A Hopeful Widow

The boys left the house for their play date. It seems bizarre starting this entry with the term play date but that was what it was. This was the last morning before their innate sense of innocence would forever be changed.

Dan and I were both raised Catholic as are our children. The boys attend the local Catholic school and our faith in God is an integral part of who we are. I had very mixed emotions prior to calling the priest. I knew the children and I needed his guidance but I was not sure what the churches stance was on suicide. In my grief and utter despair I was deeply worried he might share that the church viewed Dan’s death as a sin. A sin so great that he may not be able to spend eternity in heaven with God. If the church’s opinion differed how could I begin to reconcile his death with my children? I called Father and asked if he believed Dan was in heaven. He in turn asked me if I was able to forgive Dan, which I replied of course. He said that I should trust in God’s ability to forgive Dan and welcome him into heaven because God’s ability to forgive is even greater than mine.  Our phone call continued. I told him Dan’s parents and sisters would arrive from Phoenix in the early afternoon. We agreed it would be best for him to be at my house when they arrived and then we would gather the children and tell them of Dan’s death.

Whether or not you are part of any religion, when it comes to suicide there is a fear that in sharing the details of your loved one’s suicide you will not be accepted as you once were. And in our deepest despair it’s when we need our faith, church, family and friends to be at our side the most. I absolutely believe Dan is with God and I absolutely believe that Dan was a wonderful man who was not weak; though some may disagree, he did not give up or abandon his family.

I can say with confidence that our family, friends, and church endlessly supported us and continue to do so. We were enveloped by people’s love, kindness, and understanding. All of our basic needs were being taken care of so that we could begin to heal without judgment.

I called my psychiatrist who treats my anxiety with the prescription Zoloft, an antidepressant that has anti-anxiety affects. I explained all that had happened. During the phone call I cried and asked him to help make sure I was going to be ok. I was afraid that just like there was a “switch” in Dan when he got off the plane that the same could possibly happen to me. I had to be well; I had to be healthy for my children. I made an appointment to see him that week. The topic of me maintaining my mental health is one that could require multiple blog entries at a later date. Shock, guilt, despair, nightmares, flashbacks, difficulty concentrating, and social withdrawal were all struggles at first and continue today at a lesser extent today.

 The coroner determined Dan died by suicide; therefore an autopsy was not required. However, it was important to me that an autopsy be performed because I wanted to know if Dan’s suicide was brought on by a tumor that caused anxiety and depression along with a recent change in vision that had required prescription glasses. Or was it anxiety and depression not precipitated by another disease process? My dear friend who had been with me throughout that night started the process of ordering an autopsy.  It is actually a lengthy and difficult process. She saw how desperate I was to know as much as I could of Dan’s illness and death and she was relentless in the process. After hours and multiple phone calls she found a physician who was willing and able to perform the autopsy the same week of his death.

Family, friends, colleagues, and acquaintances were trying to contact me. Word of his suicide had already spread outside of the state. People wanted to know if Dan was dead and if it was in fact by way of suicide. I did confirm and allowed others to confirm his death but only shared suicide with a close few. I decided it was best to confirm his suicide once I had the results of the autopsy.

One of the final phone calls I felt I needed to make prior to telling the children was to the Dougy Center. My friend called on my behalf and told them our story. Their immediate advice was to tell the children the truth and soon! They then spoke to me and guided me through the steps of talking to my children…. provide them with some basic information first and then let their questions guide our conversations. They provided the names of family grief counselors near my home and welcomed us to join Dougy Center support groups in the fall. Though we did not start support groups until the fall I would continue to call the Dougy Center over the next couple of weeks for guidance. The Dougy Center is an incredible non-profit organization that provides support and resources for the grieving family. I am very grateful for the support they provided and have continued to provide my family.

I called the first name on the list of family grief counselors. I was very specific with my questions about her style of therapy, and I also inquired if she would be closing her practice anytime soon. We scheduled an appointment for me within the next week or so and decided if it went well, then the boys and I would start weekly therapy.

It’s interesting that I asked if she would be closing her practice anytime soon. I was instinctively trying to reduce the risk that someone close to them or someone that would become an integral part of their healing such as our future therapist would come into their lives and then leave. I say it over and over again that Dan did not abandon our family, yet within the first 24 hours I was already trying to reduce the risk of another loss. Dan did not choose his illness or his death, and therefore he did not abandon us, but his death has created some feeling or fears that have resulted in a fear of abandonment for both my children and myself. Primarily I worry about my children suffering another loss… sometimes too much. These feelings are not something I currently fully understand about my children or myself.

