6 “I know a hundred ways to die”: Edna St. Vincent Millay, Collected Poems, ed. Norma Millay (New York: Harper & Row, 1956), p. 264.
7 called his servant: Forbes Winslow, The Anatomy of Suicide (London: H. Renshaw, 1840; reprinted by Longwood Press, Boston, 1978), p. 298.
8 drinking boiling water: J. P. Gray, “Suicide,” American Journal of Insanity, 35 (1878): 37–73, p. 66.
9 One of Karl Menninger’s patients: K. A. Menninger, “Psychoanalytic Aspects of Suicide,” International Journal of Psychoanalysis, 14 (1933): 376–390.
10 “four spoons, three knives”: Henry Romilly Fedden, Suicide: A Social and Historical Study (London: Peter Davies, 1938), p. 305.
11 there have been several reports: R. J. Frances, T. Wikstrom, and V. Alcena, “Contracting AIDS as a Means of Committing Suicide,” American Journal of Psychiatry, 142 (1985): 656; D. K. Flavin, J. E. Franklin, and R. J. Frances, “The Acquired Immune Deficiency Syndrome (AIDS) and Suicidal Behavior in Alcohol-Dependent Homosexual Men,” American Journal of Psychiatry, 143 (1986): 1440–1442.
12 This baffling endgame: A. Feuer, “Drawing a Bead on a Baffling Endgame: Suicide by Cop,” New York Times, June 21, 1998.
13 “The cuckolded householder”: Thomas Lynch, The Undertaking: Life Studies from the Dismal Trade (London: Jonathan Cape, 1997), p. 173.
14 Anton van Hooff: A. van Hooff, From Autothanasia to Suicide: Self-Killing in Classical Antiquity (London: Routledge, 1990).
15 “To die were best”: Euripides, “Helena,” ll. 298–303.
16 By the late nineteenth century: E. Morselli, Suicide: An Essay on Comparative Moral Statistics (London: Kegan Paul, 1881): E. Durkheim, Suicide: A Study in Sociology, trans. J. A. Spaulding and G. Simpson (New York: Free Press, 1951; first published 1897).
17 “The calm, / Cool face”: Langston Hughes, “Suicide’s Note,” in A. Rampersad and D. Roessel, eds., The Collected Poems of Langston Hughes (New York: Alfred A. Knopf, 1994), p. 55.
18 “Thus,” wrote sociologist: Durkheim, Suicide: A Study in Sociology, p. 290.
19 “Even away from their own country”: Morselli, Suicide: An Essay on Comparative Moral Statistics, p. 327.
20 English, Scottish, and Irish immigrants: P. Burvill, M. McCall, T. Woodings, and N. Stenhouse, “Comparison of Suicide Rates and Methods in English, Scots and Irish Immigrants in Australia,” Social Science and Medicine, 17 (1983): 705–708.
21 In Belgium, for example: G. F. G. Moens, M. J. M. Loysch, and H. van de Voorde, “The Geographical Pattern of Methods of Suicide in Belgium: Implications for Prevention,” Acta Psychiatrica Scandinavica, 77 (1988): 320–327.
22 Poisoning and hanging: R. Desjarlais, L. Eisenberg, B. Good, and A. Kleinman, World Mental Health: Problems and Priorities in Low-Income Countries (New York: Oxford University Press, 1995).
23 a study of suicide methods: D. Lester, “Changes in the Methods Used for Suicide in 16 Countries from 1960 to 1980,” Acta Psychiatrica Scandinavica, 81 (1990): 260–261.
24 “The first thing I considered”: Quoted by M. Iga, The Thorn in the Chrysanthemum: Suicide and Economic Success in Modern Japan (Berkeley and Los Angeles: University of California Press, 1986), pp. 82–83.
25 Freud conjectured: S. Freud, “The Psychogenesis of a Case of Homosexuality in a Woman,” The Standard Edition of the Complete Psychological Works, trans. and ed. J. Strachey (London: Hogarth Press, 1955), vol. 18, pp. 147–172.
