Out Of The Darkness…

November 04, 2018.Nov-4-13

 

 

 

A day I will always remember.

A day that I totally had to have in my life.

My first Out Of The Darkness Walk for Suicide Prevention.

A day that opened my eyes to the reality and the magnitude of this problem.

I found out about this day from my nurse at work. I signed up after my good friend Mari told me she had signed up. I signed up not knowing exactly what it was going to be like, but trusting that the day was going to be…in the very least, fine. I signed our team up and placed the info on my website, partially expecting and also not expecting much response to the call for donations. While no donations came indirectly, I managed to gather a team of about 15 walkers through the help of my good friend Mari, totaling about 375usd!.

The day started like any other. We arrived early. The first emotion that struck me was that of amazement, at the number of cars already in the parking lot, even though the walk was to start about 2hrs later.

There was a sea of colors of tee-shirts, most in groups, a few scattered around, all there for one thing, in remembrance of a loved one. There were purple tees, white tees, green tees, red tees, blue tees, and multicolored ones. There were people, young and old, men and women, boys and girls, teens and young adults, toddlers and even a couple of babies. But one thing struck me hard; they were mostly Hispanics. About 99% strong! Where are the Caucasians?? Most studies I have read indicate that White males are the leading sex in Suicide, so where are they? And what about the African Americans? Do we not suffer from depression, do we not commit suicide? Are the recent studies about African American children aged 5-12yr being more likely to commit suicide than their Caucasian counterparts incorrect? Wait! I know what this is. This is the grand state of denial that is so rampant in our community. As a Nigerian, I dare to say this problem started from the Mother-land where mythic quotes like the following run rampant. “We don’t get depressed”, “such things don’t happen to our people”, “we can pray it away”, “it’s a sign of weakness, and of laziness”, “depression is not even real”, “those medications do not help, they actually make you worse”, “therapy? please, that is for Hollywood, we are black folk, we do not do therapy… Or my favorite, “don’t tell anyone you are depressed, we don’t want them to start looking at you/our family funny”.

I walk around distributing my business cards to different teams, introducing myself and explaining what I do, sharing my story about my struggle with depression and suicidal thoughts, and my own son’s depression,(which I totally did not recognize while it was happening) I notice folks sporting different color beads signifying the kind of loved one that has been lost: White for children, orange for siblings, blue for support, red for spouses, etc. I pick up some beads for my team, my wife lost her brother to suicide. On my way back to my team, I hug as many as will accept my hugs as we wait for the ceremony to begin. Some of them have lost multiple family members to suicide.

After the opening ceremony, the names of the victims are read out, I again am amazed that my assumptions are right. A huge percentage of the names called out today are Hispanic.

 

The organizers are happy to announce that over 64,000usd were raised so far,  over 273 teams registered (many more are not in organized teams), at least 300 names are called ( I don’t have the actual count, but the name calling went on for at least 30 minutes or more. They inform us it’s a 5K walk, kicked off by the release of white balloons by the family members in honor of the lives lost. Again, I am amazed, excited at the opportunity to be a part of this, yet saddened by it all.

Along the trail, I speak to dozens of parents and family members affected by suicide. It’s easy to find the parents, they are wearing white beads, they are not as animated as everyone else, and you know that look when you see their eyes. I interview a few of them, I hug ALL of them, I am touched deeply by their stories.

One young man who took his life just last month was only 25yr old. His parents still obviously devastated. His mom says she “sleeps with his picture every night, and talks to it every day”. She has lots and lots of unanswered questions. His grandmother found him in the backyard in Austin, sadly, they were not able to make it on time to the hospital.

Another mother was carrying the picture of her son-in-law. He had first served in the Army, then joined the police force, but his PTSD got the better of him.

When asked who he was walking for, one little boy simply pointed to the picture on his tee-shirt and said, “my uncle”. He had never met him.

I met yet another mom, this time, of a young 10yr old boy, who would have been 13yr this year, she is still crying for her baby lost. He had been bullied. A lot. I hugged and hugged and hugged her, and held on a little while longer. She found him hanging from his bunk bed, his belt around his neck.

