Saving others lives taking ones own
[Music]
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
[Music]
present
[Music]
you