How to Save a Life

Caveat: This may make you feel bad. If you know someone who killed himself, or herself, and you feel badly about your part in it somehow, get therapy. Or talk to someone about it. You matter, too, and despite what you might think after reading what I write below, you probably couldn't have helped that person, probably could not have saved a life. It's one of those things, best to take yourself off the hook.

One night last week FD said to me, "We should make a shiva call tonight."

Someone who sits shiva has lost a parent, sibling, or child, a member of the  family of origin. From burial to "getting up" from shiva, friends have a week to stop by and sit together with the mourners, console. Or they can call on the phone, if the mourners are out of town. My parents call it a condolence call.

I felt badly for not being on board, but it had been a long day. I just didn't want to sit anymore, not with anyone. I wanted to eat some dinner, make a few calls, work on taxes, try walking a little on the treadmill, see if I could ride a bit on the stationary bike. I told FD I had a break the next day and intended to visit our friend then, maybe do some shopping afterward. Did he want to come along then, skip tonight?

Call me before you leave, he said.

So I did, and he went along. We visited someone who had lost his father, a dear man in his eighties. Our friend talked about his mother, alone now and missing her spouse, what that must be like, missing him for what will be the rest of her life. To her, this man in his eighties died prematurely.

Sad but a relatively easy shiva call, as shiva calls go. No one lives forever, children should outlive their parents. There's a certain order that makes life just a little easier to take, sometimes.

After the visit we grocery-shopped and had some lunch. I dropped FD off at his office and started back towards mine.

Then I heard the song. I'd heard this song maybe three or four times before, and each time would think, Catchy, but what's he's saying? Is the refrain really, how to save a life? Is this song about suicide? It sounds like the lead singer is blaming himself, this mournful, plaintive voice in the band, the one full of regret.

But honestly, all due respect, words run together for me and I don't want to think this. I'm on my way to work thinking, how to save a God knows what, flashing on that first patient and  wondering where am I going with this woman. Is my treatment plan on target? One false move. . . No room for mistakes.

I’m an aquarist and have had a bad fish week, lost three, one to an attempted homicide. The bat fish didn't make it through the mauling. A trigger mistook him for a leaf, perhaps. The clowns died of broken hearts, in sympathy, no idea. They just couldn't smile anymore.

But these are people.

I get to the office early and log onto YouTube, because there's really nothing to worry about with that first patient and I know this, truly the job is in hand, the work's been done. We're in middle phase, putting together a few pieces, not resuscitating anything, anyone.

And there it is, the music video, obviously a hit, a clear winner, it pops right up. Many others boast videos "with lyrics." So apparently I am not the only one who didn't get them on the radio. Once you know the words, like everything else, meanings are clear as rain.

Where have I been? Why haven't my kids told me about this? Don't they know I need this stuff? It's like oxygen for me, a song like this. I print out the lyrics, then watch the video maybe five times, mesmerized.

Fray, the band, won't let me embed it on my blog, so readers must find it themselves or follow a link.  With their permission, here are the lyrics.

How To Save A Life:
Step one you say we need to talk
He walks you say sit down it's just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left and you stay right
Between the lines of fear and blame
You begin to wonder why you came

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Let him know that you know best
Cause after all you do know best
Try to slip past his defense
Without granting innocence
Lay down a list of what is wrong
The things you've told him all along
And pray to God he hears you
And pray to God he hears you

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

As he begins to raise his voice
You lower yours and grant him one last choice
Drive until you lose the road
Or break with the ones you've followed
He will do one of two things
He will admit to everything
Or he'll say he's just not the same
And you'll begin to wonder why you came

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life
How to save a life
How to save a life

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

CHORUS:
Where did I go wrong, I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to
Save a life

A critical thinker would watch the video and say, so emotionally manipulative. These are actors, hired to look sad, to draw attention to a problem affecting youth today, but there is no way that any of them would really want to die, would voluntarily take their lives.

But the truth could be otherwise. Although these are actors, they are representative. There is an ennui that affects young people, like old people, a psychic pain that affects the leaders of tomorrow, and I see them in my office and we talk and talk and talk, and there was a time, when I was young, that I would be on the phone all night with them. I knew so little back then.

