Doctor suicide

I have recently completed a book by Dr Pamela Wible in which she responds to suicide letters from doctors and their family members (Link is below for the free audiobook). It’s a sobering statistic to learn that on average in the USA, about 300+ of our colleagues call it quits by their own hands ANNUALLY!!!. Unfortunately, there seems to be similar statistics globally among medical students and doctors. I have read about 8 RIP statements to doctors and medical students in the past few months and saddened to hear that the powers that be respond to such findings as “we need to pick a more resilient bunch next time” which I find completely appalling.

I have as a result tried to figure out, what about medicine drives people to this extreme option in dealing with their stress. It must be the culture of medicine that does this, because I would think that we are all very similar when we start high-school compared to when we finish college. I have come to conclude its either medical education or medicine as a vocation as I will elaborate below.

Medical education

• In Australia, before you are even admitted to the university to start studying medicine, there are multitudes of tests which I understand are to ensure you are indeed the cream of the crop. This is in addition to having to pass your final high school examinations with a very high score or like me also having to do 18months of “pre-medical education” before even starting the medical degree. So, most of the people who are eventually admitted to med school are typically some of the smartest of their cohort with commonly type A personality.
• As the career is basically an apprenticeship model of learning, in that typically your lecturers are also doctors, there is always a comparison between trends of the day and how things were when the lecturer themselves was going through training. “In my days we…… or do they teach you anatomy these days?” are common and sometimes very unhelpful comments from some tutors. This model of training can also leave the trainee very vulnerable to the inherent power hierarchy of their supervisor as their evaluations can make or break speciality training applications for example. There are also many different personalities to supervisors and unfortunately, some are the type that is hell-bent on destroying some peoples careers and with the stroke of a pen, are able to do just that.
• From undergraduate degree to full consultant can take up to 15years or hard work ridiculously long hours of often unpaid work, expensive training and frequent examinations which increase the pressure and stress. This protracted learning can lead people to delay life generally i.e. dating, starting a family etc which obviously with the ever-ticking “biological clock” also adds to the pressure, especially for female trainees.
• Usually, to complete medical school and speciality training, there is an expectation that you will be moving houses frequently to do the different rotations required. This comes with learning new staff protocols, meeting new supervisors, learning new systems etc. Also, the usual contract times with hospitals are 12 monthly which means, you are applying for a job annually with no real guarantee unless you know someone who might know someone. Applying for a mortgage with a 12-month contract is one of the many hurdles one might have to deal with as they navigate everything else.

Medicine as a vocation- this profession is one of the options parents of multiple backgrounds give their kids as career choices. “You can only be/marry a doctor, lawyer, engineer, accountant/banker etc”. So by the time you get to start training in the field, the pressure invariably also starts and can trend up with time. Its also a career where one mistake can cost someone their life, where asking for help or asking for time off is sometimes seen as a weakness or where admitting you need help can lead to a report to the regulatory agency.

Without writing a whole new book about doctor suicide, reading this book and watching the related content has certainly been eye-opening for me. Why read such a morbid book or evaluate such morbid statistics I hear you ask…  well, when you seem to be losing colleagues like flies, it’s important to take stock. It makes you take a closer look at how things are and what got us here to hopefully reduce the risk to yourself, your colleagues, your loved ones and the next generation of doctors. At the end of the day, we often forget the fact that we are all human, doing the best with what we know to somehow help humanity in some little way. And, in doing all that, sometimes it can become too much and there is nothing wrong in asking for help. I am here to listen if anyone needs to chat…

http://www.idealmedicalcare.org/blog/physician-suicide-letters-answered-free-audiobook/

*Kindly share the book and this blog post- it might save a life.

 

 

 

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From the hood…

I just completed Trevor Noah’s “Born a crime” semi-autobiography and thought I would pen something down about it. When it finished, it truly felt like I was saying goodbye to a friend that I had come to know very fondly during the past few days. If you have read my previous blogs, you know how I love audiobooks and how they allow me to multitask and this one was certainly a great accompaniment to the recent transition of my life and will forever remain one my of my great reads.

Trevor, yes, we are now on a first name basis, is someone who has always seemed to be different and far removed from the kind of life I grew up in. He is currently hosting one of America’s famous late-night shows and when he was introduced in that role, I thought that was another notch that would seal our differences. Here he is now, being famous, being a millionaire etc and here I was, not being famous and certainly not a millionaire… yet. But this book gave me a glimpse of the humble beginnings he comes from and what a transformation he has made to be where he is today. Some of his early stages are somewhat like mine, not the having the white father bit or growing up during apartheid South Africa bit obviously but a lot more than I would have known had I not read the book.

Growing up in Gaborone West, G-West/G wa-wa as it is colloquially called, I can appreciate when he says he grew up in the hood. My hood had everything his hood had.

• No tarred road which meant cleaning off the dust from the house every morning only for some hoon undo all your hard work by the evening.
• Those guys who wake up to sit on the side of the road when you are going to school and you find them in the same spot on your return home
• That guy who is the hood mechanic, who has a few scrap cars in various states of repair cluttering the yard and occasionally spilling onto the side of the road
• Being sent off to buy half a loaf of bread at the neighbourhood tuckshop, which Australians call a milk bar, which was a room in someone’s house that was converted from a bedroom to a shop by installing shelves and having a large sign next to the window. My mother eventually converted our garage into one of the tuckshops which sold simple groceries and progressively added beer and braai, otherwise called BBQ, to what was on offer to its patrons. This obviously attracted a few interesting characters and we could sit at the back of the house and listen to never-ending stories about the hood.
• I was one of the girls he talks about who was essentially instructed to spend all my after-school time indoors, doing chores and studying and would get a serious hiding if ever my sister and I sneaked out and got found out.
• My mother left her teaching job to get a better-paying employment as she wanted my sister and I to attend private school despite us coming from the hood. Having been part of the public-school system, she wanted different for her children.
• There was a very famous cannabis dealer at the end our street and his place was fondly called HQ by those in the know. It was not astonishing to see the celebrities of back in the day, chilling outside the premises drinking or smoking joints as I made my way home from school.

