When Physicians Kill Themselves: Insights From Those They Leave Behind

It is estimated that 300 to 400 physicians die by suicide each year in the United States. Their survivors (suicide survivor is defined as someone who has been bereaved by the loss of a loved one to suicide) include family members, medical colleagues and friends, and in some cases, their trainees, professors and patients. All too often these diverse individuals who knew the physician in varying ways are never interviewed after the doctor’s death or they are silenced by the shroud of darkness and stigma that characterizes suicide. What follows are some observations of three such people.

As physicians, we are viewed as people who, because of our medical degrees and clinical experience, should recognize psychiatric illness in ourselves and go for help. Nothing could be further from the truth!

Mostly, we get terrified if we develop symptoms that suggest an illness of the mind and immediately shore up our defenses of denial, suppression, and sublimation. If these don’t work or we get symptom breakthrough, it is still a challenge to reach out for professional assistance.

Some physicians resort to self-medicating or ‘fiddle’ with what we prescribe. At the funeral of one of my patients, a psychiatrist who hanged himself in his office, I was approached by his son, a medical student. Through his tears and with a heart full of regret, he spoke these words:

“My dad never really stuck to the treatment you provided for him, Dr. Myers. He just hated being a patient. He felt so ashamed. I tried hard, but even my support wasn’t enough” . Very sad.  

Implicit in our calling and the Hippocratic Oath are the abiding notions of respect for humanity and preservation of life by all means. Listen to the words of Carla Fine, a doctor’s widow and author of “No Time to Say Goodbye: Surviving the Suicide of a Loved One”:

  “We have this belief that physicians have chosen that profession to continue and sustain and protect life… and when a physician kills himself or kills herself, it is very very confusing… because it’s almost as if… if they’re giving up… what’s that mean for the rest of us?” (1).

Apart from the existential meaning of this statement, could there be a false sense of security in some families of physicians that their ill loved one might be protected by the mantle of their medical degree?

As physicians, we are usually viewed by our intimates and patients as smart and exacting at what we do. This perfectionism may even extend to how we plan and enact our own suicides. Here are the words of filmmaker Sally Heckel, who lost her obstetrician gynecologist father to suicide:

“My father always said ‘if you’re going to do something, do it right’. I remember he saw a movie where a guy killed himself in the shower. He was very impressed with that. He kept repeating ‘he did it there so it’d be easy to clean up’. But where my father killed himself, the blood stains are still in the floor boards. It’s been over 20 years. When I was 17 and he was 54, my father went up into the attic and shot himself in the heart” (2).

At the end of the day, suicide is very humbling. We can gain so much from the loved ones of those who take their lives into their own hands. Learning from suicide is prevention for the next generation.

References

1. Myers MF. When Physicians Die By Suicide. Videotape. Biomedical Communications. St Paul’s Hospital. Vancouver. Canada. 1998.

2. Heckel S. Unspeakable. DVD. https://www.createspace.com/284108

Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of seven books the most recent of which are “Touched by Suicide: Hope and Healing After Loss” (with Carla Fine) and “The Physician as Patient: A Clinical Handbook for Mental Health Professionals” (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention. 

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.