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| WHAT IF YOU DON'T SUCCEED? CHAPTER 15 |
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I had a long debate with myself about whether or not to write this chapter. On the one hand, what I have to say to you here is both unpleasant and, some might argue, unnecessary. On the other hand, I promised you an honest book. Since most people who attempt suicide do not succeed, I feel I would be cheating you if I didn't share what I know about what can happen if you try to kill yourself and fail to get the job done. So, I will keep my promise. The first time I realized that suicide was something less than a sure thing and not a slick and easy way to solve one's problems, I was interviewing a man who had just been admitted to a psychiatric ward. We'll call him Charles. Charles had been depressed for many months. A middle-aged man, he had been out of work for most of a year and his unemployment checks had stopped. He had a family to feed and, try as he might, he could find no solution to his crisis. From his point of view there was only one decision left to him: suicide. He had reviewed his life insurance policy and found that there was no restriction on the payment of his death benefit if he should die by his own hand. Upon his death, his family would receive several thousands of dollars, dollars he hoped would keep them going in his absence. The day he was admitted to the hospital Charles had gotten up early and gone into the bathroom with his hunting knife - a knife with a long sharp blade. He took off his shirt. He placed the point of the blade between two ribs over what he thought was his heart and, with the force of both hands, jammed the blade inward as hard as he could. But Charles missed his heart. His missed it by a fraction of an inch. "The pain was terrible, he said. And the blood went everywhere. It ruined the carpet." I was a young psychologist when I met Charles and, frankly, his story made me wince. It frightened me to imagine a man could be so depressed and desperate as to shove a knife into his chest for a few thousand dollars. Until that moment I, maybe like you, had always thought of suicide as a neat and tidy act where, after the person has died, you would see him or her lying in a casket like anyone else - all visible signs of trauma to the body carefully concealed from friends and family by the mortician's art. But here was a man in a full chest bandage talking calmly about how he wished he'd known better where his heart was so that he could have cut it open and died. "I should have shot myself, said Charles, "but I needed some cash and had to hock my guns a few months back." Charles's wife had found him lying on the bathroom floor in a pool of blood and, with the help of her sons, they managed to get him to an emergency room where the surgeons removed the knife, sutured him, and sent him on to the psychiatric floor. He was alive now, but not out of danger, and it wasn't until several months later that, with the help of the staff and a vocational rehabilitation plan that would train him in a new profession, that Charles was able to return to a full life. Humans Are Hard to Kill Most people contemplating suicide do not realize how difficult it is to kill a human being. We're actually made of pretty tough stuff and despite what you may see on television or in the movies about how easily people can be killed, it doesn't happen that way in real life. Maybe, because of our exposure to these fictional versions of dying and our willingness to believe death is simple, we don't want to understand that dying can be both difficult and painful. Charles found this out the hard way, and so have thousands of others who have tried to kill themselves. True, there are some methods of suicide that are more successful than others. But even the most lethal methods can fail. Consider what happened to the following people - all of whose identities have been changed to protect the real person. Tom, a teenage boy, put a .22 pistol to his head and pulled the trigger. The bullet entered his temple, ripped through his brain, ricocheted around the inside of his skull, and lodged in his jaw. He did not die. Now severely brain-damaged, he lives on in a nursing home- unable to work or go to school. Mary jumped from a high bridge into a river. Many people have died making this same jump. Mary did not. Rather, she entered the water at a bad angle and broke her back. She was rescued before she could drown. Mary lives in a wheelchair. . George shot himself with a large-caliber pistol in the stomach. He destroyed a kidney. Fortunately, he had two. Bryan, arrested on a drug charge and fearful of his parents' reaction, attempted to hang himself in jail. He succeeded only in strangulating himself and losing consciousness. The loss of oxygen to his brain caused permanent brain damage. Janice cut her wrists sideways. One of the cuts ran deep enough to sever a tendon. Janice used to play the piano. She still plays, but not so well. I could go on, but I think I've made my point. If you think about suicide attempts the way we counselors do, you would know that there are serious, first-degree attempts, second-degree attempts, and third-degree attempts. First-degree suicide attempts are planned, deliberate, premeditated acts involving the most lethal means. Second-degree attempts are more impulsive, unplanned, and not as well thought out. Thirddegree attempts are those in which the person deliberately puts himself in a dangerous situation in which he may die, but his intent is not so clear. But all attempts, even very serious, firstdegree ones, do not guarantee results. Maybe these fine distinctions don't matter to you. Or maybe you haven't thought through all the possible outcomes But if you are thinking about killing yourself, please be aware of at least one other potential outcome: You may not die! The general rule is that the