My children’s Montessori teacher lost her son to suicide several years ago. When I heard of her son’s death, memories came flooding back. I recalled Tom’s upper school project in which he presented a hoverboard. This inspired much reverence and awe in my son, who later attempted the same. Tom’s mother had tended to my daughter’s bumps and scrapes on the playground and helped her learn phonics. I gathered the kids and explained what had happened and told them we would attend his memorial the following day.

Having grown up in rural Appalachia, I was familiar with the rituals of mourning the dead in a small town. In a community where nearly everyone knew everyone else, it was not entirely infrequent for me to accompany my mother after school to a showing, as we called it. When I first used that word with my husband, who was not as familiar with the funereal customs of small-town West Virginia, he was taken aback. He realized that “showing” literally meant showing of the body. That had not really occurred to me, as I had always conceptualized it more as a way to show support to loved ones. I have since adopted the term “visitation.”

My children had been to two visitations up to that point. Visitations were not commonplace, nor was the tender age, just twenty-one, that Tom had left this world, or the manner of his exodus.

Both children are introverted by nature and felt anxious about their attendance. My son felt apprehensive and asked, “Why do we have to go?” I said because he mattered, because he inspired you to dream big, and because you care about his mom. He voiced understanding, at least in theory, though my explanation did little to quell his wariness. He later blurted out in a reticent tone, “I don’t know what to say.” I took his hand in mine and explained that no one ever knows what to say, and honestly, you don’t have to say anything.

Neither he nor my daughter exactly grasped what suicide meant. Though our children are being confronted with these types of losses younger and younger, their reference point for pain had been solely physical up to that point.

Being a psychiatrist, I knew the scholarly discourse and didactic study of death by suicide. I could recite the risk factors and barriers that help us prognosticate, as well as the incidence, prevalence, and all the facts and data that I have committed to memory throughout my training and career. Still, I did not have answers. Somewhere, the translation of how to describe pain of non-physical nature—pain just as acute, stabbing, and real as, for instance, belly pain caused by appendicitis. Appendicitis involves the literal rotting of tissue within the abdominal cavity. It needs to be attended to immediately. So too do these ailments of the psyche. Both types of pain result in death when not treated, but also, like other medical ailments, even when treated, psychiatric illnesses can represent an end stage of several psychiatric disorders.

Our desire to see and perform tests to diagnose and triage illnesses, though essential, has allowed a certain cynicism to creep into our understanding of illnesses without objective measures, such as lab work, imaging, or the measurement of vital signs. When a child has a scraped knee, the sight of bright red blood serves as a sort of proof they need to be tended to—a band-aid applied, and a tincture of TLC provided. Though the pain of psychiatric illness is just as real, it often lacks the outward harbinger. There is no obvious dribble of red serum cascading down a child’s shin to flag: I need attention! The ailments unseen don’t lend themselves as easily to words that children can understand, though they are no less real. Somehow, the immediacy, the agony, and the trauma get lost in translation.

Despite my inability to find the proper words and explanation to convey the depths of this challenging and multifaceted conversation, in those moments, I wanted them to understand that our presence was important. I explained some people won’t come because they don’t know what to say when someone’s life ends tragically, but we would go because we knew what to say, which was essential: “We are sorry.”

They likely didn’t understand for years to come that witnessing to pain and sorrow usually needs no words. We pressure ourselves to do and say the right things—somehow; we push words out, painstakingly hoping they are the right ones. There are no right locutions, no magic words. Words can’t approximate the depth of pain when a child dies. Even the greatest poets and wordsmiths often cannot capture the melancholy of such a profound forfeiture. There may be no words in English or any other language that, when strung together, convey the enormity of this kind of loss.

I explained that day that words can be bodies—standing in line, witnessing to a loss, all bereft but each acknowledging a life that was there and is no more. Our bodies can serve as placeholders for all the things we feel we should say but cannot articulate. Whatever words we send out to the universe will not fill the aching abyss left by his death. But our bodies, our presence, our refusal to allow the uncomfortableness to keep us from attending—these can count as a type of word unspoken but heard.

I explained we don’t have to understand the whys and hows of a predicament to show that care. We are here in this line to state his life mattered, and that he left an irrevocable stamp on the universe. He was here on this earth for a certain number of days. He existed and moved on, but he left his legacy behind.

On that hot day, the kind that usually marks the end of the carelessness of summer easing into autumn and all the responsibilities to come, we took time to honor and celebrate his life. To show our presence as the term “showing,” which I had abandoned in favor of using the word visitation several years prior, embodied.

As seasons changed and life lumbered on, it was an important lesson to them and to me that sometimes the most brutal truths are taught without words. As summer slid into fall, we came to understand the beauty of the unspoken and allowed our bodies to reveal what our hearts wanted to say, gradually yet surely.

We will never truly understand the intricacies of a life—his life or our own. While we strive to understand, especially in medicine, the underlying causes of illness, explanations often fall short and overlook the expression of the human experience. Words cannot adequately approximate the measure of a human life. For those who loved him, it is his scent, the crinkle of his nose, the feel of his arms around a loved one’s neck—remain pieces logged into the souls of those who mourn him, stored in places in the brain that don’t transcribe words.

That day, we honored Tom’s life by gathering at the community center, where the sculpture of birds outside was situated near the end of summer.

Courtney Markham-Abedi is a psychiatrist.