Today is world suicide prevention day. It isn’t a trendy cause, and not fun to talk about. Nonetheless, it very important to raise awareness about this issue as suicide is the 3rd leading cause of death in the world among those 15 to 44 year of age.
Suicide is preventable. Drawing from personal experience, I don’t recall ever being suicidal but I have been depressed. Depression is the leading cause of suicide and annually 20-25% of Americans over the age of 18 suffer with depression. Over 80% of those who receive treatment for their depression are successfully treated.
I’ve seen suicide attempts. As I think about this day and try to make a small positive contribution, thoughts and images pop into my head. One image is that of a Polish nineteen year old girl in the ICU during my first days of residency. I’d like to share this with you.
I first saw her legs as I glanced through the sterile glass walls of the room. Pale porcelain white skin and long legs that just laid there limp and seemingly lifeless. Then I noticed waves of shiny light brown hair fanned over the pillow. I couldn’t see her face as it was covered with the ventilator tube, tape and straps. There was IV tubing coming out of her chest and arm. A black faced monitor had waves of red, blue, green and yellow displayed across its screen and the waves moved. There was a monotonous beeping sound – I can almost hear it now. There were two figures standing by the door. A middle aged woman with short blond hair and a man. Their eyes filled with what I assessed as concern and fear as they stared into the room. I think the intensive care doctor was talking to them. A few other facts pop into my head. She had attempted (unsuccessfully) to end her life with a lethal quantity of acetaminophen. Her liver and lungs had failed and she was clinging to her life. A bitter mixture of feelings swept over me. I read through her chart and though I can’t remember all the scary problems listed, many of them singularly could kill her. This beautiful young girl was barely tethered to her life through tubes and wires. What hit me was a contradictory image of someone so full and devoid of life at the same time.
Two years went by and I was doing rounds with the gastrointestinal team. One of the names on our list seemed familiar. I went in to see a strikingly beautiful, vibrant and friendly face who welcomed me with a warm smile. She was a liver transplant recipient who had been hospitalized for complications of antirejection medication. Her current condition had improved and she was getting ready for discharge. She seemed happy and filled with joy and optimism. She told me she was recently married to a man “who saved me” and wanted to know about pregnancy as she was eager to start a family. She also mentioned she had immigrated to America from Poland in her early teens with her mother who married an unkind and abusive man and how she had felt neglected and abused by both of them until she couldn’t take it anymore and tried to end her life. It hit me then – this was the same girl.
I don’t know what happened to her after this encounter. I knew her chances of pregnancy were slim as the drugs she was on were very dangerous and contraindicated during pregnancy and stopping them could kill her. I was again swept with a bitter mixture of feelings. What if it had been different, if she had asked for help, if someone had reached out and tried to help her in those desperate times. What if someone had known about her struggles. What if she didn’t reach for the bottle, didn’t swallow the pills, what if her liver hadn’t failed.
When it comes to mental illness and suicide, it is easy to jump to conclusions. To portray a black and white image. I suspect some may call her a coward, or judge her mother and step father harshly. It doesn’t matter anymore. But we don’t live in a black and white world. There is a little bit of each in the other. It is important to remember that every life deserves a chance. That every feeling must be acknowledged, even negative feelings, and that feelings pass. Someone may feel so overwhelmed with negative emotions that they feel incapable of tolerating them and wanting to escape, even if this escape comes in the form of death. Their thoughts maybe so distorted and impaired in such ways that irrational impulses may appear logical. Based on my few encounters with suicide survivors, they were happy to have “failed”. Those feelings do pass and the people who suffer with such thoughts and feelings deserve our empathy and help. It is important to not marginalized and stigmatize mental disease, depression and suicide. There is help and together we can preserve life and prevent suicide. For more information visit the following sites.