Suicide is (not) Painless

The theme song to the movie and tv series, Mash, was Suicide is Painless. It is too cumbersome to explain that song here, but to say, of course suicide is anything but. Suicide brings incredible pain to a family, maybe more so than any other cause of death. There is anger married to the bereavement, because the victim’s life could have been spared only if they had made the choice not to do it.

Last scene of the movie MASH, where the character called “Painless” is committing suicide

But suicide is very painful for the victim as well. On one level, that seems counterintuitive because they didn’t have to do it. We all have a great instinct to live and it takes an incredible amount of pain to lead someone to take their own life. Sometimes we can’t see the pain of the victim because we too feel incredible pain and are immersed in the fog of anger at them.

Suicide is one topic I wanted to discuss for a long time, but I do it with trepidation. It has been in my draft box for weeks if not months. The reason for the angst is my fear of misunderstanding. When it comes to suicide, I already know that some people will read this as me crying for help or my personal anger over something, or simply melodrama. I will be clear, this article is not about me, but about the topic of suicide. I will say with confidence that, while I have been in the past, I am not suicidal at this time. I am feeling better than I have all spring, better than many of you with chronic health problems must feel. I come to this topic as a writer, an observer of life, but will draw from my own experiences at times.

I have been studying authors for at least four years, with the hopes of becoming a better writer myself. I spent months reading everything that Hemingway had written. One of his short stories, In Another County, he describes in the detail that only he can describe, the dead of World War I. While a reporter and observer, he does draw from his own experiences because he was an ambulance driver in that war. That’s what I hope to do here, speak from experience while not talking specifically about me. Oh, and by the way, Hemingway did commit suicide … with a long gun, bullet to the head because he lost his ability to write after having shock treatments at Mayo Clinic for depression.

The real reason that I’ve decided to write on this thorny topic at this time is that my latest author study was of the American author, Sylvia Plath. Sylvia was brilliant, a child prodigy. She wrote of suicide (The Bell Jar), drawing from her own experiences, and, like Hemingway, did it … committed suicide, but young, at age 30, leaving three small children. It was her third serious attempt. Was anyone listening?

Recently we planted a tree for my nephew who took his own life … with a gun. Another nephew took his own life, about the same time, but insidiously … with a bottle. Painful losses of great people with even greater potential. I’ve had many friends and dozens of patients who have committed suicide. I’ve had the suicide prevention discussion with countless patients, me trying to pursued them from the act and into good treatment for their depression or whatever they were dealing with.

If the odds are right, of the almost 300 people who follow this blog, 50 have had suicidal ideation (thoughts or planning about it) and about 5 of you have or will have a serious attempt within your life. Maybe a couple will succeed. If writing about it prevents one of those, it was well worth the time. I do realize that many of you have never had a suicide thought in your life and you can’t understand us that do.

I’ve had several friends commit suicide, all men … all with a gun. Guns are unforgiving. Those who attempt suicide with a gun, about 98% are successful. Those who are not, are usually seriously maned.

As I mentioned, I’ve had many patients attempt and succeed at suicide. Two attempted with a gun and lived. The bullet in their heads was why they were having headaches. Suicide is the second cause of death for the younger crowd (<34) and third to fifth for the other age groups. Thinking about suicide is very common. In 2019 47,000 people died from suicide another 12 million seriously thought about it. For some groups, young men with anxiety or trauma, it is the number one cause of death.

Impulsive Suicide

I will oversimplify the situation, but suicide is either the result of a long standing mental illness, usually depression or anxiety, or a sudden crisis. Often a combination of the two.

One of my two female headache patients with a bullet in her head, said she had never suffered with depression or had thoughts about suicide. However, after thirty years of marital bliss, she came home sick one day to find her husband in bed with her best friend. They had been sleeping together, behind her back, for years. This was a sudden crisis. She was extremely upset and as the argument with her husband continued into the night, her without a tear left to cry. Eyes all dried up. Finally she said, being distraught, “I want to kill myself.” Her husband, a police officer, loaded his service revolver and handed it to her. He taunted her and dared her to do it. According to her, he placed the barrel on her temple and begged her to pull the trigger (I think he wanted the freedom to marry the girl his wife had caught him with). She did pull the trigger. But, by some miracle, maybe she winced as she shot, she lost a chunk of brain tissue, but lived. She had chronic headaches and seizures as a result. But her husband … ex-husband I should add… was not arrested because, according to her, he knew that in Minnesota it was not a crime to entice someone to commit suicide.

I know someone who attempted to kill himself by jumping off our nearby 180 foot high Deception Pass bridge. He was one of a few who survived that fall. Now a paraplegic, he told me he still wishes he had succeeded. He had suffered from depression, but the last straw was his wife leaving him for his best friend.

But talk of suicide carries a stigma. A profound stigma, where people in distress have to bury the pain. Dare they mention that they feel like killing themselves? That would put them in the position of sharp ridicule. But if they could only talk about it … that could change everything.

