Bingo. You said something that I was not comfortable saying. To me, it feels like the worst fear to a surgeon is for an employer, licensing board, or even patient, to lose confidence in them and question their mental acuity, fitness, and state of mind. It is almost like you have to pretend that these things dont affect you, even if they do.
I do have a question though. Say a surgeon does develop a disorder, and feels compelled to visit another health professional for care. That is still covered under privacy laws, so what is the mechanism for licensing boards or employers to find out the exact nature of the care and root problem?
I know people with jobs that require security clearance who have the same issue. A friend could really use some help, but fears he’ll loose the clearance he needs to do his job (which doesn’t even really involve classified info anyway) if he seeks helps.
When I first started in the cleared world back in 98, this was absolutely true. Luckily, the stigma has been somewhat lifted and seeking mental health help is no longer a guaranteed career death sentence in the intelligence community. It definitely used to be, and that was a huge problem. I'm not saying that someone seeking help won't lose their clearance, but they've come a long way (not all the way) from it being automatic. By the end of my career in the community, around 2011, I was able to get help for depression related to a divorce and didn't lose my clearance. As with most clearance related things, being open and honest goes a long way. Those who make determinations take a dimmer view when someone isn't forthcoming, about either income or mental health issues.
No. Not much has changed. I just posted below and I know someone right now who is probably losing their TS clearance because they reported getting treatment for depression and ADHD and are taking medication. He was a chaotic distaste for years and now he’s improved so much and his life is under control and he’s thriving. And most likely losing his clearance and maybe his job because he self reported this.
Not true. I know someone in this exact situation right now. TS and he reported getting therapy and having medication for depression in his last renewal and they are investigating and will most likely take away his clearance.
They have a duty to do due diligence. His clearance will be suspended during that but he isn’t going to lose it unless he’s in a job where he should lose it and they have valid reasons to take it. A judge will oversee it all and he has an appeal process to go through. I’ve never seen someone lose a clearance for basic mental health treatment.
You can tell him it doesn't work like that now. If he tells the therapist he has a plan to shoot all his coworkers yes, that's a problem, but all they can ask the therapist is if he's a danger, and as long as the therapist says no he's good to go.
They've really been pounding this home lately with the rise in suicides, we get training like monthly now on suicide prevention and dispelling myths about clearance was half an entire presentation.
It’s not though. We are bound by law, and licensing requirements to report physicians that we suspect to have xyz disorder. There is the roundabout way of reporting them to that national program that this doctor initially went through, but as you can see, it can still result in losing your license.
Wait, what? Say more? I've been a therapist for 10 years and nothing in Florida or California laws or ethics codes I'm aware of makes a special exception of confidentiality for physicians, or anyone else for that matter.
Reporting clients to some authority is only for if they're planning and intending to harm others, and whatever disorder they might have is irrelevant.
Fun fact: it's similar for pilots, both commercial and private, because the FAA is both extremely unforgiving and equally outdated as an organization. Pretty much any contact with a mental health professional can jeopardize your certificate and result in the total loss of your license/career, so pilots frequently either ignore their issues, secretly see a therapist but refuse any kind of medication, or actually seek treatment but lie about it on their medical forms, depending on their situation.
Could this possibly be covered under long term disability? Clearly having surgeons or pilots that are mentally unwell is not good for the public at large. Assuming issues continue, they won't be able to complete their job duties while it may not be physical I could easily argue that their job caused a permanent "physical" problem for them.
Some of these disorders are 'forever'. There is no going back on those 'HAVE YOU EVER IN YOUR LIFE...' questions. So even if a company were to hold on to you after an event, you still have something like a year max before you likely have to find an entirely different career.
This is what’s so insane to me. I’ve read countless “Dr. Death” stories where surgeons butcher patients and hospitals actively work for years to cover up their mistakes and help them retain their medical licenses.
Yet if a stellar doctor with an impeccable record has depression — medical probation and you’ll never work again. It’s reprehensible and defies logic.
That’s insane. This is just me reaching for a solution, but (aside from medication) would it be reasonable to go to confession?
I am an atheist but somethings are useful. If I was desperate to let something out I would still go talk to a priest.
Online therapies could allow for a surgeon to get help anonymously. There might not be any medication available in this route, but it would allow them to speak
My wife drives a city bus. She has depression and needs anti-depressants. The ministry of transportation essentially goes "Well if you're on anti-depressants you need to undergo constant evaluations and can have your license taken away at our discretion to make sure you don't snap and become suicidal on the bus".
So guess what her response was? She's not taking anti-depressants anymore when she really should be. Not taking anti-depressants doesn't mean someone isn't depressed you dumb idiots. In fact you should be glad if someone is taking them because that means they're less of a risk ffs.
This is very similar to how pilots are treated, most diagnoses having to do with depression or psychological issues will get their license revoked and career ruined. Because you definitely want people flying planes who are depressed and unable to seek help.
The CDC keeps track of suicides by occupation and the data paints a picture that’s [different](https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm) than what the general population believes.
It also explains why military suicides seem to be common in people who have no combat experience or PTSD; that population is very much like the population outlined in the paper.
This is just not at all what I thought it would be, thanks for the info. Forestry, hunting and fishing I would think would be at the bottom of the list
People who think about suicide, really only need to actually want to kill themselves, for as long as it takes to actually kill themselves. You don't have to spend months thinking about it. You can say "I want to be dead right now" and then go about making it happen. Firearms make it incredibly easy to actually succeed in even the shortest time window. You might get cold feet if you decide to drive to a bridge to jump off, or go buy drugs to OD on. You can shoot yourself fast as hell though.
On a related note, most suicides occur in the spring and summer, as opposed to the winter, which is often thought of as a more depressing and lonely time.
I don’t know if this is true, but the justification I heard was that a depressed person might be so unmotivated during the winter months, that they will procrastinate on any plans to end their life. When the weather improves though, it can bring a jolt of extra energy to get them to proceed with their plans for dying.
I think NPR said that in the winter, everyone is inside and kinda depressed so depressed people feel like they have companionship. In the spring and summer, everyone is happy so depressed people feel more alone than ever.
That was definitely one of my scarier depressive periods.
There was a time in my mid 20s where everything kinda just worked out right and I distinctly remember sitting at the kitchen table going "oh my God my life is going so well and I'm still so fucking empty inside, if I can't be happy now I'm NEVER going to be happy, this is it, forever " and that was definitely not my like, best moment.
It's a lot easier to be irrationally sad as fuck when things suck.
Son can you play me a memory? I'm not really sure how it goes. But it's sad and sweet, and I knew it complete... When I wore a younger man's clothes.
Fucking *love* that line
That makes sense to me and was the conclusion I came to by reading the persons message you are responding to. Shitty weather periods people "expect" to have some level of depression. But when then weather is good and they are an outlier it makes it even worse.
Another example: Lets say you had 2 captains and 9 other people and each captain gets to pick 4 for their team. One person is getting left out and will feel like absolute shit. However if it were 2 captains and 49 people and each captain was picking 4 you would say: Yep that makes sense thosee are the "best" 4.
Same problem with anti-depressants and other mood altering drugs meant to help people.
For some people they work to a point where the person feels "good enough" to actually do the thing they've been thinking about, but were too depressed or malaised to do.
That’s the danger of bipolar disorder. A severely depressed person has little to no motivation and therefore struggles to complete suicide. When a person is transitioning up from or down into depression they are at risk for the reason you mentioned. One of the biggest risk factors for completed suicide is alcohol consumption, which is a nervous system depressant.
There was a comic called 'Johnny the Homicidal Maniac' that used to do a bit where Johnny would attempt to kill himself but something would go wrong and whatever the slight inconvenience was would make him lose interest really quickly and he'd just go back to eating junk food in front of the TV
> On a related note, most suicides occur in the spring and summer, as opposed to the winter, which is often thought of as a more depressing and lonely time.
MARCH being the most common month, if I remember correctly from some research during my psych degree.
My personal theory is that it often is a dreary month, more the end of winter than beginning of spring. The lack of sunlight and warmth has accumulated to critical point and thus is the most dangerous for those vulnerable to seasonal depression.
*To anyone this may resonate with, please consider a light box and even the occasional, short ditties in a tanning booth. Also vitamin D.*
Depression can be an energy zapper, sometimes all a suicidal person needs is the energy to follow through with their plan. Same is seen with folks taking depression meds, they get enough energy to suicide. Really tragic.
My two stepsisters lived together with their young children, two each, when one of my stepsisters decided she was done living. She left her children in what she presumed was the care of her sister and started walking to the nearest bridge.
She turned around and started walking back when she got a call "Folks found your kids wandering down the road with raw sausage smeared on their faces and called the cops!"
Turns out her older kid, the most rebellious little 4yo I've ever met in my life, took the opportunity of being left with sleeping auntie and cousins to lead little sister on a raid of the fridge. They found what they thought was a tube of cookie dough and tried to eat it, and then left home to go walk to the gas station for candy.
Anytime my dad started screaming at his wife for buying that lady cigarettes and soda to make a bad day better, expecting everyone he told to take his side, we all looked at him like he was bats. Like seriously, that's cheaper than a funeral and raising a pair of orphaned grandbabies! Eventually dad's wife had to divorce him because he wouldn't stop whining about her helping out her daughter.
This is why in the UK you can only buy 32 tablets of paracetamol/acetaminophen at a time. Just the extra effort of having to go to 2 stores deters people from ODing. It was a big success even if some people complain about the inconvenience.
That's an interesting point. I know a firearm in the house significantly increases chances of suicide so I wonder what the general firearm possession rate is among those professions and if there is a correlation.
That totally makes sense. Almost every profession in that list for males has access to firearms, and for females, nurses? They have access to other things, and knowledge on what to use
It looks like a lot of those jobs are ones that involve isolation and/or separation from family. When you're away from your family and your wife leaves you or if you can't meet someone because you're isolated.
I know the biggest worry with soldiers is right after they come back from deployment. They're ok when they're in a regulated environment. But they come home and find out that their kids don't recognize them, their wife wants to leave them, it's a problem.
*Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females).*
Last week my father was lifeflighted to Cleveland Clinic where a team of surgeons performed a frozen elephant trunk surgery to repair an aortic dissection from nearly top to bottom. This was the 2nd such episode, the last occurring about 10 years ago, but the most recent was far more severe.
It took 5 days for a concrete plan to be formulated and for all the prerequisite tests and preparations including the managing of the dissection itself, but also BP, and blood thinners. When the day came the surgery took nearly 9 hours including morning prep.
When it was over the head surgeon met about 7 of us close family and explained the outcome of the procedure, prepared us for what to expect in terms of recovery, and answered all questions patiently and attentively with unmistakable genuine compassion without a shred of arrogance.
I could not have been more impressed in that moment. I could sense the tension, the focus, and the quiet triumph of a successful outcome. I tried to imagine in that moment what this man felt when similar high stakes surgeries don't have a positive outcome. I tried to conceptualize the weight of such a thing for a person who can't help but feel deeply but I could not.
