Night Falls Fast

by Kay Redfield Jamison

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  National Alliance for the Mentally Ill

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  National Institute of Mental Health Suicide Research Consortium

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  Notes

  I • DEATH LIES NEAR AT HAND

  1 “A tiny blade”: Seneca, “To Lucilius: On Providence.” Seneca (4 b.c.–a.d. 65), Roman statesman and philosopher, was forced to take his own life after having been accused of conspiracy by Nero, emperor of Rome. Three years later Nero, too, was forced to commit suicide.

  2 The Cro-Magnons, we believe: W. F. Allman, The Stone Age Present: How Evolution Has Shaped Modern Life—From Sex, Violence, and Language to Emotions, Morals, and Communities (New York: Simon & Schuster, 1994); Ian Tattersall, Becoming Human: Evolution and Human Uniqueness (New York: Harcourt Brace, 1998).

  3 and the hunting apes: B. B. Beck, Animal Tool Behavior (New York: Garland Press, 1980); W. C. McGrew, Chimpanzee Material Culture (Cambridge, England: Cambridge University Press, 1992); R. Byrne, The Thinking Ape: Evolutionary Origins of Intelligence (Oxford: Oxford University Press, 1995).

  4 Several—for example, the Eskimo: S. Bromberg and C. K. Cassel, “Suicide in the Elderly: The Limits of Paternalism,” Journal of the American Geriatrics Society, 31 (1983): 698–703.

  5 Among the Yuit Eskimos: A. H. Leighton and C. C. Hughes, “Notes on Eskimo Patterns of Suicide,” Southwestern Journal of Anthropology, 11 (1955): 327–338.

  6 Most of these deaths: G. Rosen, “History in the Study of Suicide,” Psychological Medicine, 1 (1971): 267–285; T. J. Marzen, M. K. O’Dowd, D. Crone, and T. J. Balch, “Suicide: A Constitutional Right?” Duquesne Law Review, 24 (1985), 1–242; Anton van Hooff, From Autothanasia to Suicide: Self-Killing in Classical Antiquity (London: Routledge, 1990); M. Crone, “Historical Attitudes Toward Suicide,” Duquesne Law Review (Special Issue: A Symposium on Physician-Assisted Suicide), 35 (1996), 7–42.

  7 Gladiators thrust wooden sticks: Seneca, “On the Proper Time to Slip the Cable,” Epistulae Morales, vol. 4, trans. R. M. Gummere (Cambridge, Mass.: Harvard University Press, 1967).

  8 The Catholic Church: Charles Moore, A Full Inquiry Into the Subject of Suicide, vol. 1 (London: Rivington, 1790), pp. 306–325; George Rosen, “History in the Study of Suicide.”

  9 St. Augustine: St. Augustine, The City of God, trans. Marcus Dods, vol. 1, (New York: Hafner, 1948) Book 1, pp. 31–39. For an excellent recent history of suicide in western culture, see G. Minois, History of Suicide: Voluntary Death in Western Culture, trans. L. G. Cochrane (Baltimore: Johns Hopkins, 1999).

  10 so as “not to bury the wicked”: H. Cohn, “Suicide in Jewish Legal and Religious Tradition,” Mental Health and Society, 3 (1976): 129–136, p. 136.

  11 The Semachot: D. M. Posner, “Suicide and the Jewish Tradition,” in E. J. Dunne, J. L. McIntosh, and K. Dunne-Maxim, eds., Suicide and Its Aftermath (New York: W. W. Norton, 1987), pp. 159–162. The Semachot is quoted on p. 160.

  12 “The general rule”: Cohn, “Suicide in Jewish Legal and Religious Tradition.”

  13 In Islamic law, suicide: Y. Al-Najjar, “Suicide in Islamic Law,” in H. Winnick and L. Miller, eds., Aspects of Suicide in Modern Civilization (Jerusalem: Academic Press, 1978), pp. 28–33.