26 Personality traits: D. Lester, “Factors Affecting Choice of Method for Suicide,” Journal of Clinical Psychology, 26 (1970): 437; D. Lester, “Personality Correlates Associated with Choice of Method for Suicide,” Personality, 1 (1970): 261–264; D. Lester, “Choice of Method for Suicide and Personality: A Study of Suicide Notes,” Omega, 2 (1971): 76–80; N. Lukianowicz, “Suicidal Behavior,” Psychiatrica Clinica, 7 (1974): 159–171; K. Noreik, “Attempted Suicide and Suicide in Functional Psychoses,” Acta Psychiatrica Scandinavica, 52 (1975): 81–106; D. Lester and A. T. Beck, “What the Suicide’s Choice of Method Signifies,” Omega, 113 (1980–81): 271–277; D. Lester, “Excitor-Inhibitor Scales of the MMPI and Choice of Method for Suicide,” Perceptual and Motor Skills, 66 (1988): 218; D. Lester, “Determinants of Choice of Method for Suicide and the Person/Situation Debate in Psychology,” Perceptual and Motor Skills, 85 (1997): 497–498.
27 The availability of the method: M. Tousignant and B. L. Mishara, “Suicide and Culture: A Review of the Literature (1979–1980),” Transcultural Psychiatric Research Review, 18 (1981): 5–32; J. R. Bowles, “Suicide and Attempted Suicide in Contemporary Western Samoa,” in F. X. Hezel, D. H. Rubinstein, and G. H. White, eds., Culture, Youth and Suicide in the Pacific: Papers from an East-West Center Conference (Honolulu: East-West Center, 1985), pp. 15–35; L. R. Berger, “Suicides and Pesticides in Sri Lanka,” American Journal of Public Health, 78 (1988): 826–828; W. H. Lo and T. M. Leung, “Suicide in Hong Kong,” Australian and New Zealand Journal of Psychiatry, 19 (1985): 287–292; K. T. Hau, “Suicide in Hong Kong 1971–1990: Age Trend, Sex Ratio, and Method of Suicide,” Social Psychiatry and Psychiatric Epidemiology, 28 (1993): 23–27; D. Lester, “Suicide by Jumping in Singapore as a Function of High-Rise Apartment Availability,” Perceptual and Motor Skills, 79 (1994): 74; R. Desjarlais, L. Eisenberg, B. Good, and A. Kleinman, World Mental Health: Problems and Priorities in Low-Income Countries (New York: Oxford University Press, 1995).
28 potentially lethal medications: D. Jacobsen, K. Frederichsen, K. M. Knutsen, Y. Sorum, T. Talseth, and O. R. Odegaard, “A Prospective Study of 1212 Cases of Acute Poisoning: General Epidemiology,” Human Toxicology, 3 (1984): 93–106; E. Isometsä, M. Henriksson, and J. Lönnqvist, “Completed Suicide and Recent Lithium Treatment,” Journal of Affective Disorders, 26 (1992): 101–104; D. Waddington and I. P. McKenzie, “Overdose Rates in Lithium-Treated Versus Antidepressant-Treated Outpatients,” Acta Psychiatrica Scandinavica, 90 (1994): 50–52.
29 Forensic pathologists, for example: C. E. Rhyne, D. I. Templer, L. G. Brown, and N. B. Peters, “Dimensions of Suicide: Perceptions of Lethality, Time, and Agony,” Suicide and Life-Threatening Behavior, 25 (1995): 373–380.
30 American adolescents: H. E. Harris and W. C. Myers, “Adolescents’ Misconceptions of the Dangerousness of Acetaminophen in Overdose,” Suicide and Life-Threatening Behavior, 27 (1997): 274–277.
31 One study conducted in the 1970s: A. Marks, “Sex Differences and Their Effect upon Cultural Evaluations of Methods of Self-Destruction,” Omega, 8 (1977): 65–70.
32 Fear of disfigurement: D. Lester, “Why Do People Choose Particular Methods for Suicide?” Activitas Nervosa Superior, 30 (1988): 312–314.
33 Age also plays a role: K. Hawton, M. Osborn. J. O’Grady, et al. “Classification of Adolescents Who Take Overdoses,” British Journal of Psychiatry, 140 (1982): 124–131; D. A. Brent, “Correlates of Medical Lethality of Suicide Attempts in Children and Adolescents,” Journal of the American Academy of Child Psychiatry, 26 (1987): 87–89; M. L. Rosenberg, J. C. Smith, L. E. Davidson, and J. M. Conn, “The Emergence of Youth Suicide: An Epidemiologic Analysis and Public Health Perspective,” Annual Review of Public Health, 8 (1987): 417–440; H. M. Hoberman and B. D. Garfinkel, “Completed Suicide in Youth,” Canadian Journal of Psychiatry, 33 (1988): 494–504; I. O’Donnell and R. D. T. Farmer, “Suicidal Acts on Metro Systems: An International Perspective,” Acta Psychiatrica Scandinavica, 86 (1992): 60–63; J. L. McIntosh, “Methods of Suicide,” in R. W. Maris, A. L. Berman, J. T. Maltsberger, and R. I. Yufit, eds., Assessment and Prediction of Suicide (New York: Guilford Press, 1992), pp. 381–397; Centers for Disease Control, “Suicide Among Children, Adolescents, and Young Adults—United States, 1980–1992,” Journal of the American Medical Association, 274 (1995): 451–452; D. De Leo, D. Conforti, and G. Carollo, “A Century of Suicide in Italy: A Comparison Between the Old and the Young,” Suicide and Life-Threatening Behavior, 27 (1997): 239–249.