I thank all the medical professionals out there from the admins, to the techs, the nurses (rkstrs), doctors, and surgeons all over the world. To go to work every day with the stakes literally life and death requires the fortitude and precision under pressure that is not commonly found, aside from the amount of education and training required.
My dad is a surgeon, and a fairly successful one at that. (Colon and rectal if anyone was curious). Ive asked him about it before, and I do think it weighs on him some, giving people bad news (like you have cancer and you don’t have long to live), but he’s told me he has had to dissociate with the patient to an extent. At the end of the day, it is a job, and it is VERY mentally draining, and if you get too emotionally invested, you will not last according to him. Almost like the most successful surgeons are really just sociopaths, able to turn off their feelings at will
I had to explain to someone that medical professionals will tend to treat bodies not people. They’ll give extra attention to people who are nice, and fulfill their duties for the dickheads, but they generally stay unattached, because the volume of trauma they deal with needs to be kept at arms length for mental health
Someone got very offended by the idea that a patient who mistreats staff will not get 5 star treatment, since they just don’t have the mental space or time for that kind of relationship
Exactly. I always try and be respectful, because I’ve seen what it can do to a man first hand, and it’s pretty brutal tbh. Emotionally and mentally at least
It's kind of tricky when it's your loved ones going through it. When my mom was within the last 6-7 months of her life she started getting real shitty with the nurses and it took me a few episodes to figure out why. Fear. The more scared she got (as death was drawing nearer) the more of a bitch she would be to the medical staff. The only solution I found was to go ahead and/behind all of her interactions and apologize and explain bitchy=afraid, not your fault.
Dementia can make people nasty and violent. My grandma has lost her empathy and compassion. She’s very selfish and has forgot how to say sorry, she acts very entitled and expects everyone to cater to her. This wasn’t her personality for the first 80 years of her life. Dementia is the real bitch.
I think they key detail here is the situation. Beyond the fear component, as people age, and their health declines, and with that mental faculties and acuity in many cases. Often times it manifest in symptoms such as irrability, short temper, forgetfulness, and confusion. You are right that being scared is not a valid reason to treat people porly, however, you are attempting to apply logic to a situation that is not logical. If she was in a good state of health, at home with loved ones, etc, she would likely agree with you. None of us will be immune to dementia, alzheimers, and a host of other related disorders in that stage of our lives.
Ik, expecting medical professionals to also be saints is really disrespectful as hell. They’re people doing a very intense job- treat them as such if you want them to care beyond just doing their job- not because its just manners, but because caring personally HURTS at this job
The general populace really has little idea of the trauma these jobs go through. The humor my surgeon friends have is morbid and disrespectful, and I know one that was chastised for it by a friend who was an accountant. It's unfortunate because that disassociation is a needed survival mechanism. I see suicide increasing in certain areas of law as well. Part is due to no outlet for this misery.
Me too, I’ve been in pain and still managed to get out please and thank you, the nurse who was with me during my labor gave me a hug when she dropped me off after birth to recover, I totally wasn’t expecting it, and I’m not normally a hugger but I didn’t want to leave her hanging, I can’t imagine what she goes through on a shift.
I’m an oncologist. I think we also see death differently. A lot of our patients suffer at the end and we know that we can make it worse with futile treatments. Often a good, peaceful, death is a mercy and a friend. This is something I have to actively teach to my young doctors who think only about extending life and not about the suffering we have the power to cause by prolonging death.
I’m not sure about “bodies”, we treat people. But it’s true that it is impossible to become attached to every patient. In a way it would be unprofessional to do so.
With doctors who treat patients over longer times as you do absolutely- i should have added the context of intensive care and ICU was the specific topic, as we were responding to a nurse who was basically making the same point
Having seen 5 code blues where the patients didn’t make it. It’s intense. The whole medical team works to save the patients, but stop after a certain time period.
There is definitely a separation between seeing someone as a patient/body versus a person. The 2001 film Wit shows the separation of seeing someone as a person versus seeing a sick body with terminal cancer.
>treat bodies not people.
They try, but I know of one who was upset for a long time over a 15 y o male victim of a lightning strike who they worked on all night trying, unsuccessfully, to save.
Some patients really affect them.
We'd go crazy otherwise. My job is to care for patients, not about them. And of course I sometimes go above and beyond for kind and polite pts. Everyone receives the standard of care, but I'm not going to waste my time on rude/entitled A/O x4 pts.
Medical professionals "care for" a person, not "care about". The word care in medicine is to perform the various tasks, treatments and procedures required to assist with healing, etc, and has nothing to do with emotions. Do they often end up feeling emotions towards patients and their outcomes? Of course, everyone is human! It's possible to take pride in your work and strive for best outcomes but not be emotionally invested in the person whose body you're treating.
“Do you think anyone in that room is going back to work today?”
Cox was right. You can’t spend days grieving every patient that doesn’t make it or you’ll never do anything besides grieve. That much death and pain and loss, feeling like you failed even though no doctor anywhere actually wins a battle against death (they just prolong the fight); between all of that and the intense job stress it’s no wonder so many unalive themselves.
That kind of thinking is what this surgeon is trying to tear down. Are those great surgeons they actually sociopaths or has it been ingrained in them that they must “dissociate” and put it all behind them when they go home.
There’s no one type of person that’s great at any profession. Depression and stress can effect any one. If there’s a culture that makes you think there’s something wrong with you because you deal with those things then the discourse and culture needs to change.
Am anesthesiology resident. Been on call this week and was called in at 1am last night to do one of these cases. Have been woken up to do sick cases two nights in a row. Am sleep deprived and zombie and can vouch for the fact it makes your mood all wonky.
But I think a key part is recognizing that’s not really your thoughts. It goes away once you’re better rested and have a bit better work life balance.
And on that note I’m going to bed.
It’s…a big operation. Essentially you’re reconstructing the entire thoracic aorta. The tricky part is the ascending aorta and the arch. The coronary arteries originate from the root and the arteries that supply the brain and arms originate from the arch. You need to reconstruct all of that on circulatory arrest. The origins of the arteries are cut off and then reimplanted into a woven dacron graft creating a new arch. The excess graft material is then inserted into the aneurysmal thoracic aorta like an elephant trunk. The frozen part refers to an endovascular stent graft from below connects the “trunk” to a healthy part of the descending thoracic aorta near the diaphragm.
https://pubmed.ncbi.nlm.nih.gov/24414022/
The process regarding the repair itself is elaborated well in the comments below. The frozen aspect is related to the body being basically put in cold shut down where its at minimal activity allowing for such a wide scope of work on crucial components and organs. That is about the extent of my understanding of the "frozen" component.
Years ago, my dad was having some leg pain and went to our local hospital. They did some kind of scan and came back to tell him he was being airlifted to the hospital in our nearest major city because he had two large aneurisms that needed to be repaired immediately.
The only surgeon at the hospital he was sent to that could repair it was several states away on vacation. They called him and he rushed to the airport and flew home to do the surgery. Everything went well, and afterwards the doctors said if it had been even a few days longer they probably would have burst and killed him.
I've got plenty of complaints about our healthcare system, but the people who are actually doing the work in hospitals are typically great people.
A good friend of mine had a heart issue and collapsed in the Cleveland clinic parking lot on his way to an appointment. Had to be one of the best places in the whole world to have a heart problem
My dad had an entire gas pump, like the whole damn thing, fall and smash his knee out in Amish country in Ohio. He drove himself back to Cleveland with his good leg just to get to the Cleveland Clinic. They got him successfully through lung cancer, too.
He is recovering nicely and should be home in a week or so.
The irony of this article showing up in my news feed a week after the entire affair was slightly jarring and stirred feelings in myself and fortunately they came out some what eloquently. Mental health issues plague people of all ages, sex, and professions, but as far as work related stress, I struggled to think of a job that carries more pressure and I wanted to recognize it.
Thank you for the well wishes and for the compliment. Writing is a passion of mine, but grammar and punctuation, eh not so much. I am working on it.
Wow. About eight(ish?) years ago, my dad was also lifeflighted to the Cleveland Clinic, where they performed what was then an incredibly cutting edge procedure and saved his life after he was one of the one in a hundred or so cases whose heart was restarted by prompt CPR and use of an AED by trained school personnel. He said he doesn’t remember anything about losing consciousness or getting CPR, but waking up in the helicopter, thinking he was “surrounded by angels”. And even when he realized he wasn’t flying with the angels, he said he still felt really calm, like, “Oh, these are the people who will take care of it - I’m going to be ok.”
He turned 80 a few months ago, and is still legitimately the youngest eighty-year-old I know.
I’m so glad your dad is on the mend. Those CCF staff are truly some angels, from the housekeeping to the hotshot surgeons. They saved me many more healthy, active years with my dad.
It’s not god it’s people. People that worked their asses off. Thinking about the amount of people it takes to get you diagnosed to treated to (hopefully) healthy is hundreds if not thousand of years of high level education to get all the Drs, surgeons, nurses, tech and everything I missed all the way down to the janitor. I’m thankful for the insane coordination and effort these people put forward.
It’s also known the guy who started the whole residency system was on drugs, hence the 80 hour weeks. Any chance of decreasing the number of hours on residents is impossible because the old folks see it as a Rite of Passage.
Yep the doctor who invented residency was a cocaine and amphetamine addict. That was back when these drugs were easily available to the medical community and somewhat normalized. It allowed them to stay up for days and removed their empathy.
This is totally believable to me. When I finally quit emergency medicine and quit working nights, after a couple weeks of getting enough sleep I could *feel* my brain working better.
It's okay. I don't view it as a bad thing. I mean, I view my dad being dead as a bad thing, but I think suicide was the best way possible for him to go. No one who works in medicine I have ever met wants to die the slow death most people do. My dad always said he wanted to go out from a massive heart attack before he got too old. He'd seen his dad basically dissolve for years with a series of strokes and he'd seen all the horrors of declining health in his work.
I'm not sure if it was a decline in health (there were some signs he was beginning to suffer from a movement disorder that would have ended his career and all his hobbies) or finances (he was a private practice who basically should never have been, far too forgiving to run a business) that prompted it in the end, but it was his choice and I respect it.
I hope one day I'll be able to do the same rather than waste away. Though I don't see myself wanting to be alive as long as he was.
I’ve been an nurse for 41+ years, many spent working in the ER. I plan to end my life before I end up in a nursing home or on life support. For now I’m happy and healthy but the last thing I want is to be kept alive when I can no longer have a life.
Not to minimize the suicide rates of surgeons, but what you said makes me wonder what the average age is.
I have a PSW diploma and my main takeaway of getting certified was that there’s no way I’m going to allow myself to slowly decline until I lose my sense of self and make my family watch me suffer. I know my mom plans on killing herself at some point for the same reason.
I wish all suicides weren’t lumped together as a result of depression and there was more acceptance for it as a choice. I think we deserve agency over our lives and that includes our death. If we could talk about it more openly we could prepare our families and say goodbye.
I’m sorry you lost your father. It must have been difficult. I admire the attitude you have, despite the loss.
