MASH, the incredibly successful TV series about medics in the Korean War, was a favorite of mine and I even had an opportunity to talk to one of those medics. When I met him, he was a brilliant, incredibly successful and revered researcher in a major hospital center (where he spent his entire professional life). He joked about how they managed to handle the depression and stress of the war and the never-ending struggle to save lives beyond saving. The solution? Sex in the ambulances with the nurses.
Sex saved the day for these young physicians and I remember (and will never forget) the words to the TV series’ theme song which wafted from my set…”suicide is painless.” I don’t think that’s so, but too many people believe that it is the end of their pain, both psychic and physical.
Someone asked me recently, on Twitter, if I thought we had a right to deny anyone that relief and it, for me, is an existential dilemma. Do we have a right to insist that anyone live or are they permitted to have that freedom to end it, if they want? Must we carefully and closely question their responses and help them make what type of decision? Outrageous, I can hear people shouting now. It’s never acceptable. Who are we to make that decision?
The question begs another; do they have the ability to make such a decision or is their reasoning ability clouded and skewed against solutions permitting life? No simple answers here and I recall that an eminent Australian scientist, David Goodall, decided that, at 104, he had enough of a life he found intolerable. He traveled to Switzerland for assistance in his suicide.
Recently, still reeling from the latest news that the rate of suicides are up in America by 25% since 1999, we read of the suicide of Kate Spade, a highly successful designer, entrepreneur and social icon around the world. Yes, she was on antidepressant medication at the time of her death and seemed in good spirits the night before she hung herself in her New York City apartment. Reading of her death reminded me of the suicide, in her barn, of the former Mrs. Robert F. Kennedy, Jr. who also suffered from depression.
Today, news of recent suicides of the famous, hit us again. It was the successful, iconoclastic chef/writer/TV host, Anthony Bourdain who killed himself in Paris. Facts are scarce, but we do know he was actively at work on his series, had a loving relationship and a daughter he adored. True, Bourdain’s past indicated a heavy involvement in drugs and, from the shows, we saw he enjoyed his share of alcoholic beverages.
No one will ever know the mental pain anyone who commits suicide suffers. It must be so severe that death is not only a good solution, it is the ONLY solution for them. Anyone who works in mental health will take issue with that and should. We aren’t in the field to promote death as a viable option to life’s turmoil. Nor are we in the field to place blame. We seek answers but, even for us, there may seem to be more questions than answers.
But at least two of the people I just mentioned, Spade and Kennedy, did seek help and it was, for them, somehow insufficient. That must have been the case for the musician Del Shannon, too, who killed himself even though he was taking antidepressant medication.
Of course, younger music fans will recall the suicide of Nirvana’s Kurt Cobain. Cobain, according to reports at the time of his death, had attempted suicide on numerous occasions. And there are many others, persons both successful and unknown.
Fields, such as medicine, have a higher rate of suicide than others because of the incredible burnout rate. The situation has become so serious that medical schools now place much more emphasis on providing counseling for students, interns and residents. A month ago, in NYC, two young physicians in training at a major medical center committed suicide. Burnout seminars for physicians are becoming more and more evident.
In the past, suicide in the medical profession was often hidden because of the stigma placed on the family as well as for insurance purposes. Death certificates were careful to place causes other than anything self-inflicted.
Stress kills. We know that and so does depression. Stress can bring on depression and grinding self-doubt. How can anyone hope to meet the often extraordinary demands of keeping up or on schedule or maintaining a sharpness in any industry? The fear of failure fueled by any doubt begins as an ember and slowly ignites into a fire that consumes them. All of this happens while the person maintains that smiling face, flashing good teeth for the camera and dances around the room talking about the bright future facing them. It isn’t so.
I’ve seen patients come out from sessions with psychiatrists, greet everyone they knew at the center and then go out and throw themselves in front of cars on a highway or hang themselves. Another, who had an extended session about plans for his future, went home, got his father’s gun from a dresser and fatally shot himself in the head. No clues regarding his thoughts of suicide. One even took anti-anxiety meds before his appointment so he wouldn’t expose his plan.
Decades ago, the whole topic of suicide began to take on more credibility in health professions. A journal of suicidology was begun and authors turned out books on suicide and death. The topic was hot. Today, there are thousands of references online and access to help has been made eminently easier, but when you’re thinking of suicide, do you turn to the internet? Why would you if you are somehow happier that you’ve made a decision that will end your pain? Reasonable? No, but it’s probably how it goes.
Suicide can happen anywhere and to anyone. I’ve read about six-year-old kids killing themselves. Of course, the cause is usually stated as an “accident” even though the circumstances point in a different direction. Stigma probably prevented the family from getting help for this child or even the lack of healthcare insurance.
How many children, covered by Medicaid, kill themselves? Try to find a qualified child psychiatrist who accepts Medicaid. Difficult to say the least. I know a family that can find only ONE pediatrician who takes Medicaid in their community, a suburb of New York City. One is not enough and we don’t know the quality of care that person may provide.
Right now, the questions and the answers are still in flux but there are resources you can find for yourself or someone else:
National Institute of Mental Health
American Foundation for Suicide Prevention
Substance Abuse & Mental Health (SAMHSA)
The Trevor Project