34 The type and degree: H. Hendin, “The Psychodynam
ics of Suicide,” Journal of Nervous and Mental Disease, 136 (1963): 236–244; F. G. Guggenheim and A. D. Weisman, “Suicide in the Subway: Publicly Witnessed Attempts of 50 Cases,” Journal of Nervous and Mental Disease, 155 (1972): 404–409; K. Lindekilde and A. G. Wang, “Train Suicide in the County of Fyn 1979–1982,” Acta Psychiatrica Scandinavica, 72 (1985): 150–154; R. L. Symonds, “Psychiatric Aspects of Railway Fatalities,” Psychological Medicine, 15 (1985): 609–621; R. Jacobson, M. Jackson, and M. Berelowitz, “Self-Incineration: A Controlled Comparison of Inpatient Suicide Attempts. Clinical Features and History of Self-Harm,” Psychological Medicine, 16 (1986): 107–116; M. J. Shkrum and K. A. Johnston, “Fire and Suicide: A Three Year Study of Self-Immolation Deaths,” Journal of Forensic Sciences, 37 (1992): 208–221. 142 “sometimes noble and weighty”: Morselli, Suicide: An Essay on Comparative Moral Statistics, p. 352.
35 “psychological constellation”: L. I. Dublin, Suicide: A Sociological and Statistical Study (New York: Ronald Press, 1963).
36 read a newspaper report: S. J. Surtees, D. C. Taylor, and R. W. Cooper, “Suicide and Accidental Death at Beachy Head,” Eastbourne Medical Gazette, 2 (1976): 22–24; S. J. Surtees, “Suicide and Accidental Death at Beachy Head,” British Medical Journal, 284 (1982): 321–324.
37 Publicity given to particular ways: D. J. Pounder, “Suicide by Leaping from Multistorey Car Parks,” Medical Science and Law, 25 (1985): 179–188; R. H. Haynes, “Suicide in Fiji: A Preliminary Study,” British Journal of Psychiatry, 145 (1984): 433–438; M. Pinguet, Voluntary Death in Japan, trans. R. Morris (Cambridge, England: Polity Press, 1993); D. J. Somasundaram and S. Rajadurai, “War and Suicide in Northern Sri Lanka,” Acta Psychiatrica Scandinavica, 91 (1995): 1–4.
38 publication of Final Exit: P. M. Marzuk, K. Tardiff, C. S. Hirsch, A. C. Leon, M. Stajic, N. Hartwell, and L. Portera, “Increase in Suicide by Asphyxiation in New York City After the Publication of Final Exit,” New England Journal of Medicine, 329 (1993): 1508–1510; P. M. Marzuk, K. Tardiff, and A. C. Leon, “Increase in Fatal Suicidal Poisonings and Suffocations in the Year Final Exit Was Published: A National Study,” American Journal of Psychiatry, 151 (1994): 1813–1814.
39 “In a free society”: J. R. Ashton and S. Donnan, “Suicide by Burning as an Epidemic Phenomenon: An Analysis of 82 Deaths and Inquests in England and Wales in 1978–9,” Psychological Medicine, 11 (1981): 735–739.
40 an almost mythic belief: Y. Takahashi, “Aokigahara-jukai: Suicide and Amnesia in Mt. Fuji’s Black Forest,” Suicide and Life-Threatening Behavior, 18 (1988): 164–175.
41 “The suicide epidemic”: E. R. Ellis and G. N. Allen, Traitor Within: Our Suicide Problem (New York: Doubleday, 1961), pp. 98–99.
42 a language and mythology soon grew up: R. H. Seiden and M. C. Spence, “A Tale of Two Bridges: Comparative Suicide Incidence on the Golden Gate and San Francisco–Oakland Bay Bridges,” Crisis, 2 (1982): 32–40.
