9 - Shame in Medicine: The Unwell Doctor
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Why does medical culture shame clinicians who experience mental illness?
This episode of The Nocturnous is sponsored by First Responders First. An initiative of Harvard TH Chan School of Public Health, Thrive Global, and Creative Artist Agency that takes a whole human approach to first responder and healthcare workforce well-being. Learn more at first-responders-first dot org. Support for the nocturneist comes from the California Medical Association.
At the Nocturnist, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
This episode of The Nocturnist covers some pretty difficult territory. We hear stories of mental illness, suicidal thoughts, and even suicidal actions. So I really encourage you to turn this off if you feel like you're not in a space to hear that kind of thing. And if you do listen, just make sure to take really good care of yourself before, during, and after listening. I also want to acknowledge that people can sometimes have really strong feelings about the language that we use to describe mental illness. And I wanna point out that all of the storytellers in this episode use their own language and their own words to describe their experience.
I am a second year medical student in Canada. I have both bipolar disorder and an O C D spectrum disorder called trichotillomania, which is a big word and it involves compulsive hair picking for those people who don't know. You can find a group for every I get denied category in medical school like being a woman in medicine, being queer in medicine, etc. etc. But there's no group for being chronically ill or mad in medicine.
But it can also be really hard because you can feel so alone in your experience and think you're the only one. I'm also really intentional and Calling it mental illness rather than some vague idea of mental health challenges. Because I've been really sick at times in my life. I think the rise of wellness culture in medicine actually makes my shame worse because it makes me feel like we're allowed to experience some kind of vague notion of burnout, maybe some depression and some general anxiety at some kind of subclinical level that apparently you can manage with just some meditation and yoga and whatnot. But we don't want to actually name what is really going on for a lot of people. There doesn't seem to be a place for a crazy person like me who needs medication before I can even consider doing things like meditation.
You're listening to the nocturneist Shame in Medicine The Lost Forest. I'm Emily Silverman. Today's episode is about shame and mental illness. And of all the episodes in the series, this was probably one of the most difficult to choose stories for, because the theme of mental illness just came up again and again and again. Sometimes the theme was explicit and other times it was more of a peripheral notion. But what seems clear is that these experiences are super common. So, what is it like to be a clinician struggling with mental illness? To what extent is shame related to mental illness a byproduct of the culture we inhabit? And what would it take for us to support ourselves and each other through these difficult seasons of life?
Now back to the story.
Anyways, here's the story I want to tell. During our psychiatry block, we've of course learned about bipolar disorder. And I'll never forget the feeling of utter horror and shame when a slide went up on the impact of bipolar disorder. And it listed how, on average, people with bipolar disorder have get ready. Twelve less years of healthy life, fourteen less years of working life, nine less years of just life. Two times the rate of employment problems and two times the rate of divorce or separation. I know the point of the slide was to emphasize to our class how bipolar disorder is a super serious illness and should be treated as such. And I think that's really important, but I also just felt so ashamed of maybe becoming one of those stats.
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Chapters
8 chapters
1
Why does medical culture shame clinicians who experience mental illness?
0:00–5:07
2
How does a medical student with bipolar disorder describe the impact of stigma on their training?
5:07–9:24
3
What does the psychiatry fellow reveal about feeling ashamed while seeking help for depression?
9:24–13:17
4
How did a neurologist‑psychiatrist’s personal loss shape their view of shame in medicine?
13:17–17:03
5
Why did a resident’s eating disorder and burnout lead to a crisis, and how was it addressed?
17:03–20:09
6
What lesson does the story of a radiologist father’s suicide teach about asking for help?
20:09–25:08
7
How can physicians create boundaries and practice self‑compassion to reduce shame?
25:08–28:29
8
What are the next steps for building a healthier medical culture after this series?
28:29–32:30