More aggressive, I haven't done that in a long time. Not only are youth at risk, of course. Anyone who has lost everything, which is easy to do, is at risk—middle-aged men and women who have no savings, no jobs, fathers, mothers, grandfathers, grandmothers, the old and the young have angst, suicidal wishes. We know them.

Along comes one, distressed, withdrawn, glassy-eyed, a friend of any age, who has changed. And let's say you have this chance, somehow, to stay, to help this friend through one night in particular, one awful night. It is a horrible position, to have to do that, to make that choice. And with grown men, it's not as if anyone is asking you to stay and hold hands, not usually.

Maybe you know. He’s not going home to anyone. He’s isolated. In a book you are reading you learn that isolated people are at higher risk. It is sometimes easier if there are friends, family around. Living with someone is better than living alone; the support is built in, not that this always helps. People can be in the next room and not be there, not be very much help at all. They may even be a part of the problem.

Thus as a real friend, you have to stay to save a life, as Fray tells us. You may have to call someone else, explain why you'll be late, maybe why you'll be out all night. Mention that you might need some assistance, too.

But you have to stay, and you might have to stay up all night.

You never want to be in charge of someone's life, it's not a great position, it's not usually what we sign up for when we say, I'll be your friend. But sometimes, by staying, we make it a little easier for a friend in trouble to hold on. Stay just a little longer, until you have a chance to bring in bigger shoulders.

It can be hard hanging in there with someone who is seemingly smiling politely back at you. (Lyrics like these strike a familiar chord. We've seen this smile). You can't politely look right on through, go your own way. To be trite, you may not pass this way again.

Between the lines of fear and blame. You begin to wonder why you came.

Except you shouldn’t wonder, because your fear is nothing compared to his, and no one, really, is to blame. Depression happens and is obviously the domain of the therapists, the professionals—doctors. We have the tools. Sometimes all we need, however, is some unknown actor to play a quiet understudy role, to be a stand in for a few hours, keep our patient alive, watch him and don’t let him let that impulsive, senseless act happen. Get through the night and then find help, the bigger guns, to fight your friend's depression. Tell someone, a parent, a primary care doctor. A cop.

Anyone can sense a death wish, you know, feel that Spidey sense tingling. It is a scary feeling, sensing a death wish, because we have no control, none over the actions of others. Intimate information, insider knowledge direct from the mouths of our suicidal friends will haunt us if the act is consummated.

Like isolation, seeing self-destructive behavior is insider information. If a friend has been hurting himself, or has been hurting for a long time, drinking and drugging without any thoughts about tomorrow, then the direction of his mood won't spontaneously lift, the negativity won't fly away, not without medical intervention. That is when we have to seek help, can’t wait around for tomorrow. It is too dangerous a cocktail, negative thoughts mixed with accessibility, the accessibility of drugs, alcohol, bullets, ropes, blades. We can't walk away the truth of our violent world. We have what to fear, old Yiddish expression.

So scary, and we’re so powerless, You wonder why you came. So you go.

When we don’t, when we reach out, they punish us. This is how they make us feel, depressed people, like we're useless and powerless, like we can't help them. Why bother? This is how they feel, useless and powerless, failures, better off dead, not worth bothering about. It is called projection, and a sensitive friend feels what is in the heart of another, this feeling that there may be, truly, nothing that can be done.

Such a trap, and so wrong! Over-rated, powerlessness, hopelessness. Push help, find those friendly cost-effective social service people at the local mental health agency, the professionals. They’ll think of something. That is the rational way of seeing despair. The social scientists can't treat everything, not every time, but God knows, they can treat depression, and more often than not, win the battle.

Someone has to stay rational, unafraid, and above all, hopeful. You, the friend, perhaps the lover, sister, brother, parent, spouse, are elected. Maybe it won't work, maybe you will lose this person in the end, but you don't really know that, do you? So you can't run away, that's for sure, hoping that in the morning your friend will be okay.

You can't stay right if he turns left. This is the projected abandonment he is hoping for, you validating his worthlessness with your leave-taking. Don't fall for these words, I'm okay, go home. Be sure someone else is on call. Or stay.

