Early on the morning of September 11th, 2017, already a solemn day for our nation, a light went out due to suicide. Our father, Patrick Vezeau, was an oral surgeon near the end of an accomplished career who quietly fought a lifelong battle with depression. He embodied the heights of achievement in his profession, and, in death, we have come to realize he exemplified the common risk of suicide among health care providers. Our nuclear family consists of a physician, a veterinary student, a PhD student, an oral pathologist, and our father, an oral surgeon. His death created a space for conversations recognizing depression as a common trait in our family, often exacerbated by our health care-driven careers.
Suicide impacts clinicians, including physicians, dentists, pharmacists, and veterinarians, disproportionately to other Americans. Though they are less likely to die of heart disease and cancer, the leading causes of death in the U.S., physicians, and veterinarians are more than twice as likely to die from suicide. Additionally, they are more likely to complete suicide due to greater knowledge of and access to lethal means. Approximately 30 U.S. health care workers are lost to suicide every week. Similarly, health care trainees are known to have higher rates of suicide than their peers. Shared sources of stress across these professions include increasing levels of student debt, estrangement from family and loved ones due to work commitment, perceived risks of seeking treatment, more time spent on paperwork, and less time spent with patients. This leads to burnout and compassion fatigue. The intensity of the COVID-19 response has only exacerbated these risks.
Our father was devoted to his family and also tirelessly involved with organized oral surgery. He was part-owner in a private practice for a large underserved area, was the lead board examiner for his specialty on several occasions, helped to restructure these examinations, and still managed to regularly publish scholarly literature. As an oral surgeon, his responsibilities were not those of a dentist alone, but also of a surgeon, anesthesiologist, and internist. As we have reflected on our father, we have come to understand he worked at the nexus of some of the most at-risk clinical professions. As such, we believe he represents the intersection of suicide risk across these health care domains.
Acknowledging the shared burden on diverse groups of health care providers will galvanize further interprofessional wellbeing efforts. Already, there is a dedicated network of mental health professionals working at the intersection of many health care fields. A number of states have integrated wellness programs that serve struggling health professionals from many fields. There is even a group in the National Academies of Medicine, the Action Collaborative on Clinician Well-Being and Resilience, devoted to advancing mental health for many types of clinicians.
To raise awareness of this shared struggle, one of the authors of this piece worked with a medical student and the office of Iowa’s Governor, Kim Reynolds, to declare September 19th as Clinician Suicide Prevention Day. This day was launched with the vision of uniting health care providers around an issue deeply impacting their interlinked professions. Those observing the day held a 30-second moment of silence – for the 30 U.S. health care workers lost to suicide every week. If two students can do this in Iowa, surely it can be replicated elsewhere.
Now, the onus is on us to carry this movement forward outside of our institutional and professional silos; moving forward together as a combined front. We must recognize, encourage, and reinforce ongoing efforts to further integrate clinician mental health and support systems. Those interested in connecting this web of wellbeing and suicide prevention can start by reaching out to friends, opening inter-organizational dialogue, sharing best practices, or joining existing efforts in these areas. In our shared journey of suicide prevention, this must only be the beginning.
Anne Lyle Vezeau de Geus is a family medicine resident. Neil Vezeau is a veterinary student. Grace Vezeau is a graduate student.
Image credit: Shutterstock.com