Suicide: Conspiracy of Silence

By Carrie La Jeunesse, DVM, CT, CCFE

 

On April 20, 2012, another Washington State veterinarian died by suicide.

There is too much suicide in general, but certainly veterinarians are overrepresented. There continues to be a disturbing taboo around discussing death in many societies, much less suicide. People attempting suicide are stigmatized, and those completing suicide leave heart wrenching, traumatic and long lasting grief in their wake. Those who otherwise might enjoy fulfilling and reasonably comfortable lives often live in a hellish limbo wherein the struggle to just make it through another day is hidden from loved ones and co-workers. They do not discuss it. They do not seek help. They don’t even really want to admit it to themselves. It is a desperately painful, lonely, hopeless place.

I know. On October 15, 2009, I nearly took my own life. This is not something I’m proud of, or even wanted to share publically. But, I could no longer stand idly by to watch yet another veterinarian die after completing suicide. I had to say something.

Life changed, literally, in an instant, when I incurred a combined spinal and spinal nerve injury while skiing (during a lesson, for goodness sake) when plowed into by an out-of-control snowboarder. My story is unique of course, but common in the simplicity of what can underlie some suicide ideations, attempts, and completions. For me, it was excruciating, unremitting, life-swallowing pain that seeped in to every moment of every day. There was no sleep free from pain. There was no thought that wasn’t interrupted by pain. There was no interpersonal interaction that was not veiled by pain. I could not take prescribed pain medications (nausea, dysphoria, and hypotension). Finances were adversely affected, I was not able to be the parent or spouse I wanted to be. My temper was short; guilt was abundant, feelings of inadequacy and worthlessness frequent. The things I love which had provided a legitimate distraction from chronic pain – veterinary work, work as a spiritual director, yoga, walks on the beach, sitting with my family, visiting with friends, going to dinner parties – all of these things either fell entirely by the wayside or were restricted to the point that all that was left was, of course, to experience pain. Pain, whether psychoemotional, physical or existential seems to speak a universal language of social isolation and desperation. I had “failed” every attempted medical intervention. Not my terminology…that of the medical profession. Heard that way, of course, it sounded like another personally determined shortcoming. We really need to think about how we language things.

Dr. Gary Carr of Washington Physicians Health Program (WPHP) provided WSVMA with some sobering statistics. Although studies in the United States are sorely lacking, studies from England, Wales and Scotland indicate relative risk for suicide that exceeds the rates for pharmacists, dentists, and medical care providers. Relative risks for suicide compared with the general population in the demographic surveyed, men aged 45-64, and female veterinarians, were 5.62 and 7.62 respectively. Yes, folks, our risk for suicide is at least as high as and likely highest, of all health care professions. Addictive behavior, anxiety disorders, depression, stress and burnout, compassion fatigue, alcohol and drug abuse, suicide ideation or attempts – the statistics are staggering. It’s time we start talking, noticing, and helping each other.

 


 

 

  • Call 911.
  • Call a suicide prevention line 1-800-273-TALK (1-800-273-8255) or 1-800-SUICIDE (1-800-784-2433).
  • Call your local county crisis line (see website for list of counties and phone numbers).
  • Call Washington Physician’s Health Program (WPHP) 1-800-552-7236 or 206-583-0127.
  • Talk to your friends or family…tell them you need their help.
  • Call a mental health care provider. Give them a chance to help you.
  • Call your primary care provider.
  • Call WSVMA for resources or visit the WSVMA website 1-800-39-WSVMA (1-800-399-7862) or 425-396-3191.

 

  • Call 911 if you think it appropriate. Err on the side of caution.
  • Call a suicide prevention line 1-800-273-TALK (1-800-273-8255) or 1-800-SUICIDE (1-800-784-2433).
  • Call your local county crisis line (see website for list of counties and phone numbers).
  • Call Washington Physician’s Health Program (WPHP) 1-800-552-7236 or 206-583-0127.
  • Dedicate to helping in whatever way you can, without sacrificing you own well-being.
  • Call WSVMA for resources or visit the WSVMA website 1-800-39-WSVMA (1-800-399-7862) or 425-396-3191.

 


 

Sadly, despite my training in thanatology (death/dying/bereavement), I find myself writing about this with more than a little negative self-judgment, embarrassment, and trepidation. I should know better than to castigate myself this way, and do when it comes to anyone else. But the stigma of suicide as “failure” or “giving up” or “selfish” runs very deeply. By virtue of the truly deafening silence surrounding it, suicide is a subject that is socially unacceptable. Because we don’t talk about it, we shroud it in shame. We make it difficult for those who might want help to feel comfortable reaching out to grab it. We make it worse because we will not talk about it. It’s time we stop. Our kids are at risk, too, but that’s another story.

We are in this together. We went through rigorous training and were “in the trenches” together. From what I’ve seen through the years, especially in my work with WSVMA, we are deeply caring and generous people. We also tend to isolate ourselves when in difficult circumstances…a “buck up,” or “suck it up” philosophy that is often counterproductive in that it keeps us from availing ourselves of help from others who might actually know more, and who might be able to help us. We plow ahead and re-invent wheels that are weary of being recreated. I did not do this, and I still nearly killed myself. I went to counseling, I prayed, I asked others to pray for me, I followed doctors’ orders, I didn’t give up on feeling better. I did everything “right.” I didn’t really want to die; I just didn’t see a single other option.

It doesn’t really matter what training or expertise you may have. It may not matter that you’ve handled lots of “stuff” in the past. That’s the point. I’m a real glass totally full kinda gal by nature. My nick name used to be “Tiny Bubbles” because I was so constantly happy. I have much love and truly engaging and challenging professional pursuits. I have so many good friends, such rewarding volunteer work, such great kids, such a dedicated husband, such amazing hobbies and self-care practices, such love. What I did not have was an answer that was at all compatible with my vision of life moving forward. I did not have a terminal disease that would eventually give me an escape from hell. The very foundation of who I knew myself to be, my place and value in the world, no longer made any sense whatsoever. I was not me anymore. My face was the face of suicide.

