Stop Physician Suicide Part 2: Reaching out to suicidal physician colleague (CME)

Posted by Dike Drummond MD

POPPodcastTEXTSimplePreventing Physician Suicide Part 2:

Reaching out to a suicidal physician colleague

[ Part 1 - The First-Person Experience of Suicidal Ideation - is here ]
[ Part 3 - Coaching a suicidal physician client - is here ]

Unfortunately, we cannot stop all physician suicides for two simple reasons.

  • Doctors are too good at hiding their struggle and distress. Our "never show weakness" programming is so very strong.

  • We know the anatomy and physiology, so doctors are very good at themselves.

What we can do is reach out to any of our colleagues who appear to be struggling.  

In this post you will learn:

~ How to recognize the signs and symptoms of burnout and suicidal ideation

~ A proven method to reach out to that friend/colleague, simply and effectively 

The end result is lives will be saved that would be lost without your caring and outreach.

Do you need help and support right now?
Connect with one of our physician coaches 
In a Free Discovery Sessionphysician coach for physician burnout

Watch or listen as Pam Pappas MD and Penelope Hsu MD - two of our coaches at share these life saving tools.

Resources Below:

~ WATCH the Podcast Video or  LISTEN to the Podcast Audio
~ SUBSCRIBE TO THE P.O.P. PODCAST on your favorite podcast service
~ READ the Full Transcript
~ Grab 1 AMA PRA Category 1 CME Credit via the CME.fy system

This is Episode #74 of our Physicians On Purpose [ POP ] Podcast - with 24,408 downloads to date. 


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POP Podcast #74: Reaching out to a colleague in distress
The signs of burnout and an effective outreach conversation - remember to take your HAT off!
The CME experience for this Video Lesson is powered by CMEfy
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Suicide and Crisis Resources:
Physician Support Line 888-409-0141
988 National Suicide and Crisis Lifeline. DIAL 988 or on the web at 

Connect with Dr. Hsu:Penny-Hsu-MD-physician-burnout-coach-the-happy-md-physician-coaching-Original-bio-head-shot_opt200W

Connect with Dr. Pappas:Pam-Pappas-physician-coach-opt300W



Physician’s On Purpose Podcast
Pam Pappas MD and Penelope Hsu MD 

Preventing Physician Suicide Part 1: Reaching out to a colleague in distress.

Dike Drummond 00:35

Hello again, Dr. Dike Drummond here at the home of in beautiful Seattle, Washington with the latest physicians on purpose podcast. This is part two of our three-part series on recognizing and preventing physician suicide.

In Part One, my colleagues Dr. Pam Pappas and Dr. Penelope Hsu, both shared their personal story of times when they had gone through an episode of suicidal ideation very briefly, honestly, thoroughly, wonderfully. So go listen to part one, if you haven't heard it already, Dr. Pappas and Dr. Hsu, are both coaches here at TheHappyMD and experienced clinicians in their own right.

And today, what we're going to do in Part Two, is talk about what might you do if you are suspicious of or recognize that one of your colleagues is struggling in a way that you are suspicious that they might be having suicidal ideation as well. The other thing we're going to talk about today is hey, if you're feeling suicidal, how might you reach out for help? And what barriers including impostor syndrome and other things might get in the way?

So I can take the lead, but I don't want to who wants to go first?


Penny Hsu 02:04

Well, I will say, I've been thinking about this, since our last conversation along the lines of like, what would have helped me, you know, what would have been a lifeline that I would have reached out to back then? Then I think, Pam, you mentioned this on our last call of in terms of like, you have so much shame and confusion and all of that, like you don't, at least for me, at that time, I didn't really want to reach out to anybody, you know, I wasn't like, hey, hey, can I tell him what was going on? You know, suicidal, wasn't something that I was like, Well, I can't wait to share this with anybody. So I was thinking, like, what would have gotten me to open up.

And I think it's something that we, you know, say all the time to our clients which is, yeah, if you have a hint of anything, being off, reach out often and reach out consistently and reach out, you know, genuinely. And I think for me, if I were on the outside looking at me, the only thing that I think anybody would have been able to pick up on was that I started to socially isolate myself further and further from people.

