“Happy” med student dies by suicide—due to perfectionism and loneliness →

Nine years ago today my friend’s “happy” daughter died by suicide—due to perfectionism and loneliness. In her mother’s words:

“Dear Pamela, On 4-11-13, I lost my 23-year-old, brilliant daughter Kaitlyn Elkins to suicide. She was just beginning her 3rd year of medical school at Wake Forest School of Medicine in Winston-Salem, NC. Saying we were and still are devastated is a great understatement, but another thing was the absolute shock as we thought she was one of the happiest people on this earth. She was sweet, brilliant, gifted in all academics as well as an artist, poet and writer, and marathon runner. And she never, ever in her whole life showed her depression to us (her parents) or her friends except she did tell her last boyfriend that she was depressed at times, but she told him we knew….we didn’t. I think she told him that so he would not tell us.

She was highly functional until the last day of her life, going to great lengths to plan her suicide and did it like a well-planned school project. She was doing very well in med school. She left us a two-page suicide note, as well as one to four of her friends and one to her sister. In it she told us she had been depressed all her life but hid it from us to protect us from it and to protect herself from it. She said she could not explain why she never sought help. She said she was exhausted from the weight of her depression and this is what made sense to her.

She always told us she loved medical school. I’m not sure, but since she said she had been depressed all her life, maybe medical school added so much stress that it made her depression worse. I think she never asked for help due to the stigma and she was a perfectionist and did not want to be seen as weak. She had to know, as well as I know, that depression is an illness, not a weakness and can be treated. But for whatever reason, she did not seek treatment.

She was an introvert, but did have close friends, but I don’t think she had any in medical school. Whenever I asked if she had any friends in med school she said that no, that mostly everyone went their own way. I did not worry about this, but in hindsight I think she felt lonely and isolated.

I had no idea that depression and suicide rates were so high in med students as well as MDs until she died. I think as a child she must have suffered existential depression that so many gifted children suffer. Feeling alone because no one thinks as deeply as most people their age do, though I did not even know what existential depression was then, but only since I have researched since her death.

Med schools and the medical profession needs to put more emphasis on mental health of their students and colleagues. They need to make it so no one fears losing their license by admitting they need help and getting it.

I wrote a book after my daughter died about these things which I hoped would shed light on these things to people that need to hear it. I am so glad you are bringing attention to this topic. I wish you continued success with this and maybe we won’t lose as many brilliant med students and physicians that could have lived on and made a wonderful impact in our world.”

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I spoke to Rhonda often. We became friends after her daughter’s suicide. Then Rhonda took her own life one year later—the same night I was honoring Kaitlyn and reading excerpts from Rhonda’s book at my talk How to graduate medical school without killing yourself. When I called to tell Rhonda we got a standing ovation, she never answered. The next morning I found out she had taken her life just like her daughter. Her last email:

“Pamela, thank you so much for your article. It was very informative. All I could think about was no wonder Kaitlyn was depressed. All I know is that by the time she killed herself and had two years of medical school under her belt, she thought she was ‘a fake, lazy and would wind up disappointing everyone.’ I don’t even know how to feel about her medical school anymore. Did it kill her? Would she have killed herself no matter what her course of study? I just don’t know. It certainly didn’t make things better . . .Thank you for keeping her picture near you. That makes me feel good. Kaitlyn would want to help all she can and so her spirit is with you often.”

After attending Rhonda’s funeral, I kept in touch with Kaitlyn’s dad, Allyn, who died from pancreatic cancer last year. Please join me in sending love today to Stephanie, Kaitlyn’s sister, who has lost her entire family.

Here’s what perfectionism, loneliness, and depression look like in med school.

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Surgeon’s “widow” calls out double doctor suicide →

Dear Dr. Wible,

After a surgeon killed himself at my husband’s office, his group hired a physician to replace him and a few weeks ago he also killed himself—at his desk at the hospital. I feel his suicide is being swept under the rug. I can no longer remain silent.

As the spouse of a dedicated and honorable surgeon, I witness countless atrocities buried under “the greater good.” In training, we’re told “things will be better.” You will be an attending! You will be more respected. You won’t have to work nights. You’ll have expensive things, pleasurable hobbies, time for family and friends. In short, IT WILL ALL BE WORTH IT. Truth is—working conditions are worse.

