I feel like I have to comment on here in light of the recent two suicides by medical interns in New York.
I feel like a medical intern committing suicide is one of those things that is shockingly sad. These are people who are so young, who worked so hard to be where they are, yet are so miserable that they are willing to end their life rather than face another day. As an attending who has a family and a good lifestyle, it's hard not to think, "How could they possibly do this?"
But at the same time, my intern year is not so long ago that I don't remember.
I was someone who was particularly miserable. I had worked really hard to be where I was, I did have a support system in that I was married, but I was still desperately depressed. I genuinely wished that a car would hit me on the way to work so that I wouldn't have to face another day of my internship. I don't think I ever had a call where I didn't feel like crying at least a few times. In fact, during at least 50% of my calls, I would go home and immediately burst into tears.
Why was I so depressed?
For starters, I worked with a couple of residents who were particularly nasty to me. But even when I had a really nice resident and coworkers, I was still unhappy. I didn't want to be at work in the middle of the night. I wanted to be home with my family. And treating sick patients, some of whom were dying, made it all that much harder and made me wish to be with my family even more.
On top of that, nothing I was doing felt incredibly important. It felt like everything I did involved following some sort of formula and not really thinking at all. If a patient had a symptom, you do the appropriate test, and treated the way the textbook told you to. It felt like a machine could do it just as well. It felt pointless. And the patients didn't seem at all grateful to us. (This probably wasn't made better by the fact that I was at a county hospital where a large percentage of the patients didn't speak English, were homeless, or drug addicts.)
But the crazy thing is, nobody knew.
Aside from my family, nobody at work had any inkling how miserable I was. I know this, because when I made the decision to leave my program (my alternative to suicide), my program director told me he had checked with my previous residents and attendings and asked them about me, and they all thought I seemed completely fine. So either I was really great at hiding my emotions, or every single intern was completely miserable, so we all basically seemed about the same.
So what can be done to keep tragedies like these suicides from happening again?
Well, I don't really know. But whatever they're doing now completely stinks. Despite the fact that all of us interns were under so much stress and pressure, nobody bothered to check in on our mental health at any time. During residency we had some sort of discussion group with a psychiatrist that we all went to, but that was useless and got canceled half the time anyway.
Maybe every program should be required to hire a good therapist to check in with all residents a few times a month and make sure they are doing all right. Maybe there should be worse consequences (or just consequences at all) for residents and attendings who are cruel to underlings. Maybe there should be more interns in every program, so if you gets sick and need a day off, you don't feel like everyone in the program hates you. (I will never forgive my co-intern who sent me a nasty email while I was having a threatened miscarriage for missing a few hours of a call.)
Even if most interns don't end up pulling the trigger, we don't want a bunch of suicidal interns responsible for patients' lives. I really think this is an issue that needs to be addressed seriously, but in the end, I sort of doubt anything will change.