美国国家公共电台 NPR When Doctors Struggle With Suicide, Their Profession Often Fails Them（在线收听）

NOEL KING, HOST:

There's a myth that doctors are kind of like professional athletes. They can take the long hours and the emotional toll. In fact, doctors are more likely to die by suicide than the rest of us are. Blake Farmer reports on new suicide prevention efforts and a movement to rethink how doctors work.

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BLAKE FARMER, BYLINE: Alarms go off so frequently in emergency rooms, doctors barely notice until a colleague gets wheeled in on a gurney.

KIP WENGER: And it's just frigging - you know, it's just devastating.

FARMER: Kip Winger still replays the scene in his mind. A young confident doctor who worked with him in emergency rooms around Knoxville, Tenn., died in one of those ERs.

WENGER: So she had multiple self-inflicted stab wounds, for lack of a better word.

FARMER: An unavoidable danger of being a doctor - you know exactly how to kill yourself.

WENGER: She took appropriate measures if that makes any sense at all - in terms of Lidocaine and doing it right and using the right blade.

FARMER: She wrapped herself in a blanket, grabbed a Bible, got in the bathtub and left a note on the door. Don't come in. Just call Kip. He was a supervisor and a friend she'd confided in him about some relationship struggles. But nothing had affected her work. Then she became part of the grim but underreported statistics. Doctors are at least 50 percent more likely to kill themselves than the general population. This death sparked some soul-searching at her employer. TeamHealth is one of the largest ER staffing companies in the country. Lynn Massingale is one of the founders.

LYNN MASSINGALE: A few of these things happened that were just so sobering. Young people don't stab themselves to death.

FARMER: It's been a touchy topic to address publicly though. TeamHealth began encouraging doctors to work fewer shifts. And they identified one of the most stressful times for doctors - when they're sued. They started pairing them with someone who's been there.

MASSINGALE: Now, we can't change the facts. But we can help you deal with the stress of that.

FARMER: Finally, to minimize clerical headaches, the company hired thousands of scribes who deal with record keeping during patient visits. Dr. Jeff Zurosky drags his assistant from room to room at a suburban hospital in Knoxville.

JEFFREY ZUROSKY: I'm going to be as gentle as I can. Does it hurt if I touch right here?

FARMER: He turns to his scribe, who makes notes in the electronic health record.

ZUROSKY: OK, so note postmenopausal.

FARMER: Technology has become a real frustration in a career that's full of stress from day one. Zurawski, who's an ER director, worries about his youngest docs with mountains of med school debt, eager to pick up shifts.

ZUROSKY: I tell them be balanced. Don't overwork yourself. Spend time with your family. Stay married if you can.

FARMER: Yet to some, the problem goes way beyond work-life balance. Family practitioner Pam Wible, of Oregon, sees it starting in medical schools where long hours and little sleep earn high praise. She calls it abuse.

PAMELA WIBLE: These people who have been previously abused are now the teachers. They're teaching the next generation of doctors.

FARMER: And when physicians seek help, they can jeopardize their medical license. Wible has collected stories of nearly 1,000 suicides and attempts. One ER doctor, who didn't want to be identified, shared his experience.

UNIDENTIFIED DOCTOR: You don't focus on the 99 you save. You end up focusing on the one that you lose.

FARMER: A 19-year-old came in with the flu. She returned in cardiac arrest. When he found out she died, he went to a dark place despite no history of depression.

UNIDENTIFIED DOCTOR: You know, I guess, like all doctors, you put that Superman cape on. And you think you can get through it.

FARMER: Then the family filed a complaint that would cost him his job. So he swallowed a lethal overdose. Police got him to a hospital just in time. He'd treated untold numbers of suicidal patients but didn't know he was at higher risk than most. He lived to tell about it but has been advised not to identify himself publicly or else hinder his prospects of ever practicing medicine again. For NPR News, I'm Blake Farmer in Nashville.

KING: That story is part of a partnership with WPLN, NPR and Kaiser Health News.

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