I tried to kill myself for the first time when I was seven years old.

I was a very precocious child, living with my mother. She left my father a few years before, and we had recently moved to Colorado. My mom was 26, and doing that early mid-life freak out where you realize 30 is approaching. With one failed marriage under the belt, she was very depressed, and very lonely. She was going out bar-hopping all the time, leaving me with neighbors. I didn’t see an awful lot of my mom at that particular period. I got really, really sad.

When I think back on it, I’m always really shocked at how clear my feelings were to me. When you’re a child of that age, it’s all gut reaction to things. I remember sitting there one night… my mom had come home and picked me up from the neighbors’ at 10 PM, and basically went and passed out. I was just sitting there awake, crying a lot, thinking about how I didn’t feel like there was ever going to be any warmth or human connection. I didn’t really have any friends. I had one friend, a boy who lived in my same apartment complex. He was very similarly emotionally precocious, and very similarly depressed with his situation. I remember that heavy feeling of not wanting to live anymore.

I tried to hang myself in the hall closet with a jump rope. I didn’t know how it worked except… rope around the neck. It hurt. The strangling feeling mirrored my feeling of being trapped and helpless. Eventually, I was able to undo the knot and drop down into the bottom of the closet. I stayed there for a couple of hours and just cried. Then I hid my jump rope and went to bed. The next morning I didn’t say anything to my mom. I don’t think she ever noticed.

Now that I’m older, I realize that there’s a difference between not wanting to live anymore and actually wanting to die.

I’ve always had this creeping doom, this constant thing in the back of my head. Now that I’m older, I realize that there’s a difference between not wanting to live anymore and actually wanting to die. Because of that, I have not made any actual suicide attempts in many, many years.

There were a few times.

When I was 10, I had a psychotic break and moved out of my mother’s house because I couldn’t deal with it anymore. I moved in with my father. His relationship had crumbled and my stepmom moved up here, but I’d stayed with him in California for a while. He went on a business trip to Los Angeles and left me by myself for a week. While he was gone, I ate every pill in the house and tried to slash my wrists. I was very serious about wanting to die then. Luckily, we didn’t have anything [strong] in the house. I went through the night having an anti-cholinergic reaction to the overdose. I puked up what must have been a half pound of powder from just the filler in the pills. I lost my hearing temporarily.

I called a suicide hotline that morning before going to school, and I didn’t really listen to anything they told me. I just had to tell somebody what happened. It was like opening up a pressure cooker; all the pressure had gone away. It was traumatic enough that it kind of reset something, and then I was okay. I wasn’t happy that I woke up, I wasn’t happy that I felt so bad, but the compulsion to die had passed.

When I was a teenager, I made a couple of serious attempts. When I was 12, I was raped at gunpoint by one of my classmates—a guy that went to my middle school and lived down the street from me. It wasn’t directly related to that. It came later, when I went back to school that week and had to face him and his friends. He had obviously told them. All of a sudden, I was being treated like it was my thing, like I was a whore.

A couple years later, I moved up here to live with my stepmother. She and my dad weren’t together, but they weren’t apart. I was living with her and he was living down the street in an apartment. He would come over, they would fight, and she would take it out on me. She and I always had problems when I was a teenager. We’re good now, but it got to the point where I got that trapped animal feeling again. My older sister had a bunch of pills and I ate them, not realizing that it was essentially another Benadryl overdose. I waited for everybody to leave the house because I was always the last one to go. I had the latest classes, so I left after everyone anyway.

I waited for my stepmom to go to her part-time job, ate all the pills, and passed out in my bed. My stepmom had forgotten something and came home. Something had tipped her off that I hadn’t left, so she came upstairs and into my room. I was on my bed, and she started to yell at me [for not going] to school. I couldn’t respond. I couldn’t talk. I was having problems with my muscles, and I couldn’t tell her what was wrong. She grabbed me and tried to bring me down the stairs. I ended up falling down the stairs because I couldn’t walk. That was when she realized that there was actually something physically wrong with me. She took me to the emergency department and I had to drink charcoal. Eventually, after sitting there for some hours, I was able to actually speak, and tell her that I just couldn’t do it anymore.

Then, of course, it triggered an entire series of events that made me feel more isolated. Like, “Oh, now we can’t trust you to be by yourself.”

My stepmom called my older sister from the hospital while she was at school, and she had a huge histrionic breakdown in class. We went to the same school, so… of course, I get back to school and everybody knew what had happened.

The nice thing, when you’re 15 years old, is that a lot of people actually do understand, even though they won’t say it to your face. They’ll call you crazy behind your back, but one-on-one, you catch their eyes and you can feel that there’s some sort of compassion, some sort of understanding there.

