Thursday, June 3, 2010

6 reasons why people commit suicide

by Alex Lickerman, MD

Though I’ve never lost a friend or family member to suicide, I have lost a patient.

I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.

The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?


Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).

People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.

In general, people try to kill themselves for six reasons:

1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.

Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields an honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.

2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.

Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.

3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is therefore not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.

4. They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.

I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.

5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.

6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.

The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.

Friday, April 2, 2010

Newark officials credit first homicide-free month in 44 years to 'large-scale' drug sweeps


NEWARK -- When the clock struck midnight on April 1, Newark reached a milestone: its first homicide-free calendar month in 44 years. While police and city officials say that’s a solid benchmark, they say there’s more work to do.

"I just think its amazing. Four consecutive weeks without a murder, " Police Director Garry McCarthy said. "The program strategies and policies are working and we’re going to stick with them, but the goal is zero (homicides).

"It’s going to take us a while to get to zero, but right now these are big changes," he said.

McCarthy credited large-scale sweeps at some of the city’s most notorious drug strongholds — in one case nearly 150 arrests during a six-month operation — as well as increased police presence on city streets at night with helping keep the city without a homicide from Feb. 28 through tonight.

Previous coverage:
• Newark records first homicide-free month in more than 40 years

• Irvington man is Newark's first homicide victim in 43 days

•Pa. man shot to death in Newark is first homicide of year
City officials also said community safety caravans as well as the installation of the ShotSpotters gunshot detection system and surveillance cameras in high-crime neighborhoods has helped.

The last time a calendar month passed without a homicide in the state’s largest city was May 1966. McCarthy said his goal is to keep the streak going as long as possible. In 2008, the city went 43 days in March and April without a homicide, the longest span since 1961.

"The reason this is happening is because of the takedown at (Garden) Spires, the reason why it’s happening is because of the takedown at Stephen Crane, Pennington Court," McCarthy said, referring to several housing projects known as havens for drug dealers. "Step by step, there’s a systematic clean-up of all these traditional locations ...We’re attacking and holding on to those locations."

There have been 10 homicides in Newark during the first three months of the year, matching the total for the same period a year ago. That’s the second-lowest first-quarter total since 1941, police said.

Since taking over the Newark Police Department in 2006, McCarthy’s approach to reducing the city’s homicide rate has been simple — fewer shootings will result in fewer deaths. That strategy appears to have held true in March, with only eight reported shootings. In March 2009, there were 11 shootings, resulting in three homicides, according to police records.

McCarthy said the arrest of 149 suspected drug dealers at the Garden Spires apartments during a six-month undercover operation may have helped stifle the homicide rate by preventing narcotics disputes that often turn deadly.

"That group of drug dealers was responsible for an inordinate amount of violence," he said. "This drug gang was involved in violent acts in a lot of other places too, not just Garden Spires."

Overall, Newark’s crime rate has dropped 13 percent compared to the first-quarter of 2009, with shootings, aggravated assaults, robberies and carjackings all lower than a year ago, police said.

"We have made major strides in reducing crime in Newark and providing our residents with a safer, stronger, and prouder community," Mayor Cory Booker said today. "This has been the result of new alliances, 21st-century technology, innovative approaches to protecting our city, groundbreaking efforts to prevent recidivism, the support of our residents, and the courage and valor manifested by Newark’s police officers."

By James Queally/Star-Ledger Staff and Sharon Adarlo/The Star-Ledger

© 2010 NJ.com. All rights reserved.

Monday, March 22, 2010

Dentist pleads guilty to dumping medical waste

PA dentist pleaded guilty to unlawful discharge of water pollutants in New Jersey.

Cape May, NJ (NewYorkInjuryNews.com) – Thomas A. McFarland, 61, of Wynnewood, Pa., agreed to pay $100,000 in fines after pleading guilty on Monday, March 15, 2010, to one count of unlawful discharge of water pollutants. The charge, a plea deal stemming from the 2008 incident in which he dumped a bag of medical waste into the Jersey Shore, was downgraded from two third-degree counts that carried up to five-year penalties. Under the plea agreement, Deputy Attorney General Edward Bonanno said his recommendation will be to give McFarland one year probation when he is sentenced on April 30, 2010, as reported by Philly Online.

