Silent Battles (1/15)


We live in a world more connected than ever before. Social media lets us view personal pictures of friends, kids, families, and people from our past. Do you want to see what an acquaintance from middle school had for lunch? Hop online, and you will find multiple pictures and a selfie of him eating sushi.

We are bombarded with minutiae from every facet of the lives all around us so why do we feel so very, very alone?

I loved “Good Will Hunting” and “Dead Poets Society,” and enjoyed the majority of Robin Williams’other films. From an outsider’s perspective, he seemed humorous to his core. Then he took his own life. This saddened many, myself included, but I never knew him. I have, however, known many with crippling depression.

When I was in medical school, I had two roommates. Both of these two men were extremely intelligent, talented, and fun guys. The three of us hung out together all the time. Medical school, being mentally, physically, and emotionally demanding, required hard work and performing at your best. I felt intimidated and overwhelmed some of the time.

My roommate, who (to be honest) was smarter than I, did great in medical school, but he became depressed during his second year. He was smart, gifted, and fun to be around, but he could barely function because of his depression. He signed himself into the hospital and received help.

Despite support from friends and family, he struggled for months trying to find joy and peace in his life. He eventually dropped out of medical school. Years later he became a teacher. This was after finishing a full year of medical school and doing very well in his second year. My other roommate and I remained as supportive as possible. Depression, however, is a bitch.

Time passed and distance separated us. As often happens, we lost touch. I saw him less and less, maybe once a year. He seemed to be doing much better, enjoying his teaching and involvement with others.

Then he killed himself.

He was handsome, smart (brilliant, actually), kind, compassionate, and simply a good man. Despite this, he took his own life. I would like to think that few people have this level of depression, but, unfortunately, many do, especially those of us in medicine.

We spend so much time trying to make everyone happy, trying to be accepted and liked by everyone, that we forget to like ourselves. Don’t get me wrong, American society often has a “me first” attitude, but nearly all of that attitude is centered on the frivolous and short-lived. Every year, physicians and medical workers rank near the top of the list for suicide.

From the world’s perspective, high levels of depression for physicians might seem counterintuitive. Doctors are considered successful. How could we not be happy?

Our careers demand near-perfection in high-stress situations. We consistently deal with people on the worst days of their lives. We must inform patients they have cancer, life-changing illnesses, or debilitating injuries. We are the harbingers of bad news. Often our hard work is rewarded with anger, disdain, or advice on how we could have done it better. Medicine is a field with rare compliments and frequent criticism; it’s not for the faint of heart, and most physicians aren’t surprised by the high level of depression in the field.

Perhaps the goal of our lives should not be the elusive, ethereal entity we define as happiness. People often term depression as the lack of happiness, which I think is a terrible definition. It goes much deeper than that.

Depression causes detachment, a feeling of removal from the world. Some who are depressed don’t feel emotions or lack of joy. Utter emptiness. Depression is being surrounded by the noise of a thousand people yet feeling completely alone. It is feeling unmotivated and undeserving. It is a helplessness that feels impossible to overcome, a hollowness echoing through you so completely that the nothingness you feel can never be filled with anything but despair.

But if you are depressed, know that it can get better. There is hope.

I do not have all the answers, but I know from multiple friends who have been in that dark place that healing often starts with a person listening to them. Spouting advice and saying “just get over it” cures nothing. Be kind and listen, truly listen. It can be the start of the healing process.

Depression is a marathon, a slow effort over time. Quick fixes and easy cures do not exist, but it can be overcome. Those of us in medicine create the illusion of invincibility. We try not to ask for help. Any display of needing assistance is seen as weakness in our minds. If you are truly depressed, ask for help. Because sometimes even the best of us are fighting silent battles that cannot be won alone.

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