Does it ever bother you to listen to people who want to kill themselves?” the medical student asked.
The attending psychiatrist glanced at the whiteboard.
The whiteboard was divided into five columns. The first showed the patient’s age; the second indicated the patient’s sex. A last name was in the third column. The fourth held the chief complaint, the reason why the person was in the psychiatric emergency room. The disposition—admit to or discharge from the hospital—occupied the fifth column.
Nearly a third of the patients had a chief complaint related to suicide.
“Yes; there are days when I feel exhausted from listening to people who say they want to die. That’s part of the work, though,” the attending said. He paused, then clicked through several screens on his computer. Pushing his chair away from the table, he said, “Come. Let’s take a walk. We’ll learn why we’re fortunate to listen to those who want to kill themselves.”
The attending unlocked the solid, windowless door. A camera attached to the ceiling watched them retreat down the hallway.
They walked through two sets of double doors into the medical emergency room. The attending paused in front of the whiteboard there. His eyes scanned the list.
“Follow me,” he said to the medical student.
They passed through hallways lined with occupied gurneys. A young woman with dark hair gingerly touched the intravenous line that was taped to her arm. An elderly man with rasping breaths gripped the side rails of his gurney. A man peeled bloody gauze away from his leg. Several people had curled their bodies underneath the thin white sheets, their eyes closed and their bodies still.
As the medical student and attending passed by the trauma bay, they slowed down. The attending pointed inside. Several nurses stood around a man lying on the gurney. Blood was splattered all over the floor tiles. Plastic bags, tubes of various sizes, and soiled white towels littered the room. Layers of gauze, some of it stained red, were wrapped around the man’s head. A mechanical ventilator heaved breaths into him. The heart monitor reported each beat with a hollow chirp.
While walking out of the room, a nurse greeted the attending with a nod. Upon seeing the medical student, the nurse murmured, “Gun shot wound to the head.”
“When people tell us they want to kill themselves, we have the opportunity to intervene,” the attending said as they walked away. “Some people, like that man, never give us that chance.”