Rest in Peace, Jing Mai.
May your story be the catalyst for change.
This week I’ve been reflecting a lot on how grateful I am to be here.
cw: suicidality
Last week, a first-year resident named Jing Mai died by suicide. After learning more of her story it seemed like she was doing everything she could; she had a supportive partner, she acknowledged that she was struggling with depression, she was seeing a therapist. I’m not sure of all of the details but she seemed to be doing all the things that I would think to do if I found myself struggling with depression during residency training. Her story could have been any of ours.
None of that stopped her death. The medical training process requires residents to work hours beyond human capacity. We, of all people, know the effects of stress and lack of sleep on the body. Yet, in order to pursue a profession to keep others well, we must sacrifice our own bodies for the health of another.
What happened to “Put your own mask on before helping someone else?” What happened to “You can't pour from an empty cup?”
According to the American Foundation for Suicide Prevention, “Roughly 300-400 physicians die by suicide each year.” That is about one every day. The path to becoming a doctor is not safe.
Since starting medical school, I have experienced symptoms of anxiety that I never had before. I see two therapists. I journal every day. I meditate most days. I eat healthy food and exercise at least four times a week. I now do all of that just to stay at my baseline and I can only do it when I am on a rotation where I have enough time.
No matter what you know about how to stay mentally healthy, nothing can help you if you don't have the time to take care of yourself.
The hours worked by residents that I have met on rotations are grueling. Most of them arrive before 6 am and were always there much later than me. On average, residents are expected to work 80 hours a week, and many work far more. The wildest thing about it is that they aren't just sleep-deprived and working a checkout counter. They are sleep-deprived and being asked to operate on people, manage medications, make clinical decisions, and hold the lives of our loved ones in their hands.
Most of us can't do simple math when we are sleep deprived, let alone manage the dosing of multiple medications in someone with complex medical issues or do an operation. I'm afraid for residency. I'm afraid for my safety and for the safety of my patients. I’m afraid of making mistakes because I haven’t slept or eaten. But residency training is the only way to get to the career I have dreamed of my whole life.
Check on your friends in medical school and residency. If they don't text back, text again. Call them. Go to their house. And if you are supporting someone on their journey in medicine, thank you.
You have no idea what your support means. It may be saving a life.
If you’re a medical student or a resident, please know your life is so valued and nothing is more important than you being okay. In case no one told you today, I’m so proud of you.
For information, help, or resources related to physician suicide, please visit: The American Foundation for Suicide Prevention