I’ve been mulling on this for awhile whether I should write about this. Since it is National Suicide Awareness month (in the US but whatevs), I thought it’s time I talk about this.
Ok I’ve never been in a state where I want to take my life away but I can understand how doctors can come to that point in their lives. More and more nowadays we hear of doctors disappearing and those taking their lives away. At least three of them occured during or just after their shift. Many of them occured after having complaints being made on them.
Earlier part of this year, I had a situation where I misjudged a patient’s condition. He looked well enough and didnt have any signs of serious illness. I did decide to have the patient be observed as he wasnt completely right yet and his condition improved within hours. Another colleague saw him, agreed with my diagnosis and discharged him. He came back within 8 hours… delirious, confused, quickly becoming ill in front of my colleagues’ eyes. He was intubated and ventilated. He had meningitis. I was told about it the next day. I went to see him in ITU and bumped into Dad – His dad said he was fine when he was discharged. Even hopping out of the unit. He deteriorated a few hours after at home.
The whole situation shook me. I spoke to many consultants, trying to gauge if I did anything wrong, thinking how I could prevent something like this next time. All of them agreed that they wouldnt have done anything else. These things happen they say. Yes, I know it happens.. I just dont want it to happen to me.
I couldnt shake off the incident. I began doubting my judgement. I would make a decision and then mull over it a few hours later. Over time, my confidence was affected. As a person who can be fairly anxious, I became even more anxious. Going home from oncalls or a busy shift, I would worry about patients, constantly thinking I might have missed something, worried that one of those I discharged will deteriorate or worse, come back dead. I couldnt sleep properly. I was crying more (more than my usual). I can get to a point where I would overthink things and panic.
This was a gradual process by the way. The anxiety went to higher levels bit by bit, it snuck on me that I thought this was somewhat normal. It dawned on me eventually how not normal it is. I couldnt bring myself to be too happy. I thought whenever I ‘lose’ myself to a good laugh or be happy… watch it, dont be too happy now, something bad might happen. By bad I mean a patient of mine would deteriorate or die because of me, I would lose my license and go to jail. It sounds ridiculous right… even writing this now sounds ridiculous to me.
I confided in the counsellor who I spoke to years ago when I was failing my exams. I reconnected with her and she made me realise how my feelings were affecting my thought processes (or is it the other way round?). She gave me practical tips on how to overcome my anxiety. I also spoke to an extent with my supervisor and another consultant who was supportive and reassuring.
The thing is… I never really spoke about it much with my family, friends and colleagues. I didnt know how to say it. I really didnt know how to tell them the magnitude of my anxiety. “Uhh I dont want to laugh too much now because you know, something bad might happen…” It was also easier to not think about it. As my mood spikes and wanes, it was easier to forget about it when I was having a good day.
I also didnt want to be seen as weak or be the failing doctor. It was if that by being anxious, I thought people will think my ability to doctor (can I make it into a verb?) is reduced. I didnt want people to judge me (and trust me, often medics are the worst judges of their own colleagues). Let me judge me. And this, I think, is why doctors get driven to that point. We bottle it up, paint a picture of absolute normality, get on our lives… not only do we not want to be seen as being impaired to work but we are also in denial ourselves. You just plod on.
Take my hand
and hold it tight.
that it will be alright.
Reach out for someone
when you feel alone,
the panic, the heaves,
you’re not made out of stone.
it will get better,
(and it might be a long way)
the sun will shine
and you will find
that you’ll be just fine.
The clouds will part,
it will no longer rain,
and you realise
that you deserve to be happy once again.