Saturday, 3 March 2012

Coping

The sad suicide of policeman David Rathband two years after he was blinded by gunman Raoul Moat, once again has brought into the spotlight the subject of self determination, particularly when it is related to ending one's own life.
In my time dealing with people that have been paralysed by sudden trauma, I have only come across two people that have decided that suicide was an option open to them.
One suffered from a severe mental disorder prior to their accident and subsequent disability, and would have, I am sure, committed suicide "whatever the weather" while the other, a man who had been paralysed from the neck down for over 18 years took his own life as a result of the death of a relative and carer.

Having said this, many patients talked about suicide during their time on rehabilitation, whilst more , I am sure, contemplated the idea silently when they experienced their darker moments post injury, whether it be in hospital or at home when life was said to have "normalised".

I have a strong stance on this subject.

As long as a person is not clinically depressed and as long as they know the full facts about their abilities after the intensive rehabilitation process is completed then if they feel suicide is what they decide for themselves..then "so be it"
And this in precis form would be what I would say to patients who ventured suicidal ideas.
People who are deeply depressed cannot be objective.......
People who don't know the full facts cannot be objective either
( and before anyone shouts I know non of us can be truly objective, but we can, I think be more balanced and clear in our thinking)

Listening and accepting what people are experiencing is vital too, as just being able to say the words without  experiencing a reaction of horror, shock or fear can be part of the healing process in itself.
Sometimes the acknowledgement of just how bad someone feels is just enough to allow that person to soldier on.

and "Soldier on," is what the majority of people do in fact .
Faced with huge challenges and massive changes to all parts of their daily lives, in my experience people just get on with things... they find a way of coping,

As it turns out for most of us, living is more important than the alternative.
But it's not always the case.........


44 comments:

  1. As a general rule, I belive that suicide is a permanent solution to a temporary problem, but I accept that there are exceptions. Mostly people who have had a massive change in their abilities, whether through illness or accident.

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  2. There have been a couple of times in my career when I've felt that the person in front of me was at significant risk of suicide, but I felt that it was a rational decision made by someone with capacity and to attempt to stop them by hospitalisation would be inappropriate.

    They were always related to terminal physical illnesses, however there are one or two extremely tormented people with schizophrenia I've also thought" I don't blame you" when I heard of their death.

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  3. I do some voluntary work with Lifeline - a 24 hour telephone counselling organisation whose aim is to reduce the numbers of suicide related deaths.
    Anyone who rings us, is by definition ambivalent, and I will work with this ambivalence and try and turn the caller away from the suicidal option.
    That said, I am in agreement with your position on suicide.

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  4. Some don't get the chance to suicide but they lay their lives on the line everyday:

    A police officer and father of six shot dead in northern NSW was a brave, tremendous bloke who spent more than half his life protecting the community.

    Senior Constable David Rixon, 40, was on duty and alone when he and another man were shot during a gunfight outside a block of units in Lorraine Street, West Tamworth, about 8am (10am NZT) on Friday.

    Paramedics and police raced to the scene before both men were rushed to Tamworth Base Hospital, where Sen Const Rixon later died.

    The highway patrol officer joined the NSW Police Force in 1990 and is survived by his wife, Fiona, and six children.


    http://www.stuff.co.nz/world/australia/6512799/Tremendous-officer-shot-dead

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  5. In principal I am pro 'assisted suicide'. But the implications of legalising such, are horrendous.

    All my recent experiences of suicide have been of young people who had their whole lives ahead of them; one was only 12. If these were executed to punish those left behind, then they certainly achieved their aim.

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  6. The problem is for those left behind. If we have an assisted suicide that has been planned for good reasons and the "loved ones" know what is going on, all well and good. But if someone hides their misery and intentions it must be awful for friends and family who must forever after feel guilty and wonder if there is something they should have said or done.

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  7. We have had two suicides in the family...both men and both clinically depressed. It is horrendous for family members. The notion of someone choosing this while being in a balanced state of mind is a nice idea John...but I don't think much of a reality.

