Mid-step on the sky bridge, boarding my flight—the message lands. Raw. Desperate. A life breaking apart in real time:

“I’ve been in health care my entire life. Surgical services. Because I spoke up against wrongdoing, stood up for myself, I’m out of a job and can’t get a job anywhere now. I’m 60 now. I don’t know what to do. I’ve had a hard life, and I buried all the pain in work. Now. Alone. Nothing but time on my hands—all of it surfacing. I have been thinking about ending my life every single day for a long time. Some nights the urge is very strong. I cry myself to sleep almost daily. Every day. I don’t want to live anymore.”

No way to respond. No way to reach out through the screen. No way to pull “anonymous” back from the edge.

At 30,000 feet, I dissect each sentence—exposing unstitched wounds, silent screams between the lines.

Touching down on the runway, I check my phone. Thirty minutes after the first message, a second comment appears on my blog. Again from [email protected]:

“After reading what I wrote, it just sounds like a pity party for myself. But why does it feel so overwhelmingly strong? Why is the belief and the rationalization of ending my life so present in my mind every single day? And some days so strong, the pain has become so overwhelming that taking a knife or fork and scraping my arms helps relieve some of it. The pain of my life has overcome all faith. Strength I once had.”

Up and down escalators, inside the tram to the next terminal, I scan both comments. Dissecting every sentence. Chasing the root of the pain that makes suicide feel like the only way out.

On my flight home, I perform a psychological autopsy on every word. Eleven themes in three categories, all crushing down on an anonymous soul.

Why does the urge to die by suicide feel so overwhelmingly strong?

Loss of identity and purpose

You weren’t just let go—you faced whistleblower retaliation. You are courageous. You stood up for ethics and patient safety, and it cost you everything.

“Out of a job.”

Not just job loss—a career exiled.

The profession that once defined you cast you out. The system you served for decades left you with nothing but time. And now, in stillness, you feel like you have “no reason to live.” You “just exist.”

You have career identity loss. You haven’t just lost a surgical job in the operating room—you’ve lost a part of yourself. Your connection to your soul’s purpose, your very identity.

You are feeling unemployable. At the pinnacle of your surgical career, with the greatest skill and wisdom, you feel discarded by the profession that once gave you meaning.

Pain of unprocessed trauma

Kids with sick parents or siblings may dream of becoming doctors—to save the ones they love. For many, health care is a refuge—a place to bury their own childhood wounds in service of others. Medicine is a trauma-inspired career.

“I buried all my pain in work.”

We all do.

Until work is gone.

Workaholism is a coping strategy that numbs—until it doesn’t. Suddenly, all unhealed wounds rip open. Patients you couldn’t save. Ghosts of childhood. Nights locked in a bathroom stall to cry.

“Now. Alone. Nothing but time on my hands—all of it surfacing.”

Without the busy operating room, you are flooded with painful memories.

Anonymous, your entire life is about service.

“Serving everyone but myself for over 25 years. I have been single for 24 years. Raised four kids by myself. Took care of mom when she passed. Then dad for seven years before he passed.”

And the worst loss? The one you never processed?

“Lost one son to an overdose.”

You are grieving personal losses.

Who takes care of you? Who wipes your tears? Who bears witness to your pain?

Isolation fuels despair.

“I’m so alone. I can’t take it anymore. God knows. I’m sorry for my weakness. I can’t pick myself up anymore. Nothing is working, and my career is over . . . I cry myself to sleep almost daily. Every day.”

You are lonely. Losing your profession means losing your people, your sense of belonging. You are grieving that loss, too.

You have non-reciprocal relationships. As a caregiver, you give endlessly. But who fills you up? Who stays when you fall?

You lack self-compassion. Like most health professionals, you minimize your pain.

But this is not your pity party. You have real loss, real grief. And you deserve real love and compassion—from others and from yourself.

“The pain has become so overwhelming that taking a knife or fork and scraping my arms helps relieve some of it.”

You are cutting yourself because physical pain makes your psychological pain visible and gives you a sense of control over your uncontrollable emotions. Please, do not make a lethal cut.

The deadly triad of suicide risk

Woven into every sentence—three unbearable weights pressing down, making death feel like the only escape.

Your words are heartbreaking:

• You feel isolated.
• You feel like a burden.
• You feel desensitized to pain and death.

A deadly triad. More importantly, these words reveal something urgent—your feelings right now.

You don’t need more facts. You don’t need to get stuck in intellectual loops. You need pain relief. The suffering you carry is real—and so is the love waiting for you on the other side of this message.

You are not weak for feeling pain.
You are not unworthy of compassion.
And most of all—you are not alone.

So we made you a gift.

Whether you are a surgeon, PA, NP, or other surgical professional—this video is for you, [email protected]. Step out of the shadows. Let us hold space for you. You don’t have to do this alone.

Pamela Wible is a family physician.