Jan 11, 2009 - Suicide

The first night during dinner break the temporary health aide, Grace, and I chat at the clinic's kitchen table. "I'm just here for a few weeks helping out while I'm off from the university. Cheryl's (the senior health aide) 15 year old brother, Elwood, commited suicide a month ago and I wanted to help support her. My son killed himself four years ago when he was 15." We don't discuss the details of either suicide. It's hard for me to make a response without sounding trite. I mumbled something like it's impossible for me to begin to know how difficult that must have been. Grace tells me she's working toward a master's degree in public health so that she can help develop a policy to prevent suicide among Alaska's Native youth.

During clinic the next day, Elwood's mother visits me ostensibly for follow up of her chronic medical problems. She is 74 years old. When I start the conversation by asking how she's doing, she says she is sleeping badly and feeling poorly. I gently ask if there is anything particular that is bothering her, and she tells me her 15 year old foster son shot himself last month while she was sleeping. She never heard the shot from her bedroom down the hall. Tears filling her eyes, she says "I don't know what I did wrong. I think and think. I don't understand why this happened. I adopted him when he was 3. His mom lives on the streets in Anchorage - using drugs and alcohol. He grandmother lives in a nearby village where she drinks all the time. He seemed always happy in our house. We have a happy house."

The following day, Grace, Elwood's foster sister comes in to see me. As a teacher's aide at the school, she saw Elwood daily. "He always had trouble with schoolwork. He was always failing everything. Paying attention was hard for him but this year (freshman in high school) he was doing better. I remember the day he killed himself. He had done well on an assignment the school tutor had given him. We told him 'way to go - we knew you could do it.' He seemed ok, happier.

He could be very moody with temper outbursts. He was always that way since we adopted him. Mom always gave him his way. Last summer he and his two friends were always in and out of the house, "the 3 hoodies" my mom liked to call them on account of their sweatshirts with hoods that they always wore.

One of the teachers said he had a girlfriend. He wouldn't talk details with her. One of the girls from school said she heard they broke up.

The night he killed himself he told Mom that he wanted the phone card so he could call his (biological) brothers and sisters in Anchorage and the one who lives in the village. But he never used it.

The other thing we remember is his last night he played with all the little kids (grand and great grandchildren) who were living in the house. Usually he'd pick up the toddlers and run around with them. But this time he held the 7 year old above his head and carried her all around the house.

I wonder if it was something to do with the girlfriend. None of us knew anything about her."

My last day in Noatak a 17 year old boy came in to see me. He muttered about a few things bothering him. A sore throat. The senior aide had already treated that. His hip hurt. And his friend killed himself. "Do you want to talk about it?" Silence. Staring at his shoes.

I started, "You know, sometimes when a kid kills himself he'll tell his friends before he does it that he's thinking about it. That's real common." His eyes flicked up to the level of my stethoscope and then back down. "That happens with adults too and you know it would be very hard for anyone, even a grownup let alone a kid, to believe that someone was serious about doing something like that." He made a low "hm". "Friends blame themselves afterwards - that they didn't do anything. And sometimes they feel so bad they think about killing themselves." By this time he is looking at me steadily. "Yea sometimes I think about just getting it over with."

By the end of the visit, after an analysis of his hip problem, he promised me he would see the village counselor and contracted with me not to hurt himself.

As I was waiting for the plane to pick me up at the airstrip, Cheryl, the energetic, upbeat senior health aide and Elwood's sister, and I chatted in the waiting room area. She said it had been hard on everyone in the family. Even her husband, who hunted with Elwood, was depressed for the first time in his life since the suicide. (I'd seen him for sleeplessness and poor concentration so severe that he didn't feel he could work at the power plant.)

"I'm doing ok though. I took a couple of years off recently. I was getting burned out again. So the time away helped." (The health aides share call, run the medical clinic,and see anyone in the village of 500 that wants medical help with backup from the medical providers in Kotzebue.)

"The hardest part was going into his bedroom to get his body. Mom wanted me to do it. His nose was blown away and his left eye was hanging off his face. Anyway, it's part of my job."