Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the memories of split-second decisions often made by instinct; and they can endure the multitude of patients’ pain and suffering every day, day after day. Added to patient-related pressures are the pressures and politics of the House of Medicine, along with a constant drumbeat to train more physicians due to the worldwide shortage of physicians. Yet physicians are human beings who feel pain like everyone else ... More

Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the memories of split-second decisions often made by instinct; and they can endure the multitude of patients’ pain and suffering every day, day after day. Added to patient-related pressures are the pressures and politics of the House of Medicine, along with a constant drumbeat to train more physicians due to the worldwide shortage of physicians. Yet physicians are human beings who feel pain like everyone else. These demands, and the associated day-to-day challenges of physicianship, can take their toll on doctors, leading to mental health problems, reduced job satisfaction and productivity, and eventually lowered retention. Stress can lead to poor communication between doctors and their colleagues and between doctors and their patients. In the long run, for doctors to avoid harming patients, they must first do no self-harm. First Do No Self-Harm, edited by three medical and mental health educators, offers a clarion call for the improved medical and mental health of physicians across the education continuum by posing and answering five fundamental questions: (1) What are the sources of stress? (2) What are the stress-related consequences for those who work and seek treatment in the House of Medicine? (3) How do they cope with their stressful jobs? (4) What strategies can be used to promote resilience among physicians? (5) How can medical and mental health educators acquire the skills and wisdom to tackle the culture of stoicism and emotional silence in the House of Medicine that encourages physicians’ self-harm?