When I started residency, you know, like, we all ate lunch together in the cafeteria. And you know, what I'm, you know, you want to get coffee, and I'll go go get hot coffee with the you know, and I was a little bit more social. But then as the dark clouds kind of came in, I stopped eating lunch with everybody, I actually would eat lunch in the call room, because during the day, no one's in the call room. So I'd eat by myself in the call room. And then at night, even if we had time to go to sleep, I wouldn't sleep, I would like wander around, or I would because my dreams were in LA, I would actually call la because midnight in LA is 3am here. So in the middle of my night, I could still call somebody's find someone who was awake. So I'd be hanging out in like a nurse's station somewhere like on the phone by myself just talking to my friends like crying. And just like not wanting to sleep, and so whereas earlier, I would try to go to sleep, and I would try to get some rest.

So I think that was just sort of me detaching from everyone and hiding as much as I could like any free time I had, I'd run to the call room because no one would be there. And I could just be by myself. So I think if anyone noticed that, and I don't know that anyone would write because we're all so busy. But if anyone did notice that and did sort of ask like, where do you go for lunch? Like, you know, what, what are you doing all night? You know, why aren't you sleeping? Maybe that would have prompted me to say something.

So I think you know, as far as us giving quote unquote advise or insight to people who are going to reach out I think that's one of the signs that you can look for is are they just sort of sight socially isolated, get you know, saying they're too busy or they're too tired to go to the happy hour after work or whatever, and use that as a red flag to say Hey, why are you too busy?

What what is going on?

You know, I haven't had lunch with you in two or three months what's going on with that?

And like Dike, you always say like, just kind of keep asking right, just don't give up. If they say, Oh, nothing, I just just, you know, I'm just going through a thing, like just kind of keep showing up.

And I think, I think if anyone had done that, for me if I really felt like someone genuinely cared why I wasn't eating lunch with everyone again, I think if I felt that they genuinely cared consistently, maybe two or three times of asking, I feel like I may have said something, you know, but we'll never know.


Dike Drummond 05:23

What would it have felt like to have somebody reach out just from the standpoint of, wow, somebody cares, as opposed to I got caught, or some some other emotion?


Penny Hsu 05:35

right? Yeah, no, that's a great point. That's a great point. Like just thinking about it when just when you said, like, what would it it felt like to have somebody care? Like, I'm getting choked up? You know, this happened like 20 years ago, like, if anybody cared. I think this is what would have happened, I would have just like falling apart. Even if someone quote, unquote, caught me, you know, and then kind of prompted with the, why are you doing this? Like, why are you hanging out in the nurse's station all night? I think even that would have maybe, again, who knows, you know, at least triggered something along the lines of like, well, this is why I'm doing it. Yeah.

But it's interesting, that concept of someone caring is still so radical to me, even now, all these years later that I'm like (crying sounds).


Pam Pappas 06:24

I love it. I really feel that, as you're describing it, like, like, right in my chest, in my belly, I feel that. And it makes me want to say, you know, backup ... some time before, the suicidal thoughts, or impulses in long hours of depression started to be the black cloud, you know, because certainly, I experienced that, and just underscoring the importance of some kind of cohesive community, even if if it's not every single member of your residency program, because you're going to have some people that are just off ,outliers, whatever that they are, but having a nucleus of at least one or two, that, you know, when they show up, they mean well.

And so this is before you even dream that you might need them. Just assume, you know, we're going to need each other at some time. And we're going to be work comrades, or companions, through what is a terrifying ordeal, which is, you know, certainly medical school in varying kinds of that when you're in residency. And everything that you mentioned, Penny, it goes along with somebody feeling extreme shame, which is rampant in medicine, medical practice, and certainly medical training.

You think of being on rounds, and somebody whipping out the New England Journal, and why didn't you read this article, and you're going, Oh, God, I'm so unworthy. That that's just, you know, like, like, a tiny example. But it's rampant.

