Doctors, too, can be plagued by thoughts of suicide


Dr. Carey Barber

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Published: Friday, November 15, 2013 at 6:01 a.m.
Last Modified: Thursday, November 14, 2013 at 9:01 p.m.

Dr. Carey Barber left three letters in the RV he drove out west from Florida.

In the first letter, he apologized profusely to whoever would find him.

The second, to the police, explained that his death was a suicide.

The third was to Barber's parents, to whom he apologized profusely. His life-long battle with depression, he wrote, had nothing to do with them.

Barber had been a beloved physician in the community medicine program at the UF Health Shands Hospital. Some close colleagues knew Barber suffered from depression and noted in the months leading up to Barber's resignation — almost two years before he died on Dec. 7, 2012, at age 48 — that he was increasingly withdrawn. But no one suspected he would actually end his life.

An estimated 400 physicians commit suicide in the U.S. each year, and physicians are at a significantly higher risk of dying from suicide than the general population, according to Medscape, a web resource for health professionals. Suicide is also the only cause of death in which the risk is higher for physicians than other causes of death.

Barber's mother, Carolyn Barber, said her son likely suffered from depression his whole life. She said she is not sure if becoming a doctor amplified that.

"I think he was under a lot of pressure. And did that have anything to do with it? That I really couldn't tell you," said Carolyn Barber, a grief counselor by profession. "There's a myriad of things that contributed to it."

Carey's depression started early, she said.

"I know he was depressed right after he graduated high school and called me and talked about it," Barber continued. "Then he went in the Army, so I thought things were OK."

Always a brilliant student, Carey was a civil engineering major in college. He decided to go to medical school because he liked helping people, Barber said.

"He was one of those people … he was there," Barber said. "If people had problems, he'd help them."

That is echoed by Carey's former colleagues at Shands, who held a memorial tribute for him after his death at Wilmot Gardens, a memorial garden on campus, located behind UF Health Shands Medical Plaza.

"His mother didn't know how many people knew and loved him," said Dr. Shenary Cotter, who worked with Carey at Shands. "Carey deserved a legacy."

Cotter and colleagues started a scholarship in Carey's name for residents in family medicine who are committed to educating medical students about preventing depression and suicide among their colleagues.

Cotter and Carolyn Barber both said Carey's broken marriage contributed to his depression before he died. Cotter added, "His journey with the Florida Board of Medicine was a source of stress."

Because Barber had a longstanding history of treatment for mental health issues, he had to defend his right to retain a license against the board, Cotter explained, adding that the board has since changed its policies so that only physicians who have been hospitalized for mental illness have to report to the board.

Dr. Lisa Merlo, assistant professor of psychiatry and a licensed psychologist at UF, said the professionals' resource network (PRN) in Florida, of which she is research director, has various programs to ensure physicians are in good health, including mental health. The board still asks physicians about their mental health history but clears them of further inquiry as long as they are participating in a PRN program, Merlo said.

She added that there are several reasons for physician depression, starting with high rates of burnout.

"You are dealing with a high-stress career. Not all of your patients get better. On top of that, there's a lot of stress because many physicians are self-employed" and have the added stress of running a business, Merlo said.

"You add into that long work hours that often create tension in terms of work-life balance," she said.

At the same time, as a group, physicians tend to dismiss their own health and are less inclined to seek help than the general population, Merlo continued. That makes it important to target them early on — especially since the stress in a medical career starts as early as medical school.

Dr. Beverly Vidaurreta, the director of student counseling at the college of medicine, said she sees about a third of any given medical school class at some point.

Many come in because of performance anxiety and self-imposed pressure, Vidaurreta said.

"What I find is that you have very bright, intelligent young people who are encountering a very rigorous curriculum and they have very high standards for themselves. It's one thing to be at the top of your class in high school and college. It's another (in) a lecture hall with 135 people who are just as smart or smarter than you are."

Vidaurreta added that recent changes in medical school curricula at UF, such as making it a pass/fail system, might lessen burdens that can lead to depression.

Merlo echoed that, explaining that the revamped curriculum is designed to make medical school a holistic, friendly environment.

That in turn, she said, could help churn out happier, healthier physicians at the outset of their careers.

And that's important not just for the doctors, but ultimately their patients, Merlo added.

"If you are responsible for the life of another person, you need to be at your best."

Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com.

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