Suicide: death from despair

We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, loss, pain, isolation, low self-esteem, failure, rejection, or financial/professional stress have experienced varying degrees of darkness and despair; it’s not a fun place to be, and not everyone makes it out alive. Some have been in such a low place that they feel their only solution to overcome this immense pain and suffering is through one final extreme act of choosing death over an unbearable life. Depression is an illness that often can be mistakenly viewed as a character flaw, a sign of weakness, or an inability to cope with everyday life. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts. It is, however, treatable; but one must be able to ask for help.

Suicide is death from despair. According to the Center for Disease Control (2018), suicide rates in the U.S. have increased 25% in the past two decades and are increasing among adults aged 45-64. Among those aged 15-34, suicide is the second-leading cause of death (CDC, 2018). When we hear about someone we know (or know of), who has committed suicide, we are often shocked. We question why/how someone would feel so hopeless as to choose to end one’s life, while others fight so hard to press on through their own struggles to live another day, grateful to be alive. No one truly knows what others are going through; we all have our own inner demons.

Those of us in healthcare have seen the outcomes of an attempted suicide. My first experience as a young PICU nurse caring for a teenage girl who attempted suicide by hanging, was extremely difficult and heartbreaking; there was no happy ending or miraculous recovery for this young, troubled girl. This story was tragic, and yet it happens everyday. She had gone through a bad break-up with her boyfriend, and the pain and rejection led her to self-mutilation, which didn’t dull the pain deep inside of her, so she hung herself. Her sister found her, and called 911. She was brought back to a life of vegetation. She wore a haunted look of pure rage, which seemed to be her only facial expression when “awake”. She had just enough brain activity to continue medical interventions. I still think about her from time-to-time when I hear of another suicide in the news, and I wonder if she ever found the peace that she was looking for so long ago. I truly hope so.

What can we do to prevent our loved ones from choosing this ultimate act of despair? First, we need to be able to recognize the signs and symptoms of depression and not be afraid to ask our friend/family/co-worker if they need help, or want to talk….or even if they have ever thought about hurting/killing themselves. We need to support better medical coverage for mental health and pre-existing conditions. We need to prevent those who have mental health conditions from being able to legally purchase a firearm. And last, we need to open our eyes and recognize when someone that we love needs help; we need to support them and not judge them. “There but for the grace of God, go I”.

Linkin Park wrote a beautiful song about suicide called One More Light (2017). The irony that one of the writers, Chester Bennington, committed suicide a year later, speaks to his state of mind and intimate understanding of the effects of suicide for the ones who are left behind to try to heal from this great loss.

Video:

One More Light (lyrics)

Should’ve stayed, were there signs, I ignored?

Can I help you, not to hurt, anymore?

We saw brilliance, when the world, was asleep

There are things that we can have, but can’t keep

If they say

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

The reminders pull the floor from your feet

In the kitchen, one more chair than you need oh

And you’re angry, and you should be, it’s not fair

Just ’cause you can’t see it, doesn’t mean it, isn’t there

If they say

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do

Well I do

Linkin Park (2017)

Songwriters: Brad Delson / Chester Charles Bennington / Dave Farrell / Francis White / Joseph Hahn / Mike Shinoda / Robert G. Bourdon

One More Light lyrics © Universal Music Publishing Group

If you, or someone that you know, are having thoughts of suicide, please seek professional help; call a friend or family member, or call the

Suicide Hotline: 1-800-273-8255

References:

American Psychiatric Association. (2018). What is depression? Retrieved from https://psychiatry.org/depression

CDC. (2018). Suicide rates rise sharply across the US, new report shows. Retrieved from https://washingtonpost.com

Linkin Park. (2017). One more light. Retrieved from https://youtu.be/Tm8LGxTLtQk

Sacred Ground

When I was young, I remember that my Dad used to joke every time we passed a cemetery, “ya know, people are dyin’ to get in there” … he thought it was so funny, and we would give him a courtesy half-laugh over the predictable double entendre. I realize that cemeteries may seem like a morbid subject to some, but I find them so interesting. I’m drawn to the history and the peaceful solemnness of the permanent resting place of so many; it is sacred ground. Every grave holds a story, and I think about the people who have walked this Earth, lived a life, and are now memorialized six feet underground by a tombstone, marking the ultimate ending to their story; the inevitable great escape to the unknown. Who were they; what did they do with the time that they were given; did they have a life well-lived; how did they die; how will they be remembered? I think about these things. That “dash” between your years from birth to death represents a lifetime; “only those who loved them know what that little line is worth” (Ellis, 1996).

