“I don’t want it to be a secret that Andrew committed suicide. If more people talked about what leads to suicide, if people didn’t talk about as if it was shameful, if people understood how easily and quickly depression can take over, then there might be fewer deaths. His four children and I are not ashamed of how he died.” ~ Susan Bryant, wife of Dr. Andrew Bryant
We need to talk about such shocking loses within the medical community in order to help, prevent and make sense of physician suicide. The above is an excerpt from a letter Susan Bryant, wife of gastroenterologist Dr. Andrew Bryant, wrote following his recent suicide in his office. I have so much admiration for this woman I have never met. I first heard about this letter from Dr. Eric Levi on Twitter @DrEricLevi this week. The impact of sharing Susan’s letter within the medical community soon became obvious.
The letter appeared elsewhere including the Brisbane Times where Andrew’s son said: “Please look out for your friends, family and those you care about, and share this message if you need to,” her son John wrote. “Check to see if they are okay. It could make a world of difference … It cannot be taboo.”
We don’t want to hear that anyone dies by suicide. When a physician dies in this way, it seems harder to make sense of. We are trained to save lives, not end our own. But we must remember that a physician is a human being first and not immune to the suffering a person may face in life.
Looking out for one another
This week, I read another article about a physician suicide, a general surgery resident, written by a fellow resident Ankit, in the In House online magazine simply titled Suicide. The resident who died was often looked upon as lazy, and someone others didn’t want to work with. He always scored well on exams, but by description, it appeared his professionalism was in question. This is usually a sign that the person has personal struggles and needs help. It may be difficult for a physician, for a variety of reasons, to do so. In some cases, just checking in with one another can be all it takes to pull someone out of a dark place. “Is everything okay?” It may or may not help, but this simple question is well worth the effort of asking.
When my husband Colin worked in a small radiology group practice, a retired radiologist Owen*, who still helped out reading films now and then, died by suicide. He lived alone, had lost a lot of money during a painful divorce, was estranged from his family, and was likely lonely given his social circumstances. In Owen’s case, one of the nurses at the hospital often checked in on him to see if everything was okay and let him know she cared. Ultimately, it was her concern that led to the eventual discovery that he had died by suicide at home.
Owen’s death occurred relatively early on in our career and unfortunately was neither the first, nor the last, physician Colin and I knew of that had died by suicide. Often, this truth is hidden out of shame, but as Andrew’s wife Susan said, “I don’t want it to be a secret”. Awareness is one of the main tools we have to encourage people who may need help to reach out.
* name has been changed for privacy reasons
Following a suicide
When someone we know dies by suicide, the language we use is important. We often use the term “committed” but this is immediately a negative connotation. This sounds like ‘committing a crime’, inappropriate and stigmatising in the context of someone ending their own life. The article “Suicide and Language: Why We Shouldn’t Use the ‘C’ Word” provides some appropriate terminology to replace words such as “committed”:
Many resources and supports are available for those left behind after suicide. Avoiding contact with the loved ones left behind only leads to more negative feelings such as blame. If you can, let them know you are supporting them just as you would following any loved one’s death.
I am only touching on a few points related to suicide, in particular physician suicide. If you are concerned about someone, or you yourself need help, please contact a local mental health organization, crisis centre or physician health program for assistance.
Out of the Shadows: Shining Light on Physician Suicide – PFSP Perspectives
Suicide Prevention is Everyone’s Business – Centre for Suicide Prevention