Physician Self-Care vs. Self-Abuse

Self-Care vs. Self-Abuse

Yesterday I posted this on Facebook and was overwhelmed by comments . . .

Today I’m celebrating 30 days of weight lifting (with a personal trainer) & back on 100% plant-based nutrition that makes me feel awesome. YESSSSS! I (finally) made the decision one month ago to start taking care of myself!!!! More than 3 decades ago (in high school) my mom asked me, “When are you going to stop taking care of everyone else and start taking care of YOURSELF?” I had no idea what she was talking about. Her question didn’t even make sense to me. I thought it was normal to caretake & nurture others. I thought my gift of opening my heart & soul to care for special needs animals & people & anyone who needed my help was what I was born to do. Only last month did her question FINALLY make sense to me. AFTER 24 years of school (& 11 years of medical training). AFTER 26 years of being a family doc and taking care of everyone who needed me regardless of ability to pay. (Oh, and I chose family medicine over pediatrics or nephrology because I wanted to take care of EVERY organ system of EVERYONE in the whole world!). “When are you going to stop taking care of everyone else and start taking care of YOURSELF?” only made sense AFTER becoming so disillusioned with big-box assembly-line medicine, I nearly ended my life by suicide. AFTER losing so many med students & doctors to suicide that I’ve been running a free physician suicide helpline on my own since 2012. AFTER being determined to find out WHY my brothers & sisters in medicine were killing themselves. AFTER investigating the suicides of 1,300 doctors & med students. AFTER seven years of running myself ragged flying across the country to help suicidal med students & residents in crisis, leading free retreats for surviving family members, vigils for deceased doctors, and organizing & facilitating a giant free retreat for 500 docs in NYC last fall to prevent doctor suicides that ALMOST KILLED ME (yes, I had pneumonia & I kept working even when several docs surrounded me and tried to force me into going to the hospital, I would NOT go. Why? I HAD WORK TO DO to help save everyone else who was suffering—and yes, I was so sick & febrile that I was probably delirious and I did hear the angel of death whispering to me in the middle of the night, “Pamela . . . Come here Pamela . . .” ).

What kind of person does something like this? There IS a word for this behavior. *** THIS IS CALLED WORKAHOLISM *** One month ago I decided to STOP BEING A WORKAHOLIC the day after publishing Human Rights Violations in Medicine: A-to-Z Action Guide, a guide that gives actionable instructions for victims to SAVE THEMSELVES. Yes, I finally cracked the code on WHY my brothers & sisters in medicine are dying by suicide. Yes, I have a solution that will prevent 99% of future suicides among doctors. Yes, I have given those instructions to victims who can now save their own lives. SO I AM FREE!! I’m here. I’m happy to guide you. I’m still running my doctor suicide helpline. However, I’m no longer going to do the work FOR YOU. I’m no longer going to do the work of 100+ people. Yep. >>> I AM NO LONGER A WORKAHOLIC. I AM NO LONGER A WORKAHOLIC. I AM NO LONGER A WORKAHOLIC. This is what SELF-CARE looks like. (& it’s not a weekend retreat. it’s not a massage, it’s not a green drink). SELF-CARE IS A PERMANENT LIFESTYLE. Have you suffered from workaholism that has almost killed you? Guess what. YOU CAN STOP THE CYCLE OF SELF-ABUSE NOW. TODAY. Who’s with me?


Above: This is me now—as a true role model for self-care (after nearly killing myself from workaholism = self-abuse).

Below: This is me last fall pointing up to the 33-story rooftop of a Mount Sinai building where a beloved colleague died by suicide. I was so determined to prevent the suicides of my brothers & sisters in medicine that I almost died by self-abuse in the process. Self-harm is not always as dramatic as suicide. Like our patients who die slowly by self-harm (no exercise, crappy diet), doctors can also die a slow suicide from self-abuse. Don’t be a victim of your own abuse. I don’t want you to land on this sidewalk with all our fallen physicians. Your FIRST JOB is to save yourself. Then save your patients.


Doctors & med students—to learn how to take care of yourself so you don’t die by your own hands, view this keynote: Physician Suicide–Prevention & Intervention.

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13 comments on “Physician Self-Care vs. Self-Abuse
  1. Char Glenn says:

    Thank you.
    That was a good idea to get your self-care book published.
    I’m glad you can take a break. (and you don’t have to do more…)
    You’ve done a whole lot.
    HUGS and KUDOS

    • Pamela Wible MD says:

      Ah it’s not a self-care book, it’s a legal strategy guide for physicians and med students who have suffered human rights violations in medicine (pretty much all of us).