But the natural impulse when feeling ashamed is just what you did the isolation. And so having somebody notice, hey, Penny's behaviors change, she's changing, like she's there at three o'clock in the morning at the nurse's station, what's, what's the deal, of course, I have to be awake at that hour to notice that you are doing that you are doing that. So if I am as oblivious as some of my classmates were, as you pointed out, I would know it.

But it's really interesting. There's an interpersonal psychological theory of suicide. And it says that there are three necessary and sufficient factors that underlie suicidality.

And one of them is when the person feels like they are a burden to others. You know, I was mentioning in our last thing about feeling like a waste of skin on the planet. Well, that would be a poetic way of saying it, like, you know, why, why am I even here? Why am I taking that thing, but the idea that, that you're a liability, it's a kind of self-loathing, and expression for sure.

The second one that they said is called warranted belongingness. And why? Well, because, as humans, you know, we are mammals. And so we're herd animals and we seek to belong or be cared for be accepted, that that's just in kind of our biological makeup. And so we do a lot of stuff that we do in order to Need, what we think is going to help us belong. But if what we're doing all the time is not working and we're being rebuffed, or we're being ignored or, or the whole place is as cold as an iceberg, then that's criteria two.

Now, the third one is that they have the acquired capability, or suicide, like creating a plan, like Penny, you in the bridge, the thoughts about that, me for months, piling up, tricyclic antidepressants. I was getting all the extra ones out of the closet, and swirling those away. For the time when I knew that I was going to need to do it. I didn't know exactly when at the at that point. But that's dangerous. So those three, when you're probably not going to hear about the third one until it's super, you know, oh, my god crisis that oh, by the way, yes, I've been collecting fentanyl or I've been getting my gun and making sure I have ammunition and you know, time off to go to the woods and shoot myself because people plan stuff out like that.


Dike Drummond 11:17

Well, and one of the concerns I always hear when people discuss that is that you didn't want the fact that you killed yourself to be a burden, right. So I'm going to jump off the bridge and make sure I wash out far enough that nobody finds me or something like that, or I'm going to make sure that the house is clean before I lay down on my freshly made bed and take all of my tricyclics. And I'll wear a diaper just in case or whatever, right? That burden is there thwarted belonging, there's a herd available. And I'd really like to be a part. But somehow, either because of my internal block or external box, I'm not able to join or something like that,


Pam Pappas 11:55

We build up stories inside us about what people's behavior or facial expressions means or does not mean. And that may be close to what is actually meant. Or it may be miles away from that could be just somebody just as tired and bedraggled and laid out as we are, and they didn't respond to your signal at the time, and you interpreted that is meaning Okay, there it is. I'm a burden, I'm worthless. It's not like trying to create drama, but it's really how it how it impacts way down deep inside our system. So I guess I'm all for doing whatever we can to build up group culture of kindness and compassion, clear sightedness, before we ever think somebody's going to need it, because we know we are. That's just all there is to it.


Penny Hsu 12:53

I was just gonna say I feel like I did some research on this more during pandemic times when everyone was stressed out. But the idea of and I think this is in the military, where you get a buddy, you get assigned a buddy, when you start basic training or something like that. And you know, the whole point of the buddy is to kind of do those check ins on a regular basis, so that it's not somebody who has to be up at 3am to notice that you're not in the in the call room with them. But it's like your buddy, and you're supposed to meet whatever it is every week or every two weeks. And it can be a five or 10 minute thing just to kind of do that, like, how are you? Are you sleeping? You know, did you eat lunch with anyone? You know, that kind of a thing?

And I think that, you know, as you're talking about how do you create community, that might be an interesting thing to try to roll out somewhere. You know, when you start intern year, you just get paired up with a buddy, whether it's another intern or second year or third, I don't I don't really know. But something to kind of foster that community because I feel like and I think we talked about this last time. Medical School is super competitive residency, super competitive, too. And so there are some people that I think will love that idea of community.

And then there's others who are going to be gunners and like I don't, I don't want to be nice to anyone, you know what I mean? I'm going to take the most admissions and make everybody look bad, you know, so, but maybe if we like, kind of nurture, like you said, a culture of this is the way we operate, and we want people to have buddies and we want to foster community, even mentioning these terms that I've never heard before but I think are brilliant. When you're starting training. Look out for these things. You know, if you're feeling this way, if you're feeling like you're not belonging, reach out to the school psychologist or your residency program director or something.


