Saving others lives taking ones own

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was the first

indian doctor and only the second

in the world to literally

create life

on 3rd september 1978

was born literally out of a test tube

or what is technically known as in vitro

fertilization or ivf

named after the most popular

deity in bengal

durga grew up

and was only second

after about two months

of the first in-world ivf

in england the creators of the first ivf

dr edwards and dr steptoe

received the reward of nobel prize

for their heartbreaking discovery in

what about dr mukhopat yes

he too received his reward

on 19th july 1981

barely three years after his

groundbreaking invention

he was found hanging in his apartment

he had committed suicide

let us shift the scenario

to very recent last few months

over the past couple of months

in a premier medical institute

three medical doctors

two of them medical students

committed suicide

one of them was actually herself

pursuing her md or specialty

in psychiatry but was admitted

in the psychiatry ward

with extreme suicidality and

a failed suicide attempt

she was discharged and wrote in her blog

that she was doing very fine and had the

gift of life

as a matter of fact she wrote in her

blog

that she helped while herself being

admitted

in the psychiatry ward another nursing

student was struggling with depression

to seek help however

she herself was again

found hanging

in her hostel room just a month

after her discharge from the psychiatric

treatment facility this time

it was a successful suicide

so what is wrong there what is the

paradox what’s going on here

doctors and medical students going to

become doctors

are in the profession of saving lives

so what’s happening that some of them

tragically end up taking their own

before we come to this question and what

possibly can be done about it

let’s go through a few quick facts to

gain a perspective

first of all let’s remember that

counting suicides

is not easy classifying your death as

suicide

and reporting of suicide is always

almost

always under reported because of stigma

we’ll come back to that later

but before that so how common is suicide

in the medical

community a recent survey in the usa

found that

the number is about 300 to 400 doctors

per year which means about one doctor a

day

second is it commoner than in

age and sex-adjusted general population

yes it is a recent meta-analysis

an aggregate of 55 studies

published in 2019 found that suicide in

the medical community

is 44 percent

higher or more common than in the

age and sex adjusted general population

another recent study published

online a few months ago found that

although in the

males suicide rate was

lower in doctors compared to the general

population but we have to keep in mind

here that in the general population

it’s men in which completed suicide is

always commoner

so it had to rise against that higher

base rate

but what was found in all these studies

consistently is that in females

the suicide rates are distinctively

higher at times

more than twice by the general

population adjusted for

age third question

is it more common in other than in other

white-collar professions again the

answer is most probably

yes compared to other white-collar

proficiencies commonering

in doctors and medical students

a final question is it

a common mode of death

amongst the causes of death in medical

students

yes it is it is probably second only to

accidents as a cause of death amongst

those who are

young 24 to 34 years of age

and finally there are particular

medical disciplines which where somehow

uh

rates of suicide are even higher

notable amongst them being

anesthesiology and psychiatry but also

perhaps

general medicine general surgery so

after this

why the main question is why again

rather than going into a theoretical

um you know discourse or lecture

let us try to recall and reconstruct

what happened to

the female medical student who committed

suicide

she was struggling with her own

depression but that was perhaps

compounded by the fact that she was

aware acutely that she came from a very

poor

tribal uh family offer of a different

quote-unquote lower cost in india

and used to hear rumors and even cheers

at other by other people living in the

hostel because of this

her parents had to take a large loan to

support her studies

and she was aware of that um

she had to cope up with a very high

demanding stressful

high performance academic institute with

her ongoing depression

which she found very difficult but she

could not talk to anyone she could not

talk to her parents because she didn’t

want to overburden them

any further she couldn’t talk to her

friends if she had any in the hostel

she could talk to her um faculty members

because she

feared that she might be you know she

might stand out

as another who cannot have seen as

incapable inefficient

cannot cope and she could not face

herself so

she had nowhere to go

suicide in the medical community or even

elsewhere

is the final irreversible outcome

of a complex web of

background causalities or background

events or processes

in this mental illness substance abuse

stress of various kinds play a definite

role

which are all very very relevant in

medical community

but there’s something else which is

extremely particularly relevant in the

medical community itself and that is

stigma stigma which literally means

a mark but a mark which is a bad mark

an unwelcome mark a mark which

discriminates

so there are multiple sources of stigma

stress of various nature treatment by

others

substance abuse mental illnesses

guilt because of a high perfectionism

and a

and the need to prove oneself repeatedly

not being able to do that all these

come with a package of stigma and delays

help seeking and impedes recovery

particularly in medical profession

there’s a very important thing in the um

in those doctors were in service like in

case of dr mukhopath

