Alzheimer's Disease, Death, Dying, MAID, Physician-Assisted Suicide, Suicidal ideation, Suicidal Thoughts, Suicide
Suicidal Moments
Suicidal Moments
by Marco M. Pardi

All comments are welcome and will receive a reply. All previous posts are open for comment. This particular post is offered in the hope that the many readers who have not previously commented will do so now. Your safety is assured, and you can contact me by email if you wish your comment posted anonymously.
Recently I was in the process of developing a joint post with Br. Mark Dohle, a Cistercian monk and very close friend, when I received one of my daily emails from a critical literary site to which I subscribe. This site reviews literature, past and present, and is a font of information and critical thinking. By the way, Br. Mark may contribute to this post as well.
On seeing a particular entry I forwarded it to several very close acquaintances, some in the field of Mental Health. None of these people have previously contributed to or commented on the site you are now reading, but given the current crisis involving, particularly, youth suicide, a couple of them have agreed that their responses may be posted and one, with permission, has sent a colleague’s cleaned response. For obvious reasons I have removed all identifiers. The citation for the book follows the discussion.
My take:
Personally, I was around nine years old when I first processed the concept of suicide (sui – Latin, self) (cide – killing). I point this out because I gave this new concept considerable thought. Admittedly, I may be over zealous in examining the meaning of words; American-English is my second language. I wondered, for example, about that trite saying, No greater love…..than to lay down one’s life for another. Is that not suicide? Does the Church give this person a pass from eternal Hell? We give medals to soldiers who throw themselves on live grenades, supposedly to save their nearby buddies. Isn’t that suicide? There has never been a day in my daughter’s life when I would not have stepped in front of a bullet meant for her. But then, I’ve been shot before. Maybe I just don’t think it would kill me.
Later in my youth I read about slow motion suicide, a lifestyle certain to bring a premature end. Does that cast doubts on people who are, for whatever reason, in high risk jobs, high risk sports?
But what really set me off was the discovery that, in mental health interviews with patients and even in general health questionnaires we find the question, in various forms, Have you ever thought about suicide? In discovering a new concept who with an I.Q. greater than a doorknob has NOT thought about it, not to do it but to understand it? I concluded people who answer No to the question about suicidal thoughts are either liars or doorknobs.
I am further disdainful of those who carelessly use the term “commit” when referencing suicide. I realize commit signals a final and perhaps irretrievable act, but I feel it is too tainted by its usage in criminal matters. And I do not view suicide as necessarily criminal. So, I prefer to use the term perform, as in He performed suicide. It wasn’t that long ago that suicides were forbidden church funerals or burial in “sanctified ground”. And, suicide is still viewed by many as prima facie evidence of mental illness. Hopefully, we are past that.
And then, there are always those simpletons who say about a suicide, They took the easy way out. I will say firmly, these are people who never seriously came close to examining the possibility for themselves. They never stared down the barrel of a loaded and cocked firearm, never held a full container of pills and thought about it. They are like the matinee soldiers I despised throughout my life.
Another area, which I have discussed in previous posts on this site, is that of medically assisted dying. Where it is legally possible in the United States the lethal dose of medication must be taken by the patient with no assistance from anyone else. Think about that. I was asked to discuss the Brittany Maynard case on nationally broadcast radio. In that situation the patient, Ms. Maynard, had to reach the conclusion that she would soon be disabled by her inoperable brain cancer to the point where she would not be able to take the medication herself. Thus, a seemingly “healthy” young woman took the medication and expired. Yes, she “killed herself”. Does this fit the commonly accepted definition of suicide?
What follows below is a response to the book review I mentioned above. This is a mid-level executive in a highly respected and successful profession living in the Pacific Northwest. (The script may be a bit off since we used different email systems.)
“I read this article last night and would like to read the book. I’ve never read anything so detailed and compelling about suicide attempts and ideation. I’ve lived with ideation so long it seems a part of my core. That includes all the ways I might attempt suicide, and have even tried to research those so I won’t botch it. There is actually very little information available online. That’s usually the only thing that prevents carrying out plans – fear of a failed attempt and placing myself in a worse situation. I rarely think about anyone being devastated, because I mostly don’t feel loved by anyone regardless.
