When Suicide Happens in the Medical Community
When suicide happens close to doctors, students, and faculty, to our families, friends, colleagues, students, residents, fellows and patients, it challenges us as individuals and as members of institutions that seek to provide safety and support. The US suicide rate has increased and suicide remains difficult to predict or to prevent despite its association with depression and addiction. It is less common in medical students and residents than in the general, age-matched population but generates troubling, complex aftershocks for us. Individuals react according to their history and style, through stages, psychological defenses, and difficult affects. Grief, shock, anger, denial, and guilt are prevalent. People responding to a close suicide seek information, asking “why”, “what if” and “if only”, despite the speculative nature of attempting to understand what happened and why. Nearby suicide may be more challenging for us in the medical profession because the helplessness it evokes undermines our sense of omniscience and omnipotence. Thus, we engage in retrospection and a search for preventive interventions that may or may not be evidence based, salutary, or healing.
The author deeply appreciates the thoughtful and substantive comments on and improvements to this manuscript by Maryaline Catillon, Katherine O. Chelby, John F. Crow, Carolyn Drake, Marc Frader, and Sondra Zabar and he thanks the wise, courageous, and supportive residents in the NYU Primary Care Residency program.
Compliance with Ethical Standards
Conflict of Interest
The author declares that he does not have a conflict of interest.
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