“JOHN KILLED HIMSELF LAST NIGHT.” the early morning telephone caller spoke his message clearly, but some deep-seated ritual made me ask him to repeat it. I already knew, though, that no amount of repetition could change the fact that my thirty-year-old son had taken his own life. John was my elder son. He graduated at the top of his high school class, earned an Ivy League degree, and for the last three years of his life endured the indescribable pain of mental illness. Those years had been uppermost on my mind, and my first thought that morning was that the constant flow of bad news and heartache had ended. The question that my voice formed was “How did he do it?”
This interest in mechanics may have seemed strange to the caller, but “how” had been an obsessive concern since the day it became clear to me that John would commit suicide. Totally exhausted by years of hallucinations, delusions, panic attacks, paranoia, sleep disorder, sexual fixations, intense depression, ineffective (though constant and costly) psychiatric treatment, and sense-deadening anti-psychotic medication, John finally realized that the career, marriage, and family he wanted were far less probable than poverty, isolation, and revolving-door hospital confinement. He calmly described his plan for suicide to his psychiatrist, who, of course, ordered immediate hospitalization. The telephone call to me came less than 48 hours after John had been released from his most recent two-month confinement, his fourth in three years. That stay taught him one clear lesson: If suicide is your aim, don’t talk about it.
You may ask what kind of father would drive along a drainage ditch and see it as a place where his son could quickly and efficiently end his life. I can tell you. He is the same father who makes a mental inventory of alternative methods that are more painful and less likely to succeed, methods that could leave a tortured invalid trapped for life in a hospital bed. He is the same father who clinically analyzes docudrama clips of Hitler’s would-be assassins strangling in agony at the end of a wire. He is the same father who wonders how many minutes one must watch life’s blood pour from open wrists while the bathtub water turns a brighter red (and who speculates whether water is necessary to ensure that the blood has no time to coagulate and stanch the flow). He is the same father who, when his son openly expresses his death wish, responds by first urging life and hope but ends by saying that he understands his son’s pain and that he will love and respect him regardless of what he decides. Was that statement a cold approval of suicide, or was it a loving attempt to spare a son the thought that his father regarded his final act as a failure? Who can know how or whether to judge a father who would do such things?
My preoccupation with mechanics made the caller’s answer—“a gun”—satisfying. Here, at least, was a swift and effective end; my son had done his research well. Although he had not fired a gun since childhood, John chose a final tool that was up to the job, a .357 Magnum, enough firepower to negate any minor error of aim when he placed it to his temple. I firmly believe that some controls should be placed on handgun sales and that guns should not be available to mentally ill people. Nevertheless, I was thankful that on the day he needed it, John had easy access to such a weapon and that he could use it well enough to spare him from more brutal methods. A friend’s son, for example, tried to jump through a fourteenth-floor hospital window, but shards of glass caught his clothing long enough for attendants to pull him back in. However lucky his rescue may have been, I shudder to contemplate the further violence this young man will inflict on himself until he finally succeeds. I know of another suicide who apparently practiced or missed on the first few shots before finally lodging the bullet in her brain. My son’s aim was far better, the single slug traveling—in the clinical words of the death certificate—“through and through” his skull.
With the “how” answered, my next question was “Where?” The matter was important. When he could no longer live alone with his demons—in the late eighties—John had returned home to live with his mother and stepfather. He felt safe in his old bedroom. In my anticipation of his death, I was concerned that it happen where he was comfortable—or as comfortable as he could be at that terrible moment—but I did not want it to happen in the house, where his mother would have to deal with his remains. My heart sank when I first thought I heard, “In the back part of the city.”
My thoughts ran to a dark and frightening part of town, where my son might have been alone in strange territory or threatened by equally deranged derelicts. I later learned that my hearing had deceived me. Instead of “in the back part of the city,” the words had been “in the back yard, by the fence.” That news brought me relief. The place was not readily visible from the house. As John said in his last note: “I had a vision of running away to die where nobody would find me. I went to behind the study with a .357 Magnum and hollow-nosed bullets. It is over.”
My next words to the caller reflected hope for myself as well as for my dead son: “At last he found peace.” Trite. So often said, inappropriately, when death takes someone who wants to live. But John wanted the peace of death, and I could applaud his success, even with a breaking heart.
From the start, my son was a perfectionist—making far more demands on himself than his mother and I did. A solemn child who always tried to do the right thing, John suffered intense pain at the slightest error or loss of face. The last of five diagnoses was that he suffered textbook “schizo-affective personality disorder.” I didn’t research this as carefully as I had the earlier diagnoses of “acute paranoid schizophrenia,” then “chronic schizophrenia,” “bipolar disorder” (manic-depression), and “chronic depression.” From listening to the doctors, I concluded the term meant that my son was unable to comprehend and deal with the subtleties of the outside world and, in particular, with human interaction.
If this is true, then it makes sense of his childhood, during which John had only a few close friends, and it explains why he could barely handle the routine of saying hello and good-bye to relatives. John’s disability carried through to his work as a computer programmer, where he could perform assigned tasks with occasional brilliance but had no perspective about what his employer did or how he himself fit into the business. In many respects, my son was like the Dustin Hoffman character in Rain Man. He was not autistic, but he was gentle and bright and tragically isolated.
Though John’s strongest desire was to have a satisfying sexual relationship, he had no notion of how to deal with women. Totally trusting, totally naive, totally loving, he was terrified and silent in the presence of any attractive female. His last effort to find love may in fact have prompted his plunge into acute schizophrenia—or it may have been a chance by-product of what was already a downhill run.
He became attracted to a woman who was a customer in a neighborhood bar he frequented, and as he related the story (the boundary between reality and hallucination is unclear), he determined that she had mysterious connections with the underworld. In his imagination, John became her lover and protector. One night, he was afraid he had disclosed information that he was convinced would prompt the Mafia to kill them both.
The misadventure with the woman produced more stress than John’s defective brain could stand. That fear, in turn, produced panic attacks that grew into paranoia, as he came to regard the occupant of every passing car as a potential assassin. Private shame escalated into humiliation when the patrons in the bar noticed his strange behavior, and eventually he began to hear voices discussing his ill-fated affair wherever he went—voices that, of course, had no basis in reality.
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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