Occupational Stress: Doctors Suffer When Unable To Save Lives

Occupational Stress: Doctors Suffer When Unable To Save Lives

Posted on Thursday, November 29th, 2012 at 1:03 pm by Life Matters Media

Physicians who treat the terminally ill may suffer from emotional stress when unable to save patients’ lives. Burnout and compassion fatigue are two serious forms of occupational stress physicians may suffer, according to research by Michael Kearney, M.D.

Kearney, a palliative care physician at Santa Barbara Cottage Hospital in California, describes burnout as “the end stage of stresses between the individual and the work environment.” Compassion fatigue is “secondary post-traumatic stress disorder, or vicarious traumatization — trauma suffered when someone close to you is suffering.”

Health care journalist Jane Brody addresses the stress and anxiety oncologists struggle with in a new article for The New York Times. Brody writes, “A doctor with compassion fatigue may avoid thoughts and feelings associated with a patient’s misery, become irritable and easily angered, and face physical and emotional distress when reminded of work with the dying.” Compassion fatigue may lead to burnout.

Up to 60 percent of practicing physicians report symptoms of burnout.

According to Brody: “Patients and families may not realize it, but doctors who care for people with incurable illness, and especially the terminally ill, often suffer with their patients. Unable to cope with their own feelings of frustration, failure and helplessness, doctors may react with anger, abruptness and avoidance.”

Physician suicide linked to occupational stress

According to Crystal Phend, senior staff writer for MedPage Today, ”Suicide among physicians appears to follow a different profile than in the general population, with a greater role played by job stress and mental health problems.”

Phend cites a study by Katherine J. Gold, M.D., of the University of Michigan in Ann Arbor, who found that problems with work were three times more likely to have contributed to a physician’s suicide than a nonphysician’s. Mental illness was also 34 percent more common before a suicide among physicians.

Up to 60 percent of practicing physicians report symptoms of burnout

“The results of this study paint a picture of the typical physician suicide victim that is substantially different from that of the nonphysician suicide victim in several important ways,” Gold wrote for General Hospital Psychiatry. ”Inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians.”

Although physicians have more access to health care, they may be reluctant to seek help. ”I think stigma about mental health is a huge part of the story. There is a belief that physicians should be able to avoid depression or just ‘get over it’ by themselves,” Gold wrote.

More than 200 of the 31,636 suicide victims reported in the National Violent Death Reporting System from 2003 to 2008 were physicians.

Meditation may help physicians

A 2008 study published by the Journal of Palliative Medicine, in which researchers studied 18 oncologists, found that physicians who viewed their work with patients as both biomedical and psychosocial found end of life more satisfying than those with a more biomedical perspective.

“Physicians, who viewed their physician role as encompassing both biomedical and psychosocial aspects of care, reported a clear method of communication about end of life care, and an ability to positively influence patient and family coping with and acceptance of the dying process,” the researchers concluded.

“In contrast, participants who described primarily a biomedical role reported a more distant relationship with the patient, a sense of failure at not being able to alter the course of the disease, and an absence of collegial support.”

Kearney recommends “mindfulness meditation,” a Buddhist-influenced practice for physicians suffering from stress. “The doctor is able to recognize he’s being stressed, and it prevents him from invoking the survival defense mechanisms of fight (‘Let’s do another course of chemotherapy’), flight (‘There’s nothing more I can do for you — I’ll go get the chaplain’) and freeze (the doctor goes blank and does nothing).” He claims that even 8-10 minutes a day of “mindfulness meditation” can help.


Some Doctors Still Believe In Psychedelic Drugs

Posted on Thursday, August 30th, 2012 at 6:00 am by Life Matters Media

Psychedelic drugs could prove beneficial to terminally ill patients suffering from anxiety and depression. The New York Times’ Lauren Slater outlines researchers’ optimism that such drugs can allay fears of death and dying. Psychedelics are undoubtedly controversial. The stain of the 1960s experimental phase remains with many American physicians, but some believe the drugs can help.

It’s been fifty years since many doctors became enamored with the drugs, known for causing hallucinations and vivid sensory experiences. The use of such psychedelics as LSD was skyrocketing. Slater writes how “psychedelics were embraced by many and used in a host of controversial studies, most famously the psilocybin project run by Timothy Leary.” President Richard Nixon called Leary “the most dangerous man in America.”

Researchers like Charles Grob, psychiatrist at Harbor-U.C.L.A. Medical Center, believe that drugs should be reconsidered as treatment options. Grob believes that a mystery remains surrounding drugs’ effectiveness against anxiety. “I don’t really have altogether a definitive answer as to why the drug eases the fear of death, but we do know that from time immemorial individuals who have transformative spiritual experiences come to a very different view of themselves and the world around them and thus are able to handle their own deaths differently.”

Psychedelic researcher Oliver Sacks recounts his own tumultuous relationship with the drugs for The New Yorker, describing his abuse of LSD and morning-glory seeds- and their inherent appeal.

Image: Flickr, SantaRosa OLD SKOOL

Image: Flickr, SantaRosa OLD SKOOL

He writes: “Many of us find Wordsworthian ‘intimations of immortality’ in nature, art, creative thinking, or religion; some people can reach transcendent states through meditation or similar trance-inducing techniques, or through prayer and spiritual exercises. But drugs offer a shortcut; they promise transcendence on demand. These shortcuts are possible because certain chemicals can directly stimulate complex brain functions.”

The transcendence would eventually help 55 year-old Pam Sakuda with her cancer diagnosis. “Shortly after having a tumor removed from her colon, she heard the doctor’s dreaded words: Stage 4; metastatic. Sakuda was given 6 to 14 months to live. Determined to slow her disease’s insidious course, she ran several miles every day, even during her grueling treatment regimens. By nature upbeat, articulate and dignified, Sakuda — who died in November 2006, outlasting everyone’s expectations by living for four years — was alarmed when anxiety and depression came to claim her after she passed the 14-month mark, her days darkening as she grew closer to her biological demise,” writes Leary.

She would take treatment from Grob. “As her fears intensified, Sakuda learned of a study being conducted by Charles Grob. . . who was administering psilocybin — an active component of magic mushrooms — to end-stage cancer patients to see if it could reduce their fear of death.”

Sakuda is quoted as saying, “I started to cry. . . . Everything was concentrated and came welling up and then . . . it started to dissipate, and I started to look at it differently. . . . I began to realize that all of this negative fear and guilt was such a hindrance . . . to making the most of and enjoying the healthy time that I’m having,” after the drugs.

“We may seek, too, a relaxing of inhibitions that makes it easier to bond with each other, or transports that make our consciousness of time and mortality easier to bear,” writes Sacks. Sakuda may have experienced her mortality in a different way, which was unique to her.

Researcher David Nutt, professor of neuropsychopharmacology at Imperial College London, told The Guardian: “Psychedelics change the brain in, perhaps, the most profound way of any drug, at least in terms of understanding consciousness and connectivity. Therefore we should be doing a lot more of this research.”

Learn more about psychedelics at NPR