A doctor suicide is more important than a cookie recipe →

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I spent last weekend in NYC. I didn’t go to a Broadway Show. I didn’t go shopping at Tiffany’s on 5th Avenue. I didn’t dine at any fine restaurants. Instead, I sat at 515 W. 59th—the location of the most recent Sinai suicide.

A new attending physician—just four days into her position at the hospital—walked across the street to a building that houses nearly 500 doctors. At 3:30 in the afternoon she stood on the roof of the 33-story high rise in her white coat. Then stepped off the ledge.

I planted myself on the pavement where she died. I brought flowers and candles. I bought her Valentine’s Day hearts full of truffles. I arranged the beautiful bouquets from all across the country. And I eulogized her—and the others who died in the same spot.

I learned of her suicide an hour after she died from the wife of a physician—a busy mom with three little kids who was begging me for help. She broke away from her usual routine—baking brownies and reading bedtime stories—to snap this photo of the scene outside her window. Then she shared this:

“I posted a heartfelt note on a private Facebook group called ‘Lives of Doctors Wives’ with over 11,000 members with the KevinMD article and your own. Many women saw it and fiercely responded in rage about what happened and very empathetic to what I wrote and wanted justice for this doctor too. But get this—the admin on the group DELETES my post! Apparently you can’t post a ‘call to action.’ I’m so upset—this group only talks about cookie recipes. WTF. If you’re going to have a group called ‘Lives of Doctors Wives’ we need to talk about these issues, so much more important than trading moving tips, come on. Anyways fortunately SO many women posted separately with just a link to your articles and so the conversation is still going. They have so much praise for you in all of the comments. I was going to screen shot and send them to you till they frickin’ deleted my post.”

What was the call to action? To buy flowers for a doctor’s memorial? To bring a candle to a vigil? To discuss doctor suicide?

I’m no stranger to physician suicide censorship.

In July of 2017, my post was deleted and I was banned from Physician Mom’s Group—a Facebook group with > 60,000 female physicians who discuss everything from the most challenging medical cases to new business ventures. Women docs give and receive advice on book covers, clothing line launches, and, of course, cookie recipes. Here’s what I wrote verbatim about the forthcoming film by Robyn Symon—an Emmy winning filmmaker who has dedicated the last 3 years of her life to addressing our doctor suicide crisis.

“Morbid post. Need help. We are designing film poster for Do No Harm film to prevent doc suicides and we’ve got an internal dispute about BEST angle for slitting one’s arteries for suicide. Here are two versions. Definitely appreciate any help. Specifically what angle would a doctor use? Thoughts?”

In the midst of a lively conversation with nearly 150 comments my post was deleted and I was banned from the site.

Kicked off PMG - 2017-07-22 at 3.30.08 PM

On 11/8/14 after medical students shared that my blog “How to graduate medical school without killing yourself” actually saved their lives, I shared it on the Student Doctor Network. I had previously attempted to share information on medical student suicide prevention. Apparently I’m not allowed to post blogs (or excerpts from my blogs) on doctor suicide—even if information can prevent suicides of their own members on Student Doctor Network. So I was banned.

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Then my book was banned from an anesthesia department. After the suicide of a former internal medicine resident and an anesthesiology resident at a prominent US hospital (in which no grief counseling was offered) an attending purchased 6 copies of my book Physician Suicide Letters—Answered to distribute to her residents. She was summoned to the office of the division chief who stole the books she had left for residents in the anesthesia workroom and told she was not to distribute these books to the residents.

After being invited by the AMA to deliver my TEDMED talk, I was disinvited shortly before the event because they were “uncomfortable” with the topic of physician suicide.

I write and speak on many topics. Somehow only the doctor suicide content keeps getting deleted and banned.

I am eternally grateful to those who have stood by me during the past 5 years in my quest to save doctors’ lives— Kevin Pho MD, The Washington Post, Medscape and TEDMED. Thank you for never censoring lifesaving content from your sites.

Censorship and secrecy will not solve our suicide crisis.

For those who are still uncomfortable with the truth, try a few of these:

Anti-SuicideRecipe

Want the ultimate in free speech? Liberate yourself from assembly-line medicine. Launch your own practice. Learn how to be the doctor you always imagined at our upcoming seminar. Can’t wait? Join the Fast track.

