Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide

Chronic Illness and Suicide Risk

What contributes to resilience?

Long before I worked in a hospital, I thought about the links between chronic illness and suicide risk. But, spending each day surrounded by people struggling to move forward with life as illness takes away many aspects of the lives they once knew has made me much more aware of the delicate balance they are holding. 

This week, a colleague sent me a piece written by Dr. Thomas B. Graboys. Graboys used to work at one of the hospitals down the street from mine. He worked there as a cardiologist until Parkinson’s Disease and dementia made it impossible for him to practice medicine.

Several years ago, Graboys wrote about this intersection of his life as a physician and his life as a patient in “Life in the Balance: A Physician’s Memoir of Life, Love, and Loss with Parkinson’s Disease and Dementia.”

His more recent words, published in a piece titled “Finding Hope in the Midst of Despair: My Decade With Parkinson’s Disease and Lewy Body Dementia” in the journal Movement Disorders, struck me with particular resonance:

”Now in the tenth year of a battle that will continue for as long as I live, I have watched as huge swaths of my abilities have calved like chunks of ice falling from a glacier into the sea. My circle of friends has shrunk, the role I used to play in family life has diminished dramatically, and my medical career is over. The physical word I am capable of navigating has become a fraction of what it once was. My mental processes have slowed to a veritable crawl. My ability to express myself is profoundly compromised... Control over my body is a formidable, ongoing struggle of mind over matter. As the disease progresses, my sense of myself erodes in parallel and I mourn those bits and pieces as I would the loss of a loved one.”

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He outlines the specifics of his battle in the piece. The conclusion, though, is what really got me:

“However, there is one aspect of the self that even my disease cannot touch and that is the soul. Though not religious in a traditional sense, I remain spiritually whole, comfortable in the knowledge that my life still matters both to the patients I treated, the family I have raised, and the family I have, by second marriage, adopted. And that is where hope lives; not a naıve hope that I will, by some miracle, have my former self restored, but hope that tomorrow, and the day after, can still be days from which a measure of joy and meaning can be derived. And from hope springs optimism that, even with great limitations, there is life to be lived.”

Next month, I’ll be giving a training to my medical social work colleagues on increasing feelings of belongingness and decreasing feelings of burdensomeness among patients at risk for suicide (building on the research generated by Dr. Thomas Joiner and colleagues), so I’m thinking a lot about what contributes to resilience in the face of adversity. Graboys’ delicate balance is inspiring and speaks to what can contribute to resilience: connection, finding meaning, and being able to see life not as black or white, only good or only bad, but as what is to be lived, in the gray.

What ideas about resilience does Dr. Graboys’ perspective bring up for you? Are there people you’ve seen maintain hope while dealing with life-altering illness?

Copyright 2012 Elana Premack Sandler, All Rights Reserved

Elana Premack Sandler, L.C.S.W., M.P.H., is a public health social worker specializing in violence and injury prevention and adolescent health promotion.

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