ugh

Today, I found out that one of my father's best friends committed suicide. I was shocked, but not shocked. This man had been chronically depressed, suffered from a chronic health condition that caused him constant pain, and his father committed suicide by shooting himself in the house.

But this was also a man that I will always remember as wearing an unruly beard and overalls even though he worked as a pharmacist most of his life. He was kinda strange and lived an unconventional life in many aspects but there was something endearing about the image that I have of him.

And now he's gone. He bought a shotgun and two days later used it on himself. My father spoke with him three days before he died and said that he knew that he was doing "worse" but he gave no indication of suicide. I don't want my father to feel guilt or regrets, but I wish that him or another one of his friends had asked, "Are you thinking about ending your life?" when they saw their friend deteriorating.

I can talk about suicide as a clinician. I can ask clients about it. I can refer tell them to call 1-800-Suicide. I can ask about risk factors, plans, methods, intentions, previous attempts. I can talk clients through a safety plan. I can talk about my QPR suicide prevention training. Assessing for suicidality is almost second nature to me at this point in my training.

But to think about this man I knew ending his life, to think about what my father might be feeling or thinking, though it's all filtered through this clinical training, this news, these facts, the images I imagine, I don't know what to say or think. In some ways it passes right through me like a ghost, like it didn't really happen to someone I know, like I just heard about it on the news, and it other ways it reaches inside me and swirls around in my chest, never quite settling anywhere.

Suicide isn't really second nature for me to face. I hope that as much as I may encounter it with clients, that I never lose touch with how precious and fragile life is and how tragic and ugly and horrible the taking of one's life is.

some matters of life and death

This past Wednesday as we were making the rounds in our geropsychology practicum, we discovered that one of my classmate's clients is probably dying, and her son was in her room, making arrangements for her end of life care. Our class escaped into a small, uninhabited dining room to discuss end of life issues. Our most politically astute classmate informed us that in Oregon, a proposition to legalized physician-assisted suicide was voted into law. We discussed how this could become an option for more older adults, and how this sort of thing already happens under the table. Basically, in hospice care, people are sometimes given morphine "to be made comfortable," but in addition to comfort from pain, the morphine dosages actually quicken death. No one can call it assisted suicide because that's illegal, but physiologically, that's basically what it is.

I feel pretty strongly that any kind of suicide for any kind of reason done by any means is still a suicide, and therefore wrong. I believe that it is up to our Creator to decide when we live and when we die, but that line isn't so firmly drawn in many cases. Working with these older adults and their families and considering the failing health of my own grandparents, I feel like I need to be aware of and sensitive to these controversial end of life issues. And who's to say that there won't come a time when I have a loved one, terminally ill, no recovery in sight, who might consider measures to end their life on their own terms?

Every resident in the nursing home either signs a DNR - Do Not Resuscitate order or a Full Code order. Full Code means that in the event that their life ends, their heart stops beating, they stop breathing, all measures will be taken to restore their life. DNR means that these measures will not be taken. Looking at their medical charts, many of the residents I see have a DNR. As a healthy twenty-three year old, the idea of having a DNR sounds so foreign to me. Why would I not want the doctors to do everything possible to continue my life? But for individuals in their 80's, 90's, and beyond, many of them feel that when it is their time to go, they will go, rather than fight death to continue to live in an unhealthy physical state. For them, DNR is the natural choice, and Full Code seems unnatural. In way, having the choice between DNR and Full Code does mean that someone is making a choice about their end of life and the terms under which they want to live or die. It might be a stretch to compare this decision to physician assisted suicide as one is a deliberate act to end a life and another is a deliberate choice to not save a life, but both are choices that people make about their life and their death.

Last night, I joined my roommates in watching this past week's episode of Grey's Anatomy, a show that I had only seen one episode of previously. (If you haven't watched this and don't won't spoilers, skip the next two paragraphs) One of the stories of this episode featured an elderly couple, the wife of whom was having a dangerous cancer surgery from which she might not survive. McDreamy (no idea what Patrick Dempsey's character's real name is) tried to emphasize how life-threatening this particular surgery was, and seemed concerned when the couple dismissively replied, "Yes, yes, we know what we're getting into with every surgery." When the wife signed the DNR, McDreamy asked them if this was the choice that they wanted to make. They said that they did, that if it was her time to go, that it was her time and they didn't want to interfere. Then, the couple lovingly kissed one another and said, "Good-bye love," explaining to the doctors, "We do this every surgery. We say good-bye, and then when she wakes up, we get to say hello again."

