My journey back from Hebden Bridge this past Monday was eventful. I had risen early for me, at 6:15 am, in time to get to the train station catch the 07:08 for Manchester. This part of the journey went well. I hurried from Manchester Victoria station to Manchester Piccadilly station and was just in time for the 08:03. By now I was very pleased with myself. For once I was going to be in work for 10 am and that’s good going. Usually when I make this journey either by car or train I’m into work at the earliest, 11:15 am.
I was sitting in the quiet zone at the front of the train. We set off. I hardly glanced at any of the other passengers. I was immersed in the latest Phillip Kerr novel ‘Prayer‘, definitely not his best. I was close to the surprising end when I felt the train hit something. There was a thud, then a loud sound of metal falling off something and somewhere and in quick succession, the feeling as of a car going over a speed bump, a rattling metal or something hard against the undercarriage of the train and a juddering and an uncommon disturbance difficult to pin down or describe. What was that, I thought? The train slowed and stopped, 400 yards or so away from the site of the incident. The coach was in silence for a while. I texted Jan about the unusual state of affairs, and saying how surprised I was that we had not been derailed. The woman across the aisle from me, about my sort of age (that is not young), with highlighted hair, brown with faint hints of blond asked “What was that that, did we hit something?” I replied “I’m surprised that we weren’t derailed”.
After some 10 minutes of no communication whatsoever, a period that seemed endless, and felt like a century had passed, the driver came over on the Tannoy and said “Ladies and gentlemen I’m afraid I have to inform you that we have hit a person!” He went on “I’ve never been involved in this kind of situation before, I have to let the authorities know and speak to my control station”. His voice was tremulous, and full of emotion. Not surprising, it’s not every day that you run a person down and kill them. Poor man. You could tell by his voice that he was in his late 20s or early 30s. It’s surprising how accurately one can judge age by voice quality. And I suppose also by smell and visual assessment. Surely he would be marked by this event for the rest of his career: a sudden and unexpected confrontation with Azrael, the fallen angel, minister of death and other uncommon tragedies!
I have never witnessed a suicide before. My early experience of suicide was walking across the railway lines at 06:30 am in Lagos on the way to catch the bus to school. At that age, at dawn, when it was still relatively dark, the body parts strewn across the line did not symbolize suicide but rather accidental death. Not that I had any clear idea what death was. It was much later that I realized that these were suicides. That footpath across the Lagos-Abeokuta line at Maboju was directly ahead of where a headmaster of my previous school lived. He was said to have killed himself. This was muttered and whispered by adults in euphemistic language with face cast away from us children and with nods and winks as the English would say. We understood that he had risen from bed in the middle of the night, had supposedly gone to the toilet and had not returned to his bed. He was found the next morning hanging from the roof beams, in the lavatory. Many years later I read A Alvarez’s The Savage God to discover that like me his headmaster too had committed suicide.
The euphemisms used and mutterings by the adults, of course, spoke to the notion of death by hanging in Yoruba culture: “Oba waja”. Shango the fourth Yoruba king, in direct succession from Oduduwa had hung himself on shea butter tree and this event that occurred at Koso was referred to as “Oba waja”, the king has entered the rafters! Or, Oba Koso (The King has not hung himself). And there is a long Yoruba tradition of kings committing suicide at the behest of their chiefs because the population had lost faith in the king or had come to resent his tyrannical rule. When matters came to this, the chiefs would send a covered calabash bowl of parrot’s eggs to signal the decision of the populace that the king commit suicide and this was referred to as “Oba shigba”- the king has opened the calabash bowl. Ritual suicide was integral to Yorubaland princely and kingly culture, hence the euphemisms for describing the act of suicide.
Since becoming a psychiatrist I have had a number of suicides of patients under my care. But never witnessed suicide. The incident on Monday, on my journey back south from Hebden bridge, drew and focused my attention to the enormity of suicide. The notion of a person standing or lying on the tracks, in sight of an oncoming train, with the clear and indubitable certainty of death was startling. The disruption to our travel plans that resulted from this incident paled in significance and impact to the effect that this death was likely to have on a large number of others, parents, siblings, spouse, children and friends. A three-hour journey lasted six hours. There was inconvenience as we had to be taken by coach from Macclesfield to Stoke to catch ongoing train to Birmingham. But, imagine waking to find a son or husband missing and later discovered to have died. Imagine what the remains would look like and the issues that family would have to face at the funeral directors and before that for identification purposes at the morgue. No matter how one looks at it, it is horrendous and extremely unnerving and troubling. Unimaginable, actually.
I have in the past seen a patient, who told me in passing, that she has a noose in her wardrobe and that she frequently shuts herself in this wardrobe, puts the noose over her neck and has the other end secured to a well fixed hook. She avoids abrasions (friction burns) by covering the rope with a soft plastic covering. I warned her about the risk of accidental death from fainting and then asphyxiation and of accidental but devastating damage to her voice box rendering her voiceless but alive. The point is that these revelations need to be listened to, understood, examined in detail and discussed. Like the doctor in Chekhov’s “On Official Duty” encounters with the subject of suicide can often be experienced as part of an undesirable duty, yet it is important to retain compassion and understanding. The fear and disquiet that the subject of suicide introduces has to be tolerated and accepted. The risk always is that the clinician will respond with callous disregard, definitely an undesirable outcome.
One of my colleagues, George Tadros had focused on suicide for his doctorate degree. He had studied suicide notes and messages amongst other things. Some of the notes were dispiriting, some evinced compassion for their relatives but others were cruel and accusatory. There was so much variety in these messages. I was most struck by those that tried to ensure that partners or children did not walk in, unprepared, for the sight of a father or husband dangling on the end of a rope at the foot of the stairs.
Death by suicide goes to the very heart of what it means to be alive and to value and cherish life just for its own sake. It challenges notions of the sanctity of life. It contradicts religious codes. It casts a shadow on the life of disabled people who live around their disability yet whose lives might be deemed of poor quality and hence expendable. And it raises profound questions about the nature of autonomy and the limits of liberty in JS MIll’s terms. And ultimately it strikes at the core of that nexus of relationships with all other sentient beings, our common humanity and the regard we have for one another and the indefinable but definite sense of loss at the senseless death of another. For a brief moment on Monday all these matters went through my mind.
Photos by Jan Oyebode