Yesterday I spent my day kicking myself over and over for not letting hypothermia kill me. I kept thinking how it would have been the perfect exit. When I was actually experiencing it I did not think that, although I wasn’t thinking clearly at all. I knew on some level I was probably going to die if I didn’t make the emergency call, yet I allowed the condition to go on for four hours. Now I’m reading how much hypothermia clouds the judgment.
One of my coworkers is a brilliant person, and has survived a lot, including parental abandonment, foster care, and cancer. They are basically one of the reasons I stay in a miserable job. Yesterday we discussed the Japanese term “karoshi” (death by overwork). We also discussed how we both virtually never stop moving and rarely take breaks – completely abusing our bodies through hard work. We even joked that sometimes we wish for death so that we would never have to work again. Yet sometimes my own experience seems like another version of slow suicide.
Some of the most brilliant people are stuck in some of the worst situations. I can understand how death seems the only way out sometimes. That’s usually my mentality, along with some pretty severe neurological and social challenges that I now know are permanent. The social ones have improved, and it has helped knowing that I have OCD. I’ve been transparent with my team about my challenges. They are sympathetic, and most constantly tell me to slow down and stop overworking.
Yesterday I found out someone at another company location ended their life. This had me wondering if they were as fed up with the company as I am, along with the corporate greed that goes along with it.
As for the author of this article and book – what a courageous person to write their story. I am always terrified to call suicide hotlines because I know they can send law enforcement. The anxiety of having to disclose my address prevents me from calling. But, I’m never actively forming a plan or about to do anything stupid. I had a botched attempt (fifteen years old), as did my sibling when they were thirteen, and of course our mother’s attempt in my early childhood. So mine are mostly just thoughts.
Thanks for sharing this. I feel on some level you understand ideation, though I’m not pressing you to share.“
clancy-martin-on-the-contradictions-of-living-through-suicidal-moments/
I found this interesting, as I trust you did as well. I happen to know I am about 30 years older than this person, and that may factor in as I easily recall the many people, including close relatives, I watched enter a long term, miserable decline from which they never emerged in living form. How many of us have similar experiences with loved ones, and come away saying I don’t want to live that way. No, I don’t have any intentions of ending my life. But I have every right to take issue with those who demand that other people “let Nature take its course, in its own time” , or, “Only God can decide when you die”.
I am as much a part of Nature as anything else, so my acts, whatever they may be, are natural. As for God, you know I am not a deist but just for the sake of argument what’s to say I can’t claim God told me to do it. Have you got a back-channel to God to fact check my claims?
Those of us working to make this site valuable to a wide spectrum of readers understand that there are some issues which are less compelling than others simply because they are irrelevant in some readers’ lives. In this case, however, we do suspect that every reader will find some relevance and therefore will render a comment….or many. As always, your comments will be answered and your identity, if you wish it, will be secure. Contact me by email if you wish anonymity, but be sure to put POST in the subject line.
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Extremely thought-provoking; I’m going to have to think about how to respond to this before I do so in the Comments. Looking back, suicide and thoughts about it, mine and others, have had a larger role in my life than would have ever previously occurred to me.
Mike
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Thank you, Mike. We are looking forward to your additional comments. Marco
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Marco, I’m really hoping this post inspires thoughtful discourse.
My initial comment lacked something I wanted to say before launching into my own experience: That you thought about suicide at just nine years old is difficult to process. It’s incredibly sad to know any child would consider ending their own life, yet many do today, or attempt to do so for various reasons. You are the first person I’ve personally known to reveal something so heart-wrenching about their childhood.
It seems almost trite to say I’m glad you didn’t follow through with any thoughts at the time, because this speaks for itself. It seems selfish as well, because I have gained and learned so much from knowing you. What I don’t want is to diminish what led you to that point. No child should ever have to consider suicide for any reason. It would be nice to imagine a world where all children know what it’s like to feel mostly carefree, retaining their innocence as long as possible. Some of us had those moments I suppose, but others by that age had already lived through circumstances many could not begin to imagine. I wonder what might have prevented those childhood thoughts from becoming a reality.
