Bioethics Blogs

Loss: The Hidden Barrier to Professional Identity Formation

By Meaghan P. Ruddy

Paying attention to the wider trends in medical education recently makes it difficult to miss the growing voice of Pamela Wible, MD and her crusade to end physician, resident and medical student suicides.  One premise of her argument is that all the language around burnout and resilience misses the point.  The point it misses? This demographic is suffering from abuse.

I tend to agree.  To this I would add that the result is not burnout but the closely related state of grief…

The book is far from closed on the causes of the depressive states that lead to suicide.  As someone who personally struggles with dysthmia, major depressive episodes and suicidality, something that that has helped me to grow through the pain is the idea that depression can be thought of as grief over loss.  There is as much a plurality over what people feel they have lost as there are people who lose things.  That being said, the smaller the subculture, the more similar the experiences, the more similar the losses.

Think more personal than the loss of patients, which happens and is very troubling.  The sorts of loss we speak of now are loss of self, loss of identity, loss of motivation, loss of so much that once mattered so much.  Medical students, pressured into attempting to master ever expanding curricula can lose the confidence in their ability to learn and think, the very talents got them into the situation in which they feel so lost.  This loss then expands to the people they may never help, the life they may never get to lead because the competition is so stiff for so few spots in the place they want so badly to be: residency.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.