Daniel Esgardo Rangel Barón: Physician Suicide and Depression II

I’m going through a hard time.  Hard enough that I told myself today I would write in this blog daily and just talk, maybe even have discussions with some readers.  I want to be a voice for those in similar places as me.  Maybe some of the things I write are what physicians who couldn’t continue anymore thought or felt but just could never tell anyone.  Maybe other doctors will feel less alone.  I apologize for my lack of master editing skills, but on days I’m not on call, I’m awake a bit past 4am and come home in the evening or early night.

I go home daily and right away start thinking about tomorrow’s anxieties like I have previously described. I drink alcohol to relax, and the same amounts I used to drink have no effect on me.  I decide whether I should keep drinking or not.  I wonder how close I am to self-harm from drinking.  I think of alternatives like tea or water, or novel meals, maybe just laying in bed in the comfort of blankets with my dogs.     

Am I going to be criticized for doing something reasonable and safe but just not the way my attending wants?  Am I going to have tools or equipment taken from out of my hand because someone is impatient?

Am I going to be talked down to loudly in front of everyone because I’m too slow at a procedure I barely have enough experience with?

Am I going to hear others talking about me in a negative way when they think I’m not around?

Am I going to disappoint people because I don’t know this medical fact because as much as I study, I’m so stressed and anxious and depressed I can hardly retain anything?

Are they going to think less of me and say it to my face again?

Is it going to be another day of being the first to show up and last to leave, working hard without anyone saying hello to me?

Like I said, I do well on exams, but no one freaking cares.  I’m really about to say something to someone in the program, but everyone before me already has and there hasn’t been any change.  I also worry about coming forth and getting labeled as a “problem resident,” or be seen as someone who needs to be closely monitored.  I don’t want people to build a case against me just because I disagree with the way things are around here and they think me being gone would be easier for the program.

There are so many stories of residents being let go or suspended for various reasons, just look it up or ask what happened to resident X from the year Y.

A problem with medicine is how hard residents work and how the sword of Damocles hangs above us all and how many of our superiors forget what that was like.  I literally haven’t seen or used some types of equipment before and I’m spoken to like I’m an insult to people’s existence.  It’s disheartening to say the least.

My second encounter with the topic of suicide in medicine was in early residency.  I’ve known of people not in my class, but in my residency program who committed suicide.

Maybe once a year we’ll sit in on a talk about depression, burnout, and “wellness,” and someone will mention those we lost, but then it’s another 364 days of no one listening, no one caring, of doctors with problems suffering in the darkness.  

No one talks about what problems those doctors who killed themselves had.  They only talk about the night they found Dr. X dead in a room after trying to find out why they wouldn’t answer their pager.

I never hear people voicing regrets and saying “I really wish I listened.  I really wish I were there for them.”  

It’s like the death of a colleague is just a passing shadow.  Just transient darkness if their life they forget about.

Today I was talked down to in front of others, I was stressed, I was anxious.  I had cold sweat on my brow for the second time this week.  I kept on making good clinical decisions, I harmed no one, and didn’t cause any problems.  But still, I’m treated like less of a person.

Where I am, I think that there are only a handful of physicians who I call “true humans.”  As in, people who ask how you are, people who help build you up in skills and confidence, and people who will just listen and understand.  I don’t even want to start talking about the personalities in medicine.  Not all doctors are kind.

Only once in residency has someone said it was a good thing I was cautious during a procedure, as an aside.

I’m sad everyday.  And during moments I think I can be happy, I think that I should probably continue being sad. 

I have a friend who I talk to who knows about my situation.  A good number of friends.  One of them tells me to go out, and that it’ll help.  I don’t see how it’s going to make my work environment any less suffocating or less of a slow poison.

I’ve told people before I think about whether or not I’ll make it through residency.  They don’t really say much back, they’re co-residents and come off as depleted as I am.  Last year I worked with people who made me question my worth as a human being, and made me question my decision to become a doctor.

Everyone around me complains, is unhappy, and shows how stressed they are.  The advice I get from people who have since graduated is always along the vein of just taking it a day at a time.  If only the people who have the power to affect our days listened and did something about it.

I feel like less of a person and almost embarrassed to be who I am because I work with people who are experts and have years of experience and they talk down to me or treat me differently, someone with barely a fraction of their knowledge and experience.

So whenever I see posts from overly excited medical students or people applying to medical school, or med students bragging about their achievements and how they’re “destined for greatness,” I just can’t continue with them.  Medical training either breaks people completely or they emerge whittled down and diminished and may or may not recover.

I have thought about ending my life before, more than once.  I’ve thought about leaving medicine and finding a way to manage of my debt.  But then I thought that would mean “they’ll have won,” “they” being everyone who has been so terrible to me.  I’m not perfect, but I show kindness and patience others, and I listen when so many around me show me their impatience, and their insults.

I can’t let the cruel people win.  I can’t become a conversation topic that surfaces once a year.  My life is worth living, as sad and eroded I feel everyday.  I think it’ll get better someday, I truly do.  At least I want it so badly I think it really will happen.

I get through everyday by sheer will I find somewhere in my spirit, and a mantra I repeat over and over: “I’ve made it this far.  I can go further.”Daniel Esgardo Rangel Barón: Physician Suicide and Depression II

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