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Suicide: An American Nightmare

Édouard Manet – Le Suicidé (ca. 1877) – Public Domain

The American suicide rate is at a 50-year high.  In 2017, 44,193 committed suicide in the U.S. and 1,652 killed themselves in New York State.  In 2016, the City’s Health Department reported that 525 people committed suicide.

Billy G., a neighbor, recently committed suicide. His death went unreported, with no obit in the Times, let alone coverage by the rest of the media.  He will be missed only by those who knew him — his family, friends, workmates or some neighbors.  Sadly, Billy was one more casualty of a life unfulfilled.

Billy was but one of the 500 or so New Yorkers who took his/her life.  But he did not shoot himself, nor take an overdose of heroin or sleeping pills, nor hang himself, jump in front of a subway or off a building, nor ceremonially cut his wrists like The Godfather’s Frankie Pentangeli, recalling Seneca and other Roman nobles of old.

No, Billy died of self-inflicted dissipation; he drank himself to death.  His death certificate likely listed heart failure, but the real cause of his death was despair compounded by drink.  The bottle was a form of self-medication for his deeply-felt sufferings.

For years, Billy slowly succumb to his own despair, a personal torment reinforced by the bottle.  His life chronicles an aspiring acting career long forgotten, efforts at writing, a failed marriage, distant children, waning comradery of workmates and growing obesity.

Most recently, he spent his lonely days ordering in food and booze and drinking with the television blaring.  He slowly, ever so slowly, retreated deeper and deeper into his own private suffering.

This should not suggest that Billy did not seek help.  He repeatedly called out to his primary-care doctor and to local hospital psych workers. He was even referred to dry-out clinics.  One discharged him after about a week because “since his hands weren’t shaking, he wasn’t a real alcoholic”; another, after he was assured that it was not faith-based or religious, started each day with the Lord’s Prayer; and a third turned out to be long closed.

No one declared Billy to be a danger to himself, a person who needed some form of voluntary institutionalization.  Forced institutionalization, even for a short term and for the sufferer’s own good, is anathema to postmodern, secular America. Thus, for those who are not legally determined to be crazy, a threat to others or can’t afford a private sanitorium, few options are available.   In an era with an eroding safety-net, for one who so suffers, s/he must either have a loved-one or money to keep from slipping into the sewer of American despair.

Towards the end, Billy repeatedly called the city’s anti-suicide hotline for help.  Once, as he was explaining that he wasn’t suicidal at the moment but troubled, two of New York’s finest knocked on his door and escorted him to his local hospital’s psych ward.  Billy, who had been repeatedly hospitalized there for alcohol-related problems, was again released after two days.  One can only wonder if anyone checked his medical records?

It’s not like Billy was alone, that no one cared for him or failed to intervene.  We, some of his neighbors, family, friends and even union comrades, repeatedly attempted to stop his descent.  We really tried, but nothing worked.  Innumerable heart-to-heart conversations and information about self-help groups proved ineffective.

Billy didn’t want to die but couldn’t keep himself alive.  None of us who knew and cared about him could take on the full responsibility that was ultimately required.

Sadly, if you lack the loved-one to take on the responsibility, you’re on your own.

***

The Centers for Disease Control and Prevention (CDC) reports that in 2016 nearly 45,000 Americans age 10 or older died by suicide. Suicide is the tenth leading cause of death, but – as the CDC warns – “is rarely caused by a single factor.  It notes that more than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death. Relationship problems or loss, substance misuse; physical health problems; and job, money, legal or housing stress often contributed to risk for suicide. Firearms were the most common method.

Suicides increase during periods of economic crisis.  During the Great Depression, suicides reached 22 per 100,000 people in 1932; this was nearly double from the early-20s rate of 12.1 per 100,000.  A 2014 study published in the American Journal of Preventive Medicine found that the Great Recession of 2007-2009 followed a similar pattern, especially for Americans aged 40 to 64 years.  It reported that suicides increased to 37.5 percent in 2010 from 32.9 percent in 2005.

Suicides by chef Anthony Bourdain, designer Kate Spade, actor Philip Seymour Hoffman and other high-profile celebrities often capture popular attention.  However, the suicide by Kalief Browder, the Bronx youth falsely imprisoned for three years on Rikers Island, shook the city.  Sadly, more than twice as many people die by suicide in New York annually than by homicide and, between 1999 and 2016, the city’s suicide rate increased by 28.8 percent.

The seven leading means New Yorkers employed to commit suicide are: (i) poisoning; (ii) hanging, strangulation or suffocation; (iii) drowning; (iv) shooting; (v) using a sharp or blunt object; (vi) jumping from a high place or before a moving vehicle; and (vii) sequelae (due to previous illness).

Two Health Dept. reports provide revealing assessment of male and female suicides:

+ In January 2019, it provided data on male suicides during the decade between 2007 and 2016.  In 2016, there were 359 suicides among men. The number of male suicides during this 10-year time period between 2007 and 2016 fluctuated between the low of 344 in 2007 and high of 404 in 2013.  During this period, men died by suicide twice as often as women. The suicide rate was highest among men ages 45 to 64, and “consistently and markedly higher [among] white males” than other racial and ethnic groups.

+ In a separate report from May 2018, it details female suicides for the period of 2006 to 2015. From 2006 to 2015, the rate of female suicide increased by 4 percent annually, but it remained lower than the national rate. “White females had the highest suicide rate among all female New Yorkers, with an average annual increase of 8 percent between 2008 and 2015.”

Missing, obviously, is information about alcohol-related deaths not identified as suicides, one of whom was Billy.  According to a 2010 report by the city’s Health Dept., “Excessive drinking kills approximately 1,500 NYC adults each year.”  Going further, it adds: “Alcohol also contributes to a tenth of all hospitalizations in the city – nearly 100,000 each year – and prompts 78,000 visits to hospital emergency departments, with a rate that more than doubled between 2003 and 2009.”

***

Every suicide is a sad story.  Billy’s story is about someone who really didn’t want to die but didn’t know how to stay alive.  He reached out to others, those who wanted to help him live, but who ultimately couldn’t save him.  In the end, the consequences of a long love affair with the bottle caught up with his body and did him in.  For those of us who knew him, we live with a sense of having failed him.

Suicide is a reality in American life, but functions as a social fiction. Throughout the country, many doctors and other medical professionals, let alone family, friends and love-ones, informally assist those suffering a terminal illness to end their life so as to prevent further suffering, particularly the loss of dignity.  This is America’s wink-and-a-nod morality.

It’s time for New Yorkers and other Americans to rethink suicide.  We need a more humane way to assist a loved-one facing a terminal illness or despair.  Physician-assisted suicide is legal in Oregon, Washington and Vermont; Montana permits assisted suicide with court approval.  Why not New York?

In addition, cities throughout the country need a better method of intervention to help people like my friend Billy from falling through the cracks.  New York, like other cities, has a public health “helpline” for those contemplating suicide.  But if Billy’s experience is any measure of its effectiveness, one too many slips through the cracks.

 

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David Rosen is the author of Sex, Sin & Subversion:  The Transformation of 1950s New York’s Forbidden into America’s New Normal (Skyhorse, 2015).  He can be reached at drosennyc@verizon.net; check out www.DavidRosenWrites.com.

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