Two doctors (unknowingly) stop each other’s suicides →

Few things shock me.

I run a suicide helpline—for doctors.

I’ve talked physicians off the ledge, out of their noose, away from their guns.

I thought I’d heard it all.

Yet today took my breath away. Two doctors (unknowingly) stopped each other’s suicides.

Nobody was prepared for what we heard in our physician peer support group.

Our group began amid the pandemic when docs contacted me from as far away as Poland, India, and New Zealand. As one person, I could no longer manage the volume, so I led group calls for suicidal doctors. Those eventually morphed into our Sunday physician trauma recovery group.

As far as I know, I maintain the only international doctor suicide registry. I’d like to stop adding names to my list. Our trauma group offers a safe space for doctors from around the world to heal together. Several claim our group has prevented their suicides.

For those who don’t realize the tremendous power of peer support, here’s an excerpt of what you missed today. Published with permission.

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Lynette: I’ve been in this trauma group a year though I’ve not been coming lately. I’ll explain why: After my family doc I truly love retired last year, I planned to continue with the “new doc” who’d be taking over her practice. Then I got a call that the new doc was dropping me before meeting me, but refilled my meds for three months to give me time to find another doc. I’d been stable and high functioning for 20 years on meds for major depressive disorder and ADHD. I was unsuccessful finding another doc, so last month I began to self-titrate, knowing an abrupt discontinuation was gonna be “not good.”

Not good, turned out worse than I imagined. I sank deeper into a dysfunctional depressive hopelessness with ADHD-exacerbated helplessness. Trajectories filled my brain all moving different speeds and paths, pinging, orbiting, colliding, overwhelming and eventually I walked into my backyard, found a good spot in the bushes that would be easy to hose down and got on the ground with my “38 special” loaded and held against my head.

Seconds from ending it all, pings were racing in my head, then one grabbed ahold of me and filled my brain—“Angela!”

When the thought of Angela overtook me, I couldn’t pull the trigger.

Angela’s my savior. She’s here today and she’s greater than the greatest great. I’d been avoiding her and everybody else’s calls for months, but one night a few weeks ago I answered. After we spoke she took it upon herself to find me a doctor. She called so many, screening them until her standards were met. She scheduled my appointment on March 27. I didn’t kill myself on March 24 in my backyard ‘cause I needed to make my appointment—for Angela!

Pamela: Wow, Angela. Amazing. Lynette, we’re so glad you are still here. Do you have a question for us? How can we all help you now?

Lynette: My question is what’s the closest you all came to suicide? And what turned you around?

Erika: Close! Two years ago, I found myself standing over a drawer of kitchen knives, thinking none of them would do the job properly. The fact that my own mother would find my body didn’t even matter to me. I was in a dark place in quarantine. Drank day and night to numb my pain. Reaching out to a helpline turned out to be a disaster. I felt foolish. Time and sick leave helped. I wish I knew about this group then!

Hannah: Lynette, this past Friday I cleaned out all my things and made a to-do list for my husband. Made sure my finances were taken care of. When I googled easiest and most foolproof method, I found Pamela and she convinced me to at least try this group first. I was close, but I don’t own a gun. Do you have someone who can hang on to your gun?

Jeff: Thanks for being vulnerable and trusting us with your story. Closest I came was after a tough shift when I felt the weight of my mistakes and considered what it would look like to just keep driving into a railing. What stopped me was prayer—I’m Christian. I was filled with an unexpected feeling of comfort that allowed me to make it safely home. I ended up taking the next day off work and it was restorative.

Priya: The time I got closest was after the second suicide in my residency in a year. I figured I’d be the third. After a 24-hour call, I went up to the hospital roof and just stared at the ground through my tears. What stopped me was the decision to leave training.

Lynette: Thanks so much y’all. I thought I’d cry today, but not sob like I am now. Priya, I totally understand ‘cause the thing about suicide for me is it offers comfort, a sense of relief, knowing if things get too painful or I just don’t wanna deal with it anymore I can make it be over in seconds.

John: That’s exactly what suicide is for me—having an “escape hatch” is a comfort. Only people like us can possibly understand. That was God—Spirit, Master of Light, Adonai—working through you Lynette. God isn’t up there inaccessible. He’s here on earth working through people like us.

