May is Mental Health Awareness Month — and Medicine Still Has Work to Do
Mental health stigma has existed for most of recorded history. While that stigma is slowly starting to lift in broader society, medicine remains stubbornly behind. Physicians and physicians-in-training still face very real fears: fear of retaliation, fear of losing privileges, fear of being seen as unfit to practice — all for simply asking for help. So most don’t. And even those who do often can’t access the support they actually need.
We have lost too many physicians to suicide. One is too many. And unfortunately, we are well beyond counting.
Every one of those individuals endured everything you have endured to earn the right to practice medicine. We share a particular kind of formation — always focused on the next milestone, terrified of a single misstep that might close the door ahead of us. We are hard on ourselves, and the system is hard on us too. Overachievers. Perfectionists. The ones who scored a 99 and wanted to know why it wasn’t 100.
That culture didn’t start with us, and it doesn’t end with us — it is passed down, generation after generation. Yes, there are duty hour restrictions now. Yes, attendings are perhaps somewhat less overtly malignant than they once were. But we still can’t call in sick without consequence. We still reschedule our own medical appointments — again and again — because patient care comes first. Until it doesn’t. Until it’s cancer. Until it’s an overdose. Until it’s suicide.
We hold wellness seminars. We talk about burnout prevention and self-prioritization strategies. And then we return to a system that makes those things nearly impossible to actually practice. I believe this tension is particularly acute in the United States — though I’ll stop short of making that a formal claim.
We need to do better.
We need peer-to-peer support resources that exist outside of our practice environments — places physicians can go without fear that what they share will follow them professionally. The Emotional PPE Project is a powerful example of what this can look like: free, peer support for healthcare workers, built by clinicians who understand what we carry.
We also need real, accessible, no-cost support when things go wrong with patients. Adverse outcomes, unexpected deaths, near-misses — these leave marks that don’t resolve on their own, and the culture of medicine rarely makes space for that.
I want to work with the ASA to build something meaningful for our members in this space. More to come — but in the meantime, I’d love to hear from you. What do you need? What has helped? What hasn’t?
We are not meant to carry this alone.
Christina Menor, MD, MS, FASA
President, California Society of Anesthesiologists
ASA Delegate | North Hollywood, CA