again related with stigma but more to do

with complaints and treatment by others

what happened in the case of bhakram

kupathi the government

did not believe his invention and

certain other doctors

they became jealous a committee was

instituted by the government

which was chaired by a professor in

radio physics

yes you heard it right radio physics and

another from gynecology another from

physiology another from neurophysiology

none of them with the needed expertise

to fathom

the far advanced field in which he was

working in the area of in vitro

fertilization and cryobiology

the committee met very quickly

just once gave very short notice

to the doctor to explain himself

did not look at the actual experiments

and

passed the dictum that the research was

bogus

it was on fraught

the fallout was terrible dr

was immediately ostracized from his

society

by his fellow colleagues he was banned

from

appearing in in interviews or going to

uh uh international conferences

for presenting his findings for which he

was invited

and finally as the proverbial strong the

camels back he was

transferred to a department in

ophthalmology in the eye department

which had got

absolutely nothing to do with his area

of expertise

that was professionally killing himself

him

in his suicide note this is what he

wrote

i can’t wait for another heart attack

to kill me

given this kind of a scenario

what can be done possibly

there are four things to my mind the

first and the foremost

but before that there is also a major

role of uh

of stigmas has been found in in research

that three out of four medical

students in a prestigious institute

found stigma was a major issue in

disclosing mental health

and another study recently published

from our institute from our department

found that up to 400 medical students

resident doctors four

out of five reported at least a moderate

degree of stress

nine out of ten fed some degree of

burnout three out of ten reported

depressive symptoms

so was it surprising that one in six of

them

actually reported some degree of

suicidal ideations

so coming back to what we can do about

it the first and foremost

is that we need to listen we need to

open up

we need to express our empathy not the

sympathy

to these people and open up safe

non-judgmental space

for the ones suffering in silence

to open up to talk to express themselves

without

having the stigma without having the

fear of retribution or repercussion

or penalization this is the most

important thing

but along with that we do need as a

second very very important major step

it a structural changes structural

changes

which would involve forming statutory or

institute level

bodies committees of setting up set up

to

to fight against discrimination of all

sorts

to fight against stigma of all sorts to

have

institutional review committees to have

safety boards so various kind of

institutional mechanisms can be created

for providing a safe recourse

to those students and doctors who need

help

another step is for

is for doctors who are in service we

need to have a change

in mindset as claire

jarrada who is the medical director of

the national

health service practitioner health

program says

and i read that going forward we have to

hold

the decline in morale among doctors

this will mean addressing many systemic

issues that are creating unhappiness

tackling the culture of naming blaming

and shaming

and essentially treating them as

intelligent adults

and not as naughty school children

this is where their skills can flourish

and this is what

will eventually help last but not the

least we have to change the language

did you notice that i did a terrible

terrible mistake

in fact i would say heena’s crying by

repeatedly saying

that so and so committed suicide

as if he or she committed an

arson a murder

a crime a rape a felony

these are committed this is the legal

language

anybody who commits an attempt to

suicide shall be imprisoned with

etc etc so even successful suicide

failed attempt as if you were judging a

person

even in their suicide whether it was

failed or whether it was successful

so i stand corrected dr mukhop

died by suicide the female medical

student died by suicide and she did

attempt

suicide earlier once

language is a very powerful tool to

carry or to dispel stigma

we need to keep that in mind none of

them

committed a crime in the end

imagine dr mukherbat hey created the

baby the test tube

the government was intrigued it set up a

committee

which was chaired by an embryologist of

eminence

a cryobiologist an in vitro

fertilization

expert and they

sat over in details the findings asked

clarifications

in the end gave a clean chit and and in

fact

appreciated this part breaking discovery

the institute and the bureaucratic

structure recognized this

sent him abroad for uh further

dissemination of his findings and

finally

funded a research institute to carry his

work further

a future was born and in the end

again imagine that the medical student

who was going through depression

spoke with a faculty member who

immediately took notice of it

created talked to the faculty of the

student welfare committee

created a ring of safety a buddy system

around her to provide her a safe space

talked with her removed her guilt about

various issues from background

cast and tribe and and the money and

everything

called the parents in a safe manner and

helped them

in in some way possible to to mitigate

their their financial burden

get reviewed the medical medication

kept a close eye on the student but

without

stigmatizing or making her stand out in

the class

and today she is she’s a psychiatrist

she treats patients she saves lives yes

she still has depressive episodes

from time to time for which she’s a

medication but she knows the limits and

she knows that she will not

take her own life she has

a future which was fostered

by proving the possibilities of the

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