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This article arose from a conversation among the directors of our foundation, Point. Michael Phillips and I wanted to publish information on how to commit suicide. Hiding such information is a vicious taboo, we opined in high libertarian dudgeon. Richard Baker, abbot of the local Zen Center and one who sees a lot of disturbed people remarked drily, "If the information were generally available, a fellow I talked with last week would be dead now. He wouldn't do it this week I think. The information that people need to know is how not to commit suicide. They think if they take an overdose of sleeping pills they'll just go to sleep and never wake up. Instead they wake up choking on their own vomit, and there's the emergency room and stomach pumping and brain damage, and it's the opposite of relief for their suffering. People try all sorts of things that don't work, all horrible."

CQ Staffer Art Kleiner got the assignment and immersed himself in it with his customary zeal. (He wants noted that "four people who have worked with suicidal people helped me articulate the article, even though they weren't directly quoted in it -- Mary Deems, Ron Jones, Larry Cohen and Ben Campbell.") Journalist Kleiner also adds, "This article was probably the most rewarding I've ever done, nightmares and all." -- Stewart Brand (CoEvolution Quarterly, Summer 1981.)

Resurrection, the voyage to the land of the dead and back again, is common enough in old legends and myths and in the experiences of people who live through a near-terminal illness or accident. But that journey is also made daily in hospital emergency rooms.

About 30,000 people kill themselves in the United States each year. An estimated ten to forty times that number try to kill themselves but don't die, either because they don't really want to die or because they don't know how.
I didn't realize the impact of that statistic until I talked to friends and acquaintances while researching this article. Everyone I talked to, whether I interviewed them or casually brought the subject up, knew someone who had attempted suicide.

Some of the stories are tragic. A friend of a friend jumped from a high building and hit a parked car several stories below. She broke most of her bones and punctured several of her inner organs, but didn't die. Instead she was wheeled, conscious, to the local emergency rom, her most privately conceived act announced to the world by the ambulance siren. She spent the next year in bed, much of it in a hospital ward allocated to critically ill victims of violence, her still suicidal mind the only functioning part of her body.

This article about what happens to people who attempt to kill themselves started as a brief review of a pair of new publications aimed at the terminally il. One booklet, the widely-publicized but little-read "death manual," How to Die With Dignity, contains a chart of lethal doses of different types of pills and methods of deliberately ensuring a calm death in a suicide attempt. It was published by Scottish Exit, a northern spinoff of British Exit, the London group that has in the past sought and won more than its share of controversy. Two of the members of the London group are now facing trial on nine charges of aiding people to kill themselves.

The other book, Let Me Die Before I Wake, is a collection of case histories of people who have committed suicide or attempted it and failed, with detailed descriptions of the methods used. It was published this spring by a Los Angeles group called Hemlock, which also counsels terminally ill people on their other options. The book's author, Derek Humphry, is a British journalist who wrote the sentimental memoir Jean's Way (1978, $5 postpaid from Hemlock, Suite 101, 2803 Ocean Park Boulevard, Santa Monica, CA 90405), the first popular book to describe what Hemlock calls "Self-Deliverance." Humphry's first wife, Jean, discovered that she had bone marrow cancer and took a fatal drug overdose as she was on the verge of becoming immobile.

"Perhaps 10 percent of our members are terminally ill," Humphry told me. "The great fear of the rest of our members is that they may face a painful, awful death one day. If they can say, 'I have this cache of pills and good advice on how to use them,' they can feel prepared if they eventually do fall ill and in the meantime can get on with the business of living."

So when I went to emergency room physicians, paramedics and therapists, I expected to hear of many people who might have needed this information -- people who, faced with a grim illness and no alternatives to it, had tried to kill themselves and ended in the emergency room instead. Wrong. People who plan deliberate suicides usually succeed -- as Humphry said, everything in the suicide manuals can also be found in medical textbooks. People in emergency rooms are usually people who attempted suicide on impulse, in temporary despair or anger. Many decide later that it was a mistake.

Married Female, age 38

"I can't bear the pain any longer. I'm tired, discouraged and unhappy."

Read other suicide notes gathered from a coroner's office.

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