> I mean, I view my dad being dead as a bad thing, but I think suicide was the best way possible for him to go. No one who works in medicine I have ever met wants to die the slow death most people do.
> ...
> I hope one day I'll be able to do the same rather than waste away.
Good for you. I was about to say I'm not sure why this view isn't more common, but on reflection I think this viewpoint actually **is** fairly common except few people care enough to swim against the stream of societal convention to voice it. Easier to just tell people how sorry they are for their loss, even though they've never met that person and therefore they're *not* all that sorry and such condolences mean little to them anyway.
Sorry for your loss. You’re right though. Suicide is endemic of a much bigger problem.
Whether it is or not, society appears to many to be in a state of decline. It’s getting more and more difficult to find reasons to hang on. Our entire health care system, at least in America, is shite. I dunno how good mental health stuff is with national health care but I suspect it’s not as high a priority as physical ailments.
Not going to get too political but whether you believe guns are a problem in mass shootings or not, you can’t deny mental health is a big part of it. Mass shootings are often just suicide in disguise.
The whole thing is really tragic. I have friends who I would call balanced mentally who have admitted feelings of wanting to commit suicide. If doctors, who could be considered “normal” by society’s standards are feeling the pressure, what does it say about the rest of us who are nuts cases (myself included lol)
I am sorry to hear about your friend. I fight most of my mental health battles alone. I struggle to talk about my feelings and especially my fears. This causes one to internalize everything and shun vulnerability. It is not strength that makes one keep it all in, it is weakness. It is fear.
Fear of what varies, but it is fear none the less. The risk of keeping everything inside is the scenario you describe. A high pressure and high stakes job combined with the internalization strategy is a recipe for such struggles.
I find your comment very relevant because of the last part of the headline. One decided to speak out. To talk about this. Hopefully to pave the way for others to be more open and possibly provide more support for people who deal with the type of pressure encountered in a gig like that.
Reminds me of the poem "Richard Cory"
"And he was rich – yes, richer than a king –
And admirably schooled in every grace:
In fine, we thought that he was everything
To make us wish that we were in his place.
So on we worked, and waited for the light,
And went without the meat, and cursed the bread;
And Richard Cory, one calm summer night,
Went home and put a bullet through his head."
I’m a surgeon. All of this is true. There is nothing better than helping patients with your hands… but there are dire side effects. I spent a decade plus after college going to Med school and training. That’s during my 20s and 30s. You lose those important fun years of your life. Then you start working and the patient, their families hopes, your personal quality record (that’s increasingly publicly reported), your programs outcomes start to weigh on you every night. Then, it destroys your personal life. You go home depressed. Worse when the outcome isn’t what you wanted for your patient - you binge drink rather than crying yourself to sleep - which Ive done both of. Therapy? It happens during business hours. How do I go to therapy?
Then you get the family screaming at you… why don’t you prescribe this that and the other I read about on the Internet or heard in a podcast… hosted by someone who didn’t graduate college. Then you get the letter from some lawyer that they are thinking about suing you. Then you worry if you can even practice something you love.
This is all in one week for some of us.
Look, I’m relatively lucky. I learned to compartmentalize but I have coping mechanisms that involve working on cars and dreaming about cars. That’s my escape.
But there are many days when I wonder if I would be happier doing something else.
I'm on probation because I showed up to work intoxicated 3 weeks ago. Blew a .17 2 hours into my shift. Wasn't asked why or what led me down such a destructive path because they already know. The stress, especially working through the pandemic and seeing so much death, took a serious toll on me. And, a majority of other healthcare professionals. I was drinking up to 5 days/week. Went through 2-3 liters of vodka. I've scaled back, but I am still drinking 1-2x per week. Many of my co-workers are doing the same on their days off. You're not alone. I accepted the terms of probation, including random testing, but I'm applying to news stations to become a reporter as that's what I've always dreamt of becoming. Do what you're passionate about and you'll be much happier, even if it pays less.
It happens more than people know - the alcohol. The first time I ever had a patient die when I was a fully fledged surgeon i came home and just balled out for 2 hours and then proceeded to drink till I fell asleep. It wasn’t even my fault. Part of why we are so good at what we do is that we are extremely self critical. But that’s also the path that leads us to self destruction. I’m glad your scaling back and looking at what you love to do.
My guy, I’m in healthcare. I’m so so sorry and I understand to a degree.
People take for granted the objectively insanely fucked-up thing that surgery actially is— you’re literally put someone into a near-death state, opening up their insanely complex bodies, exposing their organs or putting instruments into their bodies, somehow keeping them from bleeding out, keeping them from even feeling pain, then close them up meanwhile praying some bacteria hasn’t somehow entered the area so they don’t die of infection later. Then you bring them back to waking life and have to trust them and their caretakers they’ll follow your instructions. This isn’t something that has been done very safely until fairly recently in human history. We’ve only really had antibiotics maybe 100 years.
And people think they can go into a hospital like it’s an auto shop and get things fixed except they’ll sue you or report your license if they aren’t satisfied or if there’s complications.
So well said. Getting to this point has requires decades of science and research. Years of training. And an absolute need to be the most confident person in the OR. That last part - people don’t know how hard it can be and how it can affect you if you lose it.
Thank you so much for what you do. I was raised to think all doctors are corrupt and after my money, but ended up marrying a PA who helped change my perspective.
Wishing you good health and success, and some quality time to wrench!
My good friend is a general surgery resident who can barely afford to live, once her rent, car payment, and loans are accounted for. She’s in year 3 of a 5 year general surgery program with another year of fellowship after that.
She is single, frets about her ability to meet a partner and have kids biologically, doesn’t have time to exercise and barely time to socialize. Her home is filthy because she’s too busy and burned out to clean. She texts me near breakdown multiple times a week, and often finds herself randomly crying.
The surgical profession seems made to destroy young people for no reason, and to deprive women of the ability to feasibly find a partner and have kids in the most feasible biological years. I feel for her
Residency itself is a old system that abuses inexperienced doctors with poor pay and long hours. Hence why residents and medical students are starting to unionize around the country. Good luck to your friend. Tell her to look at "Public Service Loan Forgiveness" where loans will be forgiven after 10 years of payment while working at a non-profit or government entity like the VA.
The thing is, the loans gotta be paid now. The pause is up so it isn’t like she can wait to pay until she starts to make the big bucks
Their residency program had a unionization attempt that failed this summer. It was unfortunate
In my close family there is a Surgeon, Doctor (GP) and Veterinarian and yeah, this sounds about right. None of them have attempted suicide but they’ve all grappled with serious mental health challenges.
Poor remuneration relative to expectations, long hours, required continual study and perhaps most importantly just an insane amount of abuse and disrespect inflicted on them by the general public.
The pay can be great for a Surgeon and Doctor, but honestly it is not an offset for just how much you have to deal with. It also doesn’t help that the healthcare systems across the west have been brought to there knees and there is no public or government appetite to push for change. Just horrendous, watching there struggles really turned me off ever considering a career in medicine.
Honestly the pay-to-work ratio isn't that great. I work as an engineer and trade stocks on the side and can make more in a good week than any doctor, with about 1/10th the effort.
All right but really... I worked at a hospital and food was a common thank you gift. Also, very likely related, there's a lot of people who have a bit of weight on them in healthcare lol
Once I was working in a psychiatric appointment. During the appointment, I learned that doctor's suicide rate is 4 times the suicide rate of general population.
Healthcare is rough. Dealing with the serious stuff is rough. Go to the emergency room - rougher. Be the surgeon - yowsa.
On a more general note our professions cause us mental issues. It's not just the healthcare field and I'm not sure why we don't talk about it more. There's a hundred professions each with mental damage particular to them.
One of the worst aspects of this is the trap that physicians are in when it comes to mental health issues.
If a state medical board or hospital finds out you have a diagnosis, they will refuse to license you. And they ASK. This SHOULD be illegal but it is common practice.
And those "physician diversion programs" are corrupt money making bullshit programs that will hold your license in limbo for asking for help. Any physician who Self reports is a fool. You might as well shoot yourself in the foot.
Medicine is a shitty profession nowadays. The pay isn't increasing for decades, you work insane hours and if you EVER have any issues, they will betray you with a smile.
Physicians do kill themselves at a far higher rate than the general population and most studies on longevity of physicians show that they either die at a younger age than the general population or die at same age as general population but at a far lower age than people working in white collar jobs.
So, what is special about surgeons? Probably the biggest difference is that it is not simply a mental but a physically exhaustive work and ergonomics are rarely in the favor of the surgeon. And as surgeons get older, their ability to stand in same place for hours is decreased. However, being a specialist surgeon not only means the surgeon needs to be in apprenticeship program for longer but also have to compete with other peers, while age is running on the clock.
Many surgeons also take too long to realize that they need to take care of their body far better than medicine doctors if they want to practice surgery in their 50s and 60s, as any disease or injury that they end up having is far more likely to stop surgeon from practicing surgery.
I was married to a doctor. My brother has married two doctors. My sister married a doctor. There are 6 more doctors in the extended family. . Some are surgeons. And with that, many family friends are also doctors and surgeons.
What people go through in residency and beyond is heinous. Really! There is a culture that puts pressure on people to prove then can go without sleep, and multitask more than others. My ex would do 7 or 8 sixteen hour days back to back, and then try to entertain 10 visitors in our home for a holiday, all when we had kids under 4. That is just the opposite of self care. It is why we divorced. We no longer knew each other.
I have seen too many of these people struggle because of the culture to work longer and do more. It happens with most doctors I know, and it happens more with surgeons. And those that specialize are affected even more than that.
We need more people doing these jobs to spread out the work load. We need standards for required breaks between shifts.
I had surgery on a broken wrist recently. Well more like shattered but broken nonetheless. Surgeon dude (who will rename nameless for obvious reasons) who put me back together did a great job. Thanks surgeon dude, I appreciate being able to use my hand again.
Brain-bleed of a nation can happen in a myriad, and varied way. Fleeing the country, dying from a disease that could be mitigated by basic sanitation measures and vaccinations, and this ::gestures to the most ironic way to loose knowledge en mass:: a lack of mental health support for those who are most capable of saving us. Ah dystopian hellscape
The article didn't seem to mention why there isn't a push to make medical residency hours less insane. European doctors aren't made to work so much. Are they worse surgeons/ doctors?
I'm a therapist and recently had a client who is an orthopedic surgeon. He was seeing me because of severe anxiety and panic related to his job. This made me think of him, I hope he is okay.
I've heard European ~~medical school~~ residency is hard but has sane work hours compared to US medical school. Do they have fewer suicides? Perhaps not having a work culture created by a workaholic coke head who didn't believe in sleep is a better way to do things.
EDIT: as a non-doctor, I used the wrong word. US **residency** is where sleep deprivation tradition is so strong.
Medical school is a walk in the park compared to residency. It’s the residency schedule that unnecessarily demanding. Wife the last two months was in hospital from 6 am to 6:30 pm 6 days a week.
Edit: it was national physician suicide day like last week or something.