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  8. An intelligent and thought-provoking stance. One of the key factors in any potential suicide's mind should be the lasting effects that the death might have upon his/her nearest and dearest. The deceased escapes the mortal coil but the loved ones often carry the burden till the end of their lives - like a shadow that's always casting its gloom upon them.

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  9. Well put John. Get their mind settled, provide them with all the information. If this is the course they decide on there should be no shame.

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  10. I used to care for 3 patients with MS. One of them lost so much ability and needed a lot of personal care. he pleaded with the doctors to end his life, it broke my heart to know this, but his life had very little quality and no family left. He must have felt there was nothing worth living for. So sad to be in that place.

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  11. My concern for assisted suicide is that some day it turns from a 'right' to an 'expectation and responsibility'. I personally believe that a person has the right to say 'enough'.
    I believe you are right on track when having one's pain - emotional and physical - acknowledged may give them the strength to plug on long enough for relief to set in

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  12. jac
    I agree....everything should be done to treat people with a depressive illness..........people with depression simply cannot see the full picture clearly.........however like Dan, sometimes despite all that can be done...the outcome is inevitable although terribly sad.

    Some patients I have known will simply harm themselves with passive neglect....the outcome may take longer but they often achieve the same end.

    do I agree with assisted suicide?
    no I do not.....but nor do I believe that everyone can be turned back from the brink

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  13. I've stood at the abyss therefore I make no judgments...

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  14. I've never understood why a person doesn't have the right to end their own life.
    Having said that, each Sunday I visit the website Post Secrets which in turn supports the Suicide Hotline. So many teenages go through a phase of wanting to kill themselves and I feel very strongly we should guide them through it so they can contine into adulthood.

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  15. I had a friend who topped himself because he discovered that he had AIDS (as a result of a blood-tranfusion - I think he was the first person in England to have contracted it this way), but knowing what we know now, this was at best unnecessary.

    Suicide is such a selfish thing, but I suppose that's the whole point of it. Just to think that people were laying flowers at the spot where Moat shot himself (with a little help from the police).

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  16. I suspect that the majority of commenters here have never been so depressed that they thought about suicide.

    I think anyone who's never stood on the edge of that pit shouldn't judge others who obviously have.

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  17. My daughter is fatherless because he chose to suicide. I like your stance John and as the years go by, I'm beginning to understand his need to leave, where previously I've been as angry at him as I would feel towards someone who had murdered him (if you get where I'm coming from here).

    I've sat with dying friends too. However loved ones leave, their exit needs to be respected. Mental or physical, folk's need to step off is, I feel, not about the living left behind. Ohh fuck. I dunno. Maybe you are right Tom. I think out of all the comments, I like Theanne's.

    I read the article today about that policeman.

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  18. Sp
    I like your view and comment
    For most time, support,faith....whatever you can call it..does help eventually..... For those that do not find that certain amount of peace to be able to soldier on should always have our compassion

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  19. Very good post John. I'm with you, each of us has a choice and I feel that it is ultimately up to us to choose how we die......being of 'sound' mind and ability and not involving anybody directly as far as the law stands today at least over here in N.A.
    Some would question if my brother was of sound mind when he chose to commit suicide when he was 19 years old. He was perpetually 'high' on LSD for two+ years and told me that it was easier for him to deal with life on LSD than to cope with life when not. As much as I miss him, it was what he chose to do and I understand why he did.

    There are so many ways/directions to go with this. Even some people that are 'insane' and who succeed to end their misery....are they correct in what they do or should we try to 'save' them? I don't know the answer to that one!

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  20. As much as I believe I've reconciled the principle with the actuality, it still is case by case. Which begs the question, why have a principle. When my brother killed himself almost forty years ago, there was no effective treatment for his depression. He was rational enough to say he could never be "himself" again, and selfish enough to leave a wife and an eight year old daughter. He did it, it was done, but he changed many lifes in troubling ways.