Gravestones are an everlasting memorial to a life lost, but they tell very little about the person… some show a long life, and tragically, some are quite short. The picture below shows actual gravestones in the cemetery where my Dad, grandparents, and other family members, rest:

These lost souls are only to be remembered as Father, Mother, and Annie; no last name; no dates; seemingly anonymous to all who come across them.

One can only guess that these modest memorials are due to the immodest cost of a burial and gravestone… or, perhaps, those who buried them cared little about a name, or some dates… they chose to remember them simply. We will never know, and perhaps that is the way it was intended.

Do you believe in ghosts? As nurses we often witness the passing of a life; ask any nurse who works in an ICU or Oncology unit whether they have seen, or felt, something unusual, like a “presence” on their unit, and I would guess that many will say that they have. When I worked in pediatric oncology, one nurse told me that after a young boy passed away, his young cousin told his mom not to worry, she saw her cousin walking away, holding his father’s hand (his father had passed away a few years prior). Some may find it hard to comprehend such stories, but I find it comforting to think that we will be reunited with loved ones when we pass.

Reference

Ellis, L. (1996) The Dash Poem. Retrieved from https://thedashpoem.com

Being brave

I reconnected with an old friend recently, and as we were catching-up on this crazy thing called life, he gently reminded me that we all have stories. While some stories are harder to tell than others, most of us are fortunate enough to have a surplus of great memories that we carry as a reminder of who we are, and where we’ve been.

Owning our story can be hard, but not nearly as difficult as spending our lives running from it. Embracing our vulnerabilities is risky, but not nearly as dangerous as giving up on love and belonging and joy—the experiences that make us the most vulnerable. Only when we are brave enough to explore the darkness will we discover the infinite power of our light.” (Brené Brown)

Being brave can mean different things to each of us… it all depends on your ability to face your fears. Overcoming such an intense emotion isn’t easy; in fact, it can make us extremely uncomfortable, and is often the result of an act of love or necessity. My challenges with trying to be brave have changed as I have gotten older. As a child, being brave meant getting a “shot” from the doctor; as a teenager, it meant trying to overcome self-esteem issues; as an adult, it has been more about being honest when the truth was hard to hear; it was letting go after losing trust; it was starting over as a single mom. Being brave is stepping-up to a new challenge and trying again (and again) after failure. It is saying “yes” when every fiber of your being is feeling afraid and anxious and wants to (safely and comfortably) say “no”. Being brave is facing your fears and fighting a battle that you know you may not win, but will never give up trying.


Hope

“While there’s life, there’s hope“- Tolkien

Hope is exciting; it makes you feel that anything is possible. It is powerful and profound. The feeling of having hope can make even the tiniest spark of light seem like a sunrise in the making. Hope can make one walk a little lighter and feel a little happier. It can make you forget everything bad and painful, even if only for a short time. It is wise to be cautious with expectations, but I have found that even the slightest chance of something awesome happening, can make all the difference in the world between giving up or getting up.

Nevertheless, she persisted

This is not a political post; rather, it is quite personal to me, as I can’t help but deeply relate to the slogan, “nevertheless, she persisted“, which became popular in 2017 after Mitch McConnell condescendingly uttered it while trying to silence Senator Elizabeth Warren during the U.S. Senate vote to confirm (recently fired/resigned) Jeff Sessions as Attorney General. He did not know at the time that those words would resonate with so many women; me included… and yes, I bought the T-shirt. If you have been following my blog, you know that I was recently diagnosed with a rare spinal cord condition called Arachnoiditis. It is something that I had never heard of (even as a nurse), but it has come to be my fate after complications from my last spinal fusion in 2016. I am presently coming to terms with trying to advocate for my own healthcare needs and navigate through hours of online research to educate myself and practice patient-centered care; this time with me starring in the role of impatient “patient”.