Four and seven years old is so young. At their ages you may wonder if they could truly comprehend the permanence of death. Sadly our family had already experienced a profound loss. Dan’s sister, Beth, died December 3, 2010 of peritoneal cancer. She endured a two-year battle with chemotherapy and second and third opinions. At the time, Dan and I had decided it was best for me to stay home from work for a few years after Finn’s birth in 2009. Throughout that year, my boys and I would travel every few months to Arizona where Beth, her husband Ken, and their two kids Megan and Grant lived, and we’d stay for several weeks at a time. Beth and Ken asked Dan and I to raise Megan and Grant in the event something happened to them. We of course said yes. It was important to Dan, Beth, Ken and myself that we all be together as much as possible. We wanted to cement our relationship with each other’s children so they could have a more solid foundation upon Beth’s death. My boys were with Beth and her family often through her illness and ultimately during her home hospice just before her death. With Beth’s death my boys began an earlier understanding of permanence and witnessed the pain of their cousins’ loss. It was her disease that prompted me to search for support groups for her children which is how I learned of the Dougy Center.

I don’t recall exactly when I communicated with Ken after Dan’s death in the first 24 hours, but I do know that I did and I asked him to please not change his will. If he died I still wanted to raise Megan and Grant. I wanted them to know that while they had just lost their Uncle they would not lose me. Equally as important to me, I wanted to know I would not lose them. My children and I deeply love Megan and Grant and we will always play a significant role in each other’s lives.

Beth’s death complicates my children’s grief process obviously for multiple reasons. With Beth’s disease her death was imminent with Dan it was unexpected. With the loss of their Dad and Beth they developed a real fear that I could die too which impacted their daily lives and continues to do so.

Dan’s parents, sister, and the priest arrived in the early afternoon and were waiting inside my home with Grace and my mother. It was time for me to tell my boys. I walked a few houses down to the get the boys from their play date. Walking through the door and watching all of the kids play was a surreal moment. The last twelve plus hours were horrific and now my happy, innocent children would have to know the truth and feel the agony of his death. We began our short walk home, them telling me about their day. Once we were in front of our house I knelt down and told them Daddy died and went to heaven. I’ll never forget the first thing my four-year son said to me was, who is going to play “tackle” with me (he and Dan’s form of play wrestling). I do not think I had a response. I told them who was at the house and that it was time to go inside where we would talk about it more. We all gathered in the family room, the boys in my lap. My seven year old asked when and how he died. I told him when dad died and I told him dad “fell” off of a building. I told him we knew he made himself fall and that no one pushed him. He asked why would he make himself fall? I said he made himself fall because his brain was “broken” and he was in pain. His brain told him the only way the pain would end was to make himself fall and die. He asked why was his brain broken. I said his brain was broken because of an illness like cancer or one that is called depression. I explained that there was a special doctor that was with Dad who was going to help us figure out which illness made dad want to fall off of the building (the autopsy). At that point my four year old asked if he could go play. He had received as much information as his mind could handle. My seven year old cried in my arms. The priest and our family comforted us. I’ll always remember the priest told me to take it “one moment at a time”. He was so right. Taking things a moment at a time would continue for many months and on and off for at least the first year.

In the next hours, days, weeks, months and years each child would ask more questions. Some questions asked for greater detail. Other questions were asked so the boys could hear the same information to remind themselves of the events, and also because as they age developmentally they have a greater ability to understand and process the details. I took the Dougy Center’s advice that day, and I told my children the truth. We openly and truthfully talked about Dan’s death when he died, and we continue to speak openly and truthfully about him every day. I knew even then, in that time of shock and tragedy, that Dan’s illness was not shameful. I will not whisper around my children, I will not skirt around what happened. We celebrate Dan’s life and we grieve Dan’s death openly and together as a family.

Connie DeMerell

My friend gathered a notepad and pen from the kitchen; my friend, her husband, my mother, and myself started a list. Call the pediatrician, call Dan’s doctor, call Dan’s parents and sister, contact our estate attorney, call the priest, call the Dougy Center, call my doctor, order an autopsy, review finances, make a budget, hire a part time nanny.

Then we discussed our options for when the kids woke up. I knew I couldn’t tell them about Dan’s death right away because I worried about the questions that would follow. Would they ask if we would be ok, if I would die, if I would kill myself, if they would kill themselves, if we would have to move out of state, if they would have to leave their school and friends, if Dad was in heaven, if I would have to work as much as Dad did, if we would run out of money? My head was spinning. I was in shock and I knew I didn’t know how to answer any of the potential questions. Because my children had a parent die of suicide, they were now at higher risk for suicide, mental illness, drug use, and crime. Each child would have their own grief journey and challenges based on their age. I did not know what the incidence of these risks was, but any increased risk was devastating. I knew enough to be petrified that my children’s lives could be ruined and I would lose them too. I did not know how to best help support them and knew I needed help and guidance.

