‘A continued wounding’—the untold epidemic of physician suicide

Dr. Pamela Wible runs a suicide hotline for physicians. She describes herself as having been obsessed with death and suicide since she was in utero, marinating in a brew of her mother’s own severe mental illness. And as a young child, Dr. Wible could only access father-daughter time if she accompanied her dad, a pathologist, to his job at the morgue, where her childhood mind became steeped in morbid images that others her age could scarcely conceive. 

Dr. Wible claims it is generational trauma, genetics, and her unusual upbringing by parents who had their own struggles, as well as all-consuming lives as physicians both, that led to what she spends her time doing today. But there is also something uniquely fitting about her sensibility that makes Dr. Wible perfect for this raw and daunting work. She comes across as both unflinchingly stoic and soft as velvet. She speaks a mile a minute, and in very direct terms, about the scourge of physician suicides that date back centuries. But at the same time, Dr. Wible conveys a warmth and generosity not easily found when you cold-call a stranger to pick their brain for a story. But this is how Dr. Wible lives her life, in full embrace of the oath she took when she became a doctor, promising to tend to the wounds of the needy—and despite the fact that another part of her life’s work has been to call out the betrayal that infests the very medical institutions where she first swore to serve others. 

September 17 was National Physician Suicide Awareness Day. Although perhaps busier, it is like any other day for Dr. Wible, who is regularly sent reports of the latest victims of physician suicide. There is no registry or accurate accounting of these deaths, so Dr. Wible relies on the information she receives from those who know she cares, and from other sources on social and other media. She stresses that although we are aware there is a high rate of physician suicide, we do not know how many actually die by their own hand given the taboo nature of the subject. Physicians protect their own. Since they are the ones completing death certificates, for various reasons—insurance, privacy, family concerns—the truth may be fudged on the documents.

But, Dr. Wible does more than collect stories of tragic endings. Much more. In addition to her free 24/7 physician hotline, she writes about the reasons physicians are so at risk of suicidal tendencies. The data she is able to find, and her interpretation of it, based on thousands of encounters with suicidal doctors, is fascinating and devastating.

Dr. Wible believes that for certain people, herself included, who become suicidal, pursuing medicine as a career is both a trauma response and a purveyor of the continued wounding that itself can lead someone to take their own life.

In seeking a life in medicine, people with certain life experiences and emotional makeups are trying to heal something that made them feel powerless by becoming “all-knowing” doctors. But in the process, the damage done by the  inhumane conditions and depersonalization required to get through medical education, at-risk physicians- in-the-making exacerbate the generally unexplored trauma they already harbor, and are threatened with the destruction and total dissolution of self-worth, or life-worth, that precedes the act of suicide. 

As a palliative care physician myself, I felt an immediate kinship with Dr. Wible. She joked that it took her a while to realize that most people are shocked by the ease with which she approaches, and cohabitates with, graphic scenarios and intense emotional moments. She shared a particularly awkward moment when she included dark humor in an improv class. I thought back to a moment with a writing coach who, upon reading my latest piece, told me she was ill-prepared that day to read about a woman graphically dying of cancer.

I came away from my conversation with Dr. Wible thinking there are those of us who, for better or worse and perhaps because of our own highly sensitive constitutions and pain we’ve endured, are made to toil and linger in the most wrenching spaces. And perhaps, because we can, it’s our duty to do so. I also was left feeling profoundly grateful that Dr. Wible is here.