Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘loss’

Thoughts About Kate Spade and Anthony Bourdain at 28,000 Feet

As is often the case when flying I was rewarded for offering a greeting to my row mate on the plane with a bit of insight and knowledge I’d have missed had I not simply reached out a hand and said “Hi, I’m Darrell.” My momentary companion (we each moved to more spacious seats) had been a schoolmate of the recently deceased Kate Spade. He confirmed her years-long struggle with a depression that defied logic and was thus a depression that was as pathological as diabetes or heart disease or cancer. Opening my Sunday papers brings stories from the friends of Anthony Bourdain, also deceased, and his decades long struggles with the same demon disease.

Like so many others, both Mrs. Spade and Mr. Bourdain were killed by illness, cause of death: suicide.

First, a couple of statistics. Suicide is presently the 10th most frequent cause of death in the U.S. currently responsible for taking roughly 45,000 lives each year. I am a physician. Doctors die from suicide at a rate 0f 40 per 100,000, the highest rate of any profession and twice the rate of Americans in general. Suicide is the second leading cause of death among teenagers (behind accidents), having surpassed homicide for the first time in 2017. [As an aside, the U.S. loses more young lives from all causes than any other developed country. This drag on life-expectancy should always be considered when you compare the health outcomes of various countries] A very large percentage of these deaths occur in those who suffer from some kind of mental illness, of which depression is far and away the most common.

It is time for us in America to reframe our conversation about suicide for the good of those who are at risk as well as those who have lost a loved one for whom the cause of death was suicide. Let us start, as we should in all serious discussions, with the language we use. For decades at least we have used the phrase “committed suicide” when describing such deaths. It is well past time for us to retire this phrase, at least for people like Kate Spade and Anthony Bourdain. To commit is to perform a willful act while under the full control of all of your faculties. Commitment implies the performance of an action that is the culmination of rational thought. Outside of war, the act of taking a life after rational thought is the purview of the psychopath; it bespeaks the presence of evil.

People like Spade and Bourdain who are killed by suicide are not evil.

We will all come upon well-meaning entreaties from those around us offering help should one be considering suicide. We will see headlines and the like proclaiming that “Suicide can be prevented”. Can it? Can suicide be prevented by addressing suicide and the thought of suicide itself? By and large suicide is an effect, not a cause. Some suicides do, indeed, follow the rapid appearance of dismay and despair, and these may very well respond to the well-meaning aid of those who offer a phone number, an ear, or a ride to a doctor or therapist. For some, especially the young, suicide is an impulsive reaction to an overwhelming emotion. For those left behind these are the hardest for we all surely ask “what if”, and we all as surely respond “if only.”

There is suicide that kills as the consequence of illness too long in development, even with the best of care possible. Depression, Bi-polar Disease, Schizophrenia and their ilk sometimes prove untreatable in the exact same manner as cancer or heart disease. Suicide is the cause of death in the same way that liver failure might take someone with widespread cancer that began in another organ; the ultimate cause was neither the failed liver nor the suicide but the underlying disease. It is so very, very important for the family and friends and acquaintances of those who ultimately pass by suicide to understand and accept this, especially if their loved one was being actively treated. Here, in these circumstances, we the living must guard against “what if” and “if only” as if our own lives depended on it.

Because they do.

I have known you all, you who have lost and who are still here to remember. I am one of you. Friends and acquaintances, friends and family members of acquaintances–I, too, have losses. “What if” and “If only” haunt us all. For us, as it so often is, the solution lies in love and kindness extended not only to those who are suffering, but to those we have lost and most especially to ourselves. No one who loved us as we loved them would have chosen to hurt us in life; how they ultimately died was not a choice to hurt us in the passing. We will surely hurt but we must not allow ourselves to feel that we have been hurt on purpose. More so, in time we must forgive ourselves for that which we could not change as surely as we could not have saved the parent or the sibling or the friend who died from cancer. We must forgive ourselves, be kind and loving to ourselves and all of the others who share our loss, for the alternative for us is despair and dismay.

