By Geralyn Datz PhD.
Editor’s Note: I read the comment section of the National Pain Report every day. In recent months, I have been noting more isolation, desperation and people actively talking about suicide. It has been alarming. I reached out to a friend of the National Pain Report, Dr. Geralyn Datz—a psychologist and past president of the Southern Pain Society and asked her for her thoughts. What follows is a powerful personal story and advice for us all.
I logged on to my email. It was the end of a long day of seeing patients and my staff knew I was booked back-to-back for hours. In the long, inky black list of bolded messages, one subject line stood out to me. “Follow up” it read. Followed by the new patient’s name who I had just seen yesterday. It stood out to me. I don’t know why.
I opened it.
The message read that my patient had “passed away….. unexpectedly”.
I was shocked. The flashbulb memories began. A tall lean, male with a casual manner. He had laughed on a few occasions, cried on others. He had several young children. He and his wife were no longer speaking. She had moved out months before. He was young. He had severe pain as well as depression and trauma. He couldn’t afford his medications. He had maxed out all of his credit cards and truly could not afford another bill. He couldn’t get his insurance to cover a visit to a provider that he badly needed to see. I was working on helping him through the healthcare maze. I could sense things were desperate and urgent. But he minimized how dangerous and risky his depression was. I knew he did this purposefully now.
Later that day I found out the patient committed suicide.
A pit formed in my stomach. This wasn’t my first patient death but each one brings overwhelm. Sadness and feelings of helplessness wracked my brain:
Oh my God! I missed it! Could I have done something differently? Should I have spent more time? Oh no, no…. This cant be!
He had been at my office several hours, and I spoke with him for quite some time. But months, years even, of distress and medical history often cannot be adequately summarized in one office visit, no matter how long. Adding to that, he had gone without healthcare for several months before I saw him. I was the last living provider that he had spoken to. It was, quite literally, hours since I saw him. He left my office with a wry look and I knew what we covered was exhausting to him. I tried to instill hope. But was his mind already made up?
He told me his story, both medical and psychological, and I understood his position. I saw the inroads. I saw the connections and the recovery plan. I knew I could help him I just needed time. And now there was none left.
In mental health, suicide is not an uncommon topic. Until recently though, in chronic pain it was. The sense of isolation, hopelessness and loss of identity that is the experience of pain patients everywhere can become all-consuming. Now coupled with that, are the many system challenges including lack of access to healthcare, lack of coverage for services, and the more recent issue of lack of access to medication. The Opioid Epidemic has spawned a near hysteria around pain medication. This has resulted in dramatically fewer prescriptions, the fears of overdose, and lack of care planning.
In the zeal to contain a public health problem, we have forgotten about the public health.
Normally, we are programmed for Life preservation. But this is when life is going well, or at least it seems as if our problems could be solved. Or, at the very least, that there is hope that our problems can be solved. When suicidal thinking takes over, the mind becomes convinced there is no other alternative than death. This realization actually helps the suicidal person to feel relief ….believing that there is an actual end to their suffering, and that this could be in their control. Sometimes people with suicidal thinking believe others would be relieved, too. The tragic trick of depression and suicidal thinking is that it makes the person believe that permanent escape is the only reasonable solution and it will solve everything.
Suicide is a means of escape from life. But it is also a tragedy. It’s a horror. It’s a cataclysm of a life cut short and the exponential waves of grief for those that survive the person who takes the action.
Chronic pain patients need treatment. Some patients need medication, some need supplementary care, and others need both. If treatments are modified, or taken away, there must be other forms of care that follow, and are available, accessible and approved by insurance.
We can do better and we need to do better. And, for too many, we are running out of time.
If you are someone you know is considering suicide, help is available, call +1-800-273-8255 to speak with someone or text start to 74174 to message with the crisis text line.