There’s been a suicide 

By David Kopacz, MD, University of Washington & Puget Sound Veterans Affairs

 

There’s been a suicide 

An unfamiliar sound as 

I walk across the parking deck 

I look down at a man powerwashing  

a bench, 

absurdly cordoned off with those retractable 

ribbons they use at airports 

to keep everyone and everything in their place ─ 

more a psychological suggestion 

than a true barrier, 

four other people, stand around, awkwardly, 

watching one man powerwash a bench 

─ strange, I think, but I’m late for work and I power walk on. 

  

There’s been a suicide, 

our team leader tells us, 

at 4:30 PM, as everyone got off work,  

a Veteran shot himself on a park bench in front of the mental health building at 4:30 PM  

as everyone was leaving for the day.  

  

I know it is a statement─but of what?  

A protest 

of the threat of government cuts to the VA? 

of dissatisfaction with VA care? 

about the long aftermath of war? 

of the pain of life? 

  

Immediately, I think of Eileen, and send her a quick message 

about how she is a great healer 

because I remember how we lost him, a couple of years ago, 

that Marine trying to get off fentanyl. 

  

Lost. 

That makes him sound like a set of car keys, a passport, or a dog.  

Lost, gone.  

He wouldn’t come to the hospital until we found somewhere for his dog─ 

we worked really hard,  

trying to find a place for his dog,  

trying to find a place for him.  

It seemed like we did everything we could, 

but we lost him.  

A tough, sweet man, who wanted help 

but the help wasn’t enough.  

We found a place for his dog, 

but we couldn’t find a place for him, at the VA, in life, in the world.  

  

There’d been a suicide.  

  

And now he rests, below the ground, eternal rest—if there is such a thing as eternal rest, when the aftermath of war can be an eternal torment. 

  

We try. We tried. It wasn’t enough. Could we have saved him? Could he have found him before it was too late? How is his dog without him? What if we did this . . . ? What if we tried that . . . ? Maybe if we try harder next time?  

  

Sometimes, 

when you lose some things, 

you find them again, 

and others are gone forever.  

  

  

I wrote this poem just recently after the memory of “losing” a patient to suicide came back after learning about another veteran’s death by suicide. Dr. Elizabeth Kübler-Ross wrote of five different stages or phases of working with death and dying: denial, anger, bargaining, depression, and acceptance. With death by suicide, the living are left with many unanswerable questions and the mind fills in the gaps in ways that can be understood through the lenses below.

 

Denial: “It wasn’t my fault,” “There was nothing I could do.”  

Anger: at the person who died by suicide and/or at oneself, other clinicians, or the medical system.  

Bargaining: “Maybe if I had done this” or “Maybe if I had done that” this wouldn’t have happened, or “If I do x, y, z, this will never happen again.”  

Depression: internalizing guilt and responsibility for the act.  

Acceptance: after going through grief and mourning and learning what one can for the future.  

  

These stages are not things that one goes through once and ticks a box and are done with forever. Different situations arise and the mind goes back, trying to make sense of the loss and trying to prevent future tragedy. Death is a great mystery to the living, and death by suicide is an even greater mystery that leaves us with unanswered questions and wounds that can re-open again. 

 

 

 

Read more about the author on his website: https://www.davidkopacz.com/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.