Tags: medical student suicide, Mount Sinai, Mount Sinai Suicides, NYC doctor suicide, resident suicide

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My eulogy to Dr. Deelshad Joomun →

DeelshadJoomunMD

Tonight we gather as a community. Each of us to shine our light on the most recent suicide. On the life of a brilliant, loving, kind woman. A woman who dedicated her very life to helping and healing others. As a doctor.

Dr. Deelshad Joomun was not just a doctor. She was one of the first interventional nephrology fellows—and more importantly the first female one. It was not an easy road and she carved her path largely on her own reaching the pinnacle of success. Yet one week ago standing in her white coat on the roof of this 33-story building housing hundreds of hardworking doctors from Mount Sinai hospital, she stepped off the ledge.

Tonight we stand on the ground where her heart stopped. To celebrate Deelshad. Her very name means “happy heart.” An idealist, an inspiration to all, humble despite her massive success, she was never one for the limelight. Yet her life and death must not remain in the shadows.

Though first in her field, she is not the first doctor suicide at Sinai. In less than two years, three brilliant young women leapt to their deaths. Two right here.

As we pay our respects to all three—to Esha, to Kathryn, and to Deel—we also shine our lights on all the invisible ones. The hundreds of thousands of doctors who have gone before them. I was almost one of them. Though I survived, I’ve lost countless colleagues to suicide.

To heal it will take courage and community

Courage means to lead with one’s heart. And we must each have courage. Courage to stop blaming the victims as sad and weak. Courage to do more than just send another “tragic loss” email. Courage to confront institutional censorship and intimidation. Courage to fully investigate each of these suicides.

And so we gather and grieve as a community—not just Mount Sinai. Not just New York City. More than one million Americans lose their doctors to suicide each year. This is also a global public health crisis. Many die a direct result of their training—institutionalized cruelty with rampant human rights violations illegal in any other industry.

I’ve written about Deel’s suicide. Now with 20,000 Facebook shares. These flowers have been sent here from grieving people from all across the country and the world. And we must grieve as a community because the loss is far reaching. These suicides can no longer be hidden in a private funeral for the family.

Now the world is watching.

Nearly 500 residents in this building—neighbors and her friends—saw her dead body outside their windows. People on the sidewalk who screamed and called 911. The building super, the man at the concierge desk who knew her. Sinai staff and nurses now whispering in hallways (all told to keep quiet, not speak to reporters). And the thousands of patients she cared for now wondering what happened to their beloved doctor. They all must be allowed to grieve with us.

And there is another group that is watching—the depressed and suicidal doctors from all over the world who are living with the same agony. They are on the ledge now. Doctors who write begging me for help because they “don’t want to be the next one under the tarp.”

We can no longer cover up our doctor suicide crisis with a tarp and silence. We can no longer discard our doctors into body bags without investigation. We must all stand up for our brothers and sisters in medicine who walk into our hospitals and clinics everyday to so selflessly serve others.

May Deelshad rest in eternal peace and love.

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Previous articles on her suicide: Suicided doctor: covered with a tarp—and silence. Also on KevinMD. Doctor suicide: where are the vigils, cards & flowers? Refinery29 reports This hospital has a physician suicide problem.

Tags: Deelshad Joomun, Mount Sinai doctor suicide, Mount Sinai resident suicide, Mount Sinai suicide, NYC doctor suicide, NYC physician suicide

53 Comments

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Doctor suicide: where are the vigils, cards & flowers? →

How-We-Honor-Our-Doctors-Wible

Two days ago a beautiful young doctor jumped to her death beside her NYC hospital. A resident in the victim’s building writes:

“I first heard of this tragedy from your Facebook page. I am so disgusted by the silence. I am having a hard time understanding why there are not flowers by where she passed. I don’t understand why there wasn’t a candlelight vigil marking the tragedy.”

I’ve spent 5 years studying 757 doctor suicides. I’ve yet to see any doctors piling up flowers in front of the hospital for their dead colleagues. Or any patients leaving cards of appreciation and love for their dead doctors. Or any hospital CEO or staff holding candles while crying and hugging each other at midnight vigils. Why?