43 the trauma rips: M. Lafave, A. J. LaPorta, J. Hutton, and P. L. Mallory, “History of High-Velocity Impact Water Trauma at Letterman Army Medical Center: A 54-Year Experience with the Golden Gate Bridge,” Military Medicine, 160 (1995): 197–199.
44 “There is a kind of form to it”: D. H. Rosen, “Suicide Survivors: A Followup of Persons Who Survived Jumping from the Golden Gate and San Francisco–Oakland Bay Bridges,” Western Journal of Medicine, 122 (1975): 289–294, p. 292.
45 “Why do you make it so easy?”: Quoted in G. H. Colt, The Enigma of Suicide (New York: Summit, 1991), p. 334.
46 an idea resisted: P. Fimrite, “Anti-Suicide Fence Sample on Display,” San Francisco Chronicle, 10 June 1998.
47 Five to 10 percent: E. Robins, G. E. Murphy, R. H. Wilkinson, S. Gassner, and J. Kayes, “Some Clinical Considerations in the Prevention of Suicide Based on a Study of 134 Successful Suicides,” American Journal of Public Health, 49 (1959): 888–899; K. A. Achté, A. Stenbäck, and H. Teräväinen, “On Suicides Committed During Treatment in Psychiatric Hospitals,” Acta Psychiatrica Scandinavica, 42 (1969): 272–284; R. Hessö, “Suicide in Norwegian, Finnish, and Swedish Psychiatric Hospitals,” Archives of Psychiatry and Neurological Sciences, 224 (1977): 119–127; J. L. Crammer, “The Special Characteristics of Suicide in Hospital Inpatients,” British Journal of Psychiatry, 145 (1984): 460–476; U. B. Sunqvist-Stensman, “Suicides in Close Connection with Psychiatric Care: An Analysis of 57 Cases in a Swedish County,” Acta Psychiatrica Scandinavica, 76 (1987): 15–20; M. Wolfersdorf, F. Keller, P.-O. Schmidt-Michel, C. Weiskittel, R. Vogel, and G. Hole, “Are Hospital Suicides on the Increase?,” Social Psychiatry and Psychiatric Epidemiology, 23 (1988): 207–216; E. C. Harris and B. Barraclough, “Suicide as an Outcome for Mental Disorders: A Meta-Analysis,” British Journal of Psychiatry, 170 (1997): 205–228.
48 “Only too often the patients”: E. Kraepelin, Manic-Depressive Insanity and Paranoia, trans. R. M. Barclay, ed. G. M. Robertson (New York: Arno Press, 1976; first published 1921), p. 88.
49 twisted cords around the neck: G. R. Jameison and J. H. Wall, “Some Psychiatric Aspects of Suicide,” Psychiatric Quarterly, 7 (1933): 211–229.
50 “A maid in a green uniform”: S. Plath, The Bell Jar (New York: Harper & Row, 1971), p. 153.
51 Hanging and jumping are by far: K. A. Achté, A. Stenbäck, and H. Terä-väinen, “On Suicides Committed During Treatment in Psychiatric Hospitals,” Acta Psychiatrica Scandinavica, 42 (1969): 272–284; N. L. Farberow, S. Ganzler, F. Cutter, and D. Reynolds, “An Eight-Year Survey of Hospital Suicides,” Life-Threatening Behavior, 1 (1971): 184–202; A. R. Beisser and J. E. Blanchette, “A Study of Suicides in a Mental Hospital,” Diseases of the Nervous System, 22 (1961): 365–369; A. K. Shah and T. Ganesvaran, “Inpatient Suicides in an Australian Mental Hospital,” Australian and New Zealand Journal of Psychiatry, 31 (1997): 291–298; K. A. Busch, D. C. Clark, J. Fawcett, and H. M. Kravitz, “Clinical Features of Inpatient Suicide,” Psychiatric Annals, 23 (1993): 256–262; F. Proulx, A. D. Lesage, and F. Grunberg, “One Hundred Inpatient Suicides,” British Journal of Psychiatry, 171 (1997): 247–250; V. Sharma, E. Persad, and K. Kueneman, “A Closer Look at Inpatient Suicide,” Journal of Affective Disorders, 47 (1998): 123–129.
52 Jan Fawcett and Katie Busch: personal communication with Dr. Jan Fawcett, Rush–Presbyterian–St. Luke’s Medical Center, Chicago, May 1998.
