Physician trainees prevail in strike over harassed doctor’s suicide →

 

Dr. Omkar, 30-year old pediatrician trainee died by suicide after years of alleged racial harassment by head of department. Dr. Omkar is from a lower caste tribe, the only son with 2 younger sisters. Elder sister just married the day prior to his suicide. Head of department denied him leave for the wedding even though his peers agreed to cover his shifts. He was found hanging from the hospital dorm ceiling fan with the dupatta he’d bought as a wedding gift for his sister. (Most doctors in India choose this same method of suicide to end their pain). Read more ›

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Second victim syndrome suicide →

Remembering Nurse Hiatt & Baby Kaia on the anniversary of a medical error that led to her loss of life. Kim Hiatt, a NICU nurse, was accused of caring “too much”—until September 14, 2010, when she gave 1400 rather than 140 mg of CaCl) to a frail 8-month-old, whom she’d cared for many times & was close to the family—who forgave her. Devastated, she admitted her mistake immediately. Read more ›

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Why doctors don’t get mental health care →

As doctors, we deal with things you’d never want to see—mangled teens in car wrecks, new moms diagnosed with cancer, child abuse, and more. So much trauma leads to PTSD. No surprise we have a high suicide rate. We’re three times more likely to die by suicide than our patients. And (here’s the kicker) we’re PUNISHED if we seek help. Read more ›

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Blaming “difficult” patients for lack of informed consent →

A surgeon asked me to share her story of blaming “difficult” patients for lack of informed consent.

When I was a surgery resident, I saw a severely ill hospitalized man who needed a leg amputation and our attending surgeon and senior surgery residents never adequately explained to him why he needed surgery. Each morning on rounds, they kept asking him if he was ready for a leg amputation. Our patient would cry and say he didn’t want his leg chopped off. . . he didn’t know why it was necessary. The surgery team treated him with disgust . . . labeled him as a difficult patient and just walked out of the room. I think it’s extremely dangerous when doctors label patients as difficult or crazy. Everyone was calling him crazy. He was not known to have psych disorders. . . They said there is no point in even talking with him because he is completely unreasonable. It’s a very normal emotion to be scared about an amputation. Yet calling him difficult and bipolar stopped our team from conversing with him. . . .

Finally he asked me if I could explain why he needed surgery. I promised him I would. I talked to our attending surgeon and told him our patient was open to life-saving surgery; simply that he did not know what the surgery entailed, and that he was refusing because he was scared. I asked if the attending surgeon would talk to him and he said, “No.” He said if I wanted to I could, but then he also reprimanded me for staying in the hospital too long and being an inefficient doctor. At 9 pm, after I was finally done with my tasks, I sat with our patient and brought a copy of his angiogram so I could explain why he needed surgery. It was inappropriate for me as the junior resident to be the one telling him but I did my best . . . He was so thankful I spent time explaining his condition. When he understood the pros and cons and risks of surgery he decided to proceed with amputation the next morning (he could have died from gangrene otherwise). I told my seniors about my conversation. I was never thanked for my work. They just kept calling him “bipolar” for supposedly changing his mind.

WHY do doctors act this way?

With no labor law protection and no mental health care (& punishment if we seek help), some surgeons working 100-hour weeks just go numb from all the suffering. Cut off from our own emotions, doctors make fun of patients who still have emotions as “sensitive” or “crazy.” And ridicule peers who spend time with them as “inefficient.” Dehumanizing others is our defense mechanism—to avoid feeling our own pain. Because If we could feel our pain, we’d be flooded by a tsunami of tears that would incapacitate us. Doctors (over the years) have actually told me they’ve lost the ability to cry, so maybe our cries for help come out as ridicule, insensitivity, and bullying.

“If you don’t heal from what hurt you, you’ll bleed on people who never cut you.”

Full conversation with surgeon here.

Dr. Wible’s article on informed consent

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Why doctors laugh about death →

Why do doctors laugh about death?

Kobe Bryant’s widow said she didn’t know first responders would refer to her deceased loved ones as “gumbo” or “hamburger meat.”

“It’s Taco Tuesday at The Baja California Bar & Grill, two days after the helicopter crash that killed Kobe Bryant. Talk at the bar turns to the crash. LA County Sheriff’s Deputy takes out his phone. Graphic photos of Kobe Bryant’s remains. . . He has pictures of all the dead bodies. . . .Deputies laughed and found the photos amusing.” (ABC News)

First responders are not laughing because burnt bodies are funny. First responders are traumatized—and laughter releases tension—and endorphins, natural pain killers.

Most people don’t know what mangled bodies look like (and they don’t want to know). For first responders it’s just another day at work. Either laugh or cry. Dark humor is our #1 coping method. Alcohol is #2. Both legal at happy hour.

Most first responders (& doctors) have PTSD. If we admit our pain, we may be punished. A physician I know sought counseling after the death of a child, her patient. Counselor turned her into the medical board. They sentenced her to five years of monitoring. For her normal human grief.

Most guys aren’t gonna spill their guts after a helicopter crash to a psychiatrist—and risk getting labeled for life—when they can get free mental health care with the neighborhood bartender.

Sharing crime photos at cocktail hour is, of course, terrible. An onlooker said, “I can’t believe I just looked at Kobe’s burned up body and now I’m about to eat.” Most people wouldn’t be able to eat. As a physician child of physician parents, I learned to eat during gruesome conversations. At dinner, my parents discussed autopsies and described plane crash victims—charred bodies burned beyond recognition—as “crispy critters.”

Dead burned people can look like barbecue. We use food descriptions because, well, the flesh of mammals looks the same. And we’ve got to process these tragedies somehow—and some of us do it over dinner. Others bury their pain. Like the fire captain with trauma so extreme he can’t recall being at the helicopter crash. Trauma amnesia is REAL. I blocked out entire portions of my life that resurfaced last year while writing my memoir. I somehow “forgot” that I did child abuse autopsies the summer after my first year in college. Yep, blocked that out for three decades.

So rather than vilify first responders for laughing at death, consider this: Trauma laughter may be—involuntary. The wife of a physician told me: “When my ex-husband was in med school, his lab partner and friend drove out into a field one day and shot himself in the head. We found out on Halloween. My husband started to laugh; the strangest hiccupping sound I ever heard came out of his mouth. He never laughed any other way after that . . . He struggled with alcoholism, depression, and suicidal thoughts . . . “

I speak about doctor suicides at medical conferences—and doctors laugh when I’m on stage—talking about suicide. I know I’m quirky, yet I don’t think they’re laughing at me, they’re laughing about suicide. I record my speeches and I’ve counted up to three laughs per minute. . . So I googled “How many laughs per minute do I need to be a comic?” Four to six. Since I’m one laugh short of going pro, I took standup classes in NYC to learn how comedy works.  (Here are three comedy sets I performed in NYC)

“Humor is what happens when we’re told the truth quicker and more directly than we’re used to.”

Doctors aren’t comfortable with doctor suicide—it’s little too close to home—so laughter helps us dissociate a bit. Plus laughing together creates community—shared intimacy—which we really need amid the incomprehensible suffering we witness.

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