How should we respond on a medical campus when a doctor who has dedicated her life to public service dies by suicide? Surely there should be a public memorial on the sidewalk or fence where hospital staff and patients can leave balloons, handwritten notes, candles, and photos.

Grieving among community is how we heal from unexpected tragedies.

At the residency hospital where I trained, here’s the grassroots memorial for Congresswoman Gabrielle Giffords after an assassination attempt:

Gabby Gifford UMC

Seems every week communities are publicly grieving shootings. Since 1980, we’ve lost 379 people in the US to school shootings. That’s less than the number of doctors and medical students we lose to suicide in one year. Look what we do for school shootings. We shut down the schools. We let everyone go home. We put flowers on the doorstep of the school. We put teddy bears in the fence. We call in counselors from all over the place to come and help our students. We go to the local church and hold candles. On national news we are crying and hugging. We don’t do anything for medical students. Or doctors.

Seems we live in a word full of public memorials for everyone. Except doctors.

Here’s a ongoing memorial for a Swedish teen who took her life in the ocean in 2013.

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For 10 years, I pass by this ghost bike for Oregon cyclist David Minor every time I go downtown.

David Matthew Minor Ghost Bike

Here’s an Oregon roadside memorial to fallen policeman Kelly James Fredinburg.

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And a memorial for actor Robin Williams who died by suicide.

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Last Tuesday Washington State University quarterback Tyler Hilinski died by suicide. Here’s his memorial near the football stadium.

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Two days after Tyler died, a Mount Sinai doctor jumped to her death next to her hospital. I know who she is though her name still has not been publicly released. There’s no memorial. No cards. No flowers. No candlelight vigil for the woman who devoted her entire life to healing others. Here’s how we treat doctors who die by suicide.

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I have one request: If you live near W. 59th St. at 10th Ave. in NYC and you pass by this spot, please leave a note, a card, or a flower for this forgotten physician. Thank you.

If you’re a physician or med student in NYC who is distressed by this suicide, please call me at 541-345-2437 or contact me here. I wish to gift you a 100% confidential off-the-grid (no EMR!) Skype or phone session with a resident physician mental health expert. Plus I’d love to talk to you too.

UPDATE: As of Sunday afternoon one woman has left a bouquet for our fallen physician.

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Sunday (3 days after her death) now 4 bouquets:

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Monday 1/22 afternoon:

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Tuesday afternoon bouquets arriving from all over the USA. Call Flowers by Richard 212-582-3505 to order a bouquet of flowers to honor this brilliant and beautiful young doctor.

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Wednesday (1/24) more bouquets.

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I’m sitting here on the pavement where we lost this beautiful doctor preparing for our vigil tomorrow. Please join us in honoring Dr. Deelshad Joomun on Friday, Jan 26 – 6:00 pm Candlelight Vigil at W. 59th St. & 10th Ave. Saturday, Jan 27 – 1:00 pm Memorial Walk & Press Conference – 1:00 pm gather here to place flowers & cards at memorial site. At 2:00 pm we will host a brief service and then walk to 440 W. 57th Watson Hotel Renaissance A where we will continue to celebrate her life and honor those who have died before her (until 10 pm so come by when you can).

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On this frigid and windy night I lead a vigil for Deelshad Joomun MD (read eulogy here). More than 33 people attended.

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Please also read: My eulogy for Dr. Deelshad Joomun and Suicided doctor: covered up with a tarp—and silence. Refinery29 reports This hospital has a physician suicide problem.

Tags: Deelshad Joomun, doctor suicide, Mount Sinai doctor suicide, Mount Sinai resident suicide, NYC doctor suicide, residency suicides

71 Comments

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Suicided doctor: covered up with a tarp—and silence. →

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Yesterday afternoon another young doctor jumped to her death in NYC. She landed at the entrance of the building where she lived.

Within less than an hour, I received the following emails about her. All published with permission.

“Hello Pamela, I am not a doctor, but a mother of 3 and a wife of an resident physician. Tonight I watched AGAIN the police taking the body of another female doctor—lifeless—into a body bag. Two doctors died from jumping off our 33-story building in 2 years and no one seems to care. The hospital and everyone is so silent. They cover it up. No one talks about. Someone dies and everyone puts their heads down and ignores it and are told by the hospital to keep quiet—especially to reporters.