Dike Drummond 14:39

Well, and let me go back to the beginning of these discussion, too. I have faith that we can't prevent all suicides. And the reason is doctors are too good at hiding their distress because of our never show weakness programming. And we're really good at killing ourselves. So some of the most inventive suicides you'll ever see. Will be physicians killing themselves. And I've talked to a whole bunch of different people in the wake of a suicide. And I believe them when they say, look, there was no warning. So I think that it's difficult to prevent them.

But what we can do is reach out we as colleagues, as allies as compatriots, as tribe members, as heard members can reach out to the people in our universe where we see signs that they're in distress. Let's talk about four of them.

The three signs of burnout and the withdrawal that Penny described so eloquently, right, changing behavior, somebody who was gregarious and social, all of a sudden, you open the door, and there she is in the call room in the afternoon or something like that, right.

So signs of burnout, exhaustion, physical and emotional exhaustion, that does not respond to rest. The inner voice is always something along the lines of “I'm not sure how much longer I can keep going like this’.

Symptom, number two, cynical sarcastic, compassion, fatigue, telling jokes, or having to vent about your patients or your coworkers before you go back to work.

Number three, what's the use, I'm not serving a purpose, I'm not making a difference. I don't know why I'm here, I'm just taking up space.

And if you've got somebody who's exhausted, cynical and sarcastic, what's the use, and you see them change in the fact that they're less, they have less happiness, they're sad, or their heads down, they're grinding their way through the week they're withdrawing that person. I personally believe that if you know somebody like that, and if you're listening right now, I know, you know, at least one person that you're concerned about when I described this, please write their names down, please write down the name of everybody you're concerned about right now. And let's give you a protocol, a very simple protocol to reach out to them.

And the key is reach out. I can't imagine an outreach coming from your heart being a negative towards the person you're reaching out to. Now, they might yell at you. And I'll show you one of the ways that they do it because of their programming, but it's not going to hurt them in the long run, because your intentions are solid.

So here's the protocol that I've been teaching for 13 years.

Now. If you're going to reach out to somebody, make sure that nobody can see you or hear you. This needs to be totally in private. You don't even want a glass that people can see through in their see you're talking to this person, you want it to be invisible and inaudible.

You want to ask permission. “Hey, Chuck, you got a minute?”

Chuck looks at me. Like I just walked off on Mars and says, “Sure What's up dike?”

Here's the first thing you got to do. All of us carry rank. We're colleagues, we're doctors, all that kind of stuff. So I say take your rank off. And it goes like this …

Put your hand on your head, and take your hat off whatever that hat is. So in my case, I'll just say I'm a doctor. But if you're a medical director, CEO, CMO, anything like that, you're going to want to state your rank, but you put your hand on your head in your and mime that you're taking a hat off with a great big movement, “Chuck, well first of all, I'm taking my doctor hat off now”.

And I'm taking my hand if you're listening, I've got my hand on my head and I'm miming taking a hat off. “First of all, I'm taking my doctor hat off now. I've been watching you, brother. I care about you. And I'm concerned. How are you doing?”

Now? We all know what Chuck's gonna say. Just like that. What's he gonna say?

“I'm fine.” He might even go so far as saying, “What do you mean? Oh, wait a minute. I'm fine. What the hell? Why are you asking me that question? Go check? Cheryl. She looks like trash today. Yeah.”

And regardless of how vigorous this person may come back at you, and if they're a man, and you're a man, and you're not good friends, it's probably going to be this way. Is that them? Or is that their program? Is that their never show weakness program. It's almost certainly their programming.

So I want you to go into this, this outreach, expecting vigorous denial, and it's the programming, it's not anything to do with you, and you did not make a mistake. Don't go away from that interaction, say, “Oh, I shouldn't have said anything”. That's not true.