I remember a young mother in my childhood community committing suicide. I was just seven. It was the first time I had heard of killing yourself. She suffocated herself in the closet of big new beautiful house with a dry cleaning bag. My mother told me it was a shame because she was rich, therefore no excuse, and she will spend eternity in hell because suicide is unforgiveable.

Chronic Suicide

The chronic form of mental illness that can lead to suicide, like with Sylvia Plath, include depression. This form is often genetic. The book about Sylvia Plath, Red Comet, goes into great detail point out the people in her family with suicide and depression. Her grandmother was institutionalized for depression and eventually committed suicide. Her father, a Harvard professor of biology, committed defacto suicide via ignoring his medical symptoms, with the assumption it was terminal cancer. However, it was a very treatable form of diabetes … discovered too late to save his life. But he had never gone to a doctor even with extreme weight loss and a rotting foot.

Defacto Suicide

Speaking of defacto suicide, I’ve now come across this many times in my new world of cancer patients. I keep running into people who have a simple and usually treatable forms of cancer but refuse the treatment because it “isn’t natural” or “Jesus will save them.” They all have died and I find that regrettable. I would trade my non-curable cancer with theirs in a heartbeat. Did they want to die as a way out of the fear? Was it suicide? I believe so.

The Silence of Suicide

Here is the angle I want to talk about . . . the silence about it. Every society on the planet has good traits and bad. I think one of the bad traits in our society, is the stigma and reluctance of talking about suicide. I write in haste because many of these 47,000 people who died, could have been saved if they felt comfortable talking about it.

A few years ago I heard an interview with Kevin Hines. He jumped off the Golden Gate Bridge in 2000 and, like my Deception Pass bridge jumper, was one of the very few to survive. He tells the story that as he walked up the bridge, if just one person would stop and talk to him about not jumping, he would not have jumped. He had had suicide conversations with his dad previous to that day. But on that day, he passed three people, who did not speak to him, except the last. As he was getting ready to climb over the railing, a woman with a German accent asked him to take her picture. He did, then jumped. He said if she had asked him what he was doing, he would have told her. If she had told him not to jump, he wouldn’t have. He and his father now work in suicide prevention.

From My Experience

I don’t think I have any form of chronic depression. I’ve said before that I feel things very deeply. My mother told me when I was very young, “You’re not like other children. You feel things very deeply.” I feel anger, especially when people lie and those lie hurt other people. I feel sad easily, even crying when I write in the deaths of character in a book I’m working on. But I also feel elated very easily. I’ve cried at sunsets, standing and looking at mountains, and I could go on and on. Denise has a different interpretation. She says that I don’t feel things any differently than anyone else, but I share more candidly. She, growing up stoic Scandinavian, where they did not share feelings so easily. Maybe she’s right, because feelings were shared opening and freely in my childhood home, especially with my mother, a profoundly honest woman. But you can pay your money and make your choice which is better. I do relate to the Italians and Arabs (Mediterraneans) in how they were their feelings on their sleeves.

With the above said, I have had suicidal ideations a handful of times in my life. But I don’t think it is from any type of chronic depression. The first serious time was in 1990 and 1997, both times after a deep personal loss.

The closes I ever came to suicide was in 2019. I was diagnosed with cancer in January of that year. The physical suffering that I endured from that point and for the next twelve months was beyond what I thought a human could bear. Working in health care for all of my life, I assumed that we had to the tools to prevent suffering … but I had none. Until I got to the Seattle Cancer Care Alliance, I felt like no one was listening. I would tell my cancer doctor here that my suffering was horrible. His response was always along the lines of, “Do you not understand that I’m trying my best to save your life.” To which I would respond, “What’s the point?”

For months I spent sleepless nights on the floor in tears begging God for mercy. How could I sleep when the suffering was so intense 24-7? It was a profoundly intimate time with God, not me in any type of anger, but at his mercy as there were no answers for me form the medical establishment. That’s why it is so hard when people say to me, and several have, “I see that you do not have a relationship with God by the things you write on your blog.” Painful! I’ve said before, there is more intimacy in a wrestlers’ mat than a lovers’ bed.

While I had promised my kids in the hospital that I would fight the cancer and that was the only reason I had not given up before. But after about 4 months of this, I could not take it any longer. I was out of my mind in suffering. I have found out that suffering is very isolating because no one wants to hear about it as it disrupts society’s narrative that all will work out well.

At that time, there was no hope for a cure for me. My doctor said he was fighting to give me 11 months (medium survival rate for someone in my condition) and I had spent four hellish months already. I came to a juncture that I was going to end my life. I told Denise. That night, about 2 AM, I collected all of the 12 medications that I had, pour out the bottles in a big pile. I got a tall glass of water.

With a neurological system and kidneys that were severely damaged, the last thing I wanted to do was damage my liver or other organs, and then survive. This happened to a friend of mine who took an overdose of amitriptyline, was in ICU for a month and lost her liver, but survived. She took the overdose on her ex-husband’s birthday … the husband who had left her for a younger woman. So, not to digress, but that brings up another suicide motive … revenge.

