Suicide Awareness

According to the analytics of my website, by far my most popular post is Nudity is Awkward During Surgery…by far my most popular post. That begs the question, does sex sell even in patient advocacy? Or do you people hope that at some point that I will post nudie pics of me? Please feel free to leave me a strong, positive comment if your answer is yes but if your answer is no please please be kind with your comment. My self-esteem thanks you.

As much as I would love to publish a follow up to my greatest hit about nudity in surgery, this post is going to be serious. When I say serious, I mean today’s topic is about suicide awareness.

Before I dive into this topic I wanted to take a moment and mention something about my language and knowledge base I’m about ready to share in this post about suicide. In the chronic pain and rheum communities for which I am a part of, suicide is a topic of conversation but usually behind the signs with close personal advocate friends. Since birds of a feather flock together, these private talks are with fellow young people living in various levels of chronic pain where our only option for treatment is pain management, there is no cure for the chronic pain or the many autoimmune conditions that we have. All it takes is for a doctor, parent, brother or sister, loved one, or friend to regularly doubt our pain and condition and all of a sudden suicide can become a viable and practical treatment option vs a symptom of a mental health condition. I’m still very much a student of suicide awareness which means I don’t have the language, meaning, experience, and knowledge basis of other subject matter experts. This post is just as much about discovery as it is about advocacy. All I can say is I’m trying to become a better person.

Since I’m still a student, chances are good that I might say something wrong, antiqued, or even unintentionally mean or rude about suicide or suicide ideation. I’m very eager, willing, and pride myself on having an open mind so I can learn. After all, there is a shit ton of knowledge out there which takes hard work in order to obtain. What I won’t tolerate is anyone using the term ableism to describe something I might get wrong. This is a place to learn and discover, to often I’ve seen people use the term to call someone stupid. I fully admit that I am dumb, but I’m not stupid. My intent is pure even if my execution lacks. If I do something wrong, please break it down for me so I and I’m willing to bet the $100 bill (a birthday present) currently in my wallet many others can discover a smarter path to travel in our suicide advocacy journey.

Why suicide awareness you ask? In July of 2021, fellow Stanford University #Medx epatient scholar Erin committed suicide. As fellow epatient scholars, Erin and I bonded over our horrible chronic neck pain and surgeries along with the fact we both held degree’s in Political Science with an emphasis in international relations. In addition, we both strongly believed that healthcare was a human right but our country and culture considered it to be a checkbook right. We both suffered mental issues relating to our neck pain, there is just something about this pain that adds an extra physical and mental sting too it. If I remember right, we both had a plate and 4 screws at C 4/5. My second plate and 4 screws is at C 6/7 vs Erin’s whose issue went up her spine to C 2/3. If you are curious, C 2/3 is where we get the ability to turn our head to the right and left so she would have been in a ton of pain because that (my issues are now venturing into the C 2/3 area of my neck).

Due to this bond, her loss hit me hard. Erin wasn’t the first person I’ve known who choose this route, however, she was the first person who had similar health issues as I did. Although Erin had several other major health issues, like endometriosis, I could relate to her chronic pain issues due to her neck. Not only does pain hurt, it is both physically and mentally exhausting. Try and imagine waking up everyday for the rest of your life knowing that a “good” chronic pain day was a 5 or 6 out of 10 on the traditional pain scale. This was the foundation of our bond.

In Idaho, suicide is a major problem which has been getting a fair amount of press. This is probably why my job offered what it called a QPR Suicide Awareness class in its Learning Hug. Although the class was not mandatory, our Director had the goal of the entire Department taking this class. Since Erin’s passing had hit me hard, I worked with my supervisor and found a time where I could take this class. That time turned into last Wednesday.

In the interest of fairness, I will let you know right now that I was disappointed with this class. I’m not sure if it was because I had too high of expectations about learning more about the awareness of suicide or was it due to the experience with Erin, but I did not find much value in this hour long course. Here is why.

What is QPR you ask? Q means to Question. The instructor made it a point to tell us that we did not want to passively ask the person in trouble if they were thinking about killing themselves, we should directly ask “are you considering killing yourself?” Research shows that most people who tried suicide and failed actually did not want to die. P means Persuade. This is buying a few more moments of time so someone can begin to realize that they do not want to die. Finally, R means to Refer. This means to give someone names, addresses, phone numbers, rides to professional counselors or medically facilities that can begin treatment. Simply put, QPR is designed to give anyone the tools necessary to interrupt a crisis situation long enough in order to direct the person in need to help.

