Deciding to be a physician when I was in fourth grade was a natural choice. I loved science and animals. The natural world was my playground. I remember getting my acceptance letter from Baylor College of Medicine and thinking, I can realize my dream of being a small town doctor.

I entered medicine school with a sense of mission, a sense of humor, and a sense of optimism.

Four years later I graduated wondering if I would be a Good Doctor, apprehensive and saddened by the suicides of two medical student friends.

I completed a residency in family medicine, well trained to be a country doctor – but  also scarred by all the experiences:  being pimped (a term of art for a specific kind of bullying)[1] by attending physicians, seeing death up close, and being trained to have The Answer.

In a random sample of recent college graduates, those headed to medical school are happier than the average. Four years later many of them have moved into depression. In one meta-analysis, published in the Journal of the American Medical Association, “the overall prevalence of depression or depressive symptoms among medical students was 27.2%, and the overall prevalence of suicidal ideation was 11.1%. Among medical students who screened positive for depression, (only) 15.7% sought psychiatric treatment.”

I believe those percentages are low.

Throughout my career, I became involved in nearly every aspect of medical care – office family medicine; emergency medicine at a ski resort; turnaround implementer in a failing occupational medicine clinic; a medical device startup; the Federal government as both political appointee and career Fed in two different Departments; a medical communications company; and a medical insurance quality organization. Everywhere, I saw the consequences (we physicians might call them sequelae) of the missing parts and overwhelming pressures of the standard education of physicians.