At this point it was after 5:00am. We knew it was time to begin making phone calls. I called our pediatrician who knew Dan well. I recall telling him Dan had died and that he jumped off of a parking structure. I asked him not to share how he died until I had more information. I then asked if there was any hope that my children could be ok. I desperately needed hope. I needed to know if I loved them, supported them, and was present for them, that they “could” be ok. He did provide hope and guidance about the kid’s future. We agreed talking to the Dougy Center, a center whose mission is to provide support in a safe place where children, teens, young adults, and their families grieving a death can share their experience, was the best resource for direction in informing the children about his death.

I called Dan’s doctor and left a message on his voicemail. I had been in contact with him on a regular basis and had left voicemails for him the last few weeks, so calling him felt somewhat routine. I remember thinking I had to be composed and speak slowly so that I could give the details of the evening and his death. I am unsure, but I think I may have even stated that Dan took his medications as prescribed, a detail that would be important in caring for him if Dan were still alive. As I reflect on the phone message, I am curious as to why calling Dan’s doctor was such a high priority for me. Why did I feel the need to leave such a message? I did not consider that his physician would likely go into work and sit down at his desk between patients with a pen and paper, prepared to retrieve routine phone messages. And I did not consider how such a message could impact Dan’s physician. He would likely be facing a full clinic day of patients. He, like many other physicians, likely continued on in clinic providing compassionate, quality care to others while burdened with his own shock and grief. I would imagine he read though Dan’s chart looking for any signs that Dan would die of suicide. I have stated numerous times that there are unrealistic expectations placed on physicians to swallow their emotions and carry on with patient care. My awareness of this problem in the medical field and my determination to shed light on it didn’t stop me from burdening his physician while in my own grief. I believe leaving that message was my attempt to continue to care for Dan. He had died, but that would not end the deep commitment and feelings of responsibility that I have for him. I would continue to care for him as my husband and father of my children.

I called Dan’s parents and sister. I remember waiting till about 5:30am thinking they would be starting their day. I told them the truth, and there are no words that can give justice to their devastation and grief. We started making travel plans for them to arrive in Portland that same day.

I emailed our estate attorney. I believe it had only been ten months since we had last spoken to him. Dan and I had sat in his office, pregnant with Gracie, planning for our children’s future if something were to ever happen to one or both of us. We felt young and excited about our growing family. We had no reason to think we would actually need an estate plan, but it was something we thought we should do as parents for our children. At the time of my email to him I had no idea how much time I would be spending in our attorney’s office over the next 12 months handling and closing Dan’s estate. I was not aware that our attorney would actually be an essential part of our village, guiding me, with expertise and compassion, though endless paperwork and government deadlines for Dan’s estate, while always being respectful of Dan’s illness and death.

Knowing the kids would wake up for school soon, my friend walked me to my bathroom where I reluctantly took off my bloodstained clothes and showered. She offered to wash the clothes to which I said no. I ended up placing the clothes in a plastic bag and hid them in my closet. Today the clothes are still in the plastic bag packed away in a box. I have looked at and held them probably twice. The first time was to determine how I felt holding them. Would I feel closer to Dan; would they bring me peace or sadness? I don’t recall feeling closer to him holding the clothing, nor did they provide comfort or greater sadness. I think it connects me to that night. As horrible as it was, those were still my last moments with my husband and I feel compelled to never forget that evening. I feel somehow like I owe it to him.

No one should have to endure life alone and everyone has a right to die with comfort and dignity. I do not believe Dan felt he was alone in life and his struggle. He did die alone and his body remained alone for hopefully only minutes. I do not know if he had comfort as he passed, but he did die with dignity. I want our children and the world to know that when someone dies of suicide, they still maintain their dignity. Suffering from mental illness and succumbing to suicide is not shameful or selfish and does not diminish one’s beautiful life. The second time I held the clothes was to determine what I should do with them. Admittedly it feels strange to keep the clothing, particularly unwashed. I can’t throw them away because it pains me to think that the clothing with his blood would end up in a landfill. I can’t wash them because washing the clothes would wash his blood down the drain into a sewer with all of the other wastewater. I know rationally that both of those options are appropriate, but it feels like I am throwing him away. Because we had discussed years ago that he would want to be cremated when he died(which he was), I believe it would be best to burn the clothing. I can’t, however, bring myself to build a fire and carry that out. For those reasons I will leave them packed in a box until I can “do something” with them. I won’t allow the internal struggle I feel surrounding the clothing to occupy space in my mind, and I won’t live in fear of judgment as to how I choose to handle things such as this. I need to be the most complete me possible so that I can focus on my children and what’s best for their well-being and journey. As I complete this paragraph, I realize that its length is a good indication of how much thought went into something that most people would not have even considered was a struggle for me. I think it is important to share this because everyone has a “bag of clothes” they don’t know what to do with. We have no idea what others’ personal struggles are. One of my hopes is that people can feel safe to freely share their own struggles without fear of judgment. If we as adults are able to do this, we are creating a safe environment for our children to do the same.

