Dear Suicidal Surgeon, we love you, please keep breathing . . .

View 25-minute video above ⬆️. Transcript edited for clarity.

Dr. Pamela Wible: We are gathered here today to help a suicidal surgeon (and any health professional) who has written me a comment my blog. I got this yesterday right before boarding a plane, and it says:

I’ve been in healthcare my entire life. Surgical services. Because I spoke up against wrongdoing, stood up for myself, I’m out of a job and can’t get a job anywhere now. I’m 60 now. I don’t know what to do. I’ve had a hard life and I buried all the pain in work. Now. Alone and nothing, but time on my hands all of it has surfaced. I have been thinking about ending my life every single day for a long time. Some nights the urge is very strong. I cry myself to sleep almost daily. Every day. I don’t want to live anymore. There is no reason to. I just exist. Serving everyone but myself for over 25 years. I have been single for 24 years. Raised four kids by myself. Took care of mom when she passed. Then dad for seven years before he passed. Lost one son to an overdose. I’m so alone. I can’t take it anymore. God knows. I’m sorry for my weakness. I can’t pick myself up anymore. Nothing is working and my career is over.

Then I had a layover at an airport on the way home. And another comment came in 30 minutes after the first one. From the same person. I can’t respond directly, so we’re making this video. To help Anonymous, who further stated:

After reading what I wrote, it just sounds like a pity party for myself. But why does it feel so overwhelmingly strong? Why is the belief and the rationalization of ending my life so present in my mind every single day? And some days so strong, the pain has become so overwhelming that taking a knife or fork and scraping my arms helps relieve some of it. The pain of my life has overcome all faith. Strength I once had.

We have three guests from our peer support group—doctors determined to help other doctors not die by suicide. We help all medical professionals, even medical students, nursing students, any health professional who is suffering. Of course, we don’t want anyone to die by suicide. We have a lot of expertise in our group. We love helping physicians who are suffering (confidential care so no med board involvement or EMR!). Amir, what advice would you give this person who’s out there struggling?

Dr. Amir Friedman: Thank you for having me, Pamela, and hello to everybody here. I had the privilege of reading the comment that Pamela shared with us from Anonymous, What really resonated with me is that you had to take care of your family members. You took care of your mom when she passed and then your father for seven years before he passed, and you lost a son to an overdose. The reason that resonated with me so strongly is I have also had a similar experience in my family. I’m a physician. I’ve also been investigated, prosecuted (and imprisoned for insurance fraud). The loss in my family dramatically really outweighed the loss in my professional life, though. At the time, the two seemed to be equal in terms of loss.

Today when I look back, it was very difficult for me to reconcile the loss in my family. I lost two siblings and both my parents to mental illness—all to suicide. I understand that once that happens to you, it’s almost impossible to make sense of it to find a way to go forward. And I want you to know that despite the enormity of the loss, I can feel the acute pain that you’re suffering. There is a deeper understanding and a meaning for you. Because you are able to share that with us, I believe that you wanted to seek some sort of help, maybe to understand how to deal with your pain and how to move forward.

I hope that you can join us and discuss some of these tragic events as difficult as it might be. If you can, I think what you’ll see is that each one of us in our own way has suffered deep and tragic loss. But what we’ve all come to understand is that joining together, bringing all of this out into the light, what we can do is we can help each other deal with the pain and move forward. And then once again, contribute to healing of other people that are also going through this. All of us can kind of bring ourselves back up. It took me a while to do that. But today, I feel like I can help you understand your unique loss and pain and then find meaning again.

I would be very happy to share again with Pamela anonymously in a safe setting what we can do to help you to to overcome and then to find true healing and acceptance to move forward. So please, if you do hear this message, please join us. Thank you for sharing your pain and your loss. I look forward to speaking with you. If you can, join us. Thank you.

Dr. Pamela Wible: Beautiful message of love and support to our mysterious peer in medicine. I wanted to clarify one thing that you said for those who don’t know, this gentleman, he lost his career by getting caught up in an insurance scam and then losing his medical license and even having to go to prison. And what he’s emphasizing in his comments is the personal loss from losing family members can be so much more painful than even the career loss. But then the career loss, as pointed out in your message, when it’s something that you spent your whole life honing very specific skills to help people in an OR setting—that loss is extremely painful as well.

