Speaking on a recent podcast with India Today, hepatologist Dr. Cyriac Abby Philips, popularly known as “The Liver Doc,” opened up about the emotional burden carried by doctors, particularly those working in specialties where death is routine. In his book, he has also written about nightmares, insomnia, and the haunting experience of seeing the faces of his patients reflected in his own children.
“The biggest role as a clinical doctor in hepatology for me is palliative hepatology,” he said. “I take care of a lot of patients who are definitely going to die and I cannot do anything about it except give them a good, dignified, comfortable whatever time is left and a good death.”
He stressed that medicine is not limited to diagnosis and treatment alone. According to him, compassionate care remains one of the most neglected dimensions of modern healthcare. He admitted that while medical education trains doctors to manage disease, it does not prepare them for the emotional consequences of constantly witnessing pain, deterioration, and death.
“This is something they don’t teach you in medicine,” he said. “You’re going to be exposed to these patients and they’re going to die and you’re going to get affected by it.”
He also described the culture within medicine that conditions doctors to suppress emotions and maintain emotional distance from patients. “Doctors don’t cry. Keep a straight face. Deal with it,” he said, explaining the deeply embedded expectation that doctors must remain logical and unaffected regardless of what they experience daily.
At one point during the discussion, he made a deeply personal admission about the psychological toll of medical practice. “Writing this book, if I did not write this book, I think decades later I would have killed myself. It’s so depressing, medical practice,” he said.
His statements resonated strongly across the medical fraternity because burnout has become increasingly widespread among doctors in India. A recent nationwide survey conducted over six months across metropolitan cities and smaller urban centres, involving more than 1,200 physicians from both public and private healthcare institutions, found that nearly 91 per cent of Indian doctors would discourage their children from pursuing medicine as a career.
The survey identified burnout, emotional stress, fear of violence, legal pressure, and worsening working conditions as major reasons behind the growing disillusionment within the profession.
The crisis is also reflected in medical research. A 2024 PubMed-indexed study on Indian doctors revealed that more than half of surveyed physicians showed significant levels of anxiety and depression, while only 25 per cent reported maintaining any meaningful work-life balance.
Mental health experts say the emotional collapse often develops gradually over years of sustained pressure.
Dr. Saurabh Mehrotra, Director of Neurosciences and psychiatrist at Medanta, said stress and burnout are now deeply embedded within the profession. According to him, the combination of emotionally distressing cases, irregular schedules, sleep deprivation, emergency calls during the night, chronic overwork, and the inability to maintain personal relationships pushes many doctors toward severe psychological strain.
“Many departments are understaffed, which means doctors are overworked and unable to find enough time for relaxation, family, or social life,” he explained.
He added that burnout does not remain limited to emotional exhaustion alone. It often manifests physically through anxiety, irritability, sleep disorders, weakened immunity, depression, and cardiovascular complications.
Doctors working in emergency medicine experience this emotional intensity most severely.
Dr. Kiran Kumar Varma K, Associate Clinical Director and Zonal Head of Emergency Medicine at CARE Hospitals, described emergency departments as emotionally relentless environments where doctors are exposed to tragedy continuously during every shift.
“In a single shift, you may handle a major accident, a cardiac arrest, or a family suddenly losing someone unexpectedly,” he said. “Even if you become clinically efficient over time, you do not become emotionally unaffected.”
He admitted that many cases continue to haunt doctors long after duty hours end. “Sometimes it shows up quietly as poor sleep, irritability, exhaustion, or emotional numbness,” he said. “Many doctors continue functioning despite that because the profession trains us to prioritise patients first.”
According to him, one of the most difficult aspects of emergency medicine is the burden of making life-or-death decisions within minutes while distressed families wait outside for answers.
“You are expected to make critical decisions very quickly, often before the full picture is clear, while anxious families are waiting outside,” he said. “There is hardly any time to recover emotionally before the next patient arrives.”
He further explained that burnout is rarely caused by one isolated traumatic event. Instead, it develops gradually through continuous emotional and physical exhaustion accumulated over years.
For younger doctors and resident physicians, the pressure is intensified by institutional hierarchy, long working hours, academic expectations, unsafe workplaces, and increasing incidents of violence against doctors.
Dr. Aviral Mathur, consultant at Sir Ganga Ram Hospital and former president of FORDA and MAMC RDA, said the medical profession has historically glorified endurance and self-sacrifice.
“Most doctors learn to carry these experiences quietly because the system expects you to move on quickly,” he said. “That emotional load is real and cumulative.”
He warned that violence against doctors has emerged as another major source of psychological stress, especially in overcrowded government hospitals struggling with severe staff shortages and inadequate infrastructure.
“Young mothers in medicine face an especially difficult balancing act between training, duty hours and family responsibilities,” he added.
Doctors and mental health experts also pointed to the culture of silence surrounding mental health inside the profession itself. Many doctors avoid seeking help because they fear being perceived as weak or professionally incapable.
“Many doctors worry that admitting emotional distress may be seen as weakness or inability to cope,” Dr. Mathur said.
Dr. Mehrotra explained that many physicians struggle with accepting that someone responsible for healing others may themselves require psychological support.
Despite increasing awareness around mental health in wider society, medical culture continues to reward emotional suppression and endurance.
“Medical training traditionally emphasises endurance,” said Dr. Kiran Kumar Varma. “Exhaustion becomes so normalised that many doctors stop recognising burnout in themselves.”
To survive emotionally, many doctors develop personal coping mechanisms. Some rely on exercise, hobbies, or spending time with family to mentally disconnect from hospital life.
Dr. Pradeep Gadugesh from HOSMAT Hospitals described his approach as the “Ghajini rule” — forgetting work at home and forgetting home at work.
Others depend heavily on peer support, believing that conversations with colleagues who understand the emotional burden of medicine are often more effective than formal advice. Doctors also admitted that humour inside emergency departments frequently acts as an emotional survival mechanism during psychologically intense shifts, even if outsiders misunderstand it.
Across specialties, doctors repeatedly stressed the urgent need for systemic reform. Their demands include adequate staffing, humane working hours, mandatory recovery periods after emotionally intense duties, confidential mental health services, and healthier workplace environments.
Several countries have already begun treating physician burnout as a structural healthcare crisis rather than an individual weakness. The United Kingdom operates a confidential treatment service specifically for doctors, while the American Medical Association tracks physician burnout annually and many institutions in the United States now provide wellness programmes and counselling support.
Medical professionals believe the problem begins during training itself. Medical education teaches future doctors how to diagnose illness and save lives, but rarely teaches them how to process grief, trauma, guilt, emotional exhaustion, or repeated exposure to death.
As Dr. Cyriac Abby Philips explained during the podcast, doctors are trained to remain professional in front of patients while carrying their emotional burden privately.
“You can’t let emotions come in the way,” he said. “I don’t get emotional with my patients. Never. I always keep a professional tone. But I am empathetic towards them.”
Yet the emotional burden does not disappear simply because it remains hidden.
The crisis exposes one of the deepest contradictions within India’s healthcare system. Society continues to place doctors on a pedestal as healers and protectors, but behind the white coats are individuals repeatedly confronting suffering, death, impossible expectations, emotional isolation, and psychological exhaustion — often without any meaningful support system of their own.
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