Thank you for sharing something so deeply personal. I find that immensely courageous. All of the countless important and worthwhile things you have done with your life since then (and are still doing) should be reason for any reader considering suicide to give pause. We don’t know what the future holds, even if today’s problems seem insurmountable.
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Thank you, Dana. Yes, there were times over the years, starting at a young age, when that darkened hallway beckoned. But, in the immortal words of Jack Nickelson in The Shining, “I’m baaaack.”
You rightly point to children, and it is true that suicide among children has always been covered up as accidents when possible. However, as the United States falls to “the Death of a Thousand Cuts” – the taking over of library boards, school boards and locally elected offices, the exponentially increasing laws and criminal acts against the trans kids, the LGBTQ kids, the poor families, pregnant women seeking abortion, people seeking contraception, health providers, books, public education, government assistance programs, and people suspected of being Jewish, we are seeing an undeniable and very alarming increase in hopelessness among young people and subsequent suicide. The Christian Nationalists, too ignorant or too stupid to understand they are being played by a well entrenched cadre of Fascists, are quickly bringing in a dystopia that offers fewer and fewer reasons to continue struggling with life. These young people are not ignorant and they are not stupid. Yet, they see an increasingly hostile future shutting them out.
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Thank you for mentioning all of these critical issues future generations are faced with today, Marco. You have reminded us on so many occasions never to give up. Even today I have to constantly remind myself that what I have survived may help empower others, including myself.
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Thanks, Dana. I think another area which is already seeing an increase in suicide rates is the elder population, particularly where the elderly person is beyond recovery and is only awaiting the end. In the late 1990’s my brother and I put our mother (severe Alzheimer’s case) into the locked unit, called “Memory Care” of a nice Assisted Living place in Florida. Our cost was only $3,700.00 per month, easily manageable for us and she lived there only a few years at $54,400.00 per year. Yet that same form of care now averages well over $80,000.00 per year in the U.S. Even basic Assisted Living, with no medical care, averages $60,000.00 per year.
As the elderly percentage of the population increases, and the Republican efforts to slash or eliminate any form of social-financial help increases, many more families are facing bankruptcy in the dim hope of qualifying for Medicaid and a shared ward in a nursing home. Yet, the average cost for home health care (at only 40 hours per week) is well over $56,000.00 per year. Many families opt for a family member(s) assuming these duties around the clock. A multitude of studies have shown that such family caregivers lose an average of six years life expectancy due to stress.
So, many competent seniors are asking themselves why they should bankrupt the family, lose the family home and much of the possessions, and physically and emotionally damage loved ones all for the sake of dragging it out a few years, or months. While i was teaching college Thanatology courses in the 1970’s I routinely toured nursing homes in which I had placed students with selected (terminal) patients. Invariably most of the students reported their patient continually expressed a wish to die, even by suicide, and was in anguish over their inability to do so.
This problem is only going to get worse, until we recognize the parasites and predators in elected office (financially supported by American Oligarchs through the current Citizens United provision allowing the unlimited flow of money into campaigns) and vote them out.
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Thanks for this stunning account many might not consider. For these reasons I also support the badly needed Universal Basic Income. Caring for an aging parent needs to be considered a full-time job and one that requires a salary. Even $1,000 month is not enough for 24/7 care of a family member.
We can only imagine what will happen as the population ages. Who will care for all of the Millennials and GenZ children when they age? Gen Z as a whole is a generation mostly opposed to having children. Young people are far more aware than we know, and they don’t want to struggle financially to raise children when they’re already saddled with crushing student loan debt.
Without lawful (Federal) ability to end one’s life humanely and with medical assistance, it will be a problem for which this country is not prepared. I absolutely would not want my children feeling forced to care for me if there is a terminal illness. Nor would I want them spending thousands of dollars per year for me to live in a facility. I will make my own plans if it comes to that and if there are no medically assisted options where I live. It might require a return to Canada and the use of MAID.
