Doctor’s death an ‘inconvenience’ for patients

An investigation is underway after a Chicago-area doctor is found dead—a suicide according to the medical examiner. What demands investigation is the callousness with which the this doctor’s death was reported by the media—and received by neighbors, many healthcare professionals themselves.

I’m alerted to the death initially by a Facebook friend: “Pamela, check this out!” Headline: Police: Doctor found dead near hospital in Berwyn. (Interesting side note: on 4/21 ABC news changed this headline to “Man found dead near hospital in Berwyn.”)

The facts:

On Thursday, April 16, a maintenance worker calls the police to request a well-being check on a tenant, Dr. Jon Azkue, a 54-year-old physician employed at MacNeal Hospital.

Police discover his decomposed body with suicide note surrounded by helium tanks. Mistaken as propane tanks, police call the bomb squad and evacuate the 4-story building which primarily houses healthcare professionals and medical businesses. How do his neighbors and colleagues respond?

“I was actually going to get some baby food,” says Jemin George. “My daughter is in one of the vehicles and it’s been almost three hours since she’s had something to eat.”

“It’s an inconvenience for the patients,” claims Riz Ahmed, an employee at Chicagoland Retinal Consultants, a clinic located in the building.

Anna Futya, clinic manager at the retinal clinic, is also frustrated by the inconvenience. “All the calls that are coming here—whether from patients or doctors—nobody is able to answer . . . “

Wait, I thought this news story was about Dr. Jon Azkue. The headline clearly states: “Doctor found dead near hospital in Berwyn.” So why is the focus on inconvenience to patients? How did the dead doctor get scrubbed from the story?

Who is Dr. Jon Azkue? 

My online research reveals that Jon Azkue is a foreign medical graduate from Central University of Venezuela who was a senior internal medicine resident at MacNeal Hospital at the time of his death. He was just a few months away from graduating.

In this news report, Dr. Azkue is treated as if he is guilty of a crime. There is no expression of sadness for the loss of this doctor—presumably a man who spent his entire career caring for patients in at least two countries. In the comment section—amid jokes about terrorist plots and remarks about the selfishness of suicide—Doc T writes:

Wow. I’m appalled by the lack of sensitivity for the loss of life here. I myself am in residency and unless you live through it, you cannot begin to imagine the stress and sacrifices that we and our families endure—far greater than missed eye appointments. My condolences to his family and colleagues. The journalist and editor should be ashamed of the slant through which they allowed this ‘news’ to be delivered.

Facebook comments continue throughout the afternoon where Cailean Dakota MacColl, a premedical student, is equally appalled. “Hi Patient X, your doctor is selfish and died by suicide so they cannot do your eye exam today.”

Heather Springfield, another premedical student, chimes in:

I had the same line of thoughts. What a sad situation that a fellow human being who dedicated their life serving/helping others, is considered an inconvenience. It’s pretty damn ridiculous that society cries for its physicians to have an open doctor-patient relationship—to not be robots—but the moment a doctor shows their shared humanity, either they’re sued/abused/or die by suicide because they can’t take it anymore… etc. etc. What the hell is wrong with people? I wish, as a populous, we’d stop acting as if we live on separate planets when in fact, we share one planet. How hard is it to take a moment, and realize we lost a precious life to something preventable? It’s a damn shame, and my heart mourns such a loss…. This shouldn’t have happened. Shame on those residents, clinicians, and those who don’t take pause for what this is.

Physician suicide: more questions than answers

With his suicide confirmed, the real investigation must begin. Why did he die by suicide?

And why do we lose more than 400 U.S. physicians each year to suicide? Why are these suicides not investigated?

Like most suicided doctors, Dr. Jon Azkue left a note. Why are we not analyzing these suicide notes for common themes to prevent future physician deaths?

Sadly, we are unlikely to hear any more about Dr. Jon Azkue. We will not hear about the many patients he cared for, the lives that he saved. This is his 5 minutes of fame.

Pamela Pappas, MD, a psychiatrist writes:

Rest in Peace, Dr. Azkue. Being a resident at age 54 is not easy, and I’m wondering about his life and what led to this kind of end. No mention of family being notified before releasing this news to public, etc. Our culture (both medical and non-medical) apparently regards doctors as dispensable. Yes, of course patients are ‘inconvenienced’ when a doctor dies! Houston, we have a PROBLEM here, and we need serious remediation.

Why is this news story so unsympathetic to this deceased doctor?

And why are clinics, hospitals, and medical schools so willing to sweep these deaths away—often with no debriefing for survivors. Why are physicians not receiving routine on-the-job mental health support for such a high-risk profession?

Georgia Jones, a Facebook friend, shares:

This is so sad. They [doctors] deserve to have therapy without being judged or the worry of losing their job. Schools need to start preparing students for what is to come, and have help in place if they become emotionally overwhelmed. It’s so sad that this is still happening. Doctors are human beings, like us. Start treating them as such. They’re not machines! They have emotions, and believe it or not, the death of their patients DOES affect them!! Give them a break! R.I.P. Dr. Azkue. I’m sorry it came to this.

Here’s the truth: until we investigate why this doctor died by suicide, we will continue to lose more doctors. Maybe if we took a sincere interest in Dr. Azkue’s death, we could prevent the next one.

