Did your wounded child choose your career?

I often say I was “born to be a healer.” Now I know why I attract so many wounded people.

I was nine when my family disintegrated. After she lost custody in the divorce, Mom kidnapped me. “Get in the car,” she said as I walked home from school in fourth grade. I didn’t see Dad again until high school. No surprise I chose to be a family physician—since I feel compelled to be in charge of helping to heal families.

My parents are physicians. (So I had to master physician psychology to survive my childhood.) Dad’s an obsessive compulsive pathologist. Mom’s been a suicidal psychiatrist. I’ve been suicidal too. No surprise I run a free doctor suicide helpline—since I’ve been helping suicidal doctors since I was born. 

Repetition compulsion is a psychological phenomenon in which a person habitually repeats an event or circumstance over and over again. Like ending up with an abusive boss in a toxic workplace again and again. Bullied as a kid in elementary school, then bullied in medical school, then bullied as a doctor by administrators. We set ourselves up unconsciously repeat our most painful experiences—until we consciously decide to stop the pattern.

Repetition compulsion is a defense mechanism—a psychological strategy that we unconsciously use to protect ourselves from anxiety arising from unacceptable thoughts or feelings.

At a doctor “suicide retreat” I led last weekend, we confidentially shared our suicide attempts and depression with each other. Some of us realized for the first time that our childhood trauma dictated our career decisions. One physician shares (with permission): “I survived sexual abuse as a child, so to protect children I’m a pediatrician.” Others have shared: “I survived losing my brother to childhood leukemia so to help save kids from cancer, I’m a pediatric oncologist” and “I survived two suicide attempts as a teen, so to help teens I’m a child and adolescent psychiatrist.”

Helping others is noble and kind. Yet as a child I was ill-equipped to solve the emotional problems of my physician parents. So I’ve spent my life attempting to solve emotional problems of friends, lovers, and patients—often with great success. Now, of course, given my lifetime of expertise, I’m paid to do this professionally as a physician. Many physicians were caretakers as children who feel compelled to continue caretaking as adults.

Here’s the problem: Helping others without first understanding (and receiving help for) our own emotional wounds, we risk reliving our trauma. Like the emergency physician with PTSD who was raised in a violent cult now trying to help victims of violence. Like the infertile neonatologist raped as a child now caring for babies.

Workaholism is a physician coping strategy for trauma. If we distract ourselves with patients, we avoid our own pain. Eventually memories resurface, often triggered by our patients. Doctors then call me with panic attacks at work and insomnia and rumination at home—with no idea why they can’t function.

Last night an internist wrote me. Subject line: “Here we go again . . .”

“I’m not sure I can do this anymore. I’ve moved from multiple jobs and moved my family countless times. I’ve given my all to my patients and medicine. I was the second highest productive doctor out of ten and everything was going amazingly well. I was told that I was a great fit. After a year in my job I was completely blindsided with a contract non-renewal. I never had any problems with anyone; never killed anyone and always did what’s best for my patients. My family doesn’t want to move again. I’m completely dumbfounded and wondering what to do. I’ve seen counselors and psychiatrists and they have told me I’m fine but I’m completely at a loss. I’m ready to throw in the towel and not be a burden to my husband and kids. I’m grateful for what you’ve done. We’ve talked before. I have no words. All I wanted was to help people and can’t even help myself. I have no idea what’s left. I’m literally at the end of my rope.”

I get it. After six jobs in ten years, I was suicidal. I moved multiple times. I gave my all to my patients and medicine. I was the second highest productive doctor at one of those jobs. After a year in my last job I was completely blindsided with a contract non-renewal. Aha! My pattern: I realized I was a perpetual victim in a healthcare system that profits from dependency and victimology. As a disempowered doctor, I kept attracting disempowered patients who were overly dependent and sucked me dry. Over and over again. I hated my job. My patients hated their jobs. They kept begging me to complete disability paperwork. One wanted a workers comp claim filed for a paper cut that I couldn’t even find. Not kidding! I said: “Do you know how many people will get paper cuts dealing with the paperwork for your paper cut?” and I cut her off. When I launched my own ideal clinic, I stopped being a victim. Only then did I stop attracting patients who were victims.