Thank you so much for your blog, public speaking, and advocacy. Since I’m not a doctor, there’s only so much I can understand about what my husband is going through. Discovering your blog has helped me know how to help my husband in so many ways. I worry so much about him. When we’ve tried to seek mental health care, we’ve had to be top secret about it. It’s insane. I’m tired of seeing dead bodies out my window. I’m tired of being on the sidelines. I’m feeling so angry and upset. I feel so powerless. What actions can I take to make sure I never see something like this happen again? Words can never describe how it feels to see a dead body outside your window. A beautiful lifeless body of a beautiful doctor.

This is what I saw when I came home tonight—a dead doctor lying under that tarp—lifeless in the freezing cold. What I am suppose to tell my daughter when she asks, ‘Mommy what’s that?’”

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Email #2

“I’m a physician. I have a career ahead of me, which I’m too scared to speak out against. I came home again to another suicide. Another doctor dead from Mt. Sinai in NY. I think NY is a horrible place to work. Conditions are deplorable for doctors and you should investigate. Both suicides were horrible—jumped from our high rise. I’m convinced it’s the exhaustion, the demands to perform at 100% 24/7 to meet ridiculous administrative and FINANCIAL demands. We need to change healthcare. In NY doctors are blamed for everything the nurses, techs, janitors, staff don’t do. We have to do every job AND document and be nice 100% of the time. Everyone is protected by unions—except doctors. We’re criticized and destroyed with unbelievable debt. I don’t know why anyone would willingly go into this field. I love what I do, but I have grown to hate this system. I have lived in a culture of shame for too long. Would you please expose these Manhattan hospitals? They lack compassion. They are all obsessed with finances, prestige and scores. This suicide today was horrific. I came into my building—a crime scene. Don’t let another doctor’s life go unspoken for. They will likely say she was troubled, but why was she troubled!?? Because she wasn’t efficient enough? Sad and overworked? Our hospital will make it about her. Like the girl that died last year, she was too sad.”

Then I got an email that truly shocked me.

I do not have permission to publish this one so I won’t. I will say that it came from a man who I deeply admire, a man who is a health system executive in NYC. He wrote me in distress about the loss of this young doctor. He explained that hospitals investigate why things go wrong in patient care and lessons learned are shared to improve processes and prevent future deaths. When a doctor dies by suicide, how are we to learn from this tragedy if we don’t study what went wrong? Police don’t investigate suicides. Investigation is left to grieving family and friends. Don’t we have an obligation as a society and as medical professionals to understand why these suicides occur? He concludes, “If this were a patient, we’d be all over it and so would the regulators.”

A few hours before this flurry of emails, I was on the phone with a doctor who reported that her own family physician shot herself in her clinic. The doctor who called me disclosed the she had never been suicidal herself—except once, during residency for about 15 minutes. In an impulsive move she went up to the roof of her 5-story hospital. Standing on the ledge, she recalled a lecture in which she was instructed that to assure death one must jump from at least 6 stories. So she paused. Then turned around and went back to work.

Now to answer the questions posed to me by the doctor’s wife, the physician, and the hospital executive. First, I believe we all have a common goal—to end these suicides.

To the wife of the resident physician who asks, “What actions can I take to make sure I never see something like this happen again?” I say talk about these suicides. Secrets will not save us. Organize a support group for physicians and their spouses. Don’t wait for another fallen physician. Channel your passion into action. Reach out to others in your building in a way that inspires and fuels you.

To the doctor who asks, “Would you please expose these Manhattan hospitals?” I say that as doctors we must all speak up about injustice, human rights violations in medical education, and deplorable working conditions in our first-world hospitals. It’s not just Manhattan hospitals. Doctors and medical students are dying by suicide throughout the United States and the world. This is a global epidemic.

To the executive who asks, “Don’t we have an obligation as a society and as medical professionals to understand why these suicides occur?” I say yes. I hold our medical system to the highest standard when it comes to protecting human life—and that includes the lives of our doctors. As a society we must understand that this is a public health crisis. More than one million Americans lose their doctors to suicide each year. We can no longer cover up these deaths with tarps and silence. We can no longer walk away from the very people who have dedicated their lives to serving others. It’s just wrong.

