Bressler B
Suicide Life Threat Behav. 1976 Fall;6(3):169-78.
In the United States each year the equivalent of an average-size medical school graduating class commits suicide, with the highest incidence occurring in the decade following the completion of training. Of these suicides, 20% to 30% are associated with drug abuse and 40% with alcoholism. Various problem areas are considered. Role strain, leading to excessive drug use in an attempt to increase work efficiency, is coupled with a denial of the physician's own dependency needs and gratification. The problem of identity occurs in relation to the exaggerated sense of duty and obligation the physician feels in attending to the demands of the patients and their families. Medicine as magical thinking is also discussed, revealing the physician's belief in his own immunity, which is strenuously tested when he actually sets up in practice. The community's high regard for the physician further complicates the situation. Too little has been done about working with emotional problems of medical students during their training and after they begin to practice. Unfortunately, physicians feel uncomfortable in turning to colleagues for help; rather, they tend to isolate themselves, resorting to alcohol and drugs. One should question the selection of medical students and their overall training, not only in terms of academic learning but also with more consideration for the stresses and strains of the future career.
在美国，每年医学院平均规模的一个毕业班的人数相当于自杀的人数，自杀发生率最高的是在完成培训后的十年内。在这些自杀事件中，20%至30%与药物滥用有关，40%与酗酒有关。文中考虑了各种问题领域。角色紧张导致为提高工作效率而过度使用药物，同时医生否认自己的依赖需求和满足感。身份问题与医生在满足患者及其家属需求时所感受到的过度责任感和义务感有关。文中还讨论了医学作为神奇思维的情况，揭示了医生对自身免疫力的信念，而当他实际开始行医时，这种信念会受到严峻考验。社区对医生的高度尊重使情况更加复杂。在医学生培训期间以及他们开始行医后，在处理他们的情感问题方面做得太少。不幸的是，医生向同事求助时会感到不自在；相反，他们倾向于孤立自己，求助于酒精和药物。人们应该质疑医学生的选拔及其整体培训，不仅要考虑学术学习，还要更多地考虑未来职业的压力和紧张。