Yet another beautiful lady, Ms. Alyssa’s younger sister, Marisa, spoke to me. Alyssa had battled with depression for a long time and finally lost. The words inscribed on the back of Marisa’s tee-shirt read “I have run the race, I have fought the fight, now I lay me down to rest”. Her own prescription antidepressants, her path to said rest. The sisters’ resemblance is so uncanny that Marisa’s own daughter (who never met her aunt) always calls her ‘mommy’ each time she sees her photograph. It has been six years.

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The heartbreaking story of a handsome 17yr old was shared with me by his maternal aunt. She told me he had attempted suicide three times in the past. He had gotten help, he was on medication, and getting counseling, but (in her words) “the demons got to him before we could”, this happened on September 18, 2018. So fresh is it, that his mother could not bear to come for the walk.

Then, I talked at length with one mother whose team carried the flag of the Cycle Around The Globe for Suicide Prevention and Awareness. Her son, a former Special Ops US Marine, spent only 9yrs active duty, but deployed 8 times in that short time! When he eventually got out in 2012, he battled nightmares, sleepless nights, and severe PTSD. He could only sleep when heavily medicated. He eventually tired of “the voices in his head” and one single bullet did it for him, only 3yrs after he got out, a few days after his 30th birthday. “He will forever be 30” she added at the end of her story. Again, all I can do is hug her, and hold on a little longer.

On the homeward trail, I walked up to a nurse and her co-worker, both walking for someone else. She shared that her friend and ex-boyfriend had taken his own life soon after his 60th birthday. His story is unique because she states in retrospect she now realized that, after they reunited 40yr later, he had one day suddenly started “acting out” his desire to end his life, he was making specific requests like going to visit a cemetery to “say goodbye”, returning to the place they had their first date, giving away his belongings and generally no longer caring about the world. She remembers he stopped wanting to hang out with her, and only wanted to talk about death.

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The last two stories are etched in my mind. The first is from my good friend Mari, who shared that a long time ago, her friend and classmate in nursing school had gotten dressed for work one morning, arranged all her nursing books against the walls of the garage, got in the car, turned on the ignition, closed the garage door, and went to eternal sleep. Her husband found her when he returned from work. She had 2 children.

The second is from the only non-Hispanic family that I met during the walk today. There were at least 15-20 of them in their team, walking for the family Patriarch. I recognized the non-Hispanic name right away and wanted to speak with them. I spoke to his wife, his son and his daughter, as well as the rest of their family friends and relatives. He was Indian. It’s been one year.

I, myself have felt the pain of depression. I have felt the need to end it all. I didn’t, my wifener wouldn’t let me. I felt like I was a failure, a disappointment. My first marriage was over, my private practice sold for zero dollars profit. The military was stressful, and I had to file bankruptcy following bad business choices in my private practice, stemming from a poorly qualified practice manager in the person of my ex-husband. Somewhere along the line, I felt I had failed myself more than anything. I wanted out. All my pairs of shoes, my fancy designer handbags, and even my beloved children did not save me. I simply felt that ending it all was just what the world needed. I was a failure. My marriage had failed, my practice had failed, and I had failed, and nothing you could have told me would have made a difference. Luckily, my wife would not hear of it and went all the way out there, in the darkness to find me and bring me back. I owe my life to her.

In the end, I can only say that I am thankful for the Out Of The Darkness Suicide Awareness walk, thankful for the experience, thankful for the stories shared, for the hugs given and received, and praying that the families can find closure, somehow. Thankful for my family that came out to support me, my wifener who walked for her brother; mi Madre, my biggest cheerleader; and my little man-child for trouping along. Mari and her family and friends who walked with team Teen Alive, for the sparkle they added to a cloudy day. And to all those who walk for their loved ones, in the words of a Kenyan proverb, “may the grass you stand and walk on, sprout again”, and may you never have any cause to weep for your loved ones again, Amen.