As long as you're concerned about this person, my recommendation is you go back every week or two and do exactly the same thing. “Hey, Chuck, I'm taking my hat off again”. He goes, “Ah, get out of here.” Are you with me? Still his programming.

And what I'm going to tell you is you can't tell when you've saved somebody's life. There isn't a green light that goes on. There's no scoreboard that flashes another point, right. But if you're reaching out regularly to someone whose behavior has changed, and that you're concerned about and you're saying, Hey, I'm noticing I care, are you okay? Even if they refuse you? Every other week for a year, you may have saved their life.

Because what's the signal? If you're coming at this clean from your heart, what's the signal you're sending?

You're sending a number of things right here

I'm awake.

I’m concerned.

I care.

I'm a safe place.

If you said, Yeah, I'm having trouble. You know what, I'm right here. Are you with me? Now, you might get somebody to open up right away. If you're a woman, they're a woman and your friends, because there's a lot of gender and cultural barriers that are eliminated right there, right? So I'm imagining Penny says, if I even think about somebody reaching out to me, tears come up. Imagine different people reaching out to you and asking your reactions would probably be a little different, depending on who it was, right?

But our job is to notice our friends, hopefully, their friends, to notice our colleagues to notice behavior change to notice head down, cynical, sarcastic. And to reach out, we can only take responsibility for reaching out, because we can't stop all suicides. And I think that is something that ideally would be taught in medical school, rather than here now. But please write down your list and reach out to everybody who's on it. So that's what I say.


Pam Pappas 21:08

You know, what pops in my head, listening to both Penny and you Dike is the TV program years ago Tour of Duty. And Terrence Knox was like the platoon leader, and they were in Vietnam. And they use the buddy system. Just like what you were talking about Penny, everybody had their as they're going to the jungles and you know, they're going to be snipers or, well, they didn't call them electronic explosive devices that that she'd step on, or you fall into things that were pointed in, right with pillory you. So there's the, you know, the buddy system from that standpoint, but then also Terrence Knox I mean, he was rough and tough and hard to bluff, you know, he wore the headband, and he looked like, God hell on earth, if somebody was going to be opposing him, but he was dead eye on point at all times. And yet, when he got back to the camp, he was a heart-of-gold guy. And he would one by one go to anybody that looked like that, they were not with it, or that they were having trouble. And he had, I don't know, just just like Spidey sense, or who might need it. So there's rough and tough and hard to bluff tattooed guy that would scare you could be so soft and gentle. And true. I think that's why I keep watching the reruns.


Dike Drummond 22:45

Well, and I think that, there's no penalty to reach out. But there's no penalty to this conversation. So the other thing I'll say is, trust your instincts, trust the hair on the back of your neck. If you've got if you're suspicious in any way, the default setting is reach out and ask how they're doing.

Why would you not reach out and ask how buddy's doing now, depending on your program, so if you reached out to me as an intern, Oh, my I was, I was so deep in my testosterone storm, I definitely would have brushed you back for that. But I know for a fact that every year, I had periods of time, where I said, I can't go, I can't go another step further. I said “I've got to quit” every year of my career. I felt that way at one point in time in the course of the year. But there wasn't any way that my machismo would let me break through that crust. And I really didn't have anything to fall back on the tape in my head was always “but I don't know how to do anything else”. Are you with me?

And let's just let's just say one more phrase, because I've been talking about Little Voice phrases, right? The catchphrase of imposter syndrome. And you'll recognize it is? “What if they find out?”

So these are all things that will potentially keep you from asking for your own help.

Now, let me ask you this. I know that if I remember your stories correctly, neither one of you reached out for help and got help. And that was a part of what pulled you back. If you were going to reach out and look for help. Or as somebody what would that conversation have looked like? How could I read? How could I recognize an outreach from somebody in distress? I think you would have started crying or something like that Penny, right. Probably yeah.