Because I was still at a loss as to how to answer my children’s possible questions, and I had not contacted all of the people on our list. We decided that when the kids woke up, we would announce it was a special day for my girlfriend’s family and my two boys. There would be no school and my friend would take them to Starbucks for breakfast and then to her house where my children would play with her children. Her nanny, her mother who was flying in from California, and her husband would care for them so that my friend could stay by my side. I would say Dan had left for work really early.

I can’t imagine what we looked like having just experienced the shock and trauma of Dan’s death only hours before. As we gathered around the kitchen table, my seven year old appeared unsure about our story and kept asking where dad was. I loved them so much and would do anything I could to help them, but there were so many questions, and I needed more time….

Connie DeMerell

 

The story of finding Dan is one I have rarely shared. Some of the details I have never spoken or written and may never be able to. I experienced a deep personal trauma that night. A trauma that will be with me for the rest of my life. It is part of who I am now; I have accepted this and have found a way to live without it destroying me.

Despite the horrors of that evening I would not change being the one who found him. I believe I was at his side within minutes of his death. I do not have to live a life wondering what he looked like lying there, if he suffered for long before he died, if animals explored his body. I was with my husband, at his side as I should have been.

We hung up the phone at 10:05pm. Dan had to drive 6 miles home; he should have arrived in 15 minutes.  I brushed my teeth and climbed into bed. I closed my eyes and very well could have fallen asleep. I was not remotely considering he might not be coming home.

At approximately 10:30pm I glanced at the clock and realized he still wasn’t home. I called his cell. He did not answer. I thought maybe he was on the other line with one of his partners, so I waited a couple of minutes and then called back. No answer. I texted him and said I was getting worried. No response. I called him again. No answer. I texted him and said if I didn’t hear from him in the next few minutes I was worried enough that I would call a colleague he was with at the meeting. No response. I called again. No answer. I considered maybe he had a car accident. Maybe he had been pulled over by the police for a traffic violation. At approximately 10:40pm I called his colleague. She was already asleep in bed and said he should have been home by now. She said she was worried and to call her as soon as I heard something. At 10:44pm I called him and this time it went directly to voicemail.  For the first time it occurred to me that instead of an outside circumstance not allowing him to call me, he was choosing not to come home and had perhaps hurt himself. Because my mom was at my house asleep, I was able to jump in the car, wearing my pajamas, and head to his St. Vincent’s office.

The St. Vincent’s office is a 10-minute drive at that hour. I pulled into the parking lot, drove past three gentlemen exiting one of the buildings on the lot, and headed to the back entrance of Dan’s building where he usually parks. His car was not there. I turned around and drove towards the parking structure attached to his building. I saw his car parked just under a lamppost. I did not see him in the car and thought perhaps he decided to go for a walk on the small trail that runs through the green space behind the parking structure. I turned my car to pull up next to his car and my headlights illuminated his still body lying face down on the ground next to the parking structure. I immediately put the car in park, jumped out, and ran to his side yelling, “Call 911, help, call 911,” hoping to alert the gentleman I’d seen at the nearby building.

Dan’s body was lifeless, and without using any nursing judgment I immediately turned his body over. I did not consider that moving him in such a way could aggravate injuries if he were still alive. I was screaming crying asking him, “Dan, what did you do?” I repeated that question over and over again as I checked for a pulse. No pulse. Started CPR. Then stopped to assess him. I couldn’t figure out what happened. Had he been hit by a car walking through the parking lot? Had he been assaulted? His wedding ring was not on. Maybe he was shot. I looked for a bleeding wound that I could apply pressure to. The only wound I was able to see was a deep laceration to his chin. I put my fingers in the wound to see how deep it was. I noted the wound did not tunnel though his head and was not life threatening. As I was doing these things I continued to repeat the question, “Dan, what did you do?”

The three men from the nearby building had arrived and one asked, “Ma’am do you know this person?” When I replied that he was my husband the man said, “He jumped off the building.” I began to cry even more hysterically and took out my phone to call one of my best friends. I believe I called her three times and kept yelling in the phone that he was dead. She asked, “Who’s dead?” I said, “Dan, Dan’s dead.” She asked for more information but I kept hanging up. I passed the phone to one of the gentleman for assistance. I will always remain deeply appreciative for their presence and support that evening.

I only then started to hug Dan and kiss him, beginning to accept he was actually dead. I cried and told him I loved him. The paramedics and police arrived. The police officer asked me to step away from him and the paramedic said she had to confirm he was dead. I didn’t want to leave him but it was clear that I was not going to be allowed to stay by his side. The police officer brought me back to my car, which was still running. I sat in the car while the officer stood next to me with my driver door open. He wanted to ask me some questions, but first I called home repeatedly trying to wake my mom up. Finally she answered the phone and I told her he was dead, where I was, and that I was with the police. I recall the tremendous effort it took to focus my attention on the officer, understand his questions, and to articulate answers. Despite the gentleman telling me Dan had jumped from the building, my mind began to reason again that he had not killed himself and that he was involved in some type of robbery, which would explain why his wedding ring was missing.