 

Nov-4-11

“gone, but never forgotten…”

#enddepression, #endsuicide, #endthesilence, #talksaveslives, #itsoktonotbeok, #Icare

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4 Airmen, Diego and Megan

 

Dear Blog,

Howdy? Long time! Just wanted to touch base and check in with you. I am having a fabulous life, you? So, after about one month off from my Rideshare seat, I returned to it today, and as usual, I was pleasantly delighted to meet my clients. The beautiful thing about Rideshare is you never know who you might pick up next. My clients are often so different from each other. Each one teaches me a new and different lesson about life. Again, that is why I do this. The story goes like this… I am writing a book on teens, depression, and suicide. I woke up this morning and as usual, I worked on a couple of chapters, but I just didn’t feel like it was flowing the I wanted, I was having a hard time getting into my characters’ minds to tell their stories, so I declared to my mother “I NEED a depressed and suicidal teen in my life right now!”. I proceeded to explain why, when I saw the puzzled expression on her face. We both shrugged and concluded that-that was going to be a tough one to pull off. So, I go about my business for the day.

Later on, since my numéro très had a birthday party to attend for 2 whole hours, I decided to seize the opportunity, take a break from my preparation for my Executive MBA midterms next weekend, and go online on my UberXL/Lyft apps to see if anyone was interested in a fun ride with Dr. Lulu! Unbeknownst to me, the Good Lord was going to use my clients today to show me yet again that He alone is Lord and King and more importantly, the Author of the universe.

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My first client, whom we shall call “Joe” was picked up less than a mile away, he was going in for his night shift at the “Howl at the Moon” downtown San Antonio. We exchange pleasantries, and I decide on a whim to give him one of my brand new business cards and inform him that I am a Public Speaker on Teen/Young Adult depression and suicide. He, in turn, gives me two free admission coupons to HATM, with discounts on happy hour drinks etc, and proceeds to sign me up for their email list for more (free) Happy Hour goodies! I am elated, accept my coupons graciously, thank him, and self-declared it would be a good shift for me today because I had started my day literarily touched by an angel. I inquire about his choice of music vs my audible book. He says he doesn’t really care, he would rather watch “Sex and The City” on his phone, and he would have his earbuds on. We both settle in for the ride downtown, and I proceed to continue listening to my “Four Hour Work Week, by Tim Ferris”. As we approach downtown, I shut the audible off to focus on the traffic and the people, I ask him if he heard about the 12yr-old boy who had committed suicide in a nearby town lately, his response almost knocked me off my seat! “Oh yes! my co-worker’s younger brother is his best friend, they are from Jourdanton” was his immediate response! I had never mentioned the name of the town, but he knew the right one… At this, I am completely speechless at the smallness of this world! What are the odds? How could it be? But it sure was. Sitting right behind me, in my car, was someone who knew someone, who knew someone, who knew the 12-year old that had been bullied on to taking his own life at a local middle school yesterday! Wow! I LOOOOVE doing this!

Next, I pick up a (two couple) party of 4 baby boomers at the Westin. One of them is disabled and has a wheelchair. Though my Sasha is a 7/8 seater UberXL-ready 2017 Toyota Highlander, they had the hardest time getting that wheelchair to fit in her trunk. They eventually did, and I sensed they were a bit flustered with the entire process. When I asked my usual icebreaker question “so how has everyone’s day been today?”, they all grunt and puff and reply “it has been a rough one”. Trying to cheer them up, I gingerly quip, “well, at least we are on our way to fun now”, to which one of the ladies retorted, “well, we are late to our event”. I think to myself, I had nada to do with it, then I hear myself say “well this Saturday evening downtown traffic is not going to help that”… an awkward silence follows. Then I change lanes and perk up by sharing a bit about what I do as I distribute my business cards. Front seat guy now informs me that they are from Florida, but he would certainly keep my card and keep me in mind…I am like, YES! We have some small talk about hurricane Michael and its toll. Things get a bit worse when the address that he had put in as their destination on the Uber Navigation, was in the middle of the nowhere! not Shuck Shack, on Grayson and Broadway as they had wanted. Turns out all that initial frustration I had sensed was because they were with a food tasting party and had missed their bus! A couple of phone calls and a couple more U-turns later, they are safely delivered to their destination. “Bon Appetit”, I think to myself as they say their thank yous and I drive off.

