We bear the pain in different ways. For me, it feels like you’re a combat medic and you’ve used up all your tourniquets on a wounded soldier that seems to hemorrhaging from everywhere. The blood seeps through the skin, and no matter what you do you cannot stop the soldier from choking to death on their own blood, even as your hands, arms, and legs are applying pressure wherever they can. The soldier dies in your arms … and so you move on to help the next soldier and the next, all the while aware of the blood that now stains your hands, not because you killed that soldier, but because you didn’t save them. It stains your hands because you failed.
With every patient loss, the blood permeates your skin. You are unable to wash it off. It just gets darker. You acknowledge its presence every time you step up to greet the wounded. And how can you not consider it a failure when we are supposed to be preventing suicide? It is not considered tolerable for mental illness to be the reason for someone to die. No one questions the culpability of cancer as a coldhearted murderer when it comes to claim a life. But when depression, psychosis or anxiety or trauma, rend the core of someone’s existence to the point where they can no longer sustain life within the confines of their being, it is not permissible. And as long as the bar is set at preventing suicide and not acknowledging that there will be casualties that you will not be able to save, every loss will feel like a failure.
I’m not sure if the people around you completely appreciate that this person you couldn’t save was not a stranger. This was someone who shared their tears, their fears and their unfulfilled dreams with you. They shared their pain and their hopes, they allowed you a first-hand view into their despair and they let you into their world, and perhaps gave you glimpses of their soul. Therefore not only do you carry with you the weight of your self-inflicted guilt, but you also find yourself wrapped in the sadness of this loss. Sometimes their face and their conversations invade your thoughts and remind you of their intent to haunt you. You will no longer be alone since you have now acquired the company of these relentless ghosts.
It’s not that this sense of failure keeps you from taking care of others. Perhaps it even motivates you to do your best and be your best. It may act as the greatest impetus for you to be more attentive since you do not want to feel that way ever again. There may be grateful souls out there who remind you of the blessing of your presence and the indelibility your worth. You will graciously accept their gratitude and the platitudes. You’ll feel like a charlatan even though you will wish in your heart you could hang on to those words and believe that they are an accurate reflection of you. But this does little to cleanse your bloodied hands.
Zheala Qayyum is a psychiatrist.
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