November of the Soul
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436 “Sentimental prejudice”: Humphry and Wickett, Right to Die, 14–15.
436 “If a chronically sick man”: E. Slater, “Choosing the Time to Die,” in Battin and Mayo, Suicide, 202.
436 “a slobbering wreck”: Marker, Deadly Compassion, 97.
436 her sixteen-year-old cat: K. L. Lyle, Newsweek, March 2, 1992, as described in E. Newman, “Ethical Issues in Terminal Health Care, Part Three: Local Perspectives on the Right-to-Die Debate,” www.cp.duluth.mn.us.
436 “there can be no possibility”: M. R. Barrington, “Apologia for Suicide,” in Downing, Euthanasia, 159.
436 “These type of statistics”: Humphry, Good Euthanasia Guide 2005, 27.
437 “including the depressed”: National Review Online, www.nationalreview.com/interrogatory.
437 “It is realistic”: Seiden, “Self-Deliverance or Self-Destruction?” 10.
437 “At best, the living old”: Butler, Why Survive?, xi.
437 “Many elders suffer”: J. Levin and A. Arluke, “Our Elderly’s Fate?” New York Times, September 29, 1983, 27.
437 the suicide rate of elderly Americans: For an excellent overview of elderly suicide, see Conwell, “Suicide in Later Life.”
438 50 percent of elderly suicides: Barraclough, “Suicide in the Elderly.”
438 “In general, where the ‘geriatric case’”: Wrobleski, Afterwords, January 1985, 2.
439 “Since the elderly depressed”: Los Angeles Times, November 13, 1984.
439 elderly nursing home patients: New York Times, July 16, 1982.
440 “The discovery and cure”: Humphry and Clement, Freedom to Die, 58.
440 1,177 physicians: Foley and Hendin, Case Against Assisted Suicide, 298.
440 40 to 80 percent: Humphry and Clement, Freedom to Die, 55.
440 9,000 terminally ill patients: W. A. Knaus et al., “A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients,” Journal of the American Medical Association 274 (1995): 1591–98.
440 897 physicians: J. H. Von Roenn et al., “Physician Attitudes and Practice in Cancer Pain Management: A Survey from the Eastern Cooperative Oncology Group,” Annals of Internal Medicine 119 (1993): 121–26.
440 90 patients: Webb, Good Death, 120–22.
441 survey of oncologists: E. J. Emanuel, “Report of the ASCO Membership Survey on End of Life Care,” Proceedings of the American Society of Clinical Oncology 17 (Alexandria, Va.: 1998). Cited in K. Foley and H. Hendin, “Changing the Culture,” in Foley and Hendin, Case Against Assisted Suicide, 315.
441 “Physicians who unwisely prolong”: Ibid.
441 the less physicians know: R. K. Portenoy et al., “Determinants of the Willingness to Endorse Assisted Suicide: A Survey of Physicians, Nurses, and Social Workers,” Psychosomatics 38 (1997): 277–87.
441 “You don’t have to kill”: Quoted on “Rational Suicide?” 60 Minutes.
441 change their mind: Z. Zylicz, “Palliative Care and Euthanasia in the Netherlands: Observations of a Dutch Physician,” in Foley and Hendin, Case Against Assisted Suicide, 122–43.
441 “If all the care”: C. Saunders, “Dying They Live: St. Christopher’s Hospice,” in H. Feifel New Meanings of Death (New York: McGraw-Hill, 1977), 159.
442 “are no more mutually exclusive”: M. Angell, “The Quality of Mercy,” in Quill and Battin, Physician-Assisted Dying, 23.
442 “not only compatible” and “the highest rate”: T. E. Quill and M. P. Battin, “Excellent Palliative Care as the Standard, Physician-Assisted Dying as a Last Resort,” in Quill and Battin, Physician-Assisted Dying, 329.
442 “Where we proponents”: M. P. Battin and T. E. Quill, “False Dichotomy versus Genuine Choice: The Argument over Physician-Assisted Dying,” in Quill and Battin, Physician-Assisted Dying, 2.
442 “Often people ask”: N. Speijer, “The Attitude of Dutch Society Toward the Phenomenon of Suicide,” in Farberow, Suicide in Different Cultures, 164.
443 “When an older woman leaves”: Portwood, Common-Sense Suicide, 17–18.
443 for the Holy Stone: R. Gillon, “Suicide and Voluntary Euthanasia: Historical Perspective,” in Downing, Euthanasia, 182
444 “What we want”: G. B. Rolfe, “The Right to Die,” North American Review 157 (6) (1893): 758.
445 “In a rational state”: Ibid.
445 “Robert Lowell once remarked”: Alvarez, Savage God, 130.
445 “People are going to help”: USA Today, May 15, 1985, 8A.