Incidentally, Kim Aaronson, a chiropractor in Chicago, adds:

Here’s another note of interest, a local chef here in Chicago died by suicide on Tuesday of this week. It has remained in the news every day. (even covered in this NYT article) The doctor’s suicide has not even been mentioned. There is clearly uneven coverage going on here…. The FB comments show the kind of empathy the press should have shown…. You are so right on, a doctor dies and it seems that no one cares at all….

Pamela Wible, M.D., reports on human rights violations in medicine. She is the author of Physician Suicide Letters—Answered. Struggling? Need help? Contact Dr. Wible.

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60 comments on “Doctor’s death an ‘inconvenience’ for patients
  1. RN says:

    Thank you for this article. I was shocked that news coverage spent so much time on the inconvenience of the neighborhood. I knew Dr Azkue and worked with him. Shame on the public for their insensitivity to this situation. Unless you know the whole story, people, think before you speak! You never know what someone else has gone through! Who are we to judge? May he rest in peace.

    • Jon Mikel says:

      Hello RN i read you knew and worked with him. Im Jon Azkues son, currently living in mexico, is there a way we could speak?

      • RL says:

        I worked with him also and found him to be a kind doctor

      • ConcernedRN says:

        Hi, I worked with your dad months ago before I moved out of town. He was very nice and very intelligent and it breaks my heart to see that he passed away. Dios té bendiga.

      • KC says:

        I am so sorry for your loss. Will you please let me know a way to contact you via facebook or email, etc. please. I did not know your father but would like to offer condolences. If not, I totally understand. Thank you.

        • Jon Mikel says:

          Sure, to anyone that might have known my father, my email is jonlekim@hotmail.com. I would like to know details about his work and living in the hospital as I hadn´t seen him for several years. He was in fact fired on his 3rd year of the residence. The hospital doesn´t tell us why exactly. He lost his visa status as a result and would have had to leave the country. We are from venezuela, and its bad over there, really bad. That must have devastated him, as his dream, since I have memory, was to live and practice medicine in the states specially because he did his first 2 years of med school in boston. he couldn´t finish back then for financial reasons, so he went on to finish med school in venezuela and was a doctor over there several years. After Chavez though, he commited himself to his dream of practicing medicine in the states. It took him years, we though he had finally made it…

          • MT says:

            My condolences

            When did he graduate from venezuela medical school

            As an old graduate, how he got into this residency program

            Why they fired him

            Was he working as a doctor in venezuela until he got into residency here

          • Jon Mikel says:

            Many years ago, I can´t remember, early 90s?
            He did his 1st residency in venezuela, internal medicine. Worked for several years. Decided to leave the country in 2004 with a student visa. Did the equivalency test over several years while doing internships and volunteering. Got in the residency program after passing the tests. I dont know too much about the details, as i dont live in the usa.

          • Jon Mikel says:

            By the way, my family went through his stuff, they found 2 job offers for when he finished in august as well as few good letters of recomendation. A relative spoke to the program director. We still dont understand why he was fired. They told us it was a decision taken by a board, nothing that could be done there. But wouldnt give us the why.

          • Pamela Wible MD says:

            This is so sad. He was very close to fulfilling his dream. Are you in Chicago now?

          • Jon Mikel says:

            I live in mexico. I dont have the means to travel to chicago, my aunt is gathering information. She went to fulfill my fathers request to be cremated.
            She was told by someone who used to work in the hospital that another resident attempted suicide one or two years ago.

          • Pamela Wible MD says:

            Physician suicide is a huge problem in US (and many other countries such as India and UK). We are just starting to address this with the seriousness it deserves. Please let me know if I can ever do anything for you or your family. Bless you in your healing journey.

          • Suziq38 says:

            I am so sorry about your dad.
            Hopefully you will have some answers.
            The least the hospital can do is give you some answers.

    • Suziq38 says:

      Thank you for your post.
      I am sorry that he died.

  2. Mary Gerdt says:

    The doctor’s office should have closed for one day out of respect for the patients’ wellbeing. How insensitive of the living doctors to expose patients to the scene, potentially creating or tapping traumatic memories. The poor deceased MD could not control the traffic or his life. The lack of any compassion by the inconvenienced reveals one eye doctor I would avoid. Cold as ice. I wish someone had noticed him if depressed. Doctors from other countries are usually very high functioning/high status/respected where they came from. Medical school too restrictive. Sometimes Not respectful of non US medicine. Must keep talking…

  3. I am so saddened by this tragedy. The problem is real and is found in other lines of medical care. I started my training to be a Physician Assistant in 2000 at USC. Each new student was given a mentor and mine was a beautiful young girl with everything to live for plus a great career ahead of her. It was just months before her graduation when she shot herself at a red light. A doctor from the USC University Hospital was in the car behind her. I don’t know if that was even in the news. It is a sad state we are in now. I am going to share this on my blog: http://iamnotsickboy.com.

  4. Chantal says:

    The way the media has covered this is horrible, and I agree with all posters here that doctors deserve compassion and care. One of our local physicians passed away recently, and the media covered his death much more compassionately: http://www.morganhilltimes.com/news/updated-morgan-hill-doctor-dies-in-climbing-accident/article_eb31cc40-0d1a-11e4-8f7f-001a4bcf6878.html
    Thank you for this article, we will post it to our ReminderCall.com Facebook and Twitter.