The wife did not recover from surgery. When her heart stopped, her husband began pumping her chest to let it continue beating, and started crying out, "Help, someone, please, help my wife!" McDreamy and another doctor explained the DNR, and explained her wishes that that she not be resuscitated. He continue pushing on her chest, crying, "Don't leave me, please don't leave me!" As I watched this scene, tears filled my eyes. I couldn't believe that Grey's Anatomy episode was making me cry. The man continued pumping his wife's chest and eventually realized that there was nothing they could do. She would die. "I just don't want to be the one to let her heart stop." One of the doctors took over for him, but it soon became apparent that she didn't want to stop pumping this woman's heart either. Ever the hero (eyes roll), McDreamy took over, and slowed stopped pumping, allowing the woman to die as her husband sat next to her. It took a lot of effort to keep myself from bawling.

Then today, I sat on the grass under the tree in my backyard and first read some scripture, from the prophets Zechariah, Isaiah, and Micah, all about the coming Messiah, the coming kingdom, how the king will reign, how Israel will be restored, how war and idolatry and jealously will cease, how there will be joy and rejoicing. These scriptures fill me with such hope, and sitting in the shade, I looked forward to the day when those things are all fulfilled.

Then, I read a chapter from a book I've been reading called Grace (Eventually): Thoughts on Faith by Anne Lamott. The chapter was titled At Death's Window, and it's about her helping a friend with an assisted suicide and begins with the shocking first line, "The man I killed did not want to die, but he no longer felt he had much of a choice," and follows with a touching and delicate tale of a man in terminal stages of cancer who decides to end his life. I read several pages with mere curious fascination, until I read the line about how on the night he died, he asked his wife and friends to play his favorite CDs. Tears immediately filled my eyes, and I struggled to see clearly enough to read the last couple of pages describing the man's death. I finished, closed the book, sat still on the grass, gazing out at the leaves and trees, letting myself cry, pray, feel, and think. I tried to make sense of my strong reaction to this chapter and the Grey's Anatomy episode last night, and honestly, my emotional state is probably related as much to the time of the month for me (sorry guys) as it is to any other factor. The best thing that I could think of that made the most sense as I sat in the shade is that life is fragile, I am small, and God is big, but mostly that life is so incredibly fragile.

unique cargo, ugly baggage

I have about three potential blog entries already written in my head, but I've decided to first write the most salient one.

Yesterday, driving along Highway 6, a train passed me. This is pretty common as I see plenty of trains, but the cargo of this train was unique, and like nothing I'd never seen outside of movies. This train was carrying at least 40 military tanks, all desert tan.

Two weeks ago, I saw a dead man on the highway. It was late at night, and several police cars had a lane blocked off. As I approached, I noticed the wrecked cars, the ambulance, the police officers, and then there he was, contorted face down on the pavement. There were people nearby, but no one giving him medical attention, no one hauling him away on a stretcher, no officers collecting evidence, no white sheet covering him, no white chalk outline, he just lay there as car after car passed. I still don't know what happened. Was he thrown from his vehicle? Was he trying to cross the street, and hit by a car at 70 mph? This is the first time I've told anyone what I saw. I don't know that I've ever seen a dead person that wasn't in a coffin, hair and makeup nicely fixed. I'm not even positive he was dead, but why else was he face down in such an awkward position, with no one helping him?

And then there were those tanks yesterday. 40 plus killing machines being transported across Texas, that will eventually make it over to the Middle East. I described it to my mom, and she said, "That sounds like something you'd see in WWII." And it's true, while the technology as change drastically in the past 60 years, on the outside, tanks still look relatively the same. A tank is a tank is a tank, and I felt like I was transported back to a time when reminders of war were an everyday occurrence.

