Physicians are supposed to be healers extraordinaire. It is our burden and our curse. Society holds us to lofty standards. We are expected to regularly perform miracles, or at least to pull reasonably healthy rabbits out of somewhat tattered hats. And do so with compassion and consistency. And to perform this role for several decades of our lives.
As a profession, we have extremely high expectations of ourselves. We must perform our jobs perfectly. We must remain immune from emotion and not allow the human tragedies we witness daily to intrude on our psyches. Of course, we never experience such tragedies ourselves, nor would be so crass as to succumb to the temptations of unhealthy lifestyles.
Right?
Wait! Something is not quite right with this picture. We physicians live in the real world and the last time I checked, one had to be a human being to enroll in medical school. Imagine that! Doctors are homo sapiens, too. Generally speaking, we have 46 chromosomes like most of our patients, and our cells have the same kind of DNA as other humans. We live in the same society with the same stresses as other mortals. Our bodies and minds are made of the same grist and gristle as the patients we care for every day.
But it’s hard to balance these roles, that of being both a physician and a human. Very hard. No, let me be blunt. It is impossible to meet the high expectations patients have for us while simultaneously clothing ourselves with a mythic and superhuman cloak that no one can wear comfortably. When you get right down to it, we are just Toms and Marys, Emils and Francescas, like everyone else.
What happens when the juggling becomes too stressful? What happens when the ball drops? We doctors can suffer. We are not immune from the ills of strain and sickness. In fact, when we doctors suffer, we often go all out. We do it up right.
What do epidemiologists report on the health status of doctors?
- Physicians are twice as likely as non-physicians to kill themselves. The suicide rate among physicians ranges between 28 and 40 per 100,000 compared to the overall population’s rate of 12.3
- Women physicians are four times more likely to commit suicide than women who are not physicians.
- Studies of women physicians show the lifetime rate of depression to be from 19.5 to 51 percent, depending on the study.
- While the prevalence of alcoholism and illicit drug abuse among physicians is similar to that of the general population, the rate of prescription drug abuse among physicians is higher.
- Divorce rates among doctors are 10 to 20 percent higher than the general population.
- Data has been somewhat variable, but it appears physicians have a similar life expectancy as the general population.
In citing these facts, I am not trying to tarnish the silver lining. Physicians are often fabulous and interesting people. Some of my best friends are physicians. But we physicians need to understand the conundrum we inhabit, because understanding holds the key to improving our situation. If we acknowledge and accept that we face special pressures, but also realize we have the ability to cope with these pressures, we may be able some problems as our years in practice turn into decades.
We need to take care of our own health, physical and mental. We need to take care of our bodies. We need to optimize our risk factors for illnesses. We need to eat healthily. We need to exercise, at least occasionally. We need to take our medications. We need to get our GI screening tests done, our mammograms, our paps. We need to have a personal physician. And then see that doctor periodically.
We need to take care of our minds. Doctors are lucky. We live and work among healers. We have closer, more intimate connections with them than anyone else in society. Yet we often hesitate to access these healers — those angels who surround us and are willing to help in whatever way we need, and to do so with as much compassion and confidentiality as we ourselves bring to our own patients. These angels are legion. They are empathetic, sympathetic, non-judgmental, and helpful beyond words. When the time comes, and it comes to many of us, it only takes a simple phone call to get help.
Being human is not a failing.
Being immune is not an option.
Take care of yourself. I ask this of you out of very selfish motives. After all, I will need you some day. I’ve already seen a great cardiologist. I just may need a great surgeon, or psychiatrist, or head and neck doctor one day. I hope you will be there for me, that you will be in good health, of sound mind, and able to focus on me as the patient I am. I’m not asking for the moon, just for a few shining stars.
(June 2007)