“Rose would be a good person to talk to, if she’s up for it.”
I was being that annoying medical student again, asking staff for patients who would likely consent to speaking to me. I was with my friend Jack, and with that we made our way through the confusing maze of rooms before we found hers. I knocked on the door and pushed it open a fraction to hear the response. The doors cannot be locked here.
She had our back to us and turned around with a bright, cheery smile. Her thick, brown hair cascaded over her shoulders in curls I have always envied. She looked roughly my age, and with her slightly oversized band t-shirt and jeans she looked like every trendy millennial you could catch on the street. She was very welcoming and made herself comfortable on her bed as we awkwardly pushed two chairs together, notebooks and pens in hand. We regurgitated our introductions as per usual and asked for her permission to ask questions, emphasising repeatedly that she could stop the conversation whenever she pleased. Perhaps it was because it was only our second week of psychiatry, but it felt necessary to prove we were in a safe space. In hindsight, I think we overdid it a bit.
“What would you like to know?” Just by her demeanour I could tell we could be up for a challenge, she had this self-assured and nonchalant manner that made me feel as if whatever question I could come up with, she had already been asked. That I could bring nothing new to the table. But nonetheless I started with the age old question, “Tell us about what brought you here.”
“I have decided I am going to kill myself.”
Not a phrase that really surprised me, since we were in a psychiatric hospital. We’d always been taught to ask open-ended questions, to give the person an opportunity to tell their own story, so my second question was “Can you tell us more about that?”
Rose took out a thick notebook and told us her psychiatrist recommended writing out a timeline of her life. It was supposedly imperative to understand her current predicament, and we were more than happy to oblige.
It was a long and tumultuous tale, and for the sake of confidentiality I cannot divulge in too many details. But I will say and the end of it, I could not find the motivation in myself to tell her she wasn’t right in wanting to kill herself. Abuse. Violence. Death. Disease. She had gone through enough and decided that death would be far less painful than continuing to live on. Every shred of happiness in her life was so quickly snuffed out by some freak tragedy, that you’d think God himself was personally out to get her. She was exhausted with living, and saw no point in voluntarily continuing to subject herself to such trauma. She had a plan, and had been in the process of getting her affairs in order when her youth worker was alerted to her intentions and convinced her to admit herself to hospital. She was here, but was still adamant that when the time came, she’d extinguish herself from this world and free her family from the burden of her presence. And free herself from the pain she had experienced until then. I listened to all of this intently, and as desperately as I wanted to say something comforting, everything that came to mind felt so contrived and superficial. What do you say to that?
She brazenly invited us to change her mind, to say something that could refute the years of reasoning she had undergone before making this decision. Could we, having known her less than an hour, spit out something that could miraculously give her the will to live? I did not dare give myself the arrogance of thinking that I could save this woman, but there was a part of me that wanted to make an impact. Wanted to metaphorically shake her into sense and make her realise she was wrong. But I had nothing to back myself up, and by asking her to live was I simply telling her to continue suffering? The only thing I could do was to continue asking her questions, with the good intentions of triggering doubt, albeit very clumsily. “What would have to happen for you to change your mind?” She did not have an answer for that, but the fact that she did not immediately rebuke my question and say “Nothing,” made me think that perhaps there was a sliver of a possibility that something could be done.
I forgot to also mention that early in the conversation we asked what age she was. 23. The same age as Jack and I, and Rose astutely commented, “Look at us, on such different ends of life.” I was on the cusp of becoming a medical professional who would hopefully save some lives during my career, and she was perched perilously on the thin line that exists between life and death. And she was braced for impact. This was a woman who was incredibly intelligent, who once had amazing job prospects and the potential to succeed in whatever she chose. I am not saying this made her life any more worth living than others, but I am saying that the world would have lost someone who truly deserved happiness and success.
I left that day feeling incredibly dejected and helpless, her cheery “good luck to your studies,” and glowing smile etched forever in my memory. I should mention at this point that prior to meeting her we were notified of her “cluster B traits.” These are a collection of personality disorders characterised by dramatic, emotional and erratic behaviours. But even knowing that made no difference to how I saw her as a person, someone who had survived trauma after trauma and was in a lot of unresolved emotional turmoil. Now I could give you the criteria for every personality disorder, and tell you which one she likely fits into, but the diagnosis itself is not the important point here. Whilst I have memorised the theory behind it, I continue to struggle to understand what it is like to have a mental illness, how it could twist every thought and emotion into making you feel like worthless. It is not something one can truly know unless you experience it, and at the risk of sounding selfish I hope I never do. I didn’t see her suicidal thoughts as simply a symptom of her condition, and anyone who thinks it’s that simple forgets the complexity of the human mind.
The story does not end there, however. We saw her two more times following that encounter, once when she had started on a new medication, and once just before her discharge. Even from our second conversation, things had started to change. Whilst we did not choose to ask about her suicidal thoughts and again and tried to keep conversation light, it was clear that her perspective towards life was shifting. She did not like the new medication, because it made her dazed and confused. She was also going to embark on intense therapy and counselling, that seemed very daunting. But, she had received a call from her employer about a promotion and was considering it. Job promotion. You cannot accept a job promotion unless you were prepared to be there every day, right? I was surprised, and I was happy. We congratulated her on the offer, and listened as she explained the rostering conflicts and her dilemmas regarding the extra responsibility. I walked out of her room that day a different person from two weeks ago. I felt hope.
The last time I saw her was brief, but perhaps the most uplifting. We were told she was leaving that day, and that she had accepted the job offer. Yay! We knocked on that familiar door, poked our heads through and alas, she had company. Nonetheless, we excited congratulated her on her promotion, said our thank yous and goodbyes, and retreated feeling joyful. That’s the last memory of I have of her. Rose, where ever you are and whatever you are doing, I hope you know how strong and amazing of an individual you are. I wish you the best of luck on your future endeavours.
Please note that names and certain details have been altered to protect confidentiality and identities of individuals involved.