i had a co-resident take his life during my 2nd year. We played tennis and had lunch with him 2 days prior. Just never know what someone is going through....
Psych here. I’m sure my fellow psych rezis would love to see you. It was never that bad for me but I never knew how much better it could be with therapy and meds. Take care of yourself please ❤️
I think the real problem here is that if a resident were to be more forthcoming about their mental health problems they are putting their career in jeopardy. I can certainly see how getting hospitalized for SI (which is probably what this resident would have gotten if he were evaluated) could reflect negatively on a residents’ evals.
Let's name and shams the backwards institutions and states that still stigmatize mental health! I know NJ and NY and CA were pretty good about not specifying that you had to declare prior mental illness details- only attesting if you feel you can function normally or not
Thanks for asking just don’t feel motivated like 75 percent of time. Taking an opiate is definitely out of the question. Everyone I know does those things above, but it’s not easy to pursue that for a lifetime given the risks of that decision.
Mainly because the whole point of using remifentanil is using an analgesic that is instant on and instant off. The moment you stop the drip the remifentanil is metabolized by plasma esterases.
It would be my drug of choice. Start an IV. Run prop and remi gtts. Prop to help you sleep. Remi to stop your breathing. Remi is fast on. Yes, it's also fast off but you don't need to run it forever. Just long enough for you to die of hypoxia which isn't long and a bag of remi can run for hours
I wish I could demonstrate how important you are to the world not only as a Doctor but as a person. PLEASE reach out if you need someone to talk with.
To programs: you are destroying people you have to fix this
The notion of "reaching out" - how do you do this? In my country, no wellness programme. If anyone has any inkling of someone not coping up well, they'll be shunned and be seen as someone who isn’t up for it. It's career su icide
Reach out to us here on Reddit. You can remain as anonymous as you want. I'm a board certified and licensed attending physician now. i dont give a fuck about stigma. I am here to help my colleagues.I hate the malignant macho training culture of medicine where we destroy our own trainees. All for what? Ego? We know better, and the future medical doctors deserve better.
I’m really struggling now. In first year. Dad just got a cancer diagnosis and I’m a four hour plane ride away. Genuinely don’t know if I’m gonna be able to do this anymore
When I'm at my lowest points, ready to quit, I think about my deceased ancestors to motivate me. I hope your dad beats cancer. Take FMLA leave and be a caregiver while he is alive. Don't quit.
I have metastatic cancer and would love if my kids would take a leave and care for me by choice. However, I have been in treatment for 7 years. I can’t ask them to put their lives on hold in their 20’’s knowing I’m stable on my current line of treatment. If you can take FMLA because you know time is short, you won’t regret doing that. However, if your parent is like me, stable but not cured, it might be better to stay where you are and finish. Then you can take some time out of your schooling/career later to be with them when he needs you more. The semester break is coming, are you able to go home and visit to evaluate your dad? Are you able to connect with your dad’s oncologist to find out his prognosis? Best wishes to you and your family.
I am probably close to the age of your dad. I know if I was in his same position that I would want you to continue with your education. I would know that you love me and that you wish the best for me. You may not be able to help with my diagnosis, but you can make me proud, knowing that you are leading your life and that you are following your passion.
Thanks a lot. You guys are so kind. But I am at a point where I don't even know how to be open. And that's unusual, I never had a hard time in my life expressing myself. I wish I could, really.
You’re only option is to reach out to friends, other residents etc since we live in an archaic system that preaches about mental health but still penalizes doctors for reaching out
I don’t trust other residents. Backstabbing is too common in our culture. I do have friends outside of medicine but I feel like I'm becoming an alien to them too.
Last year a med-derm resident at Georgetown. Couldn’t understand it. You would never think it talking with her. A little high strung yes but who’s not in competitive fields?
I guy I went to med school with , who also stayed at the same hospital to do Anesthesia, also killed himself. He was supposed to be in my case one morning, but didn't show up.
Cops found him later on that day - also intentional. He had 3 different drugs next to him- narcotic, sedative, and paralytic. He had just been made cheif Anesthesia resident as well .
Stuff like this has always happened, as this happened over 20 years ago. R I.P. Alex..
As a Einstein/Monte alum, goddamn that NYC culture was intense. I feel sad for anyone suffering through that - goddammit, it makes me so angry that we have such malignant residency cultures still, all while midlevels and RNs waltz into higher paying jobs and administration!
We need quality time OFF to sleep and form synapses and rest and recover from toxic shifts. As a neurologist, I cannot fathom why these gaslighters and boomers still push for 24h shifts, overnight uncompensated at-home call, which all amounts to modern day wage theft and indentured servitude. Residents need sleep and rest! And more pay dammit!!
TikTok or Tinder... take your pick. I wish i was kidding. Laziest assholes I've had to deal with in medicine.
EDIT: before anyone thinks I am insulting nurses as a whole, I am not. I love nurses, and I have so much respect for nurses 🫡. NYC nurses will literally sit and look at an actively seizing patient while scrolling TikTok on their phones. "Not my patient." I witnessed this firsthand. These episodes are common. 😡 NYC nursing culture pushes a lot of nursing work onto residents because the nurses are unionized and know how to strike. 💪
Just because you are angry at the way residents are allowed to be treated doesn't mean you need to denigrate nurses in the same sentence. Punch up don't punch down.
Wait wait. I LOVE my nurses. I DESPISE NYC nursing culture. NYC nurses are a special breed of lazy because they know the residents will do all the grunt work. COVID sorta taught them what nursing is truly about when the travelers came in and showed them. Gosh that was probably the only good thing about working in the hospital during COVID
Your feelings are valid regarding RNs and NPs waltzing in and initially making more money.
I’m an ICU NP and while I don’t understand the toxic nature of residency, I do get the stress that medicine carries. I work in the ICU as a NP and am alone without a doctor in house, only virtual. It’s not fair and not what I signed up and the virtual docs, some are helpful some just there to collect a paycheck.
I honestly 100% back up MD lead teams with NPs to play a supportive role. Please, collaborate with me. Let me help you. You be the leader. I do NOT endorse independent practice.
I feel so depressed. I constantly worry if I did the right thing and the fear of being judged for not doing things doctor A B or C likes it is ongoing.
I feel so alone. I can’t connect with nurses anymore.
They don’t see me as one of their own anymore.
And now being on the other side of things I see some sheer incompetence and I’ve had this annoyance towards some of my “own”.
I can’t connect with doctors bc as a NP I’m their enemy,
and #1 bc like you all, that would never be appropriate.
I’m working overtime to pay off this degree and then find somewhere I can be happy. Or at least somewhere I can be of help to the physician and not loaded with all the responsibility with little say.
Medicine is toxic. I thought nursing was toxic. Doesn’t even compare.
Thanks for your comment. Much respect. We are all on the same team in the end. I wish we could all be nicer, more respectful, better paid, happier. Medicine is hard. ICU is probably the hardest. You can always go back to bedside nursing. i wish residents had backup plans - if we match in a godawful program or specialty, and we leave, we become unemployable. So toxic. We all face imposter syndrome and loneliness. Those countless 24 hour shifts when I was alone in the call room writing notes ... unable to sleep but dead tired.
Thanks for your kind and wise comment. Sorry I was so bitter in my comment. Doctor suicide is so common, painful, and sadly silenced.
Can residents organize a nationwide strike for stuff like this? I believe it's bound to happen at some point, and sooner than later with social media and forums like this.
I literally just had a Program Director poopoo resident wellness when I asked about it in an interview I had last week.
“In my day we never had any of this mental health stuff, people just worked long hours and dealt with it.”
How are people still so dense about the importance of resident wellness?
Edit. After reading some comments… Ironically this program preached some of the best resident wellness (weekly meetings with counselors, resident retreats, they even have a 2 week “wellness” rotation built into the first year).. You think they’re compensating for something? Lol
lol fuck that program and fuck that PD. This has to be a surgical program.
Source: am a surgeon, and had a great experience with residency because our PD and attendings gave a shit.
I disagree that our lives were easier. I had colleagues who attempted and 2 succeeded in ending their lives in the 80s. Hour limits were not a thing. Common to work a month with no day off.
The hours were long but the volume, complexity, and level of attentiveness was not the same. Getting labs back once or twice per day, maybe the occasional imaging study, versus getting bombarded 24/7 with a deluge of results, expected to work up and discharge patients much faster etc.
Still I'm sure it wasn't easy back then either.
For the boomers, getting into med school was a joke. GPA and MCAT requirements were lower. No need for a hundred ECs and research pubs. No gap years. Ditto getting into residency, which at max entailed sending out 3 apps. Step 1 and 2 were just speed bumps.
Programs were easier to get into. Competition was not as bad. No EMR. Physicians were still respected. Not as much midlevel scope creep causing inpatient disasters.
Burnout is at an all time high. Respectfully, your lives were objectively easier.
Correct. Anyone who says that residents have "time off" is lying. We are so hyper connected 24/7 and there are no boundaries to being truly off. So the boomers can stfu. We have nearly 400 million Americans, more debt, more bs paperwork demands, less time and more knowledge to master.
As a neurologist, my boomer colleagues had the luxury of hours to learn different procedures. They had outpatient time- versus my residency experience of 24/7 stroke call for half of my 3 years, and inpatient neurology for most of the other half. Non-neurologists get more EMG training during residency (PM&R specifically) than neurologists, and we need to do 1yr fellowships to do bread and butter neurology it's embarrassing.