I've felt so insulated from this current war. Yes, it's all over the news, stories, sounds, images, reports, controversies, but it still seems to far removed from my present life. I've had ROTC and Corps friends talk about it, but that's all in the future, none of them have been sent to Iraq yet. I've only known dads of friends who have been sent to Iraq, and while it's affected them, and they've told me about it, it's not my dad, or brother, or cousin, or uncle, or friend.

But this past week I've found myself more interested in the War in Iraq, listening to new reports, reading up on its origins, reading about controversies, reading about horrible, terrible, horrific things that have happened. We all heard and saw the pictures from the Abu Ghraib prison tortures, and just googling the name to check the spelling brought up horrifying images. And what about the US soldiers who raped an Iraqi girl, and murdered her and her entire family? These might be isolated incidents of a deranged and depraved few, and I don't consider them to be representative of our soldiers. But what about the high rate of sexual assaults and sexual harassment against women in our military? I truly respect our soldiers, their families, and their sacrifice. But no amount of email forwards of US soldiers hugging Iraqi children will make me believe that war does not bring out the worst in people. I know that it sometimes brings out the best in people, and purple heart medals and heroic stories are testimony to this, but I believe that many soldiers from Iraq are making a tremendous sacrifice and returning home worse from their experiences, as many sustain traumatic brain injuries and suffer from PTSD.

Am I anti-war? I hate that label, because in our society, to label someone as anti-war also means that they're radically liberal or unpatriotic, but these words are just misguided attacks. I love my country, and I hate war. War is ugly and a result of the fall and the presence of sin in the world, and as Christians, we probably should be against war. I believe that wars are sometimes necessary and there is such a thing as a just war, but I believe that this current war against Iraq was unnecessary. I know that at the time, just about everyone in Washington, reds and blues alike, believed this war to be necessary, but they were making judgments off of false information. Now that we know more of the truth, we're so far into this war, that we can't just pull out, we have to stay and attempt to stabilize the country. I hope that good will come of this, for Iraq and the United States.

I want our nation to make wise decisions about war. I want us to stand up against injustice, with the help our international community, and use our military power for good. I doubt that the Republican party can adequately do that, and I'm not sure that the Democratic party can do it either. I really can't put my full hope in political leaders and policies, but I do put my hope in the belief that one day Christ will return, he will judge the nations, and we will beat our swords (or machine guns, or tanks) into plowshares and need weapons no longer.

Until that day, tanks will roll across the plains, reminding us of our fallen state.

the twelve

About 9 years ago, a tragic accident occurred at my university, resulting in the deaths of twelve students. One of those students had been valedictorian of my high school. Though I never knew him personally, I knew his brother and others who were close to him. Watching the news coverage of the accident in my freshmen speech class was an experience as surreal and emotionally charged for my high school as was watching the second plane crash into the tower two years later in my statistics course. There's a memorial built near the accident site honoring the twelve students. I've visited it twice with each of my parents, once in the daytime and once at night. It's a beautifully designed memorial and a moving experience to read about the lives of the twelve and see their faces etched in stone. If you ever come visit, I'll take you there if you like.

This memorial is also near my parking lot, and today when I drove by I noticed an unusually large crowd entering the site and a school bus parked nearby. I suppose this was a school field trip which made me wonder: What's the educational purpose of this field trip? There are many valuable lessons to be learned from visiting this memorial: honoring those who have fallen, the transience of life, and the necessity to create something meaningful out of our lives. However, these all seem a bit too existential to fall within the normal realm of public school education. I do think I had some AP English courses that touched upon these themes, and perhaps the students were from an English course, and will soon be turning in compositions based on what they experienced. Or perhaps it was a history course, and this field trip was something akin to visiting the Vietnam War Memorial in DC. You know, I automatically assumed that the students were from a local school, but I never was able to see what the side of the school bus said. Perhaps they were actually from one of the high schools attended by one of the twelve and had driven in from somewhere near Houston or Austin. If this was the case, then perhaps no lesson was being contrived from this experience - they were simply paying homage to an alumnus. Whether they were directly connected to one of the twelve or not, I'm glad that many experience this memorial.