fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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Finding Freedom in Difference

Editor’s Note: This piece was awarded third place in the Pulse writing contest, “On Being Different.”

It was 3:00 am on my third night shift out of five, in a busy inner-city hospital in Sydney.

Having just reviewed six suicidal patients back to back, I felt tired and frustrated.

If I have to see another suicidal patient tonight…Why don’t they go and be suicidal somewhere else? I wondered wearily, then felt ashamed at the adversarial division I’d created: patient vs. doctor, them against me.

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Saved

It was a spring afternoon in Kottayam, Kerala, India, and I was a seventeen-year-old student, doing my final two years of high school at a local college, as could be done in India. I was the student-body president, with just two months to go until graduation.

And in another five minutes, I was going to end my life.

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The Day After

you ran a knife across
your wrists, you called
to say you had finally
tried coffee.

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High Stakes

As a practicing child and adolescent psychiatrist, I’ve been trained to treat depression and evaluate suicidal risk. Yet when it comes to working with an adolescent who expresses a wish not to exist, trying to clarify what’s actually meant feels daunting.

I’m reminded of this one Monday morning as thirteen-year-old Paula sits across from me in the interview room.

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And Then the Dog Died

Muscle memory. It’s an amazing thing. It’s what keeps my fingers playing Für Elise on the piano long after I’ve stopped taking lessons. It’s the pressure I sense in the crook of my elbow from linking arms with my late husband. It’s why every time I go for a walk I feel the pull of the leash from my dog Elvis, even though he too is gone.

Muscle memory holds on to real memories. And each time my muscle memory kicks in, I want to link arms with my husband, play Beethoven on the piano and walk my dog.

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He Said They Move Too Slowly

The ER doc said the trains here
Go too slow
For anybody to kill themselves
By stepping out
In front of one
As if they were sleepy little engines
Without much power
That drifted ghost-like through town
Quietly at night

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ECT Saved My Life

It was July, and the weather outside my window was sunny—but inside, it was a different story.

At the beginning of the summer I’d been diagnosed with bipolar disorder. I myself thought that I suffered from major depressive disorder.

I felt as though I were sinking into a black hole. My medications didn’t seem to be working, and my psychiatrist was out of the country for the summer.

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After the Fall

It is a chilly January night, a week after New Year’s and a few days after my twenty-fourth birthday. I’m halfway through my third year of medical school and have just started my clerkship on the hospital’s trauma unit.

I’ve been dreading this experience; I’m on twenty-four-hour call, and my heart sinks every time the pager goes off.

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A Question

Having told me you’ve had low energy
and decreased interest
in the things you used to enjoy
(reading, Canasta, sex),
I ask you,
because I believe we have enough rapport—
though how can one ever be certain—

Have you had thoughts of killing yourself?

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Healing the Little Brain

I was twenty-eight when I first walked into Matthew’s room in the neurosurgery ward at the university medical center. A newly graduated physical therapist, I was working at my first job in the field. I was there to evaluate Matthew for physical therapy, and I had all the right gear–a white lab coat, running shoes, a stethoscope, a clipboard and a goniometer (an instrument that measures joint angles)–and an enthusiastic desire to help this young man function normally.

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The Lightest Blue Eyes

Seventeen years ago, I was a senior psychiatry resident, moonlighting on weekends in the psych unit at a small rural hospital. Usually the unit was quiet. In this remote corner of northern Canada, we were taught to value resources and avoid “unnecessary” psychiatry admissions.

Arriving one rainy Friday, I headed to the ER to let them know I was there. Among the mostly frail, elderly patients, one person stood out: a healthy-looking woman in her early thirties, about my age.

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Unreturned Pages

Doug Hester 

Exhalations materialize in the dark as I walk
from the empty parking deck. I brew coffee,
then print a list–our census is up to thirty.
I grab my coat and start seeing patients:
the gastric bypasses, the nine ex-laps,
the psychotic panniculectomy patient,
and the bowel obstruction we are watching.
I page just before six to ask about his diet,
but you don’t answer me, so I move on,
jotting ins and outs, celebrating flatus.
Knocking on the Whipple’s door, I think
of you suddenly and my gut spasms,
smothered by the weight of living like this.
I page again from the ICU, staring at a phone,
wondering if

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