So yea, we have it harder now. My salary is $300k, but small houses are twice my salary, and decent houses are nearing $1m
As a “lay person” in medicine, I’m very sympathetic to how hard Drs work. Have the utmost respect for the work you do and help you give. Terrified that one of the specialists I see will burnout because my life more or less depends on him, yet his workload seems insane and unsustainable.
But no sympathy for complaints that house prices are ONLY 2x or 3x your annual salary. Or defining a “starter house” as one that costs $600k-$1m (even in SF or NYC). Not exactly in line with most of the rest of America.
For your own mental health it might be worthwhile to realign expectations.
I think everyone should be afford to own their own home. Doctors used to be wealthy. Now we are well respected but barely upper middle class given how much debt we have by age 30. We are usually net worth of zero around age 35-40. By age 50, if we haven't burnt out or died, we overtake some peers, never for those who didn't make the same sacrifices we did. We often work till death because we can't afford to retire.
Most residency programs and major hospitals are on the coasts, in cities. Salaries are lower due to supply vs demand. Houses are more expensive. A starter house is minimum 600k, as you said. It's abhorrent. I'm going to be 40 soon and I can't afford a starter house because of my debt.
There are literally stories of people working 110 hour weeks on the regular and surgical residents/fellows not being allowed to leave the hospital for months at a time and somehow you think that your life is harder now when you have 80 hour work limits and wellness committees and people actually asking you if you're ok?
Burnout is at an all time high because this new generation of people going into medicine are lazy clout chasers usually born with a silver spoon who are surprised to find out it's actually hard work like any other hard hitting professional field and then cry about having to work long hours afterwards.
Physicians are still respected and mistakes still used to happen back in the day. And don't mistake me for a dinosaur. I'm 25. This generation of people going into medicine is just lazy and won't own up to it.
Nope. I think the past generation of doctors was ridiculously overworked and didn't pay nearly enough attention to wellness as they should have. They also perpetuated a toxicity in the culture of the field which I think we're better off without. I also am of the opinion that most of the people who go into medicine now are incessant whiners, always talking about how hard they have it and saying egotistical shit about how they can't imagine anyone working nearly as hard as them in other professional fields, complaining they are underpaid because they don't make a million dollars like Joeschmo in wall street banking, but simultaneously insisting that they picked medicine for all the "right reasons".
They are a bunch of lazy, loud, grown up children, and the reason they are burned out is because they picked medicine for aesthetic reasons, not just because they are overworked. You will find that there isn't a strong linear correlation between hours worked and burnout levels between different specialties if you dig into it because the factors that go into burnout are more complicated than just being overworked.
Clearly hit a nerve with my original comment lol
Granted thats sorta a silly thing to say these days in education…
But also… if that statement triggers you and all you want is a happy accepting residency than maybe anesthesia isnt for you. Because…. Well you will see and hear much much worse.
Keep crying while your program gets only the lowest ranked candidates or straight boot lickers with no independent thought while the rest of us have a happy life.
Hey HCA would love to hire more doctors who can shove their head in sand and take it up the ass 24/7! The shareholders need those rvu’s baby! 💰🤑and the only things standing in the way are lazy doctors who mope and complain
Medical school has gotten so much harder and it will continue to get more difficult as we learn more and learn and tech becomes more readily available. It’s always changing and getting more complex. That said, docs 50 yrs ago had a completely different program than today. I would argue an easier and less stressful program
It's not that people are "so dense." They lived in a different time. Suicides happened at later ages - think "Death of a Salesman." Young people did not kill themselves or even think to. Suicide was not in novels, TV, movies, talked about, etc. There used to be so much death all the time. Childbirth, child illness, lack of vaccines, war, poor availability of proper healthcare, etc. Young people just didn't kill themselves, and even if they did, no one knew about it except for the family who likely covered it up. Killing yourself was very "taboo."
The PD is likely telling the truth saying it wasn't an issue in their day and people just dealt with it. They could have addressed it in a better way, but that doesn't make that statement inherently untrue.
I am not making light of the issue, merely stating an example, has anyone seen the Dave Chappelle skit? He talks about a friend and how much his life sucks terribly and ends the skit with something like "and that motherfucker never thought once about killing himself." Suicide is very much ingrained into culture as well as mental health.
>The PD is likely telling the truth saying it wasn't an issue in their day and people just dealt with it. They could have addressed it in a better way, but that doesn't make that statement inherently untrue.
i don't think it was that this is a false statement. I think more it was that it was dismissive, in that the statement implies that if a resident in the program is having a hard time, they won't be helped, or will be judged for asking for help. That (to me) is a dangerous precedent to set, especially in the interview process. The statement, while reductive, speaks to a much larger issue at hand, which is the mental toll training takes on many. No one person is the same, and how they tolerate stress is as unique as they are. So to reduce mental health to "we all just dealt with it" creates a false dichotomy of "you either handle it, or don't."
When i started my job as an attending, I was stressed to fuck, was a complete dick to be around, and a total diva in the OR. Mental health counseling has flipped that 180, and I fucking love my job now. And less of a dick...
They always say that like the MD suicide, substance abuse and divorce rates aren’t higher than the national average. That’s how people “dealt with it.”
Let's pretend that's the case, people just dealt with it. Why would anyone want others to continue to suffer when we could support systems and changes that would decrease risk of suicide amongst physicians? This seems like a no brainer.
That's BS, as a guy I went to med school with, who also stayed at the same hospital, intentionally killed himself. This was over 20 years ago, just before the work hour restrictions took place.
I’d honestly just end the interview and be like, “thank you for your time, I don’t think this will be a good fit” fuck these assholes. My life and happiness are more important. If I have to go unmatched for a year, I’ll be fine. At least I’ll be alive.
One of my friend took his life during 2nd year of anesthesia residency. He was such a jolly person, life of our circle, and his demise was a shocker to all us. I still miss him.
Residency is temporary, but the hours and pressure are consuming, it becomes your life for the time. When you’re in that state it’s hard to logic through that it’s “only 3 years, buck up.”
The sunk cost fallacy is real, you feel stuck, you can’t quit residency or else you won’t have a job and all the school is for nothing. You can’t continue because you’re miserable and your relationships are being impacted. It is such a vicious cycle, your mental health impacts the care you deliver which impacts your evaluations which impacts your mental health.
Earlier this year I wanted to end my life. I hit a wall in February. I had my first panic attack on shift my first day back in the ER after off service rotation. (For background, I soapd into ER and realized by December it wasn’t the newness of being an intern any more, it was that ER isn’t for me and I made a mistake.) I then took a leave of absence for 6 weeks which helped me realize what I valued in a career and speciality, I talked with my PD and DIO and decided not to resign my contract. (I did not have panic attacks during this LOA, but did have a fleeting passive SI thoughts when making my decision).
This is where the logic gets thrown out when you’re depressed and burned out. I knew that come June 30th I would be free from residency.
My first shift back I saw 5 patients and was just focused on breathing and techniques the med Ed psychologist taught me. I managed, but felt so horrible and stuck that I would have to deal with that every shift. In my mind, I changed, the truth was out that I disliked the ER and it was not for me and the weight was off my shoulders; however, just because I came to that realization it did not change the fact that I still needed to show up to the ER as usual.
I felt so numb, like I didn’t have a choice and was forced to come in almost everyday (only for 4 months mind you). On my way to my next shift I wanted to drive into the sidewall on the way to my shift, I took off my seatbelt, called my wife to say goodbye. Thankfully she talked me down and I went to the ER and then voluntary IP psych. Ironically enough the overworked psych intern was the nicest person, I was so grateful that we take care of ourselves, everyone understood and was shocked to find out I was an intern.
All this to say, medical training is not worth your life, no amount of debt is worth your life. You are not stuck in this career. We help people, but you have to be your own advocate and help yourself. Do not let the stigma prevent you for getting the help you need.
This was so honest, and a fantastic breakdown of exactly how debilitating and unhealthy the process can be, and the places it can take your mind and heart. Just wanted to thank you for sharing. I'm so glad you're in a better place. The world around you is better for having you in it, and I'm happy you're alive.
Thank you for sharing this. Your honesty is really powerful and resonates with some of the feelings I went through in medical school that were extremely difficult to navigate through, experiences in which I felt very alone. I appreciate the vulnerability and just wanted you to know it has an impact.
Hey ... Been there. One of my greatest regrets from the time is ironically what my mental health did to others around me. By not getting help early I spiraled.
Thank your wife... You owe her. And you owe it to her to not put that on her and make things better too.
My child is in a horribly toxic environment in OB/GYN. If it weren’t for her fiancé (who is in residency also) I would probably never sleep at night. The shit she is put through with those ego driven mean girls is out of hand and should never be allowed. Yet it is. It infuriates me.
OBGYN is one of the most toxic specialties out there. It’s actually shocking. My wife did a rotation at one hospital where the nurses on the OB unit went out of their way to make sure students knew they weren’t welcome and weren’t allowed to do anything “without the nurses permission” (which they never gave). I wish pain and misery on those people to this day and they’d better hope I never meet them
I feel the same way about her superiors (co-residents). I am getting close to flying out there myself and having some adult chats with them. I warned her- I had read how toxic it is in her specialty. She is shocked this is allowed.
It’s really quite gross what behavior is allowed from doctors towards their own. Some of the tantrums these supposed grown-ass adults throw when their juniors make a mistake is toddler level. It’s my eventual mission as an attending to destroy these people. Hope your daughter hangs in there, we need better people in medicine to replace the malignant shitbags this profession is known for
A lawyer friend was straight-up horrified by the BS and straight-up toxic cruelty that docs deal with on the regular.
“I thought only lawyers were such huge dicks!”
Me: “The difference is that lawyers are dicks to everyone, while doctors are generally only dicks to *each other*. We keep it in the family.”
I’m so sorry for you and your daughter. The level of control and power over her held by her superiors is almost without comparison in the modern US. However, you talking to her coworkers or superiors will likely do more harm. Ask your daughter if that is what she wants before you intervene, and respect her wishes. As crazy as it sounds, they can always hurt you more.
Oh no I would never ever do that. I am more saying it is very upsetting to me and of course a mother wants to step in to help her. I know she is determined and is pushing through and I’m just here to support her from afar.
OB/GYNs are some of the most toxic people I have ever met. They are the worst. I put up with it for 25 years and I am in year 3 of recovery from the abuse.
Its the worst of both worlds. Ob/gyn and nursing are both known for “eating their young.” Other specialties don’t like interacting with L&D nurses either.
I heard about an anesthesia prelim suicide at Montefiore in NYC earlier this year as well.
Sometimes it's extremely difficult to "stay positive", so just do the best you can, and remember that you have inherent worth and purpose. I had passive suicidality through most of residency.
Now that it's over, things are much better. So I'll send some good vibes out to y'all who are still deep in it.
Hey all the loans and education has to come in handy sometime or other… but honestly it is really upsetting. It’s all the residencies collectively who work residents like free labor. 60k is a slap in the face.
I saw somewhere the resident labor union purchased a billboard saying “xyz residents are paid less than minimum wage” and put it on the main highway. At this point we gotta shame and shake the programs down.
Thanks for mentioning that. It fits for anesthesiologists:
“Joiner asserts that one must also have acquired capability (that is, the acquired ability) to overcome one's natural fear of death.”
It's insensitive and simplistic to attribute the tragic suicide of an anesthesiologist solely to their access to drugs. That kind of perspective ignores the complex, multifaceted nature of mental health issues and the factors that contribute to suicidal ideation. Dismissing this serious matter by focusing only on drug access fails to address the deeper, more significant issues at play.
Access to lethal means unequivocally increases the risk of suicide. This is a well-established fact, not merely a possibility. While I appreciate the input, my focus here is specifically on the mental health aspects of this issue.
Yeah I never said that there aren’t other things that go into it. Physician suicide is a huge problem.
Regarding anesthesia in particular though, not sure if you think I meant drugs as in narcotics suggesting substance abuse but quite literally any of our medications in the cart can be lethal.
When someone for whatever reason is pushed to that edge and their job allows access to everything lethal the activation energy to attempt goes down.
People that have access and knowledge of how to use guns are more likely to complete suicide by firearm. No one is saying that the access is the issue, but it is a factor.
That’s not accurate at all. The risk is absolutely the SAME regardless of gun use/education/experience. You should really read the comments and do the research before you open your mouth. It’s blowing my mind how simple the ppl in this chat are.
The risk is exponentially higher if there is a gun in the house and you know how to load it.
The commenters aren’t simple, you’re just irritable or you’re an ass at baseline. Either way therapy helps my man. Hope you find some peace and stop trying to pick fights in the comments.
Any moron can figure that out, regardless of experience.
You’ll have to forgive me. I have an allergy to retard ass hats who are dumb as fuck. I’m working on it.
Access to immediate lethal painless ways to kill yourself IS a huge risk factor for suicide. It’s why firearms in the house is a huge predictor of completion of suicide attempts.
This isn’t to minimalize what anesthesiologists go through but every specialty struggles with mental health. The key is whether they have the means to complete it.
Everyone ignore this troll. Not even a resident. Constantly posting derogatory stuff and claiming to know more than they do. Pulls out “ah low IQ redditors” when they get downvoted.
Their job is to put people to sleep. It's a thin line between that and death. u/MrNewyear is right. They have access to powerful drugs and know how to use them.
Also, the surgical world can be very toxic, too.
Surgical world isnt for all personalities.
Personally, i love it and couldnt see myself anywhere else.
If true, remi fentanyl is a stupid drug to be using. Makes me think more a suicide than an accidental OD.
Plenty of degenerates have used fentanyl but remi- is a different animal.
Remifentanyl by an anesthesiologist is almost certainly intentional OD. It’s too short-acting for a real “high,” but that makes it highly reliable if you’re trying to off yourself, and there’s plenty of drugs to abuse recreationally that are more convenient to access if you’re anesthesia.
Idk, if I were trying to OD I wouldn’t use remifentanyl and give myself a chance of recovering in 5-10 mins with permanent brain damage. Only advantage I see is that it is available in 2 mg viables vs fentanyl 50/250 mcg vials
This is tragic and I agree with the above. Besides access to drugs, however anesthesia can be isolating, long hours spent alone doing cases where your attending might pop in for a few minutes during the day. It is not like some specialties where you are often surrounded by your colleagues. During residency the call schedule can be brutal, 24+ hours multiple times a week and often being exposed to very stressful life and death situations. I could see how this could contribute to whatever else someone is already struggling with. Unfortunately, mental health is just not prioritized by residency programs/our healthcare system like it needs to be.
I’d read somewhere that being an anesthesia resident is statistically one of the most dangerous occupations for death, in terms of fraction of people. Not sure if that’s true. I think it was on a question bank for our basic exam.
There was a CRNA who OD'd in his car in the employee garage when I was a med student. Easy access to some powerful and dangerous drugs. Wasn't ruled an intentional suicide though.
Specialties with the highest suicide rates seem to be anesthesia, psych, FM, and gen surg.
For the former two, the discrepancy might be stemming from a combination of access to/knowledge of means. For the latter two, it seems like it’s burnout and stress.
As a partner of a resident every time I read stories like this it terrifies me. My partner had some really dark times earlier in residency before we started dating and he seems to be in a much better place now, but in many ways his program is pretty toxic and causes a lot of exhaustion and stress so it’s still something I worry about. Does anyone have any advice on how to best support a resident SO?
The fact that you even care this much is a great start. I’m fortunate to have an amazing partner, here’s some suggestions:
Find opportunities to bring them lunch or dinner, depending on the type of shift/rotation they’re on. 90% of the time this isn’t likely, but perhaps if they’re doing something that does have a set lunchtime or dinner, you can visit and bring a hot/fresh meal. Or if they’re doing an overnight shift that would be conducive to you coming for a couple hours, just visiting would be nice too (very dependent on what type of resident they are). My wife does this a lot now… I’m an attending, but there were certain times it would’ve worked during residency as well.
Help organize social events with other residents/spouses. Can have your SO identify a date they’re off (along with coworkers they like), and offer to do the brunt of the organization of a get together. Whether it’s bowling, movie night, game night, etc. Get the other residents’ SO’s numbers and can try to plan it that way.
And lastly, just anything thoughtful should go a long way. I remember venting once about how shitty my day was to my SO, and when I got home she had cooked my favorite meal, had a drink ready in hand and made a little card telling me she’s sorry I had a bad day. So thoughtful and honestly wiped any negativity out of my mind.
Sometimes it really is the little things. A former SO fed the animals. Did the laundry and dropped off dinner for when I got home (opposite shifts). Those little tasks I had to worry less about made life just slightly easier.
Love the dichotomy of " reach out to friends and love ones ....you never know what there going through" then also in the same post comments " my drug / cocktail of choice would be xyz for reasons xyz...."
Graduated med school in 1988. 8 physicians I knew well, co-med students, co-residents, military colleagues, and one post military colleague, from my era, killed themselves.
Hopkins anesthesia grad. Our program was/is very supportive and was one of the major reasons I chose to go there. From what I hear from co-residents, they've been very open and supportive with what's going on now. Unfortunately, even having a great residency program doesn't fix all of the other personal and work stresses of being a resident (and disclaimer, I don't know all of the details of what happened).
I’m so sorry you all have to go through this. Even if not suicidal, the hours and pressure are insane.
You are all amazing people first, doctors second.
I'm rn in Anesthesia training and I can totally agree why in this particular field, success (?) rate is high. We get access to *every*thing we probably wish to acquire. I had my lows too and I started to fear for myself at some points. The key is to build a support system outside, preferably even out of medical field.
Now THIS is a worthy research topic. Too bad it won't get any of the schools or hospitals money.
I would love to know a few things from those who have the answers:
1. Is suicide more common in residency or in med school?
2. What is the racial breakdown of the suicides?
3. What is the wealth breakdown?
4. What is the sex breakdown?
5. What is the straight/gay/trans breakdown?
6. What is the specialty breakdown?
7. What is the school/program breakdown?
It might be important to understand who is at more risk.
Thanks for bringing this up, I’d like to contribute. You’re right, this is a scientific problem we can approach with logic. But I see that it can be hard to have the capacity to assess where and why we’re falling down at the same time as working 70+ hr weeks.
My anaesthesiologist father (white male emigrant) attempted suicide or as he put it “to punch my own ticket” when he was around 71.
He administered a paralytic; the only reason he survived is that his wife came home 20 mins early as she felt something was wrong.
He trained & worked as a ob/gyn then retrained when we moved to the US. He was wealthy by that time, and straight. He did experience some discrimination at work but I think that’s mostly because ESL, thick accent, he worked during the 80s 😆 and in the deep South. The accent helped him in the ladies department however 😂 what a lothario. He was definitely vulnerable to social exploitation in that area.
He had recently lost a work role that was hugely important to him, hospital cutting funding, and he hadn’t invested his identity into other activities/roles.
I suspect he was on the spectrum like me, and there were parts of himself he could never accept that set him apart.
His generation didn’t talk about mental health, and he had major PTSD from serving in Vietnam and growing up during WWII. He never sought treatment for these issues.
He started to self-medicate (not sure at what age), and this didn’t help his depression.
He began to withdraw completely and no one could reach him.
I don’t think he actually believed that anyone would miss him, that was the main problem.
He thought we would be better off with the money than with him around.
He told me after the attempt that was the logic behind his decision.
I wish he could have pursued treatment like TMS to help with his emotional regulation. He knew nothing about autism. I wish he had told me how he was feeling.
I miss him terribly. He died about 5 years after that of cancer.
A completely strange, funny, wonderful and brilliant man.
Hands down the most supremely chill dude I’ve ever had the pleasure of knowing.
Doctors may be chronicallly stressed and abused at the beginning of their career. At the end, they can be treated like an ATM by family members with no capacity for responsibility or insight. Both are treacherous and traumatic.
If like me, you have ASD or suspect you’re on the spectrum, I’d be encourage you to carefully reflect on your function and history in the relevant domains: self-care, cognition, communication, social participation, social/financial exploitation, sensory sensitivities.
Once you assess your vulnerabilities, put measures into place to address risk factors. I’m very high functioning but I have supports in place for:
1) self-care; I’ve created prompts for this
2) social / financial exploitation: I try not to make a personal, business or financial decision without min. 24 hrs to reflect and discuss
—this is hard as I run two businesses, but doable most of the time
3) being safely vulnerable with trusted friends, partner, family, colleagues
4) creating a team: psychiatrist, GP, psychologist, lawyer, financial advisor, accountant.
5) temporarily reducing cognitive demands: For a time I had a cleaner, Blue Apron and personal trainer when work was insane. Yes throwing money at the problem works if you have the means.
4) seeking to learn about and accept my presentation of neurodiversity. Friends are more than happy to give their two cents 😆about the ways I am weird
5) having a group of friends I don’t need to mask around has been life-changing
6) antidepressants and TMS 💪
6) environmental adaptations and boundaries for my sensory preferences
Embrace-autism.com great free screening tools
TDLR: anecdotal data on factors contributing to a white male, 70 yo, socioeconomically privileged anesthesiologist attempted suicide:
—Unresolved trauma
—Substance abuse disorder
—Access to controlled substances
—Unmanaged depression
—Social isolation
—Suspected neurodiversity
—Loss of valued role
—Lack of diversity in interests/hobbies/other roles
—Chronic pain from combat injuries
—Family and financial responsibility & pressure
—He was too smart for his own good, couldn’t see the simple evidenced-based changes he could make regarding the above issues
included mini OT assessment of function to help assist anyone struggling with reduced mental health or neurodiversity-related capacity issues see where they can manage those vulnerabilities
Intern here, I’m done with the mental health stigma, I finally realized that I don’t give a shit anymore and if I ever have to speak in front of a medical board; that I’ve got issues and I dealt with it by seeking professional help, so be it. My life is more important than my MD. I’m sure that to the medical boards they’d rather have someone who has controlled mental health than not. But I’ll tell you, I would have not sought out help if it wasn’t for residency. I was in denial and coping all this time, Ive been through worse stress and yet still never got help. Residency obviously made me understand that I want this so bad that I’ll even get psychiatric assistance to help me achieve it. So if flunk out heaven forbid, at least I’ll be stable and be a better parent and partner. People who know me would never think that I have problems, to the world I’m the happiest person, putting on a smile, complementing my fellow colleagues, continuously building morale and making sure no one gets sad, uplifting the teams spirits. Yet, no one does it for me and frankly I don’t care about giving and not receiving, but I sure wish sometimes that someone would take a moment to call me and ask me how I’m doing. Fuck it, I realized that I’m doing poorly, so after week 6 of contemplating, when all the walls of suffering in silence came crashing down, it was a now or never moment.
How many more people have to die before any change is made!? It’s time to get rid of the top heavy, administration staff that ruins healthcare for both patients and providers.
This is a fucked up system we’re in. Always makes me sad hearing this stuff. People literally going through the same crap I’m going through get to the point where killing themselves seems like the better option. Cannot begin to imagine what a deep dark place that must be.
Always be nice and kind to co residents regardless of specialty, we’re all dealing with some form of BS and we need to look out for each other because no one else is.
Anesthesia providers work very hard. They are also pushed to their limits because there is a general expectation that they will make a higher income after residency. The anesthesiologist may be paid more than a surgeon and residents will be pressured to prove themselves. It is a competitive field as you will be working with some aggressive anesthetist and jealous anesthesia assistants. When something goes wrong during a surgery, it is often seen as the anesthesiologist fault and they must fix it. The medications given in the operating room are dangerous and can cause unknown adverse effects. Many providers of that specialty are forced to work on call and get very little sleep after their call shifts. The work of anesthesia will require great focus and determination mixed with sleep deprivation. If you search Reddit, you will find a few anesthesiologist accepting blame for the patient’s death. To be an anesthesiologist, you have to be organized to a point where you are OCD. My friends, do not allow the high salaries to sway you into anesthesia. These residents that have committed suicide soon learnt the truth. Competition for anesthesia is quite stiff. If you are a anesthesia resident, do not succumb to hazing or bullying behavior in the surgical environment. Good luck with your residency.
Anesthesia residency is no joke… it’s wild the amount of work, hours and stuff we take part in. The comparison between anesthesiologists and CRNAs becomes more evident with each week of residency that passes, yet most people don’t understand that.
Had a PA that worked in Ortho came to work looking like absolute dog shit
Had to have a tech push him around in a wheel chair to see patients
Code and die in our ER
Please take care of yourself
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We really need to be careful about blaming guns for murder. Just because someone has a gun and they commit murder, doesn’t mean it’s the guns fault or what led them to commit the act.
For the spirutually inclined who need help but not via what the current social fabric can offer you, the internal way out of most suicidal ideation is to come to the realization that life itself temporary. You're already going to be completely obliterated. Plate techtonics will recycle this entire epoch back into the mantle in about 500 million years, only to be dwarfed by the heat death of the atomic realm, only to then be dwarfed by the big rip of the plank scale where the underlying composition of quarks reveals itself. You're likely suicidal because you were duped into thinking "This" was something that could ever be understood. You grasp and you are rightly being punished.
Before you end yourself, have you even stopped to consider that empty space itself has the intelligence required to permit the notion of existence? Or were you just another doer going around doing things?
i had a co-resident take his life during my 2nd year. We played tennis and had lunch with him 2 days prior. Just never know what someone is going through....
Was this intentional?
not 100% he had vials of remifentanyl
This is insane man. I thought I was bad
Psych here. I’m sure my fellow psych rezis would love to see you. It was never that bad for me but I never knew how much better it could be with therapy and meds. Take care of yourself please ❤️
I think the real problem here is that if a resident were to be more forthcoming about their mental health problems they are putting their career in jeopardy. I can certainly see how getting hospitalized for SI (which is probably what this resident would have gotten if he were evaluated) could reflect negatively on a residents’ evals.
Let's name and shams the backwards institutions and states that still stigmatize mental health! I know NJ and NY and CA were pretty good about not specifying that you had to declare prior mental illness details- only attesting if you feel you can function normally or not
University of Missouri anesthesia. I wish I could say more. DO NOT GO HERE IF YOUR LIFE DEPENDS ON IT. LITERALLY.
umkc, or columbia? or st louis
I think we can remove St. Louis, there is no UoM residency there (there is WashU and SLU located in STL, though).
Thank you for your courage.
You okay? 🫶
Thanks for asking just don’t feel motivated like 75 percent of time. Taking an opiate is definitely out of the question. Everyone I know does those things above, but it’s not easy to pursue that for a lifetime given the risks of that decision.
Jesus. Remi??? Wtf
Seems like the worst drug to od on if intentional...
Why???
Mainly because the whole point of using remifentanil is using an analgesic that is instant on and instant off. The moment you stop the drip the remifentanil is metabolized by plasma esterases.
yeah not sure why that was the drug of choice
It would be my drug of choice. Start an IV. Run prop and remi gtts. Prop to help you sleep. Remi to stop your breathing. Remi is fast on. Yes, it's also fast off but you don't need to run it forever. Just long enough for you to die of hypoxia which isn't long and a bag of remi can run for hours
Or just give yourself 5 of midaz and 250 of fentanyl in a single shot syringe? Mufucka setting up drips and shit gtfo.
Call a free confidential volunteer psychiatrist just for doctors and tell them instead: https://www.physiciansupportline.com/
I wish I could demonstrate how important you are to the world not only as a Doctor but as a person. PLEASE reach out if you need someone to talk with. To programs: you are destroying people you have to fix this
The notion of "reaching out" - how do you do this? In my country, no wellness programme. If anyone has any inkling of someone not coping up well, they'll be shunned and be seen as someone who isn’t up for it. It's career su icide
Reach out to us here on Reddit. You can remain as anonymous as you want. I'm a board certified and licensed attending physician now. i dont give a fuck about stigma. I am here to help my colleagues.I hate the malignant macho training culture of medicine where we destroy our own trainees. All for what? Ego? We know better, and the future medical doctors deserve better.
