What you don’t know about medical training and culture can kill you

An excerpt from Physician Suicide Letters — Answered.

When is a taboo topic no longer taboo? When is it OK to stop hiding behind euphemisms? When is it safe to tell the truth? The answer is now.

This week I uploaded 53 chapters of physician suicide letters in a book that became a #1 Amazon bestseller in less than 24 hours. No publicity stunts. No PR team. No prelaunch marketing. How does a book become a bestseller in a day? When the public is ready for the truth.

Here’s a sneak peek inside.

December 3, 2015

Dear Dr. Wible,

I’m not sure you read your [Facebook] messages but feel compelled to thank you. I was finishing term two of med school and had a bottle of Xanax in my hand. I was ready, as so many of us are. I took three then three more and came across this link, “How to graduate medical school without killing yourself,” which I believe may have saved my life and a couple of close friends who are also suffering. I’m near the top of my class and praying for death to escape the trap I’m locked into. I was in true delirium from lack of sleep and fear of failure. Studying in my sleep and waking up every hour in panic. Med school is doable but why must it be taught in this format? I read your stories and I’m just in shock how many others feel like I do or I feel like they do. Please keep sharing. You are saving lives, friend.


I’ve been receiving letters like this for three years. Not all have happy endings. I also receive letters from families who have lost their brilliant, compassionate children — during medical school. And the suicides are not isolated to student doctors.

March 23, 2015


I am not surprised at the number of suicides among medical practitioners. I was a nurse for years and went back to school to be a physician assistant. There is so much abuse handed out in training. At the time I was in school, we still had some thirty-six-hour shifts. It was difficult. At least at the university that I attended they had a buddy program. All of the first-year students were given a third-year student to help show us around and be a mentor. The problem was that before we even started our first classes, my mentor committed suicide. She was in her car on her way home still close to the hospital when she stopped at a red light then picked up a gun and shot herself in the head. The person behind her was a physician at the hospital. These things are not that unusual. It’s a sad state of affairs.


These suicides are not isolated to students of medicine, to physicians, to physician assistants. The health care cycle of abuse impacts everyone in our hospitals, clinics, and medical schools. Including patients.

February 12, 2015


When I share what happens in our academic medical center with my non-medical friends, they are astonished and disbelieving. The level of bullying in my institution is amazing, including a faculty member seriously suggesting that a resident’s mistake was so heinous that he should “off ” himself. When I speak about changing the culture of medicine, my colleagues think it is impossible to support financially. In our institution, money is a deal breaker. We have a patient wellness program with financial/insurance premium incentives, but as far as I know, no physician wellness program with incentives. I will watch what happens with you with interest. Keep doing it.


So what are the answers? How do we stop the cycle of institutional abuse? Physician suicide hotlines inside our hospitals? Resilience training for our wiped-out doctors? Meditation classes for medical students? Advocacy centers for mistreated patients?

February 13, 2015


It’s not costly or complicated to end bullying and hazing. It’s been outlawed at elementary schools, fraternities, and pretty much everywhere — except health care. How much does it really cost to be kind and compassionate? How much does it cost to replace hundreds of doctors who off themselves?


Finally an answer.

This cycle of health care abuse is a global phenomenon. I’ve received letters from Canada, Egypt, India, South Africa, UK, and the USA. There is no country in which medical students are immune from the effects of a traumatic medical education. There is no perfect health system in which doctors do not struggle to preserve their humanity and patients do not die for lack of care. There is no amount of money, no high-priced health plan that will guarantee that the doctor controlling your ventilator is not sleep-deprived or suicidal. We are all at risk.

It is time to expose the pervasive and largely hidden medical culture of bullying, hazing, and abuse that claims the lives of countless medical students, doctors, and patients. Now — for the first time released to the public — I’m sharing the private letters and last words from our doctors who could no longer bear the pain of an abusive medical system. What you don’t know about medical training and culture can kill you. These letters invite you behind the white coat and into the mind, heart, and soul of our doctors — and provide answers.

The solutions are simple.

The time to act is now.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Suicide Letters — Answered and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.

Image credit: Shutterstock.com

View 28 Comments >

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories