peristaltor (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
peristaltor) wrote2009-05-04 08:23 pm
peristaltor) wrote2009-05-04 08:23 pm
Entry tags:
Acceptable Forms of Suicide
This one isn't easy for me to write simply because it involves people I know personally, people who, for one reason or another, are killing themselves in ways our society finds somewhat acceptable.
I guess the emphasis should be on the qualifier "acceptable." Allow me to explain.
Almost two weeks ago Friday, I was lunching with a friend, Lenny. He got a text from his wife saying she felt poorly at work, and was thinking about heading home sick. On the top of things, this would hardly warrant comment, except that she is a diabetic, and the reason she felt poorly was that her blood sugar spiked to over 600. After some texting back and forth, she announced she would be heading home.
Think about this for just a moment. A normal person's blood sugar hovers around 100. Hers was high enough to drive a normal person just to the brink of insulin shock, the point where the pancreas simply gives up its supply of insulin and the person slips into a nice little coma. . . and she was driving home. (She later called Lenny a bit remorseful, after getting home safely and realizing what could very well have happened on that drive.)
I've got to say, Lenny took this pretty well. His wife has been gaining weight and denying the very real health impact this weight gain has on her diabetic condition. She's now up to the most powerful insulin medical science has available, delivered with a portable insulin pump (decorated, ironically, with a colorful jelly bean skin). This means that if her condition worsens, as it at this rate surely will, no medicine available will help her digest the increasing carb load to which she subjects herself.
Yes, increasing. She is eating herself to death.
When I first saw that insulin pump and its candy coating, we were lunching at a pizza joint enjoying the all-one-can-eat buffet. I even commented on her consumption, noting that I didn't think pizza crust was the best food doctors recommend for diabetics. (It really, really isn't.) Her eyes glazed over just a bit when I said this. Lenny later told me she has been told again and again by friends, family, health care providers and anyone else who knows that her favorite foods, all carbohydrate-rich "comfort" stuff like rice, breads, pizza, cookies, et cetera, we causing her spikes in blood glucose and weight gain. She has consistently responded by eating more of the same.
In fact, between receiving those dire texts Lenny related the last time they had visited the pho place. Her lunchtime order: A medium chicken pho, an extra side of rice, a full order of teriyaki chicken (with its own rice and salad), and a side order of gyoza. She dumped the rice into the soup (apparently because rice noodles don't pack enough carbs on their own) and ate the whole thing at one sitting.
I was stunned.
I told him she wasn't going to last at that rate. He told me he knew that, and that she would continue until a major health complication gave her a wake-up call.
Some background is in order. I mentioned Lenny had stayed home from work on this fateful day years ago because his wife "is a diabetic, and occasionally needs help watching the kids when the disease obstructs her vision." That obstructs her vision thing is key. Essentially, she has for a few years now woken up blind for a few days at a time.
From what I've heard, she's already had more wake-up calls than I could personally tolerate. Burying your head in the pillows and slapping the snooze button won't stop the alarms from sounding.
It's something of which Lenny is acutely aware. The trouble is, he can't say anything. Or do anything, really. If he says anything, he's the bad guy. If he does anything, like organize an intervention or threaten to leave her if she does nothing, he's worse. He then becomes the bad guy who picks on his wife or is willing to abandon her in her time of need. He can only support her and hint and hope those hints are not completely ignored.
And watch his wife commit suicide.
The Wednesday after that lunch, I visited an old work friend in the hospital. Check out his eyes from a few weeks ago:
Old Yellow Eyes
You are seeing what happens to a person when their liver shuts down and refuses to process the bloodstream's waste. Why would a person's liver shut down? I found out about C. from this email:
Later emails told a more dire story of a coma (from which he emerged a week before I visited) and imminent death in 72 hours. He pulled out of that, thankfully, but now is looking down the barrel of at least 6 months of recovery and subsequent rehab. . . if he survives. After all, a man with a martini tattoo on his shoulder does not go gently into that good rehab.*
So we have here two very different people killing themselves in two very different ways. What conclusions can we draw? Well, first of all let's note that there really isn't anything anyone can do in our society to help them until they seek help themselves. It's like the old joke: How many psychiatrists does it take to change a lightbulb? Only one, but the bulb has to want to change.
At this point, Lenny's wife doesn't seem to sense the urgency. When I visited him, C. seemed to accept his fate, but only time will tell if that urgency remains. After all, this is one of the three people I personally know who topped the all-time drinkers list. One is already dead. The other, last we heard, followed a crazy drug-addled girlfriend down to South America and was, again last we heard, begging anyone who got the message to come down to Panama and bail him out of jail. (I take it Panama has very different laws than we have here. You can't get out until someone comes to vouch for you. Ah, poor Cracky.)
I wonder, though, if that will change, if we as citizens will be allowed our own self-destruction in the name of Happiness's Pursuit. I'm not so sure.
In Victorian times, anyone could wander into the local apothocary and pick up some laudanum, essentially an tincture of opium. One could also buy opium by the gummy hunk. We still use opiates, of course, but have learned that their destructive addictive qualities far outweigh the need for people to get them unsupervised. Later in history, Sigmund Freud himself marveled at cocaine's theraputic qualities, including the enticing possibility of using it to help morphine addicts break their opiate addictions.
Consider also transformative technologies, like the driving of cars. When cars first put their rubber to the road, anyone who could afford the car could drive it. Anyone. Remember Paper Moon when a very young Tatum O'Neill drives around? Perfectly legal. Then people started to die in traffic accidents (more than they did with rampaging horses, which was all too common). States started to license drivers and impose penalties.
Later, driving drunk penalties got stiffer and stiffer -- not, ironically, as the incidents of drunk driving increased, but as the awareness of drunk driving increased through agencies such as MADD. Lenny himself had a grandfather that killed a pedestrian while he was driving drunk. He had to pay a $35 fine for that oopsie, but it didn't hurt his later career as a law enforcement officer (once he got out of prison for bootlegging -- those darned revenuers!)
Never mind drunk driving, one cannot today in most states ride a car without a seat belt, or a motorcycle without a helmet. What changed? Probably the cost of caring for people after accidents. We have gotten very good at patching people together, but not altogether that good at paying for the patches. The insurance agencies get to pay today, but several folks (like C.) are too poor to have had policies and rely upon charity or the state to pick up the tab.
I say this a day after taking yet another call from a well-meaning employee contracted by my health provider. He calls a few times a year to check up on me. I answer an internet poll customized by that contractor, a questionaire that asks how much I weigh, what I (generally) eat, how much I (generally) drink, whether I own a gun -- essentially probing into my lifestyle, comparing elements in that lifestyle that involve risk to the health care provider, and then -- here's the insidious part -- suggesting I change my lifestyle to reduce risk.
Why, for example, do I own a gun? Don't you know they kill people? Sure, I answer, but not as many people as swimming pools. According to Freakonomics, a ground-level swimming pool kills 100 times the children as a gun kept loaded at home:
Yet the questionaire never asked if I had a pool. Interesting. The questions keep coming, and then they find in my lifestyle some room for improvement. If I agree to meet some improvement goal, my out-of-pocket expenses won't be increased.
Knowing people like C. and Lenny's wife, I can see why insurance companies are taking these steps. I guess. That doesn't really take the sting out of it, though.
But let's go further down the speculative hole. Here's a question: You see a TV news segment about a woman who, instead of simply watching what she eats, now is a hundred pounds heavier than she was a decade ago and must rely on a $5,000 insulin pump to keep her alive. If (as it happens) her husbands employer's health insurance policy picked up the tab, you as a viewer might marvel at technology's progress to improve our lives.
If (as it may happen under a state-sponsored health care system) you see that woman as a drain on society's resources, as too selfish to take care of herself, as a glutton and evidence of society's decline, you might just entertain thoughts of contacting your lawmaker and raising a ruckus over allowing such outright waste of the taxpayer's treasure. Hey (you might say), there's nothing wrong with getting fat, but when it affects your health, it affects the taxpayer. That's when it must stop!
Lifestyle risk management: At what point do choices we make today become simply too expensive for society to allow? It's one of the vexing elements of any necessary state sponsorship of health care I can see coming, but cannot see how to stop.
*Addendum, June 17, 2009: I have learned 30 seconds ago that C. didn't make it. He died on May 15.
I guess the emphasis should be on the qualifier "acceptable." Allow me to explain.
