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Wounded Healers -
The Struggle over Physician Burnout and Suicide
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for harming patients during what Dr. Wible describes as unsafe working
conditions. And doctors often don't seek help because they fear mental
health care won't remain confidential.
In her TedMed talk on the issue that has been viewed by almost a
half million people, Dr. Wible quoted a surgeon who recounted her first
day in anatomy class. The professor told the future surgeon and her
125 fellow students that "if you decide to commit suicide, do it right so
you do not become a burden to society." The professor then described
in anatomical detail how to kill yourself.
An Army veteran who served in Afghanistan told Dr. Wible that
patrolling a war zone while under sniper fire was not as stressful as being
a medical student. "She's not the only medical student who was in the
military who told me that. They told me they'd rather be on active duty
and in armed conflict than be in medical school.
"The young woman told me that the biggest issue is a lack of collaboration in medical school, which is so damaging to mental health. We
pit these idealistic humanitarians against each other in med school as
some sort of survival test."

Exhaustion and Bullying
Dr. Wible blames medical schools and residency programs for creating
an atmosphere that bullies students while also exhausting them. One
emergency room doctor who wrote to her, took a handful of pills after
a girl he treated for the flu died. He survived to describe why he tried
to kill himself.

39% of surgical
residents
experienced weekly

burnout
symptoms.
8

Philadelphia Medicine : Summer 2020

He had sent the girl home, but then she came back 30 hours later
in respiratory distress. "There's a saying we have in the emergency room
when we witness trauma and death among the innocent - a little piece of
my soul died... We're almost never offered counseling... My psychologist
says it wasn't just the last girl. It was trauma after trauma after trauma."
The New England Journal of Medicine published a report in October
2019, that buttresses Dr. Wible's findings. The report cited an American
Board of Surgery in Training Survey that found that 39% of surgical
residents experienced weekly burnout symptoms. The survey of 262
Accreditation Council for Graduate Medical Education (ACGME)
programs had a 99% response rate.
The cause of the burnout among the resident surgeons was not just
the long hours - 65% of women residents cited gender discrimination,
20% cited sexual harassment and 32% of all surgical residents blamed
verbal and physical abuse. The higher burnout among women is blamed
on mistreatment.

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Philadelphia Medicine Summer 2020

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