This week, in order to renew several of my professional licenses, I had to do an awful lot of continuing education. Normally, I do some all year long and so there's no need to catch up. This year, probably because my son Matthew died, I have not been keeping up with many of the things I normally do. So, I had to spend quite a few hours playing catch up. Some licenses specify courses you must take while others simply specify a certain number of continuing education hours. For one of these licenses, I needed to take a course on Suicide.
Suicide was a big focus in college when we studied psychiatric nursing, and before we did state psychiatric clinicals and private hospital clinicals also. Since suicide is a point of focus in almost every specialty, such as cancer, psychiatric nursing, critical care, neurology, transplant units etc., almost everywhere I have ever worked has required some type of continuing education on recognizing suicidal behavior in your patient or a coworker. So this eight hour course, and lengthy exam is about the thirtieth time I have had to focus on the subject.
As I began to take the course, I had to think of my father. My father believed that people who were terminally ill, in pain, or in some other type of psychic pain should be entitled to receive physician assistance to safely and comfortably effect their own suicide. I vehemently disagreed. Many times I told my father that many different combinations of drugs exist enabling those who are in their final stages of life to be comfortable and make use of those final days, which are also very valuable. Our final days can be used for goodbyes, for final touches to our Will, to place the names of loved ones on our property in order to settle our estates more readily, or for simple reflection or for prayer. This was one of the few things my Dad and I disagreed about. I did agree however, that when he died, I was to allow whatever pain medication was correct and necessary, even if it possibly shortened his life by hours or days. Like any other promise I made of such import, I kept it when the time came, even hiring a Nurse Thanatologist who could properly and safely administer what was needed. I am also grateful to my father for not considering suicide in those last days which are very cherished memories at least for me, and I suspect they were important moments for him as well.
The latest information on suicide, according to the course is that almost everyone is at risk. Girls between 10-14 are at risk. Physicians and dentists are at risk. Those who have experienced trauma or loss in the last year are at risk. Veterans are at risk, probably forever. Those with seizures, Crohn's disease, Multiple Sclerosis, issues of addiction, are all at risk. Those who have had a friend commit suicide, or who have had a family member commit suicide are also, Those who gamble or use alcohol are also at risk. Young people who are bullied and those who have an eating disorder are also at risk of suicide. Professionals in the field say that we are to ask people who are having a difficult time if they are contemplating suicide. Their opinion is that the person being asked will be glad for the opportunity to talk, rather than think they are being given permission to act toward self harm. I hope they are correct.
So despite the fact that I have now taken a course of the same subject for more than 30 times, as has anyone else in healthcare, the problem continues to worsen. Suicide by all means is increasing not only in the United States, but in many places in the world as well. Apparently, requiring the attendance of courses on suicide so many times is not reducing the suicide rate, in either health care or in the general population.
Now that we have established that just about everyone you know is at risk for committing suicide, I want to say a few things about it. I have now lost two sons suddenly. One died fifteen years ago at 12 1/2 of a supposed spontaneous heart rhythm disturbance. Another son died after having turned 32, about 39 hours after having an influenza vaccine. So, I suppose we have established that I too must be at risk.
What are the reasons we should not commit suicide ? Now this is from me, and not any continuing education course. First, because if we end our lives and take ourselves out of play then we will not be present on Earth to see things improve. Yes, nothing, including the bad times, last forever. Suicide is a permanent solution to temporary problems. Secondly, because when we commit suicide, we transfer the pain from ourselves to everyone else who loved us. This is probably not the legacy you had in mind. Third, because every drop of life is precious. As my father was dying in the ICU, I got a physician order to allow him to have bottle of Newcastle Brown Ale. He truly enjoyed drinking this favorite drink from his youth while talking to his daughter. These drops of last days and moments of life are very special and should not be disrupted. We also should not disrupt any of the last tasks we may have on Earth before we are called. Lastly, we must not commit suicide because God grants us this life and the time in it, and believe me, He calls us when He is ready for us, just as God called two of my sons at a moment's notice.
Perhaps our strategy as a nation needs to change with regard to suicide. Perhaps people who commit suicide are not people with an undiagnosed psychiatric issue that missed being treated. Perhaps they are simply people who have been beaten down by the world and have found almost no encouragement in the schoolyards, the schools, the universities, the hospitals, the employers, the restaurants, or anywhere else. I am not saying that we need to baby the world. I don't want that. I am saying that bullying is unacceptable anywhere and must stop. I am saying that nurses and physicians, pharmacists, and EMTs need to have access and required hours with a counselor, just as police and veterans often do. Things we see and do, and have experienced change us, sometimes always and forever. We need to recognize this and make kindness and decency more of the rule than the exception. Why can't Christian counselors discuss suicide ? Perhaps the largest problem with so much suicide is that people are spiritually injured and are constantly batted over the head by a mandatorily secular world. God is the most important reason I would never commit suicide, and I'll bet He is for an awful lot of other people also.
On the evaluation of the course I took, I found it difficult simply to answer without expressing my annoyance and anger. I told them that there was one group they had failed to identify as at risk. People who had to take a course on the current state of affairs in the world on suicide for eight hours straight and who'd been required to take a similar course thirty times since 1981, probably were at as much risk as any other group they had listed. It seems forcing us all to take these courses isn't making much difference to anyone.
Perhaps we can, "Love one another".
