Everyone (except maybe those closest to him) was shocked by the recent suicide of Robin Williams. A great comedian and actor, it was shocking that someone who had so much felt so bad that life was not worth living.

A friend and fellow resident committed suicide in his last year of residency. I still, 32 years later, vividly remember the last time I saw him alive. I still wonder if there was some comfort or support I could have offered him to prevent what happened days later.

But there is little discussion in the press about the estimated more than 400 physician suicides a year.

Are we not great performers?

Do we not (at least to others) have so much to live for?

Can we afford to continue losing an entire medical school of physicians every year? It is possible this is even under-reported, as physicians sign the death certificates, and may be reluctant for many reasons to list the true cause of death.

What is the problem? There are so many! The loss of autonomy, malpractice, licensing issues seem to lead the list of stresses, which contribute to that depression. We feel that they are driven by mental illness, and could have gotten help, but the barriers are there.

What are the obstacles to seeking help? Reputation, social standing, pride, loss of confidentiality, all represent barriers. Seeking help from colleagues who work in the same community may not work well, because they, too, recognize all the barriers to necessary treatment.

Physicians impaired by mental illness, drug or substance abuse may go unrecognized for all the same reasons.

Let’s talk. No, really talk. Help is available.

In Pennsylvania, you can call the Physicians’ Health Programs. If you prefer total anonymity, call the national suicide prevention hotline: 1-800-273-8255 or website.

Are you wondering if you can go on? You have so much going for you. Your family, your friends, your patients and your colleagues will wonder for decades if there was something they could have done.

If you are depressed and considering suicide, get help. If you know of or are treating a colleague – it is serious, but we respond well to treatment.

Do you have a colleague or friend who you lost or saved? Share your stories.