost 50 percent of physicians reported they were burned out. Medical students’ rate of depression is 15–30 percent higher than that of the general public. Physicians are more than twice as likely to take their own lives than the general population. Female physicians are 2.5–4 times as likely to die by suicide than women in other occupations.
These are national statistics. We can—and should—do things differently in America. If we recognize and reduce the stressors that lead to burnout, we can create a supportive environment that fosters our own physical and mental well-being. This will allow us to provide the best quality care for our patients.
On June 10, 2016, I decided to speak up and raise awareness of mental health; as often, you hear about someone’s depression after they take their life. Part of my everyday living is showing my vulnerability and telling my story to let others know to keep fighting for life and to strive for an effective work-life balance. My efforts over the past four years have been to help colleagues focus on raising awareness of mental health and removing the stigma so that we begin to talk about and develop wellness strategies and overcome the hills of life. I have shared my story countless times with colleagues, medical students, and staff. I do this to destigmatize burnout and let those facing pain in silence know they are not alone. I have also taken the empathy resultant from my pain and turned it into a career focused on healing for the vulnerable.
Anthony Avellino is a pediatric neurosurgeon and the author of Finding Purpose: A Neurosurgeon’s Journey of Hope and Healing.
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