Physician Suicide: My Journey
David Hanscom, MD
Swedish Neuroscience Specialists,
Swedish Medical Center
Our culture expects doctors to be strong and stoic. Physicians do nothing to belie that impression. For instance, they rarely discuss their personal issues. It’s an unspoken
rule that if you’re ever feeling stressed, you put your head down and persevere. That’s why
I didn’t know that my close friend and fellow surgeon, Mark, was on the edge. Months
earlier, we had discussed some of the issues he was having with his practice. He seemed to
be having trouble coping, but I thought he was doing better. One afternoon last year, Mark
was assisting me in a complicated spine surgery. At 2: 30 he had to leave a little early for a
3:00 appointment. We shook hands and he said, “nice case.” It came as an incredible shock
when I heard that three hours later he was dead from a self-inflicted gunshot to his head.
I later found out that Mark, in fact, was under enormous personal stress. Mark’s problems were complicated, but I know that much of his stress stemmed from his perfectionist tendencies—if he made the slightest error at work, or in his personal life, it destroyed
him. His habit of constantly beating himself up led to uncontrollable anxiety, which had
been building for several years. The tragedy is that he didn’t seek out any help. He didn’t
feel that he could.
Mark is not an isolated case. In fact, one in 16 physicians reported having contemplated
suicide, according to a study published in the January 2011 issue of Archives of Surgery. This
rate is higher than the general public ( 6.3% versus 3. 3.%). Only 26% had sought out help. 1
Out of my 80 medical school classmates, four killed themselves within three years of
completing their training. I know of another dozen colleagues who have committed suicide.
I can imagine how those doctors felt before deciding to end their lives. About 10 years
ago, I was driving home around 6: 30 at night after a busy day at the clinic. I was agitated. I
was in my mid forties, and was experiencing crippling anxiety on a daily basis. My anxiety
had started to rear its head 12 years earlier, beginning with panic attacks and progressing
into a full-blown obsessive-compulsive disorder. For the past year, I had struggled. I saw
no way out. I was done.
That night, I weighed all of my options and decided that was it—once I pulled into the
garage, I would close the door behind me and leave the car running. But at the final moment, I turned off the car. I thought of two classmates whose physician fathers had taken
their own lives during their teenage years. I knew how devastating it was; how hard it had
been on them. I had a young son. I felt that I couldn’t abandon him and leave a legacy of
death. If it weren’t for my family, I have no doubt that I would’ve left the car on.
Burnout contributes to the stress that can drive physicians to thoughts of suicide. About
40% of physicians experience burnout, according to the California Medical Board. 2 Doctors
live with a combination of pressures that can result in burnout: ( 1) suppressed anxiety, ( 2)
perfectionism and ( 3) massive amounts of stress. These forces eventually converge and
create a crisis. For some, the crisis is relatively mild. For many, it’s disruptive to their life
and career. For others, it’s deadly.