• Anne O

Medice, Cura te Ipsum: Physician Heal Thyself

I lost a dear friend some time ago, he was a brilliant fellow, a creative genius and an excellent physician; he was also a family man and dependable friend. Tragically, he died of a disease he spent most of his medical career managing and preventing others from having. The thought of his unexpected demise leaves many in dismay to this day.

Sad as this is, he isn’t the only medical colleague I have lost to a preventable and controllable illness. You probably have heard similar stories within your circle. It then begs the question – how do medical practitioners who supposedly know all about the aetiology of preventable disease fall prey to same?

The answer is not just limited to the patient burden most physicians contend with -which is mostly overwhelming. There is the psychosocial risk they are exposed to in the workplace, the many unfavourable work schedules as well as unpleasant work environment or organizational culture. Added to this is the huge psychological burden of having to make daily life defining decisions for patients. Often, this confers huge emotional strain on the average medical professional. Not forgetting the agonizing burden of relaying unpleasant or life changing news to patients and their loved ones.

All these have an effect on mental health and wellbeing overtime. In addition, the cumulative effect these psychosocial risks have on the physical and mental wellbeing of the average physician exposes them to heart related diseases, musculoskeletal disorders and mental health issues (including sleep deprivation, depression and burnout) to mention a few. There is also the resulting drug abuse, substance abuse, alcoholism and poor dietary habits some fall into.

Often, medical practitioners tend to develop a sense of invincibility from habitually managing some of these diseases. I suspect we unconsciously ignore the fact that as humans, we all are vulnerable to infectious and non-infectious ailments and that like our patients – our lifestyle, nutritional choices and habits contribute a great deal to our wellbeing. For one, I am repeatedly astonished when I find myself doing the exact things I counsel my patients against.

Then there is the elephant in the room - the mental health issues leading some to the dark path of self-harm and suicide. Unfortunately, many health professionals are quick to overlook or deny these mental health concerns to themselves and others; yet it remains a major ill health trigger in physicians. Little wonder physician death by suicide is one of the highest occupational related deaths globally and the female gender most affected. While there is paltry of research to ascertain this, we will find sizeable supporting data both locally and globally.

Locally, there is an account of physician suicide back in the days as documented by the late Chinua Achebe in his book titled – There was a country, where he talked about his brilliant physician friend who took his own life at a time when it was relatively easier for professionals to obtain a better standard of living. In recent times, there is the account of a physician who plunged into Lagos Lagoon to end his life and currently as we grapple with the COVID-19 pandemic, there is the case of an ER doctor in New York who committed suicide after recovering from the infection. She became profoundly depressed by the number of mortalities she had encountered in her facility and it is believed she ended her own life as a consequence. There is also the case of three Russian health workers who allegedly jumped to their deaths having been involved in patient management during the pandemic. Overall, research points to other cases of physician suicide across the world.

Certainly, the medical profession imposes a depth of psychological burden on the average human thus necessitating the need for keen attention to one’s wellbeing as well as those of colleagues even as we take care of our patients. Understandably, the nature of our jobs focuses our main ‘wellbeing’ attention on our patients rather than on us. This is the cog in the wheel that get many physicians putting off having their personal health checks and ignoring warning signs from their bodies until irremediable damage is done. We must always remember that one cannot pour from an empty cup and that we are only able to give our best when we are also at our best. Jim Rohn puts it succinctly “take care of your body, it’s the only place you have to live”.

Image credit: Alex Rosenberg

In order to keep tab on our health, we must ensure to put a system in place that helps bring our health and wellbeing to the fore. Thankfully, modern technology is helping to make health monitoring easier. Wearable gadgets that help one track daily movements, blood pressure rates, heart rates and other health indices are readily available and relatively affordable. These apps and gadgets also provide aggregate data to help keep tab on health monitors using mobile devices, smart watches and computers. In addition, one may also set up a system that helps care for oneself by booking health check appointments earlier in the year and setting reminders to help keep tab on appointment dates (including routine blood pressure, blood sugar and oral health); quarterly monitoring one’s Body Mass Index and particularly engaging in healthy lifestyle habits. It also helps to get an accountability partner to help each other commit to healthy living and wellbeing.

Finally, I urge you beloved health professional and physician, do well to keep your Hippocratic oath for your own good too - “…I will prevent disease whenever I can, for prevention is preferable to cure” - Physician Heal Thyself!

Dr. Anne Olowu is a Public Health Physician and Health Promotion expert. She is the Principal Consultant at AnneAide Consulting and writes from Lagos, Nigeria.




Additional Research Sources

https://blogs.scientificamerican.com/observations/doctors-and-suicide/

https://emedicine.medscape.com/article/806779-overview

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226361

https://www.independent.co.uk/news/world/europe/russia-coronavirus-doctors-cases-covid-19-a9502876.html

https://www.kingjamesbibleonline.org/Luke-4-23/

http://www.lagostelevision.com/doctor-jumps-death-third-mainland-bridge/

https://www.medicinenet.com/script/main/art.asp?articlekey=20909

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436060/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907772/

https://www.thecable.ng/report-heavy-workload-driving-suicide-depression-among-nigerian-doctors

https://www.thenigerianvoice.com/news/250727/rising-case-of-suicide-among-nigerian-medical-doctors.html

https://www.webmd.com/mental-health/news/20180508/doctors-suicide-rate-highest-of-any-profession#1

https://www.yahoo.com/news/coronavirus-top-nyc-doctor-takes-035823014.html

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