  5. It breaks my heart to read this! I hope I am not offending anyone but it seems like we get more bio on a perpetrator in a terrorist attack then on a physician in such deep despair! Dr. Azkue surely left a legacy in care of others and how pathetic that people are so selfish! May he rest in peace and may God have mercy on the selfish people more concerned about their own inconvenience!

  6. Jim Anderson says:

    Pamela

    What is unfathomable to me is the size of the disconnect between the situation and the responses. It’s like that Phil Ochs song

    “Look outside your window there’s a woman being grabbed.
    They are taking her to the bushes and now she’s being stabbed.
    Maybe I should call the cops and help to stop the pain.
    But Monopoly is so much fun, I’d hate to lose the game.”

    It was based on a real incident…

    Jim Anderson
    lucasandjim@aol.com

  7. Dara says:

    WHY WHY WHY does the public hate doctors so much? What did we do to deserve this? I really want to know. This isn’t a rhetorical question. Did we or our predecessors abuse the system in the past so badly that it left a bad taste in everyone’s mouth? —a concerned breast radiologist.

    • anne anonymous says:

      Dara, I work in a hospital and I am also periodically a patient. In the past couple of years, I have had physicians complain they are not reimbursed (per email) for emailing, been charged $700 for an ultrasound on my nonexistent uterus, had a physician pull out a pap smear kit and begin to take a pap smear on my nonexistent cervix, been given prescriptions for another patient with very different meds, wound up doing a four day inpatient stay for a problem that should have been a simple outpatient procedure (literally no access to ortho care sooner than three months out), had a wound vac ripped off my 10″long by 5″ deep open wound (hurt!) and lots more. The public (at least me) hate doctors so much because things aren’t working well and that creates fear. I have circled the drain twice bc of medical errors, and had a good deal of unnecessary severe pain (no pain meds after open surgery w/general anesthesia for 24 hours), and the kind of fear that raises creates hatred. I enjoy the physicians I work with, but do not respect the incompetent ones (one of mine is nicknamed Dr. Death by his staff but he is a rainmaker and will never be booted out), and although I feel sorry for the exhausted and depressed and furious ones I wouldn’t go to them for care if I had options, which I often don’t. Broken system, apathetic/cynical practitioners, clueless physicians economically out of touch w/their pts. Pamela is a nice exception, and my best hope is that she and others like her will fix the broken system. I know I have no power and can just watch the train wreck with dismay. It isn’t abuse of the system so much as it is a crappy system and also a lack of provider empathy. Only some, but it’s a big enough some to make sick upset people generalize.

      • Hello Anne,

        As a pre-med student, and patient of a stupid amount of doctors (one of which, is based out of a research institute), I am disheartened that you have had to endure the bad apples of the medical field. I have had my fair share of those who probably should have either never considered medicine as their career choice, or, reaccessed their continued practice of medicine/walked away. However, I have found that the shining gems far outweigh the bad, and have made up for their rougher counterparts by embodying what the medical profession should and can be. Yet, it is those very doctors that feel just has powerless as you.

        Anyway, I digress. What I am really trying to say is: you are NOT powerless. Speak up – you have a say on who can and can’t treat you. As someone who works in the hospital, it behooves you to speak against a physician who is a walking Grim Reaper. Be the advocate for the patients who are unfortunate to be in his/her care, that you should have had when you were a patient during those difficult times. Yes, I know the potential for retaliation is high (there are laws that protect against it, but not many use it), but if more people spoke up, things would begin to change – even if it is minor (one step at a time). Raise hell if you must.

        As a baby in this field, yet a “professional patient”, I am inspired by those who stick a metaphorical middle finger in “the system’s” face, and practice medicine the way it was meant to be. I am also inspired by patients who are actively (while being respectful) engaged in their care, uncaring to what nickname they get, to ensure they are not walked over.

        Most physicians are not assholes – it’s just that the bad eggs are louder and leave a greater destruction in their wake. It’s up to patients, RNs, MDs, etc. to actively quell such behavior. Unfortunately, the current culture of medicine isn’t conducive to what it takes to actively monitors one’s profession.

        I could go on and on – as it is my personal mission, come Hell or high water – to embody/fight for true health care. The obstacles and abuse I’ll undoubtedly face, don’t phase me. My personal situation, and how I’ve been raised, has given me courage I need.

        Be well,

        Heather S.

      • Dara Lifschutz says:

        Anne, I am SO sorry you had to go through all that. The system is terribly broken, you’re right, and I too hope that our growing team of conscious caregivers will help heal it as soon as possible. And hopefully, the doctors who behave the way they did to you will recognize that they first need to heal themselves before attempting to heal others. Love and blessings, Dara

      • jojo says:

        docs aren’t making that money, its the corporate level managers leaning on them. Look up for yourself the gross annual of a hospital then the full time docs annual salary. Like all labor salaries have stagnated but production of the individual has more than doubled. Its displaced anger and frustration for most docs cause they are too weak to stand up to their employer or supervisor, so they blame those in weaker relative positions.

        • Pamela Wible MD says:

          I know. My mom are > $125/hr in the 1970s in private practice psychiatry. Now I meet primary care docs earning $65/hr in urgent care. Total BS. And we allowed this to happen.

