I had known her for over ten years, and we had shared many personal conversations. I felt I couldn’t pretend I didn’t know the grandson. In my field, which depends on the absolute confidence of patients, it’s difficult to treat someone and have a separate relationship with a close relative. She knew I was a psychiatrist and started telling me about the arduous journey her family had faced because of her grandson’s mental health struggles. Just before that hospitalization, the lovely lady who altered my clothes mentioned that her grandson had been hospitalized several times. His last hospitalization, a couple of months before his death had been the first time I didn’t care for him. This young man’s death was particularly painful because he was not a complete stranger. The emphasis lies on suicide prevention but there is not enough focus on preparing psychiatry trainees for the loss of a patient due to suicide or how to deal with the aftermath. This is true for many psychiatry training programs across the country. Suicide assessments were a fundamental part of my psychiatric training, but what to do when suicide occurs was not. I didn’t know what to do with how I felt, and too ashamed to let people know. I wished I had seen that smile during our interactions. Several times after hurting himself or threatening suicide he had been admitted to the Connecticut hospital where I work as a child and adolescent psychiatrist. I saw the smiling face of the young man I had taken care of since he was a teenager. A nurse showed me the newspaper just as I was walking in.
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