This blog was first published on KevinMD as “We are human beings before we are doctors”.
Mental illness has long been associated with shame and stigma. Although progress has been made through the efforts of global celebrities like Stephen Fry and many others to de-stigmatize mental illness – many are still ashamed to admit to it and the stigma is far from being annihilated.
Nowhere is this stigma more entrenched than within the Medical profession itself. A fact that should shock us out of our judgmental slumbers and wake us up to ask: What is really going on?
Anxiety and depression are equally prevalent in the medical profession as in the general population and more worryingly, addiction and suicide rates are actually higher than the general population. So there is no doubt that medical professionals are not immune to mental illness – indeed the opposite is true – for it seems that a medical degree is in fact hazardous to one’s mental health; hardly an advertisement for the profession!
It is hypocritical to talk about having compassion for patients who have mental illness when we still hold such stigmatizing views of it within the medical profession. It’s as if we think it’s ok for the group of human beings we call ‘patients’ to get it, but once we cross the medical threshold we enter a culture where such conditions are not permitted, nor admitted to.
Why is this?
Do we believe that a medical degree should render us immune from such ills?
Is it because we feel we should know better than to get ill?
Do we believe we are some sort of superhuman species, different to ordinary mortals or the group we call ‘patients’, that means we do not get affected by such conditions?
Do we (perhaps arrogantly) think that because we are intelligent we shouldn’t get ill?
Do we fear being perceived as weak, not coping, or perish the thought…. that we have failed in some way?
Doctors are high achievers, often perfectionists, with little tolerance for any element of perceived weakness and a profound allergy to any kind of failure.
Do we feel ashamed because despite our intelligence and our medical degree we have not been able to stave off the onslaught of illness and disease, and in this particular case, mental illness?
Are we in career fear? Concerned that any such admission will automatically compromise our present and future career prospects? Whilst there may be incidences where that is true depending on the severity of the problem – is it our default to assume it will be so and thus negate any other possibility?
Do we perceive a doctor who has been mentally ill to automatically be a less capable or competent doctor as a result?
Is it possible that someone who has recovered from mental illness will have a greater insight to the condition and be more able to relate to patients and provide a more understanding and healing presence than someone who is standing aloof in their ivory tower of perfectionism?
Will those who have come out the other side of mental illness possibly be stronger for the experience, not weaker? It is impossible to generalize for every scenario – but rather than assume the worst, we need to allow the space to consider and allow for the opposite: that healing from mental illness can and does occur and can lead someone to be in a stronger position than they were prior to the experience.
Doctors are just as human as everyone else and we are subject to the same ills everyone else. We are human beings before we are doctors, but this seems to be forgotten after entry into medical school and we become immersed in the medical culture where fear of admitting to any ill is far greater than our levels of acceptance that we too can get ill.
But there is little point in talking about having understanding, acceptance and compassion for patients if we do not have those same qualities for ourselves, or our colleagues, when similarly afflicted. If the stigma and shame associated with these conditions is to be truly dissolved then we need to take the lead, to be open to raising and discussing this within and without the profession and show the world by our example that there is no shame in being ill (mentally or physically) – but there can indeed be tremendous healing, if we are open to it.
One of the steps involved is abolishing the separation of mental and physical illness and the assumptions that go with them. Just consider how we treat or judge people differently according to the condition they have. For example, observe within yourself the immediate judgments or perceptions that come to mind when you think of someone who has:
3) Heart attack
7) Alcohol Addiction
8) Genital warts
9) HIV infection
There is this notion that those who have a physical condition are more worthy or deserving of compassion than those with a mental ill health condition, but if it is perceived to be a condition that is in some way self inflicted like a sexually transmitted disease, addiction or obesity, then forget about compassion altogether – ‘you deserve it’ – or so the thinking goes. However, with the increasing recognition of the role of lifestyle in many conditions, the number that are not self inflicted in one way or another is ever diminishing.
The point is, it is irrelevant whether the condition is physical, mental or considered to be self-inflicted or not – the true response to those who are ill or suffering in any way is to bring understanding, acceptance and compassion. To see the true person behind the condition whatever the condition may be, a person that has a body and mind that are intimately interconnected and interdependent. To see the body and mind and treat them as two separate parts is archaic, unscientific and totally flawed and only perpetuates the stigmatization of those with mental ill health conditions.
Physician Heal Thyself: Before we can offer healing to another we need to heal ourselves, and as long as we continue to stigmatize ourselves and others in the profession who have or have had mental illness, we will never be able to offer true healing to those we treat. If we in any way see ourselves as ‘other’, ‘different’, ‘superior’ or ‘better than’ those we call ‘patients’ then we are setting ourselves up to have our hubris tempered with a fall. It behoves us to address the mis-beliefs that currently pervade the culture of medicine regarding ourselves and illness and disease and it is imperative we find a new narrative – one that is accepting, allowing and healing for all.