Monday, July 21, 2003 at 10:43PM My job can be life and death
My job can be hilarious at times. It can be frustrating at times. Sometimes it can be frightening. Today though I was reminded of how it often involves a person’s life or death.
“Hi John, how you doing?” I was speaking to the coroner on the phone. “Not bad for a Monday,” I replied matching his small talk. “Say, have you all ever had a patient named Anne Smith in your hospital?” (Anne Smith is a fictitious name) “Her name isn’t familiar” I said, “but let me check the master list.” As I turned to the “S’s” on the master patient list, I found Anne’s name. She had been a patient at our hospital for a three day stay about six months prior. “Yes she was here” I said, “what’s up?” “Well,” he said, “she’s dead.”
When you work at a psychiatric hospital and you learn of a former patient dying, one of your first thoughts is - “Will I be blamed or sued.” Unfortunately, people attempt to “cash in” on any little scratch, slip and fall, and certainly suicide. I am not faulting law suits with merit, but I have seen a lot without merit. Families who have nothing to do with a person when they are alive may be quite active once their “loved one” commits suicide.
Now the fact that I could not recall Anne or her circumstances did not help. I went to medical records and pulled her chart. The coroner said he was going to send a request for records so I needed to get it anyway. As I browsed the chart, Anne’s case began coming back to me. Her husband brought her to the hospital as a walk in one afternoon. He was concerned she might be suicidal. To get to the point, Anne was admitted. As often happens, she wanted out of the hospital as badly as she wanted in. We call it a flight into health. Stress and circumstances drive a person to the brink of suicide. They seek help in a hospital. Once in the hospital, they often get restless and want out. “I feel better now,” they will tell you. “I want to live, I have so much to live for.”
Of course we agree with the “I have so much to live for” statement. “Be patient,” we tell them, “a day or two ago you were going to kill yourself - what has changed?” In Anne’s case, she was able to make the argument. She promised she would come back if she had any problems. She said her husband was very supportive. She promised to attend outpatient therapy once discharged.
Anne had a 9 month old baby and she was still mourning the death of a child one year earlier. Her response to that tragedy was an attempt on her life one year ago. This time though, Anne was discharged and that is the last we heard from her or about her until today.
I feel bad for Anne and her family. Her child will never know her. She will grow up with the stigma of suicide. She may wonder if suicide is her destiny. It won’t be a good thing. Suicide impacts so many people.
As for me, it was a reminder. What I do is important. What I say to someone may be the last advice they get. I am not so grandiose to believe I have to say the exact right thing or people may die. I do believe that I can give people hope with my words. And I believe my indifference may keep suicide on their menu of ways to handle problems.
Although saddened because of Anne’s unlived life, I am energized to make a difference in the lives of those I work with, because it is life and death.