445 “I believe that the classical”: New York Times, April 25, 1983, B8.
445 “I myself believe”: M. P. Battin, “Manipulated Suicide,” in Battin and Mayo, Suicide, 179.
PART 6 Survivors
Chapter I Merryl and Carl
455 “There are always two parties”: A. Toynbee, Man’s Concern with Death (New York: McGraw-Hill, 1969), 267, 271.
Chapter II The Mark of Cain
466 French engraving: Reproduced in J. B. C. I. Delisle de Sales, De la Philosophie de la Nature (London: 1789).
467 “decapitated”: This list is taken partially from a similar list in Cain, Survivors of Suicide, 29.
467 In 1289, it is recorded: Fedden, Suicide, 138.
468 “What punishment”: J. W. Ehrlich, ed., Ehrlich’s Blackstone (Westport, Conn.: Greenwood Press, 1973), 838.
468 the case of Lancelot Johnson: MacDonald, Mystical Bedlam, 137–38.
468 The jury’s verdict: The colonies were more lenient. In 1700, for instance, in his charter to Pennsylvania, William Penn recommended “that if any person, through temptation or melancholy, shall destroy himself, his estate, real and personal, shall, notwithstanding, descend to his wife, children, or relations, as if he had died a natural death.” (S. Yorke, “Is Suicide a Sin?” North American Review, February 1890, 277.)
468 Marc-Antoine Calas: Fedden, Suicide, 231–32.
469 “He plants a dagger”: Gregory, Sermon on Suicide, 12–13.
469 “Stay then, guilty man!”: Miller, Guilt, Folly, and Sources of Suicide, 24–25.
469 “The Sorrow which arises”: Hey, Three Dissertations, 202–3.
470 “With reference to suicide”: Winslow, Anatomy of Suicide, 152.
470 at the Annual Meeting: J. M. S. Wood and A. R. Urquhart, “A Family Tree Illustrative of Insanity and Suicide,” in Cain, Survivors of Suicide, 40–43.
470 George P. Mudge constructed: G. P. Mudge, “The Mendelian Collection of Human Pedigrees: Inheritance of Suicidal Mania,” in Cain, Survivors of Suicide, 44–51.
470 “Many are induced”: Winslow, Anatomy of Suicide, 96–97.
471 “The suicide by his last act”: Strahan, Suicide and Insanity, 90.
471 “in the hope”: Ibid., vi.
471 “But the worst of all”: J. Joyce, Ulysses (New York: Random House, 1961), 96.
471 “Nothing lowered”: Fedden, Suicide, 248.
472 “he placed the mark”: E. Lindemann and I. M. Greer, “A Study of Grief: Emotional Responses to Suicide,” in Cain, Survivors of Suicide, 67.
473 “I believe that the person”: E. S. Shneidman, “Foreword,” in Cain, Survivors of Suicide, x.
473 A 1967 study: Bergson, “Suicide’s Other Victims,” 104.
473 “Given the present stage”: H. L. P. Resnik, “Psychological Resynthesis: A Clinical Approach to the Survivors of a Death by Suicide,” in Cain, Survivors of Suicide, 177.
473 A bibliography of publications: J. L. McIntosh, “Survivors of Suicide: A Comprehensive Bibliography,” Omega 16 (4) (1986): 355–70. Also J. L. McIntosh, “Survivors of Suicide: A Comprehensive Bibliography Update, 1986–1995,” Omega 33 (2) (1996): 147–75.
473 A 2003 conference: “AFSP Releases Report on Survivors of Suicide Research Workshop,” www.afsp.org/survivor/sosworkshop903.
473 “Historically, one of the most”: McIntosh, “Suicide Survivors,” 339.
474 “To the tragic legion”: Styron, Darkness Visible, 33.
475 One study compared: L
. G. Calhoun et al., “Reactions to the Parents of the Child Suicide: A Study of Social Impressions,” Journal of Consulting and Clinical Psychology 48 (1980): 535–36.
475 “Even in the numbness”: Wechsler, In a Darkness, 13.
Chapter III Merryl: The Torture Chamber
483 Carl had left no suicide note: In 1989, nearly seven years after his death, Merryl learned that Carl had left a suicide note. Believing it would do Merryl more harm than good, her parents and in-laws had withheld it from her. Merryl wrote to Carl’s parents, who sent her a photocopy. In the four-line note, which began, “She will get over it.” Carl weighed the “misery” of staying alive against the “control” and “freedom” he would gain by killing himself. “I wish the note had not been kept from me for so long,” says Merryl. “Although reading the note gave me great pain—at seeing Carl’s handwriting, at feeling more acutely his torturous state—the overall feeling was one of relief at having the fuller knowledge and at knowing that I was in Carl’s thoughts at the end.”