  8. terry m bennett md mph says:

    Doctors have a very high rate of familial depression.
    That said, Who in hell gave these twits the right to comment on the “inconvenient death of a caregiver”
    “Whence comes such another?
    The elephant in the living room here is that the entire output of new doctors (400 per year)from two medical schools, is required to catch up with this annual loss rate, and it is well past time to see if we can stop this, now, and heal ourselves.
    There is a recent article about the effect on the production of neurotransmitters, like serotonin, in our brains, due to an undersupply of inside the brain folic acid metabolites.
    There is a buccal swab test that is easily administered and costs about $50 to read,
    The required medicine, to correct the genetic folate transport defect in blood brain transport is called Deplin, and is the levoisomer of the folate metabolites required to build neurotranmitters, and it crosses the blood brain barrier readily
    So, an easy test to see who transports folate poorly, and a cheap treatment for those whose genetics predispose them to this defect, if identified
    You can look all of this up, and Fox News did an editorial on the topic in 2013, but it fell out of the headlines and the suicides continue right along, not just doctors, but a lot of other souls as well
    Time for a detailed relook at what we think we know T M Bennett MD MPH

  9. Isis S Miller says:

    As a Mom and a physician, I know that if I die only my Family and friends will care. The patient will just be unhappy that there’s not a warm body to fill the shift and give them antibiotics.

    • Lyla says:

      I would be truly saddened if the physician I see for my chronic condition died. You have no way of knowing how much you mean to people.

  10. Thanks for bringing this story to my attention. It’s a sad situation, truly, but it reflects the declining reputation of physicians, ever-more seen as takers, not givers. It’s an oversimplification and quite unfair to a huge number of caring docs, of course, yet I would suggest to anyone who cares about the future of medicine that they consider WHY we have seen such a powerful trend for decades now. Physicians once had a strong reputation with the public: far less so today. Physicians were once granted total control over their destiny; not so today. These two trends are tightly related, and both, I suggest, have been caused by the vast increase increase of wealth and profit in medicine over the last century. Patients increasingly wonder if they’re getting sound medical advice or being used to make a buck. Often enough, the concern seems fair, when docs own labs and machines from which they order profitable tests, and when they prescribe medicines from firms from which they earn fees. Conflicts of interest have arguably become more routine in medicine than in any other profession. It’s profitable, and yet the costs mount, in power and reputation. Their Ain’t No Such Thing As A Free Lunch, truly.

  11. Pamela Wible MD says:

    This is a useful comment from my FB page from Wendy Eidman and she explains some of the unusual reporting in this case:

    So I used to be in television news (both an anchor and reporter); I can tell you exactly why this story was written the way it was. When the reporter got to the scene, she was not doing a human interest piece, which is the kind of story that you want to listen to. She covered a breaking news story, a situation that was unfolding — a possible explosive device in the building, the disruption of the residents’ lives, the consequences to the businesses involved, and the discovery of a victim in an apartment that had been rented to a physician, cause of death undetermined at the time of broadcast. It was appropriately done with the information that the reporter had at the time she had to go live.

    When I was in TV, it was station policy to not cover suicides in general unless the suicide had some consequence to the public — a person stepping in front of a train, causing the system to shut down for a time during rush hour, for example; in those cases, the story itself was the disruption of service to customers during rush hour. Management for my station felt that if they did allow coverage for suicides, the publicity might encourage suicidal people to go through with their plans.

    Since the reporter in this particular story had already gone live, it would have been good to follow up with the kind of story that you are envisioning once the coroner released the report that the doctor had indeed completed suicide. It would have been an awesome opportunity to do a series on the issue of physician suicide in general and the general state of medical care in America. I am going to hashtag the TV station so that they can read this comment and perhaps follow through during May ratings.

  12. Michael Myers MD says:

    Pamela,
    Thanks for bringing this to my attention – and for all the fine and tireless work you do to bring the world’s attention to the tragedy of physician suicide. It’s ironical that I’ve just returned from the annual meeting of the American Association of Suicidology meeting in Atlanta. I’ve just had four days of consorting with researchers, scientists, clinicians, survivors of suicide loss and survivors of suicide attempts. In short, people who care and who are trying to make a difference. So now I’m back to the everyday world. What people in the article who are “inconvenienced” don’t seem to know is that individuals who kill themselves are desperate and have greatly constricted thinking. They hurt terribly and want the pain to end – NOW! As the old adage goes, if they had the ability and judgment to worry about inconveniencing their neighbors by their suicide death, they wouldn’t need to kill themselves! Physician suicide can spark some very primitive and raw emotions in other doctors. Sadly, in my academic and clinical work with physicians, I’ve heard much worse than “inconvenience” after a fellow doctor takes his/her own life. My heart goes out to Dr Askue, his family, colleagues and patients. Their journey of healing is just beginning. May they have the resilience, courage and strength to turn and walk away from insensitive people who just don’t get it.

  13. steve lobb says:

    The incredibly stupid work load of medical interns is worse than military boot camp in a setting that is supposed to save lives. The internship also comes after years of grueling heavy study work loads. And on top of that, somehow we kind of expect Doctors to always make perfect decisions with out mistakes, as if they are superhuman. What is amazing is that there are not many more suicides in this field. And who keeps the records on how many engineers or students of the Arts etc. succumb to such a fate? Unfortunately suicide is rampant on all levels of U.S. society due to the horribly pathological culture of meaningless and confusion in general. So sad

  14. Erin, RN says:

    Wow….wowowow…

    It seems like the world is splitting into two. You cannot bring people who choose to continue to suffer along with the current world with you. You can refuse to participate in and feed the current system, live your truth as an example (i.e. – Dr. Wible :)), and respond to those still clinging to these old ways with love and compassion.

