Editor’s note: This is the first installment of a new column focused on physician wellness. Articles will run quarterly and be authored by Jennifer Villwock, MD, and Julie Wei, MD.
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September 2018Beliefs are strong. Once, when I was about 4 years old and riding the waves of nausea that came with the flu, my dad told me, “Just lie down on your right side. You will feel better.” As I rode those waves, I clung to those words—repeating them like a sacred mantra—and internalized their message as absolute truth. So completely did I believe that I would lie on my right side in any unwell situation, from stomach bugs to sinus infections to, later in life, heartache. I continue to do so to this day.
When I was in my twenties, I encountered something that not even lying on my right side could fix: severe and debilitating depression. For six months, I slept on a friend’s couch because I was terrified to be alone. Up to that point, I had only been aware of people not successfully recovering from mental illness. No one was openly sharing their experiences, and my internet sleuthing was indicating that one severe episode of depression meant lifelong medication and disability. My internal dialogue told me I would never be OK again. My friend told me I would be, and that she would tell me that every day, over and over, until it was true.
Eventually, the therapy and antidepressants started working. I smiled. Breathing once again resulted in the exchange of oxygen for carbon dioxide instead of sadness for sorrow. I not only survived but began to thrive. When I applied to medical school, I had already been tapered off my medication without incident. My primary reservation about becoming a doctor was the open secret of medicine’s toxicity; I was afraid that I could not survive another bout of depression. I tell people I deferred my admission to medical school to gain life experience, but, really, I needed the year to gather courage before taking the plunge. I eventually matriculated and, luckily, have continued to thrive.
One of my classmates did not. Her name was Jane (name changed for privacy), and she died by suicide when we were medical students. Jane was dynamic and friendly. My last memory of her is a nondescript day during which she was recruiting volunteers for a 5K race to benefit the area’s underserved population. This is not recall bias. This is simply who she was. She displayed none of the usual warning signs, because not everyone does. Her pager had recently fallen in the toilet; she had plans to get a new one that afternoon. The ripples of her life and death continue to be felt by many, including the numerous individuals who received her organs. Even in death, Jane was a healer first.