Medical Assistance in Living

An Open Letter to People on the Ledge

Frank discussion of suicide and its impact lies ahead. Please consider whether you are in a space to proceed. Thank you to my paid subscribers for supporting my work.

It’s been difficult to see so many trans and detrans people openly pondering whether another dramatic transition is the answer to the failure of the last transition, especially as medically assisted suicide becomes more accessible and accepted. Outwardly, and especially publicly, suicidal people are too drunk on their own pain to soberly contemplate their thread in the social fabric and their impact on others. Whether circumstance can ever legitimate the premature cancellation of one’s subscription to the herecurrent, is beyond the scope of this post. I have written previously about watching a dear friend pass from intractable cancer after a brief and torturous 2-month fight. In regards to suicide for reasons of mental health, I speak from experience, both as a contemplator and a survivor of completers, and regret. I hope you all can find your way out of Plato’s cave, past the shadows on the walls of your minds that are merely echoes of what is now behind you.

You imagine dying will help because that's been your past experience of help. There’s a change of state, and then you are out of pain. Your desperate motor area wants to follow through on this previously successful sequence. Such talk also gets attention, which placates. A person in deep pain once sent a text to me, which read, “someday you’ll read about a cry for help.” It was the last I would hear from them, and they were gone within a fortnight. I had stopped responding to their cries, which were typically phrased as accusations. I had asked for quiet. I remember recording their voice when I called that number after they passed. They would have been happy to know they were able to donate several organs, which are keeping several strangers alive.

Suicidal people, I believe, need to hear that grief is here to stay. Grief is the enemy we all must eventually befriend, if we are to survive. Grief is one who has come to hurt us again, the messenger that never leaves. The ally who takes who we were, and what we thought we needed most, and makes us lost and confused, seemingly alone to find our way forward. We grieve what we expected. We grieve what we never held.

Perhaps there's no true relief for the pain you are in. All we can do is wait and wait and wait. It can feel like a death sentence - so how could a death sentence be worse? - goes the desperate emotional logic. But suicide is handing your hell to everyone around you, and you are not mentally well enough to know how deeply your pain will transfer, or to whom. If you keep it contained, your walls may thicken through use, like a muscle. It may become easier to keep the lid on over time. You may not break, unless you choose to break yourself. You may be and become stronger than you feel right now.

I wish struggling people would post more about accessing MAiL (medical assistance in living) instead of the MAiD (Medical Assistance in Dying) suicidal ideation. It is unimpressive to read what an intensive process it is to determine if you are really worthy of this new and exciting medical transition. It’s the same story, the same alternative to the hard work to get better or at least to get by, to hold space for a better future even when you cannot see around that corner yet. As I've posted about before, there are several people in my feed who have been going down this mental whirlpool this year. I have no doubt their mental and physical pain is profound. Bizarre behavior does not arise from healthy and functional mental states. Despite my own bewildering pain, I have accessed MAiL for years in the form of therapy and other supports as needed at various levels at different times. I’ll keep accessing MAiL as often and at whatever level is necessary to keep on keeping on.

I truly believe we do not survive our own death, and there is nothing on the other side. I believe if you believe otherwise, you are certainly mistaken, and have entertained fantasies and believed lies. Maybe I am wrong, and we will find out eventually either way, much sooner than we expect. For now, all I have left of the lost is the relief they pressed into me. I must protect this reflection, by protecting myself, and let it continue to act in this world, through me. My outline in their minds died with them. I am heading there eventually. It is my job now to pass the time.

If you're considering ending your life imminently, please go to an ER now, and demand to be admitted. Get your change of state and loss of control in a way that keeps you here with us. Conquer the shame of the pain you're in and ask for a kind of help you can't control or direct, which may be the very help you need. If the abyss is distant enough, there are other levels of care, including partial hospitalization (you go home at the end of the day-long program, every day of the week), intensive outpatient programs (combined group and individual therapy over half a day-long, several days a week), and intensive outpatient therapy.

“The Answer”

You've got another answer and this time it’s just the thing.

A solution to your pain and you'll have no more suffering.

Sometimes dear people fall for lies they wanted to be true.

And fearful people hate themselves and can't accept what’s new.

I see the only answer is to just keep holding on.

Sometimes a new transition will not help you get along.

They say to 'trust the process.’ That's the best that you can do.

We're stuck here on a rock alone with all each other too.

You share your plans to end you and give others the idea.

And only some possess a mental hagia sofiya

I hear your cry for help, but it’s a scream within my ear.

I turn towards your dream and meet the void within your mirror.

I look at it a moment as I recognize myself.

But I always turn away and put your book back on the shelf.

I know that makes you angry and I know you don’t know why

I know it made you feel as though my love was just a lie

I can't forget the night I said “he's dead” and not “he died.”

She held me on the floor until my body heaved and cried

I used to hear her voice until I found her in my head.

I hope I meet the people who’re alive because he’s dead.

Now many years have passed and I have no more arms surrounding

but what a miracle to know, that, once - somebody found me!

I might be found again, if I can stand to risk the loss

The safety of my hopelessness and bitterness, the cost.

I must invite grief back; the foe that I must now befriend

Please come inside. I know someday you’ll hurt me bad again

But while we wait, I'll smile at the child you've brought near

This precious creature blessed to know not of this pain and fear

I wonder what she'd grow to, should I take on all the risk

Maybe a future happiness can balance what is missed.

The child will need protecting from a parent all should fear

I can only protect her if I myself am near.