My first physician colleague who died by suicide

I still remember the smell of burnt coffee from the call room that morning. It’s funny, the details your brain chooses
to keep. I don’t remember what cases were on my list or the lab values I was worried about, but I remember the Styrofoam
cup in my hand, the flickering fluorescent light, and the charge nurse walking toward me with a face that told me
something was very, very wrong.

“Did you hear about Sam?” she asked.

I hadn’t. A minute later, standing in the corner of the nurses’ station, I heard the words that would permanently change
the way I look at medicine, my colleagues, and myself:

“He died by suicide.”

This is the story of my first physician colleague who died by suicide, and the uncomfortable truth that his story is not
rare. In the United States, hundreds of physicians die by suicide every year, and the risk remains higher for doctors
than for many other professions. Behind the white coats and heroic headlines is a quiet crisis that most of us only
whisper about in hallways or debrief half-heartedly after a tragedy.

I wish I could tell you this is just a sad one-off story. It’s not. It’s part of a patternone that blends relentless
workload, perfectionism, stigma, and the belief that asking for help is a personal failure. And until we talk about it
honestly, we’ll keep losing people like Sam.

Meeting Sam: The doctor who “had it all together”

Sam was the kind of colleague you silently measured yourself against. Brilliant without being arrogant. Efficient
without being cold. The kind of attending who knew both the latest evidence and the name of the janitor’s daughter.

He made medicine look easy. He’d crack dry jokes during rounds, fix your half-finished note when your pager exploded,
and somehow still remember that your kid had a soccer game last weekend. If you had asked me to pick the least likely
person in our department to die by suicide, I might have said his name.

That’s one of the most painful truths about physician suicide: it does not look like the stereotypes we carry around in
our heads. It often looks like the colleague who is “fine,” “busy,” “tired but okay,” and “just getting through this
rotation.” It looks like the person we assume is strong enough to handle anything.

The day everything tilted

The news spread through the hospital in fragments and whispers. A group text here. A hushed conversation at the nurses’
station there. The story traveled fast, but the details arrived slowly, as if our collective mind were trying to delay
the impact.

There were the usual questions:

• “Did anyone know he was struggling?”
• “Was something going on at home?”
• “Was it work?”
• “Could we have stopped it?”

In medicine, we’re trained to dissect every bad outcome. When a patient dies unexpectedly, we schedule a morbidity and
mortality conference. We review the labs, the images, the timeline, the decisions. We ask, “What did we miss?” and “How
can we prevent this next time?”

But when a doctor dies by suicide, we often do the opposite. We go quiet. Maybe there’s a brief staff email, a short
memorial, a moment of silence. Then the OR board still lights up, clinic schedules remain full, and notes still need to
be signed.

The work doesn’t stop just because one of us does.

Why physicians are at higher risk of suicide

As the shock of Sam’s death settled into a heavy background ache, I started reading everything I could find about
physician suicide. It turned out that what happened to him was part of a larger pattern we rarely talk about in public.

Relentless pressure and impossible expectations

Physicians live in a strange paradox. We are told we are “heroes,” but expected to work like machines. Long hours,
overnight calls, high stakes, constant emotional exposure to suffering, bureaucracy that makes no sense, and the
unspoken expectation that we will always handle it.

From medical school onward, the training culture runs on messages like:

• “Push through.”
• “If you can’t handle this, how will you handle residency?”
• “Other people have it worse.”
• “Just get through this month.”

That mindset helps us survive intense training, but it also teaches us to ignore our own distress. Over time, that
becomes dangerous. Research has consistently shown that doctors face high rates of depression, anxiety, burnout, and
compassion fatigueall of which can increase suicide risk when untreated.

Burnout is not just “being tired”

“Burnout” gets casually tossed around as if it were just being exhausted after a busy week. In reality, it’s a
constellation of emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.

For physicians, burnout often looks like:

• Feeling emotionally numb with patients
• Becoming cynical about the profession you once loved
• Feeling like nothing you do actually makes a difference
• Dragging yourself to work with a sense of dread, not just fatigue

Burnout and depression are not the same thing, but they’re closely linked. Burnout can erode your sense of purpose and
hope. Depression can deepen that hopelessness and add thoughts of self-harm. Together, in a profession that resists
vulnerability, they can be a lethal combination.

