When I first wrote about suicide - 30 years ago - I was a terribly depressed person, trying to understand the deaths in my own family. While suicide continued to be the means of release for some members of my family, and while I still deplored, feared, and preached against its use as a way out of depression, I have had some reconsideration of one of the aspects of suicide against which I railed for so long.
The terminally ill face a different kind of depression than do we, the relatively well. I say relatively, because anyone who reaches my age - 73 - cannot have escaped some of the illnesses or diseases that plague the human race. I've had two kinds of cancer, several operations, and assorted other illnesses. My general health, though, remains good.
But what about those for whom disease has a daily, painfully evident nearness? Those whose bodies are deteriorating, whose minds are going? Their awareness of a death that is approaching on a path as difficult as anything they endured at a younger - healthier - age, must cause something akin to the depression that I feel.
But is it the same? Is an old man's depression about his loss of limbs or breathing ability the same as my inaccurate inner thoughts about my ability as a father? Do the constant preoccupations with loss of memory and bodily function fit on the same continuum as the depressive thoughts that cause me to be irritable when a loud noise echoes in my quiet neighborhood? Should we, in other words, call both of them depression; and should the use of suicide as an "out" be looked at in the same way for the elderly who cannot find peace with their diseases as for the young who cannot find peace with their inner thoughts?
Quickly, I need to say that all depression can be treated. All pain can be treated. There is no magic bullet for either of them, but alleviation is possible in almost all cases. If we ignore this, then death (through suicide or murder) could become a "normal" way of dealing both with old age and with pain and disease. The gerontological psychiatrist knows this, the practitioner who treats the client in a nursing home differently than the depressed lawyer at a major firm. The physician who works in the field of palliative care knows that the patient may never be rid of the depression that haunts him or her, while the rest of us may get sufficient relief so that we can go on with our work, our love, our families, our lives.
So, what kind of reconsideration have I made? How have I changed my mind over the years? It is in this: I no longer blame the older person who, because of disease or illness, takes away his own life. I used to. I used to get angry at anyone who removed himself from the world because of depression, when I knew that relief was only a pill or two away. I didn't favor (and I don't now favor) "assisted suicide" because it seems too facile a way of disposing of the elderly ill.
But I now no longer condemn people who can no longer bear the world the way it is because their pain, psychic or physical, is too much for them to bear.
I will try to prevent their pain; I will mourn them; but I can understand them. At last.
Published On: October 26, 2008