Oklahoma doctor suicides—13 reasons why →

Dedicated to the lives of Oklahoma physicians we have lost to suicide 

On January 11, 2019, I delivered this talk to the medical students at Oklahoma State University Health Sciences to a surprise standing ovation and again the following day as the Oklahoma Osteopathic Association keynote address. Audio/transcript below. (Video will be posted when available).

Dr. Jonathan Bushman: Next, we’d like to welcome our keynote speaker. Dr. Pamela Wible, M.D., is a family physician born into a family of physicians, who warned her not to pursue medicine. She soon discovered why. To heal her patients, she first had to heal her profession. Fed up with assembly-line medicine, Dr. Wible held town hall meetings, where she invited citizens to design their own ideal clinic. Open since 2005, Dr. Wible’s community clinic has inspired Americans to create ideal clinics in hospitals nationwide. Her innovative model is now taught in medical schools and featured in Harvard School of Public Health’s newest edition of Renegotiating Healthcare, a textbook examining major trends with potential to change the dynamics of healthcare. Dr. Wible speaks widely on healthcare delivery and is the best selling author of Pet Goats & Pap Smears and Physician Suicide Letters—Answered.

When not treating patients, Dr. Wible devotes herself to medical student and physician suicide prevention. She’s investigated more than 1,100 doctor suicides, and her extensive database and suicide registry reveals highest risk specialties—and solutions. In between treating her own patients, Dr. Wible runs a free doctor suicide hotline and has helped countless medical students and physicians heal from anxiety, depression, PTSD, and suicidal thoughts—so they can enjoy practicing medicine. Please help me welcome Dr. Pamela Wible.

Dr. Pamela Wible: I’m so excited to be here. I loved the last talk. We have a new DPC patient over here, the AV guy Mike is so excited to sign up. He was really influenced by that talk by Kyle. And so today I’m going to talk about how I survived my own suicidal crisis, our opioid national crisis, and a gazillion patients begging me for marijuana—to finally love my life as a doctor.

I knew I was screwed when this hippie guy with dreadlocks came to my house while I was gardening. This guy accosted me in my own garden at my home looking for pot. And I was totally confused, out of context. Then he tells me, “I heard you’re the cool doctor in town.” So he thought that I was going to give him medical marijuana by coming to my house. And then I had another patient show up. This is in Eugene, Oregon. I don’t live in Oklahoma. Another patient brought this giant pot plant on the city bus coming to his appointment with me and was hoping to trade or barter or whatever like this is his payment. I had to explain, “No, I don’t take pot. Just cash or check.”

So this is a situation in Oregon. We have a state where we were the first to decriminalize marijuana in 1973. And in 1998 we legalized medical cannabis and then recreational cannabis in 2014. And of course you know, in Oklahoma, you legalized it in 2018. So I’m like 20 years ahead of you on the influx of patients demanding pot from me. By the way, I went to med school in Texas—UTMB/Galveston. And I did not go to medical school to be running a medical marijuana mill. 

 

Ever feel like this? In a situation where everyone is making demands on you to fill out paperwork and get people onto disability. And now they want pot from you. Is this really the best use of my education and my skills? It doesn’t make any sense. Assembly-line medicine—which is what I call this production-driven model that most docs are in—made me suicidal. My job sucked.

So this was my situation. You can see that’s me there screaming for help. This is art therapy for the captive physician in a big-box clinic. I felt trapped and unable to utilize the skill set that I had to help people in seven-minute increments with an embezzling clinic manager. It was insane, double-booked patients. My life sucked. I’m sure you can relate to what I’m saying. I had to do something different.

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43 seconds to your dream job. Just answer YES to these 3 questions: →

HAPPY NEW YEAR! Want to make this year the best year ever? Here’s a simple strategy to get high-yield returns in this 43-second clip from my Vegas keynote. What would you say to these three simple questions I pose to the audience?

Can you answer YES to any (or all) of these questions?

1) Are you super excited to go to work Monday morning?

2) Are you having so much fun you’d work for free?

3) Do you hope you never have to retire?

I’m looking for people who have found their dream jobs—especially doctors who can honestly respond YES to all 3 of these questions. Please leave a comment on this blog to help us understand how in the heck you are so friggin’ excited about your job. Curious minds want to know how to replicate what you’ve done and CONGRATULATIONS!

If you CAN’T answer yes to these questions:

1) Why not?

2) When will you?

3) What’s your plan of action this year to improve your career?

I want to know what’s holding you back. Taking no action to improve your situation will pretty much guarantee that you have a similar (or worse) year. Your life is supposed to be fun. Really.

Comment below and contact me here if you want help making your dream job come true. Oh, and if you’re still in med school or residency NOW is the perfect time to plan your dream job so you can launch as soon as you graduate—even before completing residency if you want! Seriously.

Plus, if you’re premed and didn’t get accepted to med school (or if you are in med school and want to quit) you CAN still be a healer and get paid to treat patients without completing medical school (as long as you’re not planning to be a transplant surgeon or something super specialized).

Do not just sit on the couch and be sad or keep a job you despise. There is hope. Trust me.

