Make no mistake, we are living in dark times. As winter draws ever closer and early snowfall has us getting our winter gear out of the closet, many of us are dismayed to find some simple pleasures receding from our grasp –outdoor patio dining, comfortable walks outside with friends, and even less daylight. The daily COVID-19 infection counts are skyrocketing in our state and around the nation. COVID units are filling up again, and staffing levels in our hospitals and clinics are impacted by illness and quarantines due to community and family exposures. Our financial security – and that of our communities – feels at risk.
A recent headline in the Minneapolis Star Tribune “How is everybody doing? Social media show digital trail of anxiety” (reprinted from the New York Times) confirmed that I am not the only one staring at the upcoming winter with trepidation. According to the story, the Hedonometer, an invention of Chris Danforth and Peter Dodds at the Computational Story Lab at the University of Vermont, measures word choices across Twitter to calculate well-being – a kind of national happiness/sadness score. If you buy into the idea of word choices on Twitter being an accurate measure of our national mood, the emergence of the COVID pandemic has coincided with broken records for sadness days and even sadness months.
If you are looking for more traditional evidence, recent Gallup polling agrees with the Hedonometer, with Americans reporting the lowest rates of life satisfaction in almost a decade.
We are all stressed. Some of us are working long hours in COVID units or emergency rooms. Some of us are isolated, perhaps feeling guilty that our colleagues are out risking their lives at work. Some of us are struggling with children’s distance learning needs, or daycare issues. Some of us have elderly, isolated family members we cannot visit enough. Some of us are struggling with alcohol or drug use. Bringing it closer to home, physicians probably remember Lorna Breen, MD, the 49-year-old emergency room physician in New York City who took her life this past April. She treated coronavirus patients during the overwhelming early days of the pandemic and experienced the COVID-19 infection herself.
It is long past time to talk about physician suicide. Two in five physicians screen positive for depression and mental health issues. Medical students are three times likelier to die of suicide than their peers in the general population. We know that U.S. physicians have one of the highest rates of suicide of any profession. There are many reasons for this – rapidly changing rules in our workplaces, administrative inefficiencies, and hassles, EMR requirements, crushing student debt, sleep deprivation, family responsibilities. Add to that the current stresses of the pandemic, racial inequities, and social unrest.
Have you noticed – in yourself or in your colleagues – changes in mood, loss of interest in life, withdrawal? Now is the time to stop and say, “How are you doing?” Ask about self-harm if that is a concern. Your words might start a conversation that could lead to your colleague seeking help.
There are interventions that can prevent the tragedy of physician suicide. Employers must work to reduce administrative hassles and EMR burdens, provide privacy and confidentiality for those seeking help, remove stigma, remove barriers to seeking mental health assistance, and prioritize wellness in the workplace. As individuals we need to prioritize self-care, like getting adequate sleep, eating healthy foods, exercising, and leveraging that which gives us joy. We can spend time with family. We must be willing to show our vulnerability and not be afraid to ask for help.
The MMA is committed to supporting physician well-being by providing resources and support to individuals and advocating for changes to the stressful and administratively complex environments in which physicians work. Plan to join the MMA virtually on Jan. 28 at the Reclaim the Joy of Medicine: The 5th Annual Bounce Back Clinician Resilience Conference. Now more than ever, it is time to take care of yourself and your colleagues.
And remember, help is available. Contact Physicians Serving Physicians at 612-362-3747 for independent, confidential counseling and peer support resources for Minnesota physicians, residents, and medical students.
The National Suicide Prevention Lifeline is 1-800-273-TALK (8255).
Physicians are taught to help others. We can’t forget to help ourselves and our colleagues, too.
by MMA President Marilyn Peitso, MD