CHICAGO -- There's a grim, rarely talked-about twist to all that medical know-how doctors learn to save lives: It makes them especially good at ending their own. An estimated 300 to 400 US doctors kill themselves each year -- a suicide rate thought to be higher than in the general population, although exact figures are hard to come by.
Some doctors believe the stigma of mental illness is magnified in a profession that prides itself on stoicism and bravado. Many fear admitting psychiatric problems could be fatal to their careers, so they suffer in silence.
And when the pain is too much, doctors have easy access to prescription drugs and a precise knowledge of both how the body works and the amount of a drug needed for an overdose to stop breathing and halt the heart.
"All physicians have access to neat, clean ways to commit suicide," said Dr. Robert Lehmberg, a Little Rock, Ark., surgeon who has battled depression and long considered suicide "an exit strategy if absolutely necessary."
The American Medical Association has called physician suicide "an endemic catastrophe," and pledged two years ago to work to prevent the problem.
But the suicides have persisted. So the American Foundation for Suicide Prevention has launched an educational campaign in hopes of making troubled doctors more willing to seek help.
The foundation, the American College of Psychiatrists and Wyeth Pharmaceuticals, a maker of antidepressant pills, paid for the program. It includes a documentary titled "Struggling in Silence" that begins airing on public television stations this week.
"It really has been swept under the carpet," said Dr. Paula Clayton, the suicide foundation's medical director.
The foundation says 300 to 400 doctors commit suicide each year, based on estimates from research, but that more studies are needed to get a more precise count.
Another estimate of 250 yearly comes from an online article by Dr. Louise Andrew and in American Medical News, an AMA publication. But a spokesman said the AMA doesn't track doctor suicides because accurate numbers aren't available.
Suicide figures in broader society are not completely reliable because suicide is often not given as the cause of death.
The overall US suicide rate among men is four times higher than in women — about 23 per 100,000 versus about 6 per 100,000 in women, according to the most recent government data.
But among doctors, suicide rates are about equal for men and women.
A 28-state study from 1984-95 found women doctors were more than twice as likely as women in the general population to kill themselves. Men were more than 70 percent more likely inside the medical profession than overall to commit suicide.
One explanation is that most suicide attempts in the broader population are unsuccessful, while doctors know how to successfully commit suicide, said Dr. Erika Frank, who specializes in research on physician health.
Depression is often the problem.
Depressed doctors frequently decide to self-medicate but don't seek psychotherapy that could help them deal with underlying issues, said Dr. Glenn Siegel, who runs a suburban Chicago program that treats doctors with drug abuse, depression and other psychiatric problems.
"It's not a safe topic to be as open about in that profession because you're responsible for the well-being of others," Siegel said. "If you're admitting something like that, you're saying maybe you're not fit to do your job."
Adds Lehmberg, the Arkansas surgeon, who is featured in the documentary: "You just would rather take a risk with your health than your career. It's not like you get a second chance with it."
A psychiatrist in the New York area who asked to remain unidentified said he had suicidal thoughts every day for several years. But in medical school in the 1980s, he said he was so embarrassed about seeking help for depression that he went to a pay phone instead of his dorm to call a therapist.
Since then, some schools have begun teaching medical students about depression among doctors, but, he said in an interview, "so much more needs to be done."
Because the stigma persists, he said he didn't want his name used to avoid hurting his family and relationships with colleagues and patients.
Some studies have suggested depression is more common among doctors, especially women physicians, and that the high demands of a job dealing with life-and-death issues makes them prone.
But Frank questions that and said she worries that singling out physicians risks "pathologizing" a profession whose members generally "have it awfully good."
"I think the situation gets portrayed as far more grave than it really is for physicians compared to anyone else in the world," Frank said.
There could be reasons why the stigma would be worse for doctors, "but you can come up with just as many reasons why physicians would be better equipped to acknowledge" mental illness, she said.
"We've all done psychiatric training. We all know bad mental health outcomes happen to good people," she said.
A study in Denmark, published last year, found more suicides in doctors than among more than 20 other professions, including nurses, factory workers, elementary school teachers, corporate managers and architects.
But there are few comprehensive studies on suicides among US doctors.
Some have been based on newspaper obituaries, which are "flawed at best" because suicide often isn't listed as a cause of death, said Dr. Morton Silverman, a University of Chicago suicide expert.