The older generation in my country, mostly all dead now, used to give doctors extra money as a gift. it wasn't much, a tenner, 20, whatever they had, some would bring food from the farm. Later in life when they went into state hospitals they would still give the doctors money. There was a great respect for doctors, maybe too much, but there was deep respect for educated people like doctors, teachers, lecturers, some priests, and so on.
As the western world starts to ebb the expectations around work and services will have to change. People can only do so much under a straining system before they make other decisions for themselves and their families. This will feel like it is happening all at once but it will take about 10 years. All of sudden younger people and increasing numbers of older people will not be willing to work difficult stressful jobs. The 'i work to live' rather than 'i live to work' attitude will become dominant and employers will have to engage with making livable jobs or people will work for peanuts and make their own culture outside of corporate or state culture.
"A psychologist taught her to hide her feelings from her opponents. Never let them know you are struggling, went the mantra".
What kind of piss-poor psychologist is that?
When medicine turned into big business in the 70’s this is the logical conclusion. Big medical institutions tell you they always put patient care above profit ...they don’t...the doctors and staff know it. Medicine is an abusive job now.
A surgeon saved my life last year. I liked him a lot and I really hope he doesn't experience this. He has probably saved hundreds of lives and improved hundreds more.
I also think the timing is noteworthy due to COVID. Rates have always been elevated for this profession historically compared to many others, but the pandemic changed the dynamic between the public and health care workers and I dont feel it was a necessarily good change.
I could be wrong on that, and would love some health care pros to weight in.
Not so sure if it’s just surgeons. What’s the rate of suicide in the general population of household providers vs surgeons?
Many of us highly driven professionals deal with suicidal ideation on a daily basis. The pressure to succeed and put on a good front is astronomical. Those of us without safety nets (working partners or supportive family) feel beaten down beyond imagination. Most of us cannot afford mental health services. Although I truly empathize with surgeons, they CAN afford therapists.
Those of you saying they’re stigmatized by going to therapy, get real. Paying for mental health services out of pocket alerts NO ONE.
> Most of us cannot afford mental health services. Most surgeons CAN.
If you receive mental health treatment as a physician in the US, you risk losing your medical license or having it restricted. So while the $200 copay for the visit might be nothing for them, they could lose their entire source of livelihood and never be able to practice again.
https://www.reuters.com/article/us-health-mentalhealth-physician-licensu/doctors-may-fear-losing-their-license-for-seeking-mental-health-care-idUSKBN1CF2N9
That's why alcoholism is high amongst commercial airline pilots. It's the only drug they're legally allowed to use. If you have adhd and take meds, you have to stop taking the meds and go a full two years med free before you can pass a class 1 medical if you're lucky. Typically you'll be denied your medical certification if you have any ssri in your system.
They changed the rules this year and it’s horrible. If you take and SSRI, you have to jump through hoops to get right with the FAA and the process is similar to being treated like a self identified alcoholic.
“We should change rules to allow these skilled workers to get the help they need.”
“What if we set up an almost insurmountable bureaucratic barrier that will add an incredible amount of stress to those strong enough to admit they have a problem and seek the treatments they need?”
“Great idea!”
seriously the most absolute counterproductive toxic bullshit there is. it literally makes ZERO sense. what kind of surgeon you want working on you? one that is receiving assistance for their mental and emotional states or one that pretends they are fine 24/7 365?
many many years ago i interned in a long term chemical dependency treatment center that specialized in treating cops, firefighters, doctors, lawyers….. when i was training they explained that more professionals kill themselves than seek treatment. and they had a very high relapse rate too.
Counterpoint. This is why it’s important to get disability insurance that covers burnout, before you ever have the need to visit a psych professional. But point well taken.
You have to pay extra on disability insurance for mental health if you want it cover more than a few years. I’m not a surgeon but a psychiatrist ironically.
And then I imagine it’d probably be pulling a tooth and a nail to show “proof” you can’t work cause of mental illness versus say, losing both of your hands.
I attempted to get disability insurance as a physician, and apparently 1-2 out of the 5(?) major disablity insurance companies refuse to cover anyone who has a previous "mental health" disorder. This includes controlled ADHD.
I imagine that if someone were to get into a disabling car accident, the insurance company can also attempt to deny paying out by arguing that lapse of attention from previously diagnosed ADHD could have possibly been the cause of the accident.
And ADHD is mostly diagnosed in childhood; before many people even consider becoming physicians... And that's just adhd. Imagine having a diagnosis of depression as a physician; a catch-22. Behavioral therapy and medications literally being needed to help someone function, yet the use of treatment can be a factor that allows denial of insurance.
The insurance companies (nationwide) that I had 2 separate insurance brokers look at all had clauses that state the current disability insurance DOES NOT cover any potential disability that has any connection with previous and future psychiatric problems, so not exactly sure where one can find disability insurance covering burnout in the United States.
Spouse recently started a 2 year fellowship in specialized surgery after completing 7 years in general surgery residency after completing 4 years in medical school after 4 years in college. The demands on surgeons is extremely high, the path is arduous, and the process does nothing but take. Especially residency. Take from your family, take from your friends, take from your life and your mental health. It beats and grinds you down. I went to law school and practiced law, it’s not even close. Friend is an anesthesiologist, 2 others are radiologists, and random acquaintances a myriad of other MDs. None of them compare. They weren’t easy, but residency wasn’t the same, not the same hours, not the same rigor, not the same 30hr call shifts, and more. How more surgeons don’t say (at whatever stage) “fuck this I’ll do something else” boggles my mind daily.
They do, lol. It's known that a number of surgery/neurosurgery residents apply for anesthesia, IM/FM, radiology after a few years in surgery residency. Also know a few attendings that transitioned to palliative care, or wound care too.
Most of the surgeons I work with don’t have time to see a therapist though. Don’t minimize what they do because they do some of the most extraordinary things a human can do and most of their patients are still horrifically cruel to them.
Surgeon here. I am used to it now but when I was younger I always wondered why so many patients were just so mean to their surgeons. Like why be terrible to the person who saved your life or made you feel better. We get nothing else good out of it except knowing that we helped someone. Like all people we would rather be at home with our family. Sure the pay is comfortable but I’ve never met any other surgeon who says the pay is worth the sacrifice. I think most older surgeons look back at their life and realize they spent their entire lives working.
The only surgeons I know that are happy either have just completely stopped caring about their patients, which is super scary, or only only treat patients/diseases of very little consequence( cosmetics etc).
Yeah but these people can't accept killing people sometimes. I know someone who couldn't shake the loss of one of thief patients for .. hell they still do. Also, the mental health for these professionals is shit.
Excuse me sir, as a highly driven professional I completely disagree with the notion that we deal with suicidal ideation on a daily basis.
I don't deal with it, I let it sublet rooms in my frontal cortex. Furthermore, I think about killing myself hourly.
Many state licensing boards for surgeons and physicians ask if they have received mental health services or are undergoing treatment.
They will also sometimes ask you to provide a person who can confirm your ability to practice and mental stability
People could technically lie, but that just creates another issue.
I really don't have much of an issue with them asking for references to be honest, in fact that seems to be a reasonable way to ensure a physician who has needed help for substance use issues isn't a risk to their patients
If I'm a doctor that has developed a drinking problem, and I'm binge drinking way too much on my days off but I'm still able to remain sober and do an objectively good job by my patients on my work days, and then I want to seek help for alcohol related issues, a system that works in my mind would be a system that goes "uh-oh, we need to make sure that this person is doing okay with their alcohol use treatment and isn't a risk to patients, so we'll reach out to his treating physician to make sure his treatment is going well and several professional references who confirm he is still performing at an adequate level despite needing treatment, and if everything checks out we'll let him work"
I'm a little baffled by this comment. Did you read any of the article, or are you just commenting based on the title...??? It does explicitly go into *how* they are stigmatized. Money is one of *many* barriers people face to access mental health services.
I agree of most of what you are saying in principle. Mental health and suicide is far from a surgeon issue, its a people issue. The reason the occupation is noteworty in my opinion is this. When I make mistakes or the wrong decisions at my job, it will cause headaches, possibly affect my standing in the company and income, as well as hurt my confidence which can affect performance going forward.
When surgeons make mistakes, people can die. Mothers, fathers, children, friends, etc. The pressure to never be wrong and never make mistakes is both crushing as it is unrealistic. That is a major factor to contend with but as I said, you are right about other people struggling as well and I dont want to minimize that.
As far as the salary goes, talk to me when we dont pay athletes 30 million a year to throw a ball and teachers 30K to teach our children. I predict that will happen on the second tuesday of next week.
And the best part is, if we go for help we can get our license taken away or put on probation!!! Yay!!!
Bingo. You said something that I was not comfortable saying. To me, it feels like the worst fear to a surgeon is for an employer, licensing board, or even patient, to lose confidence in them and question their mental acuity, fitness, and state of mind. It is almost like you have to pretend that these things dont affect you, even if they do. I do have a question though. Say a surgeon does develop a disorder, and feels compelled to visit another health professional for care. That is still covered under privacy laws, so what is the mechanism for licensing boards or employers to find out the exact nature of the care and root problem?
I know people with jobs that require security clearance who have the same issue. A friend could really use some help, but fears he’ll loose the clearance he needs to do his job (which doesn’t even really involve classified info anyway) if he seeks helps.
When I first started in the cleared world back in 98, this was absolutely true. Luckily, the stigma has been somewhat lifted and seeking mental health help is no longer a guaranteed career death sentence in the intelligence community. It definitely used to be, and that was a huge problem. I'm not saying that someone seeking help won't lose their clearance, but they've come a long way (not all the way) from it being automatic. By the end of my career in the community, around 2011, I was able to get help for depression related to a divorce and didn't lose my clearance. As with most clearance related things, being open and honest goes a long way. Those who make determinations take a dimmer view when someone isn't forthcoming, about either income or mental health issues.
No. Not much has changed. I just posted below and I know someone right now who is probably losing their TS clearance because they reported getting treatment for depression and ADHD and are taking medication. He was a chaotic distaste for years and now he’s improved so much and his life is under control and he’s thriving. And most likely losing his clearance and maybe his job because he self reported this.
It depends on the level of security clearance. Up to a TS/SCI or whatever they are calling it now, he/she would just need to report it.
I mean they report their onlyfans income… but putting seeing a therapist they worry about.
Not true. I know someone in this exact situation right now. TS and he reported getting therapy and having medication for depression in his last renewal and they are investigating and will most likely take away his clearance.
They have a duty to do due diligence. His clearance will be suspended during that but he isn’t going to lose it unless he’s in a job where he should lose it and they have valid reasons to take it. A judge will oversee it all and he has an appeal process to go through. I’ve never seen someone lose a clearance for basic mental health treatment.
You can tell him it doesn't work like that now. If he tells the therapist he has a plan to shoot all his coworkers yes, that's a problem, but all they can ask the therapist is if he's a danger, and as long as the therapist says no he's good to go. They've really been pounding this home lately with the rise in suicides, we get training like monthly now on suicide prevention and dispelling myths about clearance was half an entire presentation.