The officer asked a range of questions. Some I feel were to determine if I was responsible for his death, some were to determine if anyone else would want to hurt him, and others were to determine if his death was a suicide. When the officer specifically asked if Dan would have any reason to kill himself I was adamant that he did not. I recall relaying that Dan had been stressed about work and had been depressed but he had no reason to hurt himself. Shortly after the questioning began my best friend’s husband (who was one of Dan’s close friends) arrived. I recall seeing him standing far away. I cried out his name and kept asking if I could talk to him, but they would not allow him to come any closer. The questions went on for hours. He asked them again and again, sometimes rephrasing them. I suppose to be sure I was being honest.

I was in shock, I was shaking, and sometimes I thought I was losing my mind. I imagine those hours looked from the outside just like it would in a movie. Moments of sobbing crying, moments of when I focused and told the officer everything I could in hopes they would be able to find out what had happened to Dan, moments of me pleading with the officer to understand that we were a normal, loving family who had been happy.

The coroner had arrived and was working to determine the manner of Dan’s death. My friend’s husband was now allowed to join me and the police had us move my car to the inside of the parking structure. I didn’t understand why but now know it was so that they could move Dan’s body. The officer and the coroner both informed me that Dan’s death was a suicide. As the coroner spoke those words I recalled turning Dan’s body over so that he was on his back. I immediately told them that I had done that. My mind had completely forgotten that detail. I am not sure if it was my mind’s way of not wanting to accept he had jumped off the building. Up until that point the acceptance of suicide would only flow into my mind for brief periods.

The officer and coroner who worked with us that evening conducted themselves with complete professionalism. I am incredibly grateful that they carried out the task that was required in a way that allowed me to remain calm enough to stay near Dan. They compassionately informed me of his suicide and stood beside me while I cried. I asked about his wedding ring. The coroner said he believed his ring fell off upon impact and they assured me they would remain at the scene to look for it. I asked if they found a note. The coroner said they searched Dan and his car but did not find a note. They told me it was time to go home but they would call me soon.

I arrived home to my mother and my dear friend, who was able to be there because of another dear friend. I believe it was around 3:00am; thankfully my children were still sleeping. The coroner called within minutes to state they found his ring just a few yards from his body, giving me some small amount of peace. My clothes, hands and feet were covered in Dan’s blood. Dan had shattered his left leg, which produced a moderate about of bleeding. I did not see the blood from his leg that night. Not sure if it was too dark or if my mind would not allow me to see it. My friend offered to help me shower, but I couldn’t shower yet. In my mind showering and changing my clothes would make Dan’s death real and would begin the rest of my life as a widow with three kids. I sat with my friend, her husband, and my mother in my living room, and for the next hour and a half I told them all of the details of the last seven weeks. We cried, we comforted one another, we reminisced about Dan, and I think we even laughed. By 5:30am we started to make a plan…

Little did I know but in those hours my village was already rallying around us. When my friend’s husband joined me at St. Vincent’s, my friend was able to go to my house and sit with my mother because another dear friend went to her house to babysit her young children. My friend’s mother booked a flight to Oregon, her husband cancelled a very important work trip scheduled for the next day, and both of these amazing couples made the first steps of changing their world to support my family. The support of these two families in particular has everything to do with the wellness my family is able to experience now.

The plan we started was the beginning of a path that included despair, agony, hopelessness, and unwavering support from my closest friends, family and community. My path is one of genuine happiness shared with profound sadness that creates difficult moments, days, nights, and sometimes weeks. It is a path of healing, hope, and resilience. As the sun came up that next day, I began to process the first step of that path; acceptance that my beloved husband was gone, and had died of suicide.

Connie DeMerell

On Easter, April 20, 2014, I had hope. We had a good day with family and friends, and the effort and work that Dan was putting into managing his depression and anxiety seemed to be paying off. Throughout the day I continued to catch tiny glimpses of the well Dan, a man who loved life and treasured each moment with his children and family.

Monday, April 21st, hope began to diminish. Dan began to worry about Tuesday. To Dan, Tuesday was going to be a difficult day. In addition to a full patient schedule, Dan also had a monthly partner meeting scheduled that evening. And Grace, nine months old, had her well visit scheduled. It had been cancelled two times prior so that I could be with Dan. Grace’s development had been on track but her speech seemed a little delayed. We felt it was best that I work from home so that I could take her to her doctor’s visit. Dan felt torn. He wanted her to be evaluated but wanted me with him in clinic that day.

In addition to not having me at his side, Dan knew that it would be a long day due to the evening meeting. He usually got home from these meetings between 10:00pm and 10:30pm. As I mentioned in a previous post had developed a bedtime routine to help him fall asleep and stay asleep. Coming home at 10:30pm would interrupt our routine. The fear of not sleeping was frightening to him. He was also concerned that if he looked and felt tired, his partners would identify his struggle with anxiety and depression. On Monday night we made a plan as to how we would handle Tuesday.

