• Dr. D

The song says "...suicide is painless..."

...but for whom?

Suicide has been on my mind for a while now. The rate has been going up steadily for decades. Physicians and nurses are at increased risk of suicide and the recent stresses in healthcare have only worsened that. It's the second leading cause of death in the 17 - 24 year old age group.


I’m going to look at the issue of suicide in the next few posts. It’s too huge a topic to cover in one sitting. I will say without question, however, that suicide is never "painless."


Suicide on a personal note

My husband shoved the phone into my hand. “It’s your mom.”


“What’s up?” It was late for her to call. Ten o’clock our time, a time zone away.


“It’s Johnny,” she said. My youngest brother. No surprise. There was always something going on with Johnny.

“What about him?”

“He’s gone.”

Ran away, I thought. Finally. He needed to get the hell out of there.


“Where did he go?”

Silence. Then, “He’s dead.”


How many things happen to a sixteen year old? Car accident? He wasn’t a very good driver. He drove too fast and when he was angry, which was most of the time, he drove faster. Fight? Road rage? Fall off a building? What - ?


“An accident? Was anybody else hurt?” I thought of my youngest sister who idolized him.

“He killed himself. He shot himself in the head. With a 22.”


It doesn't register in my mind. I don't understand...


“I called him for dinner and he didn’t come, so I went to his room. He was lying on his bed with this rifle on his chest. It looked like he had a nosebleed. And not a very bad one. Just some blood around his mouth and some just under his nose. I grabbed the gun and put it in a corner because I was worried that he’d hurt himself.”


I imagined my youngest brother’s room. A dresser with the front of one drawer hanging off, as it had been for years. No bedframe, just a bare mattress on the floor. He still wet himself

at night, so he didn’t deserve box springs or sheets. Him lying there. Skinny, in shorts and a dirty T-shirt. A nose bleed.


“…ambulance guys didn’t even try to do anything,” she had been talking while my mind wandered. “Not one of them laid a finger on him. Just flashed this light in his eyes…”


He’s in a better place

People have an unfortunate need to say something. Usually though, it would be better to just stop. Who are those words supposed to be for, anyway? How could those words comfort me when I wanted that “better place” to be here on earth?


”…it’s been (fill in the blank, one month, two months, a year…).. it’s time to get over it.”


You don’t “get over” some losses, you just go on. There is no statute of limitations on grief. I cried for ten years when someone spoke my brother’s name or I heard a song that was popular the year he killed himself. Thinking of his face or that time can still bring tears to my eyes. And that’s been a very long time ago.


Feelings about suicide change with the circumstances

No two people experience a loss due to suicide in the same way. There may be disbelief, understanding, fear.


I have had patients who ended their lives. And with each one, I grieved and felt guilty. Maybe I should have offered something different. Maybe I wasn't what they needed. Maybe they would have been better off if I had referred them to someone else.


With Johnny, my brother, I was sick to my stomach. Dry heaves. Physical pain bordering on anguish as I imagined him alone, in that shabby unfurnished room, sixteen years old and hopeless.


Later, I felt rage.


Rage at my parents for not protecting him.


Rage at myself for not fighting harder for him when I knew things were bad.


Then, rage at him when I found out the last words he spoke were to the sixteen year old girlfriend who had just broken up with him: “You’ll never have to see me again.”


Those of us who survived

The death of someone we care about is always difficult, but the death of a loved one by suicide is vastly harder. Part of this is due to the fact that the survivors hesitate to reach out to others for comfort. And those around them may be at a loss as to how to respond.


Survivors of loss due to suicide feel guilt. Maybe they should have done more or something different.


But they also feel shame. Do others think I failed the deceased? Is there something wrong with my family that this should happen?


My father wanted us to say that Johnny had been playing with the rifle and it went off. My sister refused, screaming that she wouldn’t let people think our brother was so stupid that he’d put a loaded gun in his mouth if he didn’t intend to use it.


Suicide – the unpardonable sin

Christianity is more humane about suicide today than it was in the seventies. When Johnny died, suicide was a mortal (funny how that word just seemed appropriate) sin.


Unforgiveable.


He couldn’t be buried in hallowed ground, by the old rules.


But the faithful were becoming a little more merciful then. Maybe suicide meant there was something wrong with the person. Maybe an exception could be made.


It was.


They couldn’t afford a headstone

It became an annual pilgrimage for me, to visit the town where Johnny died and search for his grave.


It wasn’t easy to do. There was no headstone.


When I asked my parents, the told me they couldn’t afford one. They afforded hotels and long trips and new furniture. But they couldn’t afford the $350 it would take to mark the final resting place of their youngest son.


It didn’t take a shrink to see denial in action.


That rock was for me

Ten years later, I had entered a new phase of life. Baby, debt, new job, a good future within reach. But the lack of a tombstone to mark my brother’s grave tore at me.


There was only one headstone carver in the whole county, so I called them.


Yes, my parents had spoken with them years before and discussed what a marker would look like. It was to be adorned with a French horn, the instrument Johnny played.


Yes, they still had the cancelled order. And yes, for $425 - inflation you know- I could have it made.


How long before they discovered it?

Four years passed, and each year I made a pilgrimage to the site.


I gazed at the words “John………” Aug 1960 – Oct 1976.” Approved of the French horn curled beneath them. Left flowers.


The call eventually came. My mother had been at the cemetery for a funeral and went to Johnny’s grave. There was a headstone there. She asked the engravers who had paid for it and they told her.


“Thank you,” she said.


“It was for me,” I replied. "I needed it."


She said nothing to that.


She never has.


Help before suicide


For anyone considering suicide, there is help. Before taking the irreversible step of taking your own life, call the National Suicide Prevention Hotline can be reached at: 1-800- 273-8255


Image of suicide report by: © Can Stock Photo Inc. /alexskopje

Image of bullet and blood by: © Can Stock Photo Inc. /gsagi

Image of mattress by: © Can Stock Photo Inc. /sirylok

Image of cemetery by: © Can Stock Photo Inc. /goghy73