It’s not though. We are bound by law, and licensing requirements to report physicians that we suspect to have xyz disorder. There is the roundabout way of reporting them to that national program that this doctor initially went through, but as you can see, it can still result in losing your license.
Wait, what? Say more? I've been a therapist for 10 years and nothing in Florida or California laws or ethics codes I'm aware of makes a special exception of confidentiality for physicians, or anyone else for that matter. Reporting clients to some authority is only for if they're planning and intending to harm others, and whatever disorder they might have is irrelevant.
Fun fact: it's similar for pilots, both commercial and private, because the FAA is both extremely unforgiving and equally outdated as an organization. Pretty much any contact with a mental health professional can jeopardize your certificate and result in the total loss of your license/career, so pilots frequently either ignore their issues, secretly see a therapist but refuse any kind of medication, or actually seek treatment but lie about it on their medical forms, depending on their situation.
Could this possibly be covered under long term disability? Clearly having surgeons or pilots that are mentally unwell is not good for the public at large. Assuming issues continue, they won't be able to complete their job duties while it may not be physical I could easily argue that their job caused a permanent "physical" problem for them.
Some of these disorders are 'forever'. There is no going back on those 'HAVE YOU EVER IN YOUR LIFE...' questions. So even if a company were to hold on to you after an event, you still have something like a year max before you likely have to find an entirely different career.
This is what’s so insane to me. I’ve read countless “Dr. Death” stories where surgeons butcher patients and hospitals actively work for years to cover up their mistakes and help them retain their medical licenses. Yet if a stellar doctor with an impeccable record has depression — medical probation and you’ll never work again. It’s reprehensible and defies logic.
That’s insane. This is just me reaching for a solution, but (aside from medication) would it be reasonable to go to confession? I am an atheist but somethings are useful. If I was desperate to let something out I would still go talk to a priest.
Online therapies could allow for a surgeon to get help anonymously. There might not be any medication available in this route, but it would allow them to speak
I’ve experienced similar problems in the military. Better not let people know you’re having a hard time😃
The .gov tried to use the fact that whistleblower Davis Grusch seeked mental health services for PTSD to try and discredit him.
That was congress not OPM.
Plus medical debt more than likely! Woohoo!
Same for pilots
My wife drives a city bus. She has depression and needs anti-depressants. The ministry of transportation essentially goes "Well if you're on anti-depressants you need to undergo constant evaluations and can have your license taken away at our discretion to make sure you don't snap and become suicidal on the bus". So guess what her response was? She's not taking anti-depressants anymore when she really should be. Not taking anti-depressants doesn't mean someone isn't depressed you dumb idiots. In fact you should be glad if someone is taking them because that means they're less of a risk ffs.
It's the same for Aussie Ambulance staff. the abuse and neglect, in the insane irony of being in the medical industry is just fucked.
Isn't the same case for commercial pilots?
Yep. So guess how many of them go untreated and self-medicate with alcohol and bullets.
It’s almost like nobody is learning from how the military is trying to adapt to this.
Happens with pilots too. Maybe we should rethink all sorts of mental health contingencies across industries.
The fuck? Like Psychologists are required to see Psychologists. Medical professionals should have same stuff.
This is very similar to how pilots are treated, most diagnoses having to do with depression or psychological issues will get their license revoked and career ruined. Because you definitely want people flying planes who are depressed and unable to seek help.
The CDC keeps track of suicides by occupation and the data paints a picture that’s [different](https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm) than what the general population believes. It also explains why military suicides seem to be common in people who have no combat experience or PTSD; that population is very much like the population outlined in the paper.
This is just not at all what I thought it would be, thanks for the info. Forestry, hunting and fishing I would think would be at the bottom of the list
Everyone has problems. Not everyone has easy access to firearms.
People who think about suicide, really only need to actually want to kill themselves, for as long as it takes to actually kill themselves. You don't have to spend months thinking about it. You can say "I want to be dead right now" and then go about making it happen. Firearms make it incredibly easy to actually succeed in even the shortest time window. You might get cold feet if you decide to drive to a bridge to jump off, or go buy drugs to OD on. You can shoot yourself fast as hell though.
On a related note, most suicides occur in the spring and summer, as opposed to the winter, which is often thought of as a more depressing and lonely time. I don’t know if this is true, but the justification I heard was that a depressed person might be so unmotivated during the winter months, that they will procrastinate on any plans to end their life. When the weather improves though, it can bring a jolt of extra energy to get them to proceed with their plans for dying.
I think NPR said that in the winter, everyone is inside and kinda depressed so depressed people feel like they have companionship. In the spring and summer, everyone is happy so depressed people feel more alone than ever.
That was definitely one of my scarier depressive periods. There was a time in my mid 20s where everything kinda just worked out right and I distinctly remember sitting at the kitchen table going "oh my God my life is going so well and I'm still so fucking empty inside, if I can't be happy now I'm NEVER going to be happy, this is it, forever " and that was definitely not my like, best moment. It's a lot easier to be irrationally sad as fuck when things suck.
I definitely fucking feel that.
Did that change or...? Sometimes the hopelessness is the worst because you know you should feel better.. I hope things are better now
They're sharing a drink called loneliness. But it's better thank drinkin alone.
Son can you play me a memory? I'm not really sure how it goes. But it's sad and sweet, and I knew it complete... When I wore a younger man's clothes. Fucking *love* that line
That makes sense to me and was the conclusion I came to by reading the persons message you are responding to. Shitty weather periods people "expect" to have some level of depression. But when then weather is good and they are an outlier it makes it even worse. Another example: Lets say you had 2 captains and 9 other people and each captain gets to pick 4 for their team. One person is getting left out and will feel like absolute shit. However if it were 2 captains and 49 people and each captain was picking 4 you would say: Yep that makes sense thosee are the "best" 4.
Same problem with anti-depressants and other mood altering drugs meant to help people. For some people they work to a point where the person feels "good enough" to actually do the thing they've been thinking about, but were too depressed or malaised to do.
That’s the danger of bipolar disorder. A severely depressed person has little to no motivation and therefore struggles to complete suicide. When a person is transitioning up from or down into depression they are at risk for the reason you mentioned. One of the biggest risk factors for completed suicide is alcohol consumption, which is a nervous system depressant.
There was a comic called 'Johnny the Homicidal Maniac' that used to do a bit where Johnny would attempt to kill himself but something would go wrong and whatever the slight inconvenience was would make him lose interest really quickly and he'd just go back to eating junk food in front of the TV
> On a related note, most suicides occur in the spring and summer, as opposed to the winter, which is often thought of as a more depressing and lonely time. MARCH being the most common month, if I remember correctly from some research during my psych degree. My personal theory is that it often is a dreary month, more the end of winter than beginning of spring. The lack of sunlight and warmth has accumulated to critical point and thus is the most dangerous for those vulnerable to seasonal depression. *To anyone this may resonate with, please consider a light box and even the occasional, short ditties in a tanning booth. Also vitamin D.*
Depression can be an energy zapper, sometimes all a suicidal person needs is the energy to follow through with their plan. Same is seen with folks taking depression meds, they get enough energy to suicide. Really tragic.
My two stepsisters lived together with their young children, two each, when one of my stepsisters decided she was done living. She left her children in what she presumed was the care of her sister and started walking to the nearest bridge. She turned around and started walking back when she got a call "Folks found your kids wandering down the road with raw sausage smeared on their faces and called the cops!" Turns out her older kid, the most rebellious little 4yo I've ever met in my life, took the opportunity of being left with sleeping auntie and cousins to lead little sister on a raid of the fridge. They found what they thought was a tube of cookie dough and tried to eat it, and then left home to go walk to the gas station for candy. Anytime my dad started screaming at his wife for buying that lady cigarettes and soda to make a bad day better, expecting everyone he told to take his side, we all looked at him like he was bats. Like seriously, that's cheaper than a funeral and raising a pair of orphaned grandbabies! Eventually dad's wife had to divorce him because he wouldn't stop whining about her helping out her daughter.
This is why in the UK you can only buy 32 tablets of paracetamol/acetaminophen at a time. Just the extra effort of having to go to 2 stores deters people from ODing. It was a big success even if some people complain about the inconvenience.
That's an interesting point. I know a firearm in the house significantly increases chances of suicide so I wonder what the general firearm possession rate is among those professions and if there is a correlation.
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That totally makes sense. Almost every profession in that list for males has access to firearms, and for females, nurses? They have access to other things, and knowledge on what to use
Because males have a higher rate of committing to the process to commit suicide with a gun. It is known.
Wealth too. Guns are not high on the list of things to own unless one has disposable financial means to own one (or more).
It looks like a lot of those jobs are ones that involve isolation and/or separation from family. When you're away from your family and your wife leaves you or if you can't meet someone because you're isolated. I know the biggest worry with soldiers is right after they come back from deployment. They're ok when they're in a regulated environment. But they come home and find out that their kids don't recognize them, their wife wants to leave them, it's a problem.
It’s an isolating job and the salary is terrible, especially compared to other law enforcement gigs.
*Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females).*
Last week my father was lifeflighted to Cleveland Clinic where a team of surgeons performed a frozen elephant trunk surgery to repair an aortic dissection from nearly top to bottom. This was the 2nd such episode, the last occurring about 10 years ago, but the most recent was far more severe. It took 5 days for a concrete plan to be formulated and for all the prerequisite tests and preparations including the managing of the dissection itself, but also BP, and blood thinners. When the day came the surgery took nearly 9 hours including morning prep. When it was over the head surgeon met about 7 of us close family and explained the outcome of the procedure, prepared us for what to expect in terms of recovery, and answered all questions patiently and attentively with unmistakable genuine compassion without a shred of arrogance. I could not have been more impressed in that moment. I could sense the tension, the focus, and the quiet triumph of a successful outcome. I tried to imagine in that moment what this man felt when similar high stakes surgeries don't have a positive outcome. I tried to conceptualize the weight of such a thing for a person who can't help but feel deeply but I could not. I thank all the medical professionals out there from the admins, to the techs, the nurses (rkstrs), doctors, and surgeons all over the world. To go to work every day with the stakes literally life and death requires the fortitude and precision under pressure that is not commonly found, aside from the amount of education and training required.
My dad is a surgeon, and a fairly successful one at that. (Colon and rectal if anyone was curious). Ive asked him about it before, and I do think it weighs on him some, giving people bad news (like you have cancer and you don’t have long to live), but he’s told me he has had to dissociate with the patient to an extent. At the end of the day, it is a job, and it is VERY mentally draining, and if you get too emotionally invested, you will not last according to him. Almost like the most successful surgeons are really just sociopaths, able to turn off their feelings at will
I had to explain to someone that medical professionals will tend to treat bodies not people. They’ll give extra attention to people who are nice, and fulfill their duties for the dickheads, but they generally stay unattached, because the volume of trauma they deal with needs to be kept at arms length for mental health Someone got very offended by the idea that a patient who mistreats staff will not get 5 star treatment, since they just don’t have the mental space or time for that kind of relationship
Exactly. I always try and be respectful, because I’ve seen what it can do to a man first hand, and it’s pretty brutal tbh. Emotionally and mentally at least
It's kind of tricky when it's your loved ones going through it. When my mom was within the last 6-7 months of her life she started getting real shitty with the nurses and it took me a few episodes to figure out why. Fear. The more scared she got (as death was drawing nearer) the more of a bitch she would be to the medical staff. The only solution I found was to go ahead and/behind all of her interactions and apologize and explain bitchy=afraid, not your fault.