The culture of silence and stigma

One of the most heartbreaking patterns in physician suicide is that many doctors never seek help, even when they know
they’re in trouble.

Why?

• Fear of losing a medical license or privileges if they disclose mental health treatment
• Shame about “not being strong enough”
• Belief that they should solve their own problems
• Worry about how colleagues will see them
• Practical barriers like no time, no privacy, or no truly confidential resources

We like to say “it’s okay not to be okay,” but many physicians quietly believe the opposite: it is not okay to
be the one who needs help. That belief isolates people who are already vulnerable.

What I missed with Sam

After Sam died, the stories started trickling outsmall hints that something was wrong, things that seemed minor in the
moment but formed a pattern in hindsight.

A nurse mentioned he had been quieter than usual on night shifts. A resident remembered that Sam brushed off a joke
about “burning out” and said, “I’m already charcoal.” Another colleague recalled that he had started declining social
invitations and saying he was “too tired” or “just needed to catch up.”

I remembered him canceling a weekend hike we’d planned, saying he had too much charting to do. At the time it felt
normal. Everyone cancels plans because of work. After his death, it didn’t feel normal anymore. It felt like a missed
checkpoint on a road we didn’t realize he was on.

Looking back, some of the warning signs that we collectively missed included:

• Withdrawal from social activities he usually enjoyed
• Increased self-deprecating humor about being “useless” or “a mess”
• More mistakes than usual, which he blamed on himself harshly
• A sense that he was always “behind,” no matter how much he worked

None of these signs guaranteed what would happen. But they were invitationsopportunities to ask real questions instead
of just nodding and moving on. I wish I had asked. I wish more of us had.

How the hospital respondedand where it fell short

To be fair, our hospital tried. Leadership organized a debrief. Counseling services were offered. There was a moment of
silence. Emails went out highlighting wellness resources.

But there were also the realities of clinical life:

• Clinic schedules that didn’t change
• Operating rooms that still had to run on time
• Calls to cover the shifts Sam would no longer work

Some people took advantage of the counseling. Others felt they couldn’t leave the floor long enough to access it. Some
physicians didn’t feel safe talking with institutional resources because they worried about documentation and
confidentiality.

The biggest thing we didn’t do was talk about what had happened in a sustained, honest way. After a few weeks, the
conversations faded. We all went back to “normal,” even though normal was what had helped break him.

What actually helps prevent physician suicide

We can’t control every factor that contributes to physician suicide, but we can build systems and habits that make it
less likely that a struggling colleague will slip through the cracks.

1. Changing systems, not just individuals

Telling burned out doctors to “practice more self-care” without changing the environment is like telling someone in a
burning building to drink more water. Helpful? Maybe. Sufficient? Absolutely not.

System-level actions that help include:

• Revising licensing and credentialing questions that punish physicians for seeking mental health care
• Providing confidential, easily accessible mental health services specifically for healthcare workers
• Designing schedules that allow true rest, not just shorter marathons between shifts
• Reducing unnecessary administrative burdens that steal time from patient care and recovery

2. Building team cultures where asking “Are you okay?” is normal

Culture lives in the small things. In how we respond when someone says, “I’m drowning.” In whether we roll our eyes or
say, “Tell me more.” In whether leaders admit their own struggles or pretend they have none.

Practical ways to shift team culture include:

• Leaders openly sharing their experiences with stress, therapy, or burnout (without oversharing details)
• Normalizing mental health check-ins at the end of difficult shifts
• Scheduling debriefs after traumatic casesnot just for clinical learning, but emotional processing
• Training attendings and chiefs to recognize signs of distress and respond without judgment

3. Empowering physicians to seek help early

If you’re a physician, you’ve probably told patients that reaching out early is a sign of strength. You deserve to
believe that about yourself, too.