Almost two weeks ago Friday, I was lunching with a friend, Lenny. He got a text from his wife saying she felt poorly at work, and was thinking about heading home sick. On the top of things, this would hardly warrant comment, except that she is a diabetic, and the reason she felt poorly was that her blood sugar spiked to over 600. After some texting back and forth, she announced she would be heading home.
Think about this for just a moment. A normal person's blood sugar hovers around 100. Hers was high enough to drive a normal person just to the brink of insulin shock, the point where the pancreas simply gives up its supply of insulin and the person slips into a nice little coma. . . and she was driving home. (She later called Lenny a bit remorseful, after getting home safely and realizing what could very well have happened on that drive.)
I've got to say, Lenny took this pretty well. His wife has been gaining weight and denying the very real health impact this weight gain has on her diabetic condition. She's now up to the most powerful insulin medical science has available, delivered with a portable insulin pump (decorated, ironically, with a colorful jelly bean skin). This means that if her condition worsens, as it at this rate surely will, no medicine available will help her digest the increasing carb load to which she subjects herself.
Yes, increasing. She is eating herself to death.
When I first saw that insulin pump and its candy coating, we were lunching at a pizza joint enjoying the all-one-can-eat buffet. I even commented on her consumption, noting that I didn't think pizza crust was the best food doctors recommend for diabetics. (It really, really isn't.) Her eyes glazed over just a bit when I said this. Lenny later told me she has been told again and again by friends, family, health care providers and anyone else who knows that her favorite foods, all carbohydrate-rich "comfort" stuff like rice, breads, pizza, cookies, et cetera, we causing her spikes in blood glucose and weight gain. She has consistently responded by eating more of the same.
In fact, between receiving those dire texts Lenny related the last time they had visited the pho place. Her lunchtime order: A medium chicken pho, an extra side of rice, a full order of teriyaki chicken (with its own rice and salad), and a side order of gyoza. She dumped the rice into the soup (apparently because rice noodles don't pack enough carbs on their own) and ate the whole thing at one sitting.
I was stunned.
I told him she wasn't going to last at that rate. He told me he knew that, and that she would continue until a major health complication gave her a wake-up call.
Some background is in order. I mentioned Lenny had stayed home from work on this fateful day years ago because his wife "is a diabetic, and occasionally needs help watching the kids when the disease obstructs her vision." That obstructs her vision thing is key. Essentially, she has for a few years now woken up blind for a few days at a time.
From what I've heard, she's already had more wake-up calls than I could personally tolerate. Burying your head in the pillows and slapping the snooze button won't stop the alarms from sounding.
It's something of which Lenny is acutely aware. The trouble is, he can't say anything. Or do anything, really. If he says anything, he's the bad guy. If he does anything, like organize an intervention or threaten to leave her if she does nothing, he's worse. He then becomes the bad guy who picks on his wife or is willing to abandon her in her time of need. He can only support her and hint and hope those hints are not completely ignored.
And watch his wife commit suicide.
The Wednesday after that lunch, I visited an old work friend in the hospital. Check out his eyes from a few weeks ago:
Old Yellow Eyes
You are seeing what happens to a person when their liver shuts down and refuses to process the bloodstream's waste. Why would a person's liver shut down? I found out about C. from this email:
I thought you would like to know that our friend (C.) is in the hospital for alcoholic hepatitis. He went in last week and in very poor shape. He had gone in for a similar problem in January and was told that he needed to stop drinking. He didn't.
Later emails told a more dire story of a coma (from which he emerged a week before I visited) and imminent death in 72 hours. He pulled out of that, thankfully, but now is looking down the barrel of at least 6 months of recovery and subsequent rehab. . . if he survives. After all, a man with a martini tattoo on his shoulder does not go gently into that good rehab.*
So we have here two very different people killing themselves in two very different ways. What conclusions can we draw? Well, first of all let's note that there really isn't anything anyone can do in our society to help them until they seek help themselves. It's like the old joke: How many psychiatrists does it take to change a lightbulb? Only one, but the bulb has to want to change.
At this point, Lenny's wife doesn't seem to sense the urgency. When I visited him, C. seemed to accept his fate, but only time will tell if that urgency remains. After all, this is one of the three people I personally know who topped the all-time drinkers list. One is already dead. The other, last we heard, followed a crazy drug-addled girlfriend down to South America and was, again last we heard, begging anyone who got the message to come down to Panama and bail him out of jail. (I take it Panama has very different laws than we have here. You can't get out until someone comes to vouch for you. Ah, poor Cracky.)