We can begin this cycle of kindness and love by choosing a different way to discuss suicide and calling it what it is: the cause of death. Do reach out to those you know who have been buried by despair and are drowning in dismay, for they might be saved. Fight for the right to do so. Do champion the recognition that mental health diseases that have no outward signs such as true depression are as real as an open fracture at the scene of an accident; they should be treated as seriously and with the same sense of urgency. Fight for the right to have these diseases treated the same way. Doing so will save lives. Love those you love as much as they will let you for as long as they are alive for the loving, and let them do the same for you.

Peace and grace be upon those who have lost loved ones who were killed by suicide. Joy and love to all who have stood with toes across the precipice and stepped back, and to those who were there to embrace them when they did.

 

Nothing Left to Lose

“When he lost his life, it was all he had left to lose.” –Lynard Skynard

Catching up on newspapers piled up while I was away last night I happened upon an article written by David Gregory, former moderator of “Meet the Press”. Mr. Gregory was on a bit of a spiritual quest, one that coincided with some turmoil in his professional life. As part of this journey he spent some time with an Erica Brown, a Jewish educator. After listening to his professional laments she offered this stunner: who would you be if you lost it all?

Stopped me right in my tracks, that one did.

Think about that for a minute. How the question was phrased and what she was asking. Not “what would you do?” or “how would you handle it?” but “who would you be?” The implication is that who you are at any given moment is only one version of who you might be capable of being given different circumstances, however wonderful or unpleasant. It dovetails very nicely, indeed, with my recent fascination with the multiverse, the quantum physics derived concept that there is an infinite number of versions of our universe in existence at any given moment.

Spend a few more minutes thinking about what it means to lose it all. For Mr. Gregory it meant losing his dream job, a job in which who he was became inextricably linked to what he did. I get that, but Mr. Gregory is still able to seek employment as a journalist, still able to work in his field. What if you could no longer do that? Say you’re a doctor and you lose either the ability or the right to practice medicine? Think “The Fugitive”. Trust me, doctors are way more wrapped up in the “what I do is who I am” thing than journalists. Just thinking about that–being prevented from being a doctor– makes me sick to my stomach. Imagine if you couldn’t work at all. Couldn’t support yourself or your loved ones and had to depend on others. That’s starting to close in a little bit more on “losing it all” I think. Who would you be then?

There’s no way of knowing if Ms. Brown meant to go this deeply, but in the developed world we live pretty well;  there’s actually a boatload of stuff we take for granted that could be lost. What if you lost your freedom? You are incarcerated, or in some way someone gains so much leverage over you that you must do their every biding. Who would you be, what part of who you have the capability of being would come to the fore if you were no longer free? Joe Coughlin, the central character in a Dennis Lehane novel I just finished compromised his father’s position as a police captain in order to buy favor and therefore survive in prison. In so doing he lost his freedom forever, even after leaving prison. He became a man without a moral compass, ruining and even taking lives in pursuit of other men’s goals.

But even at that, Coughlin hadn’t yet lost everything. What brought him to that precipice was the loss of his people. You’ve watched “Law and Order” I’m sure. I don’t remember many individual episodes of any series I ever watch, but one “Law and Order” dealing with loss comes to mind. The detectives discover a man in an institution who is mute, nearly catatonic. They need his testimony; he is the only witness to a heinous crime. In order to gain access to his memory they obtain a court order to treat him for his depression. His recovery is miraculous, and initially he is grateful for his awakening, grateful to meet distant relatives who are delighted for the return of an uncle they’d lost. All well and good until it is time to testify and we learn that he lost his job, his ability to work, and his entire immediate family in that heinous crime. Awakening means remembering that he has truly lost it all.

Who would you be if you lost it all? This poor man had nothing, and he discovered that without his people he was no one. Who would you be? His answer was “no one at all”. He refused treatment and slid back inward to nothing.

