Last May, I read a heartbreaking letter from the fiancé of a paramedic who killed himself. It was the second suicide by an employee of Austin Travis County EMS in seven months. Before that, I learned about two suicides and one suicide attempt by nurses I had worked with in the ER. Then in 2015, I began to hear about physician and medical student suicides from Dr. Pamela Wible who speaks boldly and honestly about this tragedy among our people. Every one of these suicides shares a common thread, a preventable one: they are all victims of the high-stress, abusive and broken system the industry of medicine has created.
When we are called into this profession, we naturally take on the responsibility of the world. We proudly wear the no sleep, food or breaks as a badge of honor. We're lured into believing that a 20-hour day is just part of the training. We are beaten down until we're void of feelings or emotions. And just when we're about to feel a sliver of humanity again as we care for a mother who has just lost her son, we're called to the next emergency, the next patient.
Then we have the higher-ups. The folks in their ivory towers who dictate demands from their luxury offices. Administrators, VPs, CEOs went into the profession to help as well, but are forced to be voyeurs of the bottom line. They're waiting for their minions to deliver high patient satisfaction scores and bring in the money. Dr. Wible was contacted by a pediatric gastroenterolgist who was told to increase the number of colonscopies on children to boost hospital revenue. She replied, "Shall I start by doing unnecessary procedures on your kids?" No answer. These are not evil people making decisions, but employees who enjoy their safety, security and comfort in the status quo often with eyes closed.
In 2011, the Accreditation Council for Graduate Medical Education passed legislation stating first year residents had a limit of 16-hours of work, while 2nd and 3rd year residents could still work up to 28 hours. This does not include regulations on foreign physicians who are often forced to work 30- hour shifts. They are bullied into submission because speaking out would mean loss of their work visa. Paramedics work overtime, long after a 24-hour shift and the high-stress of dealing with death and dying as first responders. Nurses work 14-16 hour shifts, three days in a row while juggling more patients than medically responsible. Physician Assistants and Nurse Practitioners are not immune to this treatment. I remember sitting in a conference room attempting to resign while my supervisors and mangers berated me to the point of tears. I left defeated, dedicating another year of service to them. We get bullied, ridiculed, terrorized, and harassed on a regular basis in training and in practice. If we fail to perform to the machismo standards then we're labeled as difficult or problematic.
This is not acceptable. Doctors, paramedics, nurses, physician assistants, medical students are humans too. We are susceptible to the same extreme exhaustion that non-healthcare workers experience. Sleep deprivation and skipping meals affects us just as much as the next person. The only difference is that we have people's health in our hands. We cannot make mistakes; it could cost someone their life.
Article five of the UN Declaration of Human Rights states:
No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
Why does our first world healthcare industry get a pass? This is abuse, plain and simple. This is abuse of a cadre of people who are selfless, dedicated and loyal to the cause. We do this because we're called to do this, shame on administrators, managers, chiefs and presidents for taking advantage of that.
Last year, I felt called to do something to help heal the suicide epidemic rampant among healthcare workers. I contacted a few medical directors who said they have resilience training on board. After talking to Dr. Wible, I realized the word 'burnout' makes the healthcare worker feel as though they have a deficit. That building resilience means there is something wrong with us. It blames the victim for our inability to deal with abuse, harassment, extreme stress, lack of sleep and mistreatment.
Yes, we feel disempowered. Yes, I wish more of my colleagues would open their own practice on their own terms. Yes, I wish we felt safe to speak out against the exploitation. That is where my work lies. I work diligently to heal the healers by creating communities of like-minded healthcare professionals. I want them to realize they're not alone in this. I encourage them to share their stories and empower them to stand up for our profession.
We are a small tribe of thoughtful, committed, formidable folks ready to take on the system, one that is growing every day. The dean of Dell Medical School recognizes the high rates of suicide and depression among students and has created an innovative program that addresses these concerns. Dr. Wible is featured in a documentary by award-winning filmmaker Robyn Symon called "Do No Harm" on Kickstarter that exposes 'the silent epidemic of physician suicide and a broken medical system that puts doctors and patients at risk.' She is encouraging people around the U.S. to lead a National Day of Solidarity to Prevent Medical Student and Physician Suicides on August 20th, 2016. We will have one here in Austin, friends and colleagues. You can become part of the change you wish to see in the system by doing your part. It is imperative to our health, our livelihood and our humanity.