Employee Survival Guide®
The Employee Survival Guide® is an employees only podcast about everything related to work and working. We will share with you all the information your employer does not want you to know about working and guide you through various work and employment law issues.
The Employee Survival Guide® podcast is hosted by seasoned Employment Law Attorney Mark Carey, who has only practiced in the area of Employment Law for the past 28 years. Mark has seen just about every type of work dispute there is and has filed several hundred work related lawsuits in state and federal courts around the country, including class action suits. He has a no frills and blunt approach to work issues faced by millions of workers nationwide. Mark endeavors to provide both sides to each and every issue discussed on the podcast so you can make an informed decision.
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Employee Survival Guide®
S6 Ep124: Dr. Carrie Cunningham's Story: When Healers Need Healing
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This episode is part of my initiative to provide access to important court decisions impacting employees in an easy to understand conversational format using AI. The speakers in the episode are AI generated and frankly sound great to listen to. Enjoy!
Beneath the sterile drapes and surgical masks lies a devastating truth: surgeons have the highest suicide rate among all physicians. A staggering 15% report having contemplated ending their lives at some point in their careers, with 6% having such thoughts within just a single year.
The juxtaposition is jarring – these talented professionals represent the pinnacle of medical achievement, yet many battle profound personal demons in silence. Through Dr. Carrie Cunningham's courageous presidential address to the Association for Academic Surgery, we witness this paradox firsthand. Despite her Harvard professorship, research grants, and leadership positions, she openly shared her struggles with depression, anxiety, and substance use disorder. Her vulnerability challenges our assumptions that external success guarantees internal well-being.
The factors driving this crisis run deep. Medical training itself plants the seeds, with studies showing one-third of interns develop clinical depression. The surgical culture's emphasis on perfectionism, combined with sleep deprivation and high-stakes decision-making, creates tremendous pressure. Add to this the startling revelation that 45% of physicians experienced serious trauma before even entering medicine, and we begin to understand the perfect storm threatening our healers.
Most concerning is the pervasive fear preventing surgeons from seeking help. Many go to extraordinary lengths – paying cash for therapy, traveling to distant cities for treatment, self-medicating – all to avoid potential career repercussions. Physician Health Programs exist in every state with impressive 90% success rates, yet many doctors don't know about these resources until they're in crisis.
True progress requires fundamental shifts: moving beyond superficial "wellness" initiatives to address genuine mental health conditions, fostering cultures where vulnerability is seen as strength rather than weakness, and creating environments where seeking help doesn't jeopardize careers. The Dr. Lorna Breen Act represents a step forward, named for an emergency physician who died by suicide after working on the pandemic frontlines.
Have you noticed signs of struggle in a colleague or friend? Reaching out could save a life. What small step might you take today to create a more supportive environment for those battling silently around you?
National Suicide Prevention Lifeline
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OK, let's unpack this. It might surprise you to learn that surgeons well, the professionals we really rely on actually have the highest rate of suicide among physicians.
Speaker 2:Yeah, it's. It's quite a stark statistic. There was a study back in 2011, I think.
Speaker 1:That's the one it highlighted that get this 15 percent reported considering suicide at some point in their career.
Speaker 2:Fifteen percent, and wasn't it something like 6% just within that past year?
Speaker 1:Exactly 6% in one year. When you hear a number like that, it really no. It makes you stop and think about the immense pressures people face.
Speaker 2:Definitely, even people who seem incredibly successful on the surface.
Speaker 1:It's a truly striking paradox, isn't it? These are individuals, you know, operating at the absolute peak of a demanding profession.
Speaker 2:Top of their game.
Speaker 1:Yet they're grappling with such profound internal struggles. It just begs the question what is it about this high stakes environment?
Speaker 2:What is it that contributes to this reality?
Speaker 1:That's exactly what we're diving into today. We want to explore the complex factors, the things contributing to these mental health challenges and surgery.
Speaker 2:And also look at potential paths toward you know, support and change, real change.