There’s a point here. A couple of them, actually. The first is that each one of us has much, much more of pretty much everything than we realize. Most of what we might lose is not really all that close to any type of “everything”, and that should inform how we view what we do have and what we are willing to do to keep it. Who would you be BEFORE losing something in order to not actually lose it? To know this is to know what we are willing to do if we need to fight not to lose everything. It’s a little closer to knowing who we really are, now.

Read this backwards from here. It hurts to lose stuff. It’s hard to get by with less money if you’ve tasted more, especially if you think you’ve become someone else because of that stuff. It’s worse if you kinda like that someone; losing the kind of job Mr. Gregory had stings. Time and again, though, we see that true loss is less easily quantified than a spreadsheet or income statement or title. To lose your people is to truly lose everything. No amount of fight is too great to not have to learn who you would be after this type of loss. Losing your freedom makes it easier to lose your people. Someone else plots your every course. Who you are needs to be someone who does as much as humanly possible to remain free.

Mr. Gregory seems to have made this leap. In the end his job was simply what he did at the time for work. Losing it actually brought his spiritual quest home, to his people. That’s the other point, right? It’s your people. You’ve not lost everything if you’ve not lost your people. Know who your people are and hold them close. Cherish and nurture them. Do it out loud and without either fear or shame.

Do whatever it takes to never have to learn who you would be if you did, truly, lose everything.

Everything Changed. Forever.

“Just like that, everything changed. Forever.” –Beth White

Let me tell you a story about strength and love. It’s a story about the love parents have for a child, and about what appears to be super-human strength in expressing that love. The story starts with sorrow, at a funeral, the event that marked a forever change after a life both agonizingly short and blessedly long. The details make this particular version of the story very powerful, but in the end the heroes of my story would tell you that the details only describe their own individual version of a story that is told millions of times every day in millions of families around the world. Theirs was just more than a bit harder, and so the love and the strength was just a bit easier to see.

I’ve not asked if I could tell this story in its truest form; I will shelter the family by not using their names. Yesterday’s funeral was agonizing, as are all funerals when young parents bury a child. It’s hard work to raise a child, you know. Children don’t naturally come equipped with the “software” necessary to survive and thrive in a family group, much less a town, or a state, or a country. Equal parts love and leverage must be applied to instill in a child all of the trappings of civilization, lest the otherwise unquenchable twins Ego and ID ride roughshod over any and all who come in contact with that child. “Crazy hard” is how one could describe the process with a standard issue, healthy child, but words simply don’t exist to describe what it is like if a child is challenged physically or mentally from a very young age. My only advice to young parents-to-be is to be prepared for the biggest change you can ever imagine, the change that comes along with each subsequent child. No one is ever prepared for what comes when that child requires all-day, every-day care.

Where does the strength come from? The love I get, especially from parents steeped in the beliefs of a Religion based upon and built from a foundation of love. But the strength to bring that love to bear every minute of every day in the face of the crushing sadness of a child who you know you will lose, who will never follow any kind of normal path? Where does that come from? You can’t use our typical, run of the mill metaphors for this. You know, like “ice in their veins”, because no one who projects such unvarnished and unquestioning love can be filled with ice anywhere. No…no, I think it is molten iron that flowed through their veins. Yes, that must be it. Iron.

Literature is filled with the stories of children neglected in the face of tragedy, or families torn asunder by either the suppressed pain at the injustice of an impaired child, or by the not unreasonable finite amount of love and strength in a family, with the other children, the marriage, or both left to fend for themselves as all energy is directed to the most needy family member. Not in this family. Theirs is a marriage forged in commitment deepened by their challenge. Theirs is a family tied closer because Mom and Dad never did that at all, never stopped parenting the other children, never stopped supporting those things that made each child unique in his or her own way. Never stopped working and worrying their way to preparing the other children for their own life’s journey.

