Suicide Hurts

The Unanswered Message

I missed the initial call. But when my phone rang a second time immediately after at 6:50 AM on a Saturday morning, I knew something was up, and it likely wasn’t something good. I felt this deep in my soul especially when the caller ID told me it was a patient with whom I was very familiar, and not due to easy or lighthearted interactions. She was a troubled soul, tormented by hypochondriacal obsessions with various bodily symptoms. With trepidation, I released the voicemail left with the first call. My worst fears were confirmed through the message of a tearful husband: his wife had taken her own life. He was responding to my call and voice mail I had left for her one day prior. It was my attempt to check on her due to a recent bout of yet another unsubstantiated fear of illness.

I was one day too late.

This is the 3rd suicide I’ve experienced with my own patients in my 34+ years as a physician. They all have stung and hurt, but the impact of each is unique. The talented friend and patient who had served me well with kindness left a gaping hole in my life and our community of friends. I can still remember sitting in the living room of his home with other caring friends who had gathered when the news came that he had gone missing. His wife talked openly of their frequent discussions about the darkness that consumed him even though he had a strong Christian faith. She repeatedly expressed to him how she and their 2 sons would rather have him broken than not at all. Alas, the darkness overtook him, and we lost a brother. The second was less emotional as he was a new patient and I didn’t know his family at all. Still, the tears of a widow burn, and her cries are felt deep in the soul.

This most recent one was different still. I had spent hours and hours examining, listening, coaching, redirecting, encouraging, pressing her towards what was factual and true, and offering spiritual guidance and assurance when necessary. That was how we spent our visits, phone calls, and texts. I wasn’t always patient with the patient, reaching frustration levels when she repeatedly sabotaged our crafted treatment plan, trusting her unstable conclusions over my careful consideration and recommendations. The image she projected to the community, acquaintances and even friends around her did not match the internal workings of her mind and heart.

Suddenly, none of it mattered. Gone. Done. No more talks, no more tests, no ifs, and/or buts.

Emotional Chaos Ensues

Suicide hurts. And it tortures those left behind in various ways. It’s a high-speed train that rushes into our lives and derails right in the center of our emotional and relational town. The carnage is widespread.

First, the shock. What?! No! Not __________. It can’t be! She was such a ____________ person. So much to live for! Disbelief rushes into a mind just that moments before was occupied with the day-to-day realities of life, but now suddenly overcome with the magnitude of the news.

Soon after come the questions. Did I miss something in her voice, her actions? Was there a cry for help that I didn’t hear, was I closed off? Did something I say or do trigger her decision or maybe push her in that direction? What could I have done differently that may have prevented this final act? Was my tough love too tough?

There may be anger in the wake of the shock. The questions become accusatory. How could she? Didn’t she care about those she left behind? Didn’t she care about me?! How…selfish, stupid, uncaring, irresponsible, etc. She lied to me by withholding this crucial information. There may be guilt. If only I had been kinder, more helpful, listened more, listened better, agreed to get together when she asked, answered that last call, been more patient, probed more. Surely there was something I could have done to help. Or as in many cases, great effort was expended but the results still negative.

Then, of course, the sadness and regret. Permanent loss. Unretrievable relationship frozen at the point of last contact. A pillar of salt that one must now dance around. No chance to ask the next question, resolve the riff, say the thing you had planned to say. How will we fill that gaping hole in our life? The empty spot at the table will never be occupied by the person again.

Once the suicide ideation train has left the station with an actual plan on board it can be almost impossible to stop it. Many have related how, in retrospect, they can recall a resolute calm that had come over the person just prior to her taking her life. It’s a trick, and it works. Just when she seemed more settled, the deadly step was taken and we are left wondering, grieving, trying to put it all together. We must acknowledge the painful truth that the decedent had made the decision independently and there was a minute chance that anyone could have persuaded her to act differently.

Preventing the “Purchase” of the One-Way Ticket

However, we can intervene before the suicide train is even scheduled. As with so many things, prevention throw open discussion is the most important message that needs to be heard regarding decreasing the incidence of suicide in our culture. We must not be afraid to use the word with someone whom we fear might be contemplating suicide. A good opening question to the discussion could be, “Do you feel like you might want to harm yourself?” If the answer is yes, a good follow-up question is, “Do you have a plan of how you would do that?” Please know this: talking about suicide doesn’t cause suicide, it’s the first step in preventing it. As a side note, when discussing a suicide that has taken place, avoid the phrase “committed suicide” which tends to make it sound more like a crime than a tragedy. “Died by suicide” is better.

Maybe you’re the one entertaining the idea that it’s just not worth continuing in the struggle that life has become. I don’t know anyone who hasn’t had the thought at one time or another that it wouldn’t matter if they were here or not, or even worse, that life would be better if they weren’t in the way. But when it goes beyond that, reaching a depth of darkness that seems impenetrable by any light, it’s time to pause right there and reach out. Those who love you need you here, want you here, even if at the moment they seem few and far between, or you are currently at odds with someone you love. There is a way out from the discouragement, the despair, and the loss you’re feeling. And you will be better for it, and so will we! Press on. Talk to someone, get professional help, and of course, talk to your doctor! It may be a slog, but you will get there over time.

Helpful Resources

Need help right now? Know someone who’s in danger? Call The National Suicide Prevention Lifeline at 800-273-8255. For help understanding risk factors for suicide and how to help prevent that outcome, visit American Foundation for Suicide Prevention – AFSP.org or Suicide Prevention Resource Center – SPRC.org