Sadly, for so many it’s too late to safely end their life as you said. I’ve read accounts of elderly people who deliberately drown in a bathtub because that is their only option.
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This is a very powerful article and it evokes many thoughts and feelings. My most predominant thought is that I understand the idea of suicide not to be an act of cowardice, but an act of choice and of still having some type of power over one’s own existence at a time of ultimate hardship. It may be seen as a final act of choice or perhaps it may not dependant on the individual’s belief system. Perhaps their essence will emerge in another form in another time and place or perhaps it will not.
It is certainly a complex subject to discuss and this only scratches the very surface.
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Thank you, Tilly. Yes, I react strongly when someone glibly calls suicide cowardice. The decision to bring an irretrievable end to one’s life and the courage to perform the act must arise out of anguish I cannot describe.
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Thanks for this article. I too pondered what is life and when is death at an early age, watching my uncles and grandparents die. We all die in the end and death is a natural consequence of life, so it’s all natural causes. Death is just a matter of when and how, not really much to do with the why of it – though the why is why we call it suicide.
When I first was diagnosed with cancer, I expect like many others, I thought more about the subject of hastening the moment of fatality – but I am glad I only thought about it and survived the cancer as well. If things had worked out differently, I don’t know. I have people about me that I love and while I’d not be able to consciously miss them, I’m sure some, anyway, would miss me. And for those people whose lives have become insufferable to them and a huge imposition on others around them, actively progressing the moment of death may be an extension of that love – free them by freeing yourself. The kindest of generosities one can undertake.
Spring, a period of renewal and one of my favourite seasons, is upon us now. I still want to enjoy the rewards of seeing life begin around me, even though I know that winter is never really that far away.
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Thank you, Ray, for this amazingly eloquent explanation of altruistic suicide, and for your closing statements. I feel compelled to go outside and immerse myself in the blossoming of new life. Thank you.
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Thank you Marco for sharing this article along with the comments from various others. I loved the transparent honestly written by Clancy Martin, it felt real and relatable to me. I feel it is such a taboo subject with great negativity attached to it. I feel this subject sits differently for everyone, I felt I could understand the writer, although as we are all different I would suspect others could not. For me personally, I have had some very difficult and dark times in my life that at multiple times have felt suicide to be an out, as much as I know I didn’t want to do it, I have thought a lot about it. I feel the thinking about it is more about the broader human experience and our time here and going to the “other side”, feeling like such stress being here and wanting to get there sooner. The allure for me is my belief about “heaven” being stress free etc, however as I have become older, I feel when we die we take where we are at in life with us, and still have to deal with ourselves after physical death, as only our physical meat suit dies. So therefore, live life, make the best of it, find the joy, give to others where you can, in however way works for you, as I now believe we are all here to contribute, learn, grow, have fun and be happy and we all die when our time is right ❤️
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Thank you, Julie. Your candor is heartening, and reminds me of how I have wondered about people who see an “afterlife” as eternal bliss; I wondered, if they think that, why don’t they go? I agree that we take our issues with us, until we realize they were transitory and ultimately irrelevant. And I agree that we die only when the time is right. Not before, not too late.
Following your adventures I am confident you are living your philosophy, and deriving great benefit thereby.
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The comments below are from Tamila:
This conversation has grown immensely. I have a few takes…
1. So interesting that someone used the word doorknob to compare someone who has never thought about suicide… it’s especially ironic because I just recently learned this year that in many LA “suicides” the LAPD allegedly uses the rope around the doorknob as a sign behind the conspiracy theory behind suspicious deaths marked as suicides. People hanging themselves…but not…
2. Assisted suicides are also extremely controversial… and I knew someone who’s mother committed suicide with the sentiment of easing the burden that would be placed o her family with the early dementia…. People have so many reasons for doing this… however, it can be seen as selfish, I don’t think anyone can really prove it to be “wrong” especially if we all agree that perception is reality.
3. I believe the reality that no one talks about is the feeling to “perform” (I agree with this beautifully sensitive notion) suicide can be ever-lingering— the urge to fight it and resist it— is the will to live; life. No matter how dark or light it gets
It’s a bottomless pit of a conversation for sure. I will never be convinced that we can know the definite answer.
