A “blue-ribbon” panel of physicians, including psychiatrists, at the University of Arkansas for Medical Sciences is developing a proactive system to identify signs of stress or mental disturbance in doctors and other medical personnel.
The suicide of Arkansas Children’s Hospital’s renowned pediatric heart surgeon Dr. Jonathan Drummond-Webb triggered the call for a new system. Drummond-Webb’s death followed other recent tragedies at the hospital: In August 2004, medical student Robert Howard killed his wife, Dr. Robin Mitchell, before leaping to his death from a UAMS dormitory, and clinical research chief for surgery Bonny Wallace was shot to death by a former tenant.
Dr. Drummond-Webb’s colleagues may be the first to benefit from the new approach that Medical School Dean Dr. E. Albert Reece wants to take, one he describes as a “brotherly-sisterly approach. We are all our brothers’ and sisters’ keepers.” Personnel who believe they are seeing signs of depression or mental disturbance in a colleague will be urged to speak to their department chairs or others in charge, anonymously. “Don’t just wait for him to stand up and say, ‘I need help.’ ”
Reece said that since Drummond-Webb’s death he has spent several hours with the surgeon’s co-workers, who he said were “overstressed,” and suffering from grief. Children’s own support program is offering its services, and Reece said he’d made personal calls to doctors himself “to offer support. … My sense is that there will be some takers.”
Dr. Rick Smith, chairman of psychiatry at UAMS, and Associate Dean Dr. Jan Shorey are heading up the panel, which Reece has charged with raising awareness at UAMS of what programs are in place to help students and employees. Reece has also instructed the group to “come up with ways by which we can make available services to faculty who usually require more creative programs,” he said, since doctors are “not as easily drawn out as the students.” The service will be offered 24 hours a day, every day, and should include acute care.
Psychiatrist Smith said “inappropriate” licensing and credentialing rules imposed by the state medical board and hospitals may keep some doctors from getting help. The “misinformed policy,” as he called it, requires doctors to report yearly if they’ve sought counseling for emotional (of substance abuse) problems.
“The issue of stigma is especially tough with physicians,” Smith said. The Arkansas Psychiatry Association taken issue with the requirement, reasoning that a doctor who’s getting help for his problems is a far better practitioner than one who’s not.
Drummond-Webb, who was widely celebrated for his surgical skills and was the subject of an ABC television special, killed himself by ingesting bourbon and the painkiller oxycodone just after midnight Dec. 26. He blocked the door to his upstairs study with a couch and left a suicide note that attacked co-workers at Children’s and the Cleveland Clinic, where he worked before coming to Arkansas.
Drummond-Webb’s wife, Lorraine DeBlanche, told police that her husband had attempted suicide in September. But Reece said that, to his knowledge, only DeBlanche knew of the September attempt. Drummond-Webb kept up his surgery schedule between September and his last day at Children’s, Reece said. Drummond-Webb’s celebratory sending home of a child he’d kept alive with an artificial heart during the wait for a donor heart was featured in a newspaper article a week before he took his life.
Would Reece’s new intervention program, which he hopes would teach people how to distinguish between casual talk and real signals of disturbance, have helped Drummond-Webb? He does not believe so. He said no one at Children’s has told him they suspected he was depressed. Drummond-Webb had discussed future plans with famed heart surgeon Dr. Michael DeBakey, who visited with Drummond-Webb in December. Instead, Reece said, he was “pumped up, so zestful, very ambitious … he didn’t give off the sense of depression.”
But in an interview with the Times last year, Drummond-Webb told a reporter that he’d considered “blowing his head off” when he’d learned the previous year he had cancer and expressed fear he didn’t have enough life insurance.
Such casual talk should be reported, Smith said. “Most people don’t talk about death or their death … multiple times, even in an offhand sort of way” unless there is an underlying problem.
Mood disorders are highly treatable, Smith added.