An open letter published with permission from a resident physician in the aftermath of a doctor suicide:
“A resident at U of M [Manitoba] has committed suicide. The school circulated and email stating that he died as if it were an accident. If I hear one more person utter the words ‘physician resiliency’ I’m going to lose it. Making this an issue about ‘resiliency’ is a pretty clever way to shift onus on the individual. In the face of this mental health crisis we hear again and again that we need to ‘bolster resiliency.’ What does that mean? Toughen up? Take time for yoga? I think the language is becoming toxic. Please tell me how one can be ‘resilient’ working 110 hours a week in an ultra-stressful environment. By using your 30 minutes of free time every week for mindfulness meditation? Organic food? Free coffee in the lounge? Let’s cut the crap and talk about real issues facing residents: the exhausting workload, the hours, the toxic working environment. access to mental health services, the inability to take personal days. So please do not insult us with talk of resiliency. We’re all resilient. We all fought hard to get here. It’s one thing to ignore a problem, and another to deliberately misdirect and mislead. Show some damn respect.”
I was asked for advice so I share the impact of gaslighting and blaming victims for lack of resiliency when they are subjected to hazardous working conditions that violate their human rights.
Gaslighting is psychological manipulation of a medical student or physician leading the victim to question their own sanity.
The goal of a gaslighter is to make a medical student or physician doubt themselves, lose their sense of identity, perception of reality, and self-worth. Article 26 of the Universal Declaration of Human Rights proclaims: “Education shall be directed to the full development of the human personality and to the strengthening of respect for human rights and fundamental freedoms.” Yet gaslighting is a common form of manipulation and mind control in medicine—often through words and phrases that are repeated over and over again until victims are so worn down that they accept (and even defend these words) as their new reality. Gaslighting is psychological warfare.
Physician “burnout” is the most popular victim-blaming buzzword used to make medical professionals question their self-worth while distracting attention from the medical system that has perpetuated human rights violations on physicians. A slang word for end-stage drug addiction first used on the streets of inner city America in the early 1970s, “burnout” is now weirdly accepted as a real condition for doctors. Despite medicine’s obsession with measuring physician “burnout” for nearly four decades, the epidemic of physician cynicism, exhaustion, and despair is worsening. Psychiatrists define “burnout” as a job-related dysphoria in an individual without major psychopathy—meaning you’re normal; your job is killing you. You are not at fault. Stop accepting blame.
The proposed solution for physician “burnout” is physician resilience. The word resilience is used to blame doctors who are truly among the most resilient human beings on the planet and simply need to be treated with respect and supported in their work. If you made it into medical school you’re already in the top one percent of compassion, intelligence, and resilience. You have no resilience deficiency. You are not defective. You are responding normally to an abusive medical system as this doctor explains:
“After a forced increase in work hours to maintain productivity, my chief publicly blew up at me unprovoked in the OR like something out of a horror movie as he morphed into a monster before my eyes and triggered my PTSD. Then the male physician administrator pats my hand, oozes sympathy, and honestly said, ‘You are clearly the most burned out of our anesthesia group. Tell me how I can help you be more resilient.’ I am a 61-year-old woman who has practiced anesthesiology for nearly 30 years: I am as bloody resilient as I can be! Why does the system create an untenable set of working conditions, causing stress and exhaustion, and when the predicted outcomes occur—I am the problem!”
To prevent physician “burnout,” health care institutions may offer physician resilience workshops to train doctors to prioritize self-care and manage their emotions so they don’t become disruptive—another term that blames doctors who express feelings of despair from gaslighting. Disruptive physicians who stand up and say no to abuse are then labeled as unprofessional. The list of gaslighting terms used to manipulate and confuse doctors are too numerous to compile (though I encourage you to keep your own list at the end of this chapter).
“Despite seeing a physician on a regular basis, I had to seek psychiatric evaluation at an emergency department,” reports a trainee. “Rather than going to a facility covered by my insurance, my program insisted I come to my own hospital—what followed was an egregious violation of my health records that were modified and used against me. I was blamed for my mental health: my ‘burnout’ and my lack of ‘resilience.’ I was coerced into resignation, and I would later discover I was not the first nor the last resident in my program to experience this. I am still on the road to recovery from this harrowing situation.”
The end result of using gaslighting words that blame doctors for the abuses committed by the medical-industrial complex is physician disempowerment, hopelessness, anxiety, depression—and suicide.
Appointing chief wellness officers to help physicians with “burnout” by mandating wellness modules for the abused can be part of the problem as illustrated in the video below.
TAKE ACTION NOW
Always ask for precise definitions of all words used to blame doctors at your medical institution. If there is no definition or the meaning is so convoluted that you are confused, then there is a high probability the word is being used to gaslight you.
Ask, “What could I have done differently. What is the proposed solution?”
Talk to a trusted mentor to get feedback before accepting any label and definition as helpful to you.
Stop using gaslighting phrases like “physician burnout.” Physicians are not the problem. Victims perpetuate the cycle of abuse by using the words of their oppressors.
Document, document, document. Save every email and record every conversation. If you are being blamed, manipulated, and confused at work, document everything. Reference Human Rights Violations Documentation Guidelines in this book.
Keep a list of words used to blame doctors at your medical institution.
To learn more about gaslighting and how to protect yourself from toxic working conditions, reference Human Rights Violations in Medicine: A-to-Z Action Guide.