As I add wood to the fire on a quiet evening, my phone rings. It’s a colleague I worked with a few years ago. I think, “Probably needs another lecturer,” and I decide I’ll answer the phone once I’m finished getting the fire going. A few moments later I realize that there is no voicemail. Maybe it was a misdial. Almost immediately, my phone rings again. A longtime friend who I haven’t spoken to in quite a while is calling. My heart sinks as I begin to realize something is wrong, and reluctantly answer the phone. He asks me if I’m home, and I quickly realize that this is not going to be a catchup phone call. In a fashion that we both have used in practice fairly frequently and almost rote, he informs me of a mutual colleague’s death. Only, he follows it with, “It was suicide, Beth.” At a loss for words, my mind races to process what I heard. No. Not him. There must be a mistake. He was the kindest and one of the smartest colleagues I’ve ever worked with. Are we sure? Maybe there was a congenital heart anomaly, or maybe he succumbed to substance abuse, and this was a horrible accident. He advises me that the manner of death could be no other.
I immediately think of his wife and children. If I’m having this much trouble processing this, I can’t imagine what they are going through. Well-liked by everyone he met, how could he feel so alone? He was always there for everyone, to explain a hard concept without making you feel dumb or to put a hand on your shoulder when you had a particularly rough day. He was just that kind of human. And now we’ve lost this wonderful person to a darkness we will never know or understand.
Suicide among healthcare professionals is a silent epidemic that nobody wants to talk about. As I think about this epidemic, I wonder if perhaps it’s because we don’t want to appear weak and ask for help. Perhaps we don’t realize we’re slipping down into an abyss. Maybe we have conditioned ourselves to behave normally in the most abnormal of circumstances to such a degree that no one knows when we’re falling in. We have to be strong for others, but have we somehow forgotten about ourselves? We give so much of ourselves, that we deplete our own stores. In the last few years, I have lost several friends and colleagues to this silent killer. It must stop. Between 2007 and 2018, nurses were 18% more likely to die from suicide than the general public (Davis et al., 2021). Healthcare workers (including nurses, physicians, advanced practitioners, and others) are particularly vulnerable to suicide for several reasons, including high-stress environments, poor work-life balance, repeated psychological trauma, difficult working conditions, and extensive knowledge and access to lethal means such as medications (Tiesman et al., 2021).
As the hours go by my phone continues to ring, as so many people are coming to the realization of what and who we have lost. Perhaps it’s our own mortality that we see. If he felt there was no way out, how do we know that we won’t feel the same at some point? Everyone’s situation is different, but we bear a similar thread as our conditioned responses to trauma as healthcare professionals makes it difficult to know when some of our friends are in trouble. By virtue of how we handle ourselves in crisis, it becomes particularly difficult to identify someone who is struggling. We have to stop asking the superficial question, “Are you OK?,” because of course we are. How else could we be? Perhaps we need to do periodic gut checks to make sure that one of us isn’t slipping through the cracks in plain sight. We have to be comfortable asking each other the hard questions that we ask our patients all the time. We have to lose the stigma that we have to be strong, no matter what is happening. We have to learn to accept help the same way that we help others. We have to do better for ourselves.
If you or someone you know, maybe contemplating suicide, please intervene. Here are some resources to help:
References
Davis, M. A., Cher, B. A. Y., Friese, C. R., & Bynum, J. P. W. (2021). Association of US Nurse and Physician Occupation With Risk of Suicide. JAMA psychiatry, 78(6), 1–8. Advance online publication. https://doi.org/10.1001/jamapsychiatry.2021.0154
Tiesman, H., Weissman, D., Stone, D., Quinlan, K., & Chosewood, L.C. (2021, September 17). Suicide Prevention for Healthcare Workers. NIOSH Science Blog. Centers for Disease Control and Prevention. https://blogs.cdc.gov/niosh-science-blog/2021/09/17/suicide-prevention-hcw/
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