Chapter IV The O’er-Fraught Heart
487 “Although mourning involves”: S. Freud, Mourning and Melancholia (1917), in Strachey, Works, 14: 243–44.
487 “Mourning has a quite specific”: S. Freud, Totem and Taboo (1913), in Strachey, Works, 13: 65.
487 A study by the National Academy of Sciences: Osterweis, Solomon, and Green, Bereavement.
488 “There’s a tendency”: Worden, Grief Counseling, 32.
489 “Sooner or later”: Ibid., 14.
489 10 to 15 percent: Ibid., 1.
489 “The first response”: K. Lorenz, On Aggression, trans. M. K. Wilson (New York: Harvest/Harcourt Brace Jovanovich, 1966), 208.
490 “psychic numbing”: R. J. Lifton, Death in Life (New York: Random House, 1967), 86–87.
491 Sheila Weller described: Weller, “Whose Death Was It, Anyway?”
492 “Guilt is a way:” E. Dunne and K. Dunne-Maxim, F. Walsh, and M. McGoldrick, Living Beyond Loss: Death in the Family (New York: W. W. Norton, 2004), 276.
492 “There is an especially”: E. Lindemann and I. M. Greer, “A Study of Grief: Emotional Responses to Suicide,” in Cain, Survivors of Suicide, 66.
492 one in ten: S. Wallace, After Suicide (New York: Wiley, 1973).
492 “Some feel guilty”: A. Pangrazzi, “Suicide: How Christians Can Respond Today,” Catholic Update, July 1984, 3.
494 In his poem “The Portrait”: S. Kunitz, The Poems of Stanley Kunitz, 1928–1978 (Boston and Toronto: Atlantic Monthly Press/Little, Brown, 1979), 86.
495 “I spit upon”: J. Berryman, The Dream Songs (New York: Farrar, Straus and Giroux, 1969), 406.
495 fatally stabbed herself: Giffin and Felsenthal, Cry for Help, 173.
496 “I see now”: Alvarez, Savage God, 258.
496 serve a preventive role: The thought of a suicide’s effect on survivors has long been a restraint on—and occasionally a spur to—potential suicides. Suffering from a bout of chronic catarrh, Seneca, who championed the idea of suicide as man’s ever-available freedom, wrote, “Reduced to a state of complete emaciation, I had arrived at a point were the catarrhal discharges were virtually carrying me away with them altogether. On many an occasion I felt an urge to cut my life short there and then, and was only held back by the thought of my father, who had been the kindest of fathers to me and was then in his old age. Having in mind not how bravely I was capable of dying but how far from bravely he was capable of bearing the loss, I commanded myself to live.” (Battin, Ethical Issues, 78.) On the other hand, many suicidal people are beyond the ability to consider the effect their death might have on friends and family. “Decisions about suicide are not fleeting thoughts that can be willed away in deference to the best interests of others,” writes Kay Jamison, who attempted suicide as a young woman. “Suicide wells up from cumulative anguish or is hastened by impulse; however much it may be set in or set off by the outer world, the suicidal mind tends not to mull on the well-being and future of others. If it does, it conceives for them a brighter future due to the fact that their lives are rid of an ill, depressed, violent, or psychotic presence.” Night Falls Fast, 292.
497 “For children”: Osterweis, Solomon, and Green, Bereavement, 125.
497 Children are even more apt: Many parents mistakenly believe that a child is too young to grieve. “They think, ‘She’s only three—she won’t feel it,’” says Sandra Fox. Until recently, in fact, it was believed that because they cannot comprehend the permanence of death until about age nine, children are unable to mourn. Today, experts say that children begin to sense separation and loss at six months and may be able to grieve by age three. Children of any age express their grief differently from adults, through physical symptoms such as restlessness, colds, and upset stomachs, or through misbehavior, academic problems, and delinquency.
498 forty-five children: A. C. Cain and I. Fast, “Children’s Disturbed Reactions to Parent Suicide: Distortions of Guilt, Communication, and Identification,” in Cain, Survivors of Suicide, 93–111.
498 seventeen patients: T. L. Dorpat, “Psychological Effects of Parental Suicide on Surviving Children,” in Cain, Survivors of Suicide, 121–42.
Chapter VI A Safe Place
523 One survivor organization runs: See Web site at www.1000deaths.com.
524 “I feel so safe”: S. Slepicka, “The Role of Support Groups in the Healing Process of Suicide Survivors” (unpublished paper).
Chapter VIII A Place for What We Lose
531 “We find a place”: Worden, Grief Counseling, 17.
531 “Ah well, slowly but surely”: D. J. Enright, The Oxford Book of Death (Oxford: Oxford University Press, 1983), 113–14.
533 “I want Dick’s death not to be bigger”: Kenyon, “Survivor’s Notes.”
