Suicide Is Not an Offense - Patient Care - @ JEMS.com


Suicide Is Not an Offense

Providers need to change the way they view this serious issue

 

 
 
 

Thom Dick | From the May 2011 Issue | Sunday, May 1, 2011


When I was just a pup, there was a guy named Autry. His parents had named him after their favorite singing TV cowboy—Gene Autry. Why they didn’t call him Gene, I don’t know.

Autry was a drunk. Not the anonymous kind some of us meet on busy nights and diagnose without so much as an exam or a single history question. No, we knew this one. In truth, he was a scarred, asymmetrical, stumbling, bottle-to-bottle, herky-jerky, bona fide drunk.

Early one morning, just after closing, a bartender found Autry asleep behind a place called the House of Draught. Apparently, he’d been rummaging for leftovers, and it looked like he had cut his left wrist and elbow several times with a shard from a Jack Daniels bottle. We were the ambulance drivers, and the cops’ directions were simple: “Take Autry to the El Cajon (Calif.) Valley emergency department (ED) and get him stitched up; we’ll pick him up later.” In those days, the EDs at most community hospitals really were just “rooms.”

During the day, you pulled up to the front entrance, and the driver alerted the receptionist, who then paged a nursing supervisor to unlock the ED room. At night, your dispatcher would try to alert the hospital prior to your arrival, and you’d access the ED via the same rear entrance mortuaries used. If a physician wasn’t available, the receptionist would alert the doctor on call. You got whoever there was. They might be a podiatrist or a dermatologist, and they might be cranky if you brought them a freebie, but they were doctors.

I was barely a driver in those days, and although I was a year older than my 21-year-old partner, his two years of experience made him our senior crewmember. He dreamed of being a cop, while I studied journalism. Our Advanced First Aid cards qualified us to be ambulance attendants. On this call, he let me drive the six miles to the ED while he attended.

He commanded Autry to stay awake and pay attention to his instructions: “Next time, cut yourself here. And don’t make the cuts crosswise; make them lengthwise, so they keep bleeding.”

People who fail to commit suicide, he said, are the ultimate failures in life. They’re too stupid to live, and they deserve our advice. He also said it’s against the law to commit suicide. Don’t discuss it, though, unless they’ve made an attempt, or you’ll just give them ideas. Don’t ask them if they’re considering suicide; you’re not a psychiatrist. And if a patient mentions suicide, just change the subject.

I was horrified. I now understand that not just anybody can do this job. But it was clear this guy had no clue about what it meant to suffer. He said that it was our job to take people to the hospital. Keep them from dying in our ambulance, if we could, but take them to the hospital.

Fortunately, in the early ’70s, hundreds of seasoned Army medics and Navy corpsmen began returning from Vietnam. So did their field surgeons. They dispelled a lot of voodoo medicine, and they sparked the beginning of this thing called EMS. It stood for Emergency. Medical. And Service.

Some 32,000 people die by suicide every year in the U.S. alone. That’s more than one every 20 minutes, not counting incomplete attempts. It’s not easy to kill the human body, unless you know what you’re doing. Even those who travel from all over the world to jump off the Golden Gate Bridge don’t always succeed. Those who try and fail fall 245 feet in four seconds. By the time they hit that cold water, they’re traveling 72 miles per hour, and they may as well be landing on concrete.

I think we really should stop being condescending, Life-Saver. We need to get rid of the word commit and change the way we think of suicide worldwide. You commit an offense, a crime or a sin. You die by suicide because you’re sick—absent a miracle of biochemistry that enables most of us to find beauty around us and joy in our lives. Often, you have difficulty sleeping. And eventually, you’re overwhelmed by a deep pain from which you can find no relief. That’s a tragedy, not an offense.

I know we can do this better. What do you think? JEMS

This article originally appeared in May 2011 JEMS as “‘Cut Yourself Here’: Rethinking our view of suicide.”




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Related Topics: Patient Care, Special Patients, Tricks of the Trade, Thom Dick, suicide, Jems Tricks of the Trade

 
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Thom Dick

has been involved in EMS for 43 years, 23 of them as a full-time EMT and paramedic in San Diego County. He's currently the quality care coordinator for Platte Valley Ambulance, a hospital-based 9-1-1 system in Brighton, Colo. Contact him at boxcar_414@comcast.net.

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