That Monday when I asked Skip’s opinion — this time, on a troubling case of weight loss — I knew I would find him with his tie askew and his glasses crooked, which I did. He sat in his chair and listened, asking questions about food insecurity and other social determinants of health.
But that Monday was different. After we talked, Skip canceled his patients for the week, left the office and killed himself.
We were all blindsided. How did we not know? Was he depressed? Was he reaching out for help? If this could happen to him, who else could it happen to?
We would later learn about his struggles with other health issues, including possible dementia, but confusion still reverberated in our exam rooms and meetings. Administrators from the hospital met with us and talked of “making time for wellness” and “taking care,” but it rang hollow, and grief was soon swallowed up by the coming tide of the coronavirus pandemic.
I think of Skip often these days, as our community of Chelsea is one of the epicenters of the novel coronavirus in Massachusetts. He dedicated his 40-year career to the MGH Chelsea HeathCare Center caring for refugees and immigrants. I am certain he would have been the first to volunteer to see covid-19 patients in our respiratory illness clinic, or he would have been handing out food supplies. Perhaps seeing the worsening disparities in our community would have further depressed him.
Although suicide across the world is declining in some areas, this is not true in our country. Suicide rates in the United States are increasing, and now account for about 1.5 percent of deaths annually since 2000. Physicians, in turn, have the highest rates of suicide of any profession, with roughly one doctor dying every day. That is nearly double the rate of the general population.
Self-care has been increasingly difficult for patients and physicians alike during these unprecedented times. Some experts note a potential “perfect storm” of growing isolation, economic stress and decreased access to community support leading to a potential jump in suicide rates during the pandemic. For health professionals in particular, this warrants particular attention.
Last spring, I found myself poring over the story of Lorna Breen, an emergency room physician who killed herself in New York after treating countless patients with the coronavirus. I related to the overwhelming duty and guilt described in her obituary. Breen kept saying, “I couldn’t do anything.”
I’ve never been suicidal, but I felt despair in April. I remember coming home from hours on duty at the overwhelmed covid-19 clinic and I felt overwhelmed myself. I couldn’t really describe what I was feeling — we’ve failed to normalize talking about mental health. Breen’s family established a fund for mental health care in the wake of her suicide, noting the difficulty she had seeking mental health care in a system that often failed to acknowledge the deep burden of its providers.
At our hospital, a lot of time