Patient Suicide: Part Eight--On Scarves and Lessons Learned

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

''And I've become more humbled by how little one can do, ultimately, to keep someone alive.'' -- Joan Wheelis, MD

I've been wearing the scarf my dead patient knitted for me the last few weeks. The scarf is made from yarn of yellow and green and blue. Soft to the touch and just a bit too short, it isn't really a scarf that I'd pick for myself. Nevertheless, I've liked having it near me, on me, and around me. I am, in fact, wearing it now while I write this entry. I'm aware of no specific reason why. I suppose the most true thing I can say is that I've been feeling particularly close to my memories of her these last few weeks.

I'm sure an analyst somewhere would have all sorts of interpretations.

Some of them might even be right.

I haven't always wanted to wear the scarf. There are times when I haven't even wanted to see it.

She gave it to me for Christmas--four months before she died. She was knitting scarves and hats as a form of distress tolerance. Some went to cancer patients being treated at a local hospital. Some went to babies who were born prematurely. One of them went to me. I kept the scarf in the closet for months. I considered giving it away. I considered throwing it away. I didn't want to see it.

I hated it.

I hated her.

The scarf made me feel guilty. I felt guilty for hating her. I felt guilty for my anger toward her. I felt like a failure because she was dead. I hated that she was dead and I hated that I felt like a failure. I hated that I hated.

I wanted all my feelings about my dead patient to go away.

I couldn't make them go away. The best I could muster was to stuff those feelings into my closet and repress them. Store them away. Bring them out later for inspection.

I didn't save her.

I couldn't save her.

She didn't want to be saved.

She couldn't be saved.

I didn't want to learn these lessons. I didn't want to learn that I cannot rescue those who cannot be rescued. I didn't want to learn that some people don't want to be saved. I didn't want to learn that no matter how hard I try, Humpty can't always be put back together.

These are some of the lessons I learned. 

I'd rather have not learned them. I'd rather my patient still be alive.

We don't always get what we want.

I'm not angry anymore. I don't feel guilty. I don't blame myself. I miss my dead patient. Sometimes a little, sometimes more intensely.

Another lesson has been bubbling up. Perhaps this is the reason why I've worn the scarf nearly every day since it's gotten cold this year.

In the wake of my patient's suicide I've become strong. I've become strong in ways that I never anticipated. I feel calmer--not just around issues of suicide, but around everything else that happens in my office. I'm learning the difference between the things I have power to influence and things that are outside my power as a psychologist.

Suicide no longer frightens me as a clinician. 

I hope it doesn't happen, and yet I don't fear it. 

There are days when I feel a little hysterical at the thought of going through this all over again. Those feelings don't last too long. I hope I'm always just a little hysterical at the thought of someone dying. 

Mostly, I welcome suicide into my office. Every day it becomes a little easier to talk about. 

I wish she didn't have to die, and yet in her death, she made suicide something that is mentionable for me--something really mentionable. Rather than frightening and silencing my patients with threats of hospitalizations and retribution, I've become more skillful and inviting suicide into the room. It's become a thing that can be spoken. A thing that can be known. A thing that is mentionable and therefore more manageable.

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.” -- Fred Rogers