Being a physician’s spouse is like being a single parent. My husband is on his 33rd straight day of call today. If we are lucky, he’ll makes it to our kid’s school performances—once every few years!

All that life sacrificed on the altar of getting to where you are. Gone. All those times you could not be there for your spouse or your kids. Gone. All those gatherings you missed and then were criticized by unsympathetic family members. Gone. By the time our husbands realize their dreams have died, they’ve lost multiple colleagues to suicide. We all know our spouse might be next. As surgeons’ wives we already refer to each other as surgeons’ widows.

Let’s be honest, most practices are not run on an altruistic basis. It’s about the bottom line and covering your ass in the event you are sued—with no emphasis on mental health—until one of your partners puts a gun in his mouth and blows his head off at work.

In the wake of such a tragedy we have group meetings, and someone says, “we need to give each other hugs and go to therapy.” Does it happen? Maybe. For a hot minute. Then it’s back to the daily grind and making sure your billing sheets are turned in every morning. No more talk of mental health. Counseling isn’t even covered on our insurance plan!

Daily trauma that doctors witness is pushed aside—left to fester until someone snaps. Sadly this isn’t limited to physicians, but also impacts their children (who have higher rates of suicide too). Our surgeon who died last week lost his son to suicide a few years ago. Yet another reason wellness MUST be a priority for everyone—not something hospital admin claim to care about and have very little tolerance for.

We all know it’s taboo for physicians to discuss being emotionally spent and at the end of their mental/physical rope. God forbid your competency be questioned and your medical license be jeopardized. With god-like standards to uphold, doctors are expected to give 110%. That’s not human, nor humane. When overworked physicians get home, they’re checked out—nearly catatonic. Wives fear bringing up even little things as it may light a fuse that sets off our husbands. We even have a Facebook group for physicians’ wives experiencing domestic violence!

One thing is for certain—more doctors will die by suicide. I pray my husband isn’t next.

May THAT truth motivate action: Tell the voice in your head that claims you need to live up to societal expectations of what a physician should be to shut the hell up. (I’m talking to women docs too). Life if short and then you die. Society won’t care. Your spouse and family will miss you. We already do!

Lastly, see a freaking therapist. You can afford it. Make time in your schedule. Take a deep breath and clear your mind for two minutes. Set your phone alarm (even if you think it seems ridiculous, come on, just 120 seconds—please, try it this week!). Yes, I know you have to see 56 patients in clinic today. Yes, I know people’s lives depend on you. However, your patient’s life depends on you being alive. Caring for your mental and physical well-being is PART OF YOUR JOB!

~ Surgeon’s “Widow”

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Dear Surgeon’s “Widow,”

Thank you for your courage! Sharing your truth is the prerequisite for healing. I agree all physicians require non-punitive, confidential, and proactive mental health care. Waiting until passive suicidal thoughts become actions is not the right plan. Upon interviewing male physician who survived suicide attempts, I’m told once they “snap,” they take definitive action within 3 – 5 minutes. We’re unlikely to save our doctors in the last minutes of their lives.

What works is creating a culture of wellness so doctors feel safe at work—appreciated by colleagues and patients. Even a short text message has averted a surgeon’s suicide. Patient thank-you cards have prevented physician suicides. We need kindness. 

To prevent future suicides, we must investigate each doctor suicide.

A targeted treatment plan, requires an accurate diagnosis. What type of suicides are we dealing with—and why? Most suicides are solitary and private. A double suicide is when two people die by suicide, often simultaneously. A suicide pact is an agreement between two or more people to kill themselves. Suicide contagion is when one suicide increases the likelihood of other suicides soon afterward and can lead to a suicide cluster when three or more suicides occur in short order at a rate greater than expected within a community. None of these terms accurately describe what happened at your husband’s practice.