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  21. What is objective? What is clear and balanced judging???

    And why is death such a big taboo. Why is it seen as a failure.

    We'll never be free until we understand that death is just one of the many natural aspects of life!

    We all create or own reality!

    Hugs
    Jon

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  22. Have we thought that suicide can be a 'selfless' act as well? Just maybe the individual saw the effect they were having on their loved ones and truly believed they were doing it for their 9the loved ones') well-being. Especially if they knew they weren't gong to 'get better'.

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  23. Tough subject; I do agree with you John when you say that a person should not be allowed to make such a decision when in a depressed state. However, I do think there are people in this world who simply, for whatever reason, cannot get through it without living in terrible personal agony. One of our long-time friends committed suicide just over a year ago, he had two young teenage boys. My friend and the boys were a a friend's house swimming that morning when he took a gun, sat naked in the bathtub in the upstairs master and killed himself. All I could think is...he could NOT have been in his right mind to do this when he knew his wife and kids would be home soon. It was about 9am. I guess he figured he couldn't go thru one more day. He'd suffered with Bi-Polar disorder and severe depression for years. An exceedingly handsome man, engineer for NASA, a one-time professional surfer...he didn't reach 50. In a way, we all understood.

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  24. thank you all for your contributions
    it is amazing that so many people here have been directly and indirectly affected by suicide

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  25. I want to have a dignified end, if that means assisted suicide why should anybody elses beliefs prevent me?
    Jane x

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  26. Having suffered from clinical depression for over 30 years, I have a slightly different outlook on suicide. There was only one time, in all of those years of struggling with depression, that I actually became suicidal. And that time was very scary. The reason it was so frightening is because it seemed perfectly reasonable and logical.

    Of course I wanted to die! My life was horrible. There was no hope of if ever getting better. Or, if it did get better, it would only be for a short time and then everything would come crashing down again. Worse than before. Nobody 'in their right mind' would want to continue to live such an existence. I was tired of fighting. I wanted peace.

    I had always thought that anyone who committed suicide was selfish. I saw suicide as the most selfish thing that anyone could ever do. Until I was suicidal. THEN it made perfect sense and I believed that it was not ME who was selfish! I was suffering and miserable! It was all the people who wanted me to live. To continue suffering, just so they wouldn't have to feel badly that were selfish.

    I truly believed the above. It was so logical and made so much sense. I resented anyone who tried to help me. They were the selfish ones.

    Fortunately, I was surrounded by loving children and expert doctors who helped me climb out of that black hole. I now take a combination of antidepressants that have kept me stable through some incredibly difficult times and I haven't returned to that brink again.

    Unless you count the time that I was in Septic Shock and almost did die and I demanded that the doctors stop treating me and let me die. That wasn't depression. That was PAIN. I didn't want to hurt anymore. Thankfully, I passed out ~ or the doctors put me under ~ soon after that point and pulled me through despite my protests. I have to admit, I was angry that they did for two weeks! Then I was glad.

    Sort of...

    (sorry for the novel ~ it's an compelling subject for me)

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  27. Soldiering on is certainly what my sister has done for the last eight years. As you know, she has MND. She still values what is left of her life and is determined to make the most of it. It helps that she has a totally devoted husband. Whether or not she has considered suicide I shan't say as that would invade her privacy, but I'm sure everyone in that situation would do so at some stage.

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  28. Nick
    I know EXACTLY what you say

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  29. Well John, you've certainly got a debate going. We're all gonna die so we've all got an opinion. My brother comitted suicide 2 1/2 years ago. He left a year old child and a child he never knew he was going to have. I am in a minority in my family. I think, bless him, at least he made his choice for him. My mother can't bear that, she says she would have coped better if someone else had taken his life or if it had been an accident. At the end of the day, it would have been better if he was alive, but he isn't and nothing will ever change that. Death is bad for the living.

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  30. I hope your alright with this John, but I posted a link to your blog. You spoke it too well.
    I love the "Soilder on"...so true..so very very true

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  31. This is an important post by a man who know what he knows, John you can change the world!