I wonder, though, if that will change, if we as citizens will be allowed our own self-destruction in the name of Happiness's Pursuit. I'm not so sure.
In Victorian times, anyone could wander into the local apothocary and pick up some laudanum, essentially an tincture of opium. One could also buy opium by the gummy hunk. We still use opiates, of course, but have learned that their destructive addictive qualities far outweigh the need for people to get them unsupervised. Later in history, Sigmund Freud himself marveled at cocaine's theraputic qualities, including the enticing possibility of using it to help morphine addicts break their opiate addictions.
Consider also transformative technologies, like the driving of cars. When cars first put their rubber to the road, anyone who could afford the car could drive it. Anyone. Remember Paper Moon when a very young Tatum O'Neill drives around? Perfectly legal. Then people started to die in traffic accidents (more than they did with rampaging horses, which was all too common). States started to license drivers and impose penalties.
Later, driving drunk penalties got stiffer and stiffer -- not, ironically, as the incidents of drunk driving increased, but as the awareness of drunk driving increased through agencies such as MADD. Lenny himself had a grandfather that killed a pedestrian while he was driving drunk. He had to pay a $35 fine for that oopsie, but it didn't hurt his later career as a law enforcement officer (once he got out of prison for bootlegging -- those darned revenuers!)
Never mind drunk driving, one cannot today in most states ride a car without a seat belt, or a motorcycle without a helmet. What changed? Probably the cost of caring for people after accidents. We have gotten very good at patching people together, but not altogether that good at paying for the patches. The insurance agencies get to pay today, but several folks (like C.) are too poor to have had policies and rely upon charity or the state to pick up the tab.
I say this a day after taking yet another call from a well-meaning employee contracted by my health provider. He calls a few times a year to check up on me. I answer an internet poll customized by that contractor, a questionaire that asks how much I weigh, what I (generally) eat, how much I (generally) drink, whether I own a gun -- essentially probing into my lifestyle, comparing elements in that lifestyle that involve risk to the health care provider, and then -- here's the insidious part -- suggesting I change my lifestyle to reduce risk.
Why, for example, do I own a gun? Don't you know they kill people? Sure, I answer, but not as many people as swimming pools. According to Freakonomics, a ground-level swimming pool kills 100 times the children as a gun kept loaded at home:
In a given year, there is one drowning of a child for every 11,000 residential pools in the United States. . . . Meanwhile, there is 1 child killed by a gun for every 1 million-plus guns. . . . The likelihood of death by pool (1 in 11,000) versus death by gun (1 in 1 million-plus) isn't even close. . . . (Levitt, Freakonomics, HarperCollins, 2005, pp. 149-150)
Yet the questionaire never asked if I had a pool. Interesting. The questions keep coming, and then they find in my lifestyle some room for improvement. If I agree to meet some improvement goal, my out-of-pocket expenses won't be increased.
Knowing people like C. and Lenny's wife, I can see why insurance companies are taking these steps. I guess. That doesn't really take the sting out of it, though.
But let's go further down the speculative hole. Here's a question: You see a TV news segment about a woman who, instead of simply watching what she eats, now is a hundred pounds heavier than she was a decade ago and must rely on a $5,000 insulin pump to keep her alive. If (as it happens) her husbands employer's health insurance policy picked up the tab, you as a viewer might marvel at technology's progress to improve our lives.
If (as it may happen under a state-sponsored health care system) you see that woman as a drain on society's resources, as too selfish to take care of herself, as a glutton and evidence of society's decline, you might just entertain thoughts of contacting your lawmaker and raising a ruckus over allowing such outright waste of the taxpayer's treasure. Hey (you might say), there's nothing wrong with getting fat, but when it affects your health, it affects the taxpayer. That's when it must stop!
Lifestyle risk management: At what point do choices we make today become simply too expensive for society to allow? It's one of the vexing elements of any necessary state sponsorship of health care I can see coming, but cannot see how to stop.
*Addendum, June 17, 2009: I have learned 30 seconds ago that C. didn't make it. He died on May 15.