  14 “keep the corpses down”: C. Gittings, Death, Burial and the Individual in Early Modern England (London: Routledge, 1988).

  15 In early Massachusets,: Howard I. Kushner, American Suicide: A Psychocultural Exploration (New Brunswick, N.J.: Rutgers University Press, 1991).

  16 they then sank his body: P. V. Glob, The Bog People: Iron-Age Man Preserved, trans. Rupert Bruce-Mitford (Ithaca, N.Y.: Cornell University Press, 1988), pp. 148–151.

  17 “The deceased was washed”: K. A. Achte and J. Lönnqvist, “Death and Suicide in Finnish Mythology and Folklore,” in N. Speyer, R. F. W. Diekstra, and K. J. M. van de Loo, eds., Proceedings of the International Conference for Suicide Prevention (Amsterdam; Swets & Zeitlinger, 1973), pp. 317–323, p. 321.

  18 In France, the body: G. Rosen, “History in the Study of Suicide.”

  19 In parts of Germany: Henry Romilly Fedden, Suicide: A Social and Historical Study (London: Peter Davies, 1938), p. 37.

  20 Early Norwegian laws: Nils Retterstol, Suicide: A European Perspective (Cambridge, England: Cambridge University Press, 1993), p. 20.

  21 “an irreparable deed”: Ibid., p. 21.

  22 “individual submission to Satan”: Kushner, American Suicide.

  23 “gibbeted and … left to rot”: Mark Williams, Cry of Pain: Understanding Suicide and Self-Harm (London: Penguin, 1997).

  24 Rather than suffering: Ibid.

  25 “Whensoever any affliction”: John Donne, Biathanatos. A modern-spelling edition with introduction and comment by Michael Rudick and M. Pabst Battin (New York: Garland, 1982), p. 39.

  26 Two recent authors: Williams, Cry of Pain; Kushner, American Suicide. Roy Porter’s Mind-Forg’d Manacles: A History of Madness in England from the Restoration to the Regency (Cambridge, Mass.: Harvard University Press, 1987) is also an excellent historical account of suicide.

  27 in mid-seventeenth-century England: Williams, Cry of Pain.

  28 the Boston Coroners’ Juries made: Kushner, American Suicide.

  29 Dorothy Bradford … “accidentally fell overboard”: Samuel Eliot Morison, Introduction to William Bradford, Of Plymouth Plantation: 1620–1647 (New York; Alfred A. Knopf, 1996), p. xxiv.

  30 Bradford himself does not mention: Bradford, ibid.

  31 Most European countries formally decriminalized: J. Neeleman, “Suicide as a Crime in the U.K.: Legal History, International Comparisons and Present Implications,” Acta Psychiatrica Scandinavica, 94 (1996): 252–257.

  32 “I am the resurrection and the life”: The Book of Common Prayer (Oxford: Oxford University Press), pp. 394–395.

  33 the Order for the Burial of the Dead: Ibid., p. 388.

  34 “desperately sensitive and confused”: A. Alvarez, “Literature in the Nineteenth and Twentieth Centuries,” in S. Perlin, ed., A Handbook for the Understanding of Suicide (Northvale, N.J.:
Jason Aronson, 1975), p. 59.

  35 “Judging whether life”: A. Camus, The Myth of Sisyphus and Other Essays (New York: Vintage, 1995), p. 3.

  36 Study after study has shown: R. M. A. Hirschfeld and G. L. Klerman, “Treatment of Depression in the Elderly,” Geriatrics, 127 (1979): 51–57; B. D. Lebowitz, J. L. Pearson, L.S. Schneider, et al., “Diagnosis and Treatment of Depression in Late Life: Consensus Statement Update,” Journal of the American Medical Association, 278 (1997), 1186–1190.