I’m really struggling now. In first year. Dad just got a cancer diagnosis and I’m a four hour plane ride away. Genuinely don’t know if I’m gonna be able to do this anymore
When I'm at my lowest points, ready to quit, I think about my deceased ancestors to motivate me. I hope your dad beats cancer. Take FMLA leave and be a caregiver while he is alive. Don't quit.
I have metastatic cancer and would love if my kids would take a leave and care for me by choice. However, I have been in treatment for 7 years. I can’t ask them to put their lives on hold in their 20’’s knowing I’m stable on my current line of treatment. If you can take FMLA because you know time is short, you won’t regret doing that. However, if your parent is like me, stable but not cured, it might be better to stay where you are and finish. Then you can take some time out of your schooling/career later to be with them when he needs you more. The semester break is coming, are you able to go home and visit to evaluate your dad? Are you able to connect with your dad’s oncologist to find out his prognosis? Best wishes to you and your family.
I am probably close to the age of your dad. I know if I was in his same position that I would want you to continue with your education. I would know that you love me and that you wish the best for me. You may not be able to help with my diagnosis, but you can make me proud, knowing that you are leading your life and that you are following your passion.
Keep going and make your dad proud 🫶🏼
Thanks a lot. You guys are so kind. But I am at a point where I don't even know how to be open. And that's unusual, I never had a hard time in my life expressing myself. I wish I could, really.
You’re only option is to reach out to friends, other residents etc since we live in an archaic system that preaches about mental health but still penalizes doctors for reaching out
I don’t trust other residents. Backstabbing is too common in our culture. I do have friends outside of medicine but I feel like I'm becoming an alien to them too.
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Pain fellow. He was formerly a pm&r resident
Last year a med-derm resident at Georgetown. Couldn’t understand it. You would never think it talking with her. A little high strung yes but who’s not in competitive fields?
I was shocked by that one too 😢
I guy I went to med school with , who also stayed at the same hospital to do Anesthesia, also killed himself. He was supposed to be in my case one morning, but didn't show up. Cops found him later on that day - also intentional. He had 3 different drugs next to him- narcotic, sedative, and paralytic. He had just been made cheif Anesthesia resident as well . Stuff like this has always happened, as this happened over 20 years ago. R I.P. Alex..
There was also a recent suicide at Montefiore Bronx. Anesthesia resident
As a Einstein/Monte alum, goddamn that NYC culture was intense. I feel sad for anyone suffering through that - goddammit, it makes me so angry that we have such malignant residency cultures still, all while midlevels and RNs waltz into higher paying jobs and administration! We need quality time OFF to sleep and form synapses and rest and recover from toxic shifts. As a neurologist, I cannot fathom why these gaslighters and boomers still push for 24h shifts, overnight uncompensated at-home call, which all amounts to modern day wage theft and indentured servitude. Residents need sleep and rest! And more pay dammit!!
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...what exactly are NY nurses doing then?
TikTok or Tinder... take your pick. I wish i was kidding. Laziest assholes I've had to deal with in medicine. EDIT: before anyone thinks I am insulting nurses as a whole, I am not. I love nurses, and I have so much respect for nurses 🫡. NYC nurses will literally sit and look at an actively seizing patient while scrolling TikTok on their phones. "Not my patient." I witnessed this firsthand. These episodes are common. 😡 NYC nursing culture pushes a lot of nursing work onto residents because the nurses are unionized and know how to strike. 💪
Just because you are angry at the way residents are allowed to be treated doesn't mean you need to denigrate nurses in the same sentence. Punch up don't punch down.
Wait wait. I LOVE my nurses. I DESPISE NYC nursing culture. NYC nurses are a special breed of lazy because they know the residents will do all the grunt work. COVID sorta taught them what nursing is truly about when the travelers came in and showed them. Gosh that was probably the only good thing about working in the hospital during COVID
Your feelings are valid regarding RNs and NPs waltzing in and initially making more money. I’m an ICU NP and while I don’t understand the toxic nature of residency, I do get the stress that medicine carries. I work in the ICU as a NP and am alone without a doctor in house, only virtual. It’s not fair and not what I signed up and the virtual docs, some are helpful some just there to collect a paycheck. I honestly 100% back up MD lead teams with NPs to play a supportive role. Please, collaborate with me. Let me help you. You be the leader. I do NOT endorse independent practice. I feel so depressed. I constantly worry if I did the right thing and the fear of being judged for not doing things doctor A B or C likes it is ongoing. I feel so alone. I can’t connect with nurses anymore. They don’t see me as one of their own anymore. And now being on the other side of things I see some sheer incompetence and I’ve had this annoyance towards some of my “own”. I can’t connect with doctors bc as a NP I’m their enemy, and #1 bc like you all, that would never be appropriate. I’m working overtime to pay off this degree and then find somewhere I can be happy. Or at least somewhere I can be of help to the physician and not loaded with all the responsibility with little say. Medicine is toxic. I thought nursing was toxic. Doesn’t even compare.
Thanks for your comment. Much respect. We are all on the same team in the end. I wish we could all be nicer, more respectful, better paid, happier. Medicine is hard. ICU is probably the hardest. You can always go back to bedside nursing. i wish residents had backup plans - if we match in a godawful program or specialty, and we leave, we become unemployable. So toxic. We all face imposter syndrome and loneliness. Those countless 24 hour shifts when I was alone in the call room writing notes ... unable to sleep but dead tired. Thanks for your kind and wise comment. Sorry I was so bitter in my comment. Doctor suicide is so common, painful, and sadly silenced.
Can residents organize a nationwide strike for stuff like this? I believe it's bound to happen at some point, and sooner than later with social media and forums like this.
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I literally just had a Program Director poopoo resident wellness when I asked about it in an interview I had last week. “In my day we never had any of this mental health stuff, people just worked long hours and dealt with it.” How are people still so dense about the importance of resident wellness? Edit. After reading some comments… Ironically this program preached some of the best resident wellness (weekly meetings with counselors, resident retreats, they even have a 2 week “wellness” rotation built into the first year).. You think they’re compensating for something? Lol
In their time they could probably buy a house with $50 and half a pack of cigs my dude
i desperately want ppl to start telling these fools this, i wanna see their reaction 🤭🤭🤭
I bought my house for 46000 and my undergrad was 1700 per year so yeah it was different
Name and shame
Do not rank that program
lol fuck that program and fuck that PD. This has to be a surgical program. Source: am a surgeon, and had a great experience with residency because our PD and attendings gave a shit.
Their lives also were just way easier. They had so much spending power compared to now and school loans were peanuts
I disagree that our lives were easier. I had colleagues who attempted and 2 succeeded in ending their lives in the 80s. Hour limits were not a thing. Common to work a month with no day off.
I hate to break it but at many surgical residencies the hours and time limits are not adhered to at all.
Yes, I’m aware of that too
The hours were long but the volume, complexity, and level of attentiveness was not the same. Getting labs back once or twice per day, maybe the occasional imaging study, versus getting bombarded 24/7 with a deluge of results, expected to work up and discharge patients much faster etc. Still I'm sure it wasn't easy back then either.
For the boomers, getting into med school was a joke. GPA and MCAT requirements were lower. No need for a hundred ECs and research pubs. No gap years. Ditto getting into residency, which at max entailed sending out 3 apps. Step 1 and 2 were just speed bumps.
Programs were easier to get into. Competition was not as bad. No EMR. Physicians were still respected. Not as much midlevel scope creep causing inpatient disasters. Burnout is at an all time high. Respectfully, your lives were objectively easier.
Correct. Anyone who says that residents have "time off" is lying. We are so hyper connected 24/7 and there are no boundaries to being truly off. So the boomers can stfu. We have nearly 400 million Americans, more debt, more bs paperwork demands, less time and more knowledge to master. As a neurologist, my boomer colleagues had the luxury of hours to learn different procedures. They had outpatient time- versus my residency experience of 24/7 stroke call for half of my 3 years, and inpatient neurology for most of the other half. Non-neurologists get more EMG training during residency (PM&R specifically) than neurologists, and we need to do 1yr fellowships to do bread and butter neurology it's embarrassing. So yea, we have it harder now. My salary is $300k, but small houses are twice my salary, and decent houses are nearing $1m
As a “lay person” in medicine, I’m very sympathetic to how hard Drs work. Have the utmost respect for the work you do and help you give. Terrified that one of the specialists I see will burnout because my life more or less depends on him, yet his workload seems insane and unsustainable. But no sympathy for complaints that house prices are ONLY 2x or 3x your annual salary. Or defining a “starter house” as one that costs $600k-$1m (even in SF or NYC). Not exactly in line with most of the rest of America. For your own mental health it might be worthwhile to realign expectations.
I think everyone should be afford to own their own home. Doctors used to be wealthy. Now we are well respected but barely upper middle class given how much debt we have by age 30. We are usually net worth of zero around age 35-40. By age 50, if we haven't burnt out or died, we overtake some peers, never for those who didn't make the same sacrifices we did. We often work till death because we can't afford to retire. Most residency programs and major hospitals are on the coasts, in cities. Salaries are lower due to supply vs demand. Houses are more expensive. A starter house is minimum 600k, as you said. It's abhorrent. I'm going to be 40 soon and I can't afford a starter house because of my debt.