Before l introduce our next guest who would like to directly speak to you, please know that we are sharing is not just for the suffering person who wrote me. Lots of people out in the world, in medicine, even outside of medicine, are struggling with thoughts of suicide. Our message today is for anyone. I hope you can pick up a tip, a hint, something that resonates with you from us today. We are all physicians and we want to help you survive your dark night of the soul.

Since I was on a plane with your messages, I made a list of themes I felt you were struggling with in your two notes to me. I’m so glad you wrote the second. one. It made me feel like you really want to engage deeper on this topic and understand the psychology of why you might be feeling this way. I’ve been running a free suicide helpline for physicians, now into my 13th year. So I have a very deep understanding of why medical professionals can end up in dark night of the soul moments. I’ll list these with a little explanation of each. Then you’ll hear from Mandy, the surgeon among us with the greatest expertise in the realm of why you feel such a deep loss of your surgical career.

My list of themes identified in your suicide notes:

1. You faced whistleblower retaliation. You literally stood up for what was right, either for yourself or a patient, and you found yourself in a hostile environment. Then without a job. And that really sucks. That’s wrong. You should have been protected. What you brought to the surface should have been dealt with so that future medical professionals and patients would not suffer in your institution. You should have never been treated that way.

2. You have career identity loss. You obviously threw yourself into this career and became very highly skilled. Possibly you’re a perfectionist like many of us. So it’s intolerable to see things that are harmful for patients when we take an oath to help people. Our career can become our entire identity, especially when your kids are grown out of the nest and you’ve lost your parents.

3. You feel like you’re an unemployable surgeon (or surgical professional). Just when you have gained such great wisdom and skill to devote, now you have no job. Very painful.

4. You have a trauma-inspired career. A lot of people pursue medicine or medical specialties to help others because they’ve been injured themselves as children. Whether that’s because you’ve had mental health issues in parents or you’ve had physical health issues yourself, usually there’s some sort of early trauma response that leads you to spend the rest of your life helping and healing others. Our career choice is often how we cope with our own pain.

5. You have a workaholic coping strategy. We throw everything into work and serving others prevents us from really hyper-focusing in our own deeper wounds. When your work is taken away from you rather suddenly in a very unfair and unethical way, you are now without your coping strategy . . .

6. You are bored and flooded with all sorts of memories that previously were shielded from you. And this can be very uncomfortable on top of the loss of your career.

7. You have personal life loss and grief that you obviously feel from losing your beloved son. I don’t know if you were married before, but you have four children. Obviously a prior partner of yours is missing from your life, All the sadness of losing that partner, having a deceased child and then the death of your parents, I just want to reiterate that is profound loss.

8. You are lonely. The loneliness you must feel is just so isolating and actually very deadly. It’s loneliness that leads to suicides and other deep mental health issues. We are here virtually to support anyone out there who’s lonely. You are not alone. We have experienced many of these things ourselves. And we want to help you.

9. You have non-reciprocal relationships. Really common with people pleasers, people with high empathy, people who go into medicine. We give everything to everyone else. And we don’t have reciprocal relationships where we’re refilled. We’re depleted by needs of others when we place ourselves in these caregiver roles. Like chronically, for a lifetime. We end up feeling really isolated, like nobody cares for us. I just want to say, we care for you. We are here for you. Every Sunday we meet. Contact me anytime. I would love your phone number, but you don’t have to reveal your name. You could write me with a real email. All I have now is Anonymous@nowhere.com. You can remain anonymous, but you don’t have to remain nowhere. You don’t have to remain isolated. You can be with us. We’re really sweet people. You’ll see . . .

10. You lack self-compassion. It really hit my heart when you said, I feel like what I just wrote was a pity party. Oh my gosh. No, you totally deserve love and compassion from others and from yourself. You are not throwing a pity party. You have had real loss, real grief, and you’re really minimizing the grief that you’re in, and we want to help you.

