Family
Last Rights
My son ended his life after three years of madness and unbearable depression. Who am I to say he did the wrong thing? John’s days were full of isolation and pain when what he longed for was freedom.
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At the height of this stressful period, John contracted spinal meningitis, an infection that would have been fatal had he not been with me the night he slipped into a three-day coma. Though he recovered, that episode brought his mental illness to an acute state and removed all doubt about his future. I became convinced that I had done him no favor by rushing him to the hospital. His next—and final—three years of unwanted life served more as a favor to me, allowing me to understand his illness and preparing me for his eventual death.
Unlike many mentally ill patients, John took his pills and obeyed his doctors. The anti-psychotic medications prescribed for him were euphemistically marketed as “correcting a chemical imbalance.” For schizophrenics, the imbalance is an avalanche of a nerve-stimulating chemical that produces such a profusion of sensations that victims cannot distinguish between reality and fantasy. In John’s case, the fantasies included pursuit by the Mafia, imaginary commentary on the radio and television discussing his impropriety, and the continued belief that he had somehow betrayed the woman he loved. This delusionary world was, to him, more true than the real world in which he was a competent worker, a gentle and loved human being, and a thoroughly worthwhile person.
“Correcting the chemical imbalance” does not entail administering a delicately tuned dose of the right stuff; instead, the pharmaceuticals that were prescribed often shut down the troublesome portion of the patient’s brain, along with many other sensory processes. These drugs, given in sledgehammer doses, can indeed stop psychotic hallucinations and delusions. But they exact a heavy price. The affective parts of the brain and personality become dulled and detached, the body moves in a zombielike trance, and characteristic facial tics can become a permanent affliction. Taking the drugs is a Hobson’s choice between madness on the one hand and a wooden life on the other. No wonder that many victims of schizophrenia choose madness.
Three years of various medications and talk with private therapists (as long as the insurance lasted), then public psychiatrists, did not alleviate my son’s mental pain. During that time, he produced a tentative hypothesis that grew into an obsessive conclusion: His unsatisfactory life was not worth the effort. Paradoxically, John’s medication did clear his mind sufficiently that he could comprehend his condition. He understood for the first time that much of what he had believed to be real had been hallucination and that his major ambitions were beyond his reach and perhaps had been since birth.
Mental health professionals sometimes describe the suicide danger periods by drawing a capital U or V, in which the bottom represents the period of acute mental illness, during which victims are so caught up in their madness that they do not understand their condition and therefore seldom take their own lives. Suicide, instead, can occur either on the downward slope of the letter, when the still-rational person can see what is coming, or on the upward slope, after a severe bout when he can comprehend his condition, decide what to do, and carry out the act. My son made his decision in a perfectly lucid period, understanding the severity of his illness and the likelihood of its return.
I regard the events of the past three years as complete. Then why have I written this piece? First, for personal therapy. Every sentence was painful, but as I examined the words to see whether they were true, I put a bit of the story to rest. Writing the essay also comforted me by placing my son’s death in a rational context. This, in turn, suggested a second purpose, which was to share my reflections with people who are close to someone who has attempted or committed suicide.
My first reflection concerns guilt. It may seem to the reader that I am proud of my son who committed suicide. That is, in fact, true. I will brook no criticism of his decision or his method. I do not believe there is any basis for guilt, either on his part or on mine. Of course, I was a mediocre parent, and of course, I did some things I wish I had not done. But my bad parenting did not cause his mental illness. I am lucky that my son’s therapy enabled him to recognize this, and he even acknowledged it in his final note. I admit that shedding parental guilt would be more difficult if his suicide had been hostile or connected to a specific event that generated a strong set of “if only’s.” But I would hold to my opinion in those circumstances as well. Serious mental illness is rooted in the physiology and chemistry of the brain, and it is far more a product of genetics than of parenting or other outside conditions.
Perhaps a greater cause of guilt is that the survivor feels relief. This is a double bind of enormous proportions. The death of a child is supposed to produce only sorrow. How, then, could I have felt that a dreadful nightmare was over? But how else could I react to the fact that I no longer had to hold my son’s hand while he relived his delusions, no longer had to take him to the county hospital for another commitment, no longer had to return telephone calls from a radio station manager complaining of yet another deranged letter from my son, and no longer had to scrimp to fund a testamentary trust so he would not eat from garbage cans and sleep on the street after I was dead?
It is not noble, lofty, or wise to say that I experienced relief when I heard of my son’s death. In particular, admitting it will not sit well with his mother and siblings. I would withhold this confession except for the chance that some survivor next week may need to know that he or she is neither evil nor alone in reacting this way and that the relief in no way denigrates the sorrow.
My next reflection concerns shame. There need be no shame connected with suicide. At John’s memorial service, the speakers openly acknowledged his illness and manner of death. Later, a number of people in attendance confided to me that a close family member (most often a father) had committed suicide when they were young and that they had not known the fact for years afterward. They still carried unresolved anger, not only at the act but also at having been misled.
Shame may be appropriate if the person who has taken his life has acted in cowardice or meanness but not when he has made and carried out a rational decision. Mental illness is painful, far more painful, I believe, than any bodily affliction. Yet, society offers greater understanding when a terminal cancer patient voluntarily ends the physical pain than when a schizophrenic ends the mental torment. Suicide can even be a heroic response to an unbearable life. No shame need be associated with that. Pride is far more appropriate—pride that the loved one had the courage to make and carry out such a decision.
I hope I have not painted so bright a picture of suicide that parents of mentally ill children will long for it. That is not my intention. We must never lose hope that medical research will produce a breakthrough; we must urge our children to live; and we must reinforce whatever satisfactions their diminished lives can absorb. I am not glad that my son committed suicide. I would rather have seen him deal with the life that he was given. I think his chances for long-term stability were about fifty-fifty and that he might indeed have achieved some happiness. But he did not choose what I preferred. John examined his life and decided that he did not want to live it. I am convinced that the person whose life is at stake bears ultimate responsibility for it, and others must honor that decision, even if it is to die.
In an effort to comfort, some friends have called my son’s death a waste. I disagree. Physical illness or an accident that snuffs out a vital and productive life can be regarded as a waste. I think, though, that my son lived as full a life as his disability allowed. He was a successful student, he worked, he abstained from recreational drugs, and he obeyed the law. Most of all, he caused no one harm. At the end, his productive life was probably over. Clearly, he felt the pain of living outweighed any foreseeable pleasure. I count neither his life nor his death a waste.
My son and I had lunch together twelve hours before he took his life. He was friendly and polite but detached. His wooden movements and emotionless face told me that he was taking his medication. We had our familiar conversation—me urging that he call his employer about returning to work—but there was a different aspect to our visit. Throughout the entire meal, John’s gaze on me was unceasing, as if he was examining and memorizing every feature. He was, in retrospect, secretly saying good-bye. My concern about giving him “permission” to take his life was misplaced. At that point, he was at peace with his decision, and he did not need my permission. He had already bought the gun, and he was playing out the last few hours of life, almost as an observer. He enjoyed his favorite dish—cheese and broccoli soup—and thanked me for the visit. That night I slept peacefully, unaware of what the morning would bring but in a real sense prepared for it.
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