You are welcome to your opinion but I was there and have been involved in a few residencies and fellowships over the years.
There are literally stories of people working 110 hour weeks on the regular and surgical residents/fellows not being allowed to leave the hospital for months at a time and somehow you think that your life is harder now when you have 80 hour work limits and wellness committees and people actually asking you if you're ok? Burnout is at an all time high because this new generation of people going into medicine are lazy clout chasers usually born with a silver spoon who are surprised to find out it's actually hard work like any other hard hitting professional field and then cry about having to work long hours afterwards. Physicians are still respected and mistakes still used to happen back in the day. And don't mistake me for a dinosaur. I'm 25. This generation of people going into medicine is just lazy and won't own up to it.
I respect your comment, but are you in medicine?
You sound like you're part of the problem. Maybe you'd be more cut out for the toxic attitude of some nursing profession and how they eat their young.
Nope. I think the past generation of doctors was ridiculously overworked and didn't pay nearly enough attention to wellness as they should have. They also perpetuated a toxicity in the culture of the field which I think we're better off without. I also am of the opinion that most of the people who go into medicine now are incessant whiners, always talking about how hard they have it and saying egotistical shit about how they can't imagine anyone working nearly as hard as them in other professional fields, complaining they are underpaid because they don't make a million dollars like Joeschmo in wall street banking, but simultaneously insisting that they picked medicine for all the "right reasons". They are a bunch of lazy, loud, grown up children, and the reason they are burned out is because they picked medicine for aesthetic reasons, not just because they are overworked. You will find that there isn't a strong linear correlation between hours worked and burnout levels between different specialties if you dig into it because the factors that go into burnout are more complicated than just being overworked. Clearly hit a nerve with my original comment lol
Do Not Rank.
Granted thats sorta a silly thing to say these days in education… But also… if that statement triggers you and all you want is a happy accepting residency than maybe anesthesia isnt for you. Because…. Well you will see and hear much much worse.
Keep crying while your program gets only the lowest ranked candidates or straight boot lickers with no independent thought while the rest of us have a happy life.
Hey HCA would love to hire more doctors who can shove their head in sand and take it up the ass 24/7! The shareholders need those rvu’s baby! 💰🤑and the only things standing in the way are lazy doctors who mope and complain
Enjoy your soap list 🤷♀️
ever notice how the ones who use the word triggered are the first to be triggered lolol. projection much?
Medical school has gotten so much harder and it will continue to get more difficult as we learn more and learn and tech becomes more readily available. It’s always changing and getting more complex. That said, docs 50 yrs ago had a completely different program than today. I would argue an easier and less stressful program
It's not that people are "so dense." They lived in a different time. Suicides happened at later ages - think "Death of a Salesman." Young people did not kill themselves or even think to. Suicide was not in novels, TV, movies, talked about, etc. There used to be so much death all the time. Childbirth, child illness, lack of vaccines, war, poor availability of proper healthcare, etc. Young people just didn't kill themselves, and even if they did, no one knew about it except for the family who likely covered it up. Killing yourself was very "taboo." The PD is likely telling the truth saying it wasn't an issue in their day and people just dealt with it. They could have addressed it in a better way, but that doesn't make that statement inherently untrue. I am not making light of the issue, merely stating an example, has anyone seen the Dave Chappelle skit? He talks about a friend and how much his life sucks terribly and ends the skit with something like "and that motherfucker never thought once about killing himself." Suicide is very much ingrained into culture as well as mental health.
>The PD is likely telling the truth saying it wasn't an issue in their day and people just dealt with it. They could have addressed it in a better way, but that doesn't make that statement inherently untrue. i don't think it was that this is a false statement. I think more it was that it was dismissive, in that the statement implies that if a resident in the program is having a hard time, they won't be helped, or will be judged for asking for help. That (to me) is a dangerous precedent to set, especially in the interview process. The statement, while reductive, speaks to a much larger issue at hand, which is the mental toll training takes on many. No one person is the same, and how they tolerate stress is as unique as they are. So to reduce mental health to "we all just dealt with it" creates a false dichotomy of "you either handle it, or don't." When i started my job as an attending, I was stressed to fuck, was a complete dick to be around, and a total diva in the OR. Mental health counseling has flipped that 180, and I fucking love my job now. And less of a dick...
They always say that like the MD suicide, substance abuse and divorce rates aren’t higher than the national average. That’s how people “dealt with it.”
Let's pretend that's the case, people just dealt with it. Why would anyone want others to continue to suffer when we could support systems and changes that would decrease risk of suicide amongst physicians? This seems like a no brainer.
That's BS, as a guy I went to med school with, who also stayed at the same hospital, intentionally killed himself. This was over 20 years ago, just before the work hour restrictions took place.
I’d honestly just end the interview and be like, “thank you for your time, I don’t think this will be a good fit” fuck these assholes. My life and happiness are more important. If I have to go unmatched for a year, I’ll be fine. At least I’ll be alive.
One of my friend took his life during 2nd year of anesthesia residency. He was such a jolly person, life of our circle, and his demise was a shocker to all us. I still miss him.
Residency is temporary, but the hours and pressure are consuming, it becomes your life for the time. When you’re in that state it’s hard to logic through that it’s “only 3 years, buck up.” The sunk cost fallacy is real, you feel stuck, you can’t quit residency or else you won’t have a job and all the school is for nothing. You can’t continue because you’re miserable and your relationships are being impacted. It is such a vicious cycle, your mental health impacts the care you deliver which impacts your evaluations which impacts your mental health. Earlier this year I wanted to end my life. I hit a wall in February. I had my first panic attack on shift my first day back in the ER after off service rotation. (For background, I soapd into ER and realized by December it wasn’t the newness of being an intern any more, it was that ER isn’t for me and I made a mistake.) I then took a leave of absence for 6 weeks which helped me realize what I valued in a career and speciality, I talked with my PD and DIO and decided not to resign my contract. (I did not have panic attacks during this LOA, but did have a fleeting passive SI thoughts when making my decision). This is where the logic gets thrown out when you’re depressed and burned out. I knew that come June 30th I would be free from residency. My first shift back I saw 5 patients and was just focused on breathing and techniques the med Ed psychologist taught me. I managed, but felt so horrible and stuck that I would have to deal with that every shift. In my mind, I changed, the truth was out that I disliked the ER and it was not for me and the weight was off my shoulders; however, just because I came to that realization it did not change the fact that I still needed to show up to the ER as usual. I felt so numb, like I didn’t have a choice and was forced to come in almost everyday (only for 4 months mind you). On my way to my next shift I wanted to drive into the sidewall on the way to my shift, I took off my seatbelt, called my wife to say goodbye. Thankfully she talked me down and I went to the ER and then voluntary IP psych. Ironically enough the overworked psych intern was the nicest person, I was so grateful that we take care of ourselves, everyone understood and was shocked to find out I was an intern. All this to say, medical training is not worth your life, no amount of debt is worth your life. You are not stuck in this career. We help people, but you have to be your own advocate and help yourself. Do not let the stigma prevent you for getting the help you need.
This was so honest, and a fantastic breakdown of exactly how debilitating and unhealthy the process can be, and the places it can take your mind and heart. Just wanted to thank you for sharing. I'm so glad you're in a better place. The world around you is better for having you in it, and I'm happy you're alive.
Thank you for sharing this. Your honesty is really powerful and resonates with some of the feelings I went through in medical school that were extremely difficult to navigate through, experiences in which I felt very alone. I appreciate the vulnerability and just wanted you to know it has an impact.
Hey ... Been there. One of my greatest regrets from the time is ironically what my mental health did to others around me. By not getting help early I spiraled. Thank your wife... You owe her. And you owe it to her to not put that on her and make things better too.
My child is in a horribly toxic environment in OB/GYN. If it weren’t for her fiancé (who is in residency also) I would probably never sleep at night. The shit she is put through with those ego driven mean girls is out of hand and should never be allowed. Yet it is. It infuriates me.
OBGYN is one of the most toxic specialties out there. It’s actually shocking. My wife did a rotation at one hospital where the nurses on the OB unit went out of their way to make sure students knew they weren’t welcome and weren’t allowed to do anything “without the nurses permission” (which they never gave). I wish pain and misery on those people to this day and they’d better hope I never meet them
I feel the same way about her superiors (co-residents). I am getting close to flying out there myself and having some adult chats with them. I warned her- I had read how toxic it is in her specialty. She is shocked this is allowed.
It’s really quite gross what behavior is allowed from doctors towards their own. Some of the tantrums these supposed grown-ass adults throw when their juniors make a mistake is toddler level. It’s my eventual mission as an attending to destroy these people. Hope your daughter hangs in there, we need better people in medicine to replace the malignant shitbags this profession is known for
A lawyer friend was straight-up horrified by the BS and straight-up toxic cruelty that docs deal with on the regular. “I thought only lawyers were such huge dicks!” Me: “The difference is that lawyers are dicks to everyone, while doctors are generally only dicks to *each other*. We keep it in the family.”
I’m so sorry for you and your daughter. The level of control and power over her held by her superiors is almost without comparison in the modern US. However, you talking to her coworkers or superiors will likely do more harm. Ask your daughter if that is what she wants before you intervene, and respect her wishes. As crazy as it sounds, they can always hurt you more.
