Anatomy of a suicidal crisis

I graduated high school one A shy of a perfect grade point average, and headed to South Bend, Indiana for college with two dozen AP credits under my belt. I earned my Bachelor of Arts from the University of Notre Dame in just three and a half years, and was inducted into the Phi Beta Kappa Honor Society after graduating Magna Cum Laude with a double major. By age 25, after working my tail off on a project at Credit Suisse headquarters in Zurich, Switzerland, I became the youngest Principal consultant at American Management Systems downtown office just a couple of blocks from Wall Street. A couple of years later, on the morning of March 1st, 1998, I was lying on my back, in a futon bed in my walk-in-closet-sized West Village studio apartment in New York City contemplating if I could summon the courage necessary to end my life. I was 27 years old.

It was the prior year, in late 1997, while working on an assignment at Royal Bank of Canada in Toronto that I began to experience insomnia for the first time in my life. My psychological crisis had its genesis in a single, negative interaction with the senior client on my sub-team on the project. At our first meeting, Doug McFarland asked me if I had any prior experience working with commercial lending, credit risk management systems. The way he framed the question indicated he assumed I would respond affirmatively, but I had no such relevant experience. I balked at saying no, and simply pivoting to explain why I would still be a valuable asset to the team and the project as a whole. Instead, I responded, “Excuse me?” as if I didn’t hear his question. The man was less than five feet away from me, and he spoke quite clearly; I was instantly and irrevocably mortified. By the time he had finished rephrasing the question slightly, I was ready to give him my “no” which I did, but I failed miserably, in my view anyway, trying to pivot back to why he should still be pleased to have me on his team.

It’s an understatement to say that I was upset by the exchange. Obsessing over it eroded my previously unshakeable confidence in my intellectual abilities. The house of cards that was my self-conception back then was built on the foundation of that confidence, which I had always thought of as firm ground, if not impenetrable bedrock. But that sixty second or so awkward exchange sowed a seed of doubt within me. That doubt was like a fissure in the foundation of my sense of self, and as the project progressed, the crack spidered. Some bad luck led me to become socially isolated as my five closest friends all coincidentally moved away from New York City over the course of several weeks. The lack of reassurance from my usual sounding boards to bolster my flagging self-confidence paved the road to my suicidal crisis. On my own to try to make sense of what was happening, I was unable to see the obvious mistake in thinking that I was making: conflating being unknowledgeable about a particular subject with being unintelligent in general.

It still seems almost incredible to me how quickly I unraveled; how quickly hope and excitement for the future were replaced by fear and apprehension. As silly as this sounds, being consumed by self-doubt and worry was a novel experience for me. The overwhelmingly negative hue of my internal dialogue about myself stripped away my self-esteem. Silencing the troubled, doubtful, fearful, constantly-questioning voice in my head at night was so difficult that sound sleep became a stranger to me. Night after night sleeping between zero to three hours at most, coupled with the relentless barrage of dark, automatic thoughts bombarding my consciousness ate away at my sanity. As I continued descending a downward spiral of disempowering thoughts, I began to ruminate over what I was doing with my life. I remember the first glimmer of my first suicidal ideation. It happened on a particularly turbulent flight home to New York from Toronto on a Friday afternoon. I remember thinking: If only this plane would just crash right now…

Unfortunately, the project’s conclusion brought me little relief, as the seemingly irreparable damage to my psyche had already been done, and I became lost in a seemingly inescapable, abysmal black hole of self-defeating and self-fulfilling thoughts. I can remember standing in my bathroom that morning on the first day of March, motionless in front of the ugly sight my mirror had become. I was staring into the listless eyes of a living dead person. Missing from them and seemingly never to return was the fire of a deeply burning determination to discover and achieve. I felt hollow and alone and lost. The dark circles under my eyes made me look like some sort of suicidal raccoon. I left the bathroom and packed a backpack with a roll of duct tape, a pair of white athletic socks, a package of over the counter sleeping pills, a small towel and a black rubber hose. My plan was to turn a rental car into a carbon monoxide gas chamber. I got dressed, laced up my boots, put on a jacket and opened the door. I stood there for a moment wondering if I would ever set foot in that apartment again, then closed the door behind me.

Down the stairs and outside, I hit the sidewalk and headed East. As I approached the entrance to the downtown train I thought to myself — this is it. This — is the moment. Take the train to the office to spend another fruitless day trying to wrestle the right words from my brain for a routine technical writing assignment, or go to the nearby car rental office and get busy bringing a pitifully sad and tragic end to the hidden misery of my relatively privileged, but clearly broken life. Make no mistake, I did not feel an ounce of sympathy for myself. That was my problem actually. Instead I felt guilt, embarrassment and shame.