    I lived in the West Chicagoland suburbs during the year that I was in medical school, before I dropped out trying to save my own life. That felt like a journey to the Underworld. Soul-less, sterile, money-driven place. I’m not too surprised by the nature of the media response.

    RIP Dr. Azkue…

  15. Doc Martin says:

    Pam I think that one of the obvious parts of the physician suicide puzzle is the total lack of compassion people feel toward doctors. We are an inconvenience to them when alive and an inconvenience to them when dead. My family has specific instructions to not publish an obituary for three years after my death to hold off on the potential lawsuits. Even working in an ideal type of practice I have to assume that I am the enemy and a potential pot of gold to many of my patients. Why not commit suicide when it feels like no one cares? It is a sad state of affairs that our country has come to when the patients feel like the enemy, and the physicians death is an inconvenience.

  16. Rosalia says:

    It is very difficult to be a resident after 40’s .
    I can imagine the pressure he suffered from attendings and even coworkers…the residency’s world is full of competition, jealousy and lack of friendship or compassion for each other. The residency programs should be aware of the” abuse of power” is going on in certain programs generating unnecessary stress and suffering leading to these type of tragedy

  17. Pamela Wible MD says:

    A physician asks me to post this anonymously:

    We lost another Angel! RIP Dr Azkue… Its not strange that I’m not shocked by the publics response. While alive we aren’t treated any different and it seems we are treated the same in our deaths.

    Does anyone know who Jon was? Not Dr Azkue, but Jon.

    I can only imagine what he had to deal with. I myself am a foreign grad, but US born and raised. Its been 7 years post grad and still not being able to match into a residency program. When I attempt to share my story of watching my mom fight cancer for 2 years, and how it played a part in the delay of my training, I don’t get empathy, but instead mocked. Shes 3 years ovarian cancer free btw.

    Mocked by friends, some family, US grads and everyone else who’s never been through Medical School….. Oh you’re a foreign grad? What they mean is oh, you couldn’t get into a US med school?

    Oh you’ re still living at home in your 30s? I thought you were a doctor, where’s you Mercedes or mansion? This is what most people think of us doctors. We’ re supposed to be rich and arrogant. Not bankrupt bc my private and federal med school loans are now over 300k, or I can’ t practice yet bc I have yet to match into a residency.

    Until we can change the stereotypes and the image that society has portrayed physicians,

    I’m afraid things won’t change.

    Doctors are people too! But most of us act like introverts. We will very unlikely ask for help. We are trained to suck it up. “Theres no crying in doctoring “. You learn that the first day of med school, any med school ( worldwide ).

    I wish I had the opportunity to have met and get to know Jon. May you find peace in heaven.

  18. My heart aches further with the news that he was apparently dead long enough to decompose before anyone noticed that he was gone. Where in hell was his training program, when he didn’t show up for work? Where were they while he was still alive — probably having some kind of internal trouble that may have made him more introverted or standoffish? (I don’t know this, but I have dealt with many physician colleagues in similar situations.) Often people around the depressed doctor recognize that something is “off,” but no one says anything.

    Many physicians do live alone, especially ones in transition — situations like divorce, training programs, locum tenens jobs, may lead to this. If you add personal suffering to this with no one to talk to about any of it, worse outcomes are bound to happen. Community is a huge part of healing for any of us, and when we can’t connect with that (or didn’t have it in the first place) we are truly doomed.

    We’ve got work to do here, people.

    • Annette Ciotti says:

      Very well said. 30 years after my graduation, and training programs are still this way? I just shake my head.

  19. ConcernedRN says:

    So so sad! I am thankful that you addressed what I have been feeling for the past week! I moved away from this area last year. I worked at that hospital for 5 years. I worked with Dr. Jon Azkue and can say that he was very pleasant, intelligent, compassionate and respectful. I couldn’t believe that there was little to no coverage about his passingly, as if the hospital was ashamed or something.
    As a human being, and moreso, a doctor, he deserved much more respect than that ABC article allowed him. Where is the empathy in the world? He was a senior resident, seeing patients in the hospital and the clinic as well. I have worked with him in code blues and seen him give his heart for patients.
    I have taken care of mentally ill family members and I know how frightening depression and suicidal thoughts can be to deal with. Clearly he was hurting and needing of professional help, but I never saw this on his face. Again, I moved away months ago. Friends say that he had recently had a change in behavior. Surely, someone could have noticed this and referred him to get professional help. Someone said that he had been let go from the residency program. This probably crushed his spirit. Instead of getting professional help, the hospital abandoned him and left him without any help in coping with his problems. Shame shame shame on this hospital!

  20. Greg Stueve says:

    No one cares when a doctor dies and no one cares when a doctor suffers from anxiety or depression. A mental illness is also an “inconvenience” for hospital administrators and medical directors. I had a medical director tell me to leave my anxiety at home. I found that quite difficult when that anxiety was work-related.

  21. Dr Mike says:

    This is how a doctor values all human life compared to how the media treated the tragic loss of this fine unfortunate physician who dedicated himself in his 50’s to one of the noblest albeit embattled professions!

