Saturday, 21 September 2013

Suicide Isn't Painless

Yesterday, Tom Stephenson wrote an eloquent and rather sad blog piece about amongst other things rural suicide.
I flippantly requested that he lightened up a little with today's posting, a thing he duly did, but once the suicidal fuse paper was lit so to speak, I couldn't quite get the subject out of my head this morning.
I think most of us, at one time or another in our lives have been affected by a suicide. Whether it be, god forbid, from the actions of a loved one, a relative, a friend or a colleague or indeed from in the actions of a complete stranger whose last final attempt at self determination affected your commute to work or daily routine.
All of us have been touched by its fallout

Several years ago I remember being responsible for the planning and implementation of nursing care of a patient who had paralysed herself in a suicide attempt.I will call her Anna.
The woman, was acutely depressed and even though she was paraplegic she remained desperate and resolute that she wanted to end it all.
We nursed her on a mattress on the floor to prevent her throwing herself face first out of bed. my ward nurses  observed her constantly as even one moment left unsupervised  gave her the opportunity to self harm, by stabbing herself with smashed crockery or even hanging herself with the tracking hoist that ran over her bed.
It was a desperate, sad and dreadful time for her and for the ward staff who had to endure the daily stresses of this kind of nursing care without the intervention of an impotent psychiatric service.
But as a team, we soldiered on.
After weeks of keeping Anna safe under the " protection" of the mental Heath act, the psychiatric services started to respond more favourably in providing trained psychiatric nursing input and our own therapists and nurses started to make tiny chinks of rehabilitation improvement with a woman, who despite being a successful professional in her previous life, still held on to the desperate desire to end her own life.
Our ward nursed Anna for several months, after which she was transferred to the unit's rehabilitation ward. We all hoped that we had kept her alive, long enough for psychiatric interventions to gain some sort of foothold, and that the depression would eventually lift, but the truth of the matter was that deep down we were just glad that she was now someone else's problem to deal with. Caring for someone who wants to die, and who seriously wants to die,is dreadfully hard work.
The misery within the person seems to pervade anything and everything.....and is a recipe for trouble on a rehabilitation unit where everyone is swimming in very choppy waters.
On the surface Anna improved somewhat on the rehab ward, she attended complementary therapy sessions with a dedicated occupational therapist, she learnt to care for herself in her wheelchair, and she was eventually taken off  constant observation by her psychiatrist. But behind her eyes, there was always that dead, depressive look of someone who for whatever reason, could not see enough joy in her own existence.
Anna committed suicide nearly one year after being admitted to our unit. That day, she placed a plastic bag over her head and lowered herself unseen from her wheelchair to the floor between two cars in the hospital car park.
I remember the day well.
And riding above my feelings of sadness and regret......I felt an overwhelming sense of relief.

58 comments:

  1. All her suffering ended...who are we to say that is wrong?
    Jane x

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    1. There was always an inevitability about the outcome, I think

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  2. This brings up a whole new conversation about allowing assisted ending of lives. I for one would allow that to happen, but that's just my own opinion..............

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    1. Hummm...as a former psychiatric nurse.... I think that everything needs to be done to " rectify" a mental depression or psychosis if that is the cause of the suicidal feelings
      Not as easy is it sounds eh?

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  3. Thank you John. That was very sensitively written, for it is a subject like you said 'has affected us all'

    My own thoughts are that adults should be allowed to choose for themselves whether to live or die and by their own hand. I do not believe any other person should be involved in the act.

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    1. I completely agree with you. And, John, a really great piece of writing.

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    2. Thank you heron and em
      I don't know where it all came from this morning

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    3. John,

      Yes, thank you for writing this piece.

      I have to agree with both A Heron and Em.

      My brother in - law (years ago)drove out into an unpopulated area and committed suicide. Not one person in the family knew he was hurting. He put a façade on for family and friends.

