Dealing with depression: one physician’s story

By Cynthia Pegram

Published: June 21, 2008

Editor’s note: Around 2002, the medical community began addressing issues related to depression and suicide among physicians. The American Foundation for Suicide Prevention initiated a dialogue, which led to a consensus statement by the American Medical Association the following year. It cited statistics that indicate physicians experience depression at roughly the same rates as the general population, although women physicians had higher rates. The statement cited barriers to treatment, includ-ing the stigma. It recommends transforming professional attitudes and institutional policies to en-courage physicians to seek the help they need. In May, AFSP worked in association with other institutions to release “Struggling in Silence: Physician Depression and Suicide,” which aired on public television.
Here’s the story of a Lynchburg doctor, who agreed to talk about his bout with depression.

Depression slams you,” said Dr. Stuart Harris.

It comes unexpectedly and opens up a dark hole of despair you just fall into, the retired Lynchburg surgeon said.

“You don’t think you can communicate with anybody.”

Don’t let it linger.

“It’s just like appendicitis,” said Harris. “The sooner you see a good doctor, the better off you are.”

Years ago, depression in a physician was a problem only discussed privately lest it affect his medical practice or his patients’ faith in him.

Not any more.

Today, medical students learn early on that depression is a life-long risk for them as well as their future patients. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the premier accrediting organization, requires hospitals to have in place a system apart from the disciplinary committees to help doctors struggling with any kind of impairment.

And this spring, public television released a program developed in cooperation with the American Foundation for Suicide Prevention, “Struggling in Silence: Physician Depression and Suicide.”

Harris — a leader in state and local medical professional organizations, and recognized at every level of his career by his colleagues — went through an episode of depression in 1992 after losing a patient he cared a lot about.

“I’m a poor loser,” he said. “I had a lot of trouble handling when I lost.”

He went to the Menninger Clinic for treatment. And he’s not afraid to share that he’s overcome severe depression.

“I’ve been there,” he said. “It’s just as important to say you’ve been down as it is to say you’ve been up.”

Born in 1931, Harris grew up as a gifted student and athlete. His way of working off anxiety was by running and lifting weights. Later, he moved with honors from Virginia Episcopal School to the University of Virginia for his undergraduate years and, later, to medical school. His surgical residency was in the Boston area, followed by a tour of duty in the military. He came back to Lynchburg to practice in 1965.

His medical education about depression came as he went through psychiatric rotation training for medical students.

Yet when depression moved into his own life, his way of dealing with it didn’t help a lot.

He uses this analogy from his childhood.

“When I was a young boy, I saw this thing hanging in a tree. I saw some hornets buzzing around it. I took a brick and hit that with a brick. I got in a situation. One: I didn’t know what it was. Two: I couldn’t handle it,” he said.

“So I stormed in to take control, instead of doing the two things I should have done. One was to get somebody who knew what it was; that was the first solution.

“The second solution was to run like hell, which I did. By the time I got away from those hornets, I’d been stung six times. My face, my shoulders were all swollen; I could hardly see. I was put in bed by grandfather, and put on antihistamines and other medications.”

Harris had applied that lesson throughout his life and in his surgical practice. “I knew what cases I could handle and what cases I couldn’t handle. And I had great associates around me. This is a very good medical community here.”

The depression was as unexpected it was hard-hitting. Harris says he had always been a serious person, tense “and a perfectionist to a fault. But I was a happy guy.”

Although depression was overtaking him in much of his life, he said his surgical skills weren’t affected.

“When I was operating and when I ran — that was my escape.”

But he just couldn’t sleep. “Then I got so that to be by myself was almost unbearable.”

Two close friends, also colleagues, told him how concerned they were, that he needed some help.

“We were very close friends as physicians, and we competed in sporting activities, in tennis and squash for 30 years,” said Lynchburg orthopedic surgeon Dr. Paul Fitzgerald.

The three talked and the friendship among them meant they say to Harris that something “had to happen and happen right away,” said Fitzgerald.

“He couldn’t keep going on.”

Harris’ reaction?

“He addressed it like a surgeon would. He had a problem and needed to do something,” said Fitzgerald. His friends helped expedite his entry into Menninger.

But accepting the tough call was exactly that for Harris.

“I have a hard time leaving the ballgame,” he said. “I am a competitor. I have a hard time raising my hand and saying, ‘Time Out.’ ”

Yet he remembered “just like the hornets. I threw the rock, therefore, I have to solve the problem.”

He entered Menninger, then in Topeka, Kan., which had a professionals-in-crisis program. He and his wife, Marie, flew out to the clinic; they interviewed her as well as him.

“They had an excellent program,” said Marie Harris.

He stayed; she flew home. He asked her to let people know he was at the clinic, and she did.

Back home, Marie Harris found great supportfor her husband and herself. “My friends rallied around me.” In the flat Kansas landscape so different from home, Harris felt bleak, deserted and lost.

But he worked hard. He started by building a strong bond with his psychiatrist.

“I knew that I’d gotten myself in that hole, and I needed someone to get me out of it. And I knew this was the person to do it.”

Having been a surgeon, he knew “I had to trust my doctor — my doctor and the good Lord.”

Just as it takes a team to win a football game, “a person can’t get themselves well,” he said.

He built rapport with the other patients, and took his medications.

Harris knew when he had begun to heal.

“All of a sudden, I got up in the morning, and things looked good,” he said. “The sun was shining, and I felt like I could make it.”

It had taken three to four weeks. He went home. If stigma was present, he said, he didn’t feel it.

“The medical profession accepted the competence of the people who said I was all right,” Harris said. “I got tremendous support. I think all doctors understand depression, whether they can treat it or not.”
Fitzgerald said that Harris did not express concern about stigma.

“He was very upfront about it in public settings,” said Fitzgerald, and that opened up the door for others to address their own problems.

“It was quite remarkable. I was in great admiration.”

Harris resumed his practice, starting with office visits, and then assisting in surgery. When he realized everything was OK, “I went back into the ballgame.”

In all, he’d only been out of the office about six weeks.

Harris thinks the treatment he got at Menninger was crucial.

Looking back, he said, “I think if I had not been there … I would have introverted and shrunk away.”

Harris continued practicing until his retirement in 2004. It took awhile to acclimate to the slower pace, and he still doesn’t feel like he has quite enough to do.

But the Harrises, who have two children, are doing some traveling and spending time with their five grandchildren, whom Dr. Harris describes as “God’s gift to grandfathers and grandmothers.”

For more information, visit http://www.doctorswithdepression.org.