Medicine, A Risky Practice To Commit Suicide

Five years ago the doctor Pamela Wible went to the funeral of a colleague who had committed suicide. As it was the third suicide of a close doctor in 18 months, he decided to do something about it to try to answer a painful question: Why? From that funeral he came out with a list of ten doctors, began to register the cases and since then has investigated almost eight hundred.

He has attended many funerals, read farewell letters, created a hotline, spoken with hundreds of doctors in their worst moments, and with the families and friends of many of those who passed away.

Among them are many who committed suicide as soon as they left a guard or their job in the hospital. Last on his list is a young nephrologist who threw herself into the void from the 33rd floor of the prestigious Mount Sinai Hospital. In fact, many doctors commit suicide in their workplace: by jumping from the roof of the hospital or by overdosing in the parking lot.

Some had been planning it for a long time, although no one around them suspected it. They seemed happy and had even bought plane tickets to go to Disneyland with their family, or they had just come from a good vacation.

Many were exemplary doctors: studious, kind, focused on giving the best of themselves to their patients. Doctors are experts in concealing and hiding our suffering, they do not teach us to name it, nor is there a planned place in the race or in hospitals to talk about it.

According to Wible, guilt, harassment and burnout are the most relevant factors. Some doctors do not get over the death of their patients, even if it was not due to their actions, and they blame themselves or do not forgive themselves for any mistakes.

Also they influence the terrible working conditions : sometimes can not withstand the stress of having to care for patients mountains in no time. Not to mention lack of sleep and exhaustion. Doctors do not usually ask for help for fear of the stigma associated with mental illness, even when this illness is often directly caused by their working conditions.

Wible dedicates much of his effort to making these suicides visible, honoring the lives of deceased colleagues and speaking publicly about the need to do something to prevent these deaths.

My doctoral thesis supervisor was Gloria Fernández Canti, a brilliant psychiatrist and a pioneer in Spain in studying the burnout syndrome among doctors and health workers. Gloria demanded in the nineties that the health system take care of the mental health of its workers. Thanks to her, I became more aware of the risks that I exposed myself to in my work as a psychiatrist.

Other colleagues like Carlos Mingote published a study a few years ago that analyzed the suicides of doctors in our country and how to prevent them. According to them, “doctors have specific healthcare needs due to high levels of alcoholism, drug dependence, marital breakdown, mental illness and suicide. Self-medication is very common among physicians, especially with hypnotics, antidepressants, and opioid analgesics. Many of these difficulties are related to stress, high responsibility and insufficient time to work and live, reconciling work and family demands ”.

Now that I teach at a medical school, I spend part of my time discussing these issues with future doctors. In the subjects of medical psychology (in the first year) and clinical communication (in the fifth year) we try to make it easier for students to talk about their emotions, how they feel in their relationship with patients and future colleagues, what their gifts are and how They will take care of them when they work as doctors, how to cope with the death of a relative or illness when it arrives, etc. In short, we try to make them aware that they will need to dedicate time and attention to taking care of their emotions and their health in order to work as doctors without getting sick.

It is only a small part of all that remains to be done to prevent physician suicides and to ensure that the practice of medicine is not a risk factor for mental illness.