The Fall of Icarus - Lessons from Physician Suicide by Dr. Gunderman

Kamia Rathore Each year, nearly 350 physicians and 150 medical students commit suicide -- these numbers point to a systemic problem in the way that mental health is perceived, monitored and treated in the health community. Dr. Richard Gunderman, a faculty member at Indiana University’s School of Medicine, leads the way in addressing physician suicide prevention.

Gunderman’s current job title encompasses, quite frankly, a lot: he’s a Chancellor’s professor of Radiology, Pediatrics, Medical Education, Philosophy, Liberal Arts, Philanthropy, and Medical Humanities and Health Studies at IU. His multidisciplinary approach was evident in his discussion on physician suicide last Friday, titled The Fall of Icarus. Weaving mythology, history, and real-life cautionary tales, Gunderman told the story of a troubled young man attending his school who seemingly had everything in order.

Landscape with the Fall of Icarus long thought to be by Pieter Bruegel.

Foundational myths, Gunderman said, can serve as contemplations of the human psyche. The story of Icarus functions as a story of vulnerability-- unheeding of his father Daedalus’ warnings not to fly into the sun, Icarus plunges into the froth of the sea below as the pair make their escape from imprisonment. The allure of this story is clear from the subsequent works it has inspired, each bringing new aspects of Icarus’ tragedy to life. Bruegel the Elder’s Landscape of the Fall of Icarus depicts an idyllic coastal town whose townspeople are unmoved from the tedium of their lives to notice Icarus crashing to his death. Too often, Gunderman remarks, we insulate ourselves from asking this simple question: how attuned are we to the suffering of others?

“Icarus,” or so the troubled student was named, seemingly had everything under control. He was among the top of his class, consistently showed a willingness to help others and held a genuine passion for medicine. Yet, towards the end of his last year at medical school, he began to show signs of manic depression, developing severe insomnia and hyper-awareness coupled with a loss of interest in school work. The signs were there, but a diagnosis was not. Icarus’ peers and faculty were hesitant to reach out to help, in part because it was difficult to believe that the “golden boy” had reached a mental lowpoint and because of the culture surrounding higher education that left mental health trailing in terms of priorities. When help did eventually come, it was too late and too little, and Icarus took his life a few weeks after graduating and starting his residency.

In Icarus’ story, Gunderman sees an inherent irony in the failure of the healing community to make sure one of its own got the help he needed. Yet, it teaches a lesson that success does not insulate anyone from fragmentation. Academic accolades don’t demonstrate happiness or health; instead, our ability to respond to others suffering is related to our fragility. Rather than stand alone as fragmented individuals, Gunderman reminds us that we achieve stability from our interconnection not only as health professionals, but as human beings.

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