Kendra: I see you Lynette. I hear you. You’re so brave. Like you, I feel suicide provides an option for comfort. I too find myself isolating and avoiding calls and texts. When I come as close as you, thinking of my family helps. Two months ago, I was so close. I tried to reach my mom by phone and was unsuccessful. I tried to reach out to church and got a voicemail. I felt abandoned by family, friends, God, and I didn’t think I’d make it through the night. Sarah—who I met in this group a year ago—stayed on the phone with me from 2:00 am until daybreak. I knew if I saw morning I’d survive the next day’s challenges. I’m so glad I’m still here.

Brittany: I can’t find the words to explain how close I’ve been, but I’ll write and share next week. I’m overwhelmed—this is like a spiritual experience hearing from you all, knowing I’m not alone and you beautiful people exist. I thought Zoom was for corporate meetings. I’ve never felt anything like this.

Pamela: Brittany, we’d love to hear your story next week. Angela, would you like to share now? What’s it feel like for you knowing you saved Lynette’s life?

Angela: A year ago last month, just after Ash Wednesday, I proclaimed my suicide plan. Plotted, planned, calculated. I had mom’s leftover hospice meds plus enough beta blockers and narcotics thanks to patients who tossed old pill bottles at me. As an overachiever, I needed to set everything up, get legal counsel, make a trust for kids, ensure everyone gets an education, leave no debts.

And that Friday night, getting dumped by a guy I didn’t find physically attractive, I said the heck with it. I’d cleanly finish the job. Seemed logical and do-able to me like most things I attempt. Why bother living? Trapped hostage in a marriage. Trapped for now by minor kids. My mom and aunt had just died. I put so much effort into everything with such little return. I’m not stupid: my patients will be taken care of by someone else. VOILA! Make sense?

Then, 36 hours later, out of the blue, Lynette’s sleepy voice was on my noon voicemail groggily croaking out something about a 500-word essay she had two hours to finish for a trauma meeting. I had to listen to it three times ’cause I found it ironic she’d be calling me after my rough week with no preconceived notion of my recent romancing. I’d just been dumped for a trauma surgeon. Let that digest for a bit while I’m hearing of a physician trauma group suggested for me. Was this to review trauma cases? Was this only for physicians who were physically assaulted? What’s a physician trauma group? Why was Lynette calling to tell me about it right then? My mind spun.

Lynette read her essay she’d written for Dr. Pamela’s group and by next Sunday I was hooked. Lynette coached me through the ridiculousness of my statements, her own suicidal thoughts, purging of toxic folks around us—I got rid of two, coming up on three soon. She listed my many accolades in her irreverent way and nick-named the doc who dumped me in words that still make me grin.

Lynette got me off the ledge without discounting what I was feeling or saying.

As did the rest of you.

I’m now happily divorced, thriving in my social life, enjoying my kids, exercising when I want to not because I’m “running away from something,” drawing a boundary with my narcissistic dad, feeling happy for the first time in a long time—and hopefully helping spare other docs from making similar mistakes!

I love you Lynette!

I pray for everyone here and send good vibes. No matter who you deify or not—who can say a higher power wasn’t at play when Lynette saved me that Sunday morning cluing me into the power of our trauma group?

Kendra: To all the new people, try the buddy system. Find someone here you can call 24/7. CALL THEM when you need to. The physician from our group who helped me through the night was not just a buddy. She’s my lifesaver and is now a lifelong friend.

[After our session I called Lynette and Angela. I wasn’t the only one in shock. They were both shocked to learn they’d prevented the other doctor’s death. Neither had revealed their near-suicides until today.]

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Note: First names have been changed since all doctors may face career suicide for admitting their pain.

Join a peer support group here.

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Is suicide a good option for me? →

A physician just wrote me:

“I know people try to prevent suicide at all costs, but on the flip side if someone is just suffering so much everyday, couldn’t it be considered the lesser of two evils? Everyone says it’s such a selfish act, but maybe the person needs to be selfish to get out of pain. How long is a person supposed to suffer? What type of life is it to sit around and suffer?”

I’ve been running a doctor suicide helpline for more than a decade and have spent thousands of hours speaking to suicidal doctors. Here’s my advice to you:

1) Ask yourself if you are terminally ill. Suicide is a legal option for terminal illness. I live in Oregon, the first state to legalize physician-assisted suicide. I’ve helped my terminally ill patients with physical illness and less than 6 months to live die by suicide. Is your illness truly terminal? Mental illness is rampant and poorly treated in our society. Most are suffering due to lack of treatment.