“How are we to learn from this tragedy if we don’t investigate?” Without an investigation, history will repeat itself. More doctors will plunge to their deaths from hospitals and resident housing complexes in NYC. If we don’t investigate this death, we are each complicit in the loss of future physicians to suicide. Now is the time for fearless leadership, for the heroes among us to reveal themselves and take a stand for our doctors—for the men and women who walk into our hospitals everyday to so selflessly serve others.

My question to you is “What will you do to prevent the next doctor suicide?

Need help?

Physician Suicide 101: Secrets, Lies & Solutions

What I’ve learned from 757 doctor suicides

Contact me anytime. I’m happy to speak to you. Plus I’m gifting a confidential therapy session with an expert on resident mental health to anyone impacted by this tragedy.

Addendum: Doctors were working in the hospital right next to this building and could see there was a woman preparing to jump. They witnessed her fall. They knew she could be one of their friends (since the building houses primarily doctors). Yet these doctors had to continue to care for patients amid their tears and screams at the window. Many have flashbacks to colleagues that jumped from same building in previous years. “It is always the same thing,” says one resident. The hospital sends the usual ‘we’ve had a tragic death’ email. They tell us to meditate, sleep, and hydrate.” Then it happens again.

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Please also read My eulogy to Dr. Deelshad Joomun and Doctor suicide: where are the vigils, cards & flowers? Refinery29 reports This hospital has a physician suicide problem.

Tags: Deelshad Joomun, doctor suicide, doctor suicide january 18, NYC doctor suicide, NYC physician suicide, physician suicide, physician suicide January 18

47 Comments

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Top 10 Lies Doctors Tell Themselves →

I’m Dr. Pamela Wible. I run a suicide helpline for doctors. I hear from a lot of physicians with distorted thinking patterns that limit our ability to reach our full potential as healers on this planet. Recognize any?

1. “I’m stuck in assembly line medicine.”

A common complaint across all specialties. I want to assure you, whether you are a GP, primary care doc, or specialist—this is a myth! I helped a child psychiatrist discover that this was not true. Even though she had had a challenging fellowship and then ended up in a very big hospital, where she was told, “There’s absolutely no way as a child psychiatrist that you can work outside of the system.” When she decided that she was going to go out on her own, she was pleasantly surprised to discover that she wasn’t stuck. Not only was she not stuck, she could thrive. And she has a thriving full practice—with a waiting list. Never put up a website. Doesn’t even take credit cards. BONUS: The CEO and top-tier managers at the hospital system—the administrators that were hassling her so much about how she was gonna fail—they actually bring their kids to see her. How about that!

2. “I’m not smart enough.”

Med students and physicians are in the top 1% of intelligence, compassion, and resilience on the planet. You’ve been valedictorian, president of all these clubs. The smartest one in the room. You’ve lost your confidence during training. When overworked, lacking emotional support from peers (amid intense competition) with accelerated perfectionism kicking in, you may feel like you are not smart enough to be a good doctor. If you made it into med school, you are very smart. You just need a safe educational and work culture that supports you.

3. “I have no power.”

You’ve got a mortgage to pay, you’ve got administrators down your throat. Family, spouse, kids. You have a lot of obligations. You start to think that your life is not your own, but you do have power. I felt the same way. My contract was up, I was the only breadwinner. I finally decided, “I don’t have to put up with this shit.” I took my career into my own hands—opened my own practice. This was back in 2005. never been happier. I cut out the middlemen, and I literally got my power back by removing all the people in my business life that were sucking my power from me. They’re like little parasites and you’re supporting them with the revenue you’re generating per minute. Sometimes upwards of 85% is going to them. Why not cut them out of the formula? Which is what I did. My overhead went from 74%, to about 10%. I was suddenly making as much as I was earning at my full-time job, working part-time on my own and having the time of my life. Remove disempowering people and organizations from your life and you will rediscover your power.

4. “I’m burned out.”