Guilty that I was even considering the idea of checking out given the depth and breadth of suffering experienced by countless others in the world. Guilty that I had achieved so little in life after having been given so much. Embarrassed that I had ever thought I was intelligent and that I could achieve anything that I set my sights on. Embarrassed that I was in a situation where I obviously needed help and was mortally afraid to ask for it. Ashamed that I was considering ending my life because I was afraid that I wouldn’t be able to earn an above average living. Ashamed of the imagined prospect of having to move back home to Delaware to live with my parents, and get a job in the local shopping mall.

Shame’s role in my suicidal crisis cannot be overstated. I saw my struggle as a sign of personal weakness. I thought this way because I believed that countless others would think the same exact thing, if they knew the details of my situation. The experience I was going through belied my positive self image as someone capable of tackling any obstacle in front of me, and led me to question every positive thing I’d ever thought about myself. Concerns over what people would think of me if they learned about my psychological and emotional turmoil filled me with dread. I didn’t even slow down as I reached the subway entrance. Instead, I headed towards the National Car Rental office a few blocks away, summoning courage with each step to continue moving forward with my suicidal plan.

Many view suicidal people as selfish cowards, but I believe it takes courage, massive amounts of courage to turn suicidal thought into suicidal action. Trying to cause your heart to stop beating, while knowing, to some degree at least, how much pain and suffering your death will cause for those who love you requires a special kind of morbid audacity. I won’t claim that there has never been a person who has died by suicide who lived selfishly during his or her life, but I insist that anyone who thinks those two words: selfish and cowardly — about the suicidal act itself, has no first hand experience with the macabre deed. The biological instinct for self-preservation is an almost insurmountable force to overcome. Death is the greatest unknown and fear-inspiring phenomenon facing each of us, which explains why possessing an enormous amount of courage is a prerequisite for dying by suicide.

Suicide can’t be accurately described as selfish either, although it’s understandable why people are prone to do so. The dictionary defines selfish as: lacking consideration for others; concerned chiefly with one’s own personal profit or pleasure. I think it is unavoidable for survivors of suicide, the friends and family of people who die by suicide, to wonder how much consideration was given to them by their loved one or friend, prior to their suicide. Regardless of how much time and consideration someone who died by suicide gave to those left to deal with life after their death, the end of physical and psychic pain resulting from suicide does not bring pleasure nor profit to the deceased. So the suicidal act, by definition, cannot accurately be described as selfish. Suicide extinguishes any notion of the self. An act that causes the sense of self to no longer exist is inherently not selfish.

While feeling despair can dramatically curb one’s appetite, it doesn’t do away with the body’s basic need for food; feeling hungry, I headed over to my favorite diner on 8th Avenue and sat down at the counter feigning normality as I ordered my favorite: banana pancakes. Eating extremely sweet or very rich, fatty foods were two of the four remaining things that could still overcome my otherwise ever present state of anhedonia: the inability to feel pleasure. I had already abandoned the other two a couple of weeks earlier: brief, muted orgasms achieved through perfunctory masturbation, and the temporary, euphoric high gained from drinking alcohol or smoking marijuana. I stopped drinking and smoking weed completely because I recalled how after-school specials I’d watched growing up called out alcohol and drug use as forms of escapism that prevent people from dealing effectively with their problems. The primary disabling aspect of my predicament was my inability to get more than a few hours of sleep a night. Ironically, my decision to quit using weed and alcohol “cold turkey” to avoid addressing my problems by becoming temporarily intoxicated, hastened my suicidal crisis. The less sleep-inducing depressants I consumed, the less sleep I was able to get.

After eating, I headed back towards the car rental agency as it started to drizzle. Parishioners were filing out of the doors of a towering Episcopalian church on the corner. I crossed the street and headed inside. The strong, familiar scent of incense in the air reminded me of my days as an altar boy as I took a seat in one of the pews a few rows from the back of the church. I just sat there listening to the unintelligible sounds of muted voices echoing off the walls and ceiling of the cavernous place of worship. As cliche as it sounds, I went into that church looking for some sort of miraculous sign that everything would be okay, or maybe for some supernatural force that might save me from my own dark, self-destructive thoughts. I recall supposing that if I was a good person that was destined to continue to live and, if there was a god, he or she, or it, would communicate this to me somehow. I sat there for about half an hour, and waited for something that simply wasn’t there or that I was unable or unwilling to see. As parishioners began arriving for the next service, I resolved to finally get this show on the road. I headed back to the car rental office, rented a small sedan and drove through the Lincoln Tunnel around midday.