more lethal the method you try the more damage your body will sustain and the greater the likelihood that you will end up disfigured or disabled if your attempt fails. As cold and hard as that sounds, it is nonetheless true. Overdoses of pills can lead to respiratory failure and may cause a coma from which you may never recover. Even modest overdoses of some over-the-counter pain remedies can destroy vital internal organs. A high-speed crash in a car may leave you a cripple for life. Slashing your wrists will not only leave scars, but you may permanently damage the tendons and muscles that control your hands. As Tom and others have learned, even a pistol shot to toe head does not guarantee death. As heartless as it may sound, I have heard doctors and nurses say of someone they have just managed to save from death and who they know will now be permanently disfigured or handicapped, "Maybe they would have been better off dead." And please remember that because of modern lifesaving methods and technology, the doctors are saving more and more people who, only a few years ago, would have died of their self-inflicted wounds. As some suicide attempters have learned, a failed attempt can be a double curse. Not only have they failed to do what they set out to do but now, in some cases, they no longer have the means or freedom or physical ability to finish the job. They may find themselves confined to a bed in a nursing home, unable to care for themselves and prisoners of their own making. And, once the treatment staff know that you have made a suicide attempt, they will take every possible precaution to see to it that you do not try again. You will not be permitted to have anything sharp in your possession - no knives to cut your meat, no razor to shave with. They may not let you have a belt to hold up your pants. You will not be permitted into a bathroom alone. You will be put on what is called a "suicide watch" and you will have very little, if any, privacy. In a word, no one will trust you for fear you will try to kill yourself again. Even if the consequences of a failed suicide attempt are not so disastrous as a lasting disability or confinement to a nursing home or mental hospital, there are other unpleasant consequences. Ann was a fifteen-year-old girl when she first cut her wrists. She helped make me aware of another problem I hadn't, at the time I met her, thought of. "I have to wear long-sleeved blouses all the time, she said, "even in the summer. When those big, clunky bracelets were in, I could sometimes get by. They would just cover the scars - provided no one looked too close. I never go swimming or to the beach because you can't hide these scars when you're in a bikini. Ann told me that when people did notice the scars on her wrists, they would sometimes innocently ask, "What happened to your wrist?" Then, realizing how such scars are usually gotten, they would catch themselves and apologize. "It's very embarrassing, Ann said. "You feel like you have to make up some story - otherwise they'll think the worst. I know that what I have said here may amount to some kind of scare tactic and that I'm trying to frighten you out of your thoughts about the suicide solution. In a way, I suppose I am. But because I have met so many people who have attempted suicide and failed, I thought I ought to share with you what I have seen and heard and learned from others. I know it is not enough just to warn people who want to kill themselves that, if they try, they may not succeed and some terrible unanticipated consequence may follow. But because I know that once you are in that terrible and lonely place and in the midst of that awful crisis of whether to live or die, you may convince yourself that the solution you seek will be neat and clean and tidy and final. This is part of the logic of suicide: that death will be quick and easy. But I will quote Murphy's Law, "If a thing can go wrong, it will." And Murphy's Law, I'm afraid, applies just as well to suicide attempts as anything else. Other Consequences Beyond the possible damage to your body if you fail to die in your attempt, there are a host of other complications. Most of these have to do with the way people will react to your attempt, how you will feel and think about yourself, and how your life will change as a result of not dying. I have tried to write about some of these consequences elsewhere in this book. But here, for now, I simply wish to remind you that a suicide attempt is like throwing a stone into a quiet pool - the impact of the stone sends ripples far and wide - ripples that affect you and everyone you know. That effect of a failed suicide attempt is often an unknown one, one which neither I nor anyone else can predict. Finally, I hope that what I have said here does, in fact, put a bit of uncertainty into your thinking about suicide. Perhaps if I can convince you that your best-laid plans can go awry and that you just could end up in much worse shape than you can possibly imagine, then maybe you will think twice about killing yourself. One thing I know: if you can hold on and get through the troubled times you are going through you will, sooner or later, come to realize that you are stronger than you think. You will, in years to come, look back on this crisis as just that - a crisis like many others you have survived and will survive. There is nothing romantic or mysterious about dying by suicide. Failing to die by suicide is not only unromantic it is a sad and tragic irony. If the newspapers printed all the stories about what happens to people like Tom and Charles and Ann and the thousands of others whose plans to suicide have failed and who have ended up crippled or disfigured or disabled, it just might cause all of us to think, not twice, but three times before we tried to kill ourselves. As Ann said to me, "Tell them not to try. It's stupid. |
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