Doctors are at risk of suicide. Every medical health board in Texas and beyond has accepted that. Dr. Karl Jawhari reviews one way to combat this by offering pastoral medical care to doctors. Pastoral care is a way in which doctors can support each other through an agreed order and chain of command. They work incredibly long hours, which is often detrimental to their health, particularly because they also have to deal with high stress environments. Dr. Jawhari was happy to read the minutes of a June board in which this became an official order of business.
Dr. Karl Jawhari on Pediatric Intensive Care
Pediatric intensive care is one of the most stressful medical environments because it involves dealing with the deaths of children. Support is in place for families and for the patients, but little support is available for the medical staff and particularly junior staff. This could and should be improved through the provision of pastoral care.
All over the world, doctors have higher suicide rates than other professions. The highest rates are among dentists and anesthesiologists. It is believed that doctors are reluctant to admit to depression and more likely to self-medicate rather than seek treatment. It is vital, therefore, that pre-suicidal states are recognized by not just the individuals, but also by other staff. Doctors are expected to be omnipotent, but none are able to live up to that reputation, which places undue stress on them.
In almost every hospital, and particularly intensive care departments, doctors (registered and residents) have died as a result of self-medication through intravenous drugs. It isn’t known whether they were deliberate suicide attempts or whether they were accidental overdoses. Little evidence exists, however, that these fatalities were keeping an addiction hidden. However, it is believed that addiction is an increasingly large problem in the medical profession. Of those addicted, 25% are anesthetists, which could also be as a result of occupational exposure, however.
Staff are known to regularly experience secondary traumatization when they work in high intensity, intensive care environments. They also are at risk of “jading”, which means they are no longer driven by passion and care but become apathic and cynical instead. It is believed that, in pediatric intensive care in particular, there is a dark side to the profession, one that causes staff to feel angry, frustrated, out of control, detached, and depressed. All of this affects their personal lives as well.
The Need for Pastoral Care
If pastoral care was to be implemented in a hospital setting, this should be a standalone position, rather than being someone who is likely to be dealing with their own dark and negative feelings. However, hospitals are finding it difficult to place such an individual, particularly because of lack of proof that staff would access their services and as a result of confidentiality issues. However, when properly explained what a pastoral medical professional would do, and when highlighted that no documentation will be maintained of the conversations they have, research has shown that trainee doctors in particular are very receptive to the idea.