According to McFarland, the bag of medical waste was dumped from his motorboat into the Townsend Inlet at the north end of Avalon on August 22, 2008. Within 24 hours, the material appeared along 15 blocks of the Avalon beachfront. The waste consisted of hypodermic needles and other debris and washed up for a period of 10 days. Seven towns closed their beaches and the Borough of Avalon spent approximately $60,000 in cleanup.

Investigators used serial numbers found on needles and a dental drill bit to trace the source of the debris. On September 2, 2008, shortly before police raided the dentist’s office, McFarland confessed to his crime and later pleaded not guilty to the charges. Through the investigation, no stable reason has been supplied for the motive.

The defendant’s first lawyer suggested McFarland had become “distraught to the point of mental illness” by his wife’s diagnosis of lung cancer. In December 2008, he checked himself into the Hampton Behavioral Health Center in Westampton Township, where a psychiatrist “determined to a reasonable degree of medical certainty” that he could not practice dentistry with “reasonable skill and safety to patients,” according to the Pennsylvania State Board of Dentistry. His license was suspended indefinitely and could be revoked.

During questioning on March 15, 2010, McFarland stated that he did not recall whether the needles, cotton swabs and capsules containing dental filling material had been used. He still has yet to offer a motive

Friday, March 12, 2010

Trauma Cleaning: Without Standards, The Pain Can Keep Coming

by Kent Berg
National Institute Decontamination Specialist

As an instructor in crime and trauma-scene recovery and a board member of the American Bio-Recovery Association, I am often approached by attorneys, the public and insurance adjusters to evaluate the service they or their clients received from other crime-scene cleanup companies.

For the most part, these are just routine questions from people who want to make sure that the service they received was within the normal parameters of good practice. But a few times each month I receive calls that just cause my stomach to knot up and my blood to boil.

With the bio-recovery industry in its 14th year, it is mind-boggling to find individuals who still decide that they are going to start-up a new company and declare themselves “experts” in crime and trauma scene cleanup without any research or training.

It is even more outrageous to find that, although they know almost nothing about the science, chemistry, biology or laws of our industry, they are charging fees that are often four or five times the industry average.

The majority of those operating in the industry today are honest, ethical professionals. It’s the few bad apples in the bio-recovery barrel, so to speak, that amplify the problems tainting our industry.

Example 1: The Hit-and-Run Guys
A husband argues with his wife in their kitchen. As she prepares supper, he grabs a shotgun and, standing in the doorway between the kitchen and dining room, blows his head off.

It is still daylight when the police arrive. In order to see better, they open the brain-splattered dining room drapes. Splatter is on the dining room and kitchen walls, but since the body fell onto the vinyl tile floor of the kitchen, the largest amount of blood pooled there.

The family asks the police about scene cleanup, and is directed to a local company. The company tells the family that payment will have to be made in cash prior to starting the job, and that the family will not be allowed inside of the house while the cleaning process takes place.

The family agrees and stays with relatives until they get the call that the job is complete and they can return. The company is long gone, and upon cursory inspection, the rooms look contaminant-free.

It is now night and, in an effort to keep neighbors from seeing into the dining room, the wife pulls the drapes closed. To the horror of the family, the drapes had apparently never been checked and still have blood and brain matter clinging to the material.

The kitchen floor appears to be clean but, when the wife walks across the floor, bright red blood spurts up between the tiles, making little puddles and polka-dotting her shoes.

If this isn’t enough to re-traumatize the family, the wife goes to remove the now-cold pot of chili from the stove and promptly throws up when she sees a 3-inch piece of her husband’s skull nestled neatly atop the pot.

The family contacted the attorney general for their state, who then called me to review the family’s statements prior to a decision on prosecution.

Example 2: The Little-Extra-on-the-Side Guys
A man who lived alone died in his bed of natural causes, but wasn’t found for several weeks. When the authorities were finally called, the decomposition could be smelled from the street.

