Tuesday, November 8, 2011

Secrets no one told you

“Three can keep a secret, if two of them are dead.” – Benjamin Franklin

This morning I lay down – cold and cramping – on a medical examination table, my bladder filled past capacity, as an ultrasound was taken to see how quickly my kidneys are dying.

There’s no emergency here. When he diagnosed me with third stage renal disease, the doctor was clear that decades could pass before I might suffer ill effects from a slow shut-down of my kidneys, which are now working at 42% capacity. People donate kidneys, after all. They’re a hardy part of the human body.

I’ve not blogged on “Death to Life” for about six months – since my second “anniversary” of my suicide attempt. During that time, I’ve worked to distance myself from that particular period in my personal history. I’ve thrown myself into my work (both paid and volunteer). I’ve rebuilt trust with friends and family that I hurt – or that I felt hurt me – when my illness was at its peak. I’ve forged new and healing relationships.

But just as I’m forced to remember that day every morning as I put on the bracelets that hide the scars on my wrists, today’s examination was a reminder that I’ve survived a suicide attempt. Unlike surviving cancer or a heart attack, it was a “survival” I didn’t celebrate at the time. It was a “survival” against my will. And with each passing week, I grow more and more estranged from that part of myself. What was I thinking? What can I do to be certain I’ll never think that way again?

You see plenty of suicides on TV and in the movies. But there are things about suicide that no one tells you. Even those of us who have tried and “failed” rarely speak of these things amongst ourselves.

But if you’re considering suicide, I’ll break the silence and tell you some of the things that I found out, which no one else will tell you:

If you attempt suicide, chances are overwhelming that you will survive. There are more than 20 attempts for every “successful” suicide. So when you wake up alive – as you most likely will – you’ll be faced with a whole new set of problems that you didn’t have before.

If you slit your wrists, you probably will not die (even if you swallow a bottle of aspirin first and slice your arteries the “right” way). Instead, you will have scars for life that will make you feel embarrassed and ashamed.

If you overdose, you will probably throw up (even if you take anti-nausea medicine and take the pills with food). If you don’t throw up while conscious, you’ll throw up when you’re unconscious; either way, your body will reject the pills. That’s what your body is designed to do.

If you overdose on acetaminophen (Tylenol), you will damage your liver. “Good,” you think? Think again. Dying from liver damage takes days, even a week. You’ll still wake up alive – you’ll just have to suffer for a long time.

If you OD on Tylenol and are discovered and rescued by emergency personnel within 8 hours, you will be hooked up to an IV of N-acetylcysteine. For 24 hours, this antidote will drip into your body, and you won’t know until the next day whether you will live or die.

If you OD on other medications, such as sleeping pills, lithium or ibuprofen, you will damage your kidneys and other vital organs. This damage may not manifest for months or years, but it will be with you the rest of your life.

In the ICU, if you are agitated and fight against medical treatment, you will be restrained either chemically, manually or both. Decisions will be made for you. You will not have control over the outcome.

During the first 24 hours, especially if you ingested multiple medications, you will be confused and panicky. You won’t know day from night. You won’t recognize people. You will be cold and hungry. But medical personnel will not be sympathetic. They are accustomed to caring for patients who wish to live. They won’t feel sorry for you.

If you attempt to sleep, you will be awakened each hour. Each time, you’ll be asked three questions: “What is your name?” “Do you know why you are here?” and “Are you going to attempt suicide again?” (The correct response to the last question is “no.”) The questions will be barked out as if you’re being interrogated (which, really, you are). The people interrogating you won’t feel sorry for you, either.

Once you pass the critical stage medically, you get to go to the psych ward. You won’t think you belong there, but that’s where they will put you. First, though, they’ll go through your financial situation. You’ll be informed the cost is $1,500 per day. Even if you have insurance, you’ll be out, at the very least, a grand for the ICU. And even though you have the legal right to refuse treatment, they’ll make it very hard for you to leave – whether you can afford to be there or not.

You’ll be in the psych ward at least three days. If you have a job, and you want to keep it, you’ll have to come up with a good excuse for your employer. And once you return to work, you’ll have to worry every day that you’ll be found out. You’ll have a better reception coming out as someone with AIDS than as a survivor of suicide.

In the psych ward, you’ll be at the bottom of the pecking order. Like child molesters in prison, suicide attempters are the objects of scorn. Everyone else wants to stay alive; you did something stupid to wind up dead. And what’s more, you “failed.”

No one will ask why you attempted. No one will try to understand your state of mind. No one will acknowledge your pain. Instead you’ll be asked to focus on “coping methods” and “behavioral therapy” techniques.

You’ll be given printouts to help you label your emotions (Anxious! Mad! Sad!). And you’ll be required to attend classes where you paint pencil boxes and glue beads on to purses. It won’t matter if you have a Bachelor of Arts degree in Psychology and Journalism. It won’t matter that you have a higher-than-average IQ. You’ll feel condescended to … and you’ll be right.

But the worst is yet to come, because eventually – after you’ve convinced a board of staff members that you’re “no longer a danger to yourself” (even if you lie) – you’ll go home. There you will face your husband, wife, mother, father, siblings, children and friends.

This is the biggest secret no one will tell you: Your homecoming won’t be like in the movies. Your loved ones will feel angry, hurt, and betrayed. People will think you are selfish and uncaring. Some will think you did it just for attention. Others will think you’re weak. Some will avoid you completely. Others will pretend to accept you, but they’ll avoid certain topics that might “trigger” you.

They’ll edit their speech to make sure no suicide jokes slip out. And if you live with them, they won’t trust you. They’ll take the razors out of the bathroom, and if you’re in the bedroom too long, they’ll ask why. Do you like your independence? If you attempt suicide, you will lose it. Guaranteed.

These are some of the lessons I learned from my attempt. I hope you remember them the next time the thought of suicide crosses your mind. If you’re like me, the urge won’t disappear overnight; in fact, it will continue to pop up again and again. But when I review the list of secrets I’ve disclosed, I’m reminded that suicide isn’t the “easy way out.” It’s the hardest way there is.