Article: The darker side of being a doctor — Dr. Eric Levi

Chandelier

Senior Member (Voting Rights)

1700-word article, currently being discussed on Hacker News.



The darker side of being a doctor​

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I’m a surgeon. I’d like to think that I’m resilient and well adjusted, having gone through medical school and rigorous surgical training. I’ve been a doctor for 13 years and much of that period has been spent training to be as good a surgeon as I could ever be. I have great family support, a physician wife who understands my work and I’ve never been diagnosed with a mental illness.​
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The suicide death of Dr Andrew Bryant, a Brisbane gastroenterologist last week hit a raw nerve. His wife wrote this honest and courageous letter.​
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Any job or profession will suck when the relentless pace of tasks makes meaningful human interactions impossible.

So sad that this is baked into a surgeon's life. Is there no easier work schedule available elsewhere?

I know one local general surgeon (a very good one) who pivoted to doing private cosmetic surgery.
I'd bet it wasn't only for the revenue, but for control over those nights on-call with call outs.

Under the gleam of "surgeon" lies a hellish existence.
 
I have to admit that even the postman’s job was a struggle because of those machines ‘that could never make a mistake’ and which delivered us poorly sorted boxes. Not to mention calculs delivery times for parcels – which were wrong.
Postmen commit suicide too, and I wonder if we shouldn’t sit down and have a chat. Watch the clouds, think about fetching some firewood. Let that machine crash. Spare a thought for that surgeon who operated whilst bombs were falling and was taken prisoner.
 
I understand that we've all had difficult experiences with doctors, but I'd just like to gently push back on some of the replies here.
And Mr Doctor has a choice.
  • Once you have committed that many years to a career, changing it seems impossible. Keep in mind just how long it takes to become a consultant surgeon with your own practice (up to 20 years, including medical school).
  • If all surgeons opted out, we'd have no surgeons. Surgery is a ROUGH path to choose.
  • People considering medical school who ask current doctors whether it's a good idea are told to only pursue it if you can't see yourself doing literally anything else. This goes 10x for surgery.
Postmen commit suicide too, and I wonder if we shouldn’t sit down and have a chat.
  • We probably should.
  • Postmen are not dealing with the impossible pressure that hospitalists and surgeons are.
  • Postmen are not grieving patients and wondering if they could have done anything different.
  • Postmen are not working all day with people's lives, health, futures in their literal hands, then after all of that incredible stress, going home to do paperwork, missing dinner with their family, and then being on call all night. Sleep deprivation combined with the endless, crushing stress of surgery.

The years of sleep deprivation, missing family and friends, losing people close to you to your insane schedule because you don't get to see them/miss their important life events, as well as the huge weight of responsibility on your shoulders is a perfect storm for suicide. I have a friend who has finished medical school and is in their first years as a junior doctor, and the number of times they have messaged me with some variation of a swear word followed by a screenshot of an admin email outlining support available following the suicide of a young doctor at their hospital is... more than I would expect. It's happened at least twice in two years, maybe three times? I shouldn't have trouble recalling how many junior doctors have killed themselves at my friend's workplace recently, because it shouldn't be any.

Anyway. I get that becoming a doctor is a choice. But if no one did, we wouldn't have any doctors. And, sure, the pay is decent. But I don't know what amount would be enough to make the sheer mortal responsibility and crushing pressure bearable.

This, and the suicides I mentioned, all happened in the Australian state I live and study medicine in, for context.

I'm not trying to say that doctors/surgeons have it worse than severe ME patients. That's just patently untrue. But I've seen some of the insane pressure put on public hospital doctors in Australia and it's ruinous. Of course, it varies by hospital and by state, and doctors aren't helped by the lack of a decent union. There are a lot of factors.

Just wanted to add some personal context.
 