2) Explore ALL your options. Even most doctors who seek help receive only conventional drugs. Have you been offered curated peer support, spiritual therapies, or psychedelic ceremonies? Have you tried ALL of them with consistency? Don’t dabble haphazardly on your own. Find an expert guide and/or facilitated program for physicians that offers a safe, structured environment for your healing.

3) Avoid the term “treatment-resistant depression.” When allopathic interventions fail  that does not mean your illness is resistant to complementary therapies. Integrative psychiatrists know that rewiring our neural networks is possible. Are you working with the right psychiatrist? Some offer a holistic and “sacred” approach to ECT and EMDR. Most physician-patients are unaware of all their options—and have no idea how to find reputable and safe non-standard therapies. One doctor shares:

“The Sacramental use of psilocybin or other entheogens was the most effective approach for me. Ceremonial use of these medicines brings in the wisdom of age-old traditions that use these Medicines to help us reconnect to ourselves, not as a solution for any particular malady but as a way to return to balance and in turn, finding deeper understanding, improvement or resolution of our depression.”

4) Use curated peer support as your first-line treatment. I suggest highly targeted peer support as the foundation of any suicide prevention plan. Isolation and loneliness is immediately ameliorated in a properly facilitated group with members who have similar emotional wounds. I’ve been leading physician peer support groups for years. Share your story. Don’t suppress your tears. Most of the time, what is needed is human interaction. One surgeon reported: “Spending two hours with you all was more helpful than any therapist I’ve seen, anything they did on inpatient psych, any help I’ve gotten yet.”

5) Consider suicide a failure of community. When suffering is individually pathologized, the person is blamed for their condition. When we recognize that the “illness” is a normal reaction to an abnormal or traumatic situation, the wisdom of the individual’s psychological response finally makes sense. Recognizing societal influences and community/family dysfunction that lead to suicidal thinking is crucial. Evaluate your ACES (Adverse Childhood Events) to help you discover your family-of origin-core wound. Reference: Did your wounded child choose your career?

6) Identify your core wound. Most suicides are a culmination of many factors poorly managed over years. Discovering the origin story or genesis of your core wound will allow you to successfully address your primary issue (versus just dealing with the sequelae of your untreated core wound). If you feel detached from your inner core, find a hobby that brings you pleasure as a way to find yourself again. Sometimes our core wound is grief for the a loss of self or self image.

7) Know that suicide is an occupational hazard of your profession. Physicians are dying by suicide triple the rate of their patients. Why? We’re groomed in an atmosphere of self-betrayal and self-abuse. Hazardous working conditions lead to destruction of our own health and personal relationships with family. Physicians are placed on a pedestal until we can no longer perform—then we are vilified. We are not allowed to be human and are disconnected from our feelings, emotions, and spiritual core. Reference: Physician Betrayal: How Our Heroes Become Villains.

8) Realize that you are a spiritual being living a finite human experience. As physicians we are cut off from our humanity and untethered from our souls. Shells of our former selves just going through the motions with no passion or zest for life—a direct result of the methodical dehumanization of medical education and practice. I’ve interviewed many physician survivors of suicide attempts. All are grateful they are alive and regret their desperate decision. Many now feel a renewed sense of spiritual connection and purpose.

9) Believe your condition is curable. When offered holistic interventions and removed from hazardous working conditions, most all physicians heal quickly. Doctors have curable mental health conditions that often began in childhood and were exacerbated by medical training and practice. One wise physician (who lost her own physician husband to suicide) shares:

“I consider no disease terminal until you think so—and self motivation is the key what you want to do with your life. If you think you will get better—you will. Spirituality says the same. You become what you believe you want to be.”

10) Your suicide is a terrible option for a curable condition.

Need to talk? Contact Dr. Wible.

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Doctors are harming patients. What can I do? →

Physician Betrayal

A med student just wrote me:

“Last month on my pulmonary rotation doctors were not serious about contact precautions. Most patients were on steroids and immunocompromised. The doctors did not wash their hands and encouraged me not to wash my hands either! They didn’t even clean their stethoscopes. So basically just carrying infections from patient to patient. On my surgery rotation, I saw surgeons show up an hour after the patient was anesthetized. I’m not happy about this, yet I’ve been told there’s nothing I can do about it. Whenever I share my concerns, they always try to minimize by saying, ‘Yeah we’re endangering patients’ lives, but it’s just because we don’t have time. What are you going to do about it?’ I don’t know what to do. Please help me.”