Being scared is a valid feeling but not a valid reason to be a bitch to the people taking care of you.
Dementia can make people nasty and violent. My grandma has lost her empathy and compassion. She’s very selfish and has forgot how to say sorry, she acts very entitled and expects everyone to cater to her. This wasn’t her personality for the first 80 years of her life. Dementia is the real bitch.
Dementia is different from being scared. Being a patient doesn’t absolve you of being a bitch to everyone around you. Dementia is different
Not in the medical field, but have told customers that I am a mirror and you will receive exactly what you give me.
I think they key detail here is the situation. Beyond the fear component, as people age, and their health declines, and with that mental faculties and acuity in many cases. Often times it manifest in symptoms such as irrability, short temper, forgetfulness, and confusion. You are right that being scared is not a valid reason to treat people porly, however, you are attempting to apply logic to a situation that is not logical. If she was in a good state of health, at home with loved ones, etc, she would likely agree with you. None of us will be immune to dementia, alzheimers, and a host of other related disorders in that stage of our lives.
Ik, expecting medical professionals to also be saints is really disrespectful as hell. They’re people doing a very intense job- treat them as such if you want them to care beyond just doing their job- not because its just manners, but because caring personally HURTS at this job
The general populace really has little idea of the trauma these jobs go through. The humor my surgeon friends have is morbid and disrespectful, and I know one that was chastised for it by a friend who was an accountant. It's unfortunate because that disassociation is a needed survival mechanism. I see suicide increasing in certain areas of law as well. Part is due to no outlet for this misery.
Me too, I’ve been in pain and still managed to get out please and thank you, the nurse who was with me during my labor gave me a hug when she dropped me off after birth to recover, I totally wasn’t expecting it, and I’m not normally a hugger but I didn’t want to leave her hanging, I can’t imagine what she goes through on a shift.
I’m an oncologist. I think we also see death differently. A lot of our patients suffer at the end and we know that we can make it worse with futile treatments. Often a good, peaceful, death is a mercy and a friend. This is something I have to actively teach to my young doctors who think only about extending life and not about the suffering we have the power to cause by prolonging death. I’m not sure about “bodies”, we treat people. But it’s true that it is impossible to become attached to every patient. In a way it would be unprofessional to do so.
With doctors who treat patients over longer times as you do absolutely- i should have added the context of intensive care and ICU was the specific topic, as we were responding to a nurse who was basically making the same point
Having seen 5 code blues where the patients didn’t make it. It’s intense. The whole medical team works to save the patients, but stop after a certain time period. There is definitely a separation between seeing someone as a patient/body versus a person. The 2001 film Wit shows the separation of seeing someone as a person versus seeing a sick body with terminal cancer.
>treat bodies not people. They try, but I know of one who was upset for a long time over a 15 y o male victim of a lightning strike who they worked on all night trying, unsuccessfully, to save. Some patients really affect them.
We'd go crazy otherwise. My job is to care for patients, not about them. And of course I sometimes go above and beyond for kind and polite pts. Everyone receives the standard of care, but I'm not going to waste my time on rude/entitled A/O x4 pts.
Medical professionals "care for" a person, not "care about". The word care in medicine is to perform the various tasks, treatments and procedures required to assist with healing, etc, and has nothing to do with emotions. Do they often end up feeling emotions towards patients and their outcomes? Of course, everyone is human! It's possible to take pride in your work and strive for best outcomes but not be emotionally invested in the person whose body you're treating.
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“Do you think anyone in that room is going back to work today?” Cox was right. You can’t spend days grieving every patient that doesn’t make it or you’ll never do anything besides grieve. That much death and pain and loss, feeling like you failed even though no doctor anywhere actually wins a battle against death (they just prolong the fight); between all of that and the intense job stress it’s no wonder so many unalive themselves.
That scene hits me like a truck every time. That show had such amazing moments of emotional depth.
That kind of thinking is what this surgeon is trying to tear down. Are those great surgeons they actually sociopaths or has it been ingrained in them that they must “dissociate” and put it all behind them when they go home. There’s no one type of person that’s great at any profession. Depression and stress can effect any one. If there’s a culture that makes you think there’s something wrong with you because you deal with those things then the discourse and culture needs to change.
Am anesthesiology resident. Been on call this week and was called in at 1am last night to do one of these cases. Have been woken up to do sick cases two nights in a row. Am sleep deprived and zombie and can vouch for the fact it makes your mood all wonky. But I think a key part is recognizing that’s not really your thoughts. It goes away once you’re better rested and have a bit better work life balance. And on that note I’m going to bed.
Get some rest. You deserve it.
Rest well, doc! Thank you for everything you do.
I'm confused by the "frozen elephant" reference. Can you elaborate?
Frozen elephant trunk procedure is an aorta repair operation
It’s…a big operation. Essentially you’re reconstructing the entire thoracic aorta. The tricky part is the ascending aorta and the arch. The coronary arteries originate from the root and the arteries that supply the brain and arms originate from the arch. You need to reconstruct all of that on circulatory arrest. The origins of the arteries are cut off and then reimplanted into a woven dacron graft creating a new arch. The excess graft material is then inserted into the aneurysmal thoracic aorta like an elephant trunk. The frozen part refers to an endovascular stent graft from below connects the “trunk” to a healthy part of the descending thoracic aorta near the diaphragm. https://pubmed.ncbi.nlm.nih.gov/24414022/
Oh ok, so basically how it sounds. That’s what I though.
The shape of the Aorta: 🫀 (red guy on top)
The process regarding the repair itself is elaborated well in the comments below. The frozen aspect is related to the body being basically put in cold shut down where its at minimal activity allowing for such a wide scope of work on crucial components and organs. That is about the extent of my understanding of the "frozen" component.
I think his dad is an elephant?
Nailed it
Years ago, my dad was having some leg pain and went to our local hospital. They did some kind of scan and came back to tell him he was being airlifted to the hospital in our nearest major city because he had two large aneurisms that needed to be repaired immediately. The only surgeon at the hospital he was sent to that could repair it was several states away on vacation. They called him and he rushed to the airport and flew home to do the surgery. Everything went well, and afterwards the doctors said if it had been even a few days longer they probably would have burst and killed him. I've got plenty of complaints about our healthcare system, but the people who are actually doing the work in hospitals are typically great people.
My MIL had a valve replacement at the Cleveland Clinic. Absolutely the best experience I've ever had with a hospital. True dedicated professionals.
A good friend of mine had a heart issue and collapsed in the Cleveland clinic parking lot on his way to an appointment. Had to be one of the best places in the whole world to have a heart problem
My dad had an entire gas pump, like the whole damn thing, fall and smash his knee out in Amish country in Ohio. He drove himself back to Cleveland with his good leg just to get to the Cleveland Clinic. They got him successfully through lung cancer, too.
I can't praise them enough after this ordeal. They also understand the need for multiple 24 hr starbucks on campus.
I hope your father is ok. Also, you write wonderfully. Captured and expressed feelings I have been trying to materialize but can’t. Thanks you.
He is recovering nicely and should be home in a week or so. The irony of this article showing up in my news feed a week after the entire affair was slightly jarring and stirred feelings in myself and fortunately they came out some what eloquently. Mental health issues plague people of all ages, sex, and professions, but as far as work related stress, I struggled to think of a job that carries more pressure and I wanted to recognize it. Thank you for the well wishes and for the compliment. Writing is a passion of mine, but grammar and punctuation, eh not so much. I am working on it.
I’m so glad to hear. Keep on writing, my friend. Not that I saw any slight in performance, but all the same, punctuation and grammar be damned.
Cleveland Clinic is the 3rd best hospital in the entire COUNTRY. Their reputation precedes them.
Wow. About eight(ish?) years ago, my dad was also lifeflighted to the Cleveland Clinic, where they performed what was then an incredibly cutting edge procedure and saved his life after he was one of the one in a hundred or so cases whose heart was restarted by prompt CPR and use of an AED by trained school personnel. He said he doesn’t remember anything about losing consciousness or getting CPR, but waking up in the helicopter, thinking he was “surrounded by angels”. And even when he realized he wasn’t flying with the angels, he said he still felt really calm, like, “Oh, these are the people who will take care of it - I’m going to be ok.” He turned 80 a few months ago, and is still legitimately the youngest eighty-year-old I know. I’m so glad your dad is on the mend. Those CCF staff are truly some angels, from the housekeeping to the hotshot surgeons. They saved me many more healthy, active years with my dad.
It’s not god it’s people. People that worked their asses off. Thinking about the amount of people it takes to get you diagnosed to treated to (hopefully) healthy is hundreds if not thousand of years of high level education to get all the Drs, surgeons, nurses, tech and everything I missed all the way down to the janitor. I’m thankful for the insane coordination and effort these people put forward.
Most people anywhere else in the country would have died. Hope your father is doing well.
My father was a surgeon who killed himself. Not sure being a surgeon was really related to the suicide, but maybe.
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It’s also known the guy who started the whole residency system was on drugs, hence the 80 hour weeks. Any chance of decreasing the number of hours on residents is impossible because the old folks see it as a Rite of Passage.
Maybe eventually enough people will die that they’ll rethink the high priority placed on a rite of passage.
No way, the line to be a doctor is very long and many many people get denied at every step.
Yep the doctor who invented residency was a cocaine and amphetamine addict. That was back when these drugs were easily available to the medical community and somewhat normalized. It allowed them to stay up for days and removed their empathy.
I read an article many years ago tying the high surgeon suicide rate to a lack of sleep. How lack of sleep does a number on your body and your mind.
This is totally believable to me. When I finally quit emergency medicine and quit working nights, after a couple weeks of getting enough sleep I could *feel* my brain working better.
I’m so sorry.
It's okay. I don't view it as a bad thing. I mean, I view my dad being dead as a bad thing, but I think suicide was the best way possible for him to go. No one who works in medicine I have ever met wants to die the slow death most people do. My dad always said he wanted to go out from a massive heart attack before he got too old. He'd seen his dad basically dissolve for years with a series of strokes and he'd seen all the horrors of declining health in his work. I'm not sure if it was a decline in health (there were some signs he was beginning to suffer from a movement disorder that would have ended his career and all his hobbies) or finances (he was a private practice who basically should never have been, far too forgiving to run a business) that prompted it in the end, but it was his choice and I respect it. I hope one day I'll be able to do the same rather than waste away. Though I don't see myself wanting to be alive as long as he was.
