Friday, 14 April 2017

Of means, and ends

On the cliff path
I don't really understand my own mind. I watch my behaviour, as an ethnographer would, and try to infer intent from observed action. I perform experiments to test hypotheses. I'm sure other people don't do this - I'm sure other people don't need to do this.

Last weekend I rode my bicycle up to the cliff path. In part, I went to see whether there were any razorbills or guillemots nesting this year (there weren't, or, if there were, I didn't see any). But in part I went consciously to test how suicidal I was. If you really want to die, I said to myself, here's your opportunity.

I didn't.

This morning I tried my usual mental test of the same issue: if I had a lethal dose of opiates in the house, would I take them? And this morning the answer is a confident 'no'.

It's hard (for me) to pinpoint when an episode of depression starts. One could say with a fair degree of truth that I've been depressed to varying degrees for more than three years, but a period of high intensity - a period in which I've been struggling badly with suicidal thoughts - started in late December and ran until very recently. I've been making preparations to end my life - 'setting my affairs in order', as they say. There have been a few days in that that I'm genuinely surprised to have survived.

But it seems that period is over - of which I have to say I'm very glad. Which makes my current behaviour even more bizarre.

I've had the veins removed from my left leg, as a consequence of childhood illness. Consequently it doesn't drain very well, and tends to develop clots. Consequently, for the last twenty years I've been on blood thinning drugs: specifically, warfarin. Warfarin is a nasty drug. The lethal dose is only three times the therapeutic dose, and dying of warfarin overdose would be extremely unpleasant. I've thought about this a great deal, because of course the one drug I do have a lethal dose of in the house, and have had all through this period, is warfarin.

It seems I've been at best a dilettante suicide. I have several means of lethality at my disposal, none of which I've used; as I say, my routine test of how suicidal I feel has been, if I had a lethal dose of opiates, would I take them? For the last many weeks the answer has been 'yes'; but I haven't chosen to take the drug I did have.

Instead I've done the opposite, and I'm still doing it. And that's bizarre.

The therapeutic dose of warfarin fluctuates with a range of factors, and consequently one needs to have the clotting ability of one's blood retested regularly. I'm currently supposed to be retested fortnightly, but in fact the last time I was tested was on the 11th of January; since then I've refused. And three weeks ago I decided to titrate the dose down and come off warfarin altogether.

Without it, I shall almost certainly die, probably quite quickly. That's OK; I've never been afraid of death. Much worse, though, I may have a disabling stroke. My decision to stop taking warfarin was, consciously, another test of how suicidal I was. I could at any time, I thought, reverse the process, take a dose, go and get tested.

Well, I could. But, although I no longer feel suicidal, I haven't. So what's going on? Why not? Is it just pride, a refusal to back down? Is it indecision?

Am I capable of killing myself out of sheer stubbornness?

I don't know. It seems I am. I really don't understand my own mind.
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The fool on the hill by Simon Brooke is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License