Doctors, You’ll Never Be Good Enough- And That’s Okay

First published May 12, 2017

Like many in the medical world, I’ve been deeply saddened by the suicide of a Brisbane gastroenterologist, the father of four children, the husband of a loving wife.

I don’t know them personally, but am touched by the email that his wife wrote and son sent online- which has triggered a flood of goodwill from his patients (the Facebook comments on the CourierMail post are so heartening) and from other health professionals and members of the public, who, like me, may not have known him personally, but felt devastated by this very unnecessary loss.

So what can we do? How do we stop others from thinking the only way out is suicide?

What’s the worst that could happen if you choose NOT to die?

Your patients may be looked after by other colleagues, or will find other specialists.

Your family will be concerned and worried about you, but they will be happier that you’re taking time to recover.

Your colleagues will most likely be concerned about you too, not mean-spirited. (If they are, why choose to work with them or choose to listen to them? What do they know about who you really are?)

Maybe part of it is our fear of delegating responsibility for our patients to others when we’re too crushed or sick to continue. Handover is so complex- even more as a consultant in private practice for many years. You would have built strong relationships with some of your patients who’ve grown with you; with your staff; with your routine. You would know their test results and the dates of their treatments off by heart.

And of course, when a patient dies, it is never easy.

Just because you’ve dealt with a patient’s demise or deterioration over and over again during the years, it doesn’t mean your feelings will be bulletproof forever.

And then, you also may fear delegating the responsibility of your struggles to others, to psychologists, to counsellors, to psychiatrists, or to a friend who’s a listening ear.

You’re good at curing patients. Why can’t you cure yourself?

You’re feeling enormous responsibility. Why burden others with that terrible weight?

There’s so much blame in medicine. We constantly want to be better. It’s the mark of a true professional, a craftsperson even in other professions. You want to better yourself.

But even doctors are only human.

Maybe we think it’s the absolute end, there’s no way out if we step back for a few days, weeks, months, years- it’s too terrifying at that moment to deal with the enormity of a future you don’t know.

We try too hard to control our futures and our patients’ futures, but as doctors and health professionals, and even startup founders, even we can’t control everything.

Maybe it’s time to recognise that and embrace it as something positive we can learn to live with.

But don’t do it alone.

Please seek help, no matter what your journey is.

Condolences and respects to Dr Bryant and his family. 

People may look like they’re doing okay on the outside, but are actually screaming for help inside. Please be kind to each other and ask directly, “are you okay?” 

Some useful sites/resources in Australia if you’re seeking help or contemplating suicide:

– Lifeline

– BeyondBlue

– Mens HelpLine

– Mindful in May

– R U OK? suicide prevention

– Victorian Doctors Health Program (please reach out even if you’re not living in the state, people are always happy to suggest other resources)

– your GP

– a psychologist

– a counsellor

– the AMA, which has other links to Drs4Drs which lists resources for Doctors in each State/Territory, and other sites; and the Australasian Doctors NetworkAustralasian Doctors Network which advocates for doctors’ health.

– Online video calls to a psychiatrist (you’ll need a GP referral but it is bulk billed)

– Lysn, a provider of online video calls to a psychologist

– your work’s Employee Assistance Program (many public and private companies including public hospitals in Australia, possibly in your country too, offer this free confidential service through external providers. The RACP also offers this, and probably other fellowship colleges do, too. Don’t be afraid to ask your HR or Workforce managers about this; it’s your right as an employee, and they are human, too, and know everyone goes through stuff.)

Feel free to list other resources you’ve found helpful below in the Comments. 

You + Career ≠ Self Worth

First published March 19, 2017

It’s devastating to hear of yet another young doctor suicide in Australia.

As the papers report, the 4th known in 6 months; probably many more unreported.

That doesn’t include the statistics for other healthcare professionals in Australia, or of those who work within healthcare; and of course, those from non-healthcare professions, too.

We don’t know the victims personally, and we’re not going to pretend we know their story.

But we know our own stories.

The pressure of our careers and perfectionism in the age of Instagram is higher than ever, and we want to remind everyone:

Your career is not your value as a person.

We know it.

And we can give advice on how things can change in the healthcare profession.

Because, this may not surprise you, these exact same issues crop up in the startup world, too. 

The same exacting degree of impossible high standards. 

Being the top one percent of the cream of the crop. 

Feeling like you have to beat and compete with that top percent of the cream of the crop. 

Congratulating yourself for pushing through 100 hour work weeks or more without a break, week on week.

Being made to feel ashamed when you try to enjoy your Sunday off but have hours of lectures to catch up on.

Being told by senior bosses and advisors that “we’ve been there, we’ve done that, we’ve pushed through insane hours at the risk to our health and our relationships, too.”

The thing is, thirty years down the track, the seniors in various professions may have neglected to realise the impact that social media and digital devices have on all industries and their workers.