Engulfed by love and raised by these iron-willed parents, this very special child lived more than a decade longer than the most optimistic expectations offered as a baby. Not just lived, though, but thrived. Because of this we attended a funeral where grief was all-consuming. A child much-beloved was lost, and we gathered in the hundreds to console his family. Will there be relief at some point? A sense of burden lifted? Of course. How can there not be? Relief, though, will not ever be the most powerful emotion for Mom, Dad, or siblings. This was a child who was loved fiercely, with ferocious strength and resolve by each member of the family. Everything has changed.

There is no word in any known language to describe a parent who has lost a child. Writing this it occurs to me that we are equally bereft of a word that would so name a sibling. Interesting, no? To have a child die before a parent is so unnatural that no part of the human race has ever come up for a word for it. This family lived for 21 years in the knowledge that it would happen to them, and yet when it did the loss was a crushing as a bolt from the blue. To feel this loss must be part of what it is to be human, no matter the details. It is the one place, the one thing that we all must certainly have in common. We need not experience the loss ourselves to have true empathy with those who have experienced it. So wired are we that understanding is unnecessary; we feel the loss as one.

We went to a funeral yesterday to share our love for a little boy who barely made it to manhood. His life was a triumph of love and resolve, of strength almost beyond belief. His parents would offer that each of us could have done it, done what they’d done if it had been demanded of us, instead. Every parent in the church checked their pulse, looked to see what flowed through their veins. In the end we all found the very same thing: tears heated by the loss we each could feel, for the little boy, his siblings, and his parents. A desperate hope that we would never find ourselves in that same place, at any time, for any reason.

Just like that, everything changed. Forever.

Sunday musings 6/25/16

Sunday musings…

1) Brexit. Certain to show up in the next “Hangover” sequel.

2) Hangover. Man, who thought THAT was a good idea?

3) Ritz. “I had the feeling you get when exiting a cinema after a matinee, blinking at the light and still half-living in the film.” WSJ on a stay at the Ritz Hotel, Paris.

Lovely writing, that. A bit hard for me to relate, though, since my last matinee was “The Jungle Book” with my 79yo Mom.

4) Sincerity. “The key to life is sincerity, and if you can fake that, you’ve got it made.” –Robert Steed 1936-2016

Man, how good is that in this election cycle?

5) Edge. Whether or not you know it, or knowing it whether or not you acknowledge it, everyone is always on the lookout for the edge. Everywhere. The edge has lots of names, but by any moniker we all seek it. Our Puritan ethic sends some of us in search of the edge in more, or harder work. Lots of that around here, chez CrossFit. Others of a different ilk seek the edge through shortcuts and work-arounds. Think PED’s and the Olympics, or access to information about a trade or a deal milliseconds before the competition. In some ways, at some times, getting the edge is about coming out on top in a zero-sum game where winning means also not losing.

What’s puzzling is when the edge is freely accessible to everyone, and yet there are legions who either ignore it or actively turn away from it. Think health. There’s some pretty easy stuff out there that will give you the edge, stack the deck in your favor if you will. Yet there are many among us who are militant in their refusal to take their piece of the edge, even when it is freely given and nearly free. You don’t need me to point out the obvious here.

I find myself torn between an intense need to teach those I care about to grab the low-hanging fruit, and an equally intense desire to not be around those who chase an irrelevant 0.01% edge in one domain while giving up10% in another. More and more I find that avoiding the latter gives me an edge.

6) Dad. A long-time columnist in my home town paper writes this morning about making it to his Dad’s bedside for a final hug, just hours before his father passed away. I’ve been thinking about my Dad quite a lot recently. He left us very quickly, his long, slow slide into oblivion interrupted quite unexpectedly and quickly. Only one sister was there. It’s kind of strange, but I find myself missing him more and more, both in the literal sense at gatherings, and the more emotional sense in his just being gone.

We missed him at both of my sons’ weddings, for example, and the space at the table next to my Mom still doesn’t look quite right 9 months on. There are 8 grandsons on my side of the family, and all of them took turns swinging their Gram across the dance floor at last week’s wedding. I found myself looking over at her table, looking for that little twinkle in my Dad’s eye, the one he always got when his wife was happy. Even as his mind betrayed him toward the end, that part of him remained. The part that so loved my Mom that her happiness brought him more joy than pretty much anything else. Alas, no twinkle. Just an empty space and the hint of his shadow.

