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A Personal Story of Loss by Suicide (Part 2 of 5) by Mukta Panda, MD

It was a busy week for me, packing up my office and balancing my physician duties with family time. My daughter and her husband were in Chattanooga visiting. That Sunday, they had a six-a.m. flight back to New York City, so I dropped them off at the airport and went to the office early.

I remember it was a crisp Sunday morning, November 15, 2015. I worked until about 9:30 a.m. and decided that was enough—I would go home and enjoy the rest of my weekend. I walked out the sliding glass door toward the parking lot and saw a figure wearing a hoody and gloves, as if they’d gone for a long run and were sitting on the ground stretching forward to touch their toes. Nobody else was around. I stopped short and yelled out, “Hello, are you okay? Hello?” No movement. I rushed back into my office and called security, “I need some help out there.” I walked back out to the sliding glass door and still saw no movement. I waited. The police car drove up and I began to approach them outside. They signaled to me to wait, saying “There’s blood all around.” I went slowly around the side of the policemen who were gathered around the body. By this time the Emergency Medical Services Ambulance had arrived. I just knew in my gut it was my friend. The EMTs started cardiopulmonary resuscitation immediately, and he was rushed to the emergency room.

As I watched, I understood the grim prognosis. I was being asked a lot of questions by the hospital administrator on call and the police. I shared what I knew. Truly, I was in a state of shock and not sure what I needed to do. I tried calling the dean but he didn’t answer. Then I called the chief financial analyst. “It’s Dr. ___. I hope he has not hurt himself.” Those were my words, because we just didn’t know. I couldn’t help thinking that he had tried to hurt himself.

I recognized another colleague’s car in the same parking lot, which hadn’t been there when I arrived. I called her. “Did you see anything when you came to work?” She said “No,” so we knew it had happened in the last thirty minutes.

Thoughts flashed through my head. What if I had come outside earlier? What if, what if, what if… I just couldn’t think anymore so I got into my car and went home. I knew the best thing I could do was to leave the scene and try to unpack in my mind what had happened. At home I told my parents. I was dumbstruck. I couldn’t tell anybody else because of the police investigation. That evening the hospital CEO called with a few questions. There wasn’t much to say.

What Ifs

When a tragic death happens like this, we want to know why. Like anyone, I looked for answers. Being in the middle generation, I see a constant battle between Baby Boomers and Millennials. Vocation is everything to the Boomers—they are the breadwinners, hard workers, devoted to their jobs. Younger physicians want quick results and are more efficient with technology. They value their recreation and time with their families. Each generation has so much to teach the other. My colleague and friend, the good physician, was invited to join a hospital practice with very young dermatologists and a four-day work week. He was being asked to fit into a mold—not right or wrong—but one he couldn’t align with. To me, it seemed he was holding that tension in a way that was agitating him. He wasn’t sure where he belonged anymore. He couldn’t keep doing what he knew so well, and he felt like he didn’t have the tools or the courage to try something new.

I asked myself, Should I have had a different conversation with him that day? Was I too busy with my own frustrations, with the change in the direction of the organization’s leadership, my decision to step down as chair? Was my lens already biased? When he came to see me that day, what did I miss so I don’t miss it in others?

While I don’t have guilt, I went through all the phases of asking “What could I have done more or differently?” and “How can I make sure this never happens again?” I felt anger, asking “Why did we let this happen?” It was not why did I let this happen, but more why did we.

I say this with humility: I never took the blame solely on my shoulders. In part, that’s because I already felt so tainted by the toxic work environment, with its constant focus on volume, speed, and productivity over quality, humanity, and building relationships.

But also—and this is important—it’s a point of self-care to know you can’t be solely responsible for a system.

On Monday back at work, I heard many different sides of the story and that he had left a note. I heard he had made arrangements for pending payments.

Two things happened after that.

A conversation with a colleague on Monday made me angry. It started with sympathy but quickly turned into dismissiveness. “Mukta, I’m really sorry. I heard what happened.”

I was already livid with grief, “I know, but we should have done something.”

“I heard he had some problems.”

That made me even more livid.

“No,” I said. “You know, he came to me recently. He told me he needed to keep working.” I shared the many varied reasons my friend, the good physician, had mentioned, the main ones being his passion for his vocation and teaching, his love and care for his patients, and his thirst for lifelong learning.

“Well, I always been told the other shoe can drop at any time,” my colleague said. “You have to have reserves.”

“Not everyone has that option,” I replied, getting more upset. “We spend eight hours of our day working here. We have to look at ourselves and ask ourselves what we could have done. We have to take care of each other, support each other.”

“I look for that support outside the hospital,” he said.

“Again, not everybody has that luxury.” I didn’t want to talk anymore. To me, his reaction seemed callous.

He looked at me and said, “Obviously you’re upset about it. I hope you take as much time as you want. If you need help, just let us know.” I was getting even more furious by this point.

I took a deep breath then and shifted into gratitude. I looked up to the heavens and said to myself, “It’s no coincidence—I don’t believe in coincidences, only confirmations.” On that very day, it so happened that I was flying to Chicago for a symposium on physician well-being hosted by the Accreditation Council for Graduate Medical Education (ACGME). I would ponder this tragedy there.

[To be continued…]

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