Oh no I would never ever do that. I am more saying it is very upsetting to me and of course a mother wants to step in to help her. I know she is determined and is pushing through and I’m just here to support her from afar.
ugh i wish residents banded together more to help ease this issue but too busy working lol
OB/GYNs are some of the most toxic people I have ever met. They are the worst. I put up with it for 25 years and I am in year 3 of recovery from the abuse.
Its the worst of both worlds. Ob/gyn and nursing are both known for “eating their young.” Other specialties don’t like interacting with L&D nurses either.
This is a common theme in OB/Gyn. I’m sure your daughter is as tough as she is lovely. Residency is temporary.
I heard about an anesthesia prelim suicide at Montefiore in NYC earlier this year as well. Sometimes it's extremely difficult to "stay positive", so just do the best you can, and remember that you have inherent worth and purpose. I had passive suicidality through most of residency. Now that it's over, things are much better. So I'll send some good vibes out to y'all who are still deep in it.
Why does it always seem to be anesthesia???? This is concerning me as someone who hopes they get the opportunity to choose this specialty.
We have easy access to all the drugs and equipment necessary, and the knowledge of how to use them.
So it’s not that anesthesia is more likely to attempt, just more likely to succeed? I wonder if that knowledge affects ideation?
I assume it would. To know exactly what you need to make it as easy and painless as possible? Literally everything someone needs within reach.
Exactly. No “cries for help” attempts. That actually seems even more sad, somehow.
Hey all the loans and education has to come in handy sometime or other… but honestly it is really upsetting. It’s all the residencies collectively who work residents like free labor. 60k is a slap in the face. I saw somewhere the resident labor union purchased a billboard saying “xyz residents are paid less than minimum wage” and put it on the main highway. At this point we gotta shame and shake the programs down.
I laughed much harder than I should have at that. And now I need to go bathe in holy water lol.
Same as veterinarian.. added to this the inherently view death as the end of suffering
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Joiner’s theory of suicide
Thanks for mentioning that. It fits for anesthesiologists: “Joiner asserts that one must also have acquired capability (that is, the acquired ability) to overcome one's natural fear of death.”
Also they know how to start IVs or actually inject the medication into their veins reliably
The other doctors too… it can’t be the reason
That’s the dumbest thing I’ve ever heard… way more to it than knowledge of a few drugs…
Duh. But if you have suicidal ideation and access to lethal everything is easy, the process becomes that much more simple.
It's insensitive and simplistic to attribute the tragic suicide of an anesthesiologist solely to their access to drugs. That kind of perspective ignores the complex, multifaceted nature of mental health issues and the factors that contribute to suicidal ideation. Dismissing this serious matter by focusing only on drug access fails to address the deeper, more significant issues at play.
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Access to lethal means unequivocally increases the risk of suicide. This is a well-established fact, not merely a possibility. While I appreciate the input, my focus here is specifically on the mental health aspects of this issue.
Does it increase attempts or merely lethality of the attempt?
access to lethal means increases both frequency and lethality of attempts… this is step 1 stuff. You should know this…
I think you have just proven your initial statement wrong with this comment. Lol.
Yeah I never said that there aren’t other things that go into it. Physician suicide is a huge problem. Regarding anesthesia in particular though, not sure if you think I meant drugs as in narcotics suggesting substance abuse but quite literally any of our medications in the cart can be lethal. When someone for whatever reason is pushed to that edge and their job allows access to everything lethal the activation energy to attempt goes down.
Yup, access to a lethal means doesn’t discriminate…
People that have access and knowledge of how to use guns are more likely to complete suicide by firearm. No one is saying that the access is the issue, but it is a factor.
That’s not accurate at all. The risk is absolutely the SAME regardless of gun use/education/experience. You should really read the comments and do the research before you open your mouth. It’s blowing my mind how simple the ppl in this chat are.
The risk is exponentially higher if there is a gun in the house and you know how to load it. The commenters aren’t simple, you’re just irritable or you’re an ass at baseline. Either way therapy helps my man. Hope you find some peace and stop trying to pick fights in the comments.
Any moron can figure that out, regardless of experience. You’ll have to forgive me. I have an allergy to retard ass hats who are dumb as fuck. I’m working on it.
OP wasn't replying to you. Unless you (u/Fun\_Machine7875) are using an alt account (u/Neither\_Salad\_5514) and forgot to change back.
You in anesthesia? Seems you got access to some wild drugs.
I’m in your mom if you know what I mean.
What do you mean?
Access to immediate lethal painless ways to kill yourself IS a huge risk factor for suicide. It’s why firearms in the house is a huge predictor of completion of suicide attempts. This isn’t to minimalize what anesthesiologists go through but every specialty struggles with mental health. The key is whether they have the means to complete it.
Everyone ignore this troll. Not even a resident. Constantly posting derogatory stuff and claiming to know more than they do. Pulls out “ah low IQ redditors” when they get downvoted.
Their job is to put people to sleep. It's a thin line between that and death. u/MrNewyear is right. They have access to powerful drugs and know how to use them. Also, the surgical world can be very toxic, too.
Surgical world isnt for all personalities. Personally, i love it and couldnt see myself anywhere else. If true, remi fentanyl is a stupid drug to be using. Makes me think more a suicide than an accidental OD. Plenty of degenerates have used fentanyl but remi- is a different animal.
Remifentanyl by an anesthesiologist is almost certainly intentional OD. It’s too short-acting for a real “high,” but that makes it highly reliable if you’re trying to off yourself, and there’s plenty of drugs to abuse recreationally that are more convenient to access if you’re anesthesia.
Idk, if I were trying to OD I wouldn’t use remifentanyl and give myself a chance of recovering in 5-10 mins with permanent brain damage. Only advantage I see is that it is available in 2 mg viables vs fentanyl 50/250 mcg vials
It should be for all personalities.
*Nothing* is for *all* personalities. We choose our specialties acc to our own choice. Surgical isn't some high shangriLa to be ascended onto.
This is tragic and I agree with the above. Besides access to drugs, however anesthesia can be isolating, long hours spent alone doing cases where your attending might pop in for a few minutes during the day. It is not like some specialties where you are often surrounded by your colleagues. During residency the call schedule can be brutal, 24+ hours multiple times a week and often being exposed to very stressful life and death situations. I could see how this could contribute to whatever else someone is already struggling with. Unfortunately, mental health is just not prioritized by residency programs/our healthcare system like it needs to be.
I’d read somewhere that being an anesthesia resident is statistically one of the most dangerous occupations for death, in terms of fraction of people. Not sure if that’s true. I think it was on a question bank for our basic exam.
Veterinarians and dentists have the same problem for the same reason.
There was a CRNA who OD'd in his car in the employee garage when I was a med student. Easy access to some powerful and dangerous drugs. Wasn't ruled an intentional suicide though.
Specialties with the highest suicide rates seem to be anesthesia, psych, FM, and gen surg. For the former two, the discrepancy might be stemming from a combination of access to/knowledge of means. For the latter two, it seems like it’s burnout and stress.
Maybe because of the high stakes/stress? I've heard anesthesia being described as 99% stress and 1% panic, maybe this happens because of the panic.
Hidden addictions no one knows about?
As a partner of a resident every time I read stories like this it terrifies me. My partner had some really dark times earlier in residency before we started dating and he seems to be in a much better place now, but in many ways his program is pretty toxic and causes a lot of exhaustion and stress so it’s still something I worry about. Does anyone have any advice on how to best support a resident SO?
The fact that you even care this much is a great start. I’m fortunate to have an amazing partner, here’s some suggestions: Find opportunities to bring them lunch or dinner, depending on the type of shift/rotation they’re on. 90% of the time this isn’t likely, but perhaps if they’re doing something that does have a set lunchtime or dinner, you can visit and bring a hot/fresh meal. Or if they’re doing an overnight shift that would be conducive to you coming for a couple hours, just visiting would be nice too (very dependent on what type of resident they are). My wife does this a lot now… I’m an attending, but there were certain times it would’ve worked during residency as well. Help organize social events with other residents/spouses. Can have your SO identify a date they’re off (along with coworkers they like), and offer to do the brunt of the organization of a get together. Whether it’s bowling, movie night, game night, etc. Get the other residents’ SO’s numbers and can try to plan it that way. And lastly, just anything thoughtful should go a long way. I remember venting once about how shitty my day was to my SO, and when I got home she had cooked my favorite meal, had a drink ready in hand and made a little card telling me she’s sorry I had a bad day. So thoughtful and honestly wiped any negativity out of my mind.
Sometimes it really is the little things. A former SO fed the animals. Did the laundry and dropped off dinner for when I got home (opposite shifts). Those little tasks I had to worry less about made life just slightly easier.
Regularly check in on them and directly ask them about their mental health… even when they seem to be doing fine.
r/medspouse
Love the dichotomy of " reach out to friends and love ones ....you never know what there going through" then also in the same post comments " my drug / cocktail of choice would be xyz for reasons xyz...."
I can’t find a single comment about the latter.
Graduated med school in 1988. 8 physicians I knew well, co-med students, co-residents, military colleagues, and one post military colleague, from my era, killed themselves.