I’ve always thought that it makes perfect sense that medical professionals don’t have much empathy for people who’s primary complaints are exhaustion and inability to perform at a normal level because that’s exactly the sort of thing they’re expected to push through. Especially hospital staff. This isn’t to say they’re not morally responsible for it but it’s a bad situation not only for the patients
 
I’ve always thought that it makes perfect sense that medical professionals don’t have much empathy for people who’s primary complaints are exhaustion and inability to perform at a normal level because that’s exactly the sort of thing they’re expected to push through. Especially hospital staff. This isn’t to say they’re not morally responsible for it but it’s a bad situation not only for the patients
Too true
 
I understand that we've all had difficult experiences with doctors, but I'd just like to gently push back on some of the replies here.

  • Once you have committed that many years to a career, changing it seems impossible. Keep in mind just how long it takes to become a consultant surgeon with your own practice (up to 20 years, including medical school).
  • If all surgeons opted out, we'd have no surgeons. Surgery is a ROUGH path to choose.
  • People considering medical school who ask current doctors whether it's a good idea are told to only pursue it if you can't see yourself doing literally anything else. This goes 10x for surgery.

  • We probably should.
  • Postmen are not dealing with the impossible pressure that hospitalists and surgeons are.
  • Postmen are not grieving patients and wondering if they could have done anything different.
  • Postmen are not working all day with people's lives, health, futures in their literal hands, then after all of that incredible stress, going home to do paperwork, missing dinner with their family, and then being on call all night. Sleep deprivation combined with the endless, crushing stress of surgery.

The years of sleep deprivation, missing family and friends, losing people close to you to your insane schedule because you don't get to see them/miss their important life events, as well as the huge weight of responsibility on your shoulders is a perfect storm for suicide. I have a friend who has finished medical school and is in their first years as a junior doctor, and the number of times they have messaged me with some variation of a swear word followed by a screenshot of an admin email outlining support available following the suicide of a young doctor at their hospital is... more than I would expect. It's happened at least twice in two years, maybe three times? I shouldn't have trouble recalling how many junior doctors have killed themselves at my friend's workplace recently, because it shouldn't be any.

Anyway. I get that becoming a doctor is a choice. But if no one did, we wouldn't have any doctors. And, sure, the pay is decent. But I don't know what amount would be enough to make the sheer mortal responsibility and crushing pressure bearable.

This, and the suicides I mentioned, all happened in the Australian state I live and study medicine in, for context.

I'm not trying to say that doctors/surgeons have it worse than severe ME patients. That's just patently untrue. But I've seen some of the insane pressure put on public hospital doctors in Australia and it's ruinous. Of course, it varies by hospital and by state, and doctors aren't helped by the lack of a decent union. There are a lot of factors.

Just wanted to add some personal context.
:hug: Hear you.

Have friends who are good people, flatted together in germany many many moons ago, for several years ,
we all worked hard and I took note of their never ending information inhaling… a few were in medicine, and -long story short -chose to step back and forgo research for a good family life , (they travel alot, have a lifestyle block semi rural), and work out of a hospital in a different country ,so as to both afford *time* and be part of a well staffed facility. They are of course exceptionally busy , live with increasing pressures , and give and give and give to their community still.
 
This has brought a memory back to me.

I'll never forget having to take my mother to A&E around 2011 and the doctor that walked into the room was so charismatic I instantly thought he must be having an amazing life. His whole demeanor was captivating. I could see the careful alertness and consideration for mum. I made a mental note of his surname for no reason but just to know who this man was. Never saw him again but a few years ago I read of a doctor suicide and when I read the name I just though, oh no, not this man, the man I had thought many years ago would have had the wind at his back. As I had thought he had had a big life. I think he had been severely injured in some way and life had become impossible for him to carry on. He was one of those people who has so much going for them.
 
This surgeon has the benefits of a very large salary, a great education, substantial prestige in his organisation that results in him being treated with respect by his colleagues, his patients and society in general, probably excellent networks with politicians and other people who make decisions about how society operates. He lives in a stable society, not wartorn, great access to information, easy ways of communicating with others, he's male. The medical colleges and the specialists themselves have a lot of control over many things, including how many new specialists are trained to help carry the workload; they essentially maintain monopolistic supply.

