The Selfishness of Suicide

I have worked in Emergency Medical Services for thirteen years. My interest in the field was sparked from a suicide that occurred during my sophomore year in college. I was living in a shitty apartment with two roommates and trying to figure out a back-up career that would fund my writing until I made it big. It was the Tuesday after Memorial Day that I woke to a loud banging on my door. My roommates were still gone from the holiday weekend, and it was an hour before my alarm was set to go off. I remember throwing my bathrobe on and dragging myself to the door to with the intent of answering it with a, what the fuck, that faded as soon as I saw who was standing there.

My Guatemalan neighbor, whose English was at a level of exchanging simple pleasantries, was standing there with a panicked expression. She began yelling at me in Spanish. My knowledge of Spanish was learned from working in restaurants and is limited to profane insults, and how to ask for pancakes. I had no idea what the hell was going on. She pulled me across the hall, into her apartment and pointed at her roommate’s bedroom door. Music was blaring from the inside, and from what I could gather from my shit-Spanish and her attempts at English, was that her roommate came home on Friday night, went directly in her room and hadn’t come out since. Again, it was Tuesday morning.

I tried to ask if she had looked in, but she just kept gesturing me to open the door and wouldn’t answer me. So I opened it. The woman was sitting upright on the floor leaned against her bed, and without even stepping inside, the three plus days of decomposition without an open window hit my nostrils; I knew she was dead. My neighbor began screaming as though an axe murderer was after her. I gave her what was meant to be a gentle push away from my ear and pointed toward my apartment and said, “go”. She did and continued to scream.

I walked into their kitchen, grabbed the portable phone off the charger and dialed 911. Dispatch transferred me over to the incoming fire unit, and it wasn’t a pleasant exchange:

Fire: We need you to go in and check for her pulse, you can find it on her neck next-

Me: Uh, no man, she’s really dead. I’m not touching her.

Fire: You could save her life. What’s the matter with you?

Me: Trust me, there is no saving her life. I’m not touching her.

Fire: Don’t you care that she could be dying?

Me: Look buddy, she’s not dying- she’s dead. For all I know it’s a fucking crime scene and I’m not touching her. I don’t even know why they’re sending you. Send the cops.

I don’t know that I’ve ever been glared with such disdain as I was by the lead firefighter when they arrived. He actually whacked me with his bag as he passed me. Much like I told them, they took one look in the room and turned around and walked out, but not without getting an I told you so, fucker glare from me. And so began what would become a career long contempt for firefighters, but that’s another story.

A little background on the dead roommate that I found out later from her family: She was a twenty-seven-year-old who had recently moved to Alaska from Florida. She moved in with Loud-Guatemalan-Lady via a roommate finder service. Loud-Guatemalan-Lady was such a class act that in the weeks following Florida’s death, she sold all her things and wouldn’t give the family any money or even her photos, claiming that Florida never gave her sixty-days notice to find a new roommate which was part of the agreement. I speak negatively of Loud-Guatemalan-Lady, because it never sat right with me that she had a corpse in her house for over three days, and claimed that she never thought to look in there and check on her... with the music blaring loud... all weekend... Bullshit. I think her story stinks as bad as Florida’s bedroom that morning, and her screams seemed like a b-movie performance. I’ve wondered her motivations for years, but in the end, I’ve come up without cause, but I can’t say that I will ever remember her in a good light.

I don’t know what brought Florida up to Alaska, but I found out from the police who camped out in my apartment for the rest of the day, that she had left a note and they were pretty sure she overdosed intentionally. That assumption was later confirmed to me by her family.

That morning planted a seed that would ultimately direct some major choices in my life. I told the above story to an EMT friend of mine a few days later, and he commented that the only thing that seemed to bother me about it was the way I was treated by the firefighter. I agreed. Dead bodies don’t bother me and I didn’t know her. He then went on to suggest that I take an EMT class, and that maybe I’d be good at it.

Don’t get me wrong, a part of me was bothered that a person who lived so close to me, never entered my story. I like to think that I could have helped her or even been a friend to her. Maybe her story could have had more chapters or at least a better ending, but I only saw her once and didn’t even know her name until the day I found her body. It was a missed opportunity, but one that I was only aware of post mortem.

She wasn’t the first suicide in my life, and after becoming a career paramedic in both a big city and a rural town, the image of her body disappears into the collage amongst a hundred others. At times, the failed attempts are harder to stomach than the successful ones, especially the attempts with firearms- people never consider how much they flinch when they pull a trigger. I’ve seen people opt out via conventional means, and others who got really creative. I’ve found people that took themselves out with the intent of being found by specific people, and others that trudged out into the middle of the woods or abandoned buildings hoping not to be discovered at all.

