Insights in Medicine and Clinical Neuroscience


Suicide is the 10th leading cause of death in the United States. Suicide rates are up 30% between 1999 and 2016. 123 people commit suicide in the United States every day.

Recent suicides of Kate Spade and Anthony Bourdain and Robin Williams have brought this issue to the front pages of the media and into our homes.

I recently had a conversation with a very bright but depressed 18 year old lad. He admitted that he’d had thoughts of suicide in the past. I asked him if he died, what would happen to him. He said that he would just “quit existing.”

I said, “So if you killed yourself, you’d just cease to exist like a rotten, dead tree?”


“How about if your mom died?”

“I don’t know. Maybe she’d be good enough to go to Heaven if there is one. I don’t know.”

Ignore for now the paradox of a mom with an afterlife while he has none whatsoever. I’ll get back to that later. Focus on his “life to dirt extinction” thinking. This response didn’t surprise me. It’s a conversation I’ve had many times with young people, and sometimes those not so young. If all we are is just an arrangement of organic material, like a tree, then there is really nothing unique about being human, nothing different than a plant. After all, that’s what we’ve been taught from elementary school through graduate school, where the science of biology alone among all the sciences defies the laws of thermodynamics. In biology, unlike physics, astrophysics, and chemistry, everything is NOT headed for disorder and entropy. Rather, organisms are becoming increasingly complex and of a higher and higher organization and order. So we are just complex, well organized trees.

And once we remove uniqueness of humanity from ourselves or someone else, it’s easy to kill them off like an animal…or a tree. Hitler did that. That’s how genocide happens. It’s the same with Armenians, or black people, or brown people, or red people, or fetuses, or old people, and on and on.

So, then, it’s also ok to kill ourselves if everything seems hopeless and we want to put an end to the hopelessness. If with death everything just ‘ends’, then we can just ‘end it’ with finality, and we are no more.

But what if we are more than a pile of organic debris? And what if ending our breathing does not end our consciousness…or worse yet, our misery? Let me tell you some stories-one a week.


Story #2

Julia, 75 years old:

She had terrible lungs. Every day Susan and I saw her on rounds, she was anxious, struggling to breathe. That isn’t unusual in these end-stage pulmonary patients. The pulmonologist and respiratory therapists were doing everything they could. We had started her on some anxiolytic medication but it helped only a little.

She arrested.

She was resuscitated. We saw her in the ICU after all the trach tubes were out. “I’ll never be afraid again. I’m not afraid to die. When they were working on me up in my room I saw an angel across the room and he came to the side of the bed and took my hand. He said not to be afraid and that I would live and be alright. I immediately felt complete peace. I still do. I’ve never felt that intense peace and love before. It was beautiful.”