My advice after more than a decade helping trainees in your situation:

1) Save your soul first. To preserve your mental health, document everything. Follow these documentation guidelines. Keep a personal journal too. Above all, stay true to yourself. To understand the cycle of betrayal in medical training, download my free ebook (20-min read): Physician Betrayal: How Our Heroes Become Villains.

2) Engage allies in collective action. You are witnessing a systemic failure of the medical education system. Nurses are your allies. Be tactful when uniting to address infection control. Hospital-acquired infections are a big deal. To avoid being the sole target of retaliation, join together with medical trainees, nurses, and/or patients to resolve safety issues. Collective action will prevent individual retaliation as this doctor explains:

“We had a professor who would intimidate us during his lectures. He’d point to somebody in the back of the room and tell them to stop doing what they were doing and pay attention or else! Well, our class knew there was nobody in the back making noise. Nobody was discourteous. We checked with the upperclassmen and discovered this had been his routine all along—intimidating the class into submission. We decided that we would not put up with this. The next time, we called him on it. The president of our class stood up and told him, ‘We know what you are doing. There is nobody in the back making noise. We are not staying in your lecture. We are leaving.’ And we got up en masse—all 160 students—and we walked to the dean’s office and reported this. We never saw the professor again.”

3) Attempt internal resolution first. Arrange a meeting for your group with your hospital safety or quality improvement team. Many hospitals have a designated infection prevention and control (IPC) team or infection control officer. You may also bring your collective concerns to your hospital ombudsman—an appointed confidential advocate who helps resolve conflict by facilitating communication between all concerned parties.

4) File external complaints. If internal resolution fails amid a systemic patient safety issue, choose a systemic intervention such as submitting your anonymous complaints to the Joint Commission and to the State Department of Health. NOTE:  Medical board complaints do not address systemic issues as they are usually lodged against individual doctors—and if you complain to your school, AAMC, or ACGME, you may end up facing retaliation.

5) Submit OSHA complaint. If your workplace is unsafe, unhealthful, or hazardous, file a confidential Occupational Safety and Health Administration complaint to trigger an on-site inspection by a compliance officer trained to protect workers and their rights. Then request a health hazard evaluation through NIOSH (National Institute for Occupational Safety and Health). They will perform an assessment of physician work conditions and file a report with recommendations. Three employees are required to request a NIOSH evaluation. Your identity will remain confidential.

6) Pursue media exposure. If you’ve exhausted all options above and nothing has changed, an op-ed signed by your group can be very effective. Bad press may lead to revenue loss and lawsuits. Your hospital may quickly address your group’s concerns to prevent further bad press.

7) Consider legal representation. Taking legal action may be the only way to hold a hospital accountable. When patients have suffered death or disability from hospital-acquired infections, hospitals may be held liable for failure to uphold medical standard of care. To pursue legal action, know your whistleblower protection rights.

For more information, reference Human Rights Violations in Medicine.

Are you a medical trainee who needs help? Contact Dr. Wible.

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Why Parents Force Kids To Be Doctors →

Future Doctor Babies

Do #FutureDoctor Babies Risk Future Depression?

When I see an infant dressed as a “future doctor,” I cringe.

I’m used to helping premeds, not preemies or toddlers in surgical scrubs. How do I stage an intervention with parents of a premed baby?

I’m Dr. Pamela Wible. I run a suicide helpline—for doctors. When I ask, “When did you decide to be a doctor?” Many say grade school—some as young as two!

I used to be in awe of their inner knowing. How can a toddler (not yet potty trained) be aiming for med school?

My friend knew at three. Her dad would always point at her in her diapers and say, “There’s my doctor!” Now she’s a nurse practitioner in her forties with depression—still trying to get into med school—still seeking validation from her deceased dad—still wanting to fulfill his dream.

Parental pressure to pursue a medical career leads to depression—which may worsen as a physician.

Last year, I got this three-word email: “Please help me.” I called right back. A woman answered—with a noose around her neck. First-generation Korean American. Her parents always demanded, “Either be a doctor or pharmacist.” Her sister’s a pharmacist. So she’s the doctor (in a toxic residency). She felt her only way out was death. I talked her down. Today she’s alive—after a career change.

Both women were branded #FutureDoctors as babies. Both were nudged in subtle—and not-so-subtle ways—since birth to pursue a profession with high rates of depression and suicide.