53 Research indicates: H. G. Morgan, Death Wishes? The Assessment and Management of Deliberate Self-Harm (New York: Wiley, 1979); P. H. Salmons, “Suicide in High Buildings,” British Journal of Psychiatry, 145 (1984): 469–472; H. G. Morgan and P. Priest, “Suicide and Other Unexpected Deaths Among Psychiatric Inpatients,” British Journal of Psychiatry, 158 (1991): 368–374; J. A. Dennehey, L. Appleby, C. S. Thomas, et al., “Case Control Study of Suicides by Discharged Psychiatric Patients,” British Medical Journal, 312 (1996): 1580; K. A. Busch, D. C. Clark, J. Fawcett, and H. M. Kravitz, “Clinical Features of Inpatient Suicide,” Psychiatric Annals, 23 (1993): 256–262; H. G. Morgan and R. Stanton, “Suicide Among Psychiatric Inpatients in a Changing Clinical Scene,” British Journal of Psychiatry, 171 (1997): 561–563; V. Sharma, E. Persad, and K. Kueneman, “A Closer Look at Inpatient Suicide,” Journal of Affective Disorders, 47 (1998) 123–129.
ESSAY • THE LION ENCLOSURE
1 “The Woman at the Washington Zoo”: Randall Jarrell (1914–1965) wrote this poem while living in Washington, D.C., in the 1950s. He and his wife frequently visited the zoo, and he drove past it almost every day on his way through Rock Creek Park to his job at the Library of Congress. Jarrell, when asked about the central character in “The Woman at the Washington Zoo,” described her as having a despair “beyond expression … inside the mechanical official cage of her life, her body, she lives invisibly; no one feeds this animal, reads out its name, pokes a stick through the bars at it—the cage is empty … she has become her own cage” (“The Woman at the Washington Zoo,” pp. 319–327, reprinted in Randall Jarrell, Kipling, Auden & Co.: Essays and Reviews: 1935�
��1964 [New York: Farrar, Straus and Giroux, 1980], pp. 324–325). Jarrell received the National Book Award for his collection of poems The Woman at the Washington Zoo. In 1965, after being hospitalized for manic-depressive illness and an attempted suicide, Jarrell was killed by an oncoming car at night. The circumstances of his death provoked considerable debate about whether it had been an accident or suicide. (J. Meyers, “The Death of Randall Jarrell,” The Virginia Quarterly Review, Summer 1982, pp. 450–467; Randall Jarrell’s Letters, ed. Mary Jarrell [Boston: Houghton Mifflin, 1985]; W. H. Pritchard, Randall Jarrell: A Literary Life [New York: Farrar, Straus and Giroux, 1990]; K. R. Jamison, Touched with Fire: Manic-Depressive Illness and the Artistic Temperament [New York: Free Press, 1993]).
2 instinct would dictate: George B. Schaller, The Serengeti Lion: A Study of Predator-Prey Relations (Chicago: University of Chicago Press, 1972).
3 The Washington Post: The Washington Post published five news stories about the death of Margaret Davis King, March 6–10, 1995, and the Arkansas Democrat-Gazette published articles on March 7, 8, and 10, 1995.
4 “Suddenly,” wrote journalist: Phil McCombs, “In the Lair of the Urban Lion,” Washington Post, March 7, 1995.
5 We have released: W. R. Breakey, P. J. Fischer, M. Kramer, et al., “Health and Mental Health Problems of Homeless Men and Women in Baltimore,” Journal of the American Medical Association, 10 (1989): 1352–1357; E. Susser, R. Moore, and B. Link, “Risk Factors for Homelessness,” American Journal of Epidemiology 15 (1993): 546–556; T. K. J. Craig and P. W. Timms, “Homelessness and Schizophrenia,” in S. R. Hirsch and D. R. Weinberger, eds., Schizophrenia (Oxford: Blackwell Science, 1995), pp. 664–684.
6 They die younger: C. H. Alstrom, R. Lindelius, and I. Salum, “Mortality Among Homeless Men,” British Journal of Addiction, 70 (1975): 245–252; Centers for Disease Control, “Deaths Among the Homeless,” Mortality and Morbidity Weekly Report, 36 (1987): 297–299; Centers for Disease Control, “Deaths Among Homeless Persons—San Francisco, 1985–1990,” Mortality and Morbidity Weekly Report, 40 (1991): 877–880; J. R. Hibbs, L. Benner, L. Klugman, R. Spencer, I. Macchia, A. K. Mellinger, and D. Fife, “Mortality in a Cohort of Homeless Adults in Philadelphia,” New England Journal of Medicine 331 (1994): 304–309. 158 In a 1986 editorial: R. J. Wyatt and E. G. De Renzo, “Scienceless to Homeless,” Science, 234 (1986): 1309.
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