I hop over to Nueva Vista, an enchanted and quaint neighborhood tucked away next to the Pearl to pick up a couple who right away complement me on Sasha. I thank them and start my usual icebreaker questions. He quickly responds, “we are doing fine, but we are interested in this your car, we are looking for a multi-seater vehicle”. I happily tell them everything I can about my Sasha, as he tells me to ignore the Uber navigation system, and proceeds to guide me through their wonderful enchanted streets instead. I note the air is different there. I inform him that I am officially in love with his side of town. We make a right turn into San Pedro on our way to the movie theater on Route 410 and he points out Alta Vista a sister neighborhood on the left, another whimsical looking part of town. As I drop them off, I note to myself (be sure to bring the wifey here for a “romantical” drive someday) Ironically, his wife or rather, lady companion did not so much as utter a single word throughout the ride, and I can’t even remember if she said goodbye. But before I could process that thought, I got a chime to pick up my next client.

Handsome “Diego” joins my space at North Star Mall. He is an energetic, mid-to-late-twenties sweet smelly, colorful young man, getting off his shift at Michael Kors. He gets in the front seat, acknowledges my white LV Neverfull which I pick up and place on the floor in the middle row, thank him for the compliment, and tell him to get comfortable, as we start our ride. With a megawatt smile, he shares that he is “dog tired” because even though he had known he had to be at work this morning at 0900hrs, he had proceeded to go out last night, and got back really late. I go into mama-bird-mode and we talk a bit about growing up and taking responsibility for actions and such. We talk a bit more about his dreams and somehow get to the topic of his roommate with whom he had had a recent fight, he gently adds that he had bought him a small (make-up) gift from MK because he “hates the energy in their apartment when they argue and fuss”. I am full of admiration for this young man, who wants to make the world a better place, one gift at a time. I like him. We arrive at his apartments shortly thereafter, but he remains in the car because he is telling me all about the recent shooting at Pegasus downtown. Apparently, he had been there that night. He recounts how his mother had unusually texted him up to three times that night, the last text coming just minutes before the shooting. He says he suspects his mom somehow sensed something bad was going to happen and had been trying to reach him. I share my own mama-bird story about me and my son at Stanford, the night I had seen him in a dream reaching out to me, I had woken up with tears in my eyes, and when I called him, it turned out he was burning up in a fever and needed his Mama. An instant friendship is born. Diego left my car after earning one of my world famous warm hugs and promising to text me his employee discount code at MK…another satisfied client.

To pick up Ms. Megan, I had to make several U-turns, drive into the gated apartment complex, and wait for almost 2 minutes. As Uber starts charging her for my wait, I note a tall slim female approaching the car. As she walks up to me, wearing the latest millennial garb of a black mid-section-revealing-cropped-tee, on black double slashed jeans and tousled hair, I note that she is easy on the makeup and I think to myself with a corner smile… “that is exactly what my daughter would be wearing if I had one”. She greets me pleasantly, apologizes for her lateness, gets in the middle row, I move my Neverfull back up front, and she gets comfy. Right away I sense she has had a sad life. Photo by Pixabay on Pexels.comShe has an ever so slight air of melancholy. I note that unlike most teens her age, she is not on her phone. She is not texting, she is not talking, she is looking straight ahead, both hands resting on her thighs and deep in thought. I remark on that, to break the ice, and she smiles ever so slightly. I know I am right. I start telling her about what I do, give her my business card. She asks for more cards and the next 23 minutes fill me with more awe than I could have ever imagined. She opens up and says the words that every parent of a teenager or everyone who is acquainted with one would give money to hear… “that is pretty cool that you are doing that”… I smile as I say, “thank you”. Then she not only proceeds to tell me that at her high school, they have had 7 suicides in the past 5 years, (the last two in the past year, one of which its anniversary is today!), but that she herself has had not one, or two, but three attempts at suicide! I CANNOT believe my ears! Earlier this morning, when I had asked the universe for a suicidal teen, I had absolutely NO IDEA this was in store for me. I thank the good Lord immensely, reach back with my right hand and take her right hand, she grabs it with both hands. and holds on, and I simply let her hold it as long as she needs to. I take a long deep breathe after she gets off at the LongHorn Steakhouse on I-35 South, shake my head slightly, and vow henceforth, to only speak out, that which I know I really want because it will come to pass.

