Dear Prudence,
One of my co-workers, “Antonia,” is struggling. We are both physicians and do shift work in a close group setting. I am probably her closest friend in our group of 30 physicians. Antonia has been diagnosed with ADHD but has never taken medication for it. She is a competent, incredibly empathetic, wonderful doctor, but frequently loses her focus: she leaves papers / stethoscopes / laptops scattered all over the hospital, fills the shared office fridge with snacks she intends to eat and never does, etc. She also has a strong tendency to talk down on herself, and it is hard to listen to. She will frequently say things like, “I took too long to do that note, so I don’t deserve to eat lunch today”; or, “I know I’m the most scatterbrained person in this office, so I understand if you guys don’t want to be my friend.”
She was recently promoted to co-lead of our physician group (no one else applied for the job, so it was her or no one) and … it’s been rough. Recently she presented a proposed change in workflow to our group at our monthly meeting. I know this is a process she has had many meetings about with other specialties and has thought through carefully. However, her presentation to our group was confusing, tangential, and really hard to follow. A lot of questions arose, she got flustered, and her answers made even less sense, and it eventually culminated in her apologizing over and over, near-tears, and withdrawing the proposal she had spent so many hours preparing.
I don’t know what to do. I think her untreated ADHD is destroying her work success and her self-esteem. When she has opened up to me privately about her difficulties in the past, I have recommended a therapist I have worked with before who was really helpful for me; she saw him one time, which I am so glad she was open to, but had no follow-up and things haven’t gotten better. I think medication for ADHD would really help Antonia, but even as a physician and her close friend, I don’t know how to talk to her about that, or if I should at all. My worry is that she already has a low self-esteem and that even my most well-intentioned comments may be hurtful and unproductive. Do I just take her to lunch and listen, keep my thoughts about meds to myself, and keep watching this slow-motion crash and burn?