Penny Hsu 24:31

Yeah, I mean, I you know, as it's funny how, like, I had blocked out this whole bridge episode of my life, honestly for like, over a decade, and it only resurfaced when I started giving speeches as a coach. But anyway, the more I think about it, and I and I will say and I will give my program director a lot of credit because we had had a conversation prior to me even starting intern year that I was already like, not feeling it and I wanted to quit so he would periodically you know, have little quote unquote meeting was with me, I think maybe quarterly or something like that. And he would ask, how are you doing? How are you doing? How are you doing? And you know, I remember my answers. Were always like, Oh, I'm okay. I'm okay. I'm okay. And I didn't ever break down and cry.

But I feel like, I don't know. Like, it's hard to sort of, it's hard to crack that shell of shame imposter syndrome. It's even to kick me out of the program. If I say something now, you know, what is everyone else going to think about it. And I do think that that consistency message that you're delivering Dike is so important. Like, maybe if I had just kept, you know, having those meetings with him more frequently, or something, maybe I would have eventually kind of cracked.

But ultimately, after the bridge moment, the very next day, I went into his office, and I was like, we got to talk. And I never told him about the bridge. But I had just said, I've had it, I've reached my navy or whatever, like I've tried, and I'm out. You know, he was very kind about it. You know, he wasn't like, what's wrong with you? Are you sure you want to do that? You know, he was just very, very kind. But I never told him. I never told him. So I don't know. Like, I honestly, that question has stumped me, like, what would I have done? Is there anything I would have done? And I don't know, what about you, Pam?


Pam Pappas 26:17

Well, I was putting myself in that position. And I think I probably would have felt caught. Like, you know, Dike was saying, Well, are you catching them? Or are you kind of seeing them, and they were when they wanted to be seen. And because I had made such efforts to keep that a secret. That part of me a secret and compartmentalize you know, squirreled away. And I, I think I was one of the recalcitrant ones. And I still do not know what I would have done, had my friends not been there that night that I went, and they did answer the door, you know, and God knows it was 1030. At night, they should have been in bed themselves. But they were watching some show or something. So I think divine providence was protected, but I might have been one of the ones lost, that's what I think,


Dike Drummond 27:17

I'm noticing there's a difference. The outcome is the same, a connection, that that brings somebody back. But there's a difference between how I feel contemplating being the one who reaches out, as opposed to how I would feel if somebody asked for help.

So what I would what I would ask is that, imagine you're being asked for help and exactly how you would respond to one of your colleagues, ask for help. And take that energy and put it into your effort at outreach. That makes sense. Not to assume that it's going to be successful, but take that same I can, all I can imagine is a big hug, I wouldn't let you go. Okay, so that's like, imagine that hug imagine that outreach, imagine that, Oh, of course, come on in here, you want something to eat? You know, I would, I would obviously, make something to eat as well, right? So take that engulfing, protective, loving energy and put it into your outreach, be ready to be rebuffed. But think about using some of that proactively going out and doing it.

I think given all the barriers, the shame, the guilt, the feelings of failure, the the what if they find out barriers that are there, it's hard to imagine somebody who would reach out and ask for help and reveal what they're going through unless they happen to be a very good friend of yours already.


Pam Pappas 28:38

Well, you know, I've often I've often heard the same words that are spoken from the heart can't reach the heart, even if the programming makes you want to fight against it. But you still you still it's soaked in a bit and you go, that's the tears that I'm starting to feel it, you know, the camomile tea or whatever. It's something and, and you can even if you don't speak at that time, you hold on to that feeling. And then maybe the next time it'll be a little less invasive feeling. And you'll be able to say, well, you know, I'm yeah, I've been feeling like shit lately. You know, this. And then if there's time and space and, and privacy. I loved what you said about that to make sure that it is private in all the ways that a person might feel safe to speak the unspeakable.


Penny Hsu 29:39

I do like that imagery of, you know, this is like one of the basic self-compassion tenants, right? Like, what would you do if a friend did come to you with those feelings? What would you say or do and then direct it back towards you? And they kind of planting the idea that that's what's waiting for you on the other side, right. If you do reach out, that's what's going to meet you there. I'm gonna cry again.

