Fade to Black (Suicide)

Dorothy Parker had it about right:

Razors pain you;
rivers are damp;
acids stain you;
and drugs cause cramp.
Guns aren't lawful;
nooses give;
gas smells awful;
you might as well live.

'Tis the season to not be jolly, for some people. The holidays are difficult for the emotionally vulnerable and Hollywood inhabitants are no exception.

Witness our suicide watch for Britney Spears after her latest debacle. Our troubled queen of tabloid trainwrecks has her visitation rights suspended after a non-exchange of the children, is whisked away by ambulance, discharges herself AMA after refusing psychiatric treatment, flies off to Mexico with her new boyfriend for a 24-hour liquid cure at the bar, and then shows up three hours late for a court hearing which she doesn't attend.

Ooops, she did it again.

And she's not the only one. Kate Hudson announced in this month's Vogue that she wishes Owen Wilson "beautiful things — health and everything that he desires in life” after his suicide attempt last August (wrist slashing and pills).

There's a long tradition of suicide attempts, near-misses, and bullseyes in Tinsel Town.

It's almost expected in the music industry. Typically, the singers make it stick: Judy Garland (and Auntie Em, too), Dorothy Dandridge, Kurt Cobain....The Singing Nun (she and her lesbian lover took an overdose of barbiturates and alcohol).

My money is on poor Amy Winehouse.

Then there are those Hollywood stars who have tried and failed. Many iconic names pop up: Maxene Andrews, Brigitte Bardot, Sammy Davis, Jr., Patty Duke, Elizabeth Taylor, Robert Young. More recently, Halle Berry, distraught over a failed marriage, tried to end her life by carbon monoxide poisoning. Drew Barrymore got it out of the way early when she tried to kill herself after leaving drug rehab in 1989 at the age of 14.

Sometimes it runs in the family. Margaux Hemingway, the actress/model granddaughter of Ernest Hemingway, died via a phenobarbital overdose. Papa Hemingway also took an early exit, as did his father, Clarence Hemingway, and his two siblings Ursula and Leicester.

And the most famous one of them all? No, Marilyn Monroe's death was probably not a suicide. Donald Spoto's 2001 biography makes a very convincing case that her death was essentially a tragic medical mistake.

The suicide rate rose by about 20% between 1999 and 2004 among middle-aged Americans, its highest point in 25 years according to the CDC (Centers for Disease Control). While four times as many men suicide, women are more likely to attempt. The 45-54 age group is led by women; men wait until retirement. What is most predictive of completed suicide is a history of serious attempts – alcohol and drugs up that risk enormously. An expression of hopelessness is a particularly ominous sign, and someone who admits to a plan is at maximum risk.

It doesn't exactly sneak up on those close to the suicide.

What to do? Ask him or her. Then ask again. For a very thoughtful further exploration of this topic, link here to read an excerpt from authors Gayle Rosellini and Mark Worden's book Here Comes the Sun.


PS:
As promised, here is the verdict on Donda West's post-surgical death last November. The autopsy report released last week states she died of "...coronary artery disease and multiple postoperative factors..." While recuperating at home the next evening after her surgery, she was left unattended long enough to vomit up old blood, aspirate it, and have a heart attack.

Remember Dr. Andre Aboolian? He's the board certified plastic surgeon who asked for a preoperative exam from an internist: "I always insist on a medical clearance for women over 40, and in this instance, it was particularly important because of a condition she had I felt could have led to a heart attack."

Kanye West's mother had a family history of heart disease and hypertension. Her sister had died of a heart attack. She, herself, had been treated in the past for hypertension. She was obese (188 lbs.) and wanted a lengthy 5 and a half-hour surgery: a bilateral mammaplasty (breast lift with 325 ml implants) and circumferential abdominoplasty (belt lipectomy, liposuction). On autopsy, her right coronary artery was found to be 50-70% occluded and she had an abnormal hemoglobin variant.

The Los Angeles coroner did not determine the manner of death, but here's how he thinks it played out. The tight postop bandages around her torso constricted her breathing, along with the pain medications which can depress the respiratory centers of the brain. If her blood was somewhat diluted with all the intra-operative fluids she received over the long surgery, it would exacerbate the drug-induced hypotension (low blood pressure). When she aspirated her vomit this further decreased the oxygen supply to the lungs. The drop in oxygenation and low blood pressure was too much for her compromised heart and she went into asystolic cardiac arrest, dying before anyone noticed.


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