It’s the first Monday Night Rides of the season, and the lineups to sign waivers is long. I’m talking to a friend I’ve not seen in far too long, when another bike friend taps my shoulder. We work together in the clinic, and because he does the building maintenance, and I am obsessive about being ready before patients arrive, we often have 7 AM chats before the day gets going. He looks somber.
“Did you hear about the news downstairs?”
I shake my head. “Downstairs” is the emergency room.
He pulls me aside, lowers his voice.
“Dr. X was found dead last night. That’s all I know.”
What?
My eyes widen, I am sure my voice was a squeaky squawk. Dr. X was young, early sixties, fit, active and healthy. Foul play? Sudden cardiac arrest?
“I dunno. Like I said, that’s all I heard.”
I roll into clinic this morning, and pump my colleagues for information.
Suicide.
Method uncertain, but no doubt it was swift, clean, and definitive. Doctors are good at that sort of stuff. We all planned our own methods in residency, probably. My method was going to be potassium chloride via IV or a giant dose of opiate.
Residency was…not the greatest for nurturing mental health.
This is a small town. Our medical community is even smaller. When another colleague died of a brain tumour two years ago, a hole was left in the fabric of this tightly woven mesh.
The hole has just gotten bigger. Bigger and ragged-edged.
A patient comes in today about a tremor.
“I’m sure it’s just anxiety or stress or hypochondriasis.” he says. “But the thing is, after I turned fifty, I started seeing friends die. Ignoring symptoms, missing cancers, that sort of thing. I don’t want that to be me.”
He does not, I reassure him, have Parkinson’s, because I know that is what he is quietly worried about. Reading between the lines is not written in to the job description, but at its core, is what my job is about. It’s arguably what all social interaction is about.
Watchful waiting, I advise, and I give him my office number to come back if things evolve. He has my personal number from before, because sometimes, in a town this size, the lines between social and professional are very, very blurred.
When I first moved here nearly a decade ago, I was startled by the demographic. I no longer needed the extra large cuff for blood pressure measurement. I no longer saw as many strokes, or illness related to lifestyle factors. People here are picture perfect models of health and vitality.
A friend of mine here recently went away to visit family, and after leaving our little bubble, she texted me from an airport lounge that we were all elite fitness models, whether we realized it or not.
With this fitness and activity, there is an emphasis on youth; maintaining it, renewing it. There are ninety year-olds still skiing the mountain, and many of my elderly patients regularly doing laps around me on the cross country ski course or passing me on a ride. What’s that they say? Pain is just weakness leaving the body.
So illness, mental or physical, is carefully wrapped up and hidden away. Last night, a conversation was had with a thirty-something friend who is due for a hip replacement. She had hit a low over the winter, and the only reason people suspected something was up was because there were no social media posts of her launching jumps on her snowboard all winter. No fricking way she’d have said anything. But she’s triumphed over other demons in her life thus far, and I expect she will be just fine. I hope.
Is she medicated? Who knows. I suspect a lot of people are. Half my medical school class was.
But Dr. X? I guess you never really know. One can look cheerful and energetic and good good good, but then plunge deep down into deep holes that no one can pull you up from, even those close to you who are in the know.
Physician, heal thyself. Or at the very least, each other.
I only wish we could have.