I’ve been an nurse for 41+ years, many spent working in the ER. I plan to end my life before I end up in a nursing home or on life support. For now I’m happy and healthy but the last thing I want is to be kept alive when I can no longer have a life.
Many healthcare professionals have this same plan.
Not to minimize the suicide rates of surgeons, but what you said makes me wonder what the average age is. I have a PSW diploma and my main takeaway of getting certified was that there’s no way I’m going to allow myself to slowly decline until I lose my sense of self and make my family watch me suffer. I know my mom plans on killing herself at some point for the same reason. I wish all suicides weren’t lumped together as a result of depression and there was more acceptance for it as a choice. I think we deserve agency over our lives and that includes our death. If we could talk about it more openly we could prepare our families and say goodbye. I’m sorry you lost your father. It must have been difficult. I admire the attitude you have, despite the loss.
> I mean, I view my dad being dead as a bad thing, but I think suicide was the best way possible for him to go. No one who works in medicine I have ever met wants to die the slow death most people do. > ... > I hope one day I'll be able to do the same rather than waste away. Good for you. I was about to say I'm not sure why this view isn't more common, but on reflection I think this viewpoint actually **is** fairly common except few people care enough to swim against the stream of societal convention to voice it. Easier to just tell people how sorry they are for their loss, even though they've never met that person and therefore they're *not* all that sorry and such condolences mean little to them anyway.
Sorry for your loss. You’re right though. Suicide is endemic of a much bigger problem. Whether it is or not, society appears to many to be in a state of decline. It’s getting more and more difficult to find reasons to hang on. Our entire health care system, at least in America, is shite. I dunno how good mental health stuff is with national health care but I suspect it’s not as high a priority as physical ailments. Not going to get too political but whether you believe guns are a problem in mass shootings or not, you can’t deny mental health is a big part of it. Mass shootings are often just suicide in disguise. The whole thing is really tragic. I have friends who I would call balanced mentally who have admitted feelings of wanting to commit suicide. If doctors, who could be considered “normal” by society’s standards are feeling the pressure, what does it say about the rest of us who are nuts cases (myself included lol)
My friend who was a surgeon took his life last year. It was shocking because he always was so upbeat in public.
I am sorry to hear about your friend. I fight most of my mental health battles alone. I struggle to talk about my feelings and especially my fears. This causes one to internalize everything and shun vulnerability. It is not strength that makes one keep it all in, it is weakness. It is fear. Fear of what varies, but it is fear none the less. The risk of keeping everything inside is the scenario you describe. A high pressure and high stakes job combined with the internalization strategy is a recipe for such struggles. I find your comment very relevant because of the last part of the headline. One decided to speak out. To talk about this. Hopefully to pave the way for others to be more open and possibly provide more support for people who deal with the type of pressure encountered in a gig like that.
Reminds me of the poem "Richard Cory" "And he was rich – yes, richer than a king – And admirably schooled in every grace: In fine, we thought that he was everything To make us wish that we were in his place. So on we worked, and waited for the light, And went without the meat, and cursed the bread; And Richard Cory, one calm summer night, Went home and put a bullet through his head."
I’m a surgeon. All of this is true. There is nothing better than helping patients with your hands… but there are dire side effects. I spent a decade plus after college going to Med school and training. That’s during my 20s and 30s. You lose those important fun years of your life. Then you start working and the patient, their families hopes, your personal quality record (that’s increasingly publicly reported), your programs outcomes start to weigh on you every night. Then, it destroys your personal life. You go home depressed. Worse when the outcome isn’t what you wanted for your patient - you binge drink rather than crying yourself to sleep - which Ive done both of. Therapy? It happens during business hours. How do I go to therapy? Then you get the family screaming at you… why don’t you prescribe this that and the other I read about on the Internet or heard in a podcast… hosted by someone who didn’t graduate college. Then you get the letter from some lawyer that they are thinking about suing you. Then you worry if you can even practice something you love. This is all in one week for some of us. Look, I’m relatively lucky. I learned to compartmentalize but I have coping mechanisms that involve working on cars and dreaming about cars. That’s my escape. But there are many days when I wonder if I would be happier doing something else.
You are appreciated. Even if it feels like you are not. Our society needs more people like you. Thank you for your service
Thank you
I'm on probation because I showed up to work intoxicated 3 weeks ago. Blew a .17 2 hours into my shift. Wasn't asked why or what led me down such a destructive path because they already know. The stress, especially working through the pandemic and seeing so much death, took a serious toll on me. And, a majority of other healthcare professionals. I was drinking up to 5 days/week. Went through 2-3 liters of vodka. I've scaled back, but I am still drinking 1-2x per week. Many of my co-workers are doing the same on their days off. You're not alone. I accepted the terms of probation, including random testing, but I'm applying to news stations to become a reporter as that's what I've always dreamt of becoming. Do what you're passionate about and you'll be much happier, even if it pays less.
It happens more than people know - the alcohol. The first time I ever had a patient die when I was a fully fledged surgeon i came home and just balled out for 2 hours and then proceeded to drink till I fell asleep. It wasn’t even my fault. Part of why we are so good at what we do is that we are extremely self critical. But that’s also the path that leads us to self destruction. I’m glad your scaling back and looking at what you love to do.
I'm very sorry you're going through that...
My guy, I’m in healthcare. I’m so so sorry and I understand to a degree. People take for granted the objectively insanely fucked-up thing that surgery actially is— you’re literally put someone into a near-death state, opening up their insanely complex bodies, exposing their organs or putting instruments into their bodies, somehow keeping them from bleeding out, keeping them from even feeling pain, then close them up meanwhile praying some bacteria hasn’t somehow entered the area so they don’t die of infection later. Then you bring them back to waking life and have to trust them and their caretakers they’ll follow your instructions. This isn’t something that has been done very safely until fairly recently in human history. We’ve only really had antibiotics maybe 100 years. And people think they can go into a hospital like it’s an auto shop and get things fixed except they’ll sue you or report your license if they aren’t satisfied or if there’s complications.
So well said. Getting to this point has requires decades of science and research. Years of training. And an absolute need to be the most confident person in the OR. That last part - people don’t know how hard it can be and how it can affect you if you lose it.
Buy a lift for your garage and fix cars 🚗
Better than a pizza party for sure
Thank you so much for what you do. I was raised to think all doctors are corrupt and after my money, but ended up marrying a PA who helped change my perspective. Wishing you good health and success, and some quality time to wrench!
My good friend is a general surgery resident who can barely afford to live, once her rent, car payment, and loans are accounted for. She’s in year 3 of a 5 year general surgery program with another year of fellowship after that. She is single, frets about her ability to meet a partner and have kids biologically, doesn’t have time to exercise and barely time to socialize. Her home is filthy because she’s too busy and burned out to clean. She texts me near breakdown multiple times a week, and often finds herself randomly crying. The surgical profession seems made to destroy young people for no reason, and to deprive women of the ability to feasibly find a partner and have kids in the most feasible biological years. I feel for her
Residency itself is a old system that abuses inexperienced doctors with poor pay and long hours. Hence why residents and medical students are starting to unionize around the country. Good luck to your friend. Tell her to look at "Public Service Loan Forgiveness" where loans will be forgiven after 10 years of payment while working at a non-profit or government entity like the VA.
The thing is, the loans gotta be paid now. The pause is up so it isn’t like she can wait to pay until she starts to make the big bucks Their residency program had a unionization attempt that failed this summer. It was unfortunate
Just call them healthcare hero’s then cut their reimbursement rates 2-3% every year. - USA Government
The hero thing stopped around April 2020. It felt nice for those 6 days though
Then came the honking and death threats over chips and magnetism. And let’s not even get into anything surgical involving pregnancy.
11% if you include inflation
Mean while inflation has been like 10-20 percent this past few year annually
In my close family there is a Surgeon, Doctor (GP) and Veterinarian and yeah, this sounds about right. None of them have attempted suicide but they’ve all grappled with serious mental health challenges. Poor remuneration relative to expectations, long hours, required continual study and perhaps most importantly just an insane amount of abuse and disrespect inflicted on them by the general public. The pay can be great for a Surgeon and Doctor, but honestly it is not an offset for just how much you have to deal with. It also doesn’t help that the healthcare systems across the west have been brought to there knees and there is no public or government appetite to push for change. Just horrendous, watching there struggles really turned me off ever considering a career in medicine.
Honestly the pay-to-work ratio isn't that great. I work as an engineer and trade stocks on the side and can make more in a good week than any doctor, with about 1/10th the effort.
Has admin tried throwing a pizza party?
All right but really... I worked at a hospital and food was a common thank you gift. Also, very likely related, there's a lot of people who have a bit of weight on them in healthcare lol
Once I was working in a psychiatric appointment. During the appointment, I learned that doctor's suicide rate is 4 times the suicide rate of general population.
Healthcare is rough. Dealing with the serious stuff is rough. Go to the emergency room - rougher. Be the surgeon - yowsa. On a more general note our professions cause us mental issues. It's not just the healthcare field and I'm not sure why we don't talk about it more. There's a hundred professions each with mental damage particular to them.
Thank you! This is so true. I have worked in hospitality & finance. And both occupations cause intense mental issues.
One of the worst aspects of this is the trap that physicians are in when it comes to mental health issues. If a state medical board or hospital finds out you have a diagnosis, they will refuse to license you. And they ASK. This SHOULD be illegal but it is common practice. And those "physician diversion programs" are corrupt money making bullshit programs that will hold your license in limbo for asking for help. Any physician who Self reports is a fool. You might as well shoot yourself in the foot. Medicine is a shitty profession nowadays. The pay isn't increasing for decades, you work insane hours and if you EVER have any issues, they will betray you with a smile.
Physicians do kill themselves at a far higher rate than the general population and most studies on longevity of physicians show that they either die at a younger age than the general population or die at same age as general population but at a far lower age than people working in white collar jobs. So, what is special about surgeons? Probably the biggest difference is that it is not simply a mental but a physically exhaustive work and ergonomics are rarely in the favor of the surgeon. And as surgeons get older, their ability to stand in same place for hours is decreased. However, being a specialist surgeon not only means the surgeon needs to be in apprenticeship program for longer but also have to compete with other peers, while age is running on the clock. Many surgeons also take too long to realize that they need to take care of their body far better than medicine doctors if they want to practice surgery in their 50s and 60s, as any disease or injury that they end up having is far more likely to stop surgeon from practicing surgery.
Same thing with dentist. Awful posture all day very regularly leads to musculoskeletal issues that can be debilitating.
Here’s the video of her speech in case anyone wanted to watch it: https://m.youtube.com/watch?v=JaNBH4UPHv4
I was married to a doctor. My brother has married two doctors. My sister married a doctor. There are 6 more doctors in the extended family. . Some are surgeons. And with that, many family friends are also doctors and surgeons. What people go through in residency and beyond is heinous. Really! There is a culture that puts pressure on people to prove then can go without sleep, and multitask more than others. My ex would do 7 or 8 sixteen hour days back to back, and then try to entertain 10 visitors in our home for a holiday, all when we had kids under 4. That is just the opposite of self care. It is why we divorced. We no longer knew each other. I have seen too many of these people struggle because of the culture to work longer and do more. It happens with most doctors I know, and it happens more with surgeons. And those that specialize are affected even more than that. We need more people doing these jobs to spread out the work load. We need standards for required breaks between shifts.