You're not gonna, you're not gonna get rebuffed, you know, like, no one's gonna laugh at you, they're gonna be there. You just have to say something, you know, because people do love you, of course, right? When you're lost. When you're lost in that much shame and pain, you think like, nobody's gonna notice that I'm gone. Nobody's gonna care. You know, I'm a burden, why? Why would I ever reach out, but hopefully, if you can hold stem out through all that darkness that like, the love that you would give is right there for you. Right? The care that you would give anybody else is right there. You just got to, like, just make the you know, it's like at like, you just got to touch.

You don't have to do a lot, right. I don't think you have to sort of be like, Well, I'm contemplating suicide, and I've been stashing all the TCAS. You know, like, I don't think you need to kind of go into any of that. I think it just needs to say like, um, I am not well, I am in a dark place. And, you know, and I think, whether it is a colleague or an advisor or a friend, or you know, anybody I think if anyone hears those words like, Hey, I'm not doing well, and I'm in a dark place. I think that would trigger, as you said, early our herd compassion, like, come here. Let me give you a hug. Let me let me, you know, cook you something. Yeah, in trauma.


Pam Pappas 31:20

Look, that's the way it is. That's the way it leaves. Right. That's the way it go in because you have all of us have a natural capacity for this to move on through. Yeah. If we keep breathing


Dike Drummond 31:35

Well, and the experience of saying I'm not okay, and noticing and being witness to the fact that the world does not collapse. At that point in time. There's no siren, no whistle, you're not putting a padded jacket and hauled off. They don't take away your diploma, you know, nothing bad happens. But you get his support. Ideally, that's the step. That's, that's a step that brings you back to realize that the things that you fear the most, like if I admitted it's all over that that's actually not true.

Okay, we need to wrap a bow on this for time’s sake. Any last things you'd like to say for this particular episode, realizing we're going to do episode number three next time, which is about how do you respond to these things, when you're in a coaching relationship? And this comes through in your client? What else would you like to do or say you're asked to be complete for today?


Pam Pappas 32:26

I'm just taking a deep breath and letting it move through. Because it's kind of stirred me up a little bit, too.


Dike Drummond 32:33

Well, thank you so much, both of you for being so open, honest, truthful and transparent on behalf of our listeners in the podcast, and the people out there that hopefully will take this information and go make a difference in their tribe in their people. Penny.


Penny Hsu 32:47

Yeah, no, I appreciate that. Taking a deep breath, I really just want to say that we're coaches and whatever. So maybe we feel more comfortable talking about this stuff. But everybody feels this way, right? And I really want to send that message out. Like, again, it's okay, if you have these thoughts. It's okay, if you do get upset. We're here like, so many people are around that do care. I wish I just want to knock down the shame wall. I really do. And hopefully, the more we talk about it, and I'm gonna cry again, next time, I'm sure you know, hopefully, my own shame wall will come down.

And my hope is that people listening and watching can understand and maybe try to knock away a little bit of their own shame wall or the shame wall that, you know, one of their colleagues might be hiding behind.


Pam Pappas 33:33

But I've got to say one other thing with that, because the shame wall, the shame the thing that is an antidote to shame, is the self compassion you were talking about for sure. But then telling your story and safe places, I underscore the safe place and that if we can become a safe place for each other, not necessarily as a coach, right as a human being, then that's, that's going to contain this stuff, an antidote, because then if we're the safe place that people feel safe to tell their story in somehow the shame starts to ebb away. I've experienced it a million times myself.


Dike Drummond 34:20

That's when you're brought into the herd. You've excluded yourself, right? But now you've brought yourself back into the tribe or the herd. Awesome.

Great stuff. So Dr. Pam Pappas, Dr. Penelope Hsu, Dr. Dike Drummond here on the physicians on purpose podcast, that's part two of our three part series on suicide. We'll see on number three, please make the list. Please reach out to your people. Take your hat off. Let them know you love them. See what happens. You never know when you're saving a life and we can't prevent all suicides, but you certainly can reach out to everybody you're concerned about. So go for it.

And until we see on the next podcast, keep breathing. Have a great rest of your day.





Who are you worried about right now? (make a list if you need to)
When will you reach out to them?
When you reached out to a colleague in the past, how did it go?
What worked and what didn't?







Tags: stop physician burnout, physician suicide, physicians on purpose podcast