Last stop for the evening was about a mile up the road on I-35 south. I pick up four Airmen from “the best tattoo place in town” according to front seat guy. They are young, late teens, early twenties-ish, full of life, and bright expectations for what the future has to offer in the best Air Force in the world, the United States Air Force, “first in flight”. After back row seat guy curses twice, I clear my throat and proceed to tell them I am a veteran of the USAF and ask how they were doing. Front seat guy tells me they are recent basic training grads from Lackland AFB, and currently at Camp Bullis for Security Forces training. Then comes a barrage of questions from all of them at the same time; “did you go through OTS?”, “did you ever get to deploy?”, “what do you think about Tyndall AFB?”, “would you do it again if given a chance?”, “what’s life like on the outside after a brief taste of the inside?” “did you do your 20yrs?” “what did you do while you were in?” etc. I smile and try my very best to address all of their concerns. One tells me he is from Kansas and would love to be stationed at McConnell AFB after I mention my brief manning-assist there. Another wants to know if I know anyone at Robbins AFB in Georgia, yet another asks me what I think about going in the reserves afterward, and then another wants to know about Alaska and if I could confirm that it is truly considered an overseas deployment. I marvel at all of this. It turns out to be such a fun trip, but I made sure I still got time to squeeze in a quick note on depression and suicide and the need to ensure they formulate good relationships and stick to the straight and narrow. By the time I drop them off at Top Golf I feel truly fulfilled and thankful for a fairly eventful and awesome shift. In a little under 3hours, I feel I have gained much more in knowledge than the nearly 80usd I have earned in cash today.

“if you want light to come into your life, you need to stand where it is shinning”

                                                                                             ~Guy Ginley~

backlit dawn foggy friendship

10th day of September 2018…

Dear Blog,

In this special month dedicated to suicide prevention awareness, and on this day particularly assigned for it’s commemoration, I wanted to take a moment to share a brief insight into teen depression and teen suicide from my perspective.

Let’s face it, teens have stressors just like we adults, sometimes more. I know most of us parents think teenage years are full of fun and games and carefree living–I am here to tell you that it is often not as we think. Not only do they have to deal with issues relating to adolescence, like the hormonal and physical body changes that accompany it, they also have to deal with school work big time. This may include dealing with AP classes, preparing for SATs and other standardized tests, taking college prep courses, as well as picking colleges and interviewing. They also may deal with dating and the drama that comes along with that, nuances of peer pressure from classmates, and pressure from coaches and teammates for those that participate in sports and other extracurricular activities like band, cheer-leading, and orchestra. I won’t even begin to mention how we parents have our own unique requirements for teens to either “be grown” or act grown, or how their siblings and other family members all have different opinions on whether the teens are grown or still children. 

Phew! That can make for tough teen years!!

So, now that we all agree that teens do have it rough, the onus is on us as family members and the community (the entire village it takes to raise them) to be more cognizant of that fact and act accordingly.

Amidst all of these teen issues listed above, it is easy for us to miss true signs of depression and or suicidal thoughts in our teens. I, for one, missed the depressive signs in my son who was then 12-year old son, and  was bullied in middle school. That sadness that has persisted for longer than 2 weeks now, might not be as a result of his or her school workload. It might not be as a result of the recent breakup from a dating partner; it might not be stress from their overscheduled life, nor pressure from their teachers or band director.

It might be depression and your teen might be suicidal as well.