Helpful steps include:

• Having a therapist who understands healthcare, even before crisis hits
• Knowing your institution’s confidential support resources (and their limits)
• Identifying two or three colleagues you can be brutally honest with when things get dark
• Setting non-negotiable boundaries around sleep, time off, and basic health

If you are struggling right now

If you’re reading this as a physicianor any healthcare workerand some part of you quietly recognizes yourself in this
story, I want to say this as clearly as possible:

You are not weak. You are not alone. And you are absolutely not beyond help.

If you are in immediate danger or thinking about suicide, please reach out for support now. In the United
States, you can call or text 988 to reach the Suicide & Crisis Lifeline, or use the online chat. If you’re outside
the U.S., contact your local emergency number or a crisis hotline in your country. Let someone know what you’re going
throughyou do not have to carry this by yourself.

Talk to a colleague you trust. Talk to your primary care clinician. Talk to a therapist who understands the medical
world. You do not have to be “bad enough” to deserve help. You deserve help because you are human.

What losing my first colleague taught me: experiences and reflections

Losing Sam didn’t just change how I think about physician suicide. It rewired how I practice medicine and how I show up
for the people around me.

I stopped pretending I was invincible

Before Sam died, I lived on a steady diet of caffeine, adrenaline, and denial. I treated sleep as optional, vacations as
a luxury, and vulnerability as a PR problem. Afterward, every “I’m fine” felt dishonest, even when I said it myself.

I started small. I booked a therapy appointment and didn’t cancel it when the week got busy. I told a trusted colleague,
“I’m not okay,” and watched them not explode or judge me. I gave myself permission to feel grief, anger, and fear
without immediately converting those emotions into productivity.

It did not make me a worse physician. If anything, it made me more present. I could sit with families in their worst
moments without feeling like I was silently cracking inside. I could notice my own limits before I hit a wall.

I started asking better questions

Before, I asked colleagues “How are you?” the way we all do in hospitalsas a quick greeting tossed over a chart or down
a hallway. After Sam, I learned to ask it differently, and sometimes to ask follow-up questions like:

• “No, reallyhow are you holding up this week?”
• “What’s been the hardest part lately?”
• “Is there anything I can take off your plate, even something small?”

Do I have time to have a deep conversation every day? Of course not. But I started treating emotional check-ins the way
I treat vital signs: not always dramatic, but essential to catch early changes before they become emergencies.

I became “that person” who brings up mental health in meetings

Is it a little uncomfortable to be the one who says, “We need to talk about the mental health impact of this schedule
change” in a room full of doctors who just want to finalize the call calendar? Yes. Do I do it anyway? Also yes.

I’ve learned that nothing changes if no one is willing to be mildly annoying in the name of sanity. Over time, other
people started speaking up, too. Residents emailed me asking how to find a therapist. Colleagues shared their own
stories of burnout and recovery. Leadership began to consider mental health as part of operational decisions, not just
a separate wellness committee agenda item.

I think differently about what it means to “save a life”

When I finished training, I thought “saving lives” mostly meant dramatic interventionsCPR, emergency surgeries,
life-saving medications. Now, I think about it more broadly.

Sometimes saving a life looks like:

• Covering a colleague’s shift so they can finally sleep
• Walking a coworker down to the employee assistance office when they admit they’re not okay
• Speaking up when institutional policies punish people for seeking mental health care
• Normalizing therapy, medication, and time off as tools of survival, not signs of failure

I don’t know if any of those actions will definitively prevent another suicide. But I know they make it more likely that
someone will reach for help before they reach for a final exit.

Carrying Sam forward

I wish I could say that time has neatly healed the grief of losing him. It hasn’t. It has softened, yes, but it still
catches me when I walk past his old call room or hear a joke I know he would have appreciated.

What time has done, though, is turn that grief into something slightly more useful. Into vigilance. Into advocacy. Into
a stubborn refusal to let the next struggling colleague feel as alone as he must have felt.

I can’t go back and ask Sam the questions I wish I had asked. But I can ask them now, of the people who are still here.
I can remind myself, my team, and anyone who reads this of a simple, radical idea:

Physicians are not infinite resources. We are human beings. And human beings need care, too.

If telling this story helps even one person pause, reach out, or feel less alone, then Sam’s legacy is more than a line
in a tragic statistic. It becomes a quiet, ongoing act of healingone conversation, one shift, one life at a time.