You are not burned out. You have been abused, manipulated, and you have experienced human rights violations in your medical education and training. We are so conditioned to blame the victim because if I tell you, “You’re burned out. It is your problem.” The reason why this gets under my skin, is that people start to think that they’re defective when they hear the word, burnout. That defective feeling leads to additional negative patterns of thinking in which you feel like you don’t belong. You’ll never make it as a physician. You don’t even belong on Earth. You’re not even helping your family. You might as well kill yourself. Blaming victims sets some on a path to ultimate self-destruction— suicide. Let’s use proper terminology. Stop the lies. Stop calling yourself burned out—when you’ve been abused, manipulated, and have literally survived years of human rights violations.

5. “I must overwork and overextend myself.”

Workaholism, alcoholism, self-medicating are the top coping strategies that we, as medical professionals, use to deal with unrealistic work demands. We subscribe to an impossible work ethic. We glorify overwork and start to believe, “In order to get everything done to meet expectations and deadlines, I have to overwork.” Your belief enables the lie to continue. Put yourself first. Take your life back. Don’t participate in self-destructive work habits. Stop believing in magic workaround gimmicks that only enable you to stay trapped in a toxic work environment, just reshuffling deck chairs. If you continue to overcompensate, overdo, overextend yourself—you can never win. Crazy thing is many doctors’ solution for overwork is to (surprise)—work harder! “I’m exhausted. I’m tired. My office isn’t working. I’ll get another phone line. I’ll get two more receptionists. I’ll add three more patients per day.” Your solution to overwork, if it’s overwork, is probably not going to work. Overworking will only lead to self-destruction. Step back. Say no. Set boundaries, Liberate yourself. You can be free.

6. “I can’t get confidential mental health help.”

Yes you can. There are so many off-the-grid options. Though you may always be at some risk with your mental health records inside an EHR, many psychologists and counselors do not use an electronic record. They keep paper charts, and they’re 100% confidential. You have many off-the-grid options that you may not be aware of so check out these 13 tips for 100% confidential mental health care.

7. “I’ll go broke.”

Don’t believe that in order to pay off debt, maintain your medical license, you have to stay in assembly-line medicine or your big-box job. Many docs find when they get a small space (even go 100% virtual), get rid of all of the administrative middlemen, and just provide health care on their own terms with low overhead—they can double their income and work fewer hours. I started my clinic for less than $3,000!

8. “It’s the system.”

We spend so much time vilifying and demonizing insurance and pharmaceutical companies, clinic managers, hospital CEOs—that we remain victimized and don’t take our own lives back. Once you realize that you have the power to practice medicine on your own terms, you end up way more successful and financially secure. You sometimes realize, along the way, that you are the problem. Your psychology has likely been the biggest obstacle to your success.

9. “Nobody cares.”

So many people who want to share your vision—support your dreams. They just need the invitation. So much of the time we isolate and we don’t communicate. We tell ourselves nobody cares. When we share our vision, we get brave enough to invite others to join us, we discover that there’s power in collaboration. More people care than we recognize. Real-life examples of the power of community: 1) I just sent a $10,000.00 check to a new doctor who inspires me in North Carolina. She’s opening up a clinic in her farmhouse this July when she finishes residency. There are so many people that want to help you. 2) Another doc got a $100,000.00 check from a philanthropist in upstate New York to open her clinic. People will jump out of the woodwork to help you. You have to believe in yourself first and realize that people care.

10. “Nothing will ever get better.”

I’m here to tell you, you are not terrible. You have not screwed it all up. It doesn’t matter if you’ve lost your license, made unethical or illegal mistakes, or missteps. It can and will get better. You just need help in strategic planning. You need to be willing to embrace change, instead of resisting it. And when you do that, through acts of courage and bravery, usually that start by telling yourself the truth. Not participating in the lies that we tell ourselves, you begin to personally and professionally experience what it’s like to have things get better, not worse. You absolutely can create for yourself, what you want your practice to look like. We are totally living in a time when huge disruption and innovation in medical practice delivery is happening—right now. Don’t miss out. Ask for help. You are not alone. Your community cares. Your loved ones care. I care. You can call me 24/7. You are a brilliant, capable, amazing person Stop selling your soul. You went into medicine with high hopes and dreams and you can absolutely be the doctor you described in your personal statement when you entered this profession.