There is something uniquely traumatic about being responsible for patients’ lives, while being crushed under a workload so punitive it gives neither the time nor space for safe assessment of those patients. Photograph: Alamy
By the end of my first
year as a doctor, I was ready to kill myself
Doctor suicide is the
medical profession’s grubby secret – but it’s unclear why some of those
dedicated to preserving life silently plot their own deaths
On my morning drives to
the hospital, the tears fell like rain. The prospect of the next 14 hours – 8am
to 10pm with not a second’s respite from the nurses’ bleeps, or the
overwhelming needs of too many sick patients – was almost too much to bear.
But on the late-night
trips back home, I’d feel nothing at all.
Deadbeat, punch-drunk, it
was utter indifference that nearly killed me.
Every night, on an empty
dual carriageway, I had to fight with myself to keep my hands on the steering
wheel.
The temptation to let go –
of the wheel, the patients, my miserable life – was almost irresistible. Then
I’d never have to haul myself through another unfeasible day at the hospital.
By the time I neared the
end of my first year as a doctor, I’d chosen the spot where I intended to kill
myself. I’d bought everything I needed to do it. All my youthful enthusiasm for
healing, big dreams of saving lives and of making a difference, had soured and
I felt an astronomic emptiness.
Made monumentally selfish
by depression, I’d ceased even to care what my husband would think of me, or
that my little boy would grow up without his mother.
As I
wrestled silently with the urge to kill myself, another house officer in my
trust went right on and did it.
To me,
that monstrous waste of young life seemed entirely logical. The constant,
haunting fear of hurting my patients, coupled with relentless rotas at work,
had rendered me incapable of reason.
Though we know large
numbers of doctors kill themselves, what is less clear are the reasons why,
when dedicated to preserving human life, some doctors silently plot their own
deaths.
A 2006 study at the University of
Pennsylvania identified that during their first year as doctors,
young physicians experienced skyrocketing rates of burnout, with symptoms of
emotional exhaustion, depersonalisation, and reduced sense of personal
accomplishment soaring from 4% to 55%.
For me, the explanation
ran deeper.
I was entrenched in a
hospital system that brutalized young doctors.
Working on my hospital’s
surgical emergency unit, there were simply too few of us to cope with the daily
onslaught of patients.
Officially eight or
10-hour days ran routinely into 13, 14 or 15 hours as we house officers worked
at fever pitch to provide what was, at best, a mediocre service for our
patients.
Run ragged, we fought to
keep our patients safe, but their numbers outstripped ours 20 or 30 to one, and
the efforts this took were superhuman.
The nurses knew, the
consultants knew, even the hospital management knew, yet no one seemed to give
a damn.
It wasn’t just exhaustion
that drove me into depression. Plenty of jobs are busy.
But there is something
uniquely traumatic about being responsible for patients’ lives, while being
crushed under a workload so punitive it gives neither the time nor space for
safe assessment of those patients.
Days were bad enough, but
nights on call were terrifying.
I remember running from
the bed of one patient, still haemorrhaging blood from her surgical wound, to
another whose heart rate had plummeted to 20, perilously close to a cardiac
arrest. Two stricken patients, but only one doctor, wracked with the knowledge that
if something went wrong, the guilt would be hers alone.
I was lucky. I was pushed
by the colleague in whom I finally confided into seeking professional help. It
took anti-depressants, therapy and a narrowly-avoided psychiatric inpatient
admission to bring me back to the land of the living.
Now, on
the cusp of junior doctors’ first national strike in 40 years, I’m astounded the health secretary
persists in ignoring unanimous condemnation of his new contract from juniors
and medical leaders alike.
If he
gets his way, Jeremy Hunt will make it easier for hospitals to abuse their
juniors, by stripping away the safeguards that stop hospitals overworking us,
fining those that do.
Under his
new contract, our hours will become even longer, even more antisocial – at a
time when we simply have nothing more to give.
And as we
are pushed to treat more and more patients, faster and faster, fatigue and
psychological distress will dull our competence: your lives will be less safe
in our hands.
And our
own?
Take it
from someone who’s been there. Watch the suicide rate climb.
Written by an Anonymous UK Based Junior Medical Doctor
16:44:00
