For a doctor who endures the responsibility of caring for other people, it is necessary to heal himself or herself before being able to do it for others, Dr RC Jiloha says as he dwells on a slew of battles that a medico face at various fronts during his/her lifetime
As we celebrated the World Mental Health Day on 10th October 2023, a news report of a cardiology professor at GB Pant Hospital, New Delhi committing suicide startled the health professionals to take a look at their own health. Though becoming a doctor is a great privilege adorned with humility and bestowed the noble responsibility of looking after the suffering of others. From medical college to residency and from trainees to specialists/super-specialists, doctors have had a certain job security and most of them eventually earn decently well. They know better how to stay fit and healthy; they are expected to live longer. Yet, the life expectancy of doctors is 59 years as compared to 67.9 years of an average person in India.
Medical profession is a stressful profession because it requires a doctor to take critical decisions in a matter of seconds during an emergency in the wake of a suddenly escalated responsibility as a clinician. An error of judgement can prove fatal and the professional has to always stay on his/her toes to avert such events. No doubt, doctors receive an extensive training to deal with the situations, the persistent work pressure and stress affects their physical and mental health. Long working hours and stress related to patient care often leaves them with no time to address their own personal problems which, if unresolved, interfere with their professional performance. They are at an enhanced risk of enduring mental health challenges and the consequent possibility of suffering various health problems.
The medical profession tops the list of occupations with the highest suicide rate among doctors. The reason untimely loss of human lives in doctors is the greater knowledge pertinent to effective and lethal suicidal means. According to a prevalence study 27.7% resident doctors suffer from depression, and 36.6% from anxiety. Many doctors hesitate to get treatment from fellow physicians, more so for mental health issues. If the doctors suffering from depression receive immediate treatment and confidential hospitalization, the death ratio can be decreased substantially. Healers, after all, too need healing.
Other reasons for early deaths include cardiac problems and cancer. Heart diseases and cancers among doctors are swiftly rising, as per the Indian Medical Association. In its 10-year-long study on 10,000 doctors, it found 282 doctors dying during the period, of which 25% died due to cancer, 2% by infection, and 1% by suicide. Desk-bound jobs, inactive lifestyle, lack of exercise, and obesity are the primary risk factors for heart diseases in addition to stress found to be the major contributor of early deaths. Working with private and public healthcare service providers, doctors have to keep up with the consistent pressure of building patient-base, providing quality care to everyone, being almost infallible, compromising their work ethics and living with a lack of work-life balance.
Although the risk of heart diseases increases with age, doctors often avoid having a regular medical check-up and tend to rely on self-diagnosis and treatment. In the study group, those who died never had a periodic health checkup during their life-time. Cancer is another important cause of premature death among doctors. Working in a setting with exposure to diverse carcinogens (ionizing radiations) can fuel the possible occurrence of thyroid and ovary cancers.
The work-related musculo-skeletal disorders due to spending long hours using the operating microscope cause health concerns like strain, backache, neck pain, carpel-tunnel syndrome, etc. and compromises the quality of life. Confidentiality issues and reservations pertinent to a particular therapy or treatment effectiveness, often prevent doctors from seeking professional help.
A healthy work-life balance needs to be promoted, especially for residents-in-training and women doctors. Having greater knowledge and a better understanding of mental and physical health issues, doctors must not undermine their own well-being for the sake of their profession or other causes.
The nobility of the profession can only be restored if healthcare is not reduced to a commercial commodity and doctors’ compassion and empathy is preserved by providing them their due space in the profession.
A healthy lifestyle including sound sleep, regular exercises, and physical activity to prevent conditions like obesity, should be adopted by the doctors in order to serve their patients better. Regular medical checkups and timely treatments are necessary. Avoiding treatment for mental health issues only worsens the problem. Looking after one's self is a duty every doctor owes to himself/herself. For a doctor who endures the responsibility of caring for other people, it is necessary to heal himself or herself before being able to do it for others.
The practice of helping others requires great strength, knowledge, and experience. But the wisdom lies in implementing the knowledge and experience to your own self, too.
(The writer is a retired professor of psychiatry from the University of Delhi and Jamia Hamdard. Views are personal)