So why do we compulsively repeat our most painful events? In our quest to gain a belated mastery over our own trauma, we yearn to relive it so we can finally create what we’ve always yearned for—a happy ending.

If you’re suffering, start journaling. Discover your own patterns. Need help? Reach out.

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17 comments on “Did your wounded child choose your career?
  1. Marcus Fidel says:

    Thanks so much for writing this and giving voice to my situation exactly. There was much mental illness in my family and it is no surprise I became a psychiatrist.I found out the hard way, that Helping others without first understanding (and receiving help for) my own emotional wounds, makes me susceptible to just repeating my trauma over and over again. A so called “Repetition compulsion,” and I’ve had enough of that–banging my head against the wall till I was a bloody pulp , not making a dent in the wall at all. Thanks for letting me vent and get my feelings and thoughts out.

  2. Anne Stohrer says:

    OMG Pamela, you have hit the nail on the head as usual.

    • Pamela Wible MD says:

      I got tired of hitting my head against the wall in futility so I just had to figure this out—for my own sanity.

  3. Dr. John says:

    How are you doing? People call you. Who do you call?

    • Pamela Wible MD says:

      So sweet of you John, I have so many doctors who are my confidants. My Dream Team of docs. Thank you for caring. XO

  4. Pamela Wible, MD says:

    Message I just received: “I am torn between you are a God send to suffering physicians and you are a suffering physician yourself capitalzing on suffering physicians.”

    I’m neither (although I’ve been called a Godsend by those I’ve helped and a capitalizer on suffering by those who are suspicious of my motives). In the end I’m just a human being doing the best I can to understand myself and help and heal others along the way. I think most doctors are probably just like me that way. I’m intensely introspective and an existential thinker. I am also very determined to expose and address injustice. It’s my job as a physician to stop needless suffering and death so this is also my calling—ending doctor suicide.

    A few comments from a recent blog answering questions posed to me by critics:

    2) What is your motivation? My primary motivation is to end medical student and doctor suicides, eradicate human rights violations in medical training, and help all health professionals live their dreams in medicine. Why do I care? I lost both men I dated in medical school to suicide and nearly lost my own life to suicide as a physician. I feel compelled to understand why doctors are dying by suicide. Many feel oppressed—even abused—by their employers. Leaving assembly-line medicine and launching my own ideal clinic resolved my suicidal crisis. Restoring physician autonomy is one solution (among many) for doctors trapped in a toxic medical system. Plus I love liberating physicians to live their dreams and care for patients the way they always intended.

    Complaint #32) You are making money off of human suffering. All doctors make money off human suffering. I’ve never charged a med student or doctor for mental health help. Never. I make money in my clinic by helping patients with human suffering like all doctors and by providing business strategy to help doctors launch independent practices. (please see deconstructing my finances at end).

    Complaint #40) Deconstruct your finances. Detail the fact that you make zero profit from retreats and seminars and such, as I assume is the case. Give numbers with regard to physicians with whom you have spoken, for free, about their stressors etc. Detail volunteer work that you do in the tragic arena of physician suicides. My income: 1) Treating patients in my clinic since 2005 (without ever turning anyone away for lack of money) 2) Helping doctors and medical trainees who want business strategy and mentorship to create their ideal clinics through seminars and retreats. 3) Inspiring doctors and med students to live their dreams through speaking events. 4) Two books on preventing physician suicide and living ones dreams in medicine (100% proceeds to suicide prevention)

    These four things fund my philanthropy: 1) Free helpline for doctors and med students. I’ve spoken to thousands of suicidal medical students and doctors since 2012 and I’ve never charged a cent (though I appreciate all the unsolicited donations). 2) Scholarships to retreats and seminars for medical students and residents. 3) $10,000 yearly scholarships to needy residents and med students to help them live their dreams in medicine 4) Doctor-suicide-related events like flying to lead memorials and candlelight vigils for physician suicide victims and free retreats I’ve held for survivors of doctor suicide.

