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Preventing suicide among medical students

Raman was a bright student and his school’s football team captain, considered very promising by his coach and peers alike. Football was not just a game to him, but a passion. Aspiring to make it to the top echelons of the sport, he even tried out for some of the big city clubs and was considering their offer to play for their lower divisions to begin with. His family of modest background was fervently against his wishes though and pushed him to study hard and become a doctor. He toiled zealously to make their dreams come true and got through the medical entrance exams to ensure a coveted seat in a government medical college. The happy ending everyone wished for! Not to be though. Throughout his first year he missed classes, failed exams, defaulted on assignments. After he was pulled up repeatedly for his insincere and lackadaisical attitude towards this hallowed profession, he jumped in front of a running train, ending his life.

Paritosh was the only son of a temple priest from a village in West Bengal far from the capital city of Kolkata. His family was poor and relied solely on his father’s meagre earnings, which fluctuated with festive seasons, for survival. Studying in a local government school where subjects were taught in Bengali, he had a stellar reputation as the “brainy bloke” who was most likely to make it big in life. Moved by the plight of his society, he was sold on the idea of becoming a doctor. And indeed, the day came! The perennial underdog had made it to the city’s medical college without any coaching or tuition contrary to the prevailing norm in cities and towns. His family was overjoyed and he became an instant local celebrity. Supposedly so, but fate had other ideas. The village boy against all odds was there rubbing shoulders with peers from the city who were much better off financially and socially. Add to that the “ignominy” of being not so well versed in English, the language of the books and curriculum. After a few instances of being mocked and jeered for his drab and plain lifestyle, he started remaining aloof and withdrawn from his batch mates. He felt a tremendous gap distancing him from the rest of his fellows. The gap was ever widening and proved too difficult to bridge at last. He succumbed to the incessant bouts of isolation and loneliness, of trying to mingle in the crowd where he was a nobody from nowhere, an unknown thrust into a jostling crowd of people with means and standing. He hanged himself in his room one night in an attempt to escape the great divide.

Life stories in context

These unfortunate instances are not just sad anecdotes. These are real people and real lives. It’s a well-established fact that suicide among medical students and doctors is higher than in the general population. It belies essential logic then that the people who are trained to have an acute sense to perceive distress and diseases ailing their patients often fall prey to these themselves. The general discourse on the matter throws up ever-growing issues of extreme stress, burnouts, depression, insomnia, poor relationships with spouses/partners, drug use and so on. These still remain the exigent issues at large, unmitigated and widespread among the community. But there are other sinister themes at play too here. Issues of bullying, casteism, favouritism, isolation, relegation of passion, to name a few, lurk behind the dark screen of mental health issues. But these are an underestimated and inexhaustible source of the larger sense of despair and hopelessness. The search for the cure may be undertaken from the careful examination of the source itself.

So, what are the options we have to dispel these dark clouds looming perilously over the medical fraternity or any rigid pedagogy-bound institutions for that matter. A number of measures and structures have been suggested and enumerated which are yet to be set in motion. Importance and awareness of mental health issues, counselling and suitable guidance, decluttering of the medical curriculum, teaching better coping skills, to name a few, are some of the supportive and preventive strategies that come up in such discussions. The stigma of mental illness and resulting pariah-like treatment meted out to such people even more so amongst the medical professionals is proving too tall a barrier to mount. But even these comforting measures are far from being the all-encompassing and holistic panacea for the infirmities underlying this unnecessarily ‘glorified’ profession. Might we try inculcating some sense of art and philosophy, some ruse of drama and culture into these ‘doctor-making machinery’?

Teaching the art of acceptance and kindness, application of empathy and generosity might be singularly helpful where all others have failed. Synchronising humanities with medical sciences might not only be a tool for recovery and healing from the rigours of the occupational hazards but also for scything across the differences that separates one man from another, one doctor from another. It might be just the soothing balm we require for sadness, isolation and frenzy that is tripping this selfless profession. It’s quite true that this profound understanding of compassion and cohesion through learnings of Humanities may make our endurance much more bearable.

(Dr. Rai is a psychiatrist in AIIMS, Rishikesh and Dr. Banerjee is a consultant geriatric psychiatrist in Kolkata; views are personal and have no bearing on the authors’ institutes or employers; Names have been changed for anonymity)

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Printable version | Oct 21, 2021 7:21:20 PM |

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