When you grow up in the hood but then experience a totally different life compared to the average hood resident, it can be very tempting to try and shake off that part of your past. I remember battling with that part of my identity in high school where I knew no one who came from the hood like me. I have however, through passage of time, learnt to look back with fondness at my history and those beginnings I came from. I even had part of our wedding ceremony in the hood, where the whole neighbourhood was invited and we sure did have a blast. Hearing Trevor recount his memories of growing up in the hood with such affection, the laugh out loud moments of his cheekiness and the overall book made my day and allow me to proudly say that I am from the hood and glad Trevor and I somewhat share that history.

*Image from Google

Books I have fallen in love with…

When my exams finally finished and I was free to whatever I pleased with my time, I decided to set myself a challenge and try to read at least a book a month for 12 months. I installed an audiobook app and decided that I would try to make my regular 40minute commute fun by reading in the car. I have read a few books in that time that have significantly changed my perspective on life and these here are the ones I would recommend as great reads.

Year of Yes – How to dance it out, stand in the sun and be your own person (Shonda Rhimes). From the creator of Grays Anatomy, How to get away with Murder, Scandal etc, this book outlines what can happen by including one word in your vocabulary- YES!!!. Although I have not fully committed to a full year of saying yes and doing things that scare me, the few times I have told my husband I am doing a “week of yes” have been really great weeks of walking off the beaten path especially with my little family. I look forward to being able to do a month of yes and eventually a full year of YES knowing that my husband will end up making me do the most outrageous things.

#Girlboss (Sophia Amoruso)– This book outlines how someone can strike it rich not by being lucky but by finding a true love and persisting despite life’s setbacks. This book talks about networking, knowing your worth and most importantly believing in your dream and working your butt off to make this a reality. She is the one who set me on a path of trying to work very hard now to enable me to retire early and look into making income in my sleep- something I still try to work on every day.

When breath becomes air (Paul Kalanithi). This book is truly AMAZING. It talks about life, love, sacrifice, medicine, fatherhood, purpose and everything in the middle. It forces you to treasure the moments with your family which for me currently include a lot of 2-year-old tantrums and just be happy to be alive. Some peoples passing is truly a loss to humanity and this is an example of such a loss.

Don’t sweat the small stuff- and it’s all small stuff (Richard Carlson). We interact with people in all our days and with each interaction risk being drawn into people’s dilemmas and dramas. This book has helped me put such interactions into perspective- a common question I ask is “will this matter in 12 months?”. If the answer is no then I try and regulate my reaction which has been great when dealing with angry patients, poor drivers who clearly don’t follow road rules or dealing with everyday stressors. I will be the first to admit that sometimes I still stress the small stuff which shouldn’t matter in 12 months but having the ability to step back and evaluate such situations has been immensely helpful for all my relationships.

Small great things (Jodi Picoult)– working as a chocolate medical profession in a mostly non-chocolate society, this book struck a particular chord with me as I could essentially relate to what Ruth was going through during the whole book. It talks about racism, privilege, and things that are sometimes unspoken but truly implied. Sadly even though we are probably living in very different times, the running thread of race is not too unfamiliar, although not to the same extremes, and probably something we are often not keen to talk about openly

To Kill a Mockingbird (Harper Lee)– classic literature talking about race relationships of years gone by. This book to me was like watching Django, 12 years a slave etc which are just really highlights of the so called societal hierarchy of yester year and the bad hand one was dealt based on the colour of their skin. When movements like #blacklivesmatter are still necessary, and the current rates of incarcerations and shooting of un armed chocolate men in the USA, it scares me to think things may not be as different to years gone as we had hoped they would be now.

Adnan’s story (Rabia Chaudry)– I was one of the people who got addicted to the podcast SERIAL after everyone had already moved on to bigger and better things and following that ASTONISHING podcast, I was intrigued to hear what else could be added to what I thought was a complete story. This book, which is about the “justice” system of incarcerating chocolate people based on either the colour of their skin, their heritage or their faith, was still a great read about injustices and prejudices we live with daily.

Thanks for the feedback – the science and art of receiving feedback well (Douglas Stone, Sheila Heen)– We receive feedback in all aspects of life. From our toddler spitting out our lovingly prepared dinner, patients telling you what impact you have had in their lives, having an argument with your spouse, asking for a pay rise etc. Dealing with this feedback and truly understanding why feedback is important, how to understand it and how to give it are things that I feel are important in helping you can grow as a person. So I thought this book was really great in improving communication pathways and also improving my listening skills in my private and work life.
I have managed to read minimum 3 books a month since August last year woooohooooo and yes, some of them were mainly fiction or autobiographical or just interesting books that looked great on the library list etc but these top 8 are ones that I would advise people to seek out to read and gain some insight into a few things. I never thought I would look forward to doing the dishes, cleaning, laundry and all those chores I did whilst momentarily escaping into my audiobook but I find myself enjoying these somewhat as they come with the added benefit of finishing off a book. I am always on the lookout for more books to spice up my commute, chores or my lunch break, so let me know below, which books you would recommend I read next and I will try to add them to my wish list and hopefully read in the near future.

*Cover illustrations sourced from Google