Australian Doctor Australian Doctor 2 June 2017 | Page 3

DOCTORS ARE HUMAN TOO
in silence anymore
‘Medicine is failing to care for its own’
THE BEREAVED
Susan Bryant is a campaigner
for doctors’ mental health from
Brisbane, Queensland.
Her husband, Dr Andrew
Bryant, took his own life in May
this year. She wrote an email
urging other doctors not to suffer
in silence, which was shared by
hundreds of thousands of people
across social media.
MY husband, Dr Andrew Bryant, was
a gastroenterologist who lived and
worked in Brisbane.
He committed suicide, in his
office, on Thursday 4 May.
After his death, I sent an email
to a few of my work colleagues,
explaining how he died. This email
took me only a few minutes to write
and was sent to about 10 people.
I finished the email by saying:
“Please, forward this email on to
anyone at the firm who has asked
how he died, anyone at all that might
want to know, or anyone you think it
may help”.
I then sent it to a couple of
neighbours. Our children, who had
seen the email before I sent it, also
posted it on social media.
In the two weeks since Andrew
died, my email has been read by
hundreds of thousands of people
around the world, published
in newspapers in a number of
countries, including the US and
the UK, and shared widely among
medical professionals.
This all seems extraordinary
to me, given the audience it was
originally intended for.
Andrew always wanted to be a
doctor. His family is full of doctors:
both his parents were psychiatrists,
two of his brothers are anaesthetists, his sister is a psychiatric nurse,
many of his cousins are doctors.
Andrew graduated from the
University of Queensland in 1985.
We were married in 1988 and moved
to live in Sydney. He completed
his specialist training at Westmead
Hospital in Sydney, where he
decided to be a gastroenterologist
and worked at the Royal North Shore
Hospital.
We returned to live in Brisbane
in 1992, where Andrew set up his
private practice.
We had four children in five years.
Andrew was a very hands-on dad,
spending lots of time with the kids —
camping, bushwalking and sailing.
He was an enthusiastic volunteer
at their schools in fathers’ groups and at their sporting clubs; he was a
junior rugby coach for many years,
was swimming club treasurer and
came to all the working bees.
Amidst all this he still found
time to be a medic in the RAAF
reserves and saw active service in
Bougainville. He was passionate
about aviation and had qualifications
in aviation medicine.
He also loved music, particularly
opera, and sang in a number of
choirs, including the medical choir
in Brisbane. He loved travel and had
been to every continent on earth.
Our lives were busy and full.
In my email, I said that “in
retrospect the signs were there”. The
tiredness, the stress, the anxiety.
But those were part and parcel of his whole life as a doctor — he was
usually tired and usually busy.
Long days, missing family meals,
working weekends to catch up on
paperwork, doing rounds, concern
for sick patients, distress over those
who died — all these had been
standard for our whole married life.
Up until late February, nothing
was out of the ordinary.
Since I sent my email I have been
contacted by many doctors, some
of whom I know, but many I do not,
who have told me how mental illness
has affected them.
Some have lost colleagues to
suicide. All of them mention the
reluctance among doctors to speak
about mental health issues.
One spoke movingly about her despair in seeing the reaction
of her colleagues to the suicide
of a colleague and their lack of
compassion.
That email concluded: “Ironically,
being a doctor is an incredibly
isolating and unforgiving profession,
and now, older, I can understand
how it fails its own.”
Many, many of the emails referred
to “the caring profession that is
failing to care for its own”.
I’m not at all uncomfortable with
the way my email has been shared
or the response it has received.
If it can help to raise awareness or
promote discussion of mental health
issues in the medical profession in
any way, that can only be a good
thing.
This wasn’t an easy decision, but
ultimately proved to be the right one,
as she made a good recovery and
felt well supported by her practice,
including when she made a graded
return to work.
Unfortunately, though it doesn’t
always go this well.
I have treated other colleagues
over the years who have struggled to
accept their limitations and have kept
working when they should have taken
a break.
Others have dropped in and out
of my appointment book briefly and
infrequently, making it hard to form a
therapeutic alliance.
Still others have presented with longstanding symptoms that they
have been tolerating or minimising.
I am constantly amazed at what
doctors will put up with. Maybe these
doctor-patients got some of what they
needed from our interactions, but the
dynamics weren’t as effective as they
could have been had we known each
other better.
Hence the most important lesson
that my doctor-patient taught me
is the importance of an established
therapeutic relationship when things
go a bit pear-shaped.
The fact that we had established the
boundaries and rules of engagement
around the easy stuff meant that
we could both turn our minds to the hard stuff when it came along. And
recovering from depression is one
of the hardest things people have
to do.
Every doctor needs their own GP
— we hear this said a lot, it’s almost
a cliché. But really what we all need
is a safe place to talk about our fears
and challenges, and to get guidance
and advice from someone we trust.
Treating our colleagues can be an
anxious experience. We worry about
making a mistake, having our clinical
acumen critically assessed, and
coming up short in the eyes of our
colleague.
But invariably, the doctor-patient
sitting across from us is feeling even more anxious and vulnerable.
It hasn’t been easy for them to
come to see you, worrying about
whether this attendance is valid and
the problem is legitimate.
Neither party needs to have all
the answers, just a preparedness to
tolerate some initial discomfort in
order to build a platform of trust and
safety.
If you would like to further develop
your confidence and skills to treat
colleagues, the Doctors Health
Advisory Services in each state deliver
training for just this purpose (see
resources below).
Special thanks to my doctor-patient
for collaborating on this story. ‘TREATING OUR
COLLEAGUES CAN
BE AN ANXIOUS
EXPERIENCE. WE
WORRY ABOUT
COMING UP SHORT.’
www.australiandoctor.com.au
2 June 2017 | Australian Doctor |
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