Like many doctors I lead mostly an internal life.  I've often thought about why this is so.  The recent suicide of a friend and colleague seems to really have affected me emotionally.  Ted was a gracious, soft-spoken man, very tenderhearted, but he was also very private, at least with me.  His son Gavin had been killed in a car "accident" in December of 2009, and I didn't meet Ted for the first time until around February of 2011.  I wasn't in a great emotional state myself at the time after being "fired" from my job as an ER physician for reasons I still can't figure out (ok, I wasn't "fired" but my contract was not renewed...the same thing) and going through my own emotional turmoil, and Ted was the only person who really seemed to believe in my abilities as a physician and give me a chance by hiring me.  Now it has been over 4 years since then and still working at the same place with no real problems with my clinical care, and Ted was my boss for most of that time.  Ted was scaling back his shifts so I think he was somewhat thankful when I joined on full-time, and whenever we would see his name on the schedule a lot of the time there he would have found someone else to work for him. However, we'd always see him on Wednesdays when the hospital administration would have all their meetings and he would always be there like clockwork.  I never really knew Ted before his son's death, but I am told he was never the same after that happened.

According to those who knew him and the newspaper reports, Ted's son Gavin was going to lunch with a friend from school and as a lot of irresponsible kids do, this 17 year old made the immature decision to drag race down a highway with another kid and lost control of the car and it flipped, and Gavin was killed instantly.  His parents were quite understandably devastated.  The driver of the other car was charged with involuntarily manslaughter which he was convicted of.  Ted, his father, was quoted on the news at the trial of the other driver who was convicted of this and said, "Mere words cannot convey what my heart and my family are feeling.  Our lives are shattered.  It is now seven months since Gavin's death, and we can see very little joy or hope in life".  It was a unfortunately a sign of what was to come and I will always wonder whether I was one of the many who was so wrapped up in my personal issues that I didn't offer my hand or heart in support.  The internal pain of that event is something I can't even imagine.  I'm not really sure if the trial and conviction of the other kid gave him any sense of closure or just added to the tragedy...

We doctors don't really hang out together, and I'm not really sure exactly why, but I have some theories.  In just a logical sense, we live very far apart and commute to work, and very few of us live locally.  We have kids and homes and other responsibilities.  There aren't that many of us to get together, and none of us takes the initiative to plan anything.  If I have a day off, chances are the others are working.  We come from many different stages in life, some younger, some older, as well as many different cultural and ethnic backgrounds.  Personally I've become somewhat of a loner.  I used to socialize with other physicians in residency, especially when there would be free dinners sponsored by pharmaceutical companies, but those mostly went by the wayside when the government deemed most of it illegal.  Now those dinners are rare, and if I did go I probably wouldn't know anyone.  There's a certain social akwardness in me I can't seem to figure out.  I used to be a very social person before I went to med school.  I was a hopeless optimist, people seemed to want to be with me, then I went to med school.  I was exposed to situations that I never dreamed of and was humiliated at times during my residency training.  I internally humiliated myself more during that time.   It was difficult to explain that to other people.  I knew I still wanted to be a doctor and couldn't imagine myself doing anything else, but I became my own biggest enemy, never wanting to let others see me sweat.  It was for good reason too, because I think the stress of my divorce was a primary factor in me being fired from my job.  The ER was so busy too that I didn't have time for personal problems.  On to the next patient...lucky to have time to eat or pee let alone cry or be vulnerable,  which was for the weak.  I did try to socialize some.  In trying to have a dating relationship it seemed like men were shy or uncomfortable about what I did for a living, and I certainly didn't fit in with the doctor wives since most all of my ER doctor colleagues are men.   What are we gonna talk about anyway?  Work?  Sports?  So I started staying home.  The nurses were my friends, but for some reason I didn't really hang out with them either.  It's partly my fault.  I should have initiated something to get together, having to get past the weird hierarchy that doctors and nurses shouldn't associate with each other, which I always thought was bullshit since my best friend is a nurse.