  37 suicide rates in the elderly are alarmingly high: Y. Conwell, R. Melanie, and E. D. Caine, “Completed Suicide at Age 50 and Over,” Journal of the American Geriatric Society, 38 (1990: 640–644; N. J. Osgood, Suicide in Later Life (New York: Lexington Books, 1992); D. C. Clark, “Narcissistic Crises of Aging and Suicidal Despair,” Suicide and Life-Threatening Behavior, 23 (1993): 21–26; M. M. Henriksson, M. J. Marttunen, E. T. Isometsä, et al., “Mental Disorders in Elderly Suicide,” International Psychogeriatrics, 7 (1995): 275–286; Y. Conwell, P. R. Duberstein, C. Cox, et al., “Relationships of Age and Axis I Diagnoses in Victims of Completed Suicide: A Psychological Autopsy Study,” American Journal of Psychiatry, 153 (1996): 1001–1008; Gary J. Kennedy, ed., Suicide and Depression in Late Life (New York: John Wiley, 1996); H. Hendin, “Suicide, Assisted Suicide, and Medical Illness,” Journal of Clinical Psychiatry 60 (Suppl. 2) (1999): 46–50.

  38 physician-assisted suicide: For thoughtful but opposing discussions of the subject, see H. Hendin, Seduced by Death: Doctors, Patients and the Dutch Cure (New York: W. W. Norton, 1997), and C. F. McKhann, A Time to Die: The Place for Physician Assistance (New Haven: Yale University Press, 1999).

  39 Suicide in the young: R. N. Anderson, K. D. Kochanek, and S. L. Murphy, “Advance Report of Final Mortality Statistics, 1995,” Monthly Vital Statistics Report, 45 (11) (Suppl. 2) (Hyattsville, Md.: National Center for Health Statistics, 1997), DHHS Publication No. (PHS) 97–1120.

  40 The 1995 National College: Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, “Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey—United States, 1995,” Morbidity and Mortality Weekly Report, 46 (1997): No. SS-6.

  41 One in five high school students: “Youth Risk Behavior Surveillance—United States, 1997,” Morbidity and Mortality Weekly Report, 47 (1997): No. SS-3.

  42 the same as those reported for high school students: L. Kann, C. W. Warren, W. A. Harris, J. L. Collins, B. I. Williams, J. G. Ross, and L. J. Kolbe, “Youth Risk Behavior Surveillance—United States, 1995,” Morbidity and Mortality Weekly Report, 45 (1996): No. SS-4; L. Kann, C. W. Warren, W. A. Harris, J. L. Collins, K. A. Douglas, M. E. Collins, B. I. Williams, J. G. Ross, and L. J. Kolbe, “Youth Risk Behavior Surveillance—United States, 1993,” Morbidity and Mortality Weekly Report, 44 (1995): No. SS-1.

  43 Data for graph: For Vietnam War deaths: United States Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, July 1998. For HIV deaths and suicide: R. N. Anderson, K. D. Kochanek, and S. L. Murphy, “Report of Final Mortality Statistics, 1995,” Monthly Vital Statistics Report, 45 (11, Suppl. 2) (Hyattsville, Md.: National Center for Health Statistics, 1997); additional statistics compiled by Dr. Alex Crosby, Centers for Disease Control and Prevention, Atlanta, Ga.; Ken Kochanek, M.A., Centers for Disease Control and Prevention (National Center for Health Statistics, Hyattsville, Md.); Dr. Harry Rosenberg, also at the National Center for Health Statistics.

  44 Thirty thousand Americans: L. F. McCraig and B. J. Strussman, “National Hospital Ambulatory Care Survey: 1996. Emergency Department Summary Advance Data from Vital and Health Statistics,” no. 293 (Hyattsville, Md.: National Center for Health Statistics, 1997).

  45 “There is … in this humour”: Robert Burton, The Anatomy of Melancholy, vol. 1 (London: J. M. Dent, 1932), pp. 431–432.