It’s within the failed attempts that I feel like I’ve learned a simple truth about the suicidal- they have transcended desperation, and found what they think is resolution. They believe that they and the world will be better off without them. They believe they’re a disappointment when they don’t get out of bed, they’re a disappointment when they do get about of bed. They think people hate them, or worse, don’t even know they exist. Only focused on their flaws and short comings, and knowing that no one wants to be around them and their misery, they choose to bow out. They BELIEVE it.

Every time I read of a celebrity suicide, or see posts on Facebook from people that are friends of friends that have lost some one, the word “selfish” inevitably works its way into the comment sections. Perhaps it’s from living in the fringe all these years, or maybe it’s an abundance of empathy, but I disagree that suicide is selfish.

Before I get to my point, I feel I need to add in this disclaimer: I will exhaust every last resource and kernel of knowledge that I possess to preserve life. If that is talking someone off a ledge or working the science of emergency medicine, I believe that life is precious and always worth saving. I don’t care if you’re the most morally skewed individual to walk across my path- if I’m involved, I am your health advocate.

I also have hope and believe in the power of getting ‘another chance’, but not everyone does.

I have a hard time thinking about true selfish behavior without thinking about the opposite- Altruism. I know that we look for and even expect to find some level of altruism in each other, and hopefully we aspire to it within ourselves. The debate on the existence of true altruism is already out there, and I have nothing new to add to it other than to agree with the ideology that true altruism doesn’t exist. We make decisions based on our own interests all the time, including doing things that make other people happy- we feel good when we make others feel good. Once we accept that, perhaps we can look at those who are so consumed by their own misery a little less ‘selfishly’, because aren’t we making their death about us?

I hear statements like, ‘How could they do that to their family? How selfish’.

So it’s selfish because they didn’t make their decision based off of other people’s need and wants? While not an altruistic decision, I don’t know that it’s purely selfish, especially when they believe they know how much their anguish is dragging their loved ones down. Who wants to hang out with someone so low that they suck the energy out of the room? I sure as fuck don’t! That shit is a bummer, man! If you’re a happy person, you can’t tell me that you want to hang out with the miserable either, because we don’t like what it does to us. Who’s selfish?

I had a patient ask me once how long they were supposed to keep going before the world would see that they tried. He had a severe anxiety disorder coupled with agoraphobia and his meds caused severe nausea, depression, chronic fatigue and chronic diarrhea. Can you imagine living every day too tired to shit water? Have no pleasure in eating food? Everyday with no relief?

I had another patient confess that they wished that they’d get cancer, and then no one would be mad at them for refusing treatment, “because that was a choice they’d accept.” She was Bipolar and chose to go off her meds because she hadn’t experienced emotion. She had not felt anything for over five years. Can you imagine not laughing, crying, or even getting angry for five years?

For some reason, it’s always easier to accept what we can see. Verbal abuse for example is always going to be more tolerated than physical abuse because the marks left behind from physical abuse are measurable. “Yeah, we hear him call her a ‘stupid bitch’ all the time, but we had to draw the line when he smacked her.” (Actual quote from a neighbor who called in an abusive stepfather). I responded to a suicide attempt by the abused daughter about two years later. She was finally successful last year. She was nineteen. A fellow first responder commented when I told her that I heard they found her body, that she was surprised that she would do it now that she was away at college and had her whole life ahead of her. I wasn’t surprised. She never received proper counseling and lived in an abusive environment her whole adolescence- the time in our life where our identity is created. How do you think she identified herself? A beautiful girl with no friends, and no support opted out. Who’s selfish?

Leave the mental aspect of it out and thinking about the chemical side of depression- after time, the brain slows production of serotonin and dopamine, the ‘skinny, horny, happy’ chemicals. Even when you do something that would normally trigger a ‘reward’ or ‘joyful’ response chemically, your brain doesn’t know what to do with it, and flushes it. Without medical intervention, these people are a suicide time bomb that we hope don’t decide to take other people out with them.

When forced to watch a body waste away to a disease, we want to make people comfortable, help them, but when asked to have the same level of support and empathy for a person that is deteriorating mentally, our expectations and reactions change. “Cheer up”, “suck it up”, “yeah life sucks for us all”, “breathe through it”, “work through it”, and additional cliché sayings that your grandmother had stitched on pillows about ‘blooming where your planted’.

What we don’t see are people running marathons to raise support for depressive disorders, or people holding rallies for bipolar research. Mental illness brings out a discomfort in most people and we tend to want to shy away. That person, that human being, through support and counseling and maybe even medication, could get into a better place, a place where they might find joy again- they’re savable. When it comes to mental health assistance, we suck at it. Who’s selfish?

Personally, I think that it’s the people with an unrealistic understanding of the suicidal that are being selfish, and I hope that if you find that someone you are close to is suffering mentally that you don’t back down, and that you stand by them and help them get the help that they need. There is hope for the hopeless, and I feel that calling the suicidal selfish is just a way to remove the burden off of us for not stepping in and helping.

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