I either knew first hand that some of my colleagues and friends were drinking a lot, but I didn't really have the courage to bring it up.  That would be weakness to admit such a thing, and to the state medical board it might mean putting one's medical license in jeopardy, even if they never showed up for work intoxicated or it never affected their work.  It becomes very taboo to bring up any kind of substance abuse or depression to anyone else.  We are taught to be the strong resilient ones after all.  If you don't feel well or don't know something it's always better to fake it.  After all, isn't medicine "show business for ugly people"?  Sometimes people who aren't doctors don't understand that quote, but we doctors do.  So far I have not become an alcoholic and this might be considered a miracle, but suffice it to say I do have other forms of coping with stress that aren't particularly healthy for me either.  I have perfected my acting role even in the midst of extreme chaos and death when I have 10 other patients to take care of, a few of whom may be very sick or just plain impatient or ignorant, and I manage to put on a smile in the midst of the obscenities flying my way because it took way too long because I was tending to a dying person and failed to save them.  To be able to take a moment to go outside, lean against a wall and cry?  Really, I'm too busy for that... I hope that Ted hadn't fallen into that endless cycle of despair with grieving in his own life, both personally and professionally.    I have recently had first-hand experience with the disease of addiction.  I was so naive before.  Not any more.  I worry about others I know and I don't know what to say.  I know for some people after drinking a lot they really aren't thinking straight.  As a healer I should know how to bring up the subject but I don't and I've often said hurtful things to those I love dealing with addiction just out of anger and frustration.

I remember the stress of my divorce which in many ways seemed like a death to me.  My conflicts with my ex went on for years regarding the kids as he became a complete stranger.   He left me mainly because my lifestyle as a physician wasn't conducive to "normal family life".  I felt guilty for crying at home about it if the kids were around and tried not to do it.  I got some counseling, but it didn't really seem to help, as I often viewed the therapist as just about as messed up as I was (particularly since I had been married to one).  I didn't know how to help myself either, since being a doctor in the ER and working crazy hours was all I'd ever known or felt comfortable in my element doing.  Then  I was named in a medical malpractice lawsuit with 6 others that my only fault was just being there.  This ridiculous thing went on for four years.  I was advised not to talk about it with anyone due to federal privacy issues, and I kept my frustration inside.  It was right before trial when the plaintiff's attorney mysteriously withdrew from the case.  There was no apology for the undue unnecessary stress it caused me.  Just a dismissal from my attorney with a lot of unanswered questions.  Life goes on,..I'm told it is just one of the many irritations one must put up with for being a doctor.  This reinforces the fact that I must act compassionate and be nice to patients and their families even if I don't feel like it and they don't deserve it just because it is a major factor in whether I get sued again.  People are under the impression that doctors are sued for mistakes.  This is so not the case.  I  had also gotten into financial trouble with the IRS who wasn't particularly sympathetic to my issues since I don't live in poverty (but then when is the IRS sympathetic to anyone?).  It was mainly due to coincidentally getting divorced during a recession and owning real estate, which in retrospect I could have done things differently but how was I to know?  I'm in a way glad for these experiences which have humbled me, but I also feel a sense of exhaustion about it.  I still must go to work and deal with a failing medical system where I am merely a provider and get less and less respect from everyone, work harder, and see our government getting involved in an already broken system and making it worse, all the while not asking any of us doctors what we think.  I often envied those who weren't doctors.  At least they had a chance of enjoying their lives, as I spend so many holidays and weekends in my self-imposed prison of work-a-holism and "making the big bucks" wondering if something was inherently wrong with me.  I don't really think I have ever contemplated suicide, but after a couple glasses of wine my mind becomes foggy and tears are more likely to flow.  So I avoid the wine sometimes because it fogs up my contact lenses when I cry.  I went through all of these experiences at the same time.  Now it is mostly over.  Why don't I feel better now?  I'm constantly worrying about people and it sometimes consumes me.  Life is indeed precious and I'm reminded of this every day.  (By the way, telling a doctor " you make the big bucks" is  just another way of saying "suck it up chump").

I am mourning the loss of Ted.  I wish we all felt like we could talk to each other.  I can't even begin to imagine what his wife and son are feeling, and I feel emotionally inept about what I'd actually say to them.  There have been others who have committed suicide after becoming physicians too and this has affected me.  I hadn't seen Ted in over 7 months.  He decided to "retire" from being a doctor all together at the end of December last year and go into some heavy machinery business with a family member.  This baffled me because he was only 56.  His heart never really seemed to be in it anyway and he never seemed to want to work very much.  Then there was this mysterious worsening tremor he would have whenever he would come to work that resembled something totally preventable that I didn't even want to think about.  I wasn't really sure if it was the death of his son or not, but I suspect that was a major factor, but I didn't know him before that so I can't say for sure.    He seemed to drop off the face of the earth since December.  We were all busy working and going about our stressful lives, dealing with way to many patients, overworked doctors and nurses, patients having an attitude and being frustrated with our care and our rushing nature.  I should have called him to see how he was doing but I didn't.  Now he is gone and it is too late to say anything or express my concern.

I have a very understanding man in my life Shawn, who has been through his own personal turmoil and I thank God for bringing him into my life.  I am not the easiest person to live with...

Rest in peace Ted Westover.  You were sweet and kind to me.  You gave me a chance when no one else would.  I am eternally grateful to have known you.