Friday, June 08, 2012
It’s June 8th and I’m thinking about suicide…not about committing it, not about personally undertaking it, but about the subject in general. My uncle killed himself on this date two years ago. It still seems achingly, almost unbearably fresh. My cousins and the rest of my extended family in St. Louis were having a get-together the weekend before it happened. I had just taken Step 1 of the US Medical Licensing Exam that Saturday (for those of you unfamiliar with it, imagine an 8-hour long exam with the potential to determine whether the career you’ve been planning for the past decade will actually come to fruition). When I got home that evening I was too tired to make the drive out to the ‘burbs, so I called and begged off. It was the last time any of us saw him alive (or dead, for that matter—after a shotgun to the head, the coroner said it wasn’t worth having anyone come in to identify him). I still kick myself for not going. I still dream sometimes that I am standing at one end of a long dead-end street; I can see my uncle’s car parked there at the end, and can vaguely see someone moving about in the driver’s seat. Panicked, I sprint towards his car as fast as my legs can carry me, heart pounding, my lungs about to burst. Faster. Faster. Faster. And always—just as I’m a few yards away—the shotgun blast tears through the air, and I drop to my knees and scream.
For the next several months after his suicide—during my first rotations of medical school—I was either in a daze or despondent. During my pediatrics rotation in the newborn nursery, I was so addled I couldn’t keep track of the babies’ weights from day to day; try as I might, I couldn’t hold the numbers in my head long enough to punch them into the calculator. I would give a patient’s weight loss or gain during rounds only to be corrected by a resident and earn an eye-roll from the attending. I was on overnight call every fourth day, which interrupted my usual routine of “finish work, go home, curl into fetal position in bed and cry until asleep,” and which made me feel even more trapped and desperate. Several times I looked up from the nurses’ station and saw my uncle standing in the hall, only to disappear as I got up to go to him (I’ve since learned that this is actually a fairly common phenomenon in the newly grieving, and not a sign of incipient psychosis as I believed at the time). I should have made my excuses and taken the rest of the rotation off, but stubborn as I am I stuck with it and ended up passing the rotation by the skin of my teeth (and by the grace of the clerkship director). I’m sure my uncle didn’t intend this. I’m not certain he was even in a state of mind to fully comprehend the effects his death would have on those of us left behind.
Over the years I’ve known several people who have killed themselves/committed suicide/died by suicide/whatever your preferred phrasing is. Too many, of course; more than seems statistically likely, and certainly more than is fair, for them, me or their friends and family. The US suicide rate is around 12 per 100,000 per year. One of my friends from high school killed himself the summer after I graduated—a sensitive, loner-ish guy with a penchant for fantasy novels and a love of nature. I still have a copy of Mark Twain’s ‘Letters from the Earth’ he loaned me that I never had the chance to return. My first year of medical school I got a call from a college friend; one of our housemates from Cornell had killed himself. He was a profoundly intelligent man, supremely passionate about…well, just about everything. I knew he’d struggled with depression, but never knew how bad it was. And then during my third year, as mentioned above, my uncle killed himself. My uncle was something of a family black sheep because his religion consisted of philosophy, science and the Sierra Club rather than Christianity; I think that was part of what made him my favorite relative. Interestingly, all the completed suicides I’ve known have been men, while all the other attempters I’ve known have been women (this is in keeping with the psychiatric maxim, “Women attempt, men complete”).
There’s more that I want to say about this, but this is getting long and I’m getting depressed. I’ll come back to it later, I think. I just wanted to honor my uncle today, and offer a picture of what suicide really does to those who are left behind. Perhaps that’s why suicide prevention and awareness is a passion of mine—I’ve seen too many people make that grave error, and want to prevent it from happening to anyone else. To quote a man who jumped off the Golden Gate Bridge (and survived!): “I instantly realized that everything in my life I thought was unfixable was totally fixable—except for having just jumped.”