I cared for a suicide patient recently.  Not an attempted suicide, a completed one.  She was efficient, effective and successful.  I pronounced her dead, filled out the appropriate forms, and went on with my shift.

While I found it tragic, and while I was moved by the sorrow of her family, I was not particularly moved.  What does that mean?

Day in and day out, emergency departments like mine are bombarded with patients coming in the door, or via ambulance, who say, ‘ I’m thinking about killing myself.’  We evaluate them, admit them, commit them, see them weeks later for the same thing and round and round it goes.  One becomes a little numb to the complaint, and to the almost hopeless cycle that our inadequate resources and dysfunctional populations produce.

But a completed suicide?  Shouldn’t that leave me more wounded?

I suppose it could be that I’m broken myself.  Heartless, cold, or the insult of insults leveled at physicians, ‘burnt out.’

Or, it could be that now, at 47, mid-way through the practice of a difficult job, in a difficult setting, with years of tragedies stored in my mind, I am simply professional.  I have the right walls, the right ability to press on through terrible things.

I’ll choose b.  I’m sorry for the death.  But I am not overwhelmed by it.  If I were, could I continue to practice?  Could I continue to function in my daily life if every horror left me shaken?  Hardly.

I’ll say a prayer for the family.  And I’ll be thankful for my wife and children.

I am not unaffected by suicide.  But neither are my foundations shaken.

Edwin

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