Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Sunday, March 25, 2012

Possible Lessons From a Teenage Suicide

About three years ago an eighteen-year-old girl committed suicide several days after being admitted to a Boston area psychiatric hospital. A year later her family filed suit against her psychiatrist, who had seen her for one and one half sessions. The case went to trial this winter, and he was exonerated. Recently I was speaking with his wife about the case. "Nothing good came of it," she said. The girl is still dead, huge amounts of money were spent, and three years were taken from the life of my friend and her young family.

The case became public record once the suit was filed. My friend, a minister, spoke about the experience in her sermon at the time of the trial, hoping perhaps to find some life lesson in the experience. As I listened to her describe the event, her emotional pain still so fresh in her telling, I, too, was moved to try to capture it in writing.

I start by borrowing from her sermon. She poignantly describes her husband two days after the girl killed herself. He was at a party, "surrounded by friends and holding our newborn son and nonetheless looking stricken." The real tragedy of the story is, of course, the death itself. But unfortunately it became a story about other things, namely guilt, blame and responsibility.

In her sermon my friend vividly portrays her efforts to find empathy for the girl's mother.
I spent most of this past week in court with Jim, and I’ve searched my heart for the gesture Jesus hands down to us, a gesture of compassion: “My heart goes out to you.” It was there early on, but following her testimony, by which it’s become clear (at least to me) that Jim was not the problem, I can only muster such compassion when I’m removed from the situation, physically out of that courtroom: “My heart goes out to you.” But when I’m there, sitting close enough to touch her, where she sits in front of me, shoulder-to-shoulder with her gentle-faced second husband (her first having himself died from self-hanging), I haven’t got it. I haven’t got it to offer.
My friend told me of her sense that this mother was unable to think about her daughter. The mother seemed to have an image of what her daughter was or should be that did not consider her child's perspective. As an example, my friend told of the mother's insistence that her daughter's private journal be admitted as evidence in the trial.

Even though I don't know any of these people, I felt this overwhelming wish to have had time with this mother before her daughter died. Would empathy then have helped her to hold her child's mind in mind ? What in her life had caused her such pain that she was unable to do this?

For I am certain that mothers never want to hurt their children. No matter how horribly a mother speaks about or behaves towards her child, given the time and space to be heard, I believe it is possible to uncover the hurt in her own life that is making this task of holding her child in mind so difficult. But the staff at the hospital didn't have time to even try. As my friend said, "They didn't know they were working on a deadline."

But now it was too late. The girl was dead. And because the mother was on the attack, specifically attacking my friend's husband, empathy was not an option. If blame must be laid for this sad situation, I would place it on the lawyer who took the case. How could someone who saw her for less that two hours possibly be responsible for a eighteen year life?

My friend described the cross-examination of her husband. The girl had missed her last session. She had also missed the previous session, and he had gone to find her. The second time he chose not to go after her, because, as he explained to the court, she had said she didn't trust him. She probably wouldn't feel comfortable being actively chased down by a man she didn't trust.

The plaintiff's attorney asked him what he had done during that time. He answered that he had reviewed her chart and thought about her. The lawyer asked, with a sneer that my friend vividly conveyed, "You thought about her?' Her husband calmly looked him in the eye and said simply, "Yes."

3 comments:

  1. I think I understand why you criticized the plaintiff's lawyer, but, imo, you're placing expectations on that individual to rise well-above his profession. The lawsuit was probably driven by the mother's need to distance herself from owning any piece of why this unfortunate kid failed to thrive; lawyers are typically tone-deaf to that sort of nuance (theirs is not to judge) so mom wouldn't have even needed to drill all-the-way thru the "A's" in the Yellow Pages, before finding willing enablers for her quest!

    Moving forward from the that tragedy, I'd like to hope that the enormous price paid by that child will result in raising the consciousness of those who contributed to her despair, and those along the way, who could have helped but didn't...

    Ironically, the mother's turning this personal tragedy into a public spectacle may inadvertently contribute to that goal — at least for others than herself...

    Thanks for briefly "re-animating" that kid by making her real for some of us who might not have known her otherwise, and for the additional value you brought to her brief existence, as a result.

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  2. I lost my sister to suicide 15 years ago after she suffered for several years from being severely ill with psychiatric health matters. I don't think there's a place for judging parents in such situations. If you have not suffered such a tragic loss, there is no way you can fathom what it is like to have a loved one first struggle with a serious psychiatric health issue and then take their life possibly after several previous suicide attempts. I think it would be very helpful for this author to read first-hand accounts of how impossibly difficult such situations are for the individual with the health condition and their loved ones.

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  3. This is a wonderful entry. It illustrates the great sadness of the truth that "hurt people hurt people". These are the chains that you seek to weaken in your work with children and families. I did not, as the previous comment intimates, see any judgment of the girl's mother, only a very human concern for your friend and her husband. Our feelings do not always follow our thoughts, but your actions and will to empathize show your character. I don't think it is ok to spread our hurt about as we seek to heal. I do not for a moment believe that a trial and an active stance of blaming can lead to anything good, for anyone involved.

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