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Journal of General Internal Medicine

, Volume 34, Issue 2, pp 317–319 | Cite as

When Suicide Happens in the Medical Community

  • Mack LipkinEmail author
Perspective

Abstract

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.

Notes

Acknowledgments

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.

References

  1. 1.
    Stone DM, Simon TR. Fowler KA, Kegler SR, Keming Y, Holland KM, Ivey-Stephenson AZ, Crosby AE. Vital Signs: Trends in State Suicide Rates — United States, 1999–2016 and Circumstances Contributing to Suicide — 27 States, 2015. MMWR. 67; No. 22 2018.Google Scholar
  2. 2.
  3. 3.
    Yaghmour, N A., Brigham, TP, Richter, T, Miller, RS, Philibert, I, Baldwin, DC, Nasca, TJ. Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment. Academic Medicine: 92: 976–983.Google Scholar
  4. 4.
    Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, Musacchio KM, Jaroszewski AC, Chang BP, Nock MK. Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychol Bull. 2017;143(2):187–232.CrossRefGoogle Scholar
  5. 5.
    United States Preventive Services Task Force. Suicide risk in adolescents, adults and older adults: screening. 2014 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/suicide-risk-in-adolescents-adults-and-older-adults-screening?ds=1&s=suicide%20screening accessed October 16, 2018
  6. 6.
    Maciejewski PK, Zhang B, Block SD, Prigerson HG. An empirical examination of the stage theory of grief. JAMA. 2007;297(7):716–23.CrossRefGoogle Scholar
  7. 7.
    Kübler-Ross E. On death and dying. Simon and Schuster, 1997.Google Scholar
  8. 8.
    Brown CR, Andrews B, Valentine JD. Metanalysis of risk factors for posttraumatic stress disorder in trauma-exposed adults, J Consulting and Clinical Psychology 68:748. 2000.CrossRefGoogle Scholar
  9. 9.
    Center for Disease Control and Prevention. Stone D, Holland K, Bartholow B, Crosby A, Davis S, Wilkins N. Preventing suicide: a technical package of policy, programs, and practices. 2017. https://www.cdc.gov/violenceprevention/pdf/suicidetechnicalpackage.pdf accessed October 16, 2018
  10. 10.
    Camus, A. The myth of Sisyphus and other essays. Trans. O’Brien J. New York: Vintage, 1991: p 3.Google Scholar
  11. 11.
    Camus A. The plague. Trans Gilbert S. New York: Vintage, 1991: p. 308Google Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  1. 1.Bellevue Hospital Center, Primary Care Internal Medicine Residency Education Program, Division of General Internal Medicine and Clinical InnovationNew York University School of MedicineNew YorkUSA

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