A well meaning family member took me out for lunch the other day, and told me that I was lucky that I have not suffered half as much as other doctors. She doesn’t actually know any other junior doctor, but said that other doctors in other hospitals must have had it a lot harder than me. Currently, the world is in turmoil for multiple reasons. The Israel-Palestinian conflict, COVID pandemic, poverty and more. Of course, in the grand scheme of things I know I have it all really great. But I wanted to write about the danger of comparing suffering.

First let’s talk about privilege

Privilege: a special right, advantage, or immunity granted or available only to a particular person or group

Being born in a country like Australia already grants a whole world of privilege. Life is good here. We have a great welfare system, health system, crime is low and look at our beaches. The streets and public spaces are clean, wages are high. Plus, we are handling COVID-19 super well, meaning that we have had less cases, deaths and lockdowns.

The government has also been financially supporting people who have lost their job during the pandemic, what a country right!

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I also had access to great education and am currently a practising doctor. Doctors have worked hard to get where they are, but they have been granted a lot of power and privilege. We are privy to patient’s most vulnerable moments, and deal with confidential information daily.

To add to all this, doctors are paid a comfortable salary (starting from $35 an hour pretax) and have job stability. People do treat you differently when you say you’re a doctor. You will have rental applications approved immediately, banks will give you that mortgage loan without a second thought, and everyone assumes you’re a good person.

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Acknowledgement

I straight up acknowledge I am speaking from a very privileged position right now. There are people battling homelessness, poverty, war zones, famine…and more.

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However – the dangers of comparing suffering

The person I met for lunch has a habit of downplaying other people’s issues. If you say “wow, I am tired from work,” they will say “well I am more tired because I work harder”.

If you express how you have been having trouble with anxiety and stress she will say, “lucky you haven’t suffered half as much as another doctor in another hospital”. A nameless, unknown doctor from a nameless hospital.

This dismisses your feelings, and is actually called psychological invalidation. This makes you feel like your issues are not important, and can lead to self-doubt. The person doing it may think they are helping you, but it is actually damaging.

It can lead to a sense of inferiority, worthlessness, confusion and alienation.

Studies show that children who experience psychological invalidation are more likely to have chronic emotional distress in adulthood, such as depression and anxiety.

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Everyone is fighting their own battles

Even though it is important to appreciate and be grateful for what you have, it is okay to have negative emotions. Every single person in this world is fighting their own battle.

As the lovely author Elizabeth Gilbert wrote:

I remember a story my friend Deborah the psychologist told me once. Back in the 1980s, she was asked by the city of Philadelphia if she could volunteer to offer psychological counseling to a group of Cambodian refugees—boat people—who had recently arrived in the city. Deborah is an exceptional psychologist, but she was terribly daunted by this task. These Cambodians suffered the worst of what humans can inflict on each other—genocide, rape, torture, starvation, the murder of their relatives before their eyes, then long years in refugee camps and dangerous boat trips to the West where people died and corpses were fed to sharks—what could Deborah offer these people in terms of help? How could she possibly relate to their suffering?

“But don’t you know,“ Deborah reported to me, “what all these people wanted to talk about, once they could see a counselor?” It was all: I met this guy when I was living in the refugee camp, and we fell in love. I thought he really loved me, but then…”

This is what we are like. Collectively, as a species, this is our emotional landscape.

I met an old lady once, almost one hundred years old, and she told me, “There are only two questions that human beings have ever fought over, all through history. How much do you love me? And Who’s in charge? Everything else is somehow manageable.”

Elizabeth gilbert

Reality: the dark side of medicine

An Australian wide study of doctors and medical students revealed that they are burnt out, and more likely to experience suicidal thoughts.

Doctors endure extreme levels of stress, and deal with death and pain daily. If this wasn’t enough, there is sexism, bullying, and racism in the work force. Plus, under staffing, very long work weeks, and the pressure to get into a medical specialty. To make it even harder, doctors and medical students feel that there is a stigma to speak out about their mental health.

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From my own personal example, when I was struggling I was told to ring the Doctor’s hotline. The doctor who gave me ‘mental health advice’ told me not to tell a counsellor or GP that I have anxiety or depression. She emphasised the need to say I have ‘stress’, as saying you have depression or anxiety will lead to the inability to have income protection.

What advice!

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The stats

  • 1 in 5 medical students and 1 in 10 doctors had suicidal thoughts in the past year
  • 3.4% of doctors are experiencing very high psychological distress, much greater than the wider community
  • Young doctors work longer hours (50 per week on average), are far more psychologically distressed, think about suicide more and are more burnt-out than their older colleagues
  • Perceived stigma is rife with almost half of respondents thinking doctors are less likely to appoint doctors with a history of depression or anxiety and four in 10 agreeing that many doctors think less of doctors who have experienced depression or anxiety. 4.5% list bullying and 1.7% list racism as a cause of stress for them.
  • Women working in health professions have a rate of suicide which is three times higher than those in other occupations

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Real life examples

Unfortunately, we all have colleagues that we know who have taken their lives.

For me it was a medical student in the grade below me, for a co-worker it was 2 people from her graduating class.

Beyond this, we have Doctors Sonia Henry and Yumiko Kadota who have come out with their own articles on issues within the medical profession.

Yumiko was an aspiring plastic surgeon at Bankstown Hospital, where she was so overworked that she had a car accident and mental breakdown. Read her story here. She recently published a book called Emotional Female.

Yumiko Kadota, Photograph: Carly Earl/The Guardian

Sonia Henry, who wrote Going Under, published a viral article called There is something rotten inside the medical profession. She voices that two of her colleagues had killed themselves by the time she was in her second year as a doctor. In any other profession this would likely lead to an inquest. Yet, alarmingly, fellow junior doctors have a joint understanding that this happens. It is not so much as a surprise, but something inevitable.

In the cutthroat, often brutalizing culture of medical or surgical training many doctors stay stoically mute in the face of daily, soul destroying adversity; at the worst case, their loudest gesture is deafeningly silent — death by their own hand.

Dr Sonia Henry

Sonia Henry, picture: Dean Sewell – Illawara Mercury article

Final words

Though doctors are a privileged group, we should not compare suffering or minimise emotions. That is the opposite of what should be done. Lives are at stake, with suicide the leading cause of death in ages 15-44 in Australia. We cannot afford to ignore people’s feelings, we need to speak up, acknowledge, and find the help that is sorely required.

The health system has to listen to junior doctors, and protect them. However, they cannot listen if these issues are not voiced.

If you are wanting to speak to someone call Lifeline Australia 13 11 14 – a 24 hour service.

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