I am a physician, specifically a urologist. However, what most people do not know about me is that I am a survivor of multiple suicide attempts. My essay attempts to tell my personal story—a story of burnout, mental illness, and suicide—and to discuss the shame that accompanied these experiences.

I completed my urologic residency in 1987 at Stanford University and began practicing with the Southern California Kaiser Permanente Medical Group in Riverside, California. My life, from the time after my residency until my retirement in 2003, can be divided into two distinct eras.

During the first era, I was happy, busy, and, I believe, a successful urologist, husband, and father. I was deeply involved in all aspects of my life. My urology practice was thriving, and my family life was fulfilling. We were engaged in sports, focused on my sons’ education, actively participating in the Church, and contributing to the community.

However, in 1998, two catastrophic medical events occurred that drastically changed everything. This marked the beginning of the second era of my life.

Firstly, in 1998, I contracted sepsis after a vacation abroad. It led to a 6-week stay in the intensive care unit, where I experienced various complications associated with sepsis, including ARDS, DIC, chest tubes, tracheostomy, and a significant weight loss of 40 pounds. A little over a year later, I suffered a snowboarding accident, which landed me in the ICU once again. This time, I had facial fractures and underwent surgeries, jaw wiring, a tracheostomy, and experienced another 40-pound weight loss.

After enduring these two severe medical conditions, I attempted to resume my practice and life. However, despite appearing well, I did not feel good. I was severely depressed and anxious, day after day, without any improvement. Following the sepsis episode, I began seeing psychiatrists who diagnosed me with bipolar-affective mood disorder. I embarked on a journey of trying various mood stabilizers, anti-depressants, and even underwent over 30 electro-shock therapy (ECT) treatments. Unfortunately, nothing seemed to alleviate my condition.

In May 1999, feeling hopeless, I made a spontaneous and poorly thought-out suicide attempt by overdosing on medication. Although I survived, I concealed this attempt and continued living with depression and anxiety. Outwardly, I tried my best to function, giving the appearance of being well-adjusted. However, my unhappiness persisted, and in 2002, I made another, more meticulously planned suicide attempt.

This time, I checked into a hotel and consumed a massive overdose of medications. I was found unconscious by hotel staff and required intubation. They informed my family that I might not survive. Despite the odds, I pulled through and found myself admitted to a locked psychiatric ward, where I underwent further ECT treatments.

Believing that working harder would lead to success, I returned to practicing urology in an attempt to regain control of my life. Sadly, the black cloud of depression continued to dominate me. In 2003, I made yet another suicide attempt. This time, it was a well-thought-out and severe attempt. I remember going to my office on a cold and dark weekend. I locked myself in, feeling disgusted with my life as I gazed at my reflection on my medical school diploma. I proceeded to lacerate my wrist and lay down on the floor, hoping to die. I fell into a deep sleep, bleeding profusely and losing around four units of blood. When I eventually woke up, my office was a chaotic scene. I realized, reluctantly, that I was not going to die. With overwhelming humiliation, shame, and sadness, I contacted the hospital operator, described my location and situation, and was readmitted to the hospital. My wrist was surgically repaired, and I found myself back in a locked psychiatric ward. At that moment, I decided that retiring was necessary for my own well-being.

Retirement brought its own set of challenges. I struggled with feelings of humiliation and failure, feeling as though I was no longer a physician. However, attending a physician writing seminar in Taos, New Mexico, proved to be a turning point for me. There, I met a fellow physician who had also experienced burnout and mental illness. She had written and published an essay that openly confronted her problems, which brought significant relief to her life. Encouraged by her actions, I wrote my own essay, “The Last Day,” in which I chronicled my story and the end of my medical practice. It was published in the 2017 Annals of Internal Medicine. I discovered that being honest and open about my mental illness, and speaking on the subject, provided tremendous therapeutic benefits for me. I hope that it has also been beneficial for our noble profession.

The underlying theme of my presentation revolves around the shame associated with mental illness in the medical community. Three moments in my life stand out as particularly shame-filled.

The first occurred in 1999 after my sepsis episode when I saw my physician, who was responsible for writing my off-work orders. I expressed that I was not ready to return to work as scheduled. The intense dissatisfaction and disappointment were evident in his demeanor. I personally delivered the medical records to my next appointment. To my horror, I discovered that the physician had written in the chart, “Dr. Lynes must return to the clinic next month without excuses!” I felt humiliated and angry, consumed by shame during that time.

The second moment of shame took place after my second suicide attempt. Following my massive overdose, my mental illness became evident to my entire partnership. I had to face the hospital wellness committee, pleading and coaxing them into allowing me to continue practicing. Once again, shame enveloped me as I confronted what I had become.

The third moment of shame occurred after my most recent suicide attempt. Following the attempt, I was admitted to the same hospital where I had practiced for 16 years. I imagined everyone discussing and disapproving of my situation. That hospital stay became a nightmarish experience, laden with humiliation and shame.

The shame associated with mental illness is prevalent not only within the medical community but also in our society as a whole. This shame does nothing to promote the understanding and treatment of this condition. Stories like mine are scattered throughout our noble profession of medicine. I hope that sharing experiences such as mine will contribute to improving this intolerable situation.

William Lynes is a urologist.