Warm regards,
Tamila
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Thanks, Dana for posting this. And Tamila, so glad to have you back. I had not heard that about the LAPD, but having lived in that area I am not surprised.
Yes, we do have quite a few conditions governing assisted suicide. It’s not as simple as people seem to think. And I agree, we must be careful in making judgments.
Your last point is enlightening. Too often we think of someone spending hours on a ledge trying to decide. But I remember in San Francisco the problem of joggers, in jogging outfits, running along the sidewalk on the bridge and suddenly leaping over the side. Hard to say when they made the decision, but they carried it through.
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From Mike:
My father’s father died sometime before I was born, but on those infrequent occasions when I asked when he’d died, Dad always avoided the question, and something in the way he did so told me I shouldn’t push it. As I grew older, that vagueness seemed increasingly odd. But it wasn’t until I was in my thirties that Dad and Mom called me and my brothers together and told us that my dad’s father had killed himself in 1947.
They’d wanted to protect us, you see, from a revelation they thought might have been traumatic. I don’t know that I’d have found it traumatic even when I was much younger; I’d never met the man, never known him, so it might as well have happened to someone in some other family somewhere else entirely. Looking back, my grandfather’s suicide might have explained a number of things about my dad’s mother; it surely affected my father, though he’d been 21 and was living far away when it happened, but I never knew how. (That was one of many questions I wanted to ask when my brothers and I went to visit my dad, days after I’d retired, to find him—only two days before he died, without warning—no longer capable of answering anything.)
But for me, at least, this “revelation” was interesting—just as finding out that my maternal umpteenth-great-grandfather had been run out of Boston for heresy in the 17th century was interesting, even kinda cool—but no more than that.
The issue of suicide and my parents had come up before then, however. Oregon was the first state in the US to legalize medically assisted suicide, in 1997, and many people have since been able to depart life on their own terms because of it. An acquaintance diagnosed with terminal ALS took advantage of that law this past January. (I have always agreed—sexist phraseology aside—with Robert A. Heinlein’s assertion that “death is every man’s privilege.”) Even before that law was passed, my parents had determined that they didn’t want to live past the time when they felt themselves to be in control of their lives, and they made preparations with that in mind.
It was not to be, however. My mother died in early 2014 of complications of diabetes and Alzheimer’s, my father of cancer and congestive heart failure not quite 18 months later. I don’t know if they simply lost their nerve or, more likely, the time never seemed right until it was too late. Perhaps it was a combination of the two. By the time she might have wanted to make that final choice, Mom was no longer mentally capable of doing so. At the end, Dad was not physically capable of doing so. (The local clinic made things easier for Dad; as he was dying, the doctor gave us morphine syrup to help keep him more or less comfortable…but he gave us quite a bit more than we needed. Just in case.)
And maybe 25 years ago a young woman I never knew jumped from the 9th floor of the office building I was working in; I was the second person on the scene. (Someone else had done the same thing, from the same place, roughly 30 years before. It is no longer possible to do so.)
So the idea of suicide in general, and in the event of my own incapacitation in particular, has long been with me. (To be honest, it had crossed my mind more than a few times for other reasons, but never seriously, never as a real option.) I have made the same decision my parents did, however: that if for some reason my ending was in sight with nothing but pain and/or the loss of my mental faculties to look forward to, I would take control of my passing one way or another.
At present, the thought of actually doing so remains a merely intellectual exercise. Whether I will actually be able to do so is another question for another time, should those circumstances and that time ever come. But I stand before those others who have taken that road, for whatever reason, with a strange mixture of sorrow, respect, and sometimes a kind of awe that they found the will to make their final exit on their terms. Calling it right or wrong is not only not for me or anyone else to say, but—after the fact—profoundly pointless, even if it is also profoundly human.
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Thank you so much, Mike. This is an eloquent treasure and beyond my ability to express my gratitude for and my appreciation of your candor. Even when it deals with persons and actions at considerable remove I feel it speaks directly to me, challenging me to explore my capacity for empathy.
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