Above all, do not end your precious life. We can’t afford to lose one more beautiful brilliant humanitarian to physician suicide. YOU ARE LOVED! The world needs you to be the amazing healer you were born to be.

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How to inspire 4000 doctors with one backpack (in 4 minutes) →

One-backpack keynote. How I inspired 4000 doctors in 4 minutes. True story.

Dr. Wible: 4 outfits for Las Vegas that I fit into my one backpack. This is it. And it’s showtime! With my PowerPoint on my Wonder Woman USB and magic backpack outfit #2. (Clapping) This is a medical system that needs to be disrupted. Backpack disruption! Into this one little backpack with 7 shirts, 2 vests 3 pairs of jeans, 2 trench coats, one coat, my bra, all these accessories and makeup. 2 pairs of shoes, electronic stuff, water bottle. 3 pairs of glasses, 2 pens into one backpack and getting on the plane in a few hours. How? Raise your hand if you’d like to know (clapping). Alright. Hey, I’m in the car with Jason who can’t believe this is the only luggage I have.

Jason: “I can’t believe it! I’ve never known a woman to pack 4 days in just a backpack. Amazing! You ought to give lessons.”

Dr. Wible: Jason, the reason why I have my backpack here is because I have some beautiful handmade designer clothing that I had to check at one point and I got it back after my last keynote. I got it out of the plane and it smelled like airline fuel.

Jason: “That happens more often than you think. I deal with a lot of people who fly and the horror stories of luggage ruined, pieces of clothing and such, you’d be surprised.”

Dr. Wible: You can’t risk it. Thank you for the ride!

Jason: Nice talking with you!

Dr. Wible: I don’t have to check any bags. No bags to check. Putting my bag through. I’m at United Airlines counter.

Flight Attendant: Please stow your larger carry-on luggage in the overhead bin and place smaller items under the seat in front of you. Stowing your rollerboards in the overhead compartments wheels first. Let a flight attendant know if you need any help.

Dr. Wible: Hey, I just got home and here is everything that I pulled out of my backpack: two trench coats, two vests, seven shirts, three beautiful necklaces, one bra, two pairs of socks, two pairs of shoes, four pairs of pants, a menstrual pad, some BandAids, some meds, my toothbrush, a bunch of little toiletries, here is my glitter, cases for three pairs of glasses, cords for cellphone, my favorite pencil, handmade wood pen, earplugs, some instructions for where to be so I don’t miss my keynote, seven packages of dried fruit, an apple, a tiny little thing of Tabasco, two Christmas gifts that I received, PowerPak little fizzy, two tea bags, money and receipts, two USB drives, a book that I highly recommend everyone read—An Inflammation Nation, that I got from my great friend, Dr. Sunil Pai, my watch, my lipstick, and two hair ties, my favorite coat that I just made. All this stuff (except for the cat) fit into this one backpack with three areas that you can store things in. Reaction Kenneth Cole is the brand so if anyone really wants to get a really good backpack that can fit a lot in. The side pockets basically there for the dried fruits and there’s a little pocket for your water bottle.

There ya go! You can be a keynote speaker on tour in the most amazing outfits ever—all without losing anything, ever having to check a bag. The crazy thing about this is that overpacked. Several items I never wore. I didn’t need half the toiletries. I brought everything I needed to bring down the house with 4000 doctors as the keynote speaker in Las Vegas.

Dr. Shaun McKee: This is the one lecture you should have seen! Pamela nailed it!

Dr. Wible: Keeping the theme of simplicity which was the theme of my speech, you don’t really need much. You actually can open your own medical clinic with two chairs, a piece of paper, and a stethoscope and if you’re a psychiatrist you can throw that out the door. With my life of voluntary simplicity, maximal joy and bliss through the roof. Launch your own practice! Live your dream! Don’t let anyone stop you!

I highly recommend that all doctors out there, don’t escape into side gigs. Stop running away. Stop using the bullshit term of burnout and get back to the reality of being a real healer. You can do it. On a few hundred bucks you can open your clinic like I did. You don’t need a whole bunch of stuff. You can friggin do all of this with your medical degree and a backpack. Don’t overcomplicate your life.

Need help packing for your next keynote, launching your dream clinic, or leaving assembly-line medicine? Contact me at IdealMedicalCare.org

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Love letters prevent suicides →

Could a few sentences on an index card save a life? Yes.

A once-suicidal teenager saved eight lives by attaching love notes to a bridge.

Could a loving note save a suicidal veteran with PTSD? Yep.

Sending caring letters is one of the only interventions proven in randomized controlled trials to reduce suicide among military. (With no adverse effects)

Doctors are the people veterans, teenagers, and others turn to when suicidal; however, physicians have the highest suicide rate of any profession. If we help suicidal doctors, they’ll be in better shape to help the rest of us. Right?

So how can a patient save a doctor’s life?

Could sending a thank you note to your doctor prevent suicide? Yes, it sure can!

I’ve spent the last six years running a suicide helpline for doctors. Physicians have actually told me that patient thank you cards have prevented their suicides. Some keep a stash of patient thank you notes in their desks to read in times of despair.