We’re constantly surrounded by information overload.

Our email inboxes keep filling.

Those Tweets keep flowing in.

Our patients demand the best, and we are doing our best within our limited neural networks. 

Peer pressure scorns you when you haven’t published enough papers.

Your brain and body work best when you have enough rest.

We have to accept that we can never know everything. 

We’re not perfect.

And despite the external factors set to validate “success,” we have to remember we’re able to set our own internal values. 

We’ve been in the undergraduate medical class where people sneered at Mindfulness and Resilience training.

We’ve been there when we were too scared to call in sick despite being sick with gastro, because we’re worried our colleagues will think we’re too “soft” or faking it.

We’ve seen colleagues return to work when they’re still having gastro, risking hospital outbreaks, because they are the only Registrar on call that weekend in a major city hospital, and their bosses don’t get paid for stepping in for them.

You feel pressured to return to work before you’re well, too.

Yet other colleagues make it difficult for the workplace to trust your cohort, because when they call in sick, they’re pictured at festive events the same day they were meant to work.

We’ve been told we’re worthless by Directors of Training, despite studying and working at the cost of seeing loved ones when they needed us.

We’ve cried through weekends off because they were never really “off” when you had to study, study, and study for fellowship.

We were told by Colleges and work paraphernalia to look after yourself and seek help.

When we tried to do more sport or see friends, we had the opportunity cost of less time for study group.

We were told we didn’t want it badly enough, and we knew that was bull.

Yet it’s never enough.

There’s always going to be someone who says you’re too “soft” or worse.

You have to learn to tune them out.

You have to know what’s important to yourself.

What happens if you do achieve that goal you’re seeking? Will it really make you happy? Or will it more likely unlock another list of far-reaching career accomplishments you’ll need to add to your LinkedIn?

You have to accept that the only thing you can be perfect at is being YOU. 

Being the one who your aunts and childhood friends call on your birthday.

The one who gets to hold your nephew.

The one who gets to laugh at your partner’s jokes.

The one who bakes the best cake in the family.

Who were you before you started your degree?

What interests did you enjoy along with medicine or your profession?

What did you do to relax?

If the answer’s “Nothing!” to all of that, you can still start something now.

Did you ever talk to anyone outside of work about your problems?

The strongest thing you can do is find someone.

Your problems are NEVER too small to share with someone who cares or is trained to help. 

Lifeline, Beyond Blue, a counsellor, psychologist, a GP, the Victorian Doctors’ Health Program– they’re all there to help you.

Most major workplaces including hospitals, manufacturing factories, corporations, and so forth- have an Employee Assistance Program or similar where staff can access free, confidential counselling sessions.

You can go to the other side of town or chat over the phone, and not let it be known to anyone in your workplace or fellowship college.

You may not click with that counsellor or listener immediately, but persist – or try someone else. It’s not personal. The counsellor relationship doesn’t have to be perfect immediately.

Try something new. The brain loves novelty. Attend an acting class. An illustration class. A free yoga session on the beach. Be anonymous. Challenge yourself to step out from what you know. That one-hour break at the new yoga session could be exactly what you need to feel reinspired.

Call a friend you haven’t seen since school. It’s amazing how similar our paths are, despite differences in uni degree (or lack of- and it’s incredible what lives people can build for themselves without a college or uni diploma!). The same stressors. The same feelings of lack of self-worth in any industry.

A key reason why we started this blog was to inspire others about healthcare and entrepreneurship. Because those skills and these stories of real people who have hit rock bottom before career success, can be used by you, too. 

It doesn’t matter if you’re medical or not.

At the crux of it, you’re doing whatever you do because you want to do good.

And doing good (and being well enough to do this) involves taking risks.

You’re thinking like an entrepreneur if you take a risk and decide to take time out from training.

You’re thinking like a startup founder by deciding to apply for a paid Biodesign Fellowship overseasinstead of following the PhD route the majority are taking.

You’re a risk-taker if you decide to apply for a Google prize through your PhD.

You’re creative by founding a cancer app combining clinicians’ and patients’ needs instead of waiting a few years to finish training before starting to make an impact.

And you’re a champion if you’re learning to deal with your fears. 

Both the medical and startup worlds must learn to be kind to their own. 

But while they’re learning how to do so (and it’s really not that hard to be nice), refuse to be a victim. 

You are in control of your actions.

Be yourself. Be passionate about being your best self, in medicine or any tribe you’re connected to.

And allow yourself to receive kindness from others.

You’re not alone.

Help can be found in Australia from many sources including Lifeline (13 11 44), BeyondBlue, Black Dog Institute, the Victorian Doctors’ Health Program, and your GP. Please comment below if you have more resources to share including outside Australia.
There is also a donation fund set up in honour of a recent doctor-suicide victim.
Thank you for reading this.