“How long after you decided to kill yourself did you take
action—overdose on pills or pull the trigger?” The answer: 3 to
5 minutes.
Ignoring doctor suicides leads to more doctor suicides.
Let’s not wait until the last few minutes of a doctor’s life when
heroic interventions are required. Most physician suicides
are multifactorial involving a cascade of events that unfold
months to years prior. So reach out to “happy” doctors today—
especially male anesthesiologists and surgeons who are least
likely to cry or ask for help. DMJ
REFERENCES
1. Bucknill JC, Tuke DH. A manual of psychological medicine.
Philadelphia, PA: Blanchard and Lea; 1858.
2. Wible P. When doctors commit suicide, it’s often hushed up.
Washington Post. July 14, 2014.
3. Wible P. Keynote. Presented at the 19th Annual Chicago
Orthopaedic Symposium; August 18, 2018; Chicago, IL.
4. AAMC Physician Specialty Data Report. 2016. https://www.
aamc.org/data/workforce/reports/457712/2016-specialtydatabook.
html. Accessed May 9, 2019.
5. American Psychiatric Association (APA) 2018. Abstract
1-227, presented May 5, 2018. https://www.medscape.com/
viewarticle/896257. Accessed May 9, 2019.
What Should I Do if I Think Someone is Suicidal?
People who receive support from caring friends and family
and who have access to mental health services are less likely
to act on their suicidal impulses than are those who are
socially isolated. If someone you know is exhibiting warning
signs for suicide:
• Don't be afraid to ask if he or she is depressed or thinking
about suicide.
• Ask if he or she is seeing a therapist or taking medication.
• Rather than trying to talk the person out of suicide, let him
or her know that depression is temporary and treatable.
• In some cases, the person just needs to know that
someone cares and is looking for the chance to talk about
his or her feelings. You can then encourage the person to
seek professional help.
especially in emergency medicine. Patient deaths—even with
no medical error—may lead to self-loathing. Suicide is the
ultimate self-punishment. Humans make mistakes. When
doctors make mistakes, they are publicly shamed in court,
on television and in newspapers (that live online forever). As
physicians, we suffer the agony of harming someone else—
unintentionally—for the rest of our lives.
Blaming doctors increases suicides. Words like “burnout”
and “resilience” are employed by medical institutions to blame
and shame doctors while deflecting their own accountability for
inhumane working conditions in failing health systems. When
doctors are punished for occupationally induced mental health
wounds, they become even more desperate.
If physicians do seek help, they risk being disciplined.
Doctors rightfully fear lack of confidentiality when receiving
mental health care, as private conversations with therapists
could be turned over to medical boards and illegally accessed
by their supervisors via electronic medical records at their
institutions. So physicians drive out of town, pay cash and use
fake names in paper charts to hide from state boards, hospitals
and insurance plans that interrogate doctors about their mental
health and may prevent or delay state licensure, hospital
privileges and health plan participation.
With a great work ethic until their last breath, physicians often
are checking in on patients, reviewing test results and dictating
chart minutes before orchestrating their own suicides. Many
leave apologetic heartfelt letters detailing the reasons for their
suicide for friends, family and staff. One orthopaedic surgeon
simply wrote: “I’m sorry I couldn’t fix everyone.”
Doctors choose suicide to end their pain (not because they
want to die). Suicide is preventable if we stop the secrecy,
stigma and punishment. In the absence of support, doctors
make impulsive decisions to end their pain permanently. I
asked several male physicians who survived their suicides,
24 Dallas Medical Journal June 2019
Dr. Pamela Wible is a family medicine
doctor in Eugene, Oregon. She received
her medical degree from University of
Texas Medical Branch and has been in
practice for more than 20 years. When
not treating patients, Pamela devotes
her time to medical student and
physician suicide prevention.
/www.swdcmi.com