Teens might become gradually withdrawn or lose their appetite, they might start losing interest in their normal daily activities or extracurriculars. Suddenly, they may no longer want to participate in competitive sports or they might simply drop out of the swim team. In some of my patients, I often note the spark is gone from their eyes–their air is of melancholy, with ashen faces and poor or no eye contact. They may begin hanging out with the wrong crowd, experimenting with drugs, or worse still, they may drop out of school altogether. Self-harm usually in the form of cutting themselves may also occur, and they often find creative ways to hide the marks and scars. For instance, be wary of the teen who always wears long sleeved sweatshirts or jogging pants in the (hot) summer. If suicidal, they might start giving away their favorite stuff, asking questions about death or asking about suicide. They often wish they are better off dead, and might mention it in passing. In truth they might be trying to reach out for help, but do not know how, or who to turn to. Regardless of the presence of friends and close family members, they might not want anyone they know, to know.

The average teen who is suffering from depression is most likely not going to tell you–their parent.

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Where do you begin?

A family history of depression is sometimes the best place to start when it comes to honing in on our suspicions about our children and their prolonged moodiness. If you have a family history of mental illness, do not ignore it… it could happen to you or your child. Adolescence is often an easy period for symptoms of depression and other mental health issues to arise. Since the teens are already faced with a myriad of other stressors, depression simply slithers in, takes a seat, and gets comfortable.

When in doubt, ask their siblings, friends, or school mates about the behavior or mood of your teen. You will be surprised at the wealth of knowledge they possess. Afterall, they often spend a lot more time with your children than you do. Furthermore, these friends might not know how to approach the topic and might not know who to go to.

Your teens’ teachers and counselors will be another great resource. They are there to help and are often very willing to assist in any capacity.

Note that your child might not tell anyone at all and might even concoct stories to hide the truth. In fact, a patient’s mom recently recounted an instance when her son had told his curious sibling that the family cat had scratched him, in response to his sibling’s inquiry about the strange cuts on his forearms.

I recommend you find a nice neutral place to sit and talk, or a simple walk around the neighborhood, or a nice long drive, or even a picnic. A good ambience might help facilitate the communication on a face-to-face basis with your child. This might be a fruitful exercise if your child will cooperate, unfortunately, most teens really do not want to confide in, nor discuss these issues with their parents, however, it is still worth a try.

A short visit to the health professional, like the family pediatrician, family doctor, counselor or therapist is always a very good decision. They will ask you the proper questions and point you in the right direction to get your teen the appropriate kind of help they need. There are multiple places you can get help for your teen as well as their siblings (because there is often a need for siblings to participate in the treatment sessions in order to adequately understand exactly what is going on) and for yourself as well (especially if there is a family history of depression). These can either be online virtually, as telemedicine, or at your regular doctor’s office.

photo of woman in white blouse leaning on gray steel shed

#endteendepression

#endteensuicide

#askdoctorlulu

1-800-273-TALK

BB

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!

Physicians, never forget your WHY…

 

Dear Blog,

Last Friday, as I sat finishing up notes on the last of my almost 30 physicals (this number is never any surprise for us Pediatricians this time of the year, it’s back to school week, so every Thomason, Dickinson and Harrison is lining up for sports physicals and regular physicals and all sorts of clearance and medication forms that need to be filled out and turned in “yesterday”) I took a deep breath and exhaled, my mind filled with the events of the day. As is customary, my beloved patients often postpone their physicals all summer, in search of sandy beaches and clear blue vacation skies, so it’s usually a mad rush the first week of school.