    Wake up America , appreciate and never take for granted that which no government or healthcare insurance company can never provide!

    http://www.sunnyskyz.com/good-news/1082/Dramatic-Photo-Shows-ER-Doctor-Grieving-After-Losing-19-Year-Old-Patient

  22. nancy says:

    It is heartbreaking to hear about medical provider suicides. People expect, “Physician heal thyself” and that they don’t need compassion or assistance sometimes. As a PA, I left medicine after 17 years in the ED due to burnout. I couldn’t really get my head around what I was feeling until someone stated working the way medical providers do gives us PTSD. I was overwhelmed for years with the patient load and severity of illness. I often had 6-9 patients at a time with varying degrees of illness, and little support from my physician “supervisors.” I am now spending time with my family, feeling guilty for not using my medical degree (and still paying on my student loans!) and still somewhat at a loss of what is next. It is really hard for others to understand the responsibility a provider lives with while working: Is this treatment the right one? Is this test necessary and if I don’t do it will I be sued? I will get a complaint if I don’t give the patient everything they want, whether it is medically indicated or not. Etc. The paperwork, the fear of lawsuits, complaints, seeing a certain amount of people per hour…..
    it doesn’t seem to end. What will help? Getting rid of insurance, for one! I think Pam is on the right track when I hear she is in a relationship with her patients and 3rd parties are not in the decision making.

  23. A former coworker says:

    Thank you for caring. I couldn’t get Dr. Azkue out of my head until I read your article that my friend from mac Neal posted. Now I feel like his soul can have some peace.
    He was a really nice doctor. I am so sad for him to be gone this way. He had such a wonderful speaking voice. He worked at the internal medicine clinic too. Spanish speaking patients liked him a lot and there are many of them in that area. Such a loss! He was a senior resident.
    God bless

  24. MJ says:

    I am appaulled at some of these comments and lack of compassion being said by his patients and his office that Jon’s death is an “inconveinience” to patients. Was Jesus Christ’s death on the cross an inconvenience as well?

    Being a doctor myself I spent 16 years of undergraduate school, graduate school, medical school, residency, chief residency, and fellowship. I was married at the age of 35 and had my first child at 39 with another on the way at the age of 40! Doctors give up an incredible amount of time but most of all compassion and emotional investment to give the very best care to their patients. They are human and with that are not immune to the pressures of being a doctor: the emotion, anxiety, enormous stress and other mental and physical illnesses if they arise. Not to mention the enormous amount of student loans we must take out and watch the intrest capitalize as we make next to nothing while in school and in training. That is taken for granted. I say shame on you who do this and do not know the facts. We are healers but not God. Only He decides if a patient lives or dies or whatever the outcome is. We help through His guidance and hands.

    The atmosphere of training can be challenging, stressful, and malignant. I do not know this man but I pray he and his family find peace in God and the Lord. We are not here forever, and it amazes me how concerned patients are about the physical posessions that we cannot take with us when we all die. Think about that and what your doctor has sacraficed so that he/she can help you or even save your life!! God Bless and RIP Dr. Azkue

  25. Mireya says:

    It is so sad to hear that a desperate human could not be safe from his despair. What took for some soul to get to the point of leaving this life? Hopeless thoughts? Hopeless feeling? All of these could have been change if this person had someone next to him to counsel him, love him as he was. I am from Venezuela too. I am a doctor too. I am a soul in a body that walks in this world for a set time, but I am optimistic in believe that we are here for a highest purpose like Dr. Azkue
    Which may be bringing to the conscious of all in the community of the epidemic in satisfaction of our profession. Let’s honor him with our voice and action and like Pam Wibble, make the move to don’t allow our current circumstances mandate our right to be happy doctors. Let’s join the movement of finding ways to change the current paradigm. We can do it and let Dr. Azkue, serve us as a symbol or image to what we need to avoid. Rest in peace. My condolences for his family.

  26. Knowhim says:

    I have known Dr Azuke for few months while i was working at the hospital , not sure what happened but came to know he has been fired from residency , this is very unfortunate incident where we lost a promising phsyician , it is not the first incident that happend but few other residents were also fired
    If the resident is fired it reflects very bad on the program itself and the program is really malignant program , residents are not respected they are treated as cheap labor, the leadership doesn’t value residents input
    some of the teaching faculty are not even qualified to teach and were poor teachers themselves , lot of stress was placed on residents to perform when they are poor performer themselves
    I myself have gone through a similar situation because of the few resident behavior who inherited their teachers traits ,
    The other residents behavior is a problem too in the program some behave as if they are better than other , try to intimidate and supress poor residents
    Half of them keep on complaining agains’t each other
    I hope people will start respecting other people and start behaving professionally

  27. Shari says:

    http://www.macneal.com/residency-programs/internal-medicine-residency-program/residents/third-year.aspx

    http://www.macneal.com/residency-programs/internal-medicine-residency-program/welcome.aspx

    Possibly they fired him because they wanted to keep their “100% pass rate” and he was struggling with the in-services.

    What angers me is that he has already been scrubbed from the list of third year residents. There is no mention of his loss on the program website. It is as though he never existed. And they waited until it was almost July to fire him.

    A&^ holes.

  28. Shari says:

    I think we should name names. The Residency Program is MacNeal Hospital Internal Medicine Residency Program, in Berwyn, Illinois (a suburb of Chicago).

    The person who approved the firing of a resident within 2 months of graduation (and who apparently has fired several others) was

    Sajan Thomas, M.D.
    Program Director, Internal Medicine Residency

    I think Dr. Thomas owes the medical community an answer as to why he felt it was appropriate to fire a resident within two months of graduation, and why he was unable to determine that the resident was unfit for duty at an earlier time.

