Before beginning work each day, Carrie Cunningham (M.D. 2001) blows into an at-home breathalyzer that’s equipped with facial-recognition software. She will do this three times a day, seven days a week, for three years.

Cunningham also does randomly-selected urine tests for drugs she’s never used and attends several weekly recovery meetings and therapy sessions.

All of this is part of a physician health program to prove that Cunningham is fit to be a doctor. 

Cunningham had long struggled with depression and used alcohol to cope with her high-stress job as a surgeon and cancer researcher. On a night out with colleagues, she had a few drinks and shared that she was depressed and feeling suicidal.

The next day, a concerned coworker told her boss, who told Cunningham that she needed help and could take a break from work. Cunningham volunteered for a multi-day professional evaluation run by the Massachusetts Medical Society.

When Cunningham read the results of her assessment, she was stunned: “The assessment team is of the opinion that [Dr. Cunningham] is currently not fit to practice medicine.” 

“It’s terrifying. You’re in just one of the worst spots in your life, and then someone says you can’t work.”

In order to return to work she would have to go to rehab and go through the monitoring program that requires those daily breathalyzers and random drug tests.

Cunningham dove into the recovery program, but she did so quietly, only telling those who absolutely needed to know. Until February 2023.

In her outgoing speech as president of the Association for Academic Surgery, Cunningham began with her successes: She is a former junior professional tennis player who competed at Wimbledon five times, a surgeon at Massachusetts General Hospital, and an associate professor of surgery at Harvard Medical School.

“But I am also human. I am a person with lifelong depression, anxiety, and now a substance use disorder.” She spoke those words to 2,000 of her peers, and tens of thousands who have since watched the YouTube recording.

Cunningham had already lost one friend to suicide. Her Medical School classmate, Christina Barkley (M.D. 2001), died by suicide in 2012.

She continued, “If I can prevent one of you from dying by suicide or suffering alone, it will be worth it.”

Since then, Cunningham has been doing at least 20 talks a year, speaking out about physician mental health and substance use disorder.

“The number one way to change stigma is by storytelling,” Cunningham says. “I am putting the same amount of effort as I did in tennis and in surgery, into recovery and changing mental health conversations.”

Cunningham also wants state medical boards to remove questions about a physicians’ past mental health from licensing and credentialing applications. She says questions like “Have you ever taken an antidepressant?” or “Have you ever had a mental health diagnosis?” can discourage physicians from seeking treatment for fear of not getting their medical licenses issued or renewed.

“If they seek help sooner, they won’t get to a place where they’re in crisis,” she says. “Self-care is a professional responsibility, and it should be just as important as taking care of your patients.”