Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The constant fear of losing a patient to suicide

Vania Manipod, DO
Physician
August 28, 2015
Share
Tweet
Share

This article was originally written on August 11, 2015.

My psychotherapy supervisor taught me a tip during residency: to pay close attention to the very first thing a patient says, and more importantly, the last topic they bring up towards the end of session. (Because it’s likely that the subject weighing most heavily on their mind is too uncomfortable to discuss at the very beginning.)

I struggled to come up with a topic to discuss on my blog today.  At first, I uploaded chipper, smiley pictures taken from a recent spontaneous trip to the coast, but there was something about my grin and carefree expressions that didn’t seem quite appropriate to post today.  I try my best to ensure that my blog posts are reflective of my current state of mind, and my current mood is actually quite solemn.

Today marked the one-year death anniversary of Robin Williams. I avoided news articles, tweets, and Instagram posts that paid tribute to the iconic, inspirational actor.  While sitting on the couch and staring blankly at the television screen, a short reel of Robin Williams popped up on entertainment news.  Not content with the mainstream, flowery, piece which strung together brief clips of some of his finest, Oscar-winning work followed by a quick moment of silence in remembrance, I picked up my phone.

While scrolling through Instagram, I focused on a long, detailed post written by a young man in which he describes his own personal battle with depression and multiple, near-fatal suicide attempts.  Robin Williams’ lost battle to mental illness motivated this man to share his story rather than isolate in shame and silence.  The words authentically describe the powerless experience of succumbing to the disease.  The depression takes exclusive command and overrides any attempt at rationalization.  And I know the story to be true because the writer is a dear friend of mine who miraculously survived.

Several of my patients have described similar experiences.  Several people living with mental illness whom I follow on social media share similar stories.  Every morning that I arrive in clinic, I log on to my electronic medical records and pray not to see a message from the coroner’s office.  As a psychiatrist, getting that dreaded phone call from the medical examiner is probably my equivalent to the oncologist receiving a call from a family member or hospice staff.  As a young teen, I vividly recall accompanying my family for routine, frequent visits to my grandparents’ apartment, where my grandfather passed away, rid of the suffering he endured from colon cancer.

A few years later, my grandmother peacefully died from multiple myeloma.  Her last words to me before she passed was that she wished for the opportunity to pay for my education and witness me become a doctor.  My other grandfather, as he approached the end stages of his battle with cancer, fulfilled his wish to fly back to the Philippines, where he comfortably spent his final days in his homeland with our large, extended family by his side.  When the medical examiner’s call ends, my immediate response is to shut the door and sit in silence.

Finally recognizing the mixture of emotions that I suppressed the entire day, I could no longer hold in my tears.  Rather than isolating (as clinicians tend to do when it comes to coping with patient loss), I attempted to share my thoughts and emotions on social media, with the goal to make others aware of the difficult emotions that we, as mental health practitioners, face when dealing with patient suicide.  The loss not only permanently impacts us professionally in our practice, but also as human beings.  I left the post on my feed for 20 seconds, then immediately deleted it.  Shame, embarrassment, and fear of judgment overrode my hope to break the norm of silence and connect with others too afraid to open up about their own experiences losing a patient to suicide.

I waited a few days to publish this post after much contemplation.  The truth is that the fear of losing a patient to suicide weighs heavily on my mind almost every day.

Vania Manipod is a psychiatrist who blogs at Freud and Fashion.

Image credit: Dan Holm / Shutterstock.com

Prev

The story of a boy who liked to draw

August 27, 2015 Kevin 1
…
Next

How pre-visit planning saves time and helps the bottom line

August 28, 2015 Kevin 3
…

Tagged as: Psychiatry

Post navigation

< Previous Post
The story of a boy who liked to draw
Next Post >
How pre-visit planning saves time and helps the bottom line

ADVERTISEMENT

More by Vania Manipod, DO

  • How this doctor beat burnout. You can, too.

    Vania Manipod, DO
  • a desk with keyboard and ipad with the kevinmd logo

    Resist the tendency to label your patients

    Vania Manipod, DO
  • I tried not to let a drug rep influence me. But he probably already did.

    Vania Manipod, DO

Related Posts

  • Losing my first patient

    Allie Poles
  • Losing a patient in an emergency

    Ton La, Jr., MD, JD
  • Don’t let fear harm your health

    Michele Luckenbaugh
  • A universal patient medical record

    Michael R. McGuire
  • A patient waits. And waits.

    Michele Luckenbaugh
  • Treating the patient’s body is not synonymous with treating the patient

    Steven Zhang, MD

More in Physician

  • A surgeon’s testimony, probation, and resignation from a professional society

    Stephen M. Cohen, MD, MBA
  • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

    Trevor Cabrera, MD
  • Collective action as a path to patient-centered care

    American College of Physicians
  • Portraits of strength: Molly Humphreys and the unseen women of health care

    Ryan McCarthy, MD
  • When embarrassment is a teacher in medicine

    Vijay Rajput, MD
  • The crushing bureaucracy that’s driving independent physicians to extinction

    Scott Tzorfas, MD
  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why your health care dashboard isn’t working and how to fix it

      Dave Cummings, RN | Policy
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
    • One injection dropped LDL by 69 percent. Should we celebrate?

      Larry Kaskel, MD | Conditions
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Why your health care dashboard isn’t working and how to fix it

      Dave Cummings, RN | Policy
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
    • One injection dropped LDL by 69 percent. Should we celebrate?

      Larry Kaskel, MD | Conditions
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...