Friday, August 5, 2011

Patient Suicide Part Three: Fully Present

This is part of an ongoing story about a patient suicide. Click here for Patient Suicide Part One: The Phone Call, here for Patient Suicide Part Two: 30 Minutes to Think, here for Patient Suicide Part Three: Fully Present, here for Patient Suicide Part Four: What's a Life Worth, here for Patient Suicide Part Five: Treat People Like They Matter, here for Patient Suicide Part Six--Leftovers, here for Patient Suicide: Part Seven--Training Monkeys/Herding Cats, and here for Patient Suicide: Part Eight--On Scarves and Lessons Learned

It was a couple of days after I got the phone call that my patient had died that a patient managed to see right through me. It was unnerving and of course, her observation was right.
"What just happened? You looked so very sad. I've never seen that before. I've never seen such deep sadness in your eyes."
I felt like I might as well have been nude. What else was there to do but respond truthfully?
"You are right. I got distracted thinking about something that happened recently was very sad. Thank you for noticing it--and noticing me. I'm sorry that I got lost for a moment and wasn't able to be there for you."
She was the only one who saw me like that. That is, she is the only one who saw me like that and mentioned noticing the sadness in my eyes. At the moment my client noticed me drifting into my own fantasy world, I was thinking about how my patient had killed herself and wondering what she experienced. I felt so very sad I couldn't be there with her.

I have some trepidation sharing this particular part of my experience. It seems almost too personal. It seems even a little dangerous. In my first draft of this part of the story I wrote something that was essentially true, but also essentially a lie. I wrote what I think a therapist is supposed to think. I wrote that I wished that I could be there so I could have saved my client. I wrote that I wished I could have been there so I could have done something.

Of course, in a way, that is true. I do wish that I could have saved her. I do wish that I could have done something. Given the opportunity I would have done anything in my power to alter this outcome. I couldn't. I have no special power to go back in time. I have no special power that allows me to alter history. This woman is dead and no fantasy can change that.

I remember the hours I spent sitting with this client. I remember exactly how she looked when she was scared and overwhelmed. I remember how her shoulders would gently roll forward. I remember how she would rock every so slightly forward and back. I remember how she would clasp her hands together and wring them. I remember her mouth moving silently speaking things that could could not be spoken. I remember how Maggie the therapy dog would gently come to her in these moments. She'd nudge her with a paw, lay her head on her foot, or crawl up in her lap and gently lick the tears off her face.

Most of all, I remember her ice blue eyes. I remember how she would eventually look up at me. She would look right into my eyes and silent beg for what she could never find: relief, comfort, and an end to her pain. She would beg me for what I could never give.

It's that image that haunts me. It's the thought of her having that experience alone in her last moments of life that is almost too unbearable for me to stand. It is my one enduring wish that I could have been with her in that last moment looking right back into her eyes, always steady, always sure. It is my wish that I could have done the only thing I ever can really do for another--offer a sense of comfort and relief by being fully present.


  1. What a touching tribute you've written about your patient, Jason. How lovely to be remembered in intimate detail with such utter compassion. It is obvious that both you and Maggie were able to truly see and connect with her suffering. You touched the very essence of this woman and I have no doubt that she felt this and was comforted by it. And I believe that she knows it now and her spirit is comforted by that knowing. And she lives on through your tender memories of her.

  2. I see nothing wrong with answering your patient honestly when she noticed you weren't yourself. I see everything right with it. If you had not answered truthfully, she might have tried to guess, possibly imagining that something was wrong in her relationship with you. I have been following your story and thank you for sharing it.
    Paula Young, LMFT

  3. Thanks for sharing this Jason. Your patient was lucky to have you as a therapist and your memories of her is a touching tribute...

  4. Dear Jason: I am so sorry for your loss. - Morgan

  5. I am sorry for the losses you have experienced too.