Message from the President – December 2018

Posted on Dec 4, 2018 in President's Message | 0 comments

As we enter this holiday season, I want to share how grateful I am for the gifts that you give our patients each and every day. I am in awe of your extraordinary competencies as caregivers and the spirit of compassion and empathy that you bring to each of our patients, colleagues and the community. I am thankful that by working together, we are able to create the best experience and guide our patients in their healthcare journey.

Caring for people in need can be exhilarating and inspiring, but it can also be exhausting. Physicians have a suicide rate that’s three times the rate of the general population and is an important issue that I will continue to address.

Pamela Wible, M.D., a family medicine physician and founder of the ideal medical care movement has spent the last six years investigating more than 1,100 physician suicides. Her message is that we need to be there for each other during times of suffering. It’s really that simple. She suggests sharing our stories and our struggles. She also suggests being a warm line for someone and offer to listen to a colleague during a time of need.

As physicians, we may suffer greatly. Many of us have repressed our memories of difficult situations we’ve encountered as a physician. In the spirit of Dr. Wible’s advice, I’ll share a story; a repressed memory that surfaced this month. It was triggered by a physician’s response to the controversial National Rifle Association (NRA) tweet stating that physicians should “stay in their lane” in response to a paper written by the American College of Physicians. The paper wrestled with how to reduce firearm violence in the U.S. consistent with the Second Amendment. Aside: to keep politics out, as one physician stated, physicians are not anti-gun, we are anti-bullet hole.

The following paragraph is a bit graphic. If you are squeamish or do not want to read something intense, please skip the rest of this paragraph and move to the next paragraph. A physician tweeted in response to the NRA’s tweet that as physicians, we are in our lane. We try to save bullet ridden patients while listening to family members scream in the hallway. This shocking statement immediately transported me back approximately 15 years when I was UCSF Anesthesiology resident doing a trauma rotation at San Francisco General Hospital. There were three anesthesiology residents working that night, including myself, when a page came through announcing three gunshot wound patients en route to SFGH. We each quickly chose one of the three trauma bays and waited. My patient was an infant. I quickly intubated the infant to the background sound of a screaming family member in the hallway. Unfortunately, our resuscitative efforts did not save our patient. I ran to the next room to help my colleagues try to save a toddler also riddled with bullet holes. Resuscitation was still being attempted. Screams continued in the background. We could not save the toddler. In the third bay, the other family member was pronounced dead. We then quickly needed to attend to cases in the operating room and on labor and delivery. We never stopped to take a breath or discuss what had just happened; I’m sure you can relate.

We experience so many traumatic events as physicians. Often, we move from one patient to the next without stopping to recognize how these intense experiences impact us. Our training teaches us how to care for our patients and not necessarily how to care for ourselves or for each other. Our current physician culture does not allow for weakness. Emotions can get in the way of logic when we are in an acute situation caring for a critically ill patient, and we are rightly trained to brush aside our emotions in this situation. However, we often carry over this logic after the acute situation has passed. As a result, we may bury our emotional reaction. Over time, this takes a toll.

About a year and a half ago, one of our physician colleagues committed suicide. He was a partner in our group. None of us knew he was suffering. It’s not in our culture to show weakness or vulnerability. We have to be tough. Suffer alone. What if we reject these norms? What if we open up to each other and discuss what has happened or is happening to us? Let’s change our culture. Let’s open up and make it abnormal to NOT discuss our experiences. As Dr. Wible suggests, in order to prevent physician suicides and, in my opinion, to better improve our overall health and well-being, we need to be there for each other during times of suffering.

The Peer Support Program is up and running. Please reach out if you would like to talk to a physician colleague trained as a Peer Supporter. Let us know if a colleague had a tough case and you’d like a Peer Supporter to check in on them. The Peer Support email address is peeroutreachABSMC@gmail.com and phone number is 510-869-8688. A Peer Support triage volunteer checks the email and telephone messages during regular business hours. Conversations with Peer Supporters are confidential and 1157 protected. It is optional to talk to a Peer Supporter; really, it’s up to you. No record will be kept other than that a phone call was made.

Our Wellness Committee also has a website on the Sutter intranet with resources including counselors, crisis hotlines including the National Suicide Prevention Hotline, books, spiritual care support, career coaching, and other resources. If you have other resources you’d like to share, please let us know. Also, if you’d like to be a part of our Wellness Committee, please contact the Medical Staff Office.

Thank you for the incredible care you provide to the patients in our community. Your dedication and compassion are deeply appreciated. Let’s continue to spread compassion throughout our hospital community. Let’s make it the norm to reach out and check in to see if our colleagues are OK. Let’s begin to discuss our intense experiences. Let’s start to change our culture and share our stories. Let’s be there for one another. Let’s become more connected to one another and continue to build a strong and healthy physician community.

Wishing you a very happy holiday season,

Jill Kacher Cobb, MD

President, Summit Medical Staff, ABSMC

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