1 Some of these people, or their families, asked that their real names not be used in this book. This is a list of the pseudonyms I have given them. Part 1: Melinda; Dana Evans; Tammy; Lucy. Part 3: Peter, Barbara, Ruth, Sally, Kathy, and Owen Newell; Bill; Anna; David Kinnell; Ellen Parker; Part 5: Fred and Holly Isham. Part 6: Mary, Karen, Linda, and Rose Vitelli; Chris; Rona Marks.
SELECTED BIBLIOGRAPHY
The literature on suicide is massive. These are the books and papers I found most useful or thought-provoking in the preparation of this work.
Books
Ackerman, D. A Slender Thread. New York: Random House, 1997.
Alcohol, Drug Abuse, and Mental Health Administration. Report of the Secretary’s Task Force on Youth Suicide. 4 vols. Washington, D.C.: U.S. Government Printing Office, 1989.
Alvarez, A. The Savage God. New York: Bantam Books, 1973.
Baechler, J. Suicides. Trans. B. Cooper. New York: Basic Books, 1979.
Barnard, C. Good Life/Good Death. Englewood Cliffs, N.J.: Prentice-Hall, 1980.
Battin, M. P. Ethical Issues in Suicide. Englewood Cliffs, N.J.: Prentice-Hall, 1982.
Battin, M. P., and D. J. Mayo, eds. Suicide: The Philosophical Issues. New York: St. Martin’s Press, 1980.
Beam, A. Gracefully Insane. New York: Public Affairs, 2001.
Betzold, M. Appointment with Doctor Death. Troy, Mich.: Momentum Books, 1993.
Bohannan, P., ed. African Homicide and Suicide. New York: Atheneum, 1967.
Bolton, I., with C. Mitchell. My Son . . . My Son . . . Atlanta: Bolton Press, 1983.
Bruller, J. 21 Delightful Ways of Committing Suicide. New York: Covici, Friede, 1930.
Bucknill, J. C., and D. H. Tuke. A Manual of Psychological Medicine. London: John Churchill, 1858.
Buie, D. H., and J. T. Maltsberger. Practical Formulation of Suicide Risk. Cambridge: Firefly Press, 1983.
Burton, R. The Anatomy of Melancholy. New York: Empire State Book Co., 1924.
Butler, R. N. Why Survive? Being Old in America. New York: Harper Colophon Books, 1975.
Cain, A. C., ed. Survivors of Suicide. Springfield, Ill.: Charles C. Thomas, 1972.
Callahan, D. Setting Limits. New
York: Simon and Schuster, 1987.
Cavan, R. S. Suicide. New York: Russell & Russell, 1965.
Choron, J. Death and Western Thought. New York: Collier/Macmillan, 1973.
———. Suicide. New York: Charles Scribner’s Sons, 1972.
Clark, B. Whose Life Is It Anyway? New York: Avon, 1980.
Coleman, L. Suicide Clusters. Boston and London: Faber and Faber, 1987.
Coser, R. L. Training in Ambiguity. New York: Free Press/Macmillan, 1979.
Donne, J. Biathanatos. New York: Arno Press, 1977.
Douglas, J. D. The Social Meanings of Suicide. Princeton: Princeton University Press, 1973.
Downing, A. B., ed. Euthanasia and the Right to Death. Los Angeles: Nash Publishing Company, 1970.
Dublin, L. I. Suicide: A Sociological and Statistical Study. New York: Ronald Press, 1963.
Dublin, L. I., and B. Bunzel. To Be or Not To Be. New York: Harrison Smith and Robert Haas, 1933.
Dunne, E. J., J. L. McIntosh, and K. Dunne-Maxim, eds. Suicide and Its Aftermath. New York: W. W. Norton, 1987.
Durkheim, E. Suicide. Trans. J. A. Spaulding, and G. Simpson. New York: Free Press, 1966.
Ellis, E. R., and G. N. Allen. Traitor Within: Our Suicide Problem. Garden City, N.Y.: Doubleday, 1961.
Evans, G., and N. L. Farberow. The Encyclopedia of Suicide. New York: Facts on File, 1988.
Exit. A Guide to Self-Deliverance. London: Executive Committee of Exit, 1981.
Faber, M. D. Suicide and Greek Tragedy. New York: Sphinx Press, 1970.
Farberow, N. L., ed. The Many Faces of Suicide. New York: McGraw-Hill, 1980.
———. Suicide in Different Cultures. Baltimore: University Park Press, 1975.
———. Taboo Topics. New York: Atherton Press, 1963.
Farberow, N. L., and E. S. Shneidman, eds. The Cry for Help. New York: McGraw-Hill, 1965.
Fedden, H. R. Suicide: A Social and Historical Study. New York: Arno Press, 1980.