Speaker 1:Right and to really get under the skin of this, we're drawing on some pretty compelling material.
Speaker 2:We are. We have the presidential address by Dr Carrie Cunningham Incredibly powerful and personal stuff.
Speaker 1:Given to the Association for Academic Surgery right and thankfully there's a YouTube transcript available.
Speaker 2:Yeah, which is great, and we're also weaving in insights from two articles that shed more light on this really serious issue of physician suicide.
Speaker 1:So consider this your kind of streamlined guide. We want you to be well informed on this crucial topic.
Speaker 2:And our aim is to go beyond just you know listing facts.
Speaker 1:Right. We want to extract the core insights, understand the complexities underneath and hopefully identify some actionable takeaways.
Speaker 2:So where do we start? How do we begin to unravel this?
Speaker 1:Well, I think Dr Cunningham's address is a really compelling entry point, just because it's so rooted in her own lived experience.
Speaker 2:Absolutely. I mean here's someone who achieved remarkable success by any conventional standard.
Speaker 1:Totally Former top junior tennis player. Harvard professor of surgery.
Speaker 2:Yeah, with significant research funding an R01 grant.
Speaker 1:And president of the AAS, a major surgical association. The list is impressive.
Speaker 2:It really is, and that's precisely what makes her story so well resonant.
Speaker 1:Because, alongside all of that success, she bravely shared her own long-term battles.
Speaker 2:Yeah, with depression, anxiety and also a substance use disorder.
Speaker 1:That juxtaposition, her professional triumphs versus her personal challenges. It really forces us to confront that common misconception, doesn't it?
Speaker 2:That outward success equals inner well-being. Yeah, absolutely.
Speaker 1:And what's particularly noteworthy is the sheer courage it took for her to be so open.
Speaker 2:Oh for sure she was fully aware of the potential risks, the professional repercussions of sharing something so personal on such a public stage.
Speaker 1:And her motivation for taking that risk. It was incredibly powerful.
Speaker 2:It really was. It seemed to stem from this profound desire to prevent others, her colleagues, from experiencing similar suffering.
Speaker 1:And specifically to reduce suicide right Inspired by losing her friend Dr Christina Rae Berkeley.
Speaker 2:Exactly that loss clearly had a huge impact.
Speaker 1:And it's crucial to note, she acknowledged her own privilege even as she spoke.
Speaker 2:She described herself as, I think, capable, free, white and with resources.
Speaker 1:Right, and she explicitly recognized how much harder these struggles must be for others.
Speaker 2:For medical students, residents, people without those advantages facing systemic barriers. That awareness adds real weight to her message.
Speaker 1:It really does. Now, one of the key points she made and this feels really important was the need to move beyond terms like burnout or wellness, even Right, when we're actually talking about serious mental health crises.
Speaker 2:That's such a vital distinction. She emphasized that, ok, burnout can contribute sure.
Speaker 1:But it's often not the fundamental issue and the solutions aren't just, you know, more self-care.
Speaker 2:No, she put it very directly, didn't she? Something like all the Peloton rides in the world are not going to make my depression go away.
Speaker 1:Exactly, and she paints a pretty sobering picture of how these crises can develop.
Speaker 2:Insidious progressive.
Speaker 1:Yeah, creeping up over time until they reach a point where, tragically, the person might not even want help.
Speaker 2:Or even believe their loved ones would be better off without them. It's just heartbreaking.
Speaker 1:It really underscores the gravity, and the sources also highlight the concerning prevalence of substance use disorders among physicians.
Speaker 2:Rates higher than the general population. Right we're on one in seven physicians.
Speaker 1:Yeah, and this is linked sadly to that higher suicide rate we see in doctors.
Speaker 2:And the data she cited from the American College of Surgeons survey.
Speaker 1:Wow, just alarming 13% of surgeons reported suicidal thoughts in the past year 13% and 10% within the two weeks before the survey. Shocking, and what struck me was that these rates were even higher for certain groups.
Speaker 2:Women residents and associate professors. I believe.
