Here are the first couple of pages of the book for stressed health professionals.
Revised 4/11/13
Intravenous
Hope, Stat!
We Need to Help Stressed or Suicidal Doctors, Nurses, Psychologists, Therapists
And Their Relatives
By William R. Taylor, M.D.
Note: If you
don't like lists and tables, and are not suicidal at this moment, feel
free to skip down to the Preface. You'll find it right after the table.
The Preface opens with this sentence: Working on
this book, Intravenous Hope, Stat! introduced me to one of the toughest cases
of self-doubt I've ever encountered:
Mine.
I
got past those doubts, as you will read later. But first, let me present some
concrete ideas about help for those in immediate danger, due to suicidal
thoughts or stress reactions.
If You Need Help Right Away
Disclaimer:
The statements and suggestions in this book are not intended to diagnose,
treat, cure, or prevent any disease. The author does not in any way guarantee
or warranty the accuracy, completeness or usefulness of any portion and will
not be held responsible for the content of any portion. Always consult with
your personal physician for specific medical advice.
If you are
thinking about suicide, or are concerned about handling stress, I placed
these "If…Then" statements in the table below to help those who need
immediate assistance. Some of the resources in this table also
appear in other parts of this book, so someone browsing at random might find
those resources even if they skipped the table. You may be interested in this
preview of a Jackson & Coker survey's recommendations, which appear in the
Appendix:
By bringing the problem [of MD mental health issues] out of the shadows
and shedding light on what can combat depression or other precursors to
suicide, it's possible to rescue those who are on the brink of self-destructive
behavior. Raising awareness of physician suicide should be an ongoing process
among all segments of the healthcare community.
This book is intended to
bring the problem out of the shadows.
Caution
Some readers have been
shocked by the table below, which starts at he highest risk level, that is, at
a point where a health professional (or any other reader) has already taken a
fatal dose of medication or prepared another means of ending their life.
Although it may seem unlikely that someone at that stage is reading this, I
think we need to face that possibility.
Why start with such a
high-risk group, who are unlikely to pick up this book when they are in their
final stages of a plan for suicide? On the chance that some of those
highest-risk individuals have never talked about suicide with anyone. I want to
let those closest to killing themselves know that they might find some hope--
if not somewhere in their lives, then perhaps somewhere in this book.
Why seek hope?
Because one of the most
powerful antidotes to the poisonous notion of suicide is at least a small
amount of hope. The amount need not
be great at the start. A milligram or two can be the initial dose.
Instructions for using the Table
See where you fit in this Table, under IF, and See
Suggestions under THEN
IMPORTANT: IF YOU ARE SUICIDAL, AIM TO MOVE YOURSELF TO A
LOWER RISK GROUP (FARTHER DOWN IN THE TABLE) FROM WHEREVER YOU FIND YOURSELF
RIGHT NOW.
FOR SUGGESTIONS ON HOW TO REDUCE YOUR RISK LEVEL, SEE THE
END OF THIS TABLE.
And if you think the mess
you're in is too complicated to cope with…also see the end of the table.
I REALIZE I'M ISSUING A NUMBER OF INSTRUCTIONS, BUT IF I
DON'T, THERE MAY BE NO ONE ELSE AT THIS MOMENT WHO CAN TELL YOU WHAT TO DO.
TABLE OF POSSIBLE SUICIDE
RISK LEVELS
IF
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THEN
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IF 1. You are a health
care provider - or anyone else reading this book -- who has already taken
the overdose you had planned to kill yourself with, or who is about to commit
suicide by some other means, see
next column
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Call 911 or the local
emergency number in your location.
Or
call a suicide hot line. One Hot
Line number is 1-800-SUICIDE (1-800-784-2433)
Another
is 1-800-273-TALK (1-800-273-8255).
If
those numbers have changed, the website is www.suicidehotlines.com
Tell them where you are
and what you have taken or are about to do. THEN DO NO FURTHER HARM TO
YOURSELF. FOLLOW THE INSTRUCTIONS YOU RECEIVE FROM THE HELP LINE STAFF. WAIT
FOR HELP TO ARRIVE.
Why do this?
Because you need to
move yourself to a slightly lower level of risk in this table of suicidal
behavior. You're (obviously) at the highest risk of death and need to move to
a lower risk level in order to take another look at your suicidal plans.
Note that I am not
asking you to give up plans for suicide, but to move to a lower risk level,
at least for now. You can reduce stress by identifying some of the factors in
your stress list (long list in Chapter 13.) You can
also "work yourself up" as suggested in Chapter
2.
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IF 2. You are a health
care provider (or anyone else) planning to kill yourself and have collected
materials needed
3. You have set a time and
place for your suicide
4. The time you have
selected for your suicide is within a few minutes to a few hours from now
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Then,
realizing that we have no relationship other than writer and reader, I ask
you to do the following:
4A.
Delay your suicide (I realize
that I probably don't have enough influence with you -- yet -- to ask you to
cancel your plans.)
4B.