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  32. I can't even get into this discussion. I am a bit more isolated than I ever was so I only learned of PC Rathband's death via Going Gently just now and I am VERY upset.

    There is usually nothing out there that can make me cry except women or suffering kids but I am shedding more than a single tear for this guy.

    In an instant, while on duty, he lost his eyesight then, in quick succession his job, his wife and his kids.

    As I recall the authorities bitched about his compensation, loads of people attended Moat's funeral and Moat's family lodged a complaint for compensation. In the meantime this poor sod slowly fell apart and now I suppose people will blame the wife for leaving him.

    It is just too tragic.

    What a State we are in when we commence to justify the most irrational act of a living being, that of suicide. Naturally, we can all concieve of reasons to end it all but those are merely reactions to the symptoms of the society in which we live. Deeply selfish and uncaring.

    I am sure his wife and kids tried. His brother obviously tried by having him flown out to Australia and the police were still keeping a loose eye on him but what everyone seems to forget is that it is the family that needs the most support and guidance, not the victim. It is the family, if they can stay together, that will readjust and provide the very best care, not some bored police welfare officer calculating her overtime at Heathrow Airport.

    The system let the family down and now the family have to pickup the pieces.

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  33. and the kids don't have a Daddy anymore.

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  34. Your post today is very interesting John because that is exactly how I feel. There is always however the moral dilemma of those left behind, but that aside I think we should have complete autonomy over our lives. I subscribe to Dignity in Dying and have done so for some years.
    It is interesting though to read thoughts by someone like you who really knows what he is talking about, so thankyou for that.

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  35. Had a suicide in the family a couple of years ago and the shockwaves are still rippling outwards to this day.

    Some how, some way, most of us manage to pull ourselves from the brink. I often wonder where that brink is or just how bad things really need to get before taking ones own life becomes a very real option.

    This guy, unexpectedly having lost his sight in such awful and injust circumstances, well, I can understand why he might have felt like he couldn't continue. Losing my eyesight would be the worst thing I could loose. I couldn't honestly say I would be able to carry on. I hope I never have to find out.

    I read that he had recurring mental images of the scum that shot him. With no 'new' visual images to replace these continuous nightmares it must have been a living hell.

    Poor guy.

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  36. "... MorningAJ said...
    I suspect that the majority of commenters here have never been so depressed that they thought about suicide.

    I think anyone who's never stood on the edge of that pit shouldn't judge others who obviously have.....



    Jesus Christ - what a condescending load of patronising codswallop

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  37. Theanne said " I stood at the abyss therefore I make no comment".

    I too have been on the brink, and it was only when looking down did I see more clearly. Thinking about a way out can sometimes be just what the doc ordered...A temporary break from real life, a gentle slip into another place where things sometimes seem clearer and where a pause.... makes the difference between being here and being there.

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  38. I think I would like to wrap this entry up
    thank you everyone for the honesty in your posts...
    x

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  39. Difficult subject - I just feel we as society first let down Raul Mote so this happened in the first place then let David Rathband down too. We so quickly forget the victim

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  40. PC Rathband's suicide broke my heart. You could see he was struggling so much. My heart goes out to his family. x

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  41. I think you are speaking wisely here, and with experience of people in traumatic situations. interesting to read Dan's comments too as I know he works as nurse

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  42. From my own nursing experience, i actually believe that some forms of depression are terminal illnesses and that death comes by that person's own hand - just as much as cancer takes other's. That is not to say that we should assist in this, not at all, but i feel that some recognition of this should be made in the aftermath - all the guilt and enquiries etc. i also think it might help those families left behind. I don't know it that makes any sense at all,so i hope i don't offend anyone.

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  43. Oops! I was all ready to comment and then you closed it, John. :-) Great post and intriguing comment thread though. It's great you made a space for everyone to talk about it. Clearly everyone needs to.
    Dxox

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