To be standing on the cusp of taking your own life is a horrible place to be in. We come into this world with great aspirations of being a good person and making a difference. It is overwhelmingly sad to reach a such a low point, of feeling trapped by suffering and no way out. That it would come to this. Me ending what life I had left … via my own hands.

Before I took my pills, I went to a (pro) suicide page. It gives instructions on how to end your life … cleanly. It listed medications and the milligrams it would take to cause certain death. I did not have enough of anything. It was only for that reason, I did not take the pills that night.

Those who have never been in this place themselves may be very angry at me at this juncture. “How could you do this to Denise and your kids?” But you have to understand that when you suffer so much and for so long, with no hope of recovery, the final exit of death is the profoundly sad choice left. If you are angry at me, then that is part of the problem of our society. Why do we have such anger at people who kill themselves, or who threaten to kill themselves, but offer them no hope, no options . . . not even a listening ear?

I’m not talking about people being mean to me. Recently a blog reader and (Trump supporter) said to me, “Mike I’m sorry other Trump supporters have treated you so badly.” I was perplexed. I haven’t been treated badly by any Trump supporter. When I spoke of Donald Trump last year it was about my concern about the big picture, not personal. The same it true here. I am not writing to complain how I was treated (the medical establishment not listening). I am writing about the big picture of the stigma that we put on self-harm. I’m as much to blame as anyone. I know that, outside of my medical work, my attention span with other people’s problems has been short. Why didn’t I listen better?

I spoke to my one nephew David on the phone several times before his death. Could I have said something more? I hadn’t spoken to Michael, my other nephew, in a while, but could I have reached out to him more? I was friends with him on FB, I could have asked him how it was going? Why didn’t those men and many other people like them, not feel safe to reach out to us?

The second point I want to make is about the victim. Recently on our community FB page a mother posted a photo of he son and announce the one year anniversary of his suicide and how she missed him. The first comment was from a heartless man who said, “So he took the easy way out.” I’m here to tell you, and I told that man, that suicide is not the “easy way out.” For those who do it, it is a horrible way out, but from their perspective at that time, the only way out.

After the night that I came close to suicide, Denise encouraged me to see a psychiatrist. I did. It went well. He listened to me, and that’s all I expected or wanted. In the end of the hour session he validated what I was feeling by telling me that it was one of the most hellish stories he had heard. He made a follow up appointment … but then COVID hit and all future appointments were cancelled. Two months later his office called me to reschedule, but by then I was past the acute phase and was heading to Seattle, where I did follow up with mental health professionals. They said up front that they would not attempt a bone marrow transplant while I was still suicidal. There they did make some attempts to alleviate the suffering too, to no avail. Fortunately, it is much better since 2019.

Sylvia Plath calls her book about her own struggles with suicide, The Bell Jar. She describes how this mood of depression and suicide descended on her, like a bell jar. The world around her becomes distorted through the glass. Her own, distorted thinking is locked under the glass . . . from which there is no escape.

I want to come back with a part II to address two issues. The first is my own “bell jar” experience in 2020. By sharing my story I want others to understand the why of suicide. The anger at the family member is so wrapped up in this unanswered question. “How could have done this to the family? She knew we loved her, why did she still kill herself?”

In the next and final installment, I also want to look at suicide within the Christian context. I’ve reviewed more than ten studies about suicide among the religious (most of those Christian sects) as compared to the non-religious.

This is a long and complex article that I had to write quickly without a lot of proof reading. I could have written it better if I had had the time. The next article will be shorter and less sloppy, at least I hope.



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3 responses to “Suicide is (not) Painless”

  1. I am grateful for your honesty and insight. I too feel deeply and struggle with chronic illnesses, ineffective treatments , and the social pressure to act “as if” my experience was something to be kept to myself. It seems important to my community that I maintain an upbeat attitude because it was “good for me”… or easier for them.

    I am currently confronting the notion of “catastrophizing”. This concept ,developed and claimed by psychologists who use scales to define personality disorders , offends me. It defines acknowledging one’s truth as a predictor for bad outcomes and pathologizes those who observe their inner world closely and feel deeply.

    Click to access Pain_Catastrophizing_Scale_Manual.pdf

    This concept has been developed over the last couple of decades and reduces the human experience of desiring to share or communicate their difficulites and fears or suffering, to pathology. Now it may be true that turning one’s attention to life affirming experiences or to beauty and gratitude help many to cope and perform better, but it seems to overlook the importance of feeling safe to express moments of fear and preoccupation with uncertainty and the need of many to feel seen , heard and understood.
    I am sorry you have had so many unfortunate encounters. I know you have dedicated yourself to healing from a deeper level of listening and respect for patients.
    I wish you well, and look forward to the next article in your voice.


  2. Suicide is a complicated topic and I’m proud of you for tackling it beautifully in your writing. Obviously in my field I have these conversations regularly and no two conversations are the same. More conversations should be had and I applaud you for opening up the topic. Well written.


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