In these times, we must check in on loved ones
Discomfort cannot be excuse to avoid talking about mental illness, suicide
MY OLDER SISTER Liza died on October 25, 2020, when all her struggles came to a head; no single factor was to blame. She did not treat or really acknowledge her mental illness. She misused drugs and alcohol. She and her wife had divorced a few years earlier, and there were rifts between her and some relatives, including our brother. Her finances and housing were unstable after a failed real estate investment in Tampa, Florida. The culmination of these circumstances made her a live grenade with the pin pulled.
When she died, friends said, “You must be in shock,” but I wasn’t. The last few years, I dreaded the day that Liza would kill herself, though I was powerless to stop it from coming. The turmoil that defined 2020 whirled Hurricane Liza bigger and stronger, until she was lethally out of control.
In 2017, Liza tried to take her life and was psychiatrically hospitalized. Her hospitalization was awful, and seemed more harmful than beneficial. She was not allowed to have her phone, so I had to call the hospital staff to retrieve Liza to take my call. It seemed overly restrictive and demeaning; I didn’t think Liza was that sick. I told her unequivocally that I needed her here and that it would be a disservice to deprive my young children of their fierce, one-of-a-kind Auntie Liza. “C’mon, you are the only one that I actually like!” I said. That coaxed a laugh. “I know, I know. I love you too,” she responded, but she didn’t promise me that she would stay. I didn’t realize that asking her to stick around, in enormous pain, so that she could see my kids every few months was too much to ask.
The hospital seemed focused on avoiding costly litigation by physically keeping Liza from harming herself and then releasing her as soon as possible. Once she convinced hospital staff that she was well enough, her discharge plan included a therapeutic day program, which I knew she would never attend, and more medications, which I knew she would not take. My nagging phone calls to “check in” and ask if she went to the program yet made no difference. With her mental illness untreated, I picked nervously at the skin around my fingernails, and I waited for the other shoe to crash down.
Their marriage was deteriorating. Liza’s mother-in-law had been visiting from Moscow for over six months. She spoke only Russian, was overtly homophobic, and for her benefit, everyone had been pretending Liza and her wife were roommates. A few years earlier, I had given them an image on canvas of them smiling in a dancing embrace at our wedding. I saw it hanging in the hallway and wondered what the mother-in-law thought about it. Liza’s wife was at work during the afternoon of our visit and her mother-in-law wasn’t there either.
Everything – from the heirloom furniture that belonged to Liza’s mother (Liza and I have the same father, but different mothers), to the artwork on the walls – was closer together here. The 200-year-old baby grand piano from my childhood home in Connecticut stood in the living room. Mom sold the house following Dad’s 2015 death, and shipped the piano to New Jersey, though she was concerned there wouldn’t be space for it. Liza said that she was teaching herself to play with my old piano lesson books that were still stored in the bench, but the piano served as a stand for potted plants and framed photos for the time being. It had served the same purpose in our house.
We all hoped our chatter about kitchen renovations and long-forgotten piano instruction would cover up the real reason we were together that afternoon. Though mental health issues were becoming less taboo, we three children of the ’50s, ’70s, and ’80s were not terribly comfortable discussing suicide. I planned to let Liza take the lead on whether she wanted to talk about what happened. She’d been through a lot and I didn’t want to push. I was also avoiding the topic of suicide, just like everyone else does.
Today, I know that not asking a depressed person about suicide is just as short-sighted as not talking to teenagers about sex. It has been a cruel education.
Whether it was due to shame or true denial, Liza did not characterize the overdose as a failed suicide that day, but she didn’t insist that it was accidental either. She vaguely mentioned prescription drugs and that she had been drinking too much vodka lately, but I struggled to follow the conversation because she was talking so much and so quickly, and jumping around from topic to topic.
Looking at my sister that day, I saw distress in her black hair’s grey roots and her tired clothing. She was wearing a black hooded sweatshirt and looked terribly bedraggled. I was used to seeing Liza put together in a perfectly orchestrated outfit, flawless skin, hair, and shoes. She always wore incredible shoes.