We had a plan. A bedtime plan I naively took comfort in, not once considering that Dan had his own suicide plan.

On Tuesday he was working in his Hillsboro clinic. It was a full patient schedule as usual. We spoke throughout the day. He sounded stressed about getting his dictations done in time for the 6:30pm meeting and was particularly concerned about staffing as some changes to the daily processes were soon to be implemented. I tried to reassure him that I would do anything he needed. He called me again from the car while driving to his downtown office for the partner meeting. During that phone call I cried. It was the first time I expressed feeling overwhelmed by working a full schedule, taking care of the kids and taking care of him. I was fully committed to taking care of him; I loved him.

I tried to reassure Dan that I was ok and was just feeling overwhelmed in that moment. I believe that the outcome would have been the same, but I will always remember that phone call and wish I had not cried. I wish I could have been stronger for him. I have considered myself a failure in that phone call. I wish I had called a friend instead.

Once at the meeting, he sat next to his physician business partners. I believe there were five other physicians present that night. Dan had known some of these physicians for 10 years; they were colleagues and friends. The group ate together and discussed the usual. Dan did not eat much and did not drink alcohol but did engage in discussions regarding the future in the usual manner. According to a colleague, he looked tired as if he had caught the same cold I was recovering from, but there were no other significant signs. I share this because it is unbelievable how someone who is hours away from succumbing to depression, anxiety and suicide can hide the extent of his disease from his colleagues and his wife. We are all health care professionals, yet we didn’t know. This is something that will follow me for the rest of my life.

He called me at 10:00pm. He told me he had to stay a few extra minutes to sign a check. He seemed calmer than in our earlier conversation. He asked me how Grace’s appointment went. I told him fine and started a conversation on a different subject. He interrupted me wanting more details about her visit. I reassured him that the pediatrician was pleased with her development, was not concerned about her speech at this time, and would reevaluate her at a later date. Then he said he had to get off the phone and would be home soon.

After the phone call I brushed my teeth and got in bed as usual. I layed quietly in bed and could have fallen asleep. I had no idea that would be my last conversation with him. Did he know that would be our last conversation? I replay it in my mind often. His last words to me were regarding the health of our daughter. It brings me to tears thinking about that moment. Did he need to be sure she was going to be ok before he could carry out his suicide plan?

It seems like as his wife and a nurse I would know. But I didn’t know. His physician friends and colleagues didn’t know. Dan dying of suicide was not a consideration in my mind that night until 30 minutes passed and he still was not home.

In retrospect I consider his increase in energy level over Easter weekend was because he had a suicide plan. He could gather the strength to have a “normal” weekend of family activities so when we would reflect on our final time together the memories would be fond. On Friday, he went to the gym where he exercised and engaged a friend in normal conversation. We watched a movie with the kids and then filled Easter eggs after we put our children to bed. Saturday we enjoyed the sunshine with the kids and played dodge ball with the boys. Saturday night we hid eggs at our home and he, in keeping with tradition, drove around to leave eggs on the front lawns for a couple of our very dear friends. Easter morning we celebrated with the children as normal. He went for a run in the afternoon before we joined our friends for a later Easter lunch. Over the weekend we even made love.

I have accepted that I could not have changed the outcome. I could not have known the depth of his silent suffering if he would not tell me. Those seven weeks were filled with unimaginable struggle, but I am grateful that he shared with me as much as he did. I will always cherish those weeks when he let me love and take care of him, the tender conversations where he revealed what he could of his struggle, and the nights he would fall asleep in my arms. We were together in sickness and health. We were together till death do us part. He was a wonderful man. We had a wonderful love.

Dan does not possess many of the risk factors for suicide and in fact he possesses many protective factors. However, Dan did not feel that he could talk openly about his illness or ask for help. He inaccurately felt he would be judged, and in his words he believed he had become a “failure”. Dan believed that people would think less of him as a person if he publicly acknowledged that he suffered from depression and anxiety. Due to a fear that people wouldn’t understand, or that his colleagues would think him weak, or that his patients would no longer trust him, Dan remained isolated and afraid.

This fact that Dan felt he had to suffer in silence is one of the aspects of his death that I continue to struggle with the most. I can’t help but believe that if Dan felt he could have asked for help without fear that people would question his ability to provide for his family, the outcome may have been different. Depression and anxiety consumes lives. We must create an environment where sharing fears and struggles more openly with friends, family, co-workers and health care providers doesn’t carry a stigma. Someone in his or her deepest despair should not feel like a “failure”.