  2 • TO MEASURE THE HEART’S TURBULENCE

  1 “to discover the elusive boundaries”: Henry Romilly Fedden, Suicide: A Social and Historical Study (London: Peter Davies, 1938), p. 9.

  2 The early Greeks: D. Daube, “The Linguistics of Suicide,” Suicide and Life-Threatening Behavior, 7 (1977): 132–182.

  3 Centuries of books: John Donne, Biathanatos (New York: Garland, 1982; first published 1647); David Hume, Of Suicide (1784, posthumous), in A. Macintyre, ed., Hume’s Ethical Writings (New York: Macmillan, 1956); Emile Durkheim, Suicide: A Study in Sociology (New York: Free Press, 1951; first published 1897); Albert Camus, The Myth of Sisyphus and Other Essays (New York: Alfred A. Knopf, 1955); J. D. Douglas, The Social Meanings of Suicide (Princeton, N.J.: Princeton University Press, 1967); Jacques Choron, Suicide (New York: Scribners, 1972); M. P. Battin and D. J. Mays, eds., Suicide: The Philosophical Issues (New York: St. Martin’s Press, 1980); R. Maris, Pathways to Suicide (Baltimore: Johns Hopkins University Press, 1981); Edwin Shneidman, Definition of Suicide (New York: John Wiley, 1985); Gavin J. Fairbairn, Contemplating Suicide: The Language and Ethics of Self Harm (London: Routledge, 1995).

  4 All suicide classification: A. T. Beck, J. H. Davis, C. J. Frederick, S. Perlin, A. D. Pokorny, R. E. Schulman, R. H. Seiden, and B. J. Wittlin, “Classification and Nomenclature,” in H. L. P. Resnick and B. C. Hathorne, eds., Suicide Prevention in the Seventies (Washington, D.C.: U.S. Government Printing Office, 1973), pp. 7–12; T. E. Ellis, “Classification of Suicidal Behavior: A Review and Step Toward Integration,” Suicide and Life-Threatening Behavior, 18 (1988): 358–371

  5 Suicide is defined: M. L. Rosenberg, L. E. Davidson, J. C. Smith, A. L. Berman, H. Buzbee, G. Ganter, G. A. Gay, B. Moore-Lewis, D. H. Mills, D. Murray, P. W. O’Carroll, and D. Jobes, “Operational Criteria for the Determination of Suicide,” Journal of Forensic Sciences, 32 (1988): 1445–1455; P. W. O’Carroll, A. L. Berman, R. W. Maris, E. K. Moscicki, B. L. Tanney, and M. M. Silverman, “Beyond the Tower of Babel: A Nomenclature for Suicide,” Suicide and Life-Threatening Behavior, 26 (1996): 237–252.

  6 The World Health Organization: World Health Organization, Prevention of Suicide, Public Health Paper No. 35 (Geneva: World Health Organization, 1968).

  7 Legal and financial issues: S. W. Abbott, “Death Certification,” Albert H. Buck, ed., Reference Handbook of the Medical Sciences, (New York: William Wood, (1901); Edwin S. Shneidman, Deaths of Man (New York: Quadrangle, 1973); D. Jacobs and M. Klein-Benheim, “The Psychological Autopsy: A Useful Tool for Determining Proximate Causation in Suicide Cases,” Bulletin of the American Academy of Psychiatry and Law, 23 (1995): 165–182.

  8 Earlier estimates suggested: L. Dublin, Suicide (New York: Ronald Press, 1963); National Center for Health Statistics, Suicide in the United States, 1950–1964; United States Public Health Service Publication No. 1000, Series 20:1, Rockville, Md., 1967; J. M. Toolan, “Suicide in Children and Adolescents,” American Journal of Psychotherapy, 29 (1975): 339–344; R. E. Litman, “Psychological Aspects of Suicide,” in W. J. Curran, A. L. McGarry, and C. S. Petty, eds., Modern Legal Medicine: Psychiatry and Forensic Science (Philadelphia: F. A. Davis, 1980); D. A. Jobes and A. L. Berman, “Response Biases and the Impact of Psychological Autopsies on Medical Examiners’ Determination of Mode of Death,” paper presented to the 17th Meeting of the American Association of Suicidology, Anchorage, Alaska, 1984.