If someone like that is incapable of making things better, incapable even of convincing his operation scheduler that 14 minutes per tonsillectomy is not sufficient to keep everyone sustainably safe, then we all might as well give up now on trying to make health care better.

Personally, I think it might be hard, but surely if doctors have widespread and genuine discontent with the status quo, it is not beyond their collective capabilities to do something about it.
 
I used to work in the hospital system in Australia over 40 years ago, and all this was a serious issue then, and everybody was saying it must change. Yet more than four decades on not only is it not better it might be even worse.

If the profession cannot even improve its own lot that does not fill me with hope for patient driven change.
 
Personally, I think it might be hard, but surely if doctors have widespread and genuine discontent with the status quo, it is not beyond their collective capabilities to do something about it.
From the little Ive seen and observed anyone who pushes back , usually small groups of older experienced medical people, get flattened by the corporate (non practising ?) medical body in NZ.

A good example: a Dr I highly respect ,calm and thoughtful fellow, who has ME/CFS but is able to practise a few mornings a week , wanted to pause vaccine injections for children and especially teenagers post Covid.
He believed there hadnt been enough research and was not convinced the first Covid Vaccine NZ purchased “did no harm”(hes not anti vaccines).
I know this is a sore subject but theres was alot of unknowns in those early days.
He was invloved in a multi signed letter to the PM. The result of that was his license was suspended , and actions were taken by our MCNZ to discredit him.
He does more than many @Hutan.
I could go on but suspect its a waste of energy :)
 
This has brought a memory back to me.

I'll never forget having to take my mother to A&E around 2011 and the doctor that walked into the room was so charismatic I instantly thought he must be having an amazing life. His whole demeanor was captivating. I could see the careful alertness and consideration for mum. I made a mental note of his surname for no reason but just to know who this man was. Never saw him again but a few years ago I read of a doctor suicide and when I read the name I just though, oh no, not this man, the man I had thought many years ago would have had the wind at his back. As I had thought he had had a big life. I think he had been severely injured in some way and life had become impossible for him to carry on. He was one of those people who has so much going for them.
:hug: yes, …makes it very real.
Ive known non-medical people whove chosen to go rather than stay (as the Marx brothers put it),
…shakes our own mortality, those that care about the souls involved.
 
Mod note: refers to the doctor referred to in the article who suicided

If my husband started behaving like this, I would put my foot down, take his phone away and call in sick for him. He clearly needed a rest.
The problem with high flying professionals (I was one myself), is that we think we are indispensable. We aren't. The world goes on without us.
Probably why ME was originally labelled as Yuppie Flu. People with top jobs push themselves when ill until they collapse.
(Except politicians of course).
What a tragic waste of life. Very sad.
 
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I don't wish to appear cruel, but seriously none of them "saw this coming"!!? And three of them were in the psychiatric field!
If my husband started behaving like this, I would put my foot down, take his phone away and call in sick for him. He clearly needed a rest.
The problem with high flying professionals (I was one myself), is that we think we are indispensable. We aren't. The world goes on without us.
Probably why ME was originally labelled as Yuppie Flu. People with top jobs push themselves when ill until they collapse.
(Except politicians of course).
What a tragic waste of life. Very sad.
You really dont always “see it coming” (Im
thinking about fellow artists here not high flyers)
 
I understand that we've all had difficult experiences with doctors, but I'd just like to gently push back on some of the replies here.
Thanks for your post.

Everyone here has seen me complain and I will continue to about how many doctors have treated me and all of us. There are systemic problems which need fixing. And yes, some personal accountability. Humility and reflection from those who have and continue to fail us would be welcome. We deserve better and also need to vent at times.

But I also think we should be mindful and not repeat the same mistake we face of failing to be able to see others suffering or worse dismiss it as trivial. We’re better than that. I’d like to think we can all demonstrate the compassion we deserve.
 
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