Self-healing is necessity for medical profession

By Joseph Cramer, M.D.
Deseret News
Published: Saturday, May 10, 2008 12:40 a.m. MDT
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Being a physician is a dangerous business. One reason why doctors make a lot of money is that part of it is combat pay. We live and practice in a critical war zone. The absence of the sounds of bullets and bombs does not diminish the risk. The medical soldier isn't just the emergency specialist who on Friday and Saturday night is an honorary member of the gun and knife club. It could be an ear nose and throat doctor. It could be a resident just starting out or an OB or family doc.

The risk of dying early is not from a stray bullet or an improvised explosive device. Doctors of medicine are at risk of self-destruction. The national average for suicide is 11 per 100,000. For physicians it may be up to 33 per 100,000, or three times most other professions. There are a variety of deaths. There is the stopping of the heart; there is the cessation of brain activity or brain death. There is also the patient where the breathing keeps going but the living has stopped. These other forms of dying are self-destruction with drugs, marital infidelity, or emotional insensitivity or instability.

Addiction, depression, ruined marriages don't have to be the price of medical school, but the seeds are there from the beginning. The selection of the best and the brightest carries the risk of recruiting the most vulnerable and the most driven. Sensitivity toward others is desirable, but over-sensitivity could be hidden underneath the white coat. Hard work is necessary, but overworking can be the outcome. High expectations are appropriate, but unreachable heights can lead to falls. The stress to do right all the time can become the unbearable tension when things don't go right. Invincibility can be protective when dealing with other's lives and limbs, but there is a chink in every type of armor.

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Suicide is the product when the personal pain is greater than the skills to manage them. For physicians, the other variables are the means and know-how. We are trained to save lives but by simple reverse engineering it is not too tough to take the lessons of healing and turn them into practices of dying.

Medicine needs to drag this reality into the light of day. Let this be a subject of reason and research. Give permission to be human but build the systems and safeguards to do super-human work.

Death comes mostly when one is alone. Reconstruct social networks not just insurance networks. Show institutional sensitivity to mirror the compassion that needs to be displayed every day in caring for others.

Use mediation and arbitration to reform liability laws so the victims and errors are compensated, but not on the backs of personal attacks and financial ruin.

Teach within the halls of medical learning diagnostic skills to uncover disease in others, but also train the medical students in the abilities to recognize the signs and symptoms of their own personal disaster.

2 comments

Recent comments

I'm an early retired RN, and I can certainly empathize with the...

To Dr. Cramer and other MDs | May 10, 2008 at 10:24 p.m.

Could it possibly be that the wrong type of person is selected to...

Hmmmm? | May 10, 2008 at 11:38 a.m.