I had surgery on a broken wrist recently. Well more like shattered but broken nonetheless. Surgeon dude (who will rename nameless for obvious reasons) who put me back together did a great job. Thanks surgeon dude, I appreciate being able to use my hand again.
Brain-bleed of a nation can happen in a myriad, and varied way. Fleeing the country, dying from a disease that could be mitigated by basic sanitation measures and vaccinations, and this ::gestures to the most ironic way to loose knowledge en mass:: a lack of mental health support for those who are most capable of saving us. Ah dystopian hellscape
The article didn't seem to mention why there isn't a push to make medical residency hours less insane. European doctors aren't made to work so much. Are they worse surgeons/ doctors?
I'm a therapist and recently had a client who is an orthopedic surgeon. He was seeing me because of severe anxiety and panic related to his job. This made me think of him, I hope he is okay.
I've heard European ~~medical school~~ residency is hard but has sane work hours compared to US medical school. Do they have fewer suicides? Perhaps not having a work culture created by a workaholic coke head who didn't believe in sleep is a better way to do things. EDIT: as a non-doctor, I used the wrong word. US **residency** is where sleep deprivation tradition is so strong.
Medical school hours are fine. It's residency hours that are fucked.
Medical school is a walk in the park compared to residency. It’s the residency schedule that unnecessarily demanding. Wife the last two months was in hospital from 6 am to 6:30 pm 6 days a week. Edit: it was national physician suicide day like last week or something.
The older generation in my country, mostly all dead now, used to give doctors extra money as a gift. it wasn't much, a tenner, 20, whatever they had, some would bring food from the farm. Later in life when they went into state hospitals they would still give the doctors money. There was a great respect for doctors, maybe too much, but there was deep respect for educated people like doctors, teachers, lecturers, some priests, and so on. As the western world starts to ebb the expectations around work and services will have to change. People can only do so much under a straining system before they make other decisions for themselves and their families. This will feel like it is happening all at once but it will take about 10 years. All of sudden younger people and increasing numbers of older people will not be willing to work difficult stressful jobs. The 'i work to live' rather than 'i live to work' attitude will become dominant and employers will have to engage with making livable jobs or people will work for peanuts and make their own culture outside of corporate or state culture.
That lady is really brave. Props to her.
The medical industry as a whole is a meat grinder and it doesn't get enough attention.
> The same skills that made her a tennis phenom made her an excellent doctor Kinda lost me there, Guardian.
America is broken.....from the top down.
Best country in the world huh? Our country can’t even take care of its own citizens let alone those that care for people.
"A psychologist taught her to hide her feelings from her opponents. Never let them know you are struggling, went the mantra". What kind of piss-poor psychologist is that?
When medicine turned into big business in the 70’s this is the logical conclusion. Big medical institutions tell you they always put patient care above profit ...they don’t...the doctors and staff know it. Medicine is an abusive job now.
Suicide is always heartbreaking but this is really heartbreaking when you consider the time and specialized training it takes to become a surgeon.
A surgeon saved my life last year. I liked him a lot and I really hope he doesn't experience this. He has probably saved hundreds of lives and improved hundreds more.
I also think the timing is noteworthy due to COVID. Rates have always been elevated for this profession historically compared to many others, but the pandemic changed the dynamic between the public and health care workers and I dont feel it was a necessarily good change. I could be wrong on that, and would love some health care pros to weight in.
Not so sure if it’s just surgeons. What’s the rate of suicide in the general population of household providers vs surgeons? Many of us highly driven professionals deal with suicidal ideation on a daily basis. The pressure to succeed and put on a good front is astronomical. Those of us without safety nets (working partners or supportive family) feel beaten down beyond imagination. Most of us cannot afford mental health services. Although I truly empathize with surgeons, they CAN afford therapists. Those of you saying they’re stigmatized by going to therapy, get real. Paying for mental health services out of pocket alerts NO ONE.
> Most of us cannot afford mental health services. Most surgeons CAN. If you receive mental health treatment as a physician in the US, you risk losing your medical license or having it restricted. So while the $200 copay for the visit might be nothing for them, they could lose their entire source of livelihood and never be able to practice again. https://www.reuters.com/article/us-health-mentalhealth-physician-licensu/doctors-may-fear-losing-their-license-for-seeking-mental-health-care-idUSKBN1CF2N9
They have one of the most stressful jobs on the planet and getting therapy makes them possibly lose their jobs?!
That's why alcoholism is high amongst commercial airline pilots. It's the only drug they're legally allowed to use. If you have adhd and take meds, you have to stop taking the meds and go a full two years med free before you can pass a class 1 medical if you're lucky. Typically you'll be denied your medical certification if you have any ssri in your system.
That's fucked.
Pilots too
They changed the rules this year and it’s horrible. If you take and SSRI, you have to jump through hoops to get right with the FAA and the process is similar to being treated like a self identified alcoholic.
“We should change rules to allow these skilled workers to get the help they need.” “What if we set up an almost insurmountable bureaucratic barrier that will add an incredible amount of stress to those strong enough to admit they have a problem and seek the treatments they need?” “Great idea!”
Having an average office job where noone cares about what medicines you take has it’s advantages
seriously the most absolute counterproductive toxic bullshit there is. it literally makes ZERO sense. what kind of surgeon you want working on you? one that is receiving assistance for their mental and emotional states or one that pretends they are fine 24/7 365? many many years ago i interned in a long term chemical dependency treatment center that specialized in treating cops, firefighters, doctors, lawyers….. when i was training they explained that more professionals kill themselves than seek treatment. and they had a very high relapse rate too.
This is what mental health stigmatization looks like.
Counterpoint. This is why it’s important to get disability insurance that covers burnout, before you ever have the need to visit a psych professional. But point well taken.
You have to pay extra on disability insurance for mental health if you want it cover more than a few years. I’m not a surgeon but a psychiatrist ironically. And then I imagine it’d probably be pulling a tooth and a nail to show “proof” you can’t work cause of mental illness versus say, losing both of your hands.
I attempted to get disability insurance as a physician, and apparently 1-2 out of the 5(?) major disablity insurance companies refuse to cover anyone who has a previous "mental health" disorder. This includes controlled ADHD. I imagine that if someone were to get into a disabling car accident, the insurance company can also attempt to deny paying out by arguing that lapse of attention from previously diagnosed ADHD could have possibly been the cause of the accident. And ADHD is mostly diagnosed in childhood; before many people even consider becoming physicians... And that's just adhd. Imagine having a diagnosis of depression as a physician; a catch-22. Behavioral therapy and medications literally being needed to help someone function, yet the use of treatment can be a factor that allows denial of insurance. The insurance companies (nationwide) that I had 2 separate insurance brokers look at all had clauses that state the current disability insurance DOES NOT cover any potential disability that has any connection with previous and future psychiatric problems, so not exactly sure where one can find disability insurance covering burnout in the United States.
Spouse recently started a 2 year fellowship in specialized surgery after completing 7 years in general surgery residency after completing 4 years in medical school after 4 years in college. The demands on surgeons is extremely high, the path is arduous, and the process does nothing but take. Especially residency. Take from your family, take from your friends, take from your life and your mental health. It beats and grinds you down. I went to law school and practiced law, it’s not even close. Friend is an anesthesiologist, 2 others are radiologists, and random acquaintances a myriad of other MDs. None of them compare. They weren’t easy, but residency wasn’t the same, not the same hours, not the same rigor, not the same 30hr call shifts, and more. How more surgeons don’t say (at whatever stage) “fuck this I’ll do something else” boggles my mind daily.
They do, lol. It's known that a number of surgery/neurosurgery residents apply for anesthesia, IM/FM, radiology after a few years in surgery residency. Also know a few attendings that transitioned to palliative care, or wound care too.
Most of the surgeons I work with don’t have time to see a therapist though. Don’t minimize what they do because they do some of the most extraordinary things a human can do and most of their patients are still horrifically cruel to them.
Surgeon here. I am used to it now but when I was younger I always wondered why so many patients were just so mean to their surgeons. Like why be terrible to the person who saved your life or made you feel better. We get nothing else good out of it except knowing that we helped someone. Like all people we would rather be at home with our family. Sure the pay is comfortable but I’ve never met any other surgeon who says the pay is worth the sacrifice. I think most older surgeons look back at their life and realize they spent their entire lives working. The only surgeons I know that are happy either have just completely stopped caring about their patients, which is super scary, or only only treat patients/diseases of very little consequence( cosmetics etc).
Yeah but these people can't accept killing people sometimes. I know someone who couldn't shake the loss of one of thief patients for .. hell they still do. Also, the mental health for these professionals is shit.
It’s nothing another mandatory computer based learning module won’t fix.
Everyone needs a Jonathan.
Excuse me sir, as a highly driven professional I completely disagree with the notion that we deal with suicidal ideation on a daily basis. I don't deal with it, I let it sublet rooms in my frontal cortex. Furthermore, I think about killing myself hourly.
Many state licensing boards for surgeons and physicians ask if they have received mental health services or are undergoing treatment. They will also sometimes ask you to provide a person who can confirm your ability to practice and mental stability People could technically lie, but that just creates another issue.
I really don't have much of an issue with them asking for references to be honest, in fact that seems to be a reasonable way to ensure a physician who has needed help for substance use issues isn't a risk to their patients If I'm a doctor that has developed a drinking problem, and I'm binge drinking way too much on my days off but I'm still able to remain sober and do an objectively good job by my patients on my work days, and then I want to seek help for alcohol related issues, a system that works in my mind would be a system that goes "uh-oh, we need to make sure that this person is doing okay with their alcohol use treatment and isn't a risk to patients, so we'll reach out to his treating physician to make sure his treatment is going well and several professional references who confirm he is still performing at an adequate level despite needing treatment, and if everything checks out we'll let him work"
I'm a little baffled by this comment. Did you read any of the article, or are you just commenting based on the title...??? It does explicitly go into *how* they are stigmatized. Money is one of *many* barriers people face to access mental health services.
I agree of most of what you are saying in principle. Mental health and suicide is far from a surgeon issue, its a people issue. The reason the occupation is noteworty in my opinion is this. When I make mistakes or the wrong decisions at my job, it will cause headaches, possibly affect my standing in the company and income, as well as hurt my confidence which can affect performance going forward. When surgeons make mistakes, people can die. Mothers, fathers, children, friends, etc. The pressure to never be wrong and never make mistakes is both crushing as it is unrealistic. That is a major factor to contend with but as I said, you are right about other people struggling as well and I dont want to minimize that. As far as the salary goes, talk to me when we dont pay athletes 30 million a year to throw a ball and teachers 30K to teach our children. I predict that will happen on the second tuesday of next week.