I consider myself a (mostly) private, independent person, but I must confess that I feel so helpless… it is scary to consider how this diagnosis will affect my future, both personally and professionally. This little blog that began as a way to express myself during a time of loss, continued on with my writing from a personal perspective about my love of Nursing, has now entered into a new challenging phase of my life. Please bear with me as I stumble through this unknown territory, one day at a time.


Change

Change can be hard; we become comfortable with habit and familiarity. The longer you stay in one place, the harder it is to leave. I feel strongly that in order to grow, one must be open to, and adapt to, the challenges of change. I (especially) advocate for trying new things in one’s career, such as earning professional certifications, or going back to school to pursue a higher degree. I have written many letters of recommendation endorsing fellow nurse friends and colleagues whom I truly believed had the potential for great things in the field of nursing for other positions, promotions, or awards… even if that meant that they would be leaving my own unit/organization for bigger and better opportunities. I applaud them for being brave to try something new. As a nurse leader, it is my responsibility to raise others “up”, and I am proud to do so, just as it was done for me by my mentor, Nicole; she taught me many things about leadership and change, and led by example. Nicole also re-introduced me to the rare genius and leadership lessons from Abraham Lincoln in Lincoln on Leadership (Phillips, 1992).

“I have simply tried to do what seemed best each day, as each day came.” –Lincoln

Some of Lincoln’s greatest quotes have held the test of time and have proven to be especially true and powerful in our current political climate.

A house divided cannot stand“- Lincoln

Yes, change can be difficult, but believe in yourself and your ability to overcome obstacles and take control of your future. Confidence comes from stepping out of your comfort zone and expanding one’s experience, expertise, and perspective in other areas. In my 30-year nursing career I have worked in many sub-specialty areas in the world of Pediatrics. I was never afraid of change; it actually sustained my love of nursing. I was challenged with each and every opportunity. These different experiences have proven to be invaluable to a nursing career well-lived and loved; I wish the same for you!


Reference:

Phillips, D.T. (1992). Lincoln on leadership: executive strategies for tough times. New York: Warner Books

Smiling through the Pain

Nurses are caretakers; it is our job and natural instinct to be the provider of care, and not be at the receiving end. I’ve been on the other side of the bed (as a patient) a few times… each experience was pure torture for me; I cringe when I think about the compromising positions that I have had to endure. I am a terrible patient. I have severe trust issues; when one has worked very hard to be fiercly independent, it is an uncomfortable feeling to be vulnerable. I have been living with back pain for years; after two spinal fusions, I have (almost) gotten used to it. I megadose on Ibuprofen and Acetaminophen two- three times a day, and I try to smile through it and not complain. I carry on with my day and know that others have it far worse than I do. I joke that it’s “tough to get old”, and I am fully aware that I am at the age where it is natural to feel aches and pains; but the reality is, pain can be exhausting. It affects everything that you do, or want to do; a simple trip to the Mall to go Christmas shopping becomes less fun and festive by the minute, and you eventually rationalize that gift cards will be a win-win this year, and head for the comfort of your car… and if you are being honest with yourself, you know that this is not normal.

The MRI showed arachnoiditis. I do not know what the future will bring, but I got through today, and tomorrow I will do the same.

Broken branches

Pain and disappointment is a heavy burden and can come from a very deep place in one’s heart, even if you have built strong walls to protect it. It is the feeling that no matter what you do, even if you tried your best, it is not enough…it can even make you feel that “you” are not enough. (Don’t believe it for a second!) Ironically, some of the people who are supposed to be the closest to us, and most trusted, can be the ones who can cause the deepest heartache; they can be one’s harshest, most unforgiving critic; they carry expectations that can become twisted in reality or perception… and sometimes, anger can make one deaf to reason, and blind to the truth. Family disagreements, if not kept in check, are toxic and can grow to become permanent “holes” in one’s life. If you care at all, you must try to repair the damage; but if you have tried, and tried again and again, then you must accept what cannot be changed.

Anger is like a strong wind; it calms down after a while, but some of the branches are already broken”– Rumi