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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
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