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Connie DeMerell

 

Before I can share his illness and death I feel it is important to reflect on Dan’s accomplishments and his blessings. He was a successful double board certified physician practicing, allergy, asthma, and immunology in both adults and pediatrics, in Portland, Oregon. He provided compassionate comprehensive care to patients and their families. Dan recognized that being part of someone’s healthcare was a privilege for which he was so grateful. He enjoyed working with adults but was most impressed with the children he cared for. He said on more than one occasion that he learned more from the children than they learned from him. He admired their resilience and honesty. He wanted patients and families to be active participants in their disease processes and made every effort to never rush his patients during appointments.

Dan had been elected to the executive council of the Northwest Allergy Forum for Oregon and Washington Allergists. Dan worked with the Immune Deficiency Foundation. He served as honorary chair for the Food Allergy Research and Education organization. Dan served as the medical advisor for the Oregon Chapter of Food Allergy and Anaphylaxis Network.

Dan loved being a physician, but what he was most proud of was being a committed husband and father to me and our three children who at the time of his death were 7 years old, 4 years old, and 8 months old. The words most commonly used by Dan’s friends to describe him are accomplished, compassionate, soft-spoken, humble, selfless, and giving.

Dan was active, engaged, successful and in a supportive marriage. Dying from suicide does not seem to “fit” for such a man. I wonder how many times I dwelled on this thought in those first days and weeks. I wonder how many times his family and friends considered this thought and still do. As his wife and a registered nurse of 14 years, I did not consider suicide was a possibility for Dan.

I believe therein lies an extremely important discussion. We have created an image in our minds of what the sufferer from anxiety, depression, and suicide looks like. I believe most of us do not consider a successful, “strong” man like Dan as a sufferer from mental illness. In truth, Dan was strong, and succumbing to anxiety, depression and ultimately suicide does not change that truth. “Strong” people suffer in silence with mental illness every day.

I believe that in order for this blog to be useful in dispelling current stigmas surrounding mental illness I need to share the details of the eight weeks that preceded Dan’s death.

Dan’s annual medical continuing education conference was scheduled in San Diego the weekend of February 27, 2014. As it approached he asked me to join him with the three kids. The kids and I would have enjoyed going with him but Dan worked so hard as a husband, father, and physician; I felt it was best for him to attend alone. The conference is jam packed with lectures and can be mentally exhausting. I wanted him to be able to attend the conference throughout the day then perhaps grab an early evening nap before going to dinner. Typically the evenings are occupied by spending time with old friends and colleagues. It is a wonderful time to share one another’s insight on medicine, disease processes, patient care, and to just catch up on the details of one another’s families. If I attended with three kids it would make it difficult for him to attend the conference and to get much needed rest and relaxation time with his friends. I told him I thought it was best he attend without us; I believed I was being supportive.

I decided I would take the kids to Arizona to visit his family and he would join us once to conference was finished on March 3, 2014. While I was in Arizona and he in California we spoke multiple times a day as usual. He seemed a bit stressed regarding the ICD 10 lecture but otherwise seemed to be himself. He socialized as usual and even completed a running race with friends. But when Dan got off the plane in Arizona he was a different person. He was still kind and loving but he had trouble getting out of bed in the morning and was really averse to engaging with his extended family. It just seemed as though routine activities were requiring more effort than they should have. Despite his fatigue and resistance to engage with others he did attend family events and conducted himself in a manner that did not cause alarm for those around us. I was concerned but thought his behavior was related to a strenuous conference schedule and hoped some rest would alleviate his withdrawn state.

Upon returning home Dan continued to perform at 100% in clinic. His physician colleagues and patients can attest to this. As one of the members of his nursing staff, I can attest to this. At home he continued to be “slower”, “off,” and experienced extreme difficulty sleeping. He seemed depressed, and in our first week at home he said he was anxious three times. By the third time I told him I was concerned because over the course of our 12-year relationship he had never used the word anxious to describe himself. I feel confident saying that he had never used that term before because I suffer from anxiety for which I have been treated at different times of my life with an antidepressant. Dan and I had discussed that it was something he had never struggled with. When I told him I was concerned he asked if I thought he should see his primary care doctor. I said yes and was truly surprised to see him make an appointment within a week without further encouragement. His doctor started him on a commonly used antidepressant, a sleep aid, and supplements to help him with his anxiety and depression.

Over the course of the next six weeks he continued to provide excellent patient care at work while struggling from depression and anxiety. Dan and I followed up with his doctor over the phone weekly and in his office every two weeks. Dan attempted to do everything in his power to save himself. He followed his doctor’s instructions to a “t”. I provided and he ate three balanced meals a day along with three snacks, he cut out caffeine and we ran together regularly. In the evenings we developed a bedtime routine to make falling asleep a little easier. He asked that I not tell anyone about his struggle including our families. He was embarrassed and did not want his struggle to change other’s perception of him. I wanted to respect his request because he was seeing his doctor, following his treatment plan, and making every effort to take care of himself. It is common for an antidepressant to take six weeks to reach its full effectiveness. I wanted to give him those six weeks of privacy as he requested and did with two exceptions.

