Suicide is the elephant within the room in drugs. We not often discuss it overtly, but it stays a silent epidemic, amongst our sufferers, and tragically, amongst physicians themselves.
I first encountered this actuality as a medical scholar in Tennessee in 2022. One among my earliest sufferers was not a lot youthful than I used to be. As a result of we have been shut in age, I felt we linked rapidly. We spoke about his struggles, and I believed I used to be serving to him. However what lay beneath the floor was one thing I couldn’t see.
Sooner or later, he stopped coming to clinic. Weeks later, I realized from his household that he had taken his personal life. The information left me shocked. I replayed each dialog, each go to. Might I’ve completed one thing otherwise? Was there one thing I missed? The guilt of dropping a affected person on this means just isn’t simply put into phrases. It leaves a mark.
There was one element that has stayed with me: We shared a love of Japanese anime and tradition. Throughout medical college, I made a lighthearted promise (a wager with classmates) that I might be taught Japanese, regardless of how troublesome. On the time, it was a joke. After my affected person’s loss of life, it turned one thing extra: a method to honor him.
On the primary anniversary of his loss of life, I traveled to Japan for a medical elective. What started as an act of remembrance became a brand new path for my life and profession. I returned repeatedly, ultimately shifting right here to work as a medical researcher and pursue a Japanese medical license.
Alongside the way in which, I started amassing goshuin, hand-drawn calligraphy stamps from temples and shrines throughout Japan. At first, it was a means to deal with grief, a private ritual of therapeutic. However over time, it turned a journey that carried me from Hokkaido’s snow-filled fields to the shrines of Hiroshima and Osaka, from quiet mountain temples to bustling metropolis facilities. Every stamp symbolized not solely a sacred house but additionally a step ahead find peace, closure, and goal.
In drugs, we’re skilled to search for diagnoses, lab outcomes, and protocols. What we’re not at all times skilled for is how you can sit with grief: our sufferers’, our colleagues’, or our personal. Studying Japanese, strolling temple paths, and filling web page after web page of goshuin was my means of grappling with the fact of a affected person’s suicide. It gave me a brand new lens of empathy and reference to others who wrestle silently.
However as physicians, we can not cease at private therapeutic. We should confront the broader difficulty. Suicide amongst sufferers is devastating, however suicide amongst physicians is a disaster as nicely. Docs die by suicide at larger charges than the final inhabitants, but stigma and silence persist. We hesitate to hunt assist, fearing judgment, licensure repercussions, or being seen as weak. Too typically, this silence is deadly.
In Japan, I’ve come to see how tradition can form approaches to grief and resilience. Practices like goshuin amassing or calligraphy (shodō) present retailers for that means, reflection, and presence. They aren’t options by themselves, however they level to one thing drugs all over the place wants extra of: areas for therapeutic that transcend checklists and metrics.
Trying again, I understand that promise I made in medical college (to be taught Japanese) was by no means nearly language. It was about discovering a method to carry ahead a affected person’s reminiscence, to remodel grief into progress, and to face the unstated realities of psychological well being in our career.
We’d like extra open conversations about suicide, each in sufferers and amongst medical doctors. Silence saves nobody. By sharing our tales, nonetheless painful, we honor these now we have misplaced and remind one another that therapeutic is feasible, not just for our sufferers, however for ourselves. Each goshuin stamp I carry is a reminder: of a affected person whose voice is gone, of a promise I’m nonetheless protecting, and of the work we should all proceed to do to confront suicide in drugs.
Vikram Madireddy is a neurologist.