When a crime-scene-cleanup company was called in, the man’s relatives were told that the odor had permeated everything in the house with disease. Their recommendation was that everything in the house should be removed and destroyed.

The family, already nauseated from the smell, relied on the “professional opinion” of the technicians and agreed to let them remove everything from the good silver and china to the appliances.

In short, every piece of furniture, appliance, electronic component and fixture was removed because they were declared “not salvageable.”

The relatives were then presented with a bill for approximately $40,000! If this wasn’t obscene enough, a few weeks later the family found many of the home’s contents that were supposedly “not salvageable” being sold at a local flea market.

Example 3: The Cutting-Down-on-Overhead Guys
It is standard practice for crime and trauma-scene cleanup companies to dispose of human-blood-contaminated items that can’t be salvaged. They do this by red-bagging and boxing these items and sending them to a medical waste processing facility. This includes dismantling recliners, mattresses, and other large items to fit in these containers.

In this case, a company responded to a gunshot suicide in an apartment. The victim had sat in his favorite recliner and put a pistol in his mouth. The subsequent wound bled profusely until there was no more blood for the heart to pump. This resulted in the complete saturation of the recliner.

In an apparent effort to save on labor and disposal fees, the crew decided that they would dispose of the recliner by wrapping it in plastic, putting it in the back of their truck and then dumping it in the woods of a neighboring county.

All seemed to go well until a few days later, when hunters found the chair and called police. Thinking that they had stumbled upon evidence of a homicide, the police launched a full-scale investigation that lasted for weeks and logged many detective hours before they were actually able to review the crime scene photos of every police department in the surrounding counties.

When the mystery was finally attributed to this particular crime-scene-cleanup company, not only were they slapped with fines for littering, they were saddled with reimbursing the cost of the investigation. Every law enforcement agency that heard about this dropped the company like a hot potato, and the subsequent media attention tarnished the reputation of crime-scene-cleanup companies everywhere.

I would like to emphasize the fact that these complaints are not clients disappointed with a poorly painted wall or an out-of-true vanity top. These are abuses by unscrupulous companies that are subjecting their clients to financial greed, improper disinfection, and re-traumatizing that no one should have to endure.

Could training and certification eliminate these types of abuse? Perhaps a good portion of them, but in the end, it is the honesty and character of the companies themselves that should be monitored. I believe the way to do that is to pursue standards, as well as meeting with our state legislators to create specific regulations for our industry.

Wednesday, January 27, 2010

Appeals panel agrees that failure to read document doesn't null contract

KEITH ARNOLD, Daily Reporter Staff Writer
A Franklin County appellate panel was unable to conclude that the Franklin County Municipal Court's determination in a breach of contract suit between a specialty home-cleaning service and the next of kin of a Grove City man who died in his home was against the manifest weight of the evidence in a recent decision.

"Upon our review of the record, we find no error in the trial court's determination that an enforceable contract existed between the parties," 10th District Court of Appeals Judge Patrick McGrath wrote for the 3-0 court.

The appellate court's holding overruled Nancy Buffington's claim that the trial court was mistaken to find that the contract between her and the cleaning service was enforceable and, therefore, obligated the woman to utilize the company's services per the agreed terms.

Buffington's father died in his home on Nov. 10, 2005, case summary provided. The man's body was discovered one-and-a-half to two days after his death. Approximately one week later, the personal belongings were removed from the home and it was listed for sale.

On Jan. 14, 2006, Buffington contracted for the services of Aftermath Inc., which provides biological remediation and cleanup services. According to the contract, the woman agreed to pay for cleanup services concerning an unattended death in the Grove City home.

Aftermath's complaint alleged that after the firm rendered services, appellant refused to pay the amount due under the contract. After a trial to the bench, the trial court concluded that a valid written contract existed between the parties and that the company was entitled to payment for the services rendered in accordance with the contract. The court awarded damages in the amount of $6,189.36 to Aftermath.