I reached out to one of his partners letting her know I was worried and I had never seen him like this. I informed Dan that I spoke with her and she and Dan communicated with each other almost daily.

The intense schedule of caring for him, the kids, and working began to take a toll on me. I called my Mom in New Orleans and asked if she could come help me take care of the kids. She surprised Dan with her arrival on April 3, 2014, our tenth wedding anniversary. To my surprise Dan shared great details of his illness with her within minutes of her arrival.

Over the course of the next two and a half weeks Dan’s status appeared to make small steps forward with a few steps backwards. Ultimately, in the days preceding his death, he began to exercise without me, sleep more soundly, and more fully engage with the kids. It appeared we were making progress. That year Easter fell on April 20, 2014. It was a really good weekend. I remember parts of it feeling so “normal.” I was seeing glimpses of my happy and energetic husband. I told him I was excited to see the progress. He told me it was taking a tremendous amount of effort, which I sincerely believed.

Dan died of suicide just two days later, April 22, 2014.

I cannot stress enough that my husband was a different man when he arrived in Arizona from his conference in March. I cannot make sense of it, but it was our reality. In the blink of an eye he developed rapid onset of depression and anxiety. Dan was a “strong” man. He had no prior history of mental illness, he did not abuse drugs or alcohol, he was not facing any medical malpractice claims, and he was not having an extramarital affair. Dan had a stable career, he was financially stable, and he did not live outside of his means. He was in a loving marriage, had three beautiful children, and was surrounded by supportive family, friends and colleagues.

According to the CDC suicide is the tenth leading cause of death. It is the third leading cause of death in teenagers. Suicide rates are on the rise. Over 90% of individuals that die of suicide have clinical depression or another diagnosable mental disorder.

Do the stigmas that surround mental illness and suicide exist because we do not understand it and fear it?

Thank you again for reading this blog through the end. The feedback I have received and number of visits to the website have reinforced my belief that sharing our story and struggle is the right thing to do.

Connie DeMerell

 

It’s been just over two years since the passing of my awe-inspiring husband. In his life, he taught me about unconditional love, forgiveness, and patience.  His actions taught me humility, compassion, and the value of serving others. In his illness and his death he has taught me perhaps even more.  My husband, Dan, suffered from rapid onset of depression and anxiety. He died of suicide April 22, 2014.

These two years have been a journey through loss, devastation, hopelessness, fear, and insecurity. Today I have profound hope, sincere joy, and a degree of independence. But that is just today and in this moment. I wanted to believe that grief was a series of stages that my children and I would move forward through and never back. But our reality is much different. The emotions we experience independently and as a family are deeply complex, and while we make definite forward progress, we continue to take side steps and back steps.

We have not traveled this journey alone, and in fact many times we were carried by the most loving of family, friends, and community- our village. Along with countless other acts of love and service, our village provided my family with meals, childcare, dog walking, and carpool.  We have relied on our village for hugs, to be shoulders to cry on, to bring laughter and joy, and to simply be there.  However, I will say one of the absolute hardest parts of this journey was accepting help. It was so painful to accept that I couldn’t do it alone.  I had to ultimately acknowledge that if I set out on this path without our village it would be a detriment to my three children.

This blog is an exploration of our grief journey, the disease depression and suicide, and in finding meaning in death.  I want to convey hope, love, and an appreciation for those who support my children and me.   This blog is about finding me again, and most importantly, it is about vulnerability.

I owe thanks to everyone who has traveled this journey with us, but at times I am physically and emotionally unable to engage others. I find myself often in what feels like isolation. When someone asks how we are I want so deeply to provide an authentic response that encompasses the complexity of our status, but I am often too depleted to provide such a response and instead retreat. I believe sharing my thoughts via this blog will give me an opportunity to sincerely relay our journey. If I can’t do this, then how can I have hope that those who are suffering in silence can ask for help? If I can’t answer honestly as to how I am coping, then does that negatively impact my children’s ability to find their unique way of grieving while knowing they are not alone?

I believe Dan’s illness and death can have an unimaginable positive impact to those around us if I allow myself to be vulnerable and speak openly. I have considered this blog for a long time and am committed whole-heartedly to the good that can come from sharing. I hope a dialogue can be started not just with my post and your comments, but also among our community and perhaps farther.

There are no words I could ever write to express my most profound gratitude to those who carried us. Thank you for reading this post through the end. I hope you will be a regular visitor and become part of our village. I hope you will ask questions even if you think they are too direct. I hope to be an open book about this process, and I truly believe sharing my feelings in this format will allow me to come out of my isolation.

I plan to share more about Dan’s disease and death for those who do not already know our story. I encourage you to read Dan’s obituary and some of the guest entries. After reading, I think you will understand why awe-inspiring is such an apt description of this truly remarkable man.

Daniel DeMerell Obituary

Connie DeMerell