What is the least painful way to die? Why do people commit suicide painfully? Why do doctors commit suicide in such painful and scary ways?
First, we should agree that it’s better to say that a person has died of suicide than to say that they have committed suicide. One step towards preventing suicides is to use less offensive and stigmatizing language when discussing the topic.
I’m Dr. Pamela Wible and I run a suicide helpline for doctors. I’ve spoken with thousands of doctors and medical students who are struggling with thoughts of self-harm. Many have wanted to end their lives.
Imagine being in a situation that seems impossible, where death is the only way out. Suicide is all too common and the suicide rate has been increasing dramatically in recent years, especially among doctors who see no other way out.
Why would someone jump from a building, take a bottle full of pills or put a gun to their head?
Health professionals are at high risk of suicide. With the stress of the pandemic and oppressive changes in the healthcare industry in recent decades, mental health issues are at an all-time high for doctors, nurses, and others.
When a medical student, resident doctor, or practicing physician contemplates a suicide attempt, they often look for a painless death. Additionally, they may not want to leave too much of a mess to be cleaned up.
Many choose to die by suicide in the location where they were wounded. When a doctor is working a 28-hour shift and is suffering inside a hospital, the physician may decide to step off the hospital roof. I led a eulogy for a young doctor suicide victim who stepped off the rooftop of a New York City hospital and her suicide is now the opening scene in this doctor suicide documentary (view trailer).
Is jumping from a building the least painful way to die?
I don’t know if we will ever have a clear answer on the least painful of the many ways to complete a suicide attempt. Suicides in which a jumper has survived reveal that landing hard on the pavement is very painful.
Yet, when a desperate suicidal physician steps off the top floor of an inner-city hospital, instant death occurs, and it is unlikely that there is much pain. Even if it is not the most painless way, the pain is over quickly.
It may seem cleaner and less painful to swallow the contents of a bottle of pain medication or sleeping pills. Yet, if a depressed nurse or doctor overdoses and survives, they may have to live with brain damage and supportive care from a family member or be moved to a nursing home.
I want to warn people that any suicide plan, no matter how foolproof it may seem, could end in disaster. Physicians who attempt to take their own lives may survive and be left living with excruciating pain from their injuries.
Self-inflicted gunshot wounds to the head do not always result in death. While the expectation is sudden death by firearm, I have cared for patients who have survived gunshot wounds to their heads and these suicide attempts may leave the victim living with a permanent disability.
When health professionals have suicidal thoughts, they may consider more issues than the least painful way to die; they also may not want to leave a big mess to be cleaned up.
Postvention is what we do in the aftermath of a suicide.
Suicide postvention involves helping people cope with what happens after suicide. What is it like for friends, coworkers, and family members?
After a suicide has occurred, postvention is all about helping the loss survivors—the family, coworkers, friends, and other close people to the suicide victim. They need help dealing with cleaning up what has been left behind. They need help handling the trauma, confusion, grief, and also to tie up loose ends left by a life that has ended too soon.
When suicide is attempted, and the person survives, we must also plan for what to do when life goes on. Either a suicidal doctor decides not to kill themselves, or they attempt suicide, and the attempt does not end with death.
What happens when doctors survive suicidal thoughts or suicide attempts? Do doctors who planned to kill themselves go on as if nothing happened? Do they simply go back to work?
What is the least painful way to live after surviving an attempted suicide?
A doctor working in an abusive healthcare system is in pain. The pain is not physical, but it can be intense, relentless emotional pain.
Here’s a letter I received from a suicidal doctor:
The decision to go to medical school was wrong. The idea that I could use the talents I have been blessed with to make a difference was a sham. I am called obscene names on satisfaction surveys by patients for not filling their prescriptions for narcotics, tranquilizers, amphetamines; called to task by supervisors for my arrogance at adhering to medical standards of care; and drowning in debt I can’t escape by bankruptcy. I am in the process of stacking my life insurance to adequately care for my wife and children. I know how and where. Knowing I am not alone does not change things.
With permission, I published a book of letters from suicidal doctors. Reading these letters can help us all understand why so many doctors secretly want to die. Download the free audiobook, Physician Suicide Letters—Answered.
The pain of living with human rights violations, inflicted by a non-caring healthcare entity, can be excruciating pain, worse than almost any imaginable physical pain. Doctors are used to the pain of complex bureaucracy, endless work, disrespect, late hours, and taking work home, some documenting medical charts in bed until they fall asleep on their computers.
At some point, for some doctors, something snaps, and they can no longer take the pain. The pain is so bad—death seems to be the only way out.
Some doctors may escape through addiction to alcohol, or an opioid addiction. They try to kill the pain with substances, rather than the irreversible solution of self-inflicted death.
Still, addiction itself often ends in death. They say that addiction is suicide on an installment plan. Maybe the best solution to prevent suicide is to take away the source of pain.
Quit your job and divorce your husband or wife—now.