    How can we arrange for the comittees that accredit programs to evaluate this hospital, since it apparently is unable to determine if residents are educable in less than 3 years, and has fired multiple residents in that period.

    It also seems to me that “board pass rates” for programs should include as a denominator all residents who start the program,not just those who complete).

  29. bee says:

    I do not know what the world has turned to, but our world is sick. I feel ashamed as a human reading this, is this all there is?
    I have always known as Physician myself that when all is said and done, its only your family that suffers; and more recently with the loss of close colleagues, brilliant ones who gave their all, Ive come to realize that nobody cares, how else can you think through comments such that a death is an inconvenience. Same way people have turned this solemn forum to blast doctors the more. Tell me, is there any profession, organization whatever that is perfect?, without any faults. Maybe we need to get some professionals or people doing their normal jobs to do the hours done by doctors, to live on their jobs as much as residents too, and get as much insults from their clients as much as we get from patients, and then sit down at the end of a week,compare notes, even compare wages and see where doctors fare………..its just not fare
    I think doctors need to fight for themselves, and for starters, think deeper, love your family just as the next person, go on holidays like normal people, stay home when you are sick, take time off to see your kids recital and football game , because at the end, your family that suffers while you run around working yourself to the burnout are those that are left to pick up the broken you and nurture you back to life or mourn your death. Live live as a human, enjoy what you do, enjoy your family, Medicine is just work like any other profession, dont be fooled, you are not irreplaceable.
    My heartfelt condolence to the loved ones of this colleague that I will never meet, Rest In peace.
    Bee, Canada

    • A former coworker says:

      I agree. As a nurse i have learned that it is not right for me to give my everything at work and to come home sad and unhappy to my husband and children and for them to suffer and me to be overwhelmed when I have to make time for my happiness and for my family. This is why I moved out of town. I used to work with Dr. Azkue. God bless him!

  30. Dr. Mike says:

    I am extremely sorry to hear about your Dad’s tragic passing. I believe he had a powerful dream that drove him so far and was unjustly and abruptly taken from him . From all the comments I’ve read about him and from those who worked with him he was unquestionably, an amazing physician and human being. Your Dad had dreams of not only being the excellent, compassionate physician he’s described as but of practicing in the “land of the free and the home of the brave”. What the hell happened to our star spangled banner anyway? Does Dr. Thomas and the others involved recognize any of these words or what they represent? When a genuine self sacrificing, highly dedicated physician is cut 2 months before he completes his life’s work dream; it’s time to isolate, demolish and rebuild a very broken system. Why did it happen? To apparently have his program look good because of some dimwit test taking skills. Is this the MOC of medical schools? The program directors will have to answer to a much higher authority for their implicit actions resulting in this tragic loss of life. In the meantime it’s about time this blog goes viral into the hundreds of thousands, Dr. Wible and lives on in perpetuity in the memory of this tremendous human being.
    I am very appreciative to Dr. Wible for her role in “opening the windows” for so many medical students, and especially physicians such as myself so we can let the air out and allow a new fresh thinking clear our minds and wake up to the fact that we are indeed very special . If we deny our own greatness we will only shortchange our patients as well as our profession and continue to allow the real abusers and perpetrators of healthcare to continue to destroy the most noble and cherished profession one can hope to embrace. Greatness is sometimes but a few inches away from where we stand, yet a tiny pebble will cause us to trip. Dr. Jon had truly embodied the qualities of the Hippocratic oath as he practiced both the art and science of medicine with love.Had those morally inept (pebbles) directors allow Dr. Jon but 2 additional months of residency they would have granted him the ability to live out the rest of his life and be able to happily provide excellent care to so many countless others. I’m convinced he lived a great human being who will live on in the hearts and memories of all those he loved and so many he touched, healed and cured along his life’s journey. These administrative decisions are only partially doctor driven; yet the powers behind the scenes will have no names or comments. May we all find comfort and be infused with powerful courage and hope in the memory of this special doctor who has been tragically taken from by the sudden injustice he fell victim to. I hope Jon’s story which is just beginning to evolve will help doctors wake up and change a system that can just as easily “throw them under the bus” as they did this fine and dedicated colleague.
    Let me be clear we are in urgent need of change and relief in our “new healthcare” system that makes unreasonable demands of physicians tantamount to outright abuse. You see physician abuse and harassment is no longer limited to residency but follows us into daily practice. The increasingly impossible demands made upon doctors today , which have very little to do with medical care are already beginning to make our residencies feel like a breeze and so many leave the profession as physician shortages are on the horizon. We must reclaim and reintegrate the art into the science of medicine and blow the dust off our own Hippocratic oath before it’s too late.
    It’s not working. We owe it to Dr. Jon Azkue to bring about important changes in America’s medical system from training to practice and reclaim our profession.
    Please help keep this post alive and booming in the memory of this tremendous physician.

    • Pamela Wible MD says:

      I’m in tears. Thank you for your words. May justice be served. May our beloved profession be brought back to life. In honor of our many, many fallen physician colleagues like Jon Azkue M.D.R.I.P.

    • A former coworker says:

      Awesome! I have fond memories of him. Thankfully here on this forum I have been able to see caring and empathic comments rather than the i humane things said on the ABC post. May his soul find rest.

