Hitting a Nerve

Death from despair


I’ve taken care of both Bill and his wife for a few years. They’re a sweet couple, each with their own neurological issues. Bill has also battled depression on and off over time. He can be a challenge, and I’ve never envied his psychiatrist.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

Bill committed suicide in the final week of April.

Patient deaths are unavoidable in medicine. It’s part of the job. Suicides, though less common, also happen. Sometimes they’re related to a sad diagnosis we’ve made, but more commonly (as in Bill’s case) they result from demons we had no control over.

I had a patient commit suicide about 6 months after I started my practice, and probably average one every 2 years (that I hear about) since then. They’re still the deaths that surprise me the most, make me take pause for a few minutes, even after doing this for 23 years.

Suicide is as old as humanity, and gets worse during difficult societal and economic times. It disproportionately affects doctors, dentists, veterinarians, and police officers, and leaves devastated families and friends in its wake.

Death because of the progression of time and disease is never easy, but perhaps more psychologically acceptable to those left behind. Death because of a tragic accident at any age is more difficult.

But when the person involved makes a conscious decision to end his or her own life, the effects on those left behind are terrible. Wondering why, questioning if they could have done something different, and, as with any loss, grieving.

Suicide remains extremely difficult to prevent. In a world where major advances have been made in many areas of medicine, including mental health, death from despair shows no sign of abating.

Maybe it’s part of the price of sentience and reason. Or civilization. I doubt it will ever stop being a public health issue, no matter how many other diseases we cure.

But, as I write a letter to Bill’s wife, that’s little consolation for those they’ve left behind.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Recommended Reading

It’s time to retire the president question
MDedge Neurology
Hanging on to the memories
MDedge Neurology
About one in five clinicians considers quitting because of pandemic
MDedge Neurology
The waiting room: Then and now
MDedge Neurology
What COVID did to MD income in 2020
MDedge Neurology
The ripple effect
MDedge Neurology
Vaccinating homebound patients is an uphill battle
MDedge Neurology
Percentage of doctors who are Black barely changed in 120 years
MDedge Neurology
Is common courtesy no longer contagious?
MDedge Neurology
Doctors lose jobs after speaking out about unsafe conditions
MDedge Neurology