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  5. You pitched this just right. What a dreadful but inescapable topic. I must say reading I also felt sad but relieved for her. I do think the poor people who had to endure the aftermath of situations like this. If perhaps there was somewhere for her to relieve herself then at least a lot of people would be spared the trauma of finding someone in a public car park...There are no straight answers though are there.

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    1. I think most of the staff dealt with it like I did......relief....and shock

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  6. The will to self-harm in young people who seem to have no obvious reason to do so is extremely difficult to impotently witness, but someone taking their own life (suicide ceased to be a crime to 'commit' quite a while ago) leaves everyone feeling as though they did not do anything to help, which is even worse. Taking someone on a one-way trip to Switzerland is something else entirely, I think.

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    1. If as much can be done to " help" before the act
      That perhaps can " cushion the blow" so to speak

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  7. Suicide is an idea I have muddled over for a long time and still can not come up with an opinion I am comfortable with. At the moment my feeling is that if someone wants to take their own life and have attempted to do so, we have no right to interfere. But that is just todays opinion....like a fly in a field of cowpatties, I just can't seem to decide.

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    1. It is a subject I have been thinking of a lot recently
      In Samaritans if someone wants to talk as they are in the process of suicide....our job is just to listen
      Nothing more unless the person involves asks

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    1. The fallout from suicide can seem never ending I guess

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  9. Assisted suicide certainly has its legal and ethical complications, but once legislation has been carefully considered (and I'm certain it will be), I would definitely be pro.

    My own experience of suicides has been horrendous.

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  10. A touching story. In my previous employment, over the years, I saw many suicides (particularly rural) and the damage it caused to families, particularly when the deceased was younger. This is a deep and complex issue and my opinions have changed and swung one way and another over the years as I hear people's point of view and personal experiences. Thanks for sharing your thoughts - a courageous thing to do.
    x

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    1. The self determination argument is a hard winding one... I too vasilate in my opinion

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  11. Just watching the 2010 film Never Let Me Go, about cloning for organ donations and the donors decision to "complete" when they have made their donations. An interesting concept and film in light of your post today.

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    1. Off to google it.... Not a film I know

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  12. Very thought-provoking and sensitive article.

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  13. My sister in law decided to end her life this year. She managed to do it in a secure psychiatric unit at the local hospital. Never under estimate the power of death or the way it calls to some people. My heart hurts every day for Husband who lost his sister, not for her, she got what she wanted. I understand your comment about relief, it's a harsh reality but it's true. It IS a relief.

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    1. Solorn
      I agree..... I have seen similar events too
      It is almost as if there is a hidden force involved
      Thank you for your comment

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  14. This is why I couldn't be a nurse. I am not strong enough.

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  15. Excellent post on a very complicated subject, John. I can so well understand the feeling of relief. And yet, I've had patients who felt suicidal and experienced that inclination pass and one patient who actually attempted suicide quite unexpectedly who is living a full and reasonably happy life today. She's very glad that she didn't succeed in ending her life ten years ago.

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    1. Thank you Kathleen .......nurses have a " duty of care" ...so they " need" to DO ...... Doing nothing is a difficult one for us

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  16. Sadly I can say that yes, I have had to support those affected by suicide which makes me so mad when people flippantly say they tried to kill themselves when they blatantly didn't or they wouldn't be here telling the tale.

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  17. The fact that she failed in her first suicide attempt probably gave her more determination to get it right the second time. It must have been extremely challenging to protect the life of someone who didn't want to be saved. You did your job John and that is all you could have done. We can only imagine the torment that was going on in her head that would make her resort to taking such measures. x

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    1. I remember thinking that it was her determination and desperation involved with her self harm which was so distressing to watch

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  18. However, there are also those that can get over their suicidal feelings and tendencies if they get the right treatment for their mental health problems - what might seem insurmountable for some 'today' could be entirely different 'tomorrow'. What a thought provoking subject. Unfortunately most of those determined to do it are often the ones who don't discuss it, so it comes as a complete shock to those left behind and a complete feeling of impotence.