  9 more recent studies indicate: A. B. Ford, N. B. Rushforth, N. Rushforth, C. S. Hirsch, and L. Adelson, “Violent Death in a Metropolitan County: II. Changing Patterns in Suicides (1959–1974),” American Journal of Public Health, 69 (1979): 459–464; D. A. Brent, J. A. Perper, and C. J. Allman, “Alcohol, Firearms, and Suicide Among the Young,” Journal of the American Medical Association, 257 (1987): 3369–3372; G. Kleck, “Miscounting Suicides,” Suicide and Life-Threatening Behavior, 18 (1988): 219–236; E. K. Moscicki, “Epidemiology of Suicidal Behavior,” Suicide and Life-Threatening Behavior, 25 (1995): 22–35; A. Ohberg and J. Lönnqvist, “Suicides Hidden Among Undetermined Deaths,” Acta Psychiatrica Scandinavi
ca, 98 (1998): 214–218.

  10 The evidence may be explicit: D. A. Jobes, A. L. Berman, and A. R. Josselson, “Improving the Validity and Reliability of Medical-Legal Certifications of Suicide,” Suicide and Life-Threatening Behavior, 17 (1987): 310–325, p. 323.

  11 In Canadian studies: G. K. Jarvis and H. C. Northcott, “Religion and Differences in Mortality and Morbidity,” Social Science and Medicine, 25 (1987): 813–824; G. K. Jarvis, M. Boldt, and J. Butt, “Medical Examiners and Manner of Death,” Suicide and Life-Threatening Behavior, 21 (1991): 115–133.

  12 In one investigation, Danish coroners: M. W. Atkinson, N. Kessel, and J. B. Dalgaard, “The Comparability of Suicide Rates,” British Journal of Psychiatry, 127 (1975): 247–256.

  13 Coroners and medical examiners: B. Walsh, D. Walsh, and B. Whelan, “Suicide in Dublin: II. The Influence of Some Social and Medical Factors on Coroners’ Verdicts,” British Journal of Psychiatry, 126 (1975): 309–312; J. Maxwell Atkinson, Discovering Suicide: Studies in the Social Organization of Sudden Death (Pittsburgh: University of Pittsburgh Press, 1978); M. C. Bradley, “Changing Patterns of Suicide in Leeds, 1979 to 1985,” Medical Science Law, 27 (1987): 201–206; M. Speechley and K. M. Stavraky, “The Adequacy of Suicide Statistics for Use in Epidemiology and Public Health,” Canadian Journal of Public Health, 82 (1991): 38–42.

  14 Indeed, most drownings: T. T. Noguchi, Coroner (New York: Simon and Schuster, 1983); A. L. Berman, “Forensic Suicidology and the Psychological Autopsy,” A. A. Leenaars, ed., in Suicidology: Essays in Honor of Edwin S. Shneidman (Northvale, N.J.: Jason Aronson, 1993), pp. 248–266.

  15 “For just as it is difficult”: J. Maxwell Atkinson, Discovering Suicide: Studies in the Social Organization of Sudden Death (Pittsburgh: University of Pittsburgh Press, 1978), pp. 124–125.

  16 Deaths in single-car accidents: D. P. Phillips and T. E. Ruth, “Adequacy of Official Suicide Statistics for Scientific Research and Public Policy,” Suicide and Life-Threatening Behavior, 23 (1993): 307–319; A. Ohberg, A Penttila, and J. Lönnqvist, “Driver Suicides,” British Journal of Psychiatry, 171 (1997): 468–472.