It’s an odd phenomenon. I have lived with significant chronic pain for many years. I had much fun incurring most of the injuries that contributed to the pain. So, I had many fond memories to at least distract me. I had, I reasoned, lived a very full, wonderful life. I had dodged a couple of bullets already, so figured that my time here was “dessert” anyway. Quality of time was important to me, but not so much quantity. I had worked really hard in physical therapy, was fortunate to have the best medical care available, the best family, the best friends. I was also told this is what life would be like “indefinitely.” When pressed for a more concise indicator of just how much more I was anticipated to endure, doctors finally leveled with me. My “condition” was expected “to remain unchanged.” My doctors liked me, I think, and did not want to give me such news. “There’s always hope,” they said, “with new therapies and techniques. Hang in there.”

I was very logical. I discussed it dispassionately with doctors, nurses, a physical therapist, and counselor. I discussed the fact that I might kill myself with my family. I told my husband and my two beloved, beloved boys that, if I did kill myself, they should remember I just could not bear another day in pain-- that it wasn’t about them. I told them I was sorry for the guaranteed pain I would cause. I begged them for forgiveness “just in case.” I told them I loved them beyond all reason and that I could not bear to leave them, but could not bear to be any longer. My family clearly did not know what to do. I never asked them, but wonder if they are like many people who think that those who talk about suicide won’t actually follow through. If I had to guess, I would say that because I am so capable, so accomplished at handling crises and calling in resources, my family expected I would figure it out.

That night, I almost called a suicide prevention hotline. But I did not. I was worried they’d intervene with a three day hold in a psyche ward. I wasn’t willing to give up one more iota of control. Suicide felt like gaining back some shred of control. My husband was sleeping downstairs (bed-sharing having mostly ceased since the slightest movement caused more pain). My son was asleep across the hall. The telephone was by the bed. I could have called a friend. None of these things occurred to me at the time. That night, I just wanted to end. I should have called. I hope you will call. I was very, very lucky.

Strangely, my Roman Catholic upbringing might have proved to be the thing that prevented me from killing myself…that old Communion of Saints thing. I’d be kicked out…wouldn’t even be able to have companionship of souls who’d gone before, for God’s sake. Even in whatever afterlife I could imagine, I would be persona non grata. I sobbed away the hours, pleading with a God I no longer believed in. I pleaded senselessly. The answer I got was “you’ll screw this up, too.” What if I did screw it up? I’d be brain injured, but just enough that I couldn’t communicate about, yep, the pain. That was the reason I stopped. I realized the pain could actually be worse, and I wasn’t going to take that chance.

I am blessed with an abundance of truly kind, decent, loving people in my life. Many whom I knew pretty well, but apparently not as well as I thought, revealed their own struggles with mental, physical and emotional anguish. They shared their stories about searches for answers, relief, and understanding. In that shared experience, there was remarkable comfort. The knowledge that I was not alone, that others understood, that others had managed to survive and be relatively happy...these were life-saving revelations. As I visited with some of these folks, I learned that the pain can be isolating, but it can also be a touch point of acceptance and mutual support. Resources and perspectives were shared that helped me with my own pain. I did not get this from the medical care providers I was seeing. It was gift I received from others who were brave enough, kind enough, selfless enough to share their stories. These people, like me, had unremittingly looked for help. In their quests, there was something of help for me. In the end, I should have called professionals.

With our state licensing, we pay for services provided by Washington Physicians Health Program (WPHP). They’re wonderful, very professional, and caring people who are dedicated to the wellness of doctors, doctors’ loved ones, and in keeping us in our professions as whole and healthy practitioners. Give them a call just to find out about the program if you’re not clear about what they do from looking at the website. Working with WPHP could save your life, your career, your family.

I am better now, but still live with significant and constant pain. This is not uncommon in veterinary medicine. I don’t think about killing myself. I’m mostly ecstatically happy despite the pain. I have a lot of my life back. I have fewer friends, but they are more precious than ever. I am not the same person I was before the injury. I don’t socialize nearly as much, and I socialize differently. I am more thoughtful about what I take on, more willing to cut myself some slack, more able to say “no” and not feel guilty. When I see my boys, I am so incredibly grateful that my suicide plan did not progress beyond that point. Despite the ongoing pain, I enjoy an even greater richness of unexpected experiences and love. I am so very glad to be alive.

So, please, if you are hurting, I can tell you that I care, WSVMA cares. You aren’t alone. There are more of us out there who understand than you could possibly imagine.


Dr. Carrie La Jeunesse, DVM, CT, CCFE, is a veterinarian with twenty-eight years of experience in small animal medicine and surgery, primarily in the area of emergency and critical care. She is a certified compassion fatigue educator, and a bereavement facilitator certified in Thanatology. In addition to being a WSVMA past president, she can be reached at (360) 731-0493 or carrielaj43@yahoo.com.

 

Resources
National Suicide Prevention Lifeline 1-800-273-TALK (1-800-273-8255)
National Hopeline Network 1-800-SUICIDE (1-800-784-2433)
King County Crisis Clinic 24-hour crisis line 866-4-CRISIS (1-866-427.4747) or 206-461-3222
National Institutes of Mental Health (NIMH) Suicide Prevention
Washington Suicide & Crisis Hotlines
Veterinarians’ Risk for Addictive Illness and Suicide - report from Washington Physicians Health Program
Physician Depression and Suicide – article from Washington Physicians Health Program

 

 

 

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