I believe that many of us surgeons recognize this story or a variation thereof. We trained for many years to be decisive, technically excellent, and resilient. Our beliefs in these ideals are strong. We reject failure and weakness because those things are incongruent with the personas we have carefully cultivated. We are doctors and surgeons first. We see patients at their most vulnerable, yet ignore some of our most human and haunting experiences. We know that burnout, depression, and maladaptive coping mechanisms are prevalent in our community and often appear early in our careers.1-3 However, much to our detriment, we do not openly discuss them. As such, we fail to normalize these experiences. We fail to share our stories of thriving after struggling, allowing negative commentary and outcomes to dominate.4 We fail to show ourselves as safe people to whom our colleagues can confide.
Tell Your Story
I once heard an ancient myth about people who were scrambling to the River Styx to be healed. A physician eagerly approached, but was stopped by the deity in charge. She was told, “No. Not you. You need your wounds.” Turns out that, rather than a weakness, our wounds are an opportunity to connect and heal.
Telling our stories and revealing our wounds is critical so that our beliefs about what it means to be good surgeons can include these human struggles. Perhaps it starts in hushed tones over coffee. Maybe after many such coffees, the dialogue opens, and our culture and beliefs slowly shift. Instead of colleagues to impress at conferences, maybe we start seeing people to support us, people who are potentially in need of support themselves.
I challenge you to ask a colleague how they are doing and crave an answer other than “good.” Ask a follow-up question. Show yourself to be a safe person. I also challenge you to respond with the truth when asked how you are doing. Allow someone else to be a safe person for you. Let’s build networks of support to not just be utilized in times of struggle, but to celebrate successes and continually elevate our community. Lastly, thank the people who have been there for you, even if it was just a kind, random word that made a difference. Your kind, random thanks could make a difference to them.
Safe people. May we know them; may we train them; may we be them.
- Graham J. Why are doctors plagued by depression and suicide? A crisis comes into focus. Stat. Published July 21, 2016. Available at: statnews.com/2016/07/21/depression-suicide-physicians.
- Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314:2373–2383.
- Mazurkiewicz R, Korenstein D, Fallar R, Ripp J. The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. Psychol Health Med. 2012;17:188–195.
- Rottenberg J, Kashdan T. Thriving after depression: why are scientists ignoring good outcomes? The Conversation. Published June 29, 2018. Available at: theconversation.com/thriving-after-depression-why-are-scientists-ignoring-good-outcomes-98288.
Dr. Villwock is an assistant professor of otolaryngology–head and neck surgery in the division of rhinology and skull base surgery at University of Kansas Medical Center in Kansas City. She is also a member of the ENTtoday editorial advisory board.
If you are struggling, there are resources available. You are not alone.
- If you, or someone you know, is considering suicide, please call the National Suicide Prevention Lifeline at 800/273-8255. Free and confidential support is available 24/7 for people in distress, prevention and
crisis resources, and best practices for professionals.
- Employee Assistance Programs (EAPs) offer free and confidential assessments, short-term counseling and follow-up services for people with personal or work-related issues. EAPs address a broad and complex array of issues affecting mental and emotional well-being such as substance use, stress, grief, family problems, and psychological issues.