Below is an
article in the British Medical Journal by
an anonymous doctor who explains why he cannot admit to having
I ADMIT THAT I AM UNWELL?
Journal 24 August 2002)
the past four years I have worked as a full time doctor. I have
completed a one year diploma course, trained in two new specialties,
presently have three different clinical roles. I have listened
counseled many patients, worked with many colleagues, and have
for being efficient, capable, and versatile. However, also during
unknown to anyone except my close family, I have had an extremely
have made two serious attempts on my life, which have left me
permanent physical sequelae. I have fought off an attempt to section
under the Mental Health Act, and I have taken a battery of
antidepressant/antipsychotic drugs that left me desperately tired
Despite all this, I have remained at work.
I have managed by becoming a professional automaton
are several reasons for this. Firstly, I am and have been too
stop. I have a chronic suicidal pain condition, which has been
linked with a
type of post-traumatic stress syndrome. The main feature of this
is an unremitting urge to end my life. It has been present in
all my waking
(and sometimes my sleeping) hours for the last four years. While
to maintain a relatively normal exterior, I have been battling
intrusive thoughts, imagery, and impulses to bring about my own
At any moment when I am not occupied, I am at extreme risk of
serious harm upon myself
I have stigmatized my own condition as it is a "mental illness."
have been, and am, too ashamed to tell my colleagues.
Lastly, and most significantly, I have always considered that
it was my
place in life to achieve. If I give in to what has happened to
me, I will
perceive that I have failed, and failure will be terminal for
I can only liken my existence during this time to a living agony,
nightmare, torture in fact there are no words with which I can
life adequately. I have woken every day preoccupied with thoughts
of killingmyself and yet terrified that I might. I cannot do it.
I have two growing
children who wave goodbye to me every morning and expect to see
night. It does not occur to them that while they are at school
I might end
my own life. I have been, and am, desperate, desolate, lost, lonely.
every day I face friends, patients, and colleagues at work.
have I achieved this? I have managed by becoming a professional
automaton. Every morning at work, I present the expected image
behaviours that I have learnt and depended on over the years,
and that have
become my professional identity. I have become very good at this.
this role I don't really know who I am.
are several reasons why I needed to write this piece. Firstly,
people especially my colleagues to know that I am suffering, but
tell them because it is ingrained in me somewhere that doctors
do not have
these sorts of problems.
I wonder how many doctors out there are also carrying on like
battling from day to day with their problems. If there are many,
why. What makes it so hard for us to admit that we are not well,
that we should go a little easier on ourselves? Is it the training?
expectation? Fear of condemnation from our colleagues? Or are
we just driven
people? As with most problems I suspect that it is a combination
part of my need to write this is to thank the people who have
devoted part of their lives to me. Although I have not been able
public, I have been supported by a small group of people who have
with untiring care, concern, and understanding, and without whom
I would not
be here. One of these is my own general practitioner, whose empathy
support have been unwavering and who I have really needed to "be
Another is my community psychiatric nurse, who has been solidly
at my side
through many a dark moment, and whose thoughts and ideas have
from week to week. And yet another is my psychiatrist, who has
an appointment at short notice. I also thank my husband and family,
battled to understand me, and lastly my partner, who has loved
me, talked to
me, cried with me, and sat awake through many nights with me without
this has not made me feel any better, as I hoped it would. But
anybody reading this is suffering as I am, then I hope it is a
them to know that they are not alone. Maybe one day I will be
able to give
myself a break and admit to my colleagues and friends that I have
I am working towards this.
initial thoughts were to write this story in a dark, humorous
ensure entertaining reading. But when I thought about it, I realized
really wasn't funny.