Mr. Nailor came to me about six months ago from the senior assisted living facility where he resided. They had a  large communal kitchen, a well-equipped craft room, and raised beds for gardening outside in the summer.  He'd lived there independently, generally sound but for a few chronic illnesses, for about a year.  Since it seemed everyone had hypertension, venous  insufficiency, arthritis, diabetes, cataracts and hyperlipidemia, he felt surrounded by peers.

After his wife died, he'd had a few very lonely years in the house where they'd raised their family. His daughter decided his quality of life would improve if he were around people his age. This was a much better place to be. 

He'd only lived there about a year before the Beast came back. Depression overtook him, washing away the energy he used to put into making puzzles in the woodshop. He lay in bed, waiting on the new antidepressant to begin its work. He didn't remember if he'd eaten dinner yet, or if it was time for breakfast. Only light sneaking around the edges of unopened curtains told if it was day or night.

Mr. Nailor had survived the Pacific theater in World War II. He was a business owner and expert woodworker. Although religious in the past, he stopped going to church when his wife died. It was too lonely being there in the pew by himself.

Today, he was weary of waiting on the drugs to work. Weary of doctors and the happy people in the hallways, going to the dining room in pairs or threesomes, laughing out loud at television, chatting about grandchildren and their beautiful daughters who'd married handsome genius doctor-lawyers.

Today, Mr. Nailor would at last gather the will to help himself. He went to the woodshop.

Hours later, I met him in the Trauma ICU, his torso pockmarked with stretched-out ovals left by the largest drillbit in the shop. "I couldn't do it...I couldn't even do it," he said without tears. "How can I do it?  They took the knives away; this was all I had. And I couldn't even do it." 

He'd put five neat holes in himself; two in the chest, three in the belly. Through the layers of fat, they didn't even knick his heart or stomach. The new antidepressant didn't work, and his mood had lightened only because he had a plan of action. A failed plan that now added weight to the burden of his depression: he could not even succeed in killing himself. 

He begged me repeatedly to help him kill himself. "Tell me how I can do it," he said over and over. No pleading has ever been sadder than this. 

Statistically speaking, elderly men are the most likely to complete a suicide attempt.  Women, especially young women, more often attempt, but use less lethal means such as pills or wrist-cutting.  When males mean to kill themselves, they use guns, mostly. And guns work. 

I told his daughter these flat statistics with all the compassion I could muster; she understood. The expression on her face said she'd been down this road before.  Depression does this to families; they live awaiting the bad news that will come one day, trying not to let that inevitability color their every moment together. But it bleeds a little into everything - holidays, postcards, wedding photographs, school reports carry its stain. Look very closely and it can be seen in many families; perhaps your own.

I wish you peace, Mr. Nailor, because I know you have not had your share. I'm not sure if it's good or bad that suicide failed you. I did my job, played my professional role, but had you died that day, would you be worse off?  Would it have merely been an end to the waiting for your daughter?  Maybe you know by now.

 (Names in my posts about nursing practice are always pseudonyms.)