04/08/2018
Everyone kept whispering, “Why?”, and the whispers remained unanswered. “Why? If only I knew… He never told us…” “How can a doctor do it?” “We are resourceful.” “We are brave!” “Was that the only way to overcome miseries?”
As the crowds stood around, some of us reassured ourselves that we would not ever do ‘it’ and some of us remembered how close we came to ‘it’. Some others wondered about the futility of life. Some were angry about the thanklessness of the jobs we do.
Another untold story of another doctor was lost in the hushed silences of committees and reports. Beyond mourning, the whispers remained unanswered!
It is about the taboo of su***de amongst doctors, because we too have been whispering witnesses, numbed by our inability to make sense of the loss. We too have cried in silence. We too have mourned our young ones and our friends. We too have been sad. And, unfortunately, we have mourned and then we have moved on without doing much.
How does a medical student learn about su***de? Probably, from descriptions in “forensic medicine” and media coverage of such event. How do you empathise with a person who wants to attempt su***de, when all you know about such a person is how to differentiate the suicidal hanging knot from a murder knot? What happens when the closest you have come to thinking about causes of su***de in your everyday life is the time when you heard the news anchor shout, “is it su***de or is it murder?”
As doctors, we are as ill-informed about the anatomy of su***de as all lay people.
MYTHS ABOUT SU***DE
Let us first address the myths about su***de. If we introspect, we will recognise when it comes to myths about mental health, mental illness or su***de, there is not much difference in the opinion that we hold as medical professionals and those held by lay people.
Myth 1: First, “su***de is an isolated occurrence which happens rarely amongst doctors”.
Reality: Every month we come across such heart-breaking stories about su***de among doctors. Doctors are not immune to being suicidal. In the last month, there were 5 headlines where doctors or medical students committed su***de. In a recent online survey conducted by Department of Psychiatry at PGIMER Chandigarh, which was published in Indian Journal of Psychiatry, it was reported that 30% doctors are suffering from depression while 17% even thought of committing su***de. This is not any different than other young professionals being depressed or committing su***de. The su***de rates amongst the young are rising in India. The numbers from the National Crime Records Bureau imply that there is a death by su***de every three minutes.
Myth 2: Su***de is an “unwanted, unacceptable and forbidden event” which is resorted to by those who are “emotionally weak, incapable or with low intelligence.”
Reality: Without glamourising su***de, it is important to recognise that it is a considered decision. It is a process wherein a person feels hopeless, and even in the face of this hopelessness, plans and thinks through the act in details. The person weighs the pros and cons, and often, he/she can stop himself/herself because of the insight that the negative impacts of su***de outweigh the possible solution it provides. Some people do lose the battle of hopelessness. However, we need to recognise that su***de is not inevitable.
Myth 3: Talking about su***de may suggest it as a solution to people and may precipitate someone to attempt it.
Reality: On the contrary, talking about su***de and exploring the risk is the obvious first step to decrease the risk of su***de. If you do not explore the risk, you will not have any chance of decreasing it. It is a part of mental health basics to explore suicidal ideas and intent, rather than ignore it.
Myth 4: Su***de is a crime or su***de is a personal choice.
Reality: These two myths are two sides of the same coin. Su***de is neither a crime nor is it a matter of personal choice. Su***de is a public health emergency. It is no more a crime or personal choice than Diabetes, Hypertension or HIV/ AIDS. It requires a public health and aware policy response, as it causes a significant loss of human capital in a society.
