What It Feels Like to Lose a Patient to Suicide
What’s it like to lose a patient to suicide, you ask?
We bear the pain in different ways. For me, it feels like you’re a combat medic and you’ve used up all your tourniquets on a wounded soldier who seems to hemorrhage from everywhere. The blood seeps through the skin and, no matter what you do, you cannot stop the soldier from choking to death on their own blood, even as your hands, arms, and legs are applying pressure wherever they can. The soldier dies in your arms …and so you move on to help the next soldier, and the next, all the while aware of the blood that now stains your hands, not because you killed that soldier, but because you didn’t save them. It stains your hands because YOU FAILED.
With every patient loss, the blood permeates your skin. You are unable to wash it off. It just gets darker. You acknowledge its presence every time you step up to greet the wounded. And how can you not consider it a failure when we are supposed to be preventing suicide? Mental illness is not considered a an acceptable reason for death.
No one questions the culpability of cancer as a cold-hearted murderer when it comes to claim a life. But when depression, psychosis, anxiety, or trauma rend the core of someone’s existence to the point where they can no longer sustain life within the confines of their being, it is not permissible. As long as the bar is set at preventing suicide and not acknowledging that there will be casualties that you will not be able to save, every loss will feel like a failure.
I’m not sure if the people around you completely appreciate that this person you couldn’t save was not a stranger. This was someone who shared their tears, their fears, tand their unfulfilled dreams with you. They shared their pain and their hopes, they allowed you a firsthand view into their despair, they let you into their world and perhaps gave you glimpses of their soul. You carry not only the weight of your self-inflicted guilt, but also the sadness of this loss. Sometimes their faces and their conversations invade your thoughts — you will no longer be alone now that you have acquired the company of these relentless ghosts.
It’s not that this sense of failure keeps you from taking care of others. Perhaps it even motivates you to do your best and be your best. It may act as the greatest impetus for you to be more attentive, since you do not want to feel that way ever again. There may be grateful souls out there who remind you of the blessing of your presence and the indelibility your worth. You will graciously accept their gratitude and these platitudes. You’ll feel like a charlatan even though you will hang on to those words and wish you could believe that they are an accurate reflection of you. But this does little to cleanse your bloodied hands.
Zheala Qayyum, MD, is a child and adolescent psychiatrist and an assistant clinical professor at the Yale University School of Medicine focusing on psycho-oncology and palliative care. She also serves as a psychiatrist in the United States Army Reserves.