Speaker 1:Exactly, those are key demographics, likely reflecting specific pressures within the system.
Speaker 2:Yeah, and that pervasive fear of seeking help that came up again and again in the sources.
Speaker 1:This massive obstacle fear of repercussions, fear of stigma.
Speaker 2:Leading to really concerning behaviors like doctors writing their own prescriptions.
Speaker 1:Or paying cash for therapy, going to other cities for treatment just to keep it secret.
Speaker 2:It's this climate of secrecy and fear it seems so deeply entrenched.
Speaker 1:And it's particularly troubling when you think about the training process itself.
Speaker 2:Oh yeah, Dr Cunningham mentioned that study showing a third of interns develop clinical depression.
Speaker 1:A third and it persists. It doesn't just go away after internship.
Speaker 2:And with the added trauma many trainees face during COVID-19.
Speaker 1:There's a real concern those trends could get worse.
Speaker 2:Absolutely. Medical training is just inherently demanding Long hours, high stakes.
Speaker 1:And often a culture that maybe implicitly values stoicism pushing through.
Speaker 2:Right, and you combine that with any pre-existing vulnerabilities people bring.
Speaker 1:Like that statistic she mentioned 45% of survey respondents had experienced serious trauma before medical training 45%, that's nearly half. Yeah.
Speaker 2:It creates a potential perfect storm for mental health issues.
Speaker 1:So, okay, let's shift towards solutions. Dr Cunningham shared some really impactful lessons from her own journey.
Speaker 2:She did, and the first one that really hit home was this fundamental principle Put health first.
Speaker 1:Yeah, and it wasn't just about your health, it was a call to action for colleagues.
Speaker 2:To look out for each other. Yeah, to step up if you think someone's struggling, even if it feels awkward.
Speaker 1:Right Checking in showing up those simple acts can make a huge difference.
Speaker 2:She really emphasized that someone's well-being when they're in crisis it just outweighs any professional concerns. And she acknowledged how uncomfortable intervening can be. Yeah, that the person might deny it. Get angry, pull away.
Speaker 1:But her message was clear If you're genuinely concerned, act anyway, trust your gut.
Speaker 2:Another critical lesson was about physician health programs, PHPs.
Speaker 1:Right, she explained. They exist in every state, a vital resource for doctors facing crises, including substance use.
Speaker 2:And it was interesting that she admitted she didn't even know about them before her own crisis.
Speaker 1:Yeah, and she made a strong point challenging the common idea that they're just punitive.
Speaker 2:Exactly. While patient safety is part of it, their main focus is also advocacy and support for the physician.
Speaker 1:Helping prevent unnecessary reporting to licensing boards, guiding them to real treatment.
Speaker 2:And the success rates she mentioned from Washington state were really encouraging Over 90 percent. No further board issues. 80 percent maintaining sobriety.
Speaker 1:That's huge. It sounds like her own experience with the PHP, though maybe tough at first.
Speaker 2:She perceived it as punitive initially.
Speaker 1:yeah, but ultimately it was beneficial for her recovery, and she stressed that sobriety alone wasn't enough.
Speaker 2:No. Addressing the underlying emotional pain was crucial.
Speaker 1:And she was so open about her own diagnoses PTSD, persistent depressive disorder, substance abuse disorder.
Speaker 2:That openness is just so important for destigmatization. Her third lesson was don't assume anything.
Speaker 1:Right. Everyone has unique experiences, vulnerabilities, hidden values.
Speaker 2:And that stat again 45% experiencing trauma before medical training. It really drives that point home the invisible burdens people carry.
Speaker 1:It does, and her point about change being constant but growth being a choice.
Speaker 2:Yeah, requiring patience and hard work, and also stating clearly depression is biological, it's an illness, not a character flaw.
Speaker 1:Such a crucial message. Then her fourth lesson, about mastery through mistakes.
Speaker 2:Ah yes, Challenging that ingrained culture of perfectionism in surgery.