Here is my first concern or almost disappointment with this technique. In order for the Question and Persuasion to work, one has to be willing to accept the responsibility of the answer from the person in the crisis situation for it to work. Without this acceptance, the person is crisis is in trouble. Lets face facts, social media does not force us to accept this responsibility. It is possible to have a fake, or superficial relationship online that is masked as true friendship. In addition, most of us are online because we are hurting (either from our illness or some form of gaslighting from the medical profession). We are not there to help others, we are their to receive help. After all, we all went online as advocates because the system has failed us in some way which meant we had to seek help through other means than our healthcare system.

A practical example. Yesterday, while at Hugo’s Deli, I was asked if I wanted anything else with my sandwich. Without thinking, I shook my head no while saying “no thank you.” Turns out I need to learn to only answer questions by speaking, turning my head to indicate no brought horrible pain. When I say horrible, I mean the cashier offered me a chair to sit down because she was worried I was going to pass out. To put it another way, there were tears in my eyes due to the neck pain. Under no circumstance did I want to help others at that point, I was to busy trying to find a way to help myself. All I wanted to do at that point was go home, grab an ice pack and a fist full of pain meds, and lay on my couch. I did not want to accept the responsibility of someone else going through their own crisis situation at that point. Lets face it, it is probably safe to say I couldn’t accept the responsibility of someone else’s answer at that point. Even if I wanted to accept the responsibility of helping Erin if she was in a crisis situation yesterday, I couldn’t because of my own health.

Yes, there is an element of selfishness involved in not wanting to accept responsibility for an answer from someone in a crisis situation. So is our desire to eat when we know someone else is hungry. Selfishness is a part of humanism, the question is not how to we prevent this but it should be how might we use this to our advantage?

Simply put, we need to start treating suicide and suicide ideation as a symptom of physical illness. I don’t want to die but I also don’t want to live a life in extreme chronic pain. If that desire is not acknowledged and accepted, suicide ideation is always going to be a treatment option in my head because it is to only tool available that will end the extreme chronic pain. From your prospective, it is easy to write off suicide ideation as a symptom of depression from being in so much pain. You might have a point. However, since I’m the chronic pain patient maybe my (or in a perfect world Erin’s) perspective should be the starting point and not yours. This seems like human centered selfishness that can save lives and reduce suicide in general.

Here is my second issue from the class. The instructor was big on the idea of offering hope to the person in crisis. Apparently hope is a good thing. At the risk of being a Debbie Downer, I do not like the idea of hope. In addition, I think its the let down that comes from hope that is destroyed that begins the process of suicide ideation to begin with.

I have the hope that my Denver Bronco’s will win the Super Bowel again (they are not even close to being able to make the playoffs right now). I have the hope that the amazing barista at Dutch Bro’s will realize I’m good looking and a great dude so she should want to date me. I hope I will win the lottery. I hope I will land my dream job as a human centered designer at a ski resort (I’m not even sure if such a job even exists). I hope to be able to ski like I use to before my surgeries and diagnosis . I hope that tomorrow at work I make a difference in someone else life. I hope this post will make someone smarter. See my point. We have hope for everything but in reality hope does not materialize. That’s not a bad thing, it just how life works. Life runs on events and processes, not hope.

I did not talk to Erin on the day she died. As I recall, I don’t think I talked to Erin the week leading to her death. So this is a huge assumption on my part but I’m willing to bet the $100 bill in my wallet that if she received hope from someone on that horrible day in July that would not have helped. I’ll bet her doctor calling her to say “hey, I believe you do have endometriosis and would like to talk to you more about it” would have changed her life. I’ll bet an extra $100 that she could have used to spoil her beloved cats would have changed her life. I’ll bet housing that made her feel safe, warm, and comfortable would have changed her life. I’ll bet a measure of quality food security would have changed her life. Ok, yes I can hope that someone in a crisis situation receives such comfort and basic human rights, but we need people to figure out how to make what should be fairly simple ideas into a human right reality.