The night I almost swallowed a bottle of Percocet post-call in residency is still clear in my mind, as is the hours leading up to it; the thoughts going through my head, the swirl of emotions seemingly pulling me like an ocean undertow.  I can only attribute my pause to a power greater than myself. The truth is when I look back on that night, I can see that those thoughts were not ones that just popped up out of nowhere on that dark evening. They were thought cancers that had been growing for months … even years before. It wouldn’t be until years later that I would see the root cause to some of these thoughts were a result of the unconscious messaging that had occurred during my journey to becoming a physician.  This unconscious messaging had led me to believe I was not capable and worse, not worthy of moving forward another day in life.

There are a few things about medical education that make it rather unique. Firstly, we spend hundreds of thousands of dollars in our medical education. For this investment, we endure thousands of hours of rigorous training, often being hazed and sometimes mentally and verbally abused in the process.  We do all of this in the name of two letters, and the opportunity to join an “elite” group of people that basically sacrifices our own lives and well being to save and enhance the lives and well-being of others.  Kind of ironic, isn’t it? Furthermore, with this kind of financial, physical, and emotional investment, one would be hard-pressed to waste it by leaving medicine.

So, here I was, at the end of my rope in residency; physically, emotionally, and mentally exhausted. Ready to quit, but feeling like I’m trapped, and there is no way out.  In my mind, there was no way I could spend the rest of my life practicing medicine in this manner (and I wasn’t even complete with training), but I had already acquired all of this debt, so for me, I was In too deep, and there was no going back.  Furthermore, my colleagues didn’t seem to have the same misgivings I had. In fact, they seemed to be doing fine.  It made me think that Maybe I’m just weak.  Which led to I’m just not good enough to be in this industry.  And although a part of me wished and longed to reach out to someone about this, I was afraid. They’ll just think I’m crazy. They will suspend my license, take away my ability to practice, or even say I couldn’t hack it. Maybe I can’t hack it, and maybe I am crazy. Ultimately, I told myself, I’m all alone, no one is really going to understand.

I was fortunate enough to have some higher power take over my body and have me actually pick up the phone, but many of my other colleagues have not been so fortunate. I’m not saying these were their thoughts, but I wouldn’t be surprised if some of what led them into the spiral didn’t have a striking resemblance to what I went through in those moments before I nearly swallowed 24 pills to end my life.  When I burned out ten years later in solo practice, I experienced the beginnings of these same thought patterns. Having had the previous experience, I was able to more quickly recognize the pattern, and it allowed me to take a step back and ask myself a few questions.

What was going on that wasn’t working? What specifically? What thought cancers are resurfacing; what is really true? Who do I trust, with whom I can completely be myself, that I can reach out to right now to and connect? What can I do to take care of myself right now at this moment?

Those were the questions that led me to do three things: 1. I reached out to a friend who was a therapist to help me emotionally process in that moment; she helped me to take a step back and see I wasn’t alone, nor was I crazy). 2. I took care of myself in the moment, and reached out to a good girlfriend, who came over and just kept me company over dinner and a few drinks.  3. I reached out to a professional coach (who also happened to be a fellow physician); he helped to put things in perspective, and create a plan to re-organize my life and my thinking in a way that not only gave me higher level of satisfaction and fulfillment, but it led me to my ultimate calling in medicine.

That night I almost took those 24 pills of Percocet, something happened. I picked up the phone. That was a critical moment for me. It was the moment that I knew I wasn’t letting the thought cancers win. It was the moment I knew I wasn’t going out like that. And even when no one was answering their phones, it was a deep knowing that it wasn’t my time that allowed God to take over. Through tears and ink stains on paper, I made it through the night.  The thought cancers still sometimes rear their ugly head; but I have created a force around me of daily practice and community, that like a can or Raid helps keeps those nasty roaches at bay. The most disturbing thing in all of this is that I know I’m not (nor have I ever been) alone. Physician burnout leading to suicide happens every day. I simply know that I was just one of the lucky ones who got away.

Maiysha Clairborne is an integrative medicine physician and can be reached at The Stress Free Mom MD.  She is the author of The Wellness Blueprint: The Complete Mind/Body Approach to Reclaiming Your Health & Wellness. 

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