A while back, I had a really rough week at the hospital. It was a combination of many things: lack of sleep, working at a site away from home, and a string of very sick patients that culminated in one of the hardest patient deaths I’ve had to handle so far in my career. I happened to mention some of this in casual conversation with a family member and it stopped them dead in their tracks.
“How do you do it?” they asked.
“Do what?”. I assumed they meant something like handling all the different medical conditions, remembering various acute and chronic treatments, or getting by on little sleep…things that we physicians take in stride on a daily basis. But they were referring to something more complex.
“The death. The devastation. The tragedy. EVERYTHING! How do you deal with seeing the things you see and still stay standing at the end of the day? How do you let it not get to you? That. How do you do that?”
I thought for a second, then I shrugged my shoulders.
“I have a person”, I said, “and if it all gets to be a little too much for me, he lightens the load. I know I can call or text him whenever I need to and he always gets it.”
My person. We met on our first clinical rotation of medical school. We were in a shabby basement in Brooklyn waiting for orientation to our psychiatric rotation. We adjusted our short white coats and exchanged nervous glances. We didn't get beyond basic introductions before we were swept off into the hospital.
One Friday shortly after that, we were assigned a shared patient on the inpatient psychiatric ward. Her name was Paraskevi, which coincidentally means "Friday" in Greek. The Universe laced the scenario with irony. I had just returned from a teaching assignment in Cyprus prior to medical school where I had learned basic Greek, and my person - who had yet to grow into his role in my life - had spoken Greek since he was a child. Thus, the fate of our friendship was sealed with the longest documented living language.
Witnessing Paraskevi’s complicated family dynamics and advanced condition, we brushed away the dust of the “book medicine” we had learned to find complexities that would act as the building blocks of our relationship. This solidified a pattern that would stick with us over the years. We asked questions about mental health and wellness, and how these things affected not only our patients but ourselves. As time passed, our conversations expanded to include end-of-life issues and together, we questioned how our profession addressed issues we felt to be at the core of everything.
During residency, we branched out into different fields, but when difficult times hit, I picked up the phone. The first time I lost a patient, he knew how I felt and talked me through it.
Together, we learned not to turn away from the darkness, but that if we looked a little bit closer, together, sometimes we could decipher a hidden message.
As time passed, we each lost colleagues to physician suicide. Multiple colleagues. Colleagues that were battling with darkness and depression, all shouldering their burden alone, which had become overwhelming. Together, we wondered, was it our chosen field? Or was it individual predisposition? How DO we deal with the things we see? How do WE survive?
It’s something that Grey’s Anatomy got right about practicing medicine: you have to have someone to call “your person”. It doesn’t have to be a spouse, a significant other, a best friend, or even a colleague, but we all need someone we can call when the shit hits the fan. Because no matter how strong and capable we all think we are, medicine is an emotionally charged profession. Without someone to help shoulder our struggles, they can easily become too heavy. We like to think we’re superhuman, but in reality, we all have a breaking point.
Without my person, the hard days would become even harder. Find a person to support you when you need it, but just as important – BE someone’s person. We’re all in this together.
Based on recent statistics, over 400 US physicians take their own lives each year. Help break the stigma behind physician depression. Reach out to a colleague - start the discussion, continue the conversation.