Equanimity, the state of psychological stability and composure, is the center point of the work of Dr. William Osler, Aequnamitas. It provides a clear definition for the role of a physician, who is required to have an equal mind and soul, as the term suggests. However, until what extent are doctors obligated to display Aequanimitas?
A few weeks back, a medical student took his own life. This has been the second case in less than a year, and this isn’t even scratching the surface of mental issue in the medical world.
Data suggests that suicide is prevalent with those that undertake medicine, with physicians more likely to commit suicide than any other profession. To put it in perspective, although various literature have the actual number different, around 400 physicians kill themselves every year.
This may seem startling, but upon further dissection, one will realize how this epidemic actually is plausible—and it begins sooner than most people think. A systematic review estimates that the prevalence of depressive symptoms among medical students was 27.2 percent while that of suicidal ideation was 11.1 percent. Across 17 countries, the prevalence of suicidal ideation only stands at 9.2 percent.
The journey to attain the title of M.D. affixed to your name is a long and perilous one; for years of studying and training dehumanizes the student for the sake of serving humanity. It serves to weed out the lackluster from the resilient and the faint from the exemplary.
Consider this: One has to survive term-long books shoved down in a week, topped with series upon series of examinations. Couple that with the gravity of being in a room with the most brilliant minds in the country, in addition to all the existing pressure outside the classroom, then you have the recipe for “a disaster waiting to happen,” as licensed physician Dr. Jose Carlos Tayag describes it.
From here on out, only the best is expected from aspiring doctors. After all, they are eventually tasked to save people’s lives. They are trained to become callous to adversity and undisturbed by emotion and pain that would drive the average person crazy. However, this ascension of the student to the role of the highly exalted physician also spells their downfall.
There exists a certain “messiah complex” among doctors. Given the fact that they hold their patients’ lives in their hands, people—as well as the physician— would often see them as some sort of savior. Besides, is there any profession where people willingly place their lives on your hands? Although this misconception is inevitable, Dr. Tayag explains that “the first pitfall of most doctors is you forget that you do not control the fate of one person.”
Saving a person’s life may be uplifting for the physician, as it is their responsibility to do so and, in turn, they accomplish their noblesse oblige. However, the flip side becomes more drastic when they fail. It is common to see physicians beat themselves up over failing to do their responsibility, “If I did this or that, I could have saved them.”
This immense frustration brought upon by failure could become fatal for the physician. After spending years being placed with high esteem for their excellence, it begins to weigh heavily. If not addressed properly, it may cause enough stress to make the physician take the easy way out. “You equate your value as a person with what you do,” Dr. Elis Maghirang explains.
It is paradoxical that, given all the exponential advancements in technology, the prevalence of both depression and suicide continues to gradually increase. More so, how can we address the issue of doctors being put on pedestals, as deities that can heal, when the system requires them to be so and the practice in itself, beginning all the way from pre-medicine, gives one power over another person’s life?
The story of the physician resembles similarities to the Greek myth of Icarus, who fell in love with the idea of becoming a god. It is unavoidable that once you fly too close to the sun, you will eventually fall.