No one in our family seemed surprised by Liza’s new diagnosis of bipolar disorder, but I was still skeptical. Liza wasn’t in the hospital for very long, and I questioned how extensive any diagnostic testing had been or whether she had cooperated with it.
Beyond the piano, the back wall of Liza’s condo was all windows. Out of those windows was a breathtaking, clear view across the Hudson River to midtown Manhattan. I commented to Liza that she didn’t need artwork because the view was more stunning than any painting she could hang. She said that she loved watching the fireworks from her sofa.
Almost three year later, when the pandemic began in 2020, everyone seemed to be struggling with too much or not enough solitude. Singles were lonely and feared they would become celibate, while families felt the stress of being shuttered inside with their children and spouses. Liza, divorced and without children, was especially affected by the isolation. Her dogs, Lady and Petunia, provided her only companionship. She was an extrovert, a hugger, and a close-talker, and she relied heavily on human connection. The lockdown abruptly cancelled the things she loved: the gym, dining out, dancing, traveling, hugging and kissing her friends and family.
The volatile social and political climate of 2020 only added fuel to Liza’s fire. Anyone who cared to know my sister knew that her tough-guy exterior was truly an act. She absorbed and internalized the pain around her, and 2020 was rife with suffering. She loathed the Trump-Pence administration and spent a lot of energy ranting about it to me during phone calls and on social media. Liza was a genderqueer woman with a chronic illness (a thyroid disorder called Graves’ Disease) and a mental illness; her disdain and fear of the administration was intensely personal. Under Trump’s rule, people like her simply did not count. I know Trump didn’t kill Liza, but his leadership fostered a pernicious atmosphere for what became her perfect storm.
I breathed a sigh of relief after the election, not realizing that I had been holding my breath. Inauguration Day – barely a week after my sister’s death – was the first time I felt hopeful and physically lighter in a long time. I wish Liza could have believed that the good guys always win. I looked up at the sky and said something aloud to the effect of, “Did you see, he’s gone? I hope you are happier. I wish you could have just held on a little longer.”
Then, six days into 2021, the nation was locked on the media and at least half of us watched in terror as an armed mob of right-wing extremists invaded the Capitol trying to block Biden’s confirmation. I watched in disbelief as angry people wearing Make America Great Again hats, animal fur and horns, and draped in American flags, poured screaming into the Capitol building. I don’t know how long we can ask people like Liza to hang on by a thread in the face of such chaos.
In 2022, the pandemic still has a tight grip on us. Most employees are working remotely. Emergency rooms are bursting at the seams at 115 percent capacity. People with broken bones, bleeding injuries, and COVID-19 sit on gurneys that line the hospital hallways. The National Guard fills in the gaps in hospital staffing. Any psychiatric treatment has been especially scarce during the pandemic, even in the medical Mecca of Massachusetts. A patient might sit in the emergency room for more than two weeks awaiting a psychiatric bed. It is easy to see how someone suffering from mental illness might forgo the hospital and succumb to suicidal thoughts, rather than wait in an emergency room for treatment that may or may not help.
The development of vaccinations seemed to be the light at the end of the proverbial tunnel, but it wasn’t. Instead, vaccination became a divisive, politically charged topic. In some poor countries, there were not enough precious vaccines to protect the population. Here, many Americans refused the readily available, free vaccines for everyone older than five. The virus, of course, continued to circulate and mutate. Still, some people refused to wear face masks. Others sent their sick children into the public schools, so as not to be inconvenienced. Some people seemed more concerned with their individual liberties above all else.
The true toll won’t be measured in weeks, as we naively thought at the pandemic’s onset, or even in years, but in generations. In addition to the more than 800,000 Americans who have died of COVID-19, we are losing people like my sister, Liza, too.We must check in on our loved ones, especially the fragile ones. We cannot use our discomfort as an excuse to avoid discussions about mental health and suicide. My fervent hope is that we consider the collateral impacts that our choices have on on other people, especially those of us whose physical and mental health already hang in the balance, sometimes fatally so.
Abigail Salois has been a practicing attorney in Worcester since 2012. She lives in Holden with her husband, children, and rescue dog Stevie. She contributes to an open dialogue about suicide loss on her Instagram page, @mourning_runs.