QMC 3 Have a suicidal medical colleague, what should I do?

I received a very important question over the week, from a doctor who has a suicidal medical colleague, asking what to do?

My answer is do everything and anything.

Suicidal medical colleague?

The data is heartbreaking, alarming even. 400-500 doctors a year kill themselves, in the US alone. Among all professions, the percentage of physician suicides is the highest. Medical school takes a tool. Internship takes a toll. Residency takes a toll. Practice takes a toll.

When a physician kills himself, I often hear the medical community say, “Who cares? He had the same resources we did, he could have gotten help, he’s weak, He had issues etc. It’s his problem.”

We judge. We blame. We leave whomever to their own devices. After all that’s what we do when we have trials.

But according to me when a physician kills himself, its not he who is weak, but us.

We failed, we gave up and we walked away. A suicide doesn’t demonstrate his failure alone, rather the failure of a community. Imagine how disconnected and unfeeling the community was to not have noticed this person’s suffering. So let’s not just blame the person. His failure is our failure.

If a doctor is suicidal and asks for help, we recommend mental health counselors. If we think they’re a danger to themselves or others we force them to see a psychiatrist. And then we go about our day, work our shift, laugh at the jokes people make behind his back and not give it a second thought.

So I laud the doctor who asked this, because dear friend, the malady of unconcern hasn’t touched you. You still care!

In this situation, let’s face it, the management doesn’t give a damn, patients are only concerned about themselves, the nurses MAY be out for your blood and that leaves YOU, my friend.

What do YOU do to help this doctor?

1. Don’t judge-  Quell the eternal cynic in you. He may be weak, he may have made bad choices, he is struggling with simple decisions, but don’t judge him.
2. Offer hope- Most  doctors kill themselves because they’ve lost hope. And when a man loses hope he loses everything. So offer hope, eternal hope. Show them the light at the end of the tunnel no matter how minuscule.
3. Offer Insight- Show them how this is not the end of the world. Their judgment is clouded and they fail to see things from a different perspective. Show them that perspective.
4. DON’T enforce an informed code of silence – Without breaking confidentiality, rally the staff, people, management around this person. Take the extra effort to make their world a better place(this is especially for toxic workplaces.)
5. Ease their suffering- If you can, then ease their suffering. Do they need references, another job, deal with grief, a broken marriage or illness, debt restructuring? How can you ease their suffering?
6. Don’t let them be lonely- You can leave them alone, but don’t let them be lonely. Learn the difference.  Take them out bowling, a movie, or just a walk. It only takes a moment for perspective to change. And for that one light bulb moment, for them to see the alternative, you may have to spend some time. But kudos to your sacrifice.
7. Mental illness- If you suspect a mental illness, accompany them to a psychiatrist. Be a pillar of strength. If they have addictions, partner them through it. You may say that’s not my responsibility, but that’s exactly what a failed community does,leaves everyone to their own devices, when they need help.

This may seem like a lot of work, but our community is a reflection of us, of what we do. We can sit on our high horses and say, he or she has the same available resources, so if he chooses to end his life, “Boohoo.”

Pamela Wiggle a physician from Oregon, is championing this fight against doctor suicides. She offers plenty of advice on her blog. She has a heart wrenching book on suicide letters written by physicians. Check it out as well.

I know this may not be medical advice, but given my psychiatric bent, these are the best solutions I know. I encourage comments, but if they have actionable steps. Let’s not argue and place blame. We know the system sucks, we know that individuals are super busy, we know that people should develop stronger emotional quotients, we know there are a number of hotlines and self-help groups out there, and we also know the reasons why doctors don’t use them. So save the discourse on what and why and give us the solutions instead. The medical community is very small and we only have each other.

Image: CCO Public Domain, Pixabay AdinaVoicu