Monday September 17, 2018 was designated as the first National Physician Suicide Awareness (NPSA) Day in this country. All of us in the mental health community can be grateful for the pioneering and hard work of Dr. Loice Swisher, clinical associate professor in the Department of Emergency Medicine at Mercy Philadelphia Hospital, who took the lead in making this happen. She worked with the Council of Emergency Medicine Residency Directors (CORD) and the American Association of Suicidology (AAS) to set up a daylong series of informative interviews hosted on Facebook. She was assisted by Chris Maxwell, AAS communications coordinator and Ramin Tabatabai, MD, program director, emergency medicine, LAC+USC Medical Center in Los Angeles, California.
The interviewees included: Debra Houry, MD, MPH, director, National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention; Christine Moutier, MD, chief medical officer, American Foundation for Suicide Prevention; John Draper, PhD, executive director, National Suicide Prevention Lifeline; Perry Lin, MD, assistant program director, internal medicine, Mount Carmel Health System, Columbus, Ohio; Claudia Mueller, MD, Stanford Surgery and the Balance in Life Program; Chris Doty, MD, emergency physician and program director, University of Kentucky, Lexington, and president of CORD; and myself. All of the interviews can be viewed here: https://www.facebook.com/cordem.org/posts/1583131255045273.
NPSA Day is hardly a day for celebrating but I was in a giddy mood. I marveled at how far we’ve come since 1962 when my roommate, Bill, killed himself. He and I were both first year medical students. He took his life, ironically, over Thanksgiving weekend. His death catapulted our entire class into shock and sorrow. But what truncated and distorted our grief was the silence. We heard nothing from the Dean’s office or faculty. Grief counseling, critical incident debriefing, and crisis intervention were alien concepts and to my knowledge were not offered to medical students or residents who lost one of their own during the 60s, and especially after a self-inflicted death. Before the 1970s and the advent of the physician health movement, medical students or physicians who killed themselves were seen as outliers, flawed, not up to the task of surviving and thriving in medical school. I even remember overhearing a professor remark once that the empty seat in our class was a waste and could have been filled by someone who was truly committed to becoming a physician.
These memories and more gave me pause on September 17. I took time away from my usual responsibilities to take a long walk. I wanted to pay homage to the huge number of physicians I’ve treated over my long career. I remember so many who were struggling with suicidal thoughts and plans, their lives full of pain and fear and desperation. I am so grateful they entrusted me with their care, and gave me the opportunity to help them reclaim their health and functioning. But I recalled also the physician patients who succumbed to suicide under my watch—or whose demise I learned of later when they were no longer my patient. They will always stay with me. As clinician survivors, are we really any different than the families who have lost someone they’ve loved, or cared about, to suicide? That is certainly the way I feel about the physician colleagues I’ve known who have taken their lives. Grief has many twists and turns for each individual — but some bits are not distinct.
NPSA Day is many things but for sure it is a day of hope. Let me borrow the last few sentences from my book Why Physicians Die by Suicide: Lessons Learned from Their Families and Others Who Cared to explain:
“…. this challenge, saving the lives of physicians, requires building bridges and cooperative work. This means, at minimum, linking the expertise and dedication of trained professionals of many stripes and the words and actions of the many courageous grieving individuals who have poured out their hearts on these pages. We must continue to be candid and rigorous — and we must keep talking about a subject that, sadly, is not going away. When that day comes, and it will, we can be quiet.”
Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of 8 books, the most recent of which are "Why Physicians Die by Suicide: Lessons Learned from Their Families and Others Who Cared" and “The Physician as Patient: A Clinical Handbook for Mental Health Professionals” (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr. Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention.
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.