New Jersey physician Ron Brown suffered from depression and killed himself in 2002. His widow, Mumtaz Bari-Brown, said she believes the stigma kept her husband from getting help in time to save his life.
As a boy, Brown had been told his father died of a heart attack, not the real cause of suicide, the widow said.
"We have to stop the hiding and the ignorance and recognize it as a disease like high blood pressure or diabetes," said Bari-Brown, who also is featured in the new documentary.
Dr. G. Richard Smith, Lehmberg's doctor and director of the University of Arkansas for Medical Sciences' psychiatric research institute, said doctors need assurance they won't risk their jobs if they seek psychiatric help.
Smith succeeded in getting changes to questions on medical license applications in Arkansas that he believes will help. The old application asked doctors if they were being treated for mental illness or ever had been. A "yes" answer required a psychiatrist's note declaring they were fit to practice medicine. Now, they need only disclose mental health treatment that was advised or required by medical authorities.
The previous form didn't keep doctors with psychiatric problems from practicing, Smith said. But it did keep "doctors who needed treatment from getting the treatment that they needed."
I don't think many people appreciate how stressful it is getting there and staying there..
a friend of mine gassed herself in her car, she was a pediatrician.
You spend a fortune in school, you isolate yourself to accumulate a wealth of information so you can pass an onslaught of board exams, you waste a large chunk of your life (the best years of your life really), you see your friends married, having kids and nice lives and your contacts dwindle as you realize you have so little in common, you don't get any sleep and on call to ridiculous hours where you might be up for 41 hours straight, you pay a heap of loans, you are constantly under the threat of litigation, people always find a way to belittle your achievements and then you spend nearly half of it on taxes..
So yeah there is a reason many commit suicide or are very nearely suicidal..
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
I don't think many people appreciate how stressful it is getting there and staying there..
a friend of mine gassed herself in her car, she was a pediatrician.
You spend a fortune in school, you isolate yourself to accumulate a wealth of information so you can pass an onslaught of board exams, you waste a large chunk of your life (the best years of your life really), you see your friends married, having kids and nice lives and your contacts dwindle as you realize you have so little in common, you don't get any sleep and on call to ridiculous hours where you might be up for 41 hours straight, you pay a heap of loans, you are constantly under the threat of litigation, people always find a way to belittle your achievements and then you spend nearly half of it on taxes..
So yeah there is a reason many commit suicide or are very nearely suicidal..
Looks pretty tough id say, my parents wants me to enter medicine next year!
Well am having none of it, even though they pressurise me so much!
Do u regret ur decision of becoming a medic sister? If u had another go at uni, would u have choosen another career? I am considering microbiology/genetics.
the system in the U.S is different. we have some programs that are like England 7 years one shot, like sophie davis etc but most of the time you have to get an undergraduate in any science. So many do micro or genetics prior to medicine... you'll have to do micro and genetics again but on a graduate level and more clinically oriented when in med school..
You should do something because you love it not because your parents want you to.. I concede you are very lucky.. my parents faught with me every step of the way, they would rather I had been a pharmacist like my sister.. I had to fight everyone including my own incertitude... It has been a very difficult and solo journey!
Do I have regrets.. all the time.. but I think all the obstacles one faces is what shapes ones character.. also bare in mind that I am female...lets just say what you might get one or two chances at getting correct, I had to get correct the first time around.. I have never personally been cut a break..
I am sorry if I sound a little bitter today, I have had a bad day.. let me sleep on this and see if I can offer better advise tomorrow..
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
when u're from south asian/ arab family you dont have much choice to escape from family pressure.
take me for example...i was good student back in high school...but that proved disaster...as my parents took it as a sign that i'm a medic-product..and passed the responsibility of being the doctor, as u know...each generation must have at least one doctor. thanks to that pressure...though in med school, i'm at the bottom of the class...doomed to fail my 1st year.
if i am to quit or fail...i'ill be a defeated 'knight' as shakespeares said...
' a knight of a thousand victory, once foiled is oft from the book of honour, razed.'
i can foresee all the 'disappointed' aunties asking me what happened when i go back...
the system in the U.S is different. we have some programs that are like England 7 years one shot, like sophie davis etc but most of the time you have to get an undergraduate in any science. So many do micro or genetics prior to medicine... you'll have to do micro and genetics again but on a graduate level and more clinically oriented when in med school..