I found myself reflecting on the patients I had seen that day as I often do at the end of my day. Most of them were mundane well baby and well child checkups, nothing really of note, a few of them had minor issues to clear up before returning to play…but one of them stood out clearly like a lily in a field of carnations…a 16year old we shall call “Maya”. I have met Maya only a couple of times in the past and I have known her to be a troubled teen, plagued with depression and anguish, never really smiling, not much eye contact, not much of an affect…just sad. I have tried to manage her depression the best I can with counseling in the office, a referral for proper psychotherapy. My good friend, and child psychiatrist sees her regularly and has placed her on an appropriate dose of antidepressants, and she reportedly goes to counseling regularly, all with little or no change in her mood(s)

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She came in that day in the company of her mother and her older 17yr old sister. I sensed something wrong right away, but I continued my usual intros and salutations and other little talk. Her mom could not stop fidgeting, with the characteristic continuous knee shaking. Her sister’s face was buried in her mobile device for pretty much the duration of the visit, except when I inquired about her. It turned out her sister was also to be seen that day. Both mother and child proceeded to explain to me that her sister needed to be seen for “stomach problems” that only happen at her high school, stemming from her “unique eating habits”, and her lunch time not being fixed at a particular time of the school day. This apparently never happens at home or during the holidays or vacation, when she reportedly “has her own eating schedule”. She wanted a note from me to the school nurse authorizing her to eat her lunch at the exact time she wanted, or she would develop abdominal cramps, nausea and headaches and “get so sick” she would end up being sent home from school. This story line and request stuck me as bizarre, I recognized a familiar thread of possible anxiety in her sister, and maybe some co-dependency in her mom, but I digress…

Maya on the other hand, wore a thick black sweat shirt and jogging pants…mind you, it is 105F outdoors in San Antonio Texas in July! As I indicated in my first two Kevinmd articles https://www.kevinmd.com/blog/2018/07/a-pediatricians-healing-spirit-treating-depressed-anxious-and-suicidal-teens.html, and https://www.kevinmd.com/blog/2018/08/why-this-physician-quit-her-job.html

I somehow am a magnet for depressed and suicidal teens, and Maya, was no different. She made absolutely no attempt to engage with me, no eye contact, shoulders drooped over, melancholic and flat affected. She appeared pale, ashen and sullen, with dark circles around her eyes, she simply looked like she could use a looooong-warm-heart-filled-hug. During the physical exam, she hesitated to take off her sweat shirt, but I insisted, eventually, her mother ordered her to do so. She did so veeerrry-reluctantly, and immediately pronated both forearms…I gently supinated them, and to my horror, revealed numerous, clearly visible, freshly carved cuts all over her forearms, extending from her wrists all the way to her elbows, on her left and right forearms respectively. I said nothing, gently turned them back to her preferred position, completed her examination, and walked back to my seat. I then calmly asked her mom about Maya’s depression and how her cutting behavior was fairing. She hurriedly replied “oh, a lot better, she is receiving counseling, and has not cut in 2years. 2yrears?? I thought to myself, more like 2days!!… Her response immediately made me stop typing on my laptop EMR,  I looked up at her, made sure my words came out clearly and as gently as my rapidly beating heart could muster, as I said, “No ma’am, I am afraid but I have to tell you that Maya has fresh cuts on her forearms and wrists, that are probably not more than 2 days old…”Self-inflicted lacerations on arm of man : Stock Photo

The rest of the visit was a bit awkward. Her mom asked to see the cuts, Maya vehemently refused, and an uneasy silence set in after I explained to mom that, she would probably do better waiting until they got home to approach her alone in her bedroom. Meanwhile, we should probably revisit her counseling sessions, and explore the possibility of an in-house facility if possible, especially since her self-completed PHQ-9 score that day was a total of zero.

I write this story today to remind myself of my why. To urge each one of us doctors to remember our why(s) Never lose sight of the reason you went into medicine, no matter what. We are a special breed, a unique set of like-minded individuals who choose service to humanity above all. We choose to make a difference in our patients’ lives regardless of all the administrative, legislative, personal and sometimes insurmountable difficulties we face daily in the field. I was reminded that day of my reason for leaving my beloved 9-5 job to follow a passion of fighting to end teen depression and teen suicide. I was reminded to follow my heart and believe in my dream. I was reminded to stay the course, because, for every Maya in my office, there are a hundred or even a thousand more out there, so, I must go forth. “The harvest is plenty, the laborers, few…”, Luke 10:2

rear view of a boy sitting on grassland

#endteendepression

#endteensuicide

#askdocotorlulu

BB

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!