3.20.2007

disturbing news

If you read my very first post, the 'guy' with the blog...

...well, I heard he's dead. This is a late entry, because I...just...couldn't understand why this happened. This guy was...in my class. He was smart, and seemed just fine. Yeah, he was a bit overbearing...and worked *way* too much, but...dead??!!

Initially friends from residency considered the possibility that perhaps he fell ill. We talked ad nauseum about the possible causes of death...the reasons...

...we even had a diagnosis: GBM (glioblastoma multiforme). A very aggressive brain tumor, that at the time of discovery it's usually endstage, leaving the patient with weeks to months of life left. Perhaps, we thought, he didn't want to end up like so many of the patients we take care of. Crazy...in pain...unable to do for themselves. Perhaps, we thought, he was too proud to be sick.

Everyone recalled various complaints and trips to the doctor in the preceding months. We racked our brains for clues. We considered homicide...but thought it would have made news. And, we considered suicide...since, usually when someone dies, and no explanation is given, it's something like that. A stigmatizing illness. Mental illness...is at the top of the list.

Finally, we hear (because time always reveal additional information), that he killed himself. We hear that he hadn't worked in a month (which was unusual), then showed up at the hospital to work a shift (but he wasn't scheduled to work that day), and later, it was noticed that some drugs were unaccounted for.

We hear that he emptied his bank account in the form of a cashiers check for his mother. Sent out some letters/emails stating his intentions....then injected himself with various drugs (drugs we use to induce anesthesia, then paralyze to prevent movement). I'm still wondering if this is true, and how he managed to accomplish that. Did he inject a paralytic first, and before it had a chance to take effect, hang a propofol drip?

Of course, like weidos, we talked about this...the possible ways, the possible drugs, the timing, everything....until we realized that....we were being weird. Normal people don't brainstorm about the possible ways someone killed themselves.

Why did he do this?

Turned out, he was addicted to prescription drugs...and had been for a long time! A long time?!

His addition likely started as...needing a little something to sleep after a transition from nights to days. Then, by being tired during the night shift, a caffeine (or more than caffeine) 'addiction' develops. Lots of the EM residents smoked. Sometimes you hear about people doing coke, meth, or whatever. And, of course we've all heard about the EM doctors that comes to work with acute alcohol intoxication...or in withdrawal.

This particular guy, he had no family. No girlfriend (we decided). No reason outside of work to really....matter to anyone. And, after working long hours, which require the use of various drugs to sleep/relax, and then function...it's no wonder he wasn't as mentally healthy as he should have been. And because medicine is so...judgmental. And it's "cool" and acceptable to be unstable, no one discusses the signs of depression in a physician. And the physician....keeps it a secret. A secret that kills him.

***

Then there was this other guy in the ortho program. He was a very good looking, nice, guy. As an intern, I actually considered going out with him....but he seemed kinda aloof. Like, he was interested, but distracted.

Eventually I saw less of him...as I advanced in my training and spent more time in the ED or ICU, and less time doing bullshit scut on overextended services (like medicine, ortho, or surgery). There was less call, so I didn't run into him in the resident's lounge all the time. He no longer did the ER consults...they had interns and junior residents to deal with us. A couple of years passed, and I would see him in the hallways from time to time.

But then, I saw even less of him. Maybe he was doing outside rotations as a senior. Then...I heard the worst rumor. I heard that he was coming to work (or not coming to work) on drugs. Looking thru my retrospectoscope, I guess there may have been an issue. But, lots of physicians have these 'issues,' basically stemming from the lack of a life outside of the hospital, and abuse to their physical bodies. On my medicine rotation there was a guy who would come to work late, not pre-round on his patients, then during rounds with the attending just cool made everything up. Just like that. Made up patient's medical problems, their progress...everything. Then, after rounds, instead of trying to 'fix' things...he'd go off to the call room and sleep all day. Drunk, passed out. His patients...didn't get anything done all day.



Back to the ortho resident:
People began realizing he had a problem...and he was subsequently put on suspension from his residency program (as a chief). That was probably the worst thing the program could have done...turned it's back. And instead of getting help...he killed himself. Again (because we're weird) we started brainstorming the possible reasons, and techniques. But in the end, it was thought to be an intentional overdose.

We should be ashamed as a community. Young doctors - after high school, medical school...then as a Chief resident (or new attending, after passing boards)...after all of this work and effort...sacrifice by friends and family...after a lifetime of discipline...and after achieving a great, long sought after goal...

to be so unhappy...so stressed out...so alone...
...that the best solution that a young *doctor* can think of, is suicide.

These two (or three) are only 3 of the many I hear about every year. I could go on and on....