You should do something because you love it not because your parents want you to.. I concede you are very lucky.. my parents faught with me every step of the way, they would rather I had been a pharmacist like my sister.. I had to fight everyone including my own incertitude... It has been a very difficult and solo journey!
Do I have regrets.. all the time.. but I think all the obstacles one faces is what shapes ones character.. also bare in mind that I am female...lets just say what you might get one or two chances at getting correct, I had to get correct the first time around.. I have never personally been cut a break..
I am sorry if I sound a little bitter today, I have had a bad day.. let me sleep on this and see if I can offer better advise tomorrow..
Ukhti,
Jazakallah Khayran for sharing this side of the medical world many people never see.
The bottom line their is only one reason a person should enter into the medical field and that is because they have a desire to help their fellow humans and are willing to experience extreme pain in order to do so.
Medicine is not a field to enter for prestige or wealth, it is a sacrifice and means giving up your life to serve your fellow humans, without prejudice, or preconcieved ideas.
The earthly rewards a Doctor may gain are not worth the sacrifice. A doctor needs to be a person who sees past their own personal desires and places the needs of others beyond their own needs.
May Allaah(swt) bless all who enter into the medical field for the right purpose and may we all be aware of the pain and suffering a doctor endures in order to help make our lives better.
JazakiAllah kheyr sister Sky, subhanAllah.. I have a cousin at the age of 23, he's also in med-school and I can see the stress but still very little of what he goes through, yet that already is hard to watch, it's a very tough job. Then I've got another cousin who works in London as a gynaecologist, and she always says it's a tough job.
format_quote Originally Posted by afzalaung
when u're from south asian/ arab family you dont have much choice to escape from family pressure.
take me for example...i was good student back in high school...but that proved disaster...as my parents took it as a sign that i'm a medic-product..and passed the responsibility of being the doctor, as u know...each generation must have at least one doctor. thanks to that pressure...though in med school, i'm at the bottom of the class...doomed to fail my 1st year.
if i am to quit or fail...i'ill be a defeated 'knight' as shakespeares said...
' a knight of a thousand victory, once foiled is oft from the book of honour, razed.'
i can foresee all the 'disappointed' aunties asking me what happened when i go back...
seriously struggling to not add to the stats...:|
SubhanAllah.. May Allah give you strength brother and grant you much sabr in these hard times! Amiin.
format_quote Originally Posted by Woodrow
May Allaah(swt) bless all who enter into the medical field for the right purpose and may we all be aware of the pain and suffering a doctor endures in order to help make our lives better.
AMIIIN!!!
Last edited by Al-Zaara; 06-04-2008 at 07:05 AM.
“If only I had checked myself”
—
Guy who wrecked himself
True leaders don't create followers...
.... They create new leaders.
I don't mind blood or dead people.. I do mind 7+ years of my prime years slaving away in med school. I'd rather not go to university at all. Plus, my brain is humanities wired, not sciences.
a friend of mine gassed herself in her car, she was a pediatrician.
I'm so sorry to hear!
You spend a fortune in school, you isolate yourself to accumulate a wealth of information so you can pass an onslaught of board exams, you waste a large chunk of your life (the best years of your life really), you see your friends married, having kids and nice lives and your contacts dwindle as you realize you have so little in common, you don't get any sleep and on call to ridiculous hours where you might be up for 41 hours straight, you pay a heap of loans, you are constantly under the threat of litigation, people always find a way to belittle your achievements and then you spend nearly half of it on taxes..
And people ask me why I refused to do med! Med is so over-rated... I wonder how many people who are dying to do it actually know what it is really like?
well i'm already in the science field i chose sciences and am goin for medical field..inshallah I hope i can cope with it and get to do what i like
“The believers in their mutual kindness, compassion and sympathy are just like one body. When one of the limbs is afflicted, the whole body responds to it with sleeplessness and fever”.
Hey there! Looks like you're enjoying the discussion, but you're not signed up for an account.
When you create an account, we remember exactly what you've read, so you always come right back where you left off. You also get notifications, here and via email, whenever new posts are made. And you can like posts and share your thoughts. Sign Up
Doctors top suicide stats
I don't think many people appreciate how stressful it is getting there and staying there..
Hide
Looks like you're enjoying the discussion, but you're not signed up for an account.
Posting Permissions
Bookmarks