Heroic doctor’s heart-wrenching letter

Most heart-wrenching e-mail I have ever received. From a true hero, Dr. Varun.

VarunLovePic

November 18, 2014

Dear Pamela,

Hi, der. I don’t know how thankful I am to you for writing that article on physician’s suicide. I really wanted to hug you after reading it. I had really rough day after seeing 130 outpatients and around 60 admission emergency in a 12 hour duty. I work as a final year MD internal medicine resident in one of the busiest hospital in India. I saw a part of myself in every page of your article  Just couldn’t stop reading the article. It is 3:00 am in the morning here and after a physically and mentally demanding day of work and studies reading your article was the best thing today.

It takes me 5 hours by flight to reach my home from my hospital. I have my wife and 6 month old son (whom I been with for 15 days since his birth) at home. I work day in and out just to be with them once in 3 months. I don’t see my colleagues smile, I hear my patients misery every day. I smile and crack jokes even when I am sad so that I can bring some joy into my patients sorrowful life.

Today I saw this patient who died, married with a son, the only earning member of his family …….his widow just wouldn’t accept that he was dead. She kept talking to him. I just didn’t know what to feel ….. I was numb for a minute thinking what if that was me …. And the kid is my son…..

I see deaths everyday in ward …..I don’t know if you would believe me, but 4 deaths per day in a single ward of 40 beds overcrowded to 125 patients admitted at a time. Two patients on a bed, two lying together on the floor. Poverty, misery and pain all around. I have declared 12 patients dead in a day during one of my duties. I just don’t feel death anymore, just don’t feel human. My uncle died recently, I felt nothing deep inside just some memories and that is it.

I write this mail hoping that the way I survive my day would help you in helping others.

I always wish my colleagues and say hi when I see them in the morning. Say hi to everyone from my ward sweeper to the guard in the ward. I never eat alone and always make sure I share my food. I always smile whenever I talk to my patients. I hold their hands when I talk. Listen music whenever possible. And everyday whenever possible I talk to my wife, father, mother, and brother (all of them are doctors).

But still this profession demands too much from us. I have thought about giving up and suicide a thousand times ……the misery was too much for me to see 12 people die in a day. The only thing that keeps me moving forward is my family and friends.

I appreciate what you are doing. It took me 4 hours to write this mail. It is 7 am in the morning. But your article was worth it. Thank you. Thanks a lot…..

Dr. Varun

Varun died by suicide on June 14, 2016.

The world has lost a beautiful healer. RIP sweet, sweet soul.

Dr. Varun’s letters published in Physician Suicide Letters and his words recited on the TEDMED stage:

Pamela Wible, M.D. is a family doctor who is dedicated to physician suicide prevention. Please be kind to your doctor. The life you save may save you. Photo credit: Dr. Varun (and his newborn son). If you are suffering, please reach out for help. Contact Dr. Wible.

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46 comments on “Heroic doctor’s heart-wrenching letter
  1. Ann Cordum says:

    You are making a difference Dr. Varun. Peace and healing be with you.

  2. That adds a lot of perspective for us in North America. You are definitely coping well under unreasonable circumstances.

  3. Judy says:

    Thank you for staying human in conditions that are so difficult. We are proud of you.

  4. we are not trained to care for ourselves or our patients we are trained to treat the result and not the cause. when you become a doctor because you care about people you are in deep trouble but when you learn to help them to live things change for you and them.

    • Shanhong Lu says:

      It is so good to see you are still here contributing to the health care shift: shifting to root causes and shifting to healing, not just managing sickness!!! Love it.

      I am in love with my life as an integrative physician: addressing stress, negative emotional and energy crisis and immune chaos due to toxicities….

      I also believe physicians and patients and the wellness participants must build their own circle and their own system where financially everyone is involved with this so called “people lifting people business of abundance and growth”.

      Finding balance in a medical life is only possible when we actually can afford to pay ourselves, take time off when we need to without getting deep in debt. I am so blessed to have found the way.

  5. Chieftb says:

    Reading this is so poignant. We physicians need to focus on self healing and self reflection rather than ICD10, HIPPA,ACOs and how much money our specialty societies can garner for us. I think in the USA, burnout is very different from the burnout this doctor expresses. Either way it’s burnout.

  6. Dawn Lovisa says:

    My heart goes out to you Dr. Varun. Thank you for writing to Dr. Wible. We need to share our stories and be here for each other.
    With love,
    Dawn Lovisa, FNP

    • Shanhong Lu says:

      When we make a shift from sickness maintenance and emergency chaos, we will truly be doing a good job. Prevention and wellness business is way more rewarding and bless those who are at the front of dying….. letting go and helping people making this transition in a more human way will save everyone the agony.

      We all have to go one day, the great news is that death is actually not hard. I strongly recommend “Dying to be me” A great book!

  7. Howard Stein says:

    You are beyond strong, my friend. Your insight and manner of coping seem to have served you well, and despite your feeling numb towards death even when it hits close to home, I would bet there is a deeply caring soul inside. It shines in your letter. I hope you continue following your heart and find a smile in every day.

  8. cathy says:

    What a beautiful picture! What a sweet baby and one can see the love you feel for this baby on your face. Your story is incredible, with what you deal with on a daily basis. You are so wonderful to help them, to make a difference, so do all you can and beyond with your limited resources. You are so inspiring. Please take care of you. 🙂 cathy in canada

  9. Dear Dr. Varun,

    Your workload seems almost too extreme to be conceivable. But one must suspend disbelief in this world of incomprehensibles. I applaud you for your compassion and resiliency. And I hope in this increasingly connected world that we as physicians can support one another in restoring sanity to our professional lives from those who are in med school and residency as well as those established in medical practice.

    It’s hard to know what you can do to change your particular circumstances but one suggestion I have at the outset is that you need to support of your fellow residents, even if it is limited to an online dialog. Hopefully, your fellow residents in your program can come together in some meaningful way – to support each other, to validate the seeming impossibility of the challenge before you, to debrief the anguish …. They too must be suffering, and barely coping, in silence.

    Please – use all resiliency skills available to help you manage through the time of your departure from your residency program (e.g. journaling; dialog; diversion; fundamental biologic needs etc.). The world is in desperate need of compassionate healers.

    And – when you’ve gotten some breathing room and some replenishment – I hope you’ll be a part of an international movement that compels change in this very sick system and enables those who have chosen the healing profession to stay healthy themselves and insist that mechanisms be put into place to facilitate that.

    At this time of increasing international strife, we need to find a way to support each other in fulfilling our profession’s shared oath – to master our craft so that we may expertly and compassionately treat illness and injury, alleviate suffering and foster all that will enable people’s health and well-being.

    I hope this will be the beginning of a larger dialog.

    Kindest regards and wishing for your and your family’s wellbeing.

  10. Barbara Mack MD says:

    On this Thanksgiving Day, Dr. Varun, I am grateful to you. In spite of the misery and suffering you witness and experience on the other side of the earth, you are still able to bring some kindness to your patients. Even if it is at the end of their life, and you can do nothing to save them, I am certain that your smile and kind words bring them some comfort they just would not have if not for you at their side, holding their hand. I hope you will soon be reunited with your family.

  11. Julie Greene says:

    Thank you for sharing this letter. I have experienced being a patient in the US system and in a South American country I now call home. What matters isn’t how “advanced” the medical facilities are, but the degree of caring. Even crowded conditions can be manageable. I was hospitalized here on an emergency basis recently for kidney problems. I was in a room with 12 beds. That’s a guess as I never got around to counting.

    The doctor, a sixth year medical student, was upfront and honest with me. He was respectful and a good listener. He considered various possibilities and wasn’t quick to judge. He was NEVER dismissive. He always sat down while speaking to me. Because I’m from the USA, I’m accustomed to being looked down on with by some haughty know-it-all. Not one of the personnel who treated me were at all like that.

    In the USA, you might get a private room. Know what that means? The potential for patient abuse is much higher. Abusers love the absence of witnesses. “Newer, better drugs” means forced and coerced drugging is on its way, all for the profit of Big Pharma. No thanks.

    It sounds like Dr. Varun is certainly a caring and compassionate doctor. I guess you gotta work with what you have. That’s true for all of us. And work for change if you feel the calling to do so.

    It’s Thanksgiving, which we don’t have here. I’m glad. I spent my last ten Thanksgivings alone anyway. I’m thankful I left the USA. It was a change, a big one. I am not the only one here from the USA who left to escape unwanted, forced medical “care.” It was the right choice for sure!

    Julie Greene and her little dog, Puzzle

  12. Mike says:

    Look up Einsteins quote on counting what counts, first step; count what’s important. Births, saves, close calls, count what’s in the positive and productive. Since we can’t go back in time counting deaths is pointless. By counting smiles you see more than we think. By looking for red flowers we see more the brain is the most powerful computing system we know of …only when it’s focused. Focus on present and future your efforts will keep your path in focus your brain on task and joy is possible. Peace to all

  13. Dear Dr. Varun,

    Thank you for sharing your life and situation with Dr. Wible, and with us. I am in awe.

    You write: “The only thing that keeps me moving forward is my family and friends.” How wonderful that you’ve created — and continue to maintain — those relationships! Every single day we have opportunity to move towards isolation, or move towards connection. Each tiny interaction matters. You are clearly a connector, and this is essential not only for your patients, but also to preserve your own life and heart. The larger community of physician healers also needs to know this, if they’ve forgotten.

    Let the wonder of being alive also be nourishing for you, just as I can see it is for your tiny son in the picture. Your gentle spirit shines through your writing and in your own photo too.

    You’ve just enlarged your circle of friends, Dr. Varun.

    Be well, and thank you for your service.

  14. Kristy Cowherd says:

    Beautiful!!!

  15. Paula says:

    Dear friend,

    I too am a physician who had contemplated suicide. I would never have gone through with it because I knew my untimely death would be a devastating loss to my family and friends. As an alternative, I then thought about retiring from medicine. However, with support and encouragement from my loved ones, I did not give up on my dream and passion. After years of sorrow, I am now working as a geriatrician and loving it.

    Previously, my heart was broken and contracted – I experience ectopy throughout the day and night. Now my heart is expanding. I feel more love and compassion for others, which has allowed me to respect myself again. I am so grateful and happy, and I am proud to be a doctor.

    Suffering is temporary, but loving relationships are eternal.

    You were, are and always will be an amazing human being. I wish you much love and strength in your life and work.

    : ) Paula

  16. William Stueve says:

    He has a hard life in difficult circumstances, but in a way I envy him. He has the freedom to practice medicine without worrying about which health insurance company insures his patients and which treatments will be denied or require endless hours to prove medical necessity. Given the restrictions and insanity of the health care “system” in America, I can only dream of being one-tenth of the hero he is.

  17. Thanks for sharing Pam. Very pertinent at Thanksgiving. We clinicians/healers should feel extremely thankful that we possess the gift of healing, despite the fact that we cannot prevent death and misery. For this gift alone, we must be very thankful – I am thankful every day for this.

    Dr. Varun, I have been in your shoes some 25+ years ago. In fact, one of the patients that I could not save in the hospital where I was a final-year medical student, was my own mother. The only reason I never developed negative thoughts was my intense focus on taking one day and once action at a time, and never worrying about processes beyond my control. Which means, every one of us docs must realize what IS in our control, and what we can influence positively. Keeping the big picture in mind will help overcome potential negative emotions. Hope this helps.

  18. Rachel Smith, Dreams Buffalo Woman says:

    I hear your suffering through your letter – and I hear the suffering of those you care for and I feel deep sadness, compassion and sympathy. It sounds so very hard. That’s awful.
    One of the most powerful prayers I have learned from my medicine elders is “May I never know how much I have helped somebody”. When I first heard that I thought what a strange, backward sounding thing to say! Now I understand it to protect me and the people I serve from enlarging my ego, that which causes separation, which is the opposite of healing. Despite the difficult and dark times, I choose to serve in the knowledge that I may be able to help, but I may never know how, or how much. I hold the door open for hope, movement, growth, healing , transformation – as they pass through invisible to me, for the eyes only of those for whom I hold it open.
    When I need to know whether that works or how that is, I need only recall the small actions of others that were at the tipping point for me, that unbeknownst to them made all the difference in my life. The woman who spoke to me kindly at the public market on the day that I stood on the threshold of taking my own life. The one who encouraged me to finish my education. The one who stopped to see if I was ok when i crashed my bike and was nearly run over by a logging truck (the truck didn’t stop). The man that smiled at me across the room and silently encouraged me to speak out in public for the voiceless ones, when I was afraid.
    When I think of you far across the ocean at night, and all the miles of darkness between and around us, I picture your message that took so many hours to write, as a small light shining across the distance. I hope as you read this, that you can picture a whole sea of little twinkling floating lights, a beautiful golden net of individual thoughtful, encouraging thoughts and well wishes for you, floating on the ocean, or on the air currents. From me. From us, your other selves. I am heartened by you, your enduring efforts, your vulnerability, your numbness. Your wholeness. And your calling out to Pamela and us in a way that affirms that between us all.
    I am reminded of how instantly and effortlessly light can fill a vast space. I am learning to look to those things easily within my reach which can help make life easier for someone who may be far away and unable to make the changes I can by the simple act of flipping a light switch, of speaking out freely, of loving where I am. Someone else here has said it already, and I simply echo from my experience, love never dies. Know that your smile is that light switch for many with whom you come into contact, and that the source of that light is clearly shining within your heart. Thank you for opening it to share with us. I see your light and it gives me hope and fortifies my resolve to keep doing my best for all the people. Like you.

  19. Wow…. Lovely work to read what y’all have written… healthcare is sometimes a very tough job, and can also be very rewarding. Sometimes we are the only touch and love patients may have in a day, a week, a month. Thank you – all of you- who take on this task of healing.

  20. Lisa Oxman says:

    Dr Varun,

    Thank you…God Bless You and keep you safe.
    Big Hugs to you and your family and friends

  21. Geoff says:

    It’s wonderful to witness this cyber-community rallying around Dr. Varun. Suffering is hard enough, but suffering alone is even worse. May we not only encourage each other in our respective difficulties, but initiate and carry forth healthy change for physicians who bear with us at so great a cost to themselves.

    Perhaps other physicians who have entered into Ideal Medical Care could after, say, 5 years after flying on their own wings, hold workshops and retreats of their own among their local peers?

  22. My heart goes out to you. I do not know how you are able to do all you do. I hear your suffering as you care for others that are suffering and your humanity as you smile, crack jokes, greet your fellow workers and stay connected to your family. I feel sad that you are under such duress and that such demands are placed on you. You are right, the profession demands way too much.

    You can make it, please hold on. You have support all the way from Boise, Idaho, USA.

    Thank you for taking so much time to write.

  23. dominique mall says:

    I only can say one thing:ouaaaa

    How brave this young doctor is and I think it is difficult for us here in the USA but I am humbled by doctor like Dr.Varun,who continues to practice compassionate medicine despite it all .

    Please know Dr.Varun that many of us feel your way many times and this makes us humans.

    Just continue the good fight like we all are and never giving up because if we do there will be no more human docs out there but only “Zombies with stethoscopes”

  24. Dale Howard says:

    Unfortunately you are surrounded by too much death and you are not even in a war zone. Every day we lose upwards of 22 military personnel in the United States to suicide. In order to get through this you must reflect upon your spiritual beliefs (whatever they may be) and the connection with your family to build fortitude! You have chosen an admirable and courageous field for your endeavors. By reflecting upon your situation and the choices you have made as a result you have empowered yourself to lead by example. That others may follow in your footsteps. We all have at sometime heard the tiny voices in the back of our minds which spew forth negative connotations. These are the demons which infiltrate and should be recognized as such so that they can be dealt with in an appropriate manner. Take strength in that you are not alone and that by putting forth the energy (by responding in writing) that you have put into motion a special acknowledgment that you will forever be in our gratitude and prayers.

  25. Sri Kolli says:

    This article brought tears to my eyes since it struck close to home and my heart. I lost my sister who was 16 years old to depression and suicide and that changed my life forever and that of my family. I had just finished medical school by then and since then I had my struggles through residency , practice and the general challenges life brings you as a parent. What keeps me going is the love of my family that is like a light in a dark tunnel on some days. Since my sister’s death, I have gotten better at diagnosing depression and become aware of it and it has helped me help others in my practice as an Internist I believe.

  26. ray says:

    Doctor’s s need not be victimized as slaves to the medical establishment. Free yourselves and love life knowing this RULE that virtually all the world’s greatest minds know is the absolute truth:
    “Whether you believe you can or you believe you can’t, your right”. – Henry Ford
    #Power of positive thinking
    #Earl Nightingale
    #Norman Vincent Peale
    I want to meet you Dr Wible to discuss the actual root cause and proven solution regarding doctor’s depression.
    Doctors are not who people (including most doctors themselves) think they are…

  27. Hearne Moore RN says:

    Thank you for your eloquent letter Dr. Varun. Yes, there are quite a few of us out here who have zipped up so many body bags over the years that we have lost count. The key is to remember that “virtue is its own reward,” i.e. knowing that what unfolds is often unstoppable but that even delaying death a bit can be very helpful in permitting family members to grieve and to allow concerned individuals to cover a great distance to say a last goodbye in the nick of time. Your heroic efforts are humbling to ponder. Do whatever to need to do to nourish yourself and avoid professional burnout. You are a great treasure, and you undoubtedly are inspiring many others to continue “the battle;” myself included.

  28. Brite says:

    RIP Dr Varun.

    Varun succumbed to his pressure on 14.06.2016.

  29. Oh my God, I remember Dr. Varun from his letter, and from responding to it. He is dead? By his own hand?

    “The only thing that keeps me going is my family and friends.” Medicine in so many other countries is worse even than it is here. And the sense of being a failure when we cannot keep up the unreasonable pace. He was in India? Pakistan? Not sure. I am so very sad at this news. We have lost a dear colleague, his patients have lost their doctor, and his family has lost a son, husband, father and brother. Senseless, irretrievable loss.

    With breaking heart,
    Pam

  30. Oh, how very sad.

    May he rest forever.

  31. Melissa says:

    To whom it may concern,

    Is it possible to hire more doctors, so that the work day can be cut down to eight hours a day? We need more medical schools, in the US and more residency programs. Overall, we need more Doctors.

    Furthermore, Doctors should each have a private room to sleep eat and relax. More break time. Because, we need to take care of the health care providers that help so meny of us when we are ill.

    Their must be a way to give Physicains better working conditions.

    P.S can you also include stories about susessful Doctor’s (I don’t mean monitarily) I’m talking about Doctors who are happy and not overworked, can we find them and tell their stories as well? Maybe, if those stories are published then it can give hope, and the ones who are on the edge can try something different. I want to hear and read about the good and bad so something can be done.

    Maybe, we can form a lobby to help doctors have a better working conditions.

    Thank you

    Mel M.

  32. Pamela Wible MD says:

    I have just received confirmation of Varun’s suicide: “Came across a post that you shared written by a certain Dr. Varun Babu in 2014. He suicided three days back. Don’t know why I felt the need to inform you. I didn’t know him personally in any way. Anyway, thank you for the beautiful work that you do. With much respect.”

  33. neena says:

    My God blessing sweet soul. It makes me cry.

  34. May God bless and comfort Dr Varun, his family, friends, patients, colleagues and readers. Bring them peace, Lord, as you guide those of us left here to make healthcare suicideproof.
    My every prayer and effort from this day forward will include ways to stop the torture of doctors, nurses, techs, and administrators who work in medicine.
    May Dr Varun’s life and death and have purpose in the name of the one who loves and protectsee us all. Amen

  35. Vera Halina says:

    so sad. too bad he didn’t receive help
    Blessings and prayers to him and his family

  36. Kiran Babu says:

    Hi all I’m Brother of late Dr Varun Babu. He committed suicide 5months back. Thanks all for blessings. As Far as I am concerned Souls are immortal. Expecting Rebirth soon

  37. Luci Code says:

    Hi Pamela~

    getting ready for a 12 hour work day-and that’s just while I am in the office. It doesn’t include the time it will take to complete the records, because we are not allowed anytime to actually complete our records at the office-takes up time needed to see the next person waiting for hours to see someone. No I am not in India. I am in MANhattan….
    xx

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