First Do No Harm

My father, James Michael Twombley, MD, (a.k.a., Mike) inspired me to follow him into medicine. Unfortunately, his death by suicide on August 17, 2011, sent me reeling.

I have spent the decade-plus since searching for answers that are undoubtedly impossible to find. As a physician myself, I wondered what I might have missed that led my dad to that last act of despair. Had there been signs? What could I have done to intervene? And to address the bigger picture, I asked myself, Why are doctors "burning out," suffering in silence, and taking their own lives? Am I, too, at risk of taking my life like my father did? As physicians, and as a society, is there anything we can do to reverse this trend?

After years of not having definitive answers about my father's mental health or his decision to end his life, I decided that the best way to honor his memory was to do whatever I could to educate others on the rarely discussed truths about physician mental health and suicide. After exploring the topic, I've now decided to share my findings in this book. I wrote this book for those considering the field of medicine, enrolled in medical school, practicing medicine, loving someone in the medical field, or seeking to better understand physician mental health (including suicide) or help someone who may be struggling; this may be a psychologist/therapist, healthcare leader, or colleague of physicians.

In First Do No Harm: A Physician's Burnout and Mental Health Survival Guide from Medical School to Retirement, I'll share parts of my father's life to highlight potential events that contributed to his death. Additionally, for those of you who are medical providers, I will make recommendations to help you safeguard your mental and physical health as you practice. Finally, I'll offer insights for those who love someone working in the medical field, so you can look for potential warning signs.

As you read, you may see yourself in some of these situations or recognize traits of someone you know or love. Or you may be reading this because you're entering medical school or considering a role in medicine, and you want to know the ins and outs of protecting your mental health before it becomes a crisis. My hope is that any connections you make to the book's content will help you seek guidance or assist others in finding healing.

-Katherine E. Twombley, M.D.

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