Driving inside that car, a machine I believed I could use to end my life, the depressing reality of my situation weighed more heavily on my sleep-addled mind. It’s natural for an unhappy person to look beyond the present moment into an imagined future where some degree of happiness or satisfaction, at least, will exist — this is the essence of hope. It is a powerful, life preserving coping mechanism. Hopelessness, on the other hand, is a state of consciousness that’s hard to describe in words, and impossible to imagine without firsthand experience. The journey from suicidal thought to suicidal action is marked by the wasting away of hope. Suicides occur when the amount of pain and suffering experienced by someone outweighs that person’s ability to go on living with that pain. The life-threatening delusion of the irrationally suicidal mind is the belief that pain and suffering will only worsen or will persist unchanged, indefinitely. Although suicide will obviously bring an end to any physical or emotional suffering, people deluded about the immutability of their pain who die by suicide, irreversibly and tragically deal with a temporary problem in a permanent, hope-foreclosing way. The temporary problem that was overcoming my coping ability, was the lethal combination of insomnia and despair that unhinges many people who engage in suicidal behavior. I struggle to capture in words what it felt like to become hopeless and to lose the ability to think rationally. The very few positive or marginally hopeful thoughts that arose in consciousness were immediately disbelieved as unrealistic, wishful thinking. Conversely, the ceaseless torrent of fearful, doubtful, negative thoughts about the past and the imagined future were regarded as unequivocal truths, and compelled me to take steps towards suicide. Unfortunately getting any substantial, restorative rest became impossible for me. This left my sleep deprived mind unable to work out the trap it had set for itself, as I drove around aimlessly during the remaining daylight hours searching for an appropriate place where I might end my life.

After several hours of parking in a number of different spots in various industrial parks and residential developments only to eventually abandon them after deeming them not private enough, the day’s light began to wane. I stopped at a roadside diner and had another high-fat favorite: two grilled cheeses with potato chips and a glass of unsweetened ice tea with no less than half a dozen sugar packets. I got back into the car, and as I started the engine I wondered if I had just eaten my last meal ever. I continued driving around aimlessly for awhile before I pulled into a parking lot with no visible security system and few lights. There was a series of long, narrow, windowless, beige buildings. I drove to the back of the site, passing more than a dozen of the buildings, and parked the rental car behind the last one. I shut the engine off and proceeded to complete the handiwork necessary to turn my rental car into a makeshift carbon monoxide gas chamber. I got back into the car, and started the engine. It was clear that my rig was working as the hose began to pump hot, moist air into the car. I turned on the radio and sat there listening to music trying not to think about what my parents or brother and sisters would think if they could have seen me. I managed to not allow myself to imagine what it might be like for them to learn of my death.

Carbon monoxide is a silent, invisible killer. You can’t see it, and it has no odor, so you can’t smell it or taste it either, but breathe enough of it in, and you will surely expire. Carbon monoxide or “CO” suffocates its breathing victims by impeding their blood’s hemoglobin from delivering oxygen to the body’s tissues. Gasoline and diesel powered automobile engines, wood-burning stoves and house fires, even cigarettes emit the noxious gas as a result of the incomplete combustion of the carbon in the fuel being consumed. While CO may be odorless, car exhaust is far from it; it reeks actually. For years after this experience the smell of car exhaust would turn my stomach. It doesn’t anymore and I almost miss the visceral reminder of that very dark night in my life, provided by the frequently encountered odor. Although it no longer makes me feel sick like it used to, the smell still reminds me of how far down I fell, and for that I am grateful.

In spite of the fact that I was sitting inside of a running rental car inhaling carbon monoxide gas, I did not back then, nor would I now characterize myself as someone who was determined to die that night. Of course the strength of suicidal intentions can vary from person to person. The method employed by someone who attempts or dies by suicide says a lot about their degree of certainty around taking suicidal action. People who die from self-inflicted gunshot wounds or those who jump to their deaths seem compelled to shuffle off of this mortal coil to a degree that I simply was not. Where they stand about whether “to be or not to be” seems apparent. That said, it’s not hard to find stories of suicide attempt survivors who have jumped off of bridges who immediately regretted their predicament a split second after it was too late to reconsider. Suffice it to say that most suicidal people are tortured by ambivalence about moving away from life and towards death, and it is certainly possible to not “really want to die” but still be so suicidal that you end up killing yourself semi-intentionally. If I had died as a result of my suicidal behavior, that would have been the case, and no one would have ever known it.

