You Died by Suicide

You died by suicide.

This morning I was rushed. I always feel rushed. I feel rushed by More.

In healthcare, More is this tangible thing like a fork or a spoon. It is creative, continually morphing into a new shape, disguising its true self when it is nothing more than a plague meant to turn physicians into machines, hoping to one day remove all of humanism from the incredibly delicate and difficult practice of medicine. Yesterday More was the number of patient visits being tracked. The day before this More took form as patient satisfaction scores. Last week More was the system reminding me of the hundreds of incomplete tasks that needed completion—if only there were thirty hours in the day I tell myself; if only I was a machine which never needed sleep. How dare of me to require such a thing.

More is the villain creating a sense of rush in all physicians, resembling a dementor, no empathy for humans, no sympathy for doctors, existing only as a dark shadow of greed moving through the world sucking the life out of all who cross its path. Its existence is to act exclusively at the benefit of its most trusted ally: Corporate Healthcare.

Corporate Healthcare is a system designed to make money at the expense of vulnerable individuals—like you. More’s ally, however, is less scary looking then itself. Resembling a human form, it is often found wearing a suit, tie, and fake grin. It is the ultimate gaslighter, manipulating society to believe its actions are motivated by kindness and altruism while physician's actions deemed to be driven by money and greed. This manipulation is accomplished by promoting deceptive agendas that only they benefit from. For example, some agendas aim to reduce the number of hospital staff despite the overflowing patients who often spill into hallways, requiring more work with less staff. Or agendas that cause perseveration over irrelevant data whereby any percentage less than one hundred means the physician has failed. Or the agenda to replace physicians with less trained individuals who are often cranked out by an education system that allows both 100 percent acceptance and pass rates to any who apply. All of which are nothing more than ineffective solutions meant to be a rouse to deflect the truth: More and its ally are the cause of our nation’s healthcare crisis. They disguise the word agenda behind words like budget cuts, decreasing healthcare costs, human-kindness, providers, the economy of scale, thrive, ACO’s. All mascaraed agendas and all real sources of poor patient outcomes and of the ever-rising cost of our very broken healthcare system.

They are responsible for your death.

I thoroughly dislike them both. This is especially true today.

Today started the same. 4:00 AM alarm goes off. The snooze button pushed. 4:10, the alarm goes off again. I tell myself, one more snooze. 4:20, the alarm goes off—already? I have to get up now. I get myself ready, allowing thirty minutes of quiet while all four of my babies sleep. I blink; it’s 4:50. I head to the hospital to round on the newborns who just came into the world, the irony this would later create, as this is where you and I first met. I quietly go from room to room apologizing to the parents for waking them up so early, explaining my being there was to examine their daughter or son and I needed to do so before my clinic started.

One baby, two babies, three babies, the last one. I blink. I had examined and confirmed all the newborns are healthy, and I head back home. It is now 6:40 AM and time to get lunches and backpacks ready. I blink again; it’s now 6:50. Kids are up and running around the house like mad-men. Sentences that reverberate between the walls seem to always be the same: Where is your homework? Mom, Kaeden took my water bottle. No, this is my water bottle. Kids, please be kind. Mom, I said I wanted the green bowl. Where is my library book? Those are not your socks; those are mine. Mom, Ryan took my socks.

I blink. It is 7 AM. Our nanny arrives. I spend a few minutes filling her in on the day’s activities. Kisses go around to all of my little nuggets. 7:10 and I am out the door.

The clinic seems quiet this morning. Usually filled with laughter, music, witty banter, but today there is none. I thought this was weird, but I am rushed, no time to ponder the change in atmosphere, I have hospital charting to complete from my early morning work before my first patient arrives otherwise More will creep into my day like a heavy fog rolling into the San Francisco Bay.

I blink, the quiet is because of you. “You died,” they said, “by suicide.” My medical staff repeats this over and over again, each time revealing a greater sense of worry with each time it is repeated, and with each time I fail to respond.

You died by suicide. This will be hard to hear.

Instantly, this warm, vibrant, alive person who I spent so much time with treating, healing, caring for is now laying, lifeless on a cold metal table surrounded by others, lifeless, laying on cold metal tables. You died by suicide. This is all I hear in my mind. You laying on the cold metal table is all I see in my mind. I can feel my insides panic, break, my heart now in the middle of my gut, feeling so heavy I succumb to gravity and it drops me to the ground. 7:28, my first patient has arrived. I blink. 7:34, my first patient is roomed and ready to go. I, however, am not. I am not prepared for today because twelve minutes ago I learned that you died by suicide and instead of laying comfortably in your warm bed where you should be, you are now laying on a cold metal table. I feel rushed. More is so unkind; it won’t even allow me the opportunity to release one of the millions of tears I wish to shed over you. Even the internal panic I have buried in my core which I hold on to so stoically feels rushed; even it is terrified of More.

I blink. I move through my morning like a great actor. I could be an actor. All physicians could be. I take a deep breath, enter each room, plaster a smile on my face and pretend that the hurt and pain inside me isn’t consuming me, praying it does not show because More would never allow it. More controls me, and I am a slave to it. I have to emotionally detach from you for the next eight minutes and will have to repeat this many times today. I feel rushed. Always rushed to see more, be more, smile more, treat someone’s pain more. There is still the need for more yet because More is not my friend, that more is never for me, the physician, always for someone else demanding it, financially gaining from it.

You died by suicide, but it was not your fault. There was a time when I would have blamed myself as your physician. I will not blame you. I will not blame me. More and its ally are to blame. When I begged the system to admit you because I feared for your safety, but they sent you home anyway—that was because of More, and it's ally. When I tried tirelessly, spending hours on the phone, missing family events, making other patients wait, to locate out-patient resources for you that ultimately were denied due to your inability to pay and rejected by an insurer who decided they knew more about your needs than me, this was because of More and it's ally.

Corporate healthcare is responsible for your death. You did not die by suicide; you died by Corporate Healthcare. I now hear this in my head. I will remain committed to working tirelessly for you, exposing those whose sole intention is to profit off of illness and the vulnerability of others. More and its ally are not your friends. I am, and I am a physician. I am your physician.

You died by Corporate Healthcare.

I am now home, where I am safe, away from More and its ally.

I am now free to release the millions of tears over the loss of you.