A few months ago, I wrote about physician burnout. The story included well-researched statistics to support the points made — a standard practice in my profession. The piece was sobering but, unfortunately, incomplete.

Since April, when that post was published, two very thought-provoking events have arisen involving my medical colleagues. First, a physician friend of mine took his own life — a tragedy beyond explanation. Despite my calling him a longtime colleague and friend, I was completely blindsided by his death.

As a result, I have embarked on a long period of self-reflection: Exactly what do we mean when we call someone a “work friend”? How much do we actually think about this person when we are not sharing a conference table? Does working together give me the right to refer to someone as a friend without other responsibility to the relationship?

In turning this over and over in my mind, I have reflected on the friends in my life; it seems, at least for me, that how much we know about them depends on when we met them. Certainly, the college years seem to forge the bonds of forever friendship. But as we grow older and society grows busier, we may not know those who don’t live with us nearly as well, at least not across the broad spectrum of their lives. This limits our ability to know when a casual friend is in trouble and needs support.

[See: 9 Things to Do or Say When a Loved One Talks About Taking Their Life.]

In the medical field, our training is meant to make us “emotionally strong” so that we can face the stress that inherently comes with making what, at times, will be life-and-death decisions. We are taught to be strong, something I pride myself on being. I am resilient and detached to some degree in my professional work. We hold people to that in many ways: peer review of behavior, progressive discipline plans and credentialing processes. We encourage physicians to seek help but then ask if they are taking medications for depression and other conditions, which may seem judgmental, setting ourselves up for dangerous silence.

This particular connotation of strength creates an atmosphere of aloofness. Add to that the constraints of trying to see all the patients, do the paperwork and focus on quality metrics, and very few of us have time left to work on the fundamentals of being good friends. We get our lunch, wave or say “hi” to a colleague and head back to our offices to grab a few minutes to catch up on email. We never sit down and get to know someone — the concept of the doctor’s lounge continues to fade away. We don’t give actual pats on the back or hugs, even in an appropriate context or as part of normal human behavior. And we never say aloud how much we treasure our colleagues as people, only praising the work that they do. For those who have tried, it just makes the speaker and the audience uncomfortable. The days of our medical colleagues being like family seem to be fading. And our data is corroborating that truth.

[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]

My doctor friend was not a statistic. He was a talented and compassionate person, an amazing educator and a true asset to our profession. I grieve for him but also for our loss in medicine, for the patients and students who will never have his direct influence again. I find comfort in the many he did shape and who will carry on his legacy through their life, work and teaching. And I know that our losses will not end unless significant change is made, both in the overall training and expedition of our careers, but in our personal interactions as physician colleagues as well.

The second thought-provoking episode occurred when a different national colleague gave a lecture where he opened up about his own struggles with addiction and the journey he had taken to overcome them. It was an amazing moment in medicine, in bravery and in humility. He spoke up and out to start chipping away at the stigma that causes secrecy and denial about things that can happen in all lives, including those of the designated healers. The room was packed, silent and respectful. There was a standing ovation rather than awkward discomfort. And then, a deluge of questions and comments. It was as if a barricade had been removed and it was OK to speak about the formerly taboo. This colleague is not a statistic either — he is a pioneer, blazing a new cultural trail in his wake. He is reminding us as physicians to heal one another.

So what is the power of one in this situation? I am grappling to find what I singularly can do. I am fortunate: I often have venues where I am in front of my colleagues. Will I be brave enough to acknowledge the fondness I have for them as people, or will I just focus on the work because that is easier? Will I send the email or better yet a written note for great things that happen, or just stick to the condolence cards when tragedy has already ensued? Will I speak up like my bravest colleague and help shape a better system that does not punish doctors who seek help? Or will I just try to make it through my day, retreat into my family and not accept the responsibility that comes with referring to someone as a doctor friend?

[See: Apps to Mind Your Mental Health.]

Yes, my friends are more than statistics, as were the hundreds of other doctors who took their own lives this year. In the aftermath, I must continue to search for the power of one and act on it, for all my doctor friends near and far; those I have met and those I have not. I will reach out, take someone to lunch, gush over their joys and be present for them before they are in trouble. I will take a minute out of my presentations at times to let them know I am blessed to be with them as people, as well as doctors. Going beyond my comfort zone — and theirs — will be part of my professional and personal responsibility. I will join their journeys and invite them into mine, before it is too late for either of us.

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A Deadly Silence: My Pledge to Combat Physician Suicide originally appeared on usnews.com