Talk about your suicide decision with a
· Trusted friend
· A prescribing physician who can help you decide to
try antidepressants, or change you to a different dose or different
medication or can discuss Transcranial Magnetic Stimulation (TMS), which
might work when antidepressants have not
· Or psychotherapist
· Or colleague
· Or member of the clergy
Or
call a suicide hot line. One US
Hot Line number is 1-800-SUICIDE
(1-800-784-2433)
Another
is 1-800-273-TALK (1-800-273-8255).
If
those numbers have changed, the website is www.suicidehotlines.com
·
I
found a variety of international hotlines on Google, searching under "worldwide suicide
hotline numbers." However some did
not have listings for all the headings they presented. This site seemed
promising (in March 2013) Includes Canada http://suicideprevention.wikia.com/wiki/International_Suicide_Prevention_Directory
Or
check other help lines (in phone book or on Internet)
· Or talk to a member of your family -- recognizing
that not everyone has a family, or the kind of relationship where you would
inform them of a plan for suicide.
4C.
As I said at the top, if you have already taken the overdose or other
steps to kill yourself, call
911 or the local emergency ambulance number in your location.
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ON THE OTHER HAND, IF…
5. The time you have
selected for your suicide is farther off, but within the next few days
6. You have told no one
about your plans
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THEN, Realizing that we
have no relationship other than writer and reader, I ask you to do the
following:
A. Follow one or more of
the suggestions in part 4B above
B. Take a look at the Table
of Clinicians' Stresses and Possible Sources of Support in the Appendix
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ON STILL ANOTHER HAND, IF…
7. You have told or hinted to someone about your plans, or feelings
about killing yourself (told a psychotherapist, member of the clergy, family
member, friend, colleague, suicide hot line, or other source of help)
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THEN
A. Have they believed you?
B. And are you or they
taking action to keep you alive?
C. Do you think that plan
will be enough to keep you alive?
D. If you answered
"No" to A, B, or C, then find another person to talk to in the list
in number 4 B above
IF THE FIRST PERSON YOU
TALK TO DOESN'T UNDERSTAND OR TAKE STEPS TO KEEP YOU ALIVE, TALK TO SOMEONE
ELSE OR CALL A DIFFERENT HOT LINE
E. Take a look at the Table
of Clinicians' Stresses and Possible Sources of Support in the Appendix
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ON STILL ANOTHER HAND
(Your fourth hand, if my count is right)
You have thought about
suicide, but your situation fits OTHER POSSIBILITIES (to next column)
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OTHER POSSIBILITIES, such
as
8. You have thought about
suicide but have no specific plans
9. You have thought about
suicide but have decided to wait till after a particular event (someone's
birthday, a holiday, etc.)
THEN You need to discuss
these thoughts with one of the people in number 4B above
Or Take a look at
the Table of Clinicians' Stresses and
Possible Sources of Support in the Appendix
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OR Number 10 or 11 applies
to you
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10. You find yourself
under excessive stress, but have no thoughts about suicide, or changing jobs
within your profession, or leaving your profession.
THEN parts of this book,
such as Chapter 2, Chapter 3,
or Chapter 4, might be helpful
OR 11. You are under
excessive stress and wondering whether you could change jobs within your
profession, or leave the profession (retire early, change to something you
always wanted to do.) You can read about people who have made such decisions
in Chapter 10 or in the Appendix.
OR Take a look at
the Table of Clinicians' Stresses and
Possible Sources of Support in the Appendix
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OR 12. You are a family
member, friend, or colleague of a health care provider who you think could be
suicidal
OR 13. You are a family
member, friend, or colleague of a suicidal health care provider who has tried
suicide and survived
OR 14. You are a family
member, friend, or colleague of a health care provider who has killed himself
or herself.
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THEN you might find Chapter 6 helpful.
There are other self-help books or sites, such as:
http://www.amazon.com/Power-Prevent-Suicide-Guide-Helping/dp/1575422069 (where several books are described;
if you do not feel comfortable shopping for such books at a local bookstore,
you can order them online.)
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15. FINALLY, IF you don't
fit any of the above descriptions;
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I hope you will try to
understand how stressful life can be for health professionals, some of the
men and women you will meet in this book. The above items might fit some of
them, and these items might be helpful to you, if you feel suicidal, even if
you're not a health professional.
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REDUCING YOUR RISK
LEVEL -- a few suggestions about where to look in this book
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Work yourself up via Chapter 2; Read my challenge of the reasons you're not getting
help for your emotional or unemotional state (Chapter 4);
take a look at your alcohol or drug use via Chapter 14;
challenge your idea that your family would be better off without you (Chapter 15); take the same challenge regarding
co-workers and patients (Chapter 16)
I'll repeat some of these
suggestions later.
And in case you missed this above,Take a look at the Table of Clinicians' Stresses and Possible
Sources of Support in the Appendix
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And if you think the
mess you're in is too complicated to cope with…
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…you're right! The
challenges you face as a health professional are far worse than anything our
poor brains have evolved to cope with over the last ten or twenty thousand
years. But maybe we can muddle through some of this mess together.
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