Speaker 1:This one really resonated the idea that you get better by learning from mistakes, not by trying to be flawless.
Speaker 2:She talked about how that fear of failure, of losing, can be so destructive.
Speaker 1:And those internalized bruises from that perfectionist culture.
Speaker 2:Yeah, they stop people reaching out for help when they most need it.
Speaker 1:And the emphasis on self-compassion really stood out.
Speaker 2:Definitely that we're often kinder to others than ourselves.
Speaker 1:And relying on external validation is just not sustainable in the long run.
Speaker 2:Her fifth lesson linked recovery and identity. She broadened the definition of addiction.
Speaker 1:Right Not just substances, but any behavior used to avoid vulnerability.
Speaker 2:And recovery isn't just stopping the behavior, it's this whole process.
Speaker 1:Self-reflection processing, trauma building, healthy coping skills, nurturing connections.
Speaker 2:And consciously separating your professional identity from your personal worth. That's vital in a field like surgery.
Speaker 1:Where the job can so easily become everything. Her point about reconnecting with other parts of life, other values, was powerful.
Speaker 2:Then the sixth lesson authentic connection is everything. This really hit the core of that isolation many struggling physicians feel yeah, that loneliness.
Speaker 1:She mentioned depression as maybe grief for lost connections.
Speaker 2:And that connection itself is like an antidote to addiction and despair.
Speaker 1:It's a stark reminder, isn't it? Caregivers feeling so isolated themselves.
Speaker 2:And the impact of things like patient death, medical errors. They take a huge toll.
Speaker 1:Which is why proactive peer support programs are so essential.
Speaker 2:In her seventh lesson. Just listen, Such practical advice for supporting someone.
Speaker 1:Being present, validating feelings, not jumping in to fix things.
Speaker 2:Just simple human connection and knowing when to encourage professional help.
Speaker 1:Her final lessons really packed a punch too. Feel the pain.
Speaker 2:Yeah, that numbing emotions also limits joy and love turned towards discomfort.
Speaker 1:Vulnerability isn't weakness, it's strength and hope. Hope requires action.
Speaker 2:Goals plans, flexibility, perseverance, agency, all of that.
Speaker 1:And exposing shame and fear reduces their power. Progress is slow but steady.
Speaker 2:And she finished with a strong call for cultural change and advocacy.
Speaker 1:We need open, honest conversations to tackle stigma and bias.
Speaker 2:She pointed out the contradiction Difficulty accessing your own mental health records, yet pressure to disclose them.
Speaker 1:And highlighted the Dr Lorna Breen Act as a vital step forward.
Speaker 2:Creating safer environments for seeking help.
Speaker 1:It was so important learning about Dr Breen herself the ER doc who died by suicide after working on the pandemic front lines Tragic.
Speaker 2:And the foundation in her name is doing such crucial advocacy work now. So the consistent thread through all this material is that surgeons face a significantly higher risk of suicide compared to the general public and even other doctors.
Speaker 1:The demanding work, sleep deprivation, high pressure, perfectionism yeah, it all adds up.
Speaker 2:But that reluctance to seek help because of stigma and fear of consequences, that remains a critical barrier we have to break down.
Speaker 1:It really paints a picture of a community committed to healing others, yet struggling with its own well-being.
Speaker 2:Dr Cunningham's story, plus the broader data, just underscores the urgent need for a cultural shift.
Speaker 1:A fundamental shift around mental health in the profession.
Speaker 2:Absolutely Embracing vulnerability as strength, fostering connection as necessity, prioritizing mental health as well essential.
Speaker 1:For the individual surgeon and for the health of the entire profession. Couldn't agree more so as we wrap up this deep dive. I'm thinking about the broader implications here. Yes, we focused on surgery.
Speaker 2:But the pressures, the identity struggles, the fear of asking for help.
Speaker 1:These themes resonate way beyond medicine, don't they? In many high stakes fields, maybe even in our own lives, For sure. So a final thought for you listening what small concrete step could you take today to maybe help foster a more supportive For sure?