Save the Saviours: How to minimize sudden death among young doctors? Medical professionals are life saviors and work extremely hard to make the correct medical diagnosis and perform life-saving procedures. They often have hectic work hours which leave them little or no time for self-care and rejuvenation. As per the Indian Medical Association's (IMA) Kerala study, an Indian doctor's average lifespan is 55–59 years, which is almost 10 years less than that of the general population who can on average live up to 69–72 years. Save the Saviours: How to minimize sudden death among young doctors? Doctors, arguably, are some of the most intelligent and smart people on the planet. Having survived cutthroat competitions (NEET) and excelled, anyone would think they would be the most sensible souls. Especially when they have the knowledge to do so, wouldn't they take the best care of their own health and bodies to lead a long, fruitful, and disease-free life? However, when we retrospectively think about the life of a medical professional, we realize that we doctors are notoriously famous for neglecting our own advice. Doctors (dealing with life and death) have extremely disordered eating and sleeping schedules, as well as a higher-than-normal consumption of junk/unhealthy food. Smoking and drinking are no less common among medical professionals than it is among the general population. Good and sound sleep is also rare among busy medical professionals. The unending cups of tea and coffee to “remain alert” and the kachodi, vadapav, and samosa snacks which we have in operation theatres, in lieu of lunch also take their toll. Most of us would agree that a lot of our own colleagues have not had a health checkup in years. During the past few years, the sudden death of young doctors/medical professionals in India shocked the entire medical fraternity. Recently, the sudden demise of several young doctors due to massive myocardial infarction came as shocking sad news for medical colleagues. Similarly, few young, highly skilled and talented doctors succumbed before the age of 45 years. Sudden early deaths have frequently been reported among medical professionals during the past few years.[1-3] This indicates an alarming trend of the sudden death of doctors and is also closely associated with stress/burnout, a sedentary lifestyle, long working hours, and socio-economic factors. Sudden deaths among doctors One of the most important reasons is overwork, stress, lack of physical activity, and lack of regular health checkups. Young and middle-aged doctors are in a critical period of their family and professional career development. Not only do they hope to make breakthroughs in clinical services as well as academic research, but they also face pressure from patients and their families. The escalation of contradictions between doctors and patients has also become an increasing mental burden in the practice of many medical professionals. Sudden cardiac death, stress, and burnout Middle-aged doctors have heavy familial responsibilities, such as paying bank loans for medical/ophthalmic practice, supporting parents, rearing children, and making mortgage payments, which cause them to work harder (6 to 7 days in a week) without any breaks. Deteriorated working environment, serious violence against doctors, and decreased patient–physician trust also intensified the sense of “stress/burnout” in doctors. Male medical professionals, especially in a surgical specialty and operative care, have larger overloads and longer working hours, which may be the primary cause of sudden cardiac death due to heart attack. Besides, incorrect stress relief manners also affect doctors' heaths, such as excessive alcohol consumption, smoking, and long-term energy drink consumption. Lack of exercise and obesity also increase the risk of acute myocardial infarction and stroke. Cancer Cancer has figured prominently in the Indian Medical Association study as a causative agent for premature death among medical professionals.[4] However, a direct relationship between doctors' premature death and cancer needs to be examined more precisely through well-conducted studies. Theoretically, medical professionals are exposed to various occupational and environmental factors that may increase cancer risk. Doctors are a unique group of individuals who are routinely exposed to multiple carcinogens, such as ionizing radiation and various chemicals. Exposure to high doses of diagnostic and therapeutic ionizing radiation is known to increase the incidence of various cancers, like those of the thyroid and the ovary. The high incidence of differentiated thyroid cancers among doctors specialized in various disciplines of radiology is testimony to this. Even young residents in the specialty are reported to be associated with a higher incidence of cancers. Besides radiation and chemicals, the other factor known to cause cancer among doctors is stress itself. Stress caused by a heavy workload, burnout syndrome, compassion fatigue, and chronic sleep deprivation can cause cancer. Suicide In addition to cardiac ailments and cancer, suicide among Indian doctors is a concern and remain one of the important causes of sudden death among medical students/residents and young medical professionals. The medical profession is considered more stressful, but mental health is still a subject of taboo in the medical profession in the Indian context. Medical professionals have a higher suicide risk, 2.5 times more than the general population. Karoshi Death Deaths by overwork in Japan are so common that there's a unique word for it — Karoshi. According to one of the recently published news, a 26-year-old doctor in Japan took his own life after working more than 200 hours of overtime in a month. According to his family, he developed depression after not taking a day off in three months. COVID-19 vaccine and heart attack While the COVID-19 vaccines are saving lives, some side effects related to heart have been reported. According to a paper published in the open-access scientific journal MDPI, until now, more than 670 million people have suffered from COVID-19 worldwide, and roughly 7 million death cases were attributed to COVID-19.[4] The association of heart disease, especially myocarditis, with the COVID-19 vaccine is still being evaluated. There has been some evidence of this association especially in young people after the second dose of vaccine but that risk is overall small as compared to the potential benefits of vaccination. Lack of regular medical checkups Medical professionals usually neglect regular medical checkups themselves, which results in some potential diseases not being timely detected, such as diabetes, coronary artery disease, hypertension, hyperlipidemia, hyperuricemia, etc. How to save the saviors? Every effort should be made to promote a healthy work-life balance, especially for residents-in-training and female doctors/medical professionals. The important issues need to be addressed and the nobility of the profession must be restored where health care is not merely a commercial commodity and doctors aren't money-making machines. Their compassion and empathy need to be preserved and their grievances need to be taken into consideration. Medical professionals overlooking their health and ignoring the early warning symptoms is the other primary reason behind premature death. Having greater knowledge and a better understanding of mental and physical health issues, doctors must not undermine their own well-being for the sake of their profession or other things. They will do no good to their patients if they aren't taking adequate care of their own selves first. This is why the phrase heal thyself is used by doctors frequently.[5-7] The onus is on medical professionals/ophthalmologists to take responsibility for their own health. They must not be reluctant to seek advice from specialists among their colleagues and not attempt to treat themselves. Those known to be genetically prone to vascular disease must pay attention to addressing modifiable risk factors and effective lifestyle changes that could contribute to a catastrophe. Those known to have cancers running in families must subject themselves to stringent cancer screening programs. Medical professionals/ophthalmologists must function humanely, doing justice to the nobility of their profession, and not sidestepping their responsibilities and accountability toward patients. They must keep open the channel of unconditional communication founded on honesty, truth, and readiness to accept responsibility, for patients and their families. The health of the entire nation depends on medical professionals. But, to achieve that goal, first, we need to be healthy. As they say in an airplane safety briefing: We must first ensure to put on our own oxygen masks, before we help others. We suggest that each and every ophthalmologist/doctor should take responsibility for his/her own health. Medical professionals/ophthalmologists should regularly perform aerobic exercise or connect with families and friends for support, instead of excessive smoking and drinking. Besides, regular medical checkup (blood pressure, blood sugar, ECG, Echocardiography, etc.) is an effective approach to detecting and decreasing the risk of some potential diseases such as diabetes, coronary artery disease, hypertension, and stroke. Government, non-government organizations, medical/ophthalmic societies, and media should help to improve the working environment and re-establish doctor–patient trust, which may further decrease the sense of “stress/burnout” for doctors. A change of lifestyle and healthy work-life balance—adding yoga, exercise, and meditation to reduce stress, maintain quality eating, and maintain body weight—can save many young doctors/ophthalmologists' lives. #SavetheSaviours: #DrSureshKPandeyKota #DrVidushiSharmaKota #SuViEyeHospitalKota