Why do parents pressure children to go to medical school? Is this a form of child abuse by well-meaning parents who only “want the best” for their kids?

Top 10 reasons parents force babies to be doctors

1. Trophy children

Social currency and bragging rights. A physician trophy child with the best test scores means superior genes. How important is the trophy? After losing their son to suicide in med school—a family was given the option to sign a nondisclosure agreement—to never speak about their son’s death—in exchange for his diploma. They chose the diploma.

2. Proof of great parenting

A medical diploma proves mommy and daddy did everything for their kids and were the best parents ever!

3. Financial security

Babies are an investment and parents want a financial return. “We’re poor, so we’re counting on you to be a doctor or we wasted our lives.” My friend’s parents actually say this to her.

4. Parent’s dream

Family members will implant (even subconsciously) their own unfulfilled dreams in their offspring. Students have told me, “I hate medical school, but my parents want me to be a doctor.”

5. Tradition

Some families want baby boys to have matching circumcisions, others want babies in matching professions. A sad med student from India told me she had “no choice”—everyone in her family is a doctor!

6. Playing it “safe”

Is choosing a “non-risky” career for your newborn better than letting your kid pick a  job they’d love? Parents believe sending their child to train in a hospital with hundreds of doctors is the safest place on Earth—until they lose their #FutureDoctor to suicide.

7. Peer pressure

When Jewish mothers say, “my son the doctor,” other Jewish mothers—like my grandma—want the same thing. As a mama’s boy, my dad was told to be a doctor. He planned to be a sculptor and work in motion pictures—but ended up a theatrical pathologist sculpting corpses in the morgue.

8. Pinnacle of success

The doctor-as-God image makes medicine feel more like a religion than a profession. Giving birth to a #FutureDoctor must feel like birthing Jesus.

My ex has audio of his mom reading him a book: “A Trip to the Doctor” at age two. In her Brooklyn accent she pleads, “Don’t you want to be a doctor to help all the boys and girls?” He screams, “No! I don’t wanna be a doctor!” She keeps repeating her question—until he agrees.

9. Peace of mind

When your kid is well paid and can save your life in the middle of the night with the best medical care ever—you’ll have no more worries.

10. Parental love

My divorced parents are not-so-emotionally-available workaholic doctors. Both tried to talk me out of medicine, but I knew as a kid the only way to spend time with them was to tag along to work in the morgue and psychiatric hospitals (and I loved it!).

When I became a doctor, I interrogated my parents on why they became doctors. Separately (so they couldn’t cheat). Both listed the usual: help people, good money, stable job. “But why?” I pressed them for the real reason. Dad poured another glass of vodka and murmured, “So my mother would love me.” Mom got pissed before spewing out the truth, “Because I thought my mother would finally love me.”

So yep, I get really creeped out by these #FutureDoctor onesies.

Future Doctor Onesie

 

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Doctor Buys Patients Gym Memberships →

Fear and isolation have led to alarming rates of anxiety, depression—even suicides—in our community and exercise is a great way to shed ‘pandemic pounds,’ improve mental health, and combat social withdrawal—all while supporting a local business—a win-win for everyone.

So I’m announcing a philanthropic community partnership with IN Shape Fitness to help combat the devastating physical, emotional, and economic setbacks to my friends, neighbors, and patients with free gym memberships.

I’m Dr. Pamela Wible and I run a suicide helpline—for doctors—a profession with a high rate of suicide. We can all see the emotional toll of the pandemic on patients—and doctors. When I’m not on the phone with suicidal med students and doctors from around the country (& even as far as India) you can often find me at the gym.

My goal is to inspire people to exercise—a great first-line intervention for anxiety, depression, and suicidal thinking—and get back in shape physically and emotionally.

I invite you to join IN Shape Athletic Club—your new full-service fitness facility featuring free weights, Paramount circuit training, modern cardiovascular equipment, tanning beds—even childcare. You’ll receive a free orientation with your own certified personal trainer to demo proper technique and provide the right exercise plan to achieve your health goals. Enjoy group yoga, dance, strength-training, and Zumba classes—all free with your membership.

Are you ready to get IN Shape?

Call 541-687-2200 for a personal tour of our spacious, safe, clean, and friendly club with staff who always welcome you by name—with a smile. Plus I’d LOVE to exercise with you! 💕

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