People are hesitant to give life-changing advice. What if the advice is wrong? No one wants to give bad advice on a major life decision.
If I saw someone being eaten alive by piranhas in a river, I would not hesitate to tell them to get out of the water immediately. What if I saw someone being eaten alive by their job or their marriage?
Maybe it is time that we see situations for what they are. Doctors who go to work and then think about killing themselves don’t necessarily have a mental health problem—they have a job problem.
Planning for what to do after contemplating suicide should include radical removal of the abusive job that is causing extreme pain. Quit the job that is killing you, and you can’t go wrong.
A job that is killing you is not worth the money. It is not worth avoiding confrontation or hurting people’s feelings, because they don’t want you to leave.
If you know you need to quit, and you don’t know how—ask for help. Sometimes you need an advocate who will stand by you and say it is okay to save your own life.
Do suicidal doctors have to quit being doctors?
What percentage of doctors have had a suicidal thought at some point in their career? Could it be as high as 100%? It might be 100%.
Suicidal thoughts do not have to be about wondering what the least painful way to die might be. Suicidal plans do not have to include buying a gun or looking down from the ledge at the top of the building.
A doctor might call their life insurance agent to check on their policy benefits. Is the suicide clause in effect yet? Will the wife and kids get paid in the event of suicide?
When doctors go to a psychiatrist or psychologist, they are at risk for being turned in to the authorities. Health professionals are encouraged to rat each other out about addictions and self-harm thoughts.
Does having suicidal thoughts lead to doctors losing their license? Not necessarily, though if it gets to the medical board, they may actually discipline doctors for having a natural response to intractable pain.
To avoid medical board punishment, a physician friend shared:
After reading an article about one woman’s journey through hell after being honest on those [medical board] application questions, I sought care an hour away. I drove an hour in another direction to nervously fill prescriptions for antidepressants. I required several meds to stop thinking of suicide all day every day. My suicidal thoughts were 100% work-related.
You have a right to be pain free.
Euthanasia is assisted suicide. One person helps another person to end their own life, with the intent of ending intractable pain.
Suicidal doctors have asked me to help them die. I do not help doctors die by suicide. I help doctors live and enjoy their careers.
A hospice program, similar to euthanasia, is a humane method for helping a person with palliative care before death. Often, a morphine injection in hospice becomes a lethal injection when it causes respiratory depression and death.
In many developed countries, euthanasia is not legal. In some countries people may be punished and shunned after surviving a suicide attempt. We would like to think that there are always alternatives to suicide, even when there is pain that won’t go away.
A lethal dose of morphine may make sense to some people when the dying patient has terminal cancer and not much time left to live. But what if the pain is from an abusive career choice?
Anesthesiologists have the highest suicide rate among all doctors and due to their easy access to painless lethal means victims frequently end their lives through intravenous pain killers and anesthetics.
Why does it seem so unthinkable to tell a doctor that it is fine for them to quit? Leaving an abusive job and starting over may be the best suicide prevention strategy.
A doctor can leave their job and still be a doctor. Doctors can be pain free, free of abuse.
Execution by employment must stop.
It seems ridiculous that we would expect someone to find a way to survive in an abusive, painful job. Yet as health professionals we follow our calling by taking an oath.
Did we take an oath to harm ourselves? Have we become disposable people? When did doctors agree to be expendable?
Even though we say healthcare workers are on the front line, as first responders, we are not military personnel at war. It is not the same front line.
Doctors must not be expected to give up their lives for their profession. The job is expendable, not the person, or even the career.
A doctor can still be a doctor, even after quitting an abusive job. All it takes is some simple planning.
Enjoy the sunrise without fear of pain.
Imagine waking up, early in the morning, right before the sun comes up. You walk outside, as the first light shines through the clouds.
People are getting ready for work, ready to face the grind of rush-hour traffic. They are lining up at coffee shops for a rush of caffeine and sugar.
What are you going to do with your morning? Maybe you will go back to sleep and get another hour or two or rest.
You can dream peacefully, until your body is ready to awaken naturally. There is no pressure from anyone to move, until you are ready to move.
Or, you might decide to take a brisk walk around the neighborhood, a bike ride, or a nice jog. How you spend your morning is completely up to you—when you take back your freedom.
What is the least painful way to live and the best way to be happy?
Instead of worrying about the least painful way to die, we should instead ask ourselves how we can continue living with less pain. Suicide is an escape from unbearable pain with no end in sight.
There are always solutions other than suicide. There is always another way out. Do you have a bucket list? Are there things you would like to do or see in life?
Why not start fulfilling your bucket list now? There is nothing stopping you from going almost anywhere and doing almost anything.
If you can’t afford a plane ticket, take the train or bus. Or just start walking.
Anything is better than suicide. You never know what magical experience life will bring to you if you just hang on for one more day.
You can make a decision to try something new. You can make a decision to do what will make you feel happy, fulfilled, and grateful. All you have to do is make a decision and take action and change your life for the better.