11. You are cutting yourself. Sometimes by cutting, you need to see physically your pain on your body. As a surgical. professional that’s probably something very close to your heart. You’ve been in ORs. You’ve been in cutting scenes. And so now you’re cutting yourself as a way for you to feel the pain physically. But please do not make a lethal cut. Please contact us.

And I want to hand this over to Mandy, a very beautiful woman and surgeon. She has lots of insight to share.I actually called Mandy from the airport on my layover and read your words to her. I was so wanting to help you, but I couldn’t reach out to you. You did not leave your number. I don’t have your email. So Mandy and I spoke about you.We came up with this idea of talking to you through video. We hope you watch this. Mandy, what do you think?

Dr. Mandy Rice: First of all, I wanted to say to this person that what you’re seeing here is some just genuine love. We get to visit with each other every week and we’ve gone through some struggle that we’ve all had and that friends of ours that join us on Sundays have had. And it’s so healing to not be alone. I just want to extend the offer like my other friends here have said to join us because it’s so helpful that we can explore and experience and relieve ourselves of these painful experiences and these painful thoughts.

I have read through your note and it really hit me hard because it resonates with me. I also had a whistleblower experience where you stand up for something that’s done wrong in the surgical space. I’m not sure if you’re a physician or if you are a nurse or a scrub tech or an orderly, but you’re obviously in the surgical field and that’s a very high stakes area where a lot is going on and it’s very pressurized. We essentially live in a tunnel in our world there. And it can be very emotionally challenging. Then when you see something that’s either harming a patient that we’re working on or potentially harming each other and you’re so bold as to stand up and say, hey, this is wrong. We need to change it. How confusing and frustrating that then you are the one that has to deal with the repercussions, that you are the one who is fired or let go or removed from the position. There’s so much betrayal. There’s so much isolation in that that no one ever really talks about. And there’s certainly not much support. At least I didn’t feel that I had much support when I was experiencing that. And that’s very heavy. And it takes a long time to heal. If you even understand how to heal from that.

I’m glad you’re able to write down your frustrations and past trials and tribulations. That’s a way to get it out of your brain, so that it doesn’t have to stay inside you. I also like the fact that you list all the beautiful things that you’ve done. I’m not sure that you had that positive aspect in your mind when you wrote them, but when I read them, I saw someone who’s strong. I saw someone who’s caring. You raised four children. That’s beautiful.

The loss of your son, I cannot imagine. I know you loved him and his life certainly touched a lot of people. And I hope you have beautiful memories to look back on. And I think that the fact that you helped your parents, that’s so noble, it’s so caring, it’s so gentle. I know all of these things had taxing aspects to them. But I invite you to look at the strength you demonstrated in doing all of these things and surviving all of these things and thriving beyond and see that you are meant for more . . .

This time frame where you don’t have employment, I understand all too well. I’ve had different years where I had stood up for problems and had lost my job temporarily. And this struggle of trying to find a new job is very, very difficult, especially when you feel like you’re having to give reasons why you weren’t employed. And that can be completely arduous. But I also know that there’s this concept of being able to pivot. And I wonder if that might be something that you could consider . . .

I love that you’re still breathing. I love that you’re still processing things. I love that you’re getting things out of your brain. and onto paper or online, maybe open yourself up to something new. I don’t know if you notice this, but you just getting this out of your brain and onto the screen has given yourself a voice. It’s given a voice to yourself, to your story, to your pain. And you’re not alone. That blog alone is full of people in pain who have survived so many different trials. And we’ve gone through so much pain. And the fact that you’re still breathing and hopefully watching this and typing, that is a sign that you have a story that someone else could heal from as well as yourself. Listen to your own story and see your strength there.

I invite you to join us. I invite you to consider that we already feel like we want to be a part of your life. You’re not alone. Please keep breathing. Please keep typing. And please join us on Sunday. We want to see how our love could help you and you can help others. It’s a relationship waiting to happen.

Dr. Pamela Wible: Oh, Mandy, that’s so beautiful. I love what you said. And you look gorgeous, by the way, the lighting. Very nice. You look like you’re a beautiful portrait. To Anonymous, it’s all about reframing what you’re going through. I know this sounds so crazy, but your worst day could be the best day of your life. Like when you reframe your pain, you now have more wisdom and you’re available to help others, just like we are.