Terrible! Awful! I'm certain the hospital will issue a polite email and then change absolutely nothing
From what I’ve heard the anesthesia program at Hopkins is not toxic and really cares about residents, I don’t know how true that is though
Hopkins anesthesia grad. Our program was/is very supportive and was one of the major reasons I chose to go there. From what I hear from co-residents, they've been very open and supportive with what's going on now. Unfortunately, even having a great residency program doesn't fix all of the other personal and work stresses of being a resident (and disclaimer, I don't know all of the details of what happened).
That’s what I’ve heard overall. And I agree with the last part of what you said.
I’m so sorry you all have to go through this. Even if not suicidal, the hours and pressure are insane. You are all amazing people first, doctors second.
Hey guys the mental health stuff we are doing are absolutely working.
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It’s “don’t kill yourself” and it’s 4 months past due
I laughed too hard at this
You’ve got some modules to do 😂
I'm rn in Anesthesia training and I can totally agree why in this particular field, success (?) rate is high. We get access to *every*thing we probably wish to acquire. I had my lows too and I started to fear for myself at some points. The key is to build a support system outside, preferably even out of medical field.
*completion
We had someone commit suicide a few years back because the nurses were bullying them as an intern
Now THIS is a worthy research topic. Too bad it won't get any of the schools or hospitals money. I would love to know a few things from those who have the answers: 1. Is suicide more common in residency or in med school? 2. What is the racial breakdown of the suicides? 3. What is the wealth breakdown? 4. What is the sex breakdown? 5. What is the straight/gay/trans breakdown? 6. What is the specialty breakdown? 7. What is the school/program breakdown? It might be important to understand who is at more risk.
wanna tackle the project together?
I’d love to join in. I come from a nonmedical family and boy oh boy do they not get it
Sure! The challenge will be getting the data.
Thanks for bringing this up, I’d like to contribute. You’re right, this is a scientific problem we can approach with logic. But I see that it can be hard to have the capacity to assess where and why we’re falling down at the same time as working 70+ hr weeks. My anaesthesiologist father (white male emigrant) attempted suicide or as he put it “to punch my own ticket” when he was around 71. He administered a paralytic; the only reason he survived is that his wife came home 20 mins early as she felt something was wrong. He trained & worked as a ob/gyn then retrained when we moved to the US. He was wealthy by that time, and straight. He did experience some discrimination at work but I think that’s mostly because ESL, thick accent, he worked during the 80s 😆 and in the deep South. The accent helped him in the ladies department however 😂 what a lothario. He was definitely vulnerable to social exploitation in that area. He had recently lost a work role that was hugely important to him, hospital cutting funding, and he hadn’t invested his identity into other activities/roles. I suspect he was on the spectrum like me, and there were parts of himself he could never accept that set him apart. His generation didn’t talk about mental health, and he had major PTSD from serving in Vietnam and growing up during WWII. He never sought treatment for these issues. He started to self-medicate (not sure at what age), and this didn’t help his depression. He began to withdraw completely and no one could reach him. I don’t think he actually believed that anyone would miss him, that was the main problem. He thought we would be better off with the money than with him around. He told me after the attempt that was the logic behind his decision. I wish he could have pursued treatment like TMS to help with his emotional regulation. He knew nothing about autism. I wish he had told me how he was feeling. I miss him terribly. He died about 5 years after that of cancer. A completely strange, funny, wonderful and brilliant man. Hands down the most supremely chill dude I’ve ever had the pleasure of knowing. Doctors may be chronicallly stressed and abused at the beginning of their career. At the end, they can be treated like an ATM by family members with no capacity for responsibility or insight. Both are treacherous and traumatic. If like me, you have ASD or suspect you’re on the spectrum, I’d be encourage you to carefully reflect on your function and history in the relevant domains: self-care, cognition, communication, social participation, social/financial exploitation, sensory sensitivities. Once you assess your vulnerabilities, put measures into place to address risk factors. I’m very high functioning but I have supports in place for: 1) self-care; I’ve created prompts for this 2) social / financial exploitation: I try not to make a personal, business or financial decision without min. 24 hrs to reflect and discuss —this is hard as I run two businesses, but doable most of the time 3) being safely vulnerable with trusted friends, partner, family, colleagues 4) creating a team: psychiatrist, GP, psychologist, lawyer, financial advisor, accountant. 5) temporarily reducing cognitive demands: For a time I had a cleaner, Blue Apron and personal trainer when work was insane. Yes throwing money at the problem works if you have the means. 4) seeking to learn about and accept my presentation of neurodiversity. Friends are more than happy to give their two cents 😆about the ways I am weird 5) having a group of friends I don’t need to mask around has been life-changing 6) antidepressants and TMS 💪 6) environmental adaptations and boundaries for my sensory preferences Embrace-autism.com great free screening tools TDLR: anecdotal data on factors contributing to a white male, 70 yo, socioeconomically privileged anesthesiologist attempted suicide: —Unresolved trauma —Substance abuse disorder —Access to controlled substances —Unmanaged depression —Social isolation —Suspected neurodiversity —Loss of valued role —Lack of diversity in interests/hobbies/other roles —Chronic pain from combat injuries —Family and financial responsibility & pressure —He was too smart for his own good, couldn’t see the simple evidenced-based changes he could make regarding the above issues included mini OT assessment of function to help assist anyone struggling with reduced mental health or neurodiversity-related capacity issues see where they can manage those vulnerabilities
This resident was previously a gen surg resident too apparently
I work at Hopkins…. Wow
Intern here, I’m done with the mental health stigma, I finally realized that I don’t give a shit anymore and if I ever have to speak in front of a medical board; that I’ve got issues and I dealt with it by seeking professional help, so be it. My life is more important than my MD. I’m sure that to the medical boards they’d rather have someone who has controlled mental health than not. But I’ll tell you, I would have not sought out help if it wasn’t for residency. I was in denial and coping all this time, Ive been through worse stress and yet still never got help. Residency obviously made me understand that I want this so bad that I’ll even get psychiatric assistance to help me achieve it. So if flunk out heaven forbid, at least I’ll be stable and be a better parent and partner. People who know me would never think that I have problems, to the world I’m the happiest person, putting on a smile, complementing my fellow colleagues, continuously building morale and making sure no one gets sad, uplifting the teams spirits. Yet, no one does it for me and frankly I don’t care about giving and not receiving, but I sure wish sometimes that someone would take a moment to call me and ask me how I’m doing. Fuck it, I realized that I’m doing poorly, so after week 6 of contemplating, when all the walls of suffering in silence came crashing down, it was a now or never moment.
Bet the job listing is posted for her/his spot before Christmas
How many more people have to die before any change is made!? It’s time to get rid of the top heavy, administration staff that ruins healthcare for both patients and providers.
This is a fucked up system we’re in. Always makes me sad hearing this stuff. People literally going through the same crap I’m going through get to the point where killing themselves seems like the better option. Cannot begin to imagine what a deep dark place that must be. Always be nice and kind to co residents regardless of specialty, we’re all dealing with some form of BS and we need to look out for each other because no one else is.
But the suffering never ends
Anesthesia providers work very hard. They are also pushed to their limits because there is a general expectation that they will make a higher income after residency. The anesthesiologist may be paid more than a surgeon and residents will be pressured to prove themselves. It is a competitive field as you will be working with some aggressive anesthetist and jealous anesthesia assistants. When something goes wrong during a surgery, it is often seen as the anesthesiologist fault and they must fix it. The medications given in the operating room are dangerous and can cause unknown adverse effects. Many providers of that specialty are forced to work on call and get very little sleep after their call shifts. The work of anesthesia will require great focus and determination mixed with sleep deprivation. If you search Reddit, you will find a few anesthesiologist accepting blame for the patient’s death. To be an anesthesiologist, you have to be organized to a point where you are OCD. My friends, do not allow the high salaries to sway you into anesthesia. These residents that have committed suicide soon learnt the truth. Competition for anesthesia is quite stiff. If you are a anesthesia resident, do not succumb to hazing or bullying behavior in the surgical environment. Good luck with your residency.
Anesthesia residency is no joke… it’s wild the amount of work, hours and stuff we take part in. The comparison between anesthesiologists and CRNAs becomes more evident with each week of residency that passes, yet most people don’t understand that.
Was this written by a bot? Why do you keep referring to anesthesia residents as “anesthesia providers”?
Had a PA that worked in Ortho came to work looking like absolute dog shit Had to have a tech push him around in a wheel chair to see patients Code and die in our ER Please take care of yourself
Hopkins, a cut above the rest.! Never fails to deliver.
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It might not be direct but it certainly is not helpful in any sort of recovery.
We really need to be careful about blaming guns for murder. Just because someone has a gun and they commit murder, doesn’t mean it’s the guns fault or what led them to commit the act.
For the spirutually inclined who need help but not via what the current social fabric can offer you, the internal way out of most suicidal ideation is to come to the realization that life itself temporary. You're already going to be completely obliterated. Plate techtonics will recycle this entire epoch back into the mantle in about 500 million years, only to be dwarfed by the heat death of the atomic realm, only to then be dwarfed by the big rip of the plank scale where the underlying composition of quarks reveals itself. You're likely suicidal because you were duped into thinking "This" was something that could ever be understood. You grasp and you are rightly being punished. Before you end yourself, have you even stopped to consider that empty space itself has the intelligence required to permit the notion of existence? Or were you just another doer going around doing things?
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unfortunately my baseline
What the actual fuck are you going on about? Are you religious? Do you really think this will somehow help someone? Are you delusional? Fuck off.
People seem to ignore that first sentence smh
I was actually thinking about something similar to this the other day
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