Dr. Wible’s keynote delivered at the 19th Annual Chicago Orthopaedic Symposium (begins with a beautiful legacy to the life of Dr. Dean Lorich by Dr. Matthew Jimenez). Downloadable MP3 above.
Thank you. I’m truly honored to be here and extremely grateful that you have given me more than 10 minutes to discuss doctor suicide. Looking at your agenda (three days of q-10-minute lectures back-to-back) as a family doc, I’m just a little blown away that you can cover complex acetabular fractures and mangled lower extremity grade IIIC salvage versus amputation in 10 minutes when I can barely treat a patient with a UTI or step throat in 10 minutes.
I’d like to dedicate my presentation today to Dr. Dean Lorich—and to the many orthopaedic surgeons we’ve lost to suicide. I’ve had the opportunity to get to know many of these men through their colleagues who reported their suicides to me and more intimately through their mothers, sisters and children left behind.
Today, for the first time, I’m sharing my data—what I’ve discovered from investigating more than 1000 doctor suicides—and specifically the suicides of 33 orthopaedic surgeons. Data—often devoid of emotion and humanity—means little without a human face so I’ll start by sharing the incredible lives of two orthopaedic surgeons whom I deeply admire, Dr. Steven Ortiz and Dr. Benjamin Shaffer.
Most of you know Dean. Just curious how many of you know Steve or Ben?
Though we know each other professionally, how many of you feel you really know each other personally—the deep feelings and inner world of your colleagues? I want you to truly know these two men—not just as skilled surgeons—but as the amazing human beings we were blessed to have on this planet. And then I’d like to invite you to get to know each other (while you are still living) as deeply as I’ve gotten to know Steve and Ben posthumously. I’ll begin with Ben . . .
The orthopedic community suffered a devastating loss with the suicide of Dr. Ben Shaffer. He was in practice 25 years as a much beloved and trusted orthopaedic surgeon in Washington DC. Dr. Shaffer graduated from the University of Florida College of Medicine, completed his orthopaedic residency in NYC where he was chief resident, then specialized in sports medicine with a fellowship at the Kerlan-Jobe Orthopaedic Clinic.
The author of more than 50 publications (21 were textbook chapters), Dr. Shaffer trained orthopaedic surgeons around the world. He has an impressive 41-page CV (officially the longest I’ve ever read). He was the medical director or team physician to a gazillion professional sports teams in the DC area. Dr. Shaffer was also consultant to the National Ballet, NHL physician for the 2010 Olympics in Vancouver, PGA Golf Tour, Women’s World Cup Skating, and the list goes on . . . Impressive! Right?
Yet Ben was more than a surgeon, he was a kind, sweet, brilliant sensitive soul who could relate to anyone—from inner city children to supreme court justices. He was gorgeous and magnetic and he loved helping people. So why does a guy this successful end his life?
As with most suicides Ben’s was multifactorial. He had marital distress, diminishing reimbursement, and personal health problems. He was recovering from recent back surgery and still dragging his foot so he couldn’t run or work out (activities that would have made him feel better).
Ben also had chronic anxiety. He saw multiple therapists during his lifetime. His psychiatrist had recently retired and passed him on to a new one who didn’t know him. He had been on anxiolytics for years and was weaned off two months before his suicide. Ultimately it was Ben’s uncontrolled anxiety and insomnia (related to sudden change in medication regimen) that led to his death. For insomnia, he was told to take Benadryl or meditate—both ineffective as he was still sleeping just two or three hours per night and trying to operate and see patients each day.
Eight days before he died, he was prescribed Prozac and Seroquel which worsened his insomnia, increased his anxiety, and led to paranoia. Then his psychiatrist told Ben he’d be on medication for the rest of his life. Ben was devastated, hopeless that he’d ever have a normal life. Ben told his sister he felt backed into a corner with no good options and it was “game over.”
Days before Ben died, his therapist asked him if he was thinking of suicide and he said, “Yes.” He then asked Ben if he knew how he would do it and Ben said, “Yes.” He then asked, “Are you going to do it?” Ben said, “No.” (Ben was smart enough to know that “yes” could potentially cause a problem for a physician.)
Ben knew he should check himself into a hospital, but he was panicked because of career ramifications due to the stigma attached to doctors seeking help for mental health. He was terrified that he’d lose his patients, his practice, his marriage, and that everyone in DC—team owners, players, patients, colleagues—would know about his mental health problems and he’d be shunned.
The night before he died, Ben finally told his partners he needed the rest of the week off because he wasn’t sleeping well. He was ashamed, yet they were fine covering for him. Ben left the hospital in sheer terror. He wanted to tell them that he had changed his mind.
