07/03/2019    Patrick DeHeer, DPM

Preventing Suicides of Pediatric Residents (Peter Bellezza, DPM)

Yesterday, as I stood in the hallway of a
memorial service for a respected Indiana
podiatric physician's memorial service, Dr.
Belleza's response to my post on PM News, came to
mind as I watched my colleague's wife cry
throughout his memorial service and his son sing
beautiful hymns. My colleague called me looking
for help two days before he chose to take his own
life. Our conversation ended on a positive note
as I offered some ideas and suggestions to assist
him in his time of need. We were not best
friends, but we were professional colleagues for
more than 25 years. This explains him reaching
out to me.

The Tuesday, after I learned of the incident, I
emailed about 30 leaders within the podiatric
profession to assist getting our survey out to
podiatric residencies so we can, in fact, examine
if suicidal ideation in podiatry is similar to
our allopathic and osteopathic colleagues.
Shortly after my initial email, I was informed of
four other DPMs committing suicide (one third-
year student, one resident, one attending at a
residency program, and another practitioner). I
know there are more, unfortunately. My question
to Dr. Belleza is, is one DPM committing suicide
enough? Is it four? Is it ten?

I am as research-based as it gets, it is time we
took a look at our profession. APMA's website has
numerous resources for physician well-being and
suicidal ideation, but maybe we need more
resources for those at-risk. His response is
uninformed and presumptuous. If you read any of
the research of physician suicide, to think you
can "weed out" potential at-risk students is
absurd.

I know I am speaking from a place of pain and
mourning now, but I found Dr. Belleza's response
offensive. I will be happy to share the research
on physician suicide with him or anyone else.
Just because it has not been studied in podiatry
does not mean it does not exist. Our program is
trying to examine our profession because, in my
mind, one of my colleagues committing suicide is
one too many.

Patrick DeHeer, DPM, Indianapolis, IN

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07/03/2019    Larissa Paulovich, DPM

Preventing Suicides of Pediatric Residents (Peter Bellezza, DPM)

Dr. Bellezza’s lamentable letter implies that the
stressors of our training programs are the only
reason why a resident would commit suicide, and
ignores that 1 in 12 Americans suffer from
depression and 18% from anxiety.

So your opinion is that a resident “suck it up”
ignore their depression because they want to
appear “tough” or don’t want to be stigmatized
since it’s “just podiatry”. But I’d like you to
combine that feeling with the following scenario:
A “lowly DPM resident” is overworked because
their senior residents “already took all that
call as first years” so they’re now on call for
38 days straight, they’re also feeling pressure
from their spouse for not being around, in the
back of their mind they’ve had to put off the
$200,000 student loan bill at 6.8% interest
yearly because they’re barely making ends meet as
a resident, and of course their attending (you
know the one they just follow around at surgery
centers) is rude and condescending, and that one
ER doctor is calling them in for every broken toe
that walks into the hospital at all hours and
they can’t say no.

Do you believe this is an exceptional occurrence
of events Because if we poll our residents out
there, I guarantee you most of them are dealing
with the majority of those issues (even the ones
you believe to only clip toenails all day). So if
you think that blocking people from going to
podiatry school at all seems to be the answer,
you’ve essentially recommended discrimination
against anyone who has ever experienced
depression, anxiety etc. which according to the
NIMH is the leading cause of disability in the
U.S. in 15-44 year olds .

Mental health Screenings, education, support from
those around them, peers and attending alike,
that’s the start to preventing suicide. A
resident shouldn’t feel have to feel embarrassed,
weak or looked down on for asking /needing help.
When the latter feelings impede someone from
getting the help they need, it becomes easier to
turn to substance abuse or suicide.

Perhaps a psychiatry rotation should be added to
all podiatry core rotations so in the future, as
we progress as a profession, we don’t completely
ignore the complexity of mental health issues and
we can abstain from making comments like “our
residency is easy, stay out of podiatry” as a
solution to suicide prevention.

Larissa Paulovich, DPM, Keller, TX