The dark side of doctoring – an Australian doctor’s suicide prompts debate

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No one saw it coming but last week, Dr Andrew Bryant took his own life in his office.

The sudden death of the Australian doctor, a gastroenterologist for more than 20 years, shocked the community in Brisbane. Dr Bryant had shown no obvious signs of the deep distress he was shouldering, which led to his depression which eventually took his life.

His suicide prompted his wife to write an email to his friends and colleagues, because she “(doesn’t) want it to be a secret”.

“His four children and I are not ashamed of how he died,” she wrote.

In her email, which her son posted online later, she explained how her husband had grown “very dispirited and non-communicative” just before Easter.

“[He] became anxious – about his private practice, about being behind in his office administration, about his practice finances, about some of his patients, about his competence,” she said.

“He hadn’t been sleeping well since late February; but he was never a great sleeper,” she wrote. “He was very busy with work; but he had always been busy.”

She described how his workload has been overwhelming at times but her husband soldiered on.

“He continued to see patients, do lists, go to work, get home late,” she said.

“In retrospect, the signs were all there. But I didn’t see it coming.”

Neither did Dr Bryant’s colleagues or family which include both his parents who are psychiatrists, and two of his brothers are doctors, his sister is a psychiatric nurse.

“[None] of them saw it coming either,” Ms Bryant said.

His death should not be kept secret, she added.

“I don’t want it to be a secret that Andrew committed suicide. If more people talked about what leads to suicide, if people didn’t talk about as if it was shameful, if people understood how easily and quickly depression can take over, then there might be fewer deaths. His four children and I are not ashamed of how he died.”

Her email has since gone viral and has prompted discussion in Australia.

One of the doctors who have taken to express their own experience is surgeon Dr Eric Levi who, on 13 May, wrote a blog post entitled, “The dark side of doctoring“.

“Although I’ve never had serious suicidal thoughts, I – like many other doctors – have been through many dark seasons,” he wrote. “Depression, anxiety, burnout, suicidality, hopelessness, lethargy, anhedonia, feeling flat, worry, and the like are all different flavours of the same phenomena: the negative human response to internal or external stressors.”

“Work is often the critical exacerbating and perpetuating factor in those dark times,” he said, and named 3 factors which had contributed to his descent into the “dark pit of despair”.

These, he said, were a loss of control, loss of support & loss of meaning.

“I went into medicine knowing that I will have to sacrifice much for the sake of my patients,” Dr Levi said. “What I am realising is that today in modern medicine, a doctor is just one of the many commodities in this complex industry. It’s no longer about the patient. It’s about the business of hospitals. Patient satisfaction officers, Theatre Utilisation officers, Patient Flow Coordinators. These are all business roles.”

He explained how at times he gets burned out and can’t “control my emotions at work and at home.”

“I’m not inherently an offensive or rude person, I’m just a person pushed to the limits and set to fail because of the circumstances around my work. Same surgeon, different jobs. The forces that pushed me to losing control of my emotions are likely the same forces that might push some of us to suicide.

His blog post is worth a read, for an insight into the average day of a surgeon or doctor.

Dr Bryant with his daughter Charlotte

Ms Bryant said since her email became public, she has been contacted by many people expressing gratitude for her speaking up on the issue.

“It’s a huge problem in the medical profession and I’ve been contacted by so many doctors, particularly those who have had a colleague die by suicide,” she told the media.

“It’s like I’ve scratched the surface … people have contact me and said they were never allowed to talk about a suicide because it’s still such a taboo subject,” she said.

Dr Bryant’s daughter, Charlotte, paid her own tribute to her father.

“Dad was the best father, he loved and was so proud of my brothers and I. He loved life, especially singing, dancing, classical music and cycling,” she wrote.

“He was funny, witty and exceptionally smart. He worked extremely hard as a doctor, and he cared so much for his patients.”