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    1. This is the part of the puzzle which is the most important for me.
      However there are always people that do not have an underlying illness to treat

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  19. I feel terribly sad that someone can feel as if there is absolutely nothing to live for.

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  20. A big part of my life has been a battle with severe depression and self harm so your blog has really touched me today. Just because we are born doesn't mean we all want to live as your patient demonstrated, regardless of what other people think or feel.

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    1. I am blessed with an optimistic slant on most things
      It is something that I generally take for granted
      .....and shouldn't
      Thank you for sharing your thoughts x

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    2. Reading your blog is the best dose of therapy going however lousy my day

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  21. I had an elderly patient who told me about previous suicide attempts and her continuing desire to die. I reported it and she was put on suicide watch. She ended up dying an absolutely miserable death after the amputation of part of a leg because of a bedsore. It was just sad all round. I still don't know if I did the right thing. Maybe I should have left her to her own devices.

    Love,
    Janie

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  22. I'm a police officer in a public protection unit and I'm constantly amazed an saddened at the number of calls we receive and have to attend. The really sad times are when someone does it rather than phoning you, ignoring the advice you give and then calling again the next night : (

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    1. I think you have the hardest job of all
      I

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  23. Here in Oz, suicide is the leading cause of death for people aged under 44. More people die from suicide than are killed on our roads. It is too often used as a permanent solution for temporary pain. Which is sad and bad...

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  24. Suicide has so tragically touched our lives over the last 5 years. Two of my son's friends, my husband's boss, a second cousin...oh my. All males. These poor men just don't seem to seek help the way women do.
    Everyone always says what a selfish act it is. But the poor dears are in such pain. I've suffered from severe depression...I may not understand the act, but I understand their pain.
    My heart always breaks for those left behind.

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  25. I think assisted suicide (as brought up in the comments above) is one thing in facing a terminal illness where there is no hope of a cure and quite another when it comes to mental illness that there quite likely could be a remedy to bring about improvement. That poor tormented woman....I am glad, although it was hard on all of you, that she did receive kindness and good care in her last months on this earth. Thank you for that.

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  26. I lost my sweet niece Anna (no relation to the story) the pain haunts our family each and every day even two years later. The desire to end one's own life is a disease. A most likely fatal one but that does not mean we give up the fight to help them live.

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    1. Sensitively put thank you

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  27. My brother was 19 when he committed suicide. He was in a lot of mental pain and confused for a couple of years. He preferred his 'drug induced' world than to have to battle with the 'real' world. He suffered a lot and couldn't take it any longer. His death was swift and deliberate and I would like to think painless. A very selfless act.

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  28. Wow~ very powerful story, John. I agree with Sherry, it is most devastating to those left behind.

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  29. No one can really feel another's pain. Anna' s life must have been excruciatingly awful and that is sadder than her death.

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    1. My thoughts exactly I think

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  30. I was moved so deeply in so many ways by this. Suicide is so personal and public. The fact that Anna had some kind care from all of you is wonderful. What saddens me is that she may not have seen or felt it through all her pain. Or maybe she hated that it was temporary. The not knowing why and having to soldier on is what hurts the survivors. Bless you and the staff for doing what you had to do and mourning her with relief and sorrow.

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  31. Such a sad story. She was so desperate. Everyone that cared for her did a wonderful job, but if someone is determined they will succeed. My youngest brother took his own life suddenly, we all felt we had let him down but now know there was probably nothing we could of done to stop it.
    Rosezeeta.

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  32. Those that do it have an end to their pain, those they leave behind have to deal with it often for a long, long time.

    A thought provoking post John, I understand your last paragraph completely.

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  33. Our seventeen year old nephew took his life two weeks ago. I'm afraid I'm not very objective about the subject right now.

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