Sunday, December 02, 2007

They Won't Be Better Off

One of our local hospitals recently had a tragedy: a man walked up to the ER triage desk, handed the nurse a signed note that said, "I want to be an organ donor," pulled out a gun, and shot himself in the head. He died.

Apparently the victim did not, thank God, threaten anyone else: nor were there children in the area to be traumatized by watching the shooting. But I can't imagine what the triage nurse must be going through. Clearly there wasn't time for anyone to stop the man who died: he was determined. He had a plan and carried it out. Everything happened very quickly. But people who were there -- especially the nurse -- must keep seeing the incident over and over, replaying like a film behind their eyes. They must be haunted by it.

I wonder if they'll ever not be haunted by it, even though they didn't know the suicide victim. And those who did know him, his family and friends, will surely struggle for years, if not decades, with his death.

My paternal grandfather killed himself before I was born. The family doesn't talk about it much, but the impact on all of us -- even those who never knew him -- is still profound. There have been other suicides in and around our circle. A good friend of my father's jumped out a high window when I was a little girl; Dad's second wife was a widow whose first husband shot himself. I barely knew my father's friend and didn't know my stepmother's first husband at all, but their deaths still chill me.

Others hit closer to home. In 1987, a brilliant and charming young coworker at one of my temp jobs in New York orchestrated an elaborate final journey that culminated in his shooting himself in the head at the base of Mount Denali in Alaska. In 1988, one of my college roommates -- an even more brilliant medical student -- jumped out of her apartment window. I still think about Joel and Sumi at least once a week; during my own dark times, I think about them every day.

Although I suffer from depression, I've never been actively suicidal, partly because I'm keenly aware of how many people would suffer, would grieve and rage, if I killed myself. When I find myself flirting with the idea, I draw up a list of those people, stopping at twenty-five or thirty, but knowing there are really many more. I'm quite certain that neither Joel nor Sumi would have put me on any such list; nonetheless, the sorrow of their deaths has never left me. I think about them, and I think about their families, and I think about the people -- construction workers, in Sumi's case -- put into the horrible position of finding their bodies, of having those images burned into their brains.

The week after I heard about the hospital suicide, I visited a suicidal patient during my own hospital shift. The patient told me, "I wanted to kill myself so I'd stop hurting my family."

Usually I deal well with suicidal patients; I'm compassionate to them, and I'm pretty good at getting them to open up. But with this patient, I did all the wrong things. Those words pressed a nerve, one that was rawer than I knew, and I found myself lecturing. "Killing yourself would hurt your family much more than anything else you've done! If you want to stop hurting them, please stay alive and find ways to make amends!"

The patient withdrew, no doubt put off by the heat of my words. The terrible ill-logic of depression -- "they'd be better off without me" -- is a symptom of illness, not a rational thought process. Arguing with someone in that state doesn't help. It's like arguing with the wind. I knew that.

I knew that. This patient needs medication and psychotherapy, not a hectoring chaplain. I handled the visit badly, and realized afterwards that the words came out with such force because, for years now, I've wished I could have said them to my grandfather, to my father's friend and my stepmother's first husband, to Joel and Sumi.

The holidays are hard on people; Joel killed himself during this time of year. And so, even though it may do no good, this is my message to anyone struggling with such profound despair that death seems preferable, such great pain that it seems as if everyone in the vicinity will be better off if you're no longer alive:

The people who love you won't be better off. The people who hate you won't be better off. Casual acquaintances, co-workers, and the strangers who have to deal with your remains will not be better off.

Please don't kill yourself. Please call someone and ask for help instead, even if you think nothing can ease the pain. Give hope a chance. Read this page from the Mayo Clinic. Call a friend. Call 911.

Please choose life.


  1. Anonymous7:06 PM

    That was a beautiful post. I think of suicide almost every day (it's gotta be hormonal...), but remember the suicide of a close friend's sister--great sorrow and chaos ensued. The ripples are still spreading outward. Thank you for your strong message.

  2. Beautiful post, Susan. I'm glad you have those lists of friends who would miss you. Please add me to them. I'd feel the same way if my friend Jerry ever did what he keeps saying he wants to do and ended it all.

    A few years back a co-worker suicided after he went home. I didn't know him well but it still affected me. Partly because I said hi to him during the evening and wondered if I should try to get to know him better. I'll always wonder about that but know that I can't do it now.

    Peace & Hope!

  3. Anonymous11:13 AM

    I too suffer from depression off and on throughout my life, and have had suicidal thoughts but never come close to acting on them.

    Despite the insight and empathy this has given me, I still find myself angry with the man who shot himself in front of the nurse. If you really feel suicide is the solution, that's your business, but don't make people left behind suffer needlessly. He could have quietly overdosed on pills somewhere where a non-family member/non-acquaintance would have discovered him. What he did to that poor nurse is inexcusable. Sorry, but I find it hard to sympathize in this instance.

    Jeff P.

  4. This is beautiful, Susan, thanks.

    What really struck me was your need to say this to someone contemplating suicide. I wonder: when is it right to speak the unguarded truth? How do you draw that line on a regular basis? I suspect, as a chaplain, you might have struggled with this quite a bit more than the average medical student, so do you have any insights to offer?

  5. Thanks, everybody.

    Alexis, I'm going to have to think about that. (And I may write a post about it!)

  6. Hi Susan-
    Been catching up on our Blog, and especially the posts on depression. Since I wrote yo about TNB last year have suffered several traumatic things that have pushed me to-and once over-the edge.
    Still not able to get past things and am daily faced with the question of "Why bother?" "Why keep on hurting?".

    As of yet have found no answer. Despite out much vaunted Canadian Medical coverage, where I live in an area where does not offer help for the paymenbt of pschologists, and physhciatrists are available upon referal of your doctor, it can often take months to get to see one.

    PS-I love the title of your blog-and thank you once again for the train of thoughts that you kicked off with TNB. And followed up on with the Recommend about "Mountains beyond Mountains"
    Wish I could come up with Dotore Paulo's strength. what a remarkable man.


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