The Intimacy of Tragedy

October 7, 2016

As I alight from the Tube in the East End I see the man I’ve come to visit. We’ve never met in person but we hug with affection like old friends. Our two-year relationship consists of intermittent email correspondence and a telephone call over a year ago. We turn from the station and head toward his home. Normally a 15-minute walk, we take an hour, conversing non-stop and pausing frequently to minimize distractions. We stop by the school where his wife completed her primary education. I am listening more than talking – and that is exactly what I want. I am thinking to myself about the power of tragedy and how its horror builds intimacy between people. I feel like I’ve known this man all my life.

Getting Out of the Office

I’m in London interviewing loved ones of doctors who have ended their lives by suicide. This is a continuation of a research project that I mentioned in a previous blog piece December 1, 2015 . Today, I spent over four hours talking to Dave Emson, freshwater palaeoecologist and retired specialist radiographer. He lost his wife Daksha, a psychiatrist, and their 3-month-old daughter Freya to “extended suicide” almost 17 years ago, in October 2000.

Daksha came to the UK from India with her family at the age of 8, speaking very little English. A gifted student, she easily won acceptance to the Royal London Hospital Medical College. She was diagnosed with depression after a serious suicide attempt in medical school. Initial treatment worked but her recovery was short-lived, as she had a number of relapses requiring many different medications, hospitalizations and courses of ECT. After a manic episode, she was diagnosed with bipolar illness. Her medical studies took longer than usual but, as her husband stated, “she distinguished herself by obtaining first-place in all her exams, coming second in the whole of the University of London, despite missing most of her lectures due to hospitalizations and sitting her exams in the aftermath of depression” and she won a large number of academic awards. She completed residency training in psychiatry and received her MRCPsych certificate as well as a MSc in mental health studies. Her research interests were in both forensic and community psychiatry.

Daksha and Freya

Dave and Daksha were married for 8 years and he told me that she never experienced a relapse during those years. She came off her medication while trying to become pregnant and experienced 3 consecutive miscarriages before their longed-for daughter Freya was born on July 4, 2000. She remained off her meds while breast-feeding with the goal of weaning and restarting her Lithium and antidepressant when Freya was 3 months old. However, just a day or two before an appointment with her psychiatrist, she crashed into a delusional psychosis, which she managed to successfully hide from both him and her husband. She hinted at “evil forces” to her husband as he left for work in the morning. Eight hours later, he returned to a goodbye note on the kitchen table and a house of horrors — the lifeless body of his daughter and his badly burned wife. Daksha had stabbed Freya to death then set them both afire. She died 3 weeks later in a burn unit.

A Journey of 17 Years, and Counting

Fast forward now to today. We are standing in front of his house, the same house. It’s a beautifully maintained attached home circa 1890s in this vibrant dynamic section of the city. As we enter, Dave tells me he that he hoovered for my arrival. The house is immaculate. He shows me the living room, a serene room with a large marine aquarium. “I replaced the shrine to them with this tank about 2 years ago, quite fitting, don’t you think?”. I have to agree. There is a beautiful framed picture of Daksha and Freya on a table in the corner with a small votive candle burning and casting a warm glow.

As Dave approaches the 17th anniversary of losing his family (“my girls” he repeats with love and awe) he is wistful and humble. He frequently mentions his PTSD and uses the verb “dissociate” a lot. He has had courses of very helpful psychotherapy, after years of being “left out in the psychiatric wilderness”. He refers to ups and downs and a bad patch last winter. He is no longer suicidal (he has gotten rid of a noose he fashioned from rope) and the powerful urge to join his “girls” is now gone. He has been able to let go of his rage and bitterness that is a common accompaniment to suicide bereavement. He is busy with his environmental work. He has become very close to the neighbors, wind-rush arrivals from Jamaica that have become more like family to him (family of the great Lennox Lewis, no less!).  They know his story from neighborhood lore and the media attention, and they have come to offer him deeply personal and caring support. “We don’t talk about it, but I know they watch over me. That’s very nice, and very, very much appreciated.”.

With the afternoon waning and much time passing, I mention that I need to be running along. As we leave to walk back to the station, Dave asks me if he can give me a gift. I am jarred by his humility (he is asking me for permission to give a gift, not a pronouncement that he’d like to give me a gift). I blurt out “Of course!”  It is a framed photo of a beaming Daksha and Freya taken by Dave in their garden two days before their deaths. I am speechless. My misty, rapidly blinking eyes are not lost on him. Dave adds that he lost both of his parents over the past 2 years and this photo was theirs, a gift from him after the funeral. I am really choked now.

Our walk back to the train takes only 15 minutes this time. We hug again, wave good-bye and away I go. I turn back and wave good-bye again. I bound on to the crowded train and take a deep breath. And another. And one more.

Sometimes it’s good to get out of the office.

Addendum:

For the interested reader, the independent inquiry into this tragedy is available online:  http://www.simplypsychiatry.co.uk/sitebuildercontent/sitebuilderfiles/deinquiryreport.pdf

References

Myers MF. “Physician Suicide: Are We Failing Our Colleagues?” Psych Congress Network. December 1, 2015.

Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of seven books the most recent of which are Touched by Suicide: Hope and Healing After Loss (with Carla Fine) and The Physician as Patient: A Clinical Handbook for Mental Health Professionals (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr. Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention.  

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.