  31. Dr. Mike says:

    At times our own light goes out and is rekindled by a spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us.
    Albert Schweitzer

    Let’s all continue to rekindle this special light of Dr. Jon, in order to bring light into the lives of others.

  32. jojo says:

    Scary quote from the programs website

    “ADDITIONAL INFORMATION
    •Residency training is not an entitlement or a convenience; it is a privilege and what we do is our duty to the people (i.e. our patients) of the State of Illinois. Hence it is our goal to recruit the best physicians possible to take care of and learn from our patients in our community. We look for physicians with high motivation, high sense of responsibility, high level of discipline, willingness to work hard, ability to work well in teams, compassion, and caring attitude. The Internal Medicine clinical learning at MacNeal Hospital will be academically demanding, strict, and intense for all three years of your training.
    •Only a select few applicants will be invited for interview. A timely response (to our e-mail invite) reserves an interview slot for you. No response or late response (> 48 hours) may mean losing an interview slot for you. Please check your e-mail daily during the interview season. Telephonic solicitation for interview or status of your application will not be entertained. We will place candidates on a waiting list based on needs of the program.”

    He doesn’t seem to realize while residency is not an “entitlement” and is a “privilege”, people have certain workplace rights….although for residency fair labor standards do not apply. Reminiscent of MLB when players only had year to year contracts before the owners got taken to court. They were stuck on the same team and put up with deflated wages.

    that guy should not be allowed power over other people, he sounds blatantly abusive from the website they advertise

  33. jojo says:

    And if you want to stop physicians being the abused mules of corporate healthcare then organize. Maybe you cant do a sit down strike, but you can stop writing notes except the essential. Stop going to committee meetings, stop doing QI BS, stop teaching students which will get the hospital in trouble with medical school regulators. Do not rush patients out of the hospital by not cooperating with case managers sticking them in a cruddy rehab. Slow the speed of patient care to what it used to be and at a safer one. The BS admissions can be blocked and anyone else transferred to other facilities. Your billion dollar a year employer will feel the hurt pretty quick. And as long as enough people do it, stick to it, and tell locum strike breakers to respect it something could change. Patients will end up benefiting the most stopping this madness.

    only a physician can admit and d/c a patient. Even if you had to unwillingly transfer Pt care, some other MD needs to accept them.

    just stop them from getting reimbursed and they’ll make conscessions

  34. jojo says:

    Oh and a lot of our BS work will get dumped on nurses, what they legally can do, and they will have a fit and leave or strike. They dictate hospital policy more than docs. They are also more used to farming their work out to techs now, so it wont go well when they get more work.

    and hopefully you got a base salary to survive on without rvu’s

  35. Dr. John J. Shigo says:

    I attempted suicide 3 times because I felt trapped in an unforgiving world. I was enduring a very traumatic divorce and felt that I could not survive and be alive anymore. After being saved the third time I had the insite to seek help with friends as family and even my psychiatrist did not recognize my manic-depressive symptoms and classical signs. I almost self-destructed. I had no desire to live, enjoy life and be happy! My planning failed! Friends not doctors, rescued me. It’s amazing that after I recovered my admission to my hospital medical staff was questioned because of my attempted suicides. My application was referred to the Executive Committee and they approved me after a lengthy interview. I guess they thought I was still human, but not intelligent in the past, mentally. I rehabilitated with the Physician Rehabilitation Committee for 3 years and was allowed to start practice because of compliance in six months.

    For the last 10 years, I have been stable and not suicidal. I plan to teach medical students and physicians, how to recognize the subtle responses made by potential he suicidal physicians and medical students. One of my classmates in medical school jumped out the six story window to his death. It’s shameful how we as doctors and in this case medical students, turned a blind eye to a deadly disease – suicide. The causes are usually stress related events – work, study, interpersonal relations, financial loss, divorce or loss of a mother or father or family member. This does not exclude the genetics of depression, manic-depression and anxiety disorders!
    As I look back at my past as a physician since 1970, I am able to recognize the signs and symptoms of suicidal ideation. I am grateful as a human being to be able to help my fellow colleagues who are suffering from this terminal illness. It is my intention now become an integral part of any Ideal Medicine Organization, like that of Pamela Wible’s group. As I have treated my patients with dignity and respect and consider them a part of my family, I relate to Pamela’s Practice of medicine. I give all my patients my private phone number — mobile, so they can reach me at any time and for whatever reason. It’s amazing how many times I have been hugged and thanked my patients/friends!
    It is only now, that I realize my calling as a healer/ physician. I’m amazed how long after the Hippocratic oath that I took upon graduation that I finally can say I am truly worthy of my role as a physician in my community. Thanks for the opportunity for me to discuss my learning process with suicide. John

  36. Jasana says:

    Pamela,
    Thanks for your article. I am an Ophthalmologist from Brazil and I am working right now to get a license as a Pharmacist. Being a physician is stressful and I have a family now. I just don’t need that much responsability over my shoulders and I want more time to enjoy my life, family and friends. Life is short.
    My best wishes,
    Jasana

  37. It is not only young physicians who are vulnerable. Older physicians either become cynical, quit before their time or worse. It is not surprising that in big cities dying is an inconvenience. In the smaller cities and towns where advanced health care is not as abundant, the death of a person is still a tragedy. That is the reason why I am still practicing. There is still a sense of community and belonging out here in the rusting belt.

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