Regarding Suicide

[simpy]

I came across this link today on the internet. It's a suicide note written by someone who had been sexually abused as a child.

 

http://gizmodo.com/5726667/the-agonizing-last-words-of-bill-zeller?skyline=true&s=i

 

This hit home to me for a few reasons. I think it's a good read which is why I'm posting it here. What do you guys think?

 

I think this really highlights a lot of the issues regarding trust between a doctor and patient. This story could have been fantastically different if only the author had been trusting enough to talk to someone. But maybe what happened to him is enough to destroy trust. In that respect, to what extent should a medical professional be aware of this? How would you have handled it as a physician if you had learned about it? My answer would have been cut and dry until reading this letter.

[tomasonshelby]

I think that when you come to a crossroads and you think that is no other solution than death the most important thing is to tell someone about that, confess to someone because it won't be so agonizing when someone understands you and helps you! It can be a stranger too, it doesn't matter, because it is very hard to tell this things to someone you love... that's why they leave notes behind...

 

Don't do it!

[future_doc]

I think this really highlights a lot of the issues regarding trust between a doctor and patient. This story could have been fantastically different if only the author had been trusting enough to talk to someone. But maybe what happened to him is enough to destroy trust. In that respect, to what extent should a medical professional be aware of this? How would you have handled it as a physician if you had learned about it? My answer would have been cut and dry until reading this letter.

 

"You may wonder why I didn't just talk to a professional about this. I've seen a number of doctors since I was a teenager to talk about other issues and I'm positive that another doctor would not have helped. I was never given one piece of actionable advice, ever. More than a few spent a large part of the session reading their notes to remember who I was. And I have no interest in talking about being raped as a child, both because I know it wouldn't help and because I have no confidence it would remain secret. I know the legal and practical limits of doctor/patient confidentiality, growing up in a house where we'd hear stories about the various mental illnesses of famous people, stories that were passed down through generations. All it takes is one doctor who thinks my story is interesting enough to share or a doctor who thinks it's her right or responsibility to contact the authorities and have me identify the molestor (justifying her decision by telling herself that someone else might be in danger). All it takes is a single doctor who violates my trust, just like the "friends" who I told I was gay did, and everything would be made public and I'd be forced to live in a world where people would know how ****ed up I am. And yes, I realize this indicates that I have severe trust issues, but they're based on a large number of experiences with people who have shown a profound disrepect for their word and the privacy of others."

 

I don't know that physicians per se are trained to deal with this situation, perhaps a specialist psychiatrist. And yes, I would have done a referral but would not have informed the police if it was no longer ongoing and he was an adult. He is absolutely right to hasve trust issues with professionals. I recall he Mendendez brothers who killed their parents, one of the brothers told his psychologist, who told his g/f, who told the police to get even his her ex-b/f psychologist. One should be very careful in trusting one's professional advisors. Indeed, in one jurisdiction outside of Canada, the way to spread misinformation isto tell your client something in privilege and the world will know w/i 24 hours. His trust issues were entirely valid and he was not necessarily being cautious to the extreme, especially in his situation where his loving family threw him out of the home due to their greater love of G-d than their own flesh and blood.

 

It is a sad, sad story and I believe if I were a seasoned physician I would not know what to do for hi other than refer him to someone much more competent in this field than I. Life was unbesrable for practically his entire life and he tried his best to cope and survive. Happiness had eluded him and was not possible. I understand his decision, which was not rushed, and he thought it out intellectually for quite some time before he acted upuon this considered decision. He was seeking peace, to be free of torment, and this was the only option open to him he found, as he explored life.

 

Your question relating to destoryed trust and to what extent should phyisicians be aware of this, I am powerless to give an informed or meaningful opinion. It is too far above my level of competence. We cannot gain trust by telling others to trust us. Confidence and trust are built up over time and we are judged by our deeds. Unfortunately, there are some incompetents in practice and their incompetence is often discovered only after decades in some cases, when the damage has already been done and is beyond repair, like the Ontario pathologist whose flawed testimony convicted may for murder, etc. So, the question indeed is who you do trust, who can you trust in our and any profession. Madoff scammed billions from friends and others.