It’s been 8 years since I’ve swung a golf club. After thousands of rounds in the company of hundreds of very fine people, the game of golf doesn’t owe me anything, and I only rarely give it any thought anymore. That’s why it’s so strange that I’ve found myself dreaming about playing golf. Like every night dreaming about playing golf. I admit that I miss the camaraderie of the game. The tomfoolery on the first tee as you haggle over the bets to come bookending the jackassery in the bar afterward as the lies grow and the round becomes so epic in the re-telling that Harvey Pennick himself couldn’t have made us better golfers. I do miss that, but the playing? For whatever reason, the game itself has left me.

Or so I thought, until the dreams began. It doesn’t take a Freud to figure out that the dreams have little to do with golf, of course. They are about missing Dad. You see, after seeing my Mom happy, it turns out that the next best thing for my Dad was to see his kids happy, and on the golf course we tended to have happiness as we got old enough to care less about our scores and more about our foursomes. Thinking back I recall lots of twinkles in my old man’s eyes in the company of his sons on a golf course.

There’s no real point here, my friends. No teachable moment at the end of these musings. Just an old guy at the stage of life where loss has the edge, missing his Dad and wondering when, or if, that ever gets any easier.
 I’ll see you next week…bingo

Mourn Like You Meant It

There’s been lots of loss around the White house of late. Lost parents, parents soon to be lost, lost innocence, lost friends, lost trust. Tons of loss. Some of those losses are inevitable of course, but others are sadly losses born of the choices made by others. Whatever. We–you and I and our loved ones–do not get to make choices for those who come in and out of our lives. While that knowledge provides little salve for the sting of loss it at least allows us to make a clean break, to leave behind a loss after a proper amount of legitimate, honest mourning.

A problem arises when mourning is tinged with regret. This is made all the more problematic when the regret is not honest regret, when it is disingenuous, the result of a conscious decision made without any consideration of anyone other than oneself. You know how this goes. “I wish I’d visited Papa more after he got sick.” “My best job was the first one I ever had; I should have gone back and asked if I could start again.” “Man, I can’t believe ABC is closing. No place was ever as good that.” “I wonder if it would be different if I’d gone and had that beer with XYZ.”

Some regret is real. I get that. You’ve got a crappy job and you need it, and you just can’t get on a plane to see your Dad/Mom/sibling. Deep down you think you were wronged in some way at some time by somebody, that your boss/family member/friend could have been better to/for you and you had no choice but to leave the job/business/friendship. Heck, there are some families where so much toxicity is directed toward you that the only way you can remain healthy is to separate from the family. I get that, but let’s face it, stuff like that is not the norm. In most cases everyone could have tried harder, done better. Including you.

You, and I, can legitimately regret that, not trying harder.

What’s the lesson here? Well, as I said some losses are unavoidable. Death comes for us all. Miss that chance and it’s gone forever. Suck it up and spend the time BEFORE it’s time to mourn. The person who departs gets no satisfaction from your regret, they simply left saddened by your absence.

All the rest? Well, your choices have consequences for everyone involved. Bad or sad things are at least partly on you, and protestations of regret (Oh I wish I’d; Oh I should have) make it infinitely worse. Suck it up and own your decision. Suck it up and own the consequences. A business that depended on you folded because you left? A friendship ended because you gave up? A family less close because you were all “Cat’s in the cradle” all the time? You chose one of your ‘wants’ over some meaningful someone’s ‘need’? Saying you miss this or that about any or all of these only makes it worse. You chose to miss it.

Listen, I’ve done all of the above and properly suffered because of it. Some things are too valuable to take a chance on needing to mourn them. It’s much less painful, and much more believable, when you’ve made every effort possible to prevent a loss. Then others will believe you when you say “I miss…”

More importantly, you’ll believe it yourself.