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February 13, 2005
      

This Suicide Was Senseless and Preventable!

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Remember:

Optimal health care can be achieved
only when patients are educated
about their health and patients and
physicians work together as
treatment partners in an
atmosphere of mutual respect.


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Janice (not her real name) had been corresponding with me via email and talking with me on the telephone for a few months. She and her fiancé James (not his real name) had moved into their new apartment, but placed their wedding on hold until her Migraines were better controlled because they wanted to be able to better enjoy the wedding and honeymoon. Janice was a 32-year-old elementary school teacher who wanted two children of her own - a boy and a girl. She wanted the boy to be born first so her little girl would have the big brother she'd always wanted but never had. James is a 36-year-old architect. He'd have agreed to a houseful of children if that was what Janice wanted, but thought her plans of a boy and girl were perfect, especially the part about the older brother. He liked the thought of his daughter having an older brother to look out for her.

Janice was doing everything "right." She was seeing a neurologist, taking preventives, using triptans as soon as a Migraine attack began, using rescue medications sparingly when triptans failed. On her computer, is an Excel spreadsheet with her Migraine diary. She always made notes in a notebook, then transferred the data to the Excel diary so she could track and graph it to look for significant patterns. Janice had done an elimination diet and identified a few food triggers that she avoided faithfully. Her other triggers were fairly well identified, but not as easily managed. Weather changes and the fluorescent lighting in her classroom were two of her worst triggers. Since she'd been making no progress with her current neurologist, she was waiting for an appointment with a Migraine specialist. Still, about once a month, even with her triptans and rescue medications, a Migraine would spiral out of control, and James would need to take her to the emergency room.

James is what I'd call a model partner. When he and Janice began dating, and he learned she had Migraine disease, he told her he wanted to know more about it so he could help her. He was determined to understand the disease and be as helpful and supportive as humanly possible. James even wished he could experience a Migraine so he'd understand better. He had read books and articles, the emails between Janice and me, and had emailed me himself. We had also talked on the phone a couple of times.

More than once, Janice had expressed to me what many Migraineurs do -- the frustration of being treated like a "drug seeker" in the ER. Although she'd been treated with suspicion and disrespect, by the end of each visit, she had been able to convince someone to call her doctor, and the visit was resolved with her Migraine treated appropriately.

Unfortunately, there came that horrible morning when I got a phone call from James. Janice had committed suicide the night before while he slept. She'd had a Migraine that didn't respond to her triptans or rescue meds, so he'd taken her to the ER. They immediately encountered a problem when, because he was neither her spouse nor medical power of attorney, he wasn't allowed to accompany her to the exam room. They decided not to push the point for fear of seeming "difficult." James told me he was, "shocked beyond words when she came back out in less than half an hour." Sadly, she didn't come out so quickly because she'd gotten quick and effective treatment. On the drive home, she told James that a doctor she'd never seen before had treated her. He'd come into the exam room, checked her reflexes, and told the nurse what kind of injection to give her. Janice told him another doctor there had tried that before, it didn't work, and asked him to call her doctor, who was glad to receive such calls. The ER doctor replied, "I'm not calling anyone. I know how to treat people like you." By that time, the nurse was back, and gave her the injection. Both the doctor and nurse left. The nurse returned with Janice's discharge papers. When Janice objected to being discharged because she felt no better, the nurse left, and the doctor returned. He told her to "vacate that bed for people who really need it" or he'd call security.

After they got home, Janice and James went to bed. Janice got up and went into the bathroom. James heard water running into the bath tub, and thought Janice was going to soak in a nice, hot bath -- something she often did when she had a Migraine. He drifted off to sleep waiting for her. In the morning, he awoke, and instantly knew something was wrong. Janice was not in bed. He found her still in the bath where she had consumed a couple of glasses of wine then slit her wrists. He called 911, but the bath water and Janice were both cold already. It was too late.

As he told me what had transpired, James sobbed. He sobbed out of grief, anger, and guilt. Obviously, he's grieving losing Janice. He's also angry, but he's not entirely certain with whom he should be angry. He knows he's angry with the ER doctor, but feels it goes deeper than that. He's angry with the true "drug seekers" who make it difficult for legitimate patients to get care, the U.S. House of Representatives because the National Pain Care Policy Act of 2003 is still sitting in committee, with DEA scrutiny that makes some doctors afraid to treat patients in pain, and with a society that apathetically allows all of this to continue. He feels guilty because he wishes he'd tried to do something at the hospital and because he fell asleep and didn't check on Janice while she was in the bath. He feels that he should have stayed awake until she came back to bed; that if he had, he could have "saved her." I understand his grief and share his anger, but he has no reason to feel guilty. He loved Janice, supported her, and her suicide is not his responsibility.

I'm not going to add much commentary to this, but leave it to you to think about. I just want to say this suicide was senseless and preventable. Our system is very dysfunctional and needs to be fixed.

 

 
       
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 The American Headache and Migraine Association (AHMA)...

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other headache disorders and their family, friends, and care partners.
Anyone interested in the concerns or patients with these disorders is welcome to join.

The AHMA exists to EASE the burden of Migraine and other headache disorders through Education, Awareness, Support, and Engagement.

www.ahma.ws


 

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