    In summary, I’ve never made money from suicidal medical students of physicians. I’ve spoken to thousands of physicians/medical students since 2012 related to their mental health and guidance on an array of other topics—for free. I earn money primarily from treating my patients and providing business strategy for physicians and trainees who want to launch independent practices. I am also now paid to speak on health care delivery and physician wellness. I live a simple life in a 900-square-foot house with no debt and no children. I have just signed the papers with my attorney to leave 100% of my estate to scholarships for medical students and physicians.

  5. Ramin says:

    Pamela – I think you are spot on!!

    So what is the solution ? stop practicing medicine ?

    For those of us who are married with children, living in a 900sq ft home is really not an option.

    • Pamela Wible MD says:

      You can make 3 x as much and live in a 30,000 SF house if you like. With children. With your spouse. Heck, you could move your entire extended family into your mansion. I just choose to live simply.

      Where did you get the idea that you’d have to live in a 900 SF house to live your dreams?

      Watch this video with instructions to triple your income as I have (and do way less work)

  6. Eileen Forrestal says:

    I had a stomach washout when I was three after an accidental overdose of aspirin – and ‘chose’ a career as an Anaesthesiologist’ intubating people over and over – until I retired. Now I use words to heal not tablets and tubes!!! Much happier now. A conscious choice.

  7. Angela F says:

    Thanks Pamela that was really great to read. Lots of Drs have been tricked into being enablers. Our western world is teeming with victims for the enablers. The medicated victim status has almost destroyed my 22 year old daughters life. My wife is a traumatized mess too. The social engineering also drives people to the victim status so as to justify more pharmaceutical sales. Its very clever. For now.

  8. Bernie Siegel, MD says:

    can i adopt you as my chosen bonus child?
    and give you a bonus dad or BD
    i have done it with others and saved their lives

    Bernie Dad or Bonus Dad

  9. Hariclia Hristea says:

    a beautifully thought, felt through insight and shared experience, as always, you have a great way to people’s hearts. Thank you for this gift, it is for many of us, physicians, a treasure in the same journey of healing the healer first rather than last!

  10. Rita Losee says:

    Good morning, Pam!

    I LOVED reading your email this morning. I really resonated with the trauma/workaholic premise.

    Can see it clearly, although, based on my current schedule at age 79, I haven’t completely extricated myself from
    those old ways of being. Chuckling as I wrote that!

    Not only seeing the pattern in my own life, but in my parents, in my ex-husband’s. It certainly is contagious; we give it
    to those we love.

    I so deeply appreciate you and the truths you share.

    Wishing you nothing but ease, grace, and blessings!


  11. A Resident says:

    Hi Doc Wible

    Welp… once again you have managed to wallop me over the head with much-needed insight.
    Yes. I survived childhood sexual abuse and find myself treating patients with trauma-related psychiatric sequelae.
    Yes. I was a hospital corpsman (field medic) with the Marine Corps infantry, have lost 6 of my Marines to suicide in the past decade and a half, and find myself working with suicidal patients.
    Yes. I married a woman from an abusive home fueled by alcohol and the fruits of war (who is amazing and healing and providing a home for our daughters that is 180° from what she had growing up), and find myself trying to fix everyone else’s problems and protecting patients from abusive men who I sometimes want to destroy.
    Yes. I love what I do. Yes. I hate what I do.
    Yes. I feel powerless to create my own professional reality — at least until I am through with this never-ending slog of residency.
    No. I am not suicidal. But I f***ing get it.
    I appreciate you, Doc.
    Keep rolling.

  12. David Cain says:

    Wow. This really resonated with me. Thank you for helping raise awareness on this issue! I spent my entire childhood in ERs with my father who was sick his entire life. Now I am working round the clock in ERs trying to help people like my father. I am fully running on the “repetition compulsion” hamster wheel, subjected to toxic and abusive employers and fellow providers. It’s time for me to make a change!!

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