This is not to say a person should be manipulated to stay by suicide threats designed to control the relationship. This is entirely different, a typically borderline personality modus operandi, and it is not an easy call to make. One in five with this disorder do kill themselves. But threats are threats, and as such need to be taken to a higher court. There is a fine line between dependency and despondency, but sensing you are walking that line, it is best to get out of the helper/rescue role.

It is too big for you. It is too big for most of us. That is why such people are so lonely.

Oh, so much to say. Why did I start?

Because so many people, after a suicide, say, I knew.

I tell people to talk openly about it, about this idea that most of us have had, at least once in our lives, that life is too tough, that we wouldn't mind finishing it. And they should discuss meaning, why choosing life is the better alternative, because there is meaning. It is our job to find it.

Having the discussion doesn’t make it your job to find meaning for your friend, the one who wants to die. It is the job of professionals. But you can play with it. It is a wonderful, rich, very intimate conversation we're talking about, and as such can be therapeutic. Therapists have no corner on these conversations. We do tell people that a suicide is permission to the generations to come that it is okay to throw their lives away. And if you do happen to help a friend find meaning, if together you find that elusive raison d’etre, within the throes of discussing depression, you are amazing, both of you are, and should consider this profession.

Oh, but we aren’t finished. In the process of this philosophical discussion, should your friend mention a suicide plan, then this is a heads up, don't take it lightly. There is real risk. Your friend is capable, armed, can exact a suicide. Now is the time to phone for help. More drama now, less later.

You can and should call parents, if there are any, and they are around. Real friends know how to find them, aren't afraid of these people, the ones who birthed a suicidal buddy, who brought a suicidal friend into the world. It is possible that these people hold the key to something very elemental to your friend's survival.

If there are no relatives nearby, then you may be the closest relative right now. You don’t want to lose him, but he can be such a burden, sometimes we give up. If it were our child with a fever, we wouldn’t give up. This is a child with a fever.

Where did I go wrong, I lost a friend. Somewhere along in the bitterness.

Whose bitterness? Suicide is an angry act, a vitriolic act. At some point there's energy, enough to make it so, that decision, the one that spells relief. It takes a lot of psychic energy. The decision to do it can be invigorating. So we watch people when they say they're feeling better, watch them more closely. We're thinking, the energy is available, the time is now. He's going to go left. There's so much energy in the bitterness and anger. Toxic stuff.

Let him know that you know best. Cause after all you do know best

All you know is there’s something really wrong here. Even we, the professionals, the ones who know, don't give advice. We listen. We teach from experience and we do it gently, if we do it at all. All we know is we find death repulsive. Our friend does not.

When your Spidey sense says, You're not getting through, this person is going to try it again, it is time to call for reinforcements. I've had kids never see me again because I forced a hospitalization.

Enough. It is a blogger’s prerogative to ramble on, but you get the idea. You know the symptoms to look out for, the loss of interest in the usual pleasurable activities, not caring about school or work, not caring about hygiene, expressing hopelessness and helplessness, giving away possessions, revealing a suicide plan.

You don't want to be an armchair therapist, here, not a self-appointed therapist, certainly don’t want to beat on someone's short-comings, not ever. Like Fray warns us in the song, we don't tell a person what he doesn't want to hear.

Our unconditional love and support? It might feel good, but it might not, won’t necessarily save anyone’s life and doesn't take the place of professional help. It is all we have to offer, however, when someone won’t get help. The real kicker is that people can fool the healthcare professionals. As soon as they’re released, they overdose or shoot a bullet through their heads.

When they have had help and given up, it is the worst. We have to reinforce that therapists are a dime a dozen. Try another.

Meanwhile, scheduling is impossible, and there are no appointments and your friend is taking his feelings into his own hands, dosing out his own medicine, not caring if it helps or not. And you're there and you can tell, he's too drugged up, or he's drinking too much, that this isn't good.

So you call 911.

And there, you've saved a life.

You don't have to wonder about any of it, you don't have to wonder why you came, why you stayed. The un-timeliness is what we're talking about, the premature death, the one we want to avoid, no different in its importance than the one we talked about earlier, the octogenarian who still died prematurely, at least according to his wife.

We want to save a life at any age. That's why we stay. We—you—are a part of it.

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