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Suicide and Compassionate Care

Suicide and Compassionate Care

For the last three years I’ve had the honor of being a personal advocate for a Vietnam Veteran and good friend. There have been a number of, well, “questionable” circumstances at the Veterans Administration Medical Center (VAMC) with regard to his care. By that, I mean that someone who is more knowledgeable than me would question the care my friend has received. But this post isn’t about that. It’s about something else – a larger issue that encompasses both health care and compassionate care.

Full disclosure: my relationship to my friend is not regulated by the Health Insurance Portability and Accountability Act since I have no legal responsibility nor active role in “protecting” his privacy, and this post has been written with his full understanding and cooperation.

Not once in the three years that I’ve been close to my friend’s situation has anyone ever said to him “I’m so sorry.” Those three words are just missing from the lingo of government health care professionals. Let me give you an example.

I was able to make a referral for my friend to the director of our local Vet Center. Because I’m familiar with the many issues for which my friend needs care, I provided a high-level summary of some of the questions my friend is attempting to answer as he nears end of life, strives to provide adequate care for his wife (who suffers dementia and Alzheimer’s disease and has been physically abusive to the point of breaking most of the bones in my friend’s lower left leg), and does his best to continue to receive care from the VAMC.

The local Vet Center, which is one of the best in the nation, simply offered my friend referrals to other sources of assistance. I understand that this is how things are done, but the fact is that at no time did my friend receive any kind of empathy.

Sadly, it seems that a lack of empathy from our government has reached epidemic proportions. It’s not hard to say “I’m sorry” and really mean it. I do it a lot…and I’m just a piano player. Seems reasonable to me that highly trained professional caregivers with lots of letters after their names ought to be able to say it too. But no: that’s not what my friend experiences. Not from the VAMC; not from his Congressional Representative’s Veterans liaison; not from the Vet Center; not from the folks caring for his wife; not from the folks checking up on him (he’s presumed to be “at risk” for suicide); not from the various other people engaged in my friend’s other numerous public assistance issues.

Granted, my friend will probably die from a number of things most of us will never encounter – complications arising from exposure to Agent Orange for example. Although he’s in his mid-sixties, he will probably die sooner than most of those in his generation. That alone, to me, is a cause for compassion. Even as I honor his military service in a terribly mistaken conflict, I’m very sorry that my friend will probably pass away before his time. I’ve told him this. I feel that someone needs to.

So let me offer a few tips to the pros, staff and volunteers in government (and “non-profit”) health care who may have missed class when such things were discussed. These few words go a long ways toward making your inability to provide assistance less insulting.

  • If there’s nothing you (or your department or organization) can do, please begin every explanation of this fact with these words: “I’m so sorry: I wish there was something I could do to help….”
  • If you (or your department or organization) can only offer limited assistance, please begin every explanation of this fact with these words: “I’m so sorry: there’s not much I/we can do….”
  • Finally, if you are the bearer of really bad news, please please please begin every conversation with your patient as follows: “I’m so sorry to be the bearer of bad news….”

This is not hard, doesn’t require an advanced degree, and takes a lot of the bite out of being a government caregiver with a huge waiting list trying to do his/her best. Those of us on the outside feel your pain too.

The point is that, in many ways, offering one’s humanity to another appears to be a lost art. When we had education in etiquette such things were simply part of the skills most humans learned; these days, not so much. It’s as if our whole vocabulary for being human beings has been corrected politically, or legislated out of use (by HIPAA, for one example) or simply ignored in the face of overwhelming demands to do more with less. Clearly this is unacceptable.

Human beings are, first of all, human. We are not numbers. We do not fit into neat cubbyholes labeled with various diseases, disorders and issues. In case anyone hasn’t noticed this recently, take a look at social media. You will find there that most of the many billions of us who are online and don’t care who knows that we are all distinctively unique.

I understand that government is trying hard to be compassionate when it comes to health care, especially for Veterans. I also understand that there are limitations on government, since it must do its best for the most and cannot by its very nature respond to each of us on a personal level. If you have any doubts about this, write to a few of your elected officials – for any reason – and take note of how you are treated. If you are invited to have a one-on-one coffee talk with any of them, you are a very lucky individual.

When it comes to caring for Veterans, there seems to be one thing that works: mentoring. Mentoring, at its heart, is human kindness. It is one human being caring enough about another to extend a genuine, compassionate connection. That simple act, offered consistently over time, has done more for the Veterans with issues than any other program offered by a government agency or humanitarian program ever will. Why? Because simple human kindness offers meaning to someone who might not have much meaning left in his or her life.

We know from solid psychological evidence over the centuries that people with a reason to live won’t kill themselves, and will have a hard time permitting needless killing of others to take place. This could be an insight in the current trendy effort to “end Veteran suicide.”

We ought to know that removing compassion from care also removes a reason to live from the cared-for. I feel that’s criminally neglectful. Don’t you?