Think about why we are all here. We have all gone through the dark night of our soul moments where we thought maybe we shouldn’t be alive. And we’re still here. We’ve learned so much. We’ve lost colleagues who are no longer breathing. And we don’t want to read any more obituaries of our peers—ethical, loving empaths dying in droves.This can stop when we come together.

The reason why I feel like we’re not able to stop this is we haven’t come together in a safe place. As you noticed in the workplace, when you bring up a problem, you can get retaliation or punishment instead of being honored, loved, respected, and supported in a safe community. Which is why it’s good to come together with people who are trustworthy, who understand what you’ve been through, but they’re not your direct colleagues. Like us, for example, we’re in all different parts of the U.S. We probably don’t even know you. You’ve maybe never seen us before. We’re the perfect people who want to support you. Totally nonjudgmental.

I just want to say how overpowering it is when you feel like you lose your career. You can always come back. So many ways you can contribute. I don’t even have a medical license anymore. I retired. Now I feel like I’m more effective than ever, helping more people. So believe me, there are ways that you can use your skills inside and outside the OR in the future. I just want to encourage you not to give up. I understand how painful it is. I went through six jobs in 10 years. I’ve been unemployed a number of times and it’s really hard. But I’m an example (like Mandy and Amir) of somebody that bounced back. You can too.

We don’t often recognize that a lot of our pain starts in our childhood. And a lot of us had really deep struggles in childhood that led to this career. We want to wrap our hands around the little version of you and let you know that it’s. okay and you’re safe. And a lot of the healing process is going back and helping that little version of ourselves make their way through the world as an actual integrated whole human adult who is supported and loved by peers. You deserve that. I don’t want you to leave this earth prematurely without experiencing the great joy of being a whole human adult who is loved.

You deserve support for your grief, your loss. We want to be in a relationship with you that is truly reciprocal. You might not have ever had one before where people are just here for you and you can trust us. And we’re not here to get anything from you or generate revenue from you or anything. We just want you to be a guest and come and we’ll support you. Maybe next Sunday you’ll join us. We’re here every Sunday at 1 p.m. Pacific (join us for free). We wanted to create this special video just for you to let you (and anyone else who’s suffering in the medical profession) know that you deserve compassion. We want to help you have compassion for yourself. We want to give you a large dose of compassion that you’ve probably never felt from your peers, at least in the dose that we have to deliver it.

Dr. Amir Friedman: You Pamela and Mandy said it so well. We are all in this together. We really share and feel very close to all the pain you’ve experienced. We want you to reach out to us. And we know that we may not have all the answers. We’d like to start a conversation with you. Let’s begin a discussion about all the things that we all know were so terrible and tragic. Let’s share that. Then hopefully through that discussion, we can turn the page and we can see what might be possible in the future and what we can all contribute to help one another. And I really look forward to that. I hope that you join us.

Dr. Pamela Wible: Mandy, do you want to say anything in closing, a parting word for our new friend, who we hopefully will meet soon?

Dr. Mandy Rice: You’re not alone. Keep breathing. Go outside. Take some deep breaths. Look at the sky. Stretch your limbs. Get some blood flowing. Maybe do a couple of jumping jacks. Get some dopamine, serotonin. This is nature’s antidepressant. Drink a big glass of water and reach out to us. We’re ready to help.

Dr. Pamela Wible: This is our fun little tribe here, all ready to help any medical professional who wants to be understood for the their pain. All you’ve seen in the OR, it is very important to not just keep that in your body as a stored memory or experience. These scenes need to be released in community among a group of people that can understand these surgical scenes. Mandy is a surgeon and our other guest here today, he’s an anesthesiologist. So I think you’re going to find some camaraderie that you’ve been looking for for a really long time and we can’t meet you. Please just reach out to Pamela Wible. That’s me. Pamela Wible  (like Bible). IdealMedicalCare.org. We are here to ideally give you the care you’ve always wanted in your life from your peers. God bless you. Please keep breathing.