We have no terminology for the phenomenon of occupational suicide of a physician who replaces another physician who has died by suicide. On my registry of nearly 2,000 doctor suicides, I know of several cases in which very similar physicians die within less than two years in the same institution (even on the same spot). Example: Two J1/H1-Visa Muslim physicians from Mauritius die by stepping off the same NYC hospital building. Why? No investigation has been launched. Two Jewish orthopaedic surgeons from the same practice die by gunshot wound. I’ve spoken with a suicidal Jewish anesthesiology resident who inherited his pager from a prior Jewish anesthesiologist who died by suicide at the same hospital. One common theme in these scenarios is a toxic workplace rife with bullying and overwork that leads to loss of multiple physician lives. In my quest for a precise name for this phenomenon, some physicians have suggested these cases are occupational homicides due to human rights violations.

To stop the loss of life, we must diagnose the problem and treat what appears to be a systemic issue claiming individual lives with no end in sight. More doctors will die unless we have the courage (like you) to speak out and define the real occupational culprit.

~ Pamela L. Wible, M.D.

P.S. The Occupational Safety and Health Act (OSHA) protects workers from being killed or harmed at work. The physician work environment is clearly in violation of the OSHA. High-hazard industries such as hospitals and clinics with more than 10 employees must record work-related injuries that require more than first aid on an OSHA form and post a summary of their yearlong injury log in a place where workers can view it. You have the right to request full copies of the report from your employer. Within 8 hours after an employee death due to a work-related incident, employers must report the fatality to OSHA. When medical institutions fail to report physician death by overwork within 8 hours—as required by OSHA—it is a breach of institutional integrity, an active cover up, and an obstruction of justice. The law requires employers to provide employees with working conditions free of known dangers. If unsafe, unhealthful, or hazardous: (a) file an OSHA complaint; (b) request the latest yearlong OSHA injury report to ensure your employer has reported all workplace deaths, and; (c) request a NIOSH evaluation.

Author’s anonymity is upheld per her request. For physician trauma recovery support groups, monthly retreats, (including physician widow retreats) & free physician suicide helpline, contact Dr. Wible here.

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Honoring our physicians who have died by suicide →

Join our FREE doctor suicide survivors support group here.

Wall of Remembrance from award-winning documentary, Do No Harm: Exposing the Hippocratic Hoax, a film exposing our doctor suicide crisis that honors nearly 100 doctors who have died by suicide. May we never forget them. ❤️‍🩹

Greg Hamlin Miday, M.D., Internist

Kevin Thomas Dietl, D.O., Degree Awarded Posthumously

Kaitlyn Nicole Elkins, Medical Student

Sean Michael Petro, Medical Student Read more ›


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Dear deathly afraid of seeking help ❤️‍🩹 help is here. ⬇️ →

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Launch your coaching practice—without a medical license →

Enjoy the above 51-minute video excerpt from our advanced business mastermind on how to start coaching. Download MP3 audio below. Please share with all who are struggling in need of inspiration and a quick cash infusion.

THIS IS FOR YOU IF . . . 

1. You are unmatched to residency, did not complete residency, or do not have an active medical license.

2. You want to retire from medicine and continue to work a really cool retirement gig as your own boss.

3. You want to add a coaching arm to your existing ideal clinic (you may enjoy it so much that you go 100% coaching).

What is a physician coach? A physician coach helps clients move from their present state to a more desirable future in a co-creative partnership either one-on-one or in small curated groups. A coach will help clients normalize emotions, identify challenges and transform obstacles into victories to achieve goals. YOU DO NOT NEED A MEDICAL LICENSE to be a physician health coach.

Should YOU launch a coaching practice?

TAKE THE QUIZ

1. Would you like to help clients worldwide?

2. Would you like to see clients one day per week from your beach house?

3. Would you love to stop paying dues & licensing fees?

4. Would you like to never pay medical liability premiums again?

5. Would you love to only have super-ideal non-victim clients?

6. Would you love to have a successful practice—without residency?

7. Would you like to stop hoop-jumping?

8. Would you enjoy all prepaid cash clients?

9. Would you love to ditch your EMR—and heal people without charting?

10. Would you like to go to sleep at night with no loss-of-license worries?

11. Would you like to get mental health care without fear of losing your license?

12. Would you love to have freedom of speech, freedom to practice your healing art in alignment with your highest values without emotional blackmail, threats, manipulation?

If you answered YES to 10 or more questions you should DEFINITELY launch your coaching practice in 2022.

Please view video excerpt above for details & join us for our weekly support groups.

Need more guidance? Contact Dr. Wible

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