The panel noted Buffington signed both a site cleanup agreement and a fee agreement for non-insurance-related jobs. Additionally, the court rejected the woman's claim there existed no evidence that she understood or agreed to biological remediation of her father's home.

"... As noted by the trial court, appellant's stated failure to read the documents prior to signing them is of no consequence as it is well-established that the failure to read the terms of a contract is not a valid defense to enforcement of the contract," as in Haller v. Borror Corp. (1990), 50 Ohio St.3d 10, 14.

"Further, appellant's argument that she was 'mistaken' equally fails because 'relief for a unilateral mistake of material fact will not be provided where such mistake is the result of the negligence of the party seeking relief,'" as in Hikmet v. Turkoglu, 10th Dist. No. 08AP-1021, 2009-Ohio-6477, and Marshall v. Beach (2001), 143 Ohio App.3d 432, 437.

Fellow 10th District Judge Susan Brown and John Connor joined McGrath to form the majority.

The case is cited as Aftermath Inc. v. Buffington, 2010-Ohio-19.

Date Published: January 19, 2010

Tuesday, January 19, 2010

Haiti Relief Mission - Update 01-18-2010

A team of twenty from H.E.A.R.T. 9/11 will be responding to take part in the relief effort in earthquake-ravaged Haiti on Wednesday, January 20, 2010. They will land in Santo Domingo and use that as a jumping off point to Haiti. Our members will join in the herculean task of helping that devastated country. They have medical supplies and expertise that are so badly needed in this decimated area.

We have received a tremendous response from our members to our request for participation in a relief mission. The first deployment will see a team of twenty volunteers from H.E.A.R.T. 9/11 evaluate the situation and, if need be, more relief missions will be planned.

Our thanks go out to all and we ask for your continued support and prayers. H.E.A.R.T. 9/11 will be able to help those in need because we have received tremendous support and funding from the benevolence of Jefferies & Company (Jefferies is an independent, full-service securities and investment banking firm serving companies and their investors globally. Check out this article from their website at: Jefferies - Haiti Relief News Story). We thank them as well.
Hopefully, there will be updates from wherever the team is and we ask that you will go to our website at: www.HEART911.org

The owner of Bio-Recovery Corporation, Ron Gospodarski will be amongest this group of twenty police, firefighter and paramedics. We wish them Godspeed in there endeavors.

Friday, January 15, 2010

US Army suicides hit grim record for 2009

WASHINGTON — Suicides in the US Army rose to a new record in 2009, with 160 soldiers taking their lives, the military said Friday, calling it a "painful year."

Army leaders had warned that the suicide rate was on track to surpass last year's toll of 140, but said the causes of the spike remain unclear.

"There's no question that 2009 was a painful year for the army when it came to suicides," said Colonel Christopher Philbrick, deputy director of an army suicide prevention task force.

Ten suspected cases of suicide in December for active-duty soldiers brought the total number for last year to 160, the Pentagon said in a statement.

The army has come under severe strain from years of war in Iraq and Afghanistan, with officers citing repeated deployments and the stress of combat as fuelling an increase in depression and marital problems.

But the grim toll of suicides was not necessarily triggered by repeated combat tours in Afghanistan and Iraq, according to the military's own research.

The causes appeared to vary from base to base and about one-third of the soldiers who committed suicide had not yet deployed to combat missions in Afghanistan or Iraq, officials say.

Top military leaders, including the chairman of the Joint Chiefs of Staff, Admiral Mike Mullen, have appealed to officers to ensure soldiers who need psychological help do not face ridicule or risk to their careers.

The army has adopted a range of initiatives to try to contain the problem, hiring hundreds of mental health specialists and launching an elaborate scientific research project to try to understand the trend.

Officials have also expressed concern about suicides among veterans and among military spouses and family members.

Admiral Mullen's wife, Deborah Mullen, told a conference this week that more needed to be done to monitor suicides of spouses and members of military families, something the Pentagon does not track precisely.

Often the spouses of service members are reluctant to seek help as they fear it could damage their loved one's career prospects, she said.