  2. IG says:

    Love it!!!! Yes, i agree with you 100%. Its almost like a curse, workaholics. Its nice to see that I am not thw only one to think in similar ways. Its so hard to fight the urge to please others, to take care of others, to put their needs above ours. Its so hard. But it has to be ME the one to decide that. Like you said, it is up to us to make the PERMANENT LIFE STYLE CHANGE. It is uncomfortable. But it is doable. Thank you for sharing your thoughts.

  3. Jaime says:

    Very good piece of ideas, in such hard Profession.

  4. Anita says:

    I love this! You look fabulous!
    Honest and inspiring.
    Let us know a little more about your diet, if possible.

    • Pamela Wible MD says:

      At the moment I feel addicted to red lentils and quinoa! AMAZING superfoods 🙂 Love my green smoothies too.

  5. Sinead says:

    Delighted you’ve decided to embrace permanent self-care.

    This sentence made me laugh out loud and also sit up straight in my bed (it’s 7am in Ireland).

    “Oh, and I chose family medicine over pediatrics or nephrology because I wanted to take care of EVERY organ system of EVERYONE in the whole world!)”

    Wow, ain’t that a motivation tweezed from the noise in our heads.

  6. Samantha says:

    Hi Dr. Pamela,

    I wanted to say that I’m overjoyed for you that you have adopted a self-care lifestyle and have chosen to leave behind workaholism. It is a powerful demonstration of self-love. You deserve to live a life full of joy, balance, ease which is informed by a significant awareness of and appreciation for your own inherent worth that is not defined by how much you do for others.

    With love,


  7. Melissa says:

    I’m glad you’re taking care of yourself. I met you and read your book during medical school. Your words were a lifeline for me during training, inspired me to speak up for co-residents and stand up to my med school and residency when they were being abusive, and helped to guide my career decisions. I’m sure there are many thousands of docs who have had the same experience. You are making a huge difference. And you deserve (and have deserved all along) to take care of yourself!

  8. Sue Zimmermann says:

    Dear Pamela,

    THANK YOU so much for sharing this!

    I spoke with you last year about my friend from internship, a general surgeon who had committed suicide. This past weekend I attended a gathering of her friends and family on the year anniversary of her death. People shared memories of what a bright, funny person she was. She was also a perfectionist, and it really hit me how we as physicians feel that we have to be perfect – we can never make a mistake, we can’t say “no”, we have to be there for everyone. We tell ourselves that nobody is perfect, that we have to take care of ourselves because otherwise we can’t take care of others, etc.. But why is it so hard to internalize this advice – when we would never expect our loved ones or anyone else to be perfect?

    We need to see more examples of strong, brilliant physicians like you who are not only saying that it’s OK not to be “perfect”, but taking action.

  9. Donald says:

    congratulations Pamela, taking care of yourself allows you to take care of others.
    my most important question when I was conducting interviews to the medical school
    was how the candidate handled stress; what was their pressure release to diffuse
    stressors they had no idea existed. so good ya lassie. mine was a 10 mile run every
    off-call day. I would go in to the hospital in the morning and leave the next night then
    run 10 miles in 70 minutes that next day would begin; the call day was burned away.
    and I began that journey 6 years before going to medical school and continues to the
    present 49 years later and counting. be well young lady. cheers-Donald

  10. Regina Bahten says:

    I’m glad you are publicly taking care of yourself, and I’m glad you learned before you had cancer. Cancer (and my mother’s slow death from astham) taught me that although I’m a pretty talented doc, I still only have a finite amount of hours in the day, and no matter what I do, there will always be more wothwhile work left to do. i”m the only one who determines whether or not I feel guilty about that. It took a while to accept that while I was not able to give my mom the care I wanted when she was dying, it as more important to her to have her other (crazy) kids involved. Would not have been my choice, but it was her death, not mine. So learning our limits is hard, but worthwhile. The solution to every problem is NOT another pound of my (or your) flesh.

    Anyhow, keep up the self-care. No one else can do it for you.

    Warmest regards,


    PS, your comment about wanting to take care of every organ of every person really resonated with me. I felt a little guilty telling patients that they would have problems outside my scope, but I’m getting used to it!

  11. RB says:

    I think all of the above contribute to the workaholism/perfectionism and the thought that we do want to help everyone, and we really don’t want someone in the profession who doesn’t feel that way to some degree. Also, the books teach us how to address problems, with kind of an unspoken expectation of “it will work and everything will be fine.” There’s never anything about “try this, it probably will work but not always.” Also, we get so much of our self-worth from what we do, and more is better. Like veterans, we don’t share our moments of vulnerability. Senior soldiers never want to turn real responsibilities over to juniors, even if they’ve trained them and even if they remember that they were once the junior. There’s a fear that no one else can do the mission as well. Which is of course BS.

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