Turns out old-fashioned letter writing can save not only veterans and doctors. Caring letters prevent suicides in the general population all across the world.

To help prevent suicides among our healers, one amazing medical student I know has launched a compassion project in which doctors-in-training are writing anonymous love letters to each other then leaving them in medical schools and hospitals. Here are a few of their letters:

I’ve studied more than 1100 doctor suicides. I’ve interviewed families, friends, colleagues. I’ve read autopsy reports on doctors, their last texts and suicide letters.

What if your letter really could prevent a physician suicide? Would you write one? (Please know that compassionate letters are therapeutic for both the writer and receiver)

This holiday please join our doctor love letter campaign

Patients: After you open your presents, consider writing a few quick thank you notes to the wonderful emergency doctors (nurses, EMTs, veterinarians) who couldn’t be home for the holidays. Then drop off your cards at the local hospital.  Some folks in my town are doing this as a Christmas church project!

Medical students & doctors: Write about your struggles with advice on how you made it through a challenging time in your training or practice. Share a few uplifting words of wisdom for someone who may be in trouble now. Don’t be fooled—even “happy” doctors die by suicide. Give letters of appreciation to specific people or leave anonymously in special locations.

Surviving families: If you’ve lost someone to suicide in medicine, please know that there are many more struggling in medicine with similar suicidal thoughts and feelings. I encourage you to write the kind of letter that you wish your loved one would have received from a secret admirer—someone who understood his/her struggles and could offer insight, hope, and love. The kind of letter that might have changed the course of his or her life and prevented that fatal decision.

Daily I’m in contact with medical students and doctors who are in pain and struggling. If you’d like me to distribute your letters to those who need your words most, please mail them to:

Pamela Wible, MD
Doctor Love Letters
P.O. Box 5225
Eugene, OR 97405 

Note: If you mail me letters to distribute, either seal and indicate on envelope that it is for a medical student of doctor. Or you can leave letters open and then I can read and sort them to people who need your specific words most.


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America: 393,300,000 guns & 28,000 psychiatrists →

(Update to 2012 America: 350,000,000 guns & 47,000 psychiatrists)

 

Untreated mental illness + guns = predictable catastrophes.

America in 2018 = 307 mass shootings in 311 days.

This week a veteran with presumed PTSD shot up Borderline Bar & Grill. His Facebook declaration:

“I hope people call me insane… (laughing emojis).. wouldn’t that just be a big ball of irony? Yeah.. I’m insane, but the only thing you people do after these shootings is ‘hopes and prayers’.. or ‘keep you in my thoughts’… every time… and wonder why these keep happening…”

Shall we do what the shooter seems to be asking for—help those with insanity—or just hope and pray?

Or fall into our usual anti/pro-gun divide?

Let’s analyze the irony identified by the gunman before the devastating slaughter of 13 Americans.

Let’s dive into the uncharted territory of human psychology—the mind of a straight shooter before a calamity. His prophetic post may reveal the answer we’ve been seeking.

Because we the people are responding exactly as he predicted.

Vilifying the shooter as insane.

Offering victims our hopes and prayers.

Is this the best we can do?

They say insanity is doing the same thing over and over again and expecting a different result.

Yet we keep going round and round the same post-carnage questions: Where did he get the gun? Did he acquire it legally? What was his motive?

Rather than interrogate the shooter postmortem, let’s do a psychological autopsy on the living—analyze our response for clues as to why the killings continue.

I’ve got a unique vantage point on mental health care in America.

I was once a suicidal physician. Now I run a physician suicide hotline. I’ve spoken to thousands of suicidal physicians and investigated more than 1100 doctor suicides (some homicide-suicides). Doctors have the highest suicide rate of any professions. Even higher than veterans.

If doctors can’t get proper mental health care, will patients fare any better? Unlikely. Here’s why.

America has 393,300,000 guns and only 28,000 psychiatrists (that’s 14,046 civilian-owned guns per U.S. psychiatrist—up from 7447 guns per U.S. psychiatrist in 2012).

That means we’ve doubled the number of guns per psychiatrist in just 6 years.

Increasing firearms while decreasing mental health access is not a winning strategy.

Why do we have so many guns and so few psychiatrists?

We have a constitutional right to bear arms. We have no constitutional right to health care.

America is a world leader in mental illness. Most Americans will develop at least one mental illness. More than half begin during childhood. Yet more than half of our psychiatrists are on the verge of retirement.

Meanwhile America remains the most heavily armed nation in the world with 120 guns per 100 U.S. citizens—that’s more than one gun per person. Nearly half of all Americans have at least one gun at home.

The human brain controls the gun.

People will find a way to end their pain. A civilized society offers civilized solutions. A violent society offers violent solutions.

In America it’s easier to find a gun than a psychiatrist. Ammunition costs less than medication. No prescription necessary.

So who’s insane? The shooter? Or us?

(I’m not inherently against guns. I’m against untreated mental illness. And I’m against untreated mental illness + guns, pipe bombs, machetes or anything else that can damage life on Earth).

Pamela Wible, M.D., reports on human rights violations in medicine. Dr. Wible attends therapy weekly to maintain her sanity and wishes all Americans enjoyed the same luxury.

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