Tuesday, March 24, 2015

American Doctors Are Killing Themselves and No One Is Talking About It: "It’s estimated that at least 400 U.S. doctors kill themselves every year. Many are struggling with depression, anxiety, or addiction."

It’s estimated that at least 400 U.S. doctors kill themselves every year. Many are struggling with depression, anxiety, or addiction.
Greg Miday was a promising young doctor with a prestigious oncology fellowship in St. Louis. He spoke conversational Spanish, volunteered with the homeless, and played the piano as if he’d been born to it. He had rugged good looks, with dark wavy hair and a tall, athletic build. Everybody—siblings, patients, friends, nurses, professors, fellow doctors, and above all, his physician-parents—adored him.
On the evening of June 21, 2012, Greg drew a bath, lit candles, and put his iPod on speaker. He drank a copious quantity of vodka, and placed family photos on the ceramic ledge of the tub. At some point, he scribbled out a note that read:

“Dear Some,
My Family, I love you.
To others who have been good friends, I love you too.
This is just the end of the line for my particular train.
Earth wasn’t a particularly great place for me.
We’ll see what else is out there.
Will miss you all!  
Am sorry for what it’s worth. Greg Miday.”
Then he climbed into the warm water and with surgical skill, punctured the arteries carrying blood to his hands and feet.
His parents called the next morning, but got no answer. Frantic, they reached his landlady, who summoned the St. Louis police after she heard music playing from the apartment but could not get Miday to open the door.
St. Louis police found the body. He was 29 years old.
Miday was one of a growing number of doctors who die by suicide each year. While no organization collects official data on physician suicides, Pamela Wible, a family medicine doctor in Eugene, Oregon, who writes about the phenomenon, says that at least 400 doctors kill themselves annually. That’s the size of an entire medical school class.
Wible believes that the numbers are higher than that, since doctors close ranks around each other and prod coroners to rule the cause of doctor deaths as “unplanned”—even when they are obviously not. “Accidental overdoses?” Wible asks. “You’ve got to be kidding me. Doctors calculate doses for a living.”
Because doctors have the knowledge of anatomy as well as access to lethal doses of drugs, they have a far higher suicide “completion” rate than the general population. A 2005 essay published in JAMA found that male doctors killed themselves at a rate 70 percent higher than other professionals; among female doctors, that rate ranged from 250 to 400 percent higher.
“Unfortunately,” says Bradley Hall, a Bridgeport, West Virginia, addiction medicine physician, “suicide is one thing doctors are pretty good at.”
The little-noticed, little-discussed trend has enormous implications. Since the average annual caseload of most family doctors is roughly 2,300 patients, 400 physician deaths could mean that a million Americans lose their doctors to suicide each year. 
There are many theories about why so many doctors kill themselves. They face the pressures of “assembly-line medicine,” merciless scheduling demands, fights with insurance companies, growing regulations, and an explosion in scientific literature with which their knowledge must remain current. Their debt burdens often total hundreds of thousands of dollars, and they work in constant fear of malpractice suits.  
Internists routinely screen their patients for depression and anxiety—it’s considered the standard of care for an annual physical. But doctors, Wible says, must live up to a different set of standards. In medical school, professors teach their driven young students to put their own emotions aside, even as they attend to tragedy. “In general, we’re in a profession that will shun you if you show weakness or suffering in any way,” she says.
But the taboo on discussing mental illness in medicine is beginning to waver. Wible’s 2014 “Medscape” story on doctor suicide had more than 100,000 readers and attracted 800 comments, the most in the website’s 20-year history. In a related article, she recounted the story of a retired surgeon whose medical school professor told his students that if they decided to commit suicide, they should do it right. He then provided detailed instructions.

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