Mental Health in Medical Providers

So far, two of my medical school classmates have taken their lives, and we still have two years to go—in addition to residency. Mental health is consistently undervalued in the medical field, leading to a rise in suicide and burnout.

The first two years of medical school were undoubtedly intense. We had around 40 hours of lecture each week to master, and at the end of the two years we sat for a cumulative board exam–Step 1–which determines what kind of doctor you can be and thus, how much money you can make. Walking around the hospital with your Step 1 score embroidered on your white coat is not much of an exaggeration.

The deaths were a huge tragedy and wake-up call, and I was soon to realize, now as a third year medical student, that the pressure is only just beginning.

After spending twelve weeks rotating through the surgical specialties, I got a feel for the life of a surgeon. While there are exceptions, I found that overwhelmingly, the surgeons I encountered were curt, dismissive, hard, impatient, and short-tempered. And I was soon to find out why. The surgical residents were overworked and underpaid and under tremendous pressure. They weathered high expectations from their superiors and, perhaps more significantly, from themselves. It comes as no surprise that their interpersonal skills would suffer over time.

I’m not here to complain about a process that has been ironed into medical education since the dawn of Western medicine—whether you want to call it professional hazing or not. I’m here to reflect on the wellbeing of medical workers in America and the vicious cycle into which they are swept due to an innocent desire to help those in need.

Residents run the hospital, a fact which is chalked up to their need to learn and, less publicly, the money their cheap labor saves hospitals. The result is low wages and long hours, which leads to sleep deprivation, resentment and often, burnout. What an odd thing, I think to myself, to take the people whose role in society is among the most important and force them into these working conditions.

It wasn’t until 2003 that residents’ hours were regulated—a development which only occurred after patients started dying on the table from medical error. The regulation? Eighty hours over six-day weeks, averaged over a month. That’s double what the average American works. Further, residents have examinations which require studying after what is often a 14-hour shift. By the end of the week, you’ve got an exhausted doctor craned over an operating table with somebody’s fate in their gloved hands, running on four hours of sleep and a gallon of coffee. After six years of this (ten if you count medical school), it is not hard to imagine a morning where this doctor wakes up to all the aspects of her life which she has neglected and becomes suddenly overwhelmed. It is not hard to imagine why this resident decides to scream at the medical student standing in the corner; or swerves into a tree on her way home because she fell asleep at the wheel; or hangs herself in the closet when she gets home because people are dying all the time and deep down she feels she’s been dead a long time, too. It is these conditions which lead physicians to have among the highest suicide rates.

Two of my classmates have committed suicide, and it never reached the news. Who are the people sitting on the medical boards who continually sweep these deaths under the rug, tucked away from the public eye? Who is to say this number won’t grow as the pressure builds? What will it take for something to be done?

Doctors are expected to be super humans—the white coat their capes. They are not to show weakness, sadness, or fatigue. They are to be there for their patients before they are there for themselves. But doctors are people, too, and in adapting to the demands of medical work already I have seen how it can affect people. I have stood all day in a sterile operating room, demeaned for things over which I had no control, unable to defend myself due to the hierarchy which defines the hospital. I have had days where I had to pull over on my drive home because I couldn’t see through the tears. I have stolen away to find an empty room where I could scream, grieve for the patients I had seen, mourn my own new-fangled fate as some sort of machine. Each day I go in, I am reminded of my classmates who never made it to third year, pushed over a fine line which led them to take the action they did. They started as bright minds with a desire to help; they ended a statistic.

We need to protect our doctors for the sake of our patients—for the sake of all of us. We need to stop treating mental health as a weakness, especially in medical providers where emotional demands run high. We need to stand up when we are mistreated because nothing is worth the trends we are seeing. They say there is a shortage of doctors, so why are we making it so hard to keep the ones we have?

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