Queer youth are five times more likely to die by suicide. I did not know that. I knew nothing about Andrea Gibson until after their death earlier this week from Ovarian Cancer. Every word they wrote throbbed with a cry against injustice. They were an activist for tenderness, a warrior for the human heart. I have spent most of today reading her poems and they sing to me. Gibson lived deeply and spoke candidly about moments when things got too much for them.
“When your heart is broken, you plant seeds in the cracks and pray for rain.”
“Just to be clear,” they wrote, “I don’t want to get out without a broken heart. I intend to leave this life so shattered there’s gonna have to be a thousand separate heavens for all of my flying parts.”
During Saagar’s illness, I was helpless. Also, I was rubbish at asking for help. A few weeks into Saagar’s unrelenting and forever changing moods, I was baffled. I realised I couldn’t do this alone, I needed to ask for help. Most of my family lived in India so I needed to hurry up.
Looking back, I asked somewhat hesitantly, by sending a group e-mail to my family members in India. Some tried to help and couldn’t. Others didn’t try. Yet others kept mum. Some advised me to send him to India. Some couldn’t even pick up the phone. I was so panicked that I couldn’t think straight. It didn’t cross my mind that I needed support too. The fact that I was a hot shot doctor at a hot shot hospital did not help. At that point, I was simply his desperate mother.
I texted a distant uncle on Tuesday night to say I was really worried about Saagar and we needed urgent help. He lived 20 minutes away. He texted back to say he could only help on weekends. By Thursday, it was all over. I suppose none of us had the slightest inkling of the disaster that was hurtling towards us.
Helplessness was the darkest cloud there ever was. It was a humiliating beast of a thing. It had completely obliterated the way I saw myself – capable, resourceful. It had made me a stranger to myself. Again and again, it invaded from the past to leave me without oxygen. I imagined I would limp through the rest of my life, trying to get to a point of relief, of grace. There was no way of getting that ghost of helplessness off my back.
A few years after his death, on a warm quiet afternoon on a beach in Goa, I invited Ms Helplessness to sit with me. We sat cross legged on the wooden floor of the beach hut. We looked into each other’s eyes for a few still moments. With tears streaming down my face, I extended both my hands toward her, and she took them in hers, gently squeezing them and then loosening her grip. I steeled myself and looked harder into her eyes.
I hate you. I forgive you for nearly killing me once. Thank you for showing me I can’t control what happens.
Maybe there’s a power beyond us both, that rules.
Promise me, you won’t be so cruel again. Will you? She had her gaze fixed on the ground in front of us. A tearful silence ensued. Then she stood up and walked away.
“What can we do to offer wrap-around care to our patients?”
In the live Q&A at the end of the NCISH conference yesterday, this question was asked of the panel. The Chairperson directed it towards me. I can’t remember what I said. This morning I woke up with what I would have liked to say.
For wrapping, we need two things. One, the fabric which we are going to use to wrap and the person we want to wrap. Let’s discuss them one by one.
The fabric
The fabric of Suicide prevention in Health-Care is made up of two things – people and systems. Let’s look at them a bit closely.
People
What are the beliefs of the people?
I know of an ENT surgeon from another country who wanted to move to the UK and the only job he could find was in Psychiatry. So, he is now training to be a Psychiatrist. Is he interested in suicide prevention? Do Health-care professionals believe that suicides are preventable? Are they content that simply by treating mental illness they are doing their job?
What are the attitudes and abilities of the people?
When the Emergency department calls to say there is a suicidal individual waiting to be seen, how do they feel? Are they excited to have an opportunity to make a difference? Or is it a drain on the limited time and energy they have? Do they know how to build a compassionate connection with someone who has lost all hope? Have they received any training in Suicide Prevention? Do they have enough self-compassion to look after someone else well?
Do they have the resources and the knowledge to do a good job?
Do they have access to their past history? Do they have beds on the ward? Can they ask a colleague for a second opinion if they have a doubt about how to involve family or friends in their care? Do they know of other resources, like charities, activities and people that may help this person? Do they have comprehensive and informative leaflet they can share with them? Do they have the means to follow them up?
b. Systems
Does the system have capacity? Are the various parts of the system effective and joint-up enough to be able to hold the person they are trying to wrap or are there big holes in this part of the fabric? Do the various parts of the system share the same mental model, a shared knowledge, pre-suppositions, and beliefs that can be used to help achieve mutual goals? Are their practices evidence- based? Do they investigate deaths with a view to learn lessons and implement change? Do they look after the well-being and emotional health of their employees? Do they hold themselves accountable when things go wrong?
2. The person
Allowing space for them to express themselves. Help maintain their sense of agency. Inform them it is safer for them to involve other people who care for them. Equip them with resources. Give them the support they need. Ask them what would help them? Listen. Sit with their despair. Acknowledge it. Keep them connected with their life as they know it. Keep hope alive for them.
Know that the person at the centre of the wrapping is of great value.
Information is useful if it becomes knowledge. Knowledge is useful when it becomes wisdom. So, let us not stop at information.
So many years have passed but… I was invited to speak at a national conference last month. I said yes.
National Confidential Inquiry into Suicide and Safety in Mental health (NCISH) 11th Annual conference on the 8th of May 2025 at 10 am UK time. This year the focus is on people who had been in contact with Mental Health services within a year of their death. It’s free, short and online.
Did you know there’s an organisation that brings science and spirituality together? Its mission is to create a kinder, heart-centered world where we care for one another and live harmoniously. It’s called the HeartMath Institute and offers many free resources.
They have found that the heart is not just a mechanical pump. It contains thousands of nerve cells. That is probably the reason our memories and trauma are stored in various parts of our body, mainly the brain and heart.
We were taught in school that the brain is a master-organ but it’s the heart that tells it what to do. The intelligence of creativity, innovation and intuition resides in the cells of the heart. Brain neurons are the antennae that follow the heart’s desires. For example, I want to speak and understand Spanish says the heart. The brain follows.
We humans have a stunning ability to self-regulate. Our biology is engineered as a soft technology. Our fundamental physiology is made up of ion-potentials across membranes. We’re the only form of life that can harmonise its two major neural organs through Heart-Brain Coherence. We can alter the chemistry in our bodies. Once this coherence occurs, we can heal and be healthy. The immune system is strengthened, longevity enzymes rise and stress is reduced at a molecular level. Three minutes of this shift can produce beneficial effects for 6 hours.
3 steps:
Shift in focus – into the heart
Shift in breath – slow it so the exhalation is longer than the inhalation
Shift in feeling – a positive feeling – initiate Gratitude on demand.
We are powerful self-regulators. It is a God-like ability that we have, to heal ourselves. We’re conditioned to feel helpless and think we need external help. Sometimes we do need interventions, but we can honour the gift of this body to heal ourselves.
