The mood hung in the air like a clenched jaw and slumped shoulders. I watched a fellow patient shuffle by the nurses’ station with his little paper cup. You know, the ones that are an inch or two tall and wide with a slight lip; the kind you see strictly in hospitals. I knew it was brimming with multiple meds, probably the colors of the rainbow. The purple antidepressant, the yellow mood stabilizer, the blue antipsychotic, and the light green with the middle stamped out with the shape of a heart, benzodiazepine. And, of course, there had to be the red ones – the laxative that we all were prescribed because our medications were so constipating. It was a beautiful and sunny day outside with birds calling their mates or just to hear themselves, who knows. The lazy summer breeze was moving the tree limbs, and they looked like they were dancing. The drone of the cicadas that only hatch every 10 years provided the melodramatic theme song of the movie I seemed to be watching. Was it a movie? No, I reminded myself. I am here. This is real. I am in my body. I sometimes forget the difference between the world within and the world without. My gaze goes back to my fellow patient. He was tall with a hollow, absent look on his pale face. He was wearing light blue pajamas that were slightly wrinkled and brown sheepskin-lined slippers that shuffled with a noise of swish, swish. If he were going faster, he might have looked like he was on ice skates. No, that is too smooth and gliding for what I see. He looks more like he is trying to walk on ice. The difference was that his arms were lax at his side, with none of the animations it took to stay upright on the ice. It was slow, and his feet barely left the tiled floor. My view of him is blurry as I look through the screened window. I am outside on the smoking porch, feet up and slouched in my overstuffed rattan chair, feeling rather like poured concrete. I shouldn’t smoke, but it is better than killing myself right now. Someone told me my fellow patient was a doctor at one time. He came here every few weeks for Electroconvulsive Therapy. He often didn’t know where he was or where he was going. They said he couldn’t remember his own family sometimes. The therapy erased his memory. Was he once a doctor? It was hard to believe this shell of a man, who now just shuffled around the day room, was once a surgeon with a busy practice. He must have been smart, quick, and steady to get through medical school and training. How far down in life could one go? Pretty far, I guess. I remind myself that I was once full of life and a busy, busy Obstetrician-Gynecologist. That seemed so far away now. I held my head in my hands, moving my forehead up and down, and then took the last drag from my cigarette and attempted to extinguish it in the disgusting, overflowing ashtray. Disgusting. How far had I gone away, I thought? Was I coming or going? How far down would I go? I couldn’t tell.

I had been at the hospital for several weeks at the point of meeting my fellow shuffling doctor patient. We eventually got the news that Dr. Rathburn had hung himself from one of those beautiful trees that the wind made dance. How sad. It adds to my own grief. Who had found him? How did he look? Babies that are born with a nuchal cord have the cord wrapped around their neck. That’s the closest I have seen to a hanging. I once delivered a baby who had it wrapped around 3 times, and by the time he was born, his face looked bloated and bruised, his tongue swollen and sticking out, and he had petechiae (small dots of microscopic veins that burst) on his face. I wonder if he looked similar. Did he have petechiae? How would he even do that? I wish I knew. I wish I had said goodbye. I wish the image of him shuffling by me would leave my head. Would every warm and beautiful summer afternoon with the tree limbs dancing remind me of him, of this place, of this horrible feeling? That was something to look forward to. At least I was thinking of the future. That had not been possible just a few short weeks ago. When it’s dark, it is bleak, like black silence, and an extraordinary effort to move and operate the body. The pain of the empty feeling in my heart and just holding my head on my neck seemed unbearable at times. Right, I am here, and I am feeling better. At least the empty blackness is gone most of the time. I light another cigarette. It’s better than crying.

Dr. Rathburn, you haunt me still. I was so close. It could have been me.

*Note: Dr Rathburn is a fabricated name, and I went through the experience of being suicidal over 20 years ago. A long and successful career followed. I am now a retired OB/GYN and coach physicians full-time. I know coaching would have made a difference in my burnout – before I became clinically depressed. At the time, I felt alone and suffered in silence. I do not want even one of my colleagues to feel that terrible pain and advocate for peer support programs and access to mental health resources that include coaching for those with burnout and psychiatric care, and counseling for those who are clinically depressed.

Let’s change the conversation about burnout and depression.
A cultural shift to being human with human psyches is in order. The sooner the better. ☤

Dr. Alley-Hay is a retired OB/GYN and Certified Physician Development Coach.
She has a blog and can be found for coaching at dralley-hay.com

This article was originally published on KevinMD.com and printed with permission of the author.