When trying to explain the nature of this complex ambivalence to friends and family after the fact, I would tell them that sitting in the running car breathing in CO gas was akin to me dragging a sharp blade across my wrist without breaking the skin. An action I had taken a number of times leading up to that point. Essentially I was trying on the suicidal act to see if it fit, knowing deep down, that it did not. Of course I wanted psychological and emotional relief from the toll taken by insomnia and feelings of despair. Cornered by cognitive impairment, misguided shame, and deplorable stigma-reinforcing beliefs… I could have fallen prey to the absurd delusion that death just might bring me relief. With a mindset like that, the exorbitant price to pay to end suffering, and to escape shame would have been my life itself, of course, but I wasn’t close to being committed to paying that price. I had a mostly full box of over the counter sleeping pills with me that I never used, because to my mind, doing so would have been equivalent to shooting myself in the head. While I wasn’t determined to end my life, I obviously wasn’t ready to admit that I desperately needed help either. Despite my reluctance to reach out for help, I had taken steps a few days earlier to do just that. My company had an employee assistance program with a telephone hotline to arrange mental health appointments for employees in distress. I had called the hotline two days earlier and reported that I was having difficulty sleeping, and that it was affecting my ability to do my job. I arranged for an appointment on Monday, March 2nd to see a psychologist. At the end of the call, the woman who had helped me set up the appointment asked me point blank, “Have you considered hurting yourself in any way?” I responded immediately and instinctively with a lie, and said that I had not, compelled to continue to safeguard the secrecy of my suicidal ideations.

I was aware of the symptoms of acute carbon monoxide poisoning: light-headedness, confusion, headache, vertigo and tinnitus or ringing in the ears, and after sitting in the car for about twenty minutes, I still felt no noticeable negative effects of the poisonous gas. However about twenty minutes later I began to feel light-headed, and there was a noticeable high-pitched ringing in my ears. Over the next several minutes as I inhaled more CO gas, I felt my pulse quickening, as I was forced to breathe more deeply with each breath. Eventually, I became so light-headed, it was clear that I was about to lose consciousness. I quickly opened the door and got out of the car, falling to my knees as I did so. I gasped to fill my lungs with the fresh, cool, night air. I remained on the ground, on all fours, for a couple minutes breathing deeply to try and clear my head. The ringing in my ears had increased in volume and unlike the light-headedness, it did not subside as I breathed in fresh air. When my head was clear enough to stand again, I got up, walked around to the back of the car and ripped the hose of the tailpipe, and put it back in the trunk. I opened up all of the windows and turned the fan on high to clear the car of the CO-laden air. After a few minutes, I closed the windows, got back into the car and proceeded to drive back towards Manhattan.

I parked at a gas station with a view of the Manhattan skyline and stared at it. It was passed 1:00AM at this point, and I remember thinking, I can drive back to the City, return the rental car, go home, get into bed and not sleep as usual, until it was time to get up for work. Then, call in sick and go see the doctor, and finally admit that I was quite unwell and in need of help, or… I could go back and turn the rental car into a gas chamber again. There is no telling precisely why I was compelled to do what I did.

It was getting close to 2:00AM by the time I pulled into a parking lot adjacent to another industrial warehouse in Secaucus. There were no cars parked in the lot and a tall hedgerow between the road and parking lot obscured the view of my rental car from anyone who might drive by. The thoughts running through my head as I reset my suicidal rig sounded like this: You’re not ready to go home yet and admit your troubles, but you don’t have the guts to let the gas overcome you either. So, you’re going to get back into this car and repeat this stupid exercise until day breaks. Then you can drive back to the city, completely defeated, call in sick to work and finally go to the doctor and admit that you’re utterly lost.

With my rig reset I got back into the car and started the engine. I sat there in silence, listening to the hum of the motor. My mind wandered to my family, and I imagined what they would think if they could see me in this situation. As it had the first time around, the moisture in the exhaust, coupled with the cool night temperatures, caused condensation to form on the inside of the car windows. I wrote the word SORRY in the condensation with my finger, and reclined the driver’s seat as far back as it would go. I rolled onto my right side, and then, sometime before beginning to feel any effects of the CO gas again, I fell asleep.

Later that morning a guy named Norman, the warehouse manager, showed up for work and called 911 to initiate the series of events that would save my life. Judging from my medical records, the near death experience that I had occurred underneath of the red cross of an ambulance speeding its way to the Jersey City Medical Center.