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Life & Times

My loss

Ahmeda Ali
British Journal of General Practice 2019; 69 (685): 391. DOI: https://doi.org/10.3399/bjgp19X704789
Ahmeda Ali
Irish College of General Practitioners, Dublin, Ireland. Email:
Roles: GP
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‘May the radiance and beauty of their lives never be defined by their death.’

(Nathalie Himmelrich, 2019, https://nathaliehimmelrich.com)

INTRODUCTION

Suicide. The act of intentionally ending one’s life. The ripple effect. Affects not only the victim, but also affects all — leaving no one unscathed. Suicide does not take away the pain, it gives it to someone else. Does one ever truly get over a suicide loss?

Suicide is a leading cause of death, particularly in young people, both in Ireland and worldwide. An estimated 1 million people die by suicide worldwide each year.1 However, attempted suicides are much more common than actual suicides.2 Approximately 12 000 people attempt suicide each year in Ireland.3

MY JOURNEY

The whirlwind of events started during my journey to work.

I started my daily rituals, the key in the ignition, ready to go — ready even to make a small difference in one person’s life. I methodically hummed a small prayer under my breath — hoping and praying to do no harm. I unapologetically cross my fingers and would cross my toes if I could, knowing deep within that superstitions follow us everywhere.

I continued to drive. I arrived at my practice, started my computer. One of our receptionists rushed into the room, with a frantic expression. ‘Ahmeda, you need to have a look at this.’ She was talking, passing on patient details. The name sounded so familiar, but yet a distant memory.

I was trying to picture the patient and reignite my memory. I felt totally clueless. I had no idea whom she was talking about. She then continued to describe what had happened, and I remember just seeing her mouth move but not hearing what was being said. ‘OK. Don’t worry. I will deal with this.’

I turned and shut the door. Close the door, the easiest way to shut the world out.

In my mind, I registered a ‘lesson’ for myself — never undermine the ways of body language; an artistic writing tool.

I prepared my doctor’s bag, unsure of what I should take to handle the situation. I called through to our practice nurse, hoping she would join me for moral support. She was pregnant, and I felt selfish asking her to join me, but she was more than happy to come and assist. I let out a big sigh of relief. We arrived at the lake, the still water so calm. Rays of sunshine slowly touching the cool water. An eerie sense of peace, of calm. Yellow tape surrounding the tall trees. I ducked under the tape, tightly gripping my pristine dark-brown doctor’s bag.

‘Seventy-eight year old female, found in the lake a few hours ago by her son-in-law.’ The daughter had noticed her mother was missing from her bed around 4 am and they had all gone out to search for her. I assume that this was my patient’s last ever stroll. Her last stroll out to the wilderness, where she did not want to be found. The police had a body bag ready for me and slowly unzipped the plastic bag.

Yes, that was her. That was my patient. Margaret Reilly,* a petite woman whose brown hair, usually so neatly combed, was now ruffled. Her eyes wide open. On her left hand, her watch, the clock hands had stopped. Just as time had stopped for her.

She was wearing her usual deep-purple coat, thick enough to keep her warm but not thick enough to protect her from ending her own life. Underneath her purple coat, a beautifully made cardigan, which she had probably knitted herself.

I remembered how she had come to see me about her ‘dry eyes’ and I was taken back to how our conversations led to her passion about knitting jumpers. Can conversations change lives? What was a warm sunny day now started to feel very cold.

THE LENS OF REALISM

Maybe if I spoke my findings aloud, it would confirm the reality of finding my patient. A verbal assessment was made. On general inspection, pale and wet with no obvious signs of life. No respiratory effort noted. No response to verbal stimuli. No response to painful stimuli. No carotid pulse palpable. Pupils fixed and dilated bilaterally. No heartbeat or breathing sounds noted during 3 minutes of auscultation. There was a long pause. Death confirmed at 10:15 am. We zipped up the bag.

And all that remained were memories slipping through the frail hands of time.

That was it. My first death certification in the community.

Footnotes

  • This is an abridged version. The full essay can be accessed at bjgplife.com/myloss where there is also an audio reading by the author.

  • ↵* Margaret Reilly is an anonymised name.

  • © British Journal of General Practice 2019

REFERENCES

  1. 1.↵
    1. Wikipedia.
    (2019) Epidemiology of suicide. https://en.wikipedia.org/wiki/Epidemiology_of_suicide (accessed 27 Jun 2019).
  2. 2.↵
    1. World Health Organization
    (2019) Suicide data. https://www.who.int/mental_health/prevention/suicide/suicideprevent/en/ (accessed 27 Jun 2019).
  3. 3.↵
    1. Health Service Executive.
    (2011) Suicide facts. https://www.hse.ie/eng/health/az/s/suicide/suicide-facts.html (accessed 8 Jul 2019).
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British Journal of General Practice: 69 (685)
British Journal of General Practice
Vol. 69, Issue 685
August 2019
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My loss
Ahmeda Ali
British Journal of General Practice 2019; 69 (685): 391. DOI: 10.3399/bjgp19X704789

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British Journal of General Practice 2019; 69 (685): 391. DOI: 10.3399/bjgp19X704789
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  • Before I go ...
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  • Physical health checks for people with severe mental illness during COVID-19
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