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Amid tragedy, a doctor’s most heroic act may be to
listen - to be a sacred witness to the suffering of patients.
Yet where do heroic doctors go with their pain? Who lis-
tens to the suffering of physicians? The guilt of not being
able to do more for patients. The burden of delivering dev-
astating news to families. The work-related anxiety and
depression due to unrealistic expectations of perfection-
ism. Few venues exist for medical students and physicians
to share their uncensored lived experiences. Welcome to
a special issue of Qualitative Research in Medicine and
Healthcare dedicated to physician mental health and the
unexplored lives of our wounded healers. 

Doctor suicide has been a well-hidden occupational
hazard of the medical profession for more than a century.
Though students enter medicine with their mental health
on par with or better than their peers, they are up to three
times more likely to kill themselves according to the
American Medical Student Association. In some resi-
dency programs 75% of interns meet criteria for major de-
pression. We know that suicide risk increases with
untreated mental illness. Physicians who die by suicide
are less likely to be receiving mental health care compared
with non-physician suicides. In fact, doctors are more
likely to self-medicate for anxiety, depression, and suici-
dality - with tragic outcomes. Why?

Here physicians share their personal journeys with
anxiety, depression, PTSD, and suicide amid life-and-

death decisions for patients - and themselves. Some doc-
tors have prevailed. Others have been injured by the very
agencies claiming to support them. A few have lost careers
due to seeking help for occupationally induced mental
health wounds. 

So how do we harness health in a system that under-
mines the mental health of our healers? Well - meaning
medical institutions offer physician wellness activities
with ice cream, yoga, and chamomile tea, yet these pro-
grams have been less effective at addressing the vicarious
trauma doctors sustain from helping victims of child
abuse, domestic violence, and social injustice. To create
a culture of wellness in medicine, simple foundational so-
lutions are proposed and celebrated here such as the recent
decision by the National Board of Medical Examiners to
change the United States Medical Licensing Examination
from a numeric grade to pass/fail and the Federation of
State Medical Board’s decision to remove questions from
licensing applications that may violate the Americans with
Disabilities Act. 

Eradicating mental health stigma from within medi-
cine allows our healers to receive the non-punitive psy-
chological support they require - and as a result we all
benefit. 

May you enjoy this unique opportunity to explore
physician psychology.

Introduction to the Special Issue on Physician Mental Health

Pamela Wible

Family Physician, Founder Ideal Medical Care, Eugene, OR, USA

Correspondence: Pamela Wible, P.O. Box 5225, Eugene, OR
97405, USA.
Tel.: +1.541.345.2437.
E-mail: roxywible@comcast.net

Received for publication: 29 October 2019.
Accepted for publication: 12 November 2019.

This work is licensed under a Creative Commons Attribution Non-
Commercial 4.0 License (CC BY-NC 4.0).

©Copyright: the Author(s), 2019
Licensee PAGEPress, Italy
Qualitative Research in Medicine & Healthcare 2019; 3:98
doi:10.4081/qrmh.2019.8922

[page 98]                                     [Qualitative Research in Medicine & Healthcare 2019; 3:8922]

Qualitative Research in Medicine & Healthcare 2019; volume 3:98

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