In my adult life, now that I realize that not wanting to live anymore doesn’t equate to wanting to die, I can feel that compulsive feeling coming on. It was triggered circumstantially when I was a teenager, and I was not equipped to differentiate. It all automatically was, “I can’t do this anymore. I need to die.” I don’t get that anymore. I still get the, “I can’t do this anymore, and I don’t want to live anymore,” feeling. I still get the suicidal ideation periodically, but I recognize it as a stress response. I recognize it as something broken in my fight-or-flight.

So, while I still periodically get that feeling, it’s not dangerous. It’s like, “Okay, this is how we’re feeling.” Luckily, I’ve gotten comfortable enough to be able to tell the people that are close to me when that’s happening, and ask for a little more emotional support. [I am] able to say, “I’m not coping right, right now.” It’s helped me in my own personal life to remove some of that stigma from myself and the way that I deal with myself. It allows me to treat myself gently and actually ask for help, which I’m really grateful for. I’m really grateful for the people around me, the people who love me, and being able to recognize that I can deal with it rationally, so they can as well. Then it passes.

Honestly, when you work in the psych ward, the worst thing you can think of is having to actually use those services. It’s one of those things that’s like, if I were to be on the other end of this, would I ever be able to come back? Would I lose all of my credibility? I don’t like the way that, as Americans, we deal with the stigma surrounding self-injury and suicidal ideation. There is the emergency response, which is to isolate, restrain, and that sort of thing, but we haven’t figured out a compassionate way to go from that to helping people become more functional.

Working in healthcare, and specifically dealing with patients who are in the process of getting the help that’s available for those sort of feelings, there are minimal resources. But, when I think about how it feels to be suicidal, how it feels to actually want to die… I realize that, yes, it is an acute issue, but it’s oftentimes chronic. As far as I’m concerned, it’s terminal. I wish that, as a society, it was treated with that same sort of seriousness as any other terminal illness.

A lot of times, if it is a situational thing, getting that sort of help can alleviate some of that and maybe give somebody the tools to change their mind.

If it was my show, if it was my world, I would say, “Okay, we’re going to acknowledge that it’s your life and you’re done with it.” Then you treat it like a terminal illness. People with terminal illnesses have help putting their affairs in order. They have help with transitioning with their family. A lot of times, if it is a situational thing, getting that sort of help can alleviate some of that and maybe give somebody the tools to change their mind.

But the immediate response to somebody who wants to die is to tie them down and drug them up. They still have that life, you know? They still have to someday step out of the hospital. It becomes really hard, when you’re depressed, to follow through with the things that would eventually make your life better.

Des: Talk to me more about death with dignity, or assisted dying.

Emily: Death with dignity would be a very simple integration if you actually treated suicidal ideation as a terminal illness, as opposed to an acute breakdown. Right now, you can get assistance with ending your life if you have a terminal illness. You can do it on your own terms, you can call the shots, and get help putting your affairs together. Make it a hospice situation. Sometimes people make that decision and they get better. Sometimes they make that decision, sit on their meds for a while, and change their mind. You don’t get treated like a criminal for it. You don’t get treated like a failed human being. It seems like it would be really easy to extend that level of amnesty.

Des: What’s the difference between when your body is sabotaging you versus when your mind is sabotaging you?

Emily: That’s a very good question. I don’t know. My body’s been trying to mutiny for years. I’ve had leukemia for ten years now, and I’ve had melanoma. I’ve gotten to the point now where I’m afraid to go to the doctor to see how my body is failing me. God forbid it would be my mind that turns against me. I honestly don’t understand why we, as a society, treat that [differently]. I mean, if somebody breaks their leg, you don’t go, “Ah! Now you’re a worthless piece of shit.” You say, “Oh, maybe you should stay off of it for a little bit, and can I grab the door for you?”

I’m especially sensitive to people’s mental health issues. Not only because of my job, and because of my own personal issues, but where I live, there are so many marginalized people. It’s a chicken or egg thing. Was their mental state the reason that they ended up on the street, or was being on the street what made them crazy?

We’re really gentrified. The economic disparity just becomes more and more acute. It’s shocking. [My friend] is homeless. I’ll sit with him and his friends sometimes and listen to what people say as they go by. I remember a guy walking by, and he said, “Ah, it must be nice not to have anything to do, or to not have any responsibilities.” Are you freaking kidding? Get to the point where you spend your entire day working on your next meal.

I go to work for eight hours every day, and don’t really think about it. Money dumps into my bank account, I pay my rent for the roof over my head, and go grocery shopping when I feel like it.

[My friend] will bring his accordion out and play for hours. At the end of the day, he might get three bucks, he might get thirty bucks. Then, it’s like, “Okay, we can fill the belly.” Then we have to deal with tackling, “Where am I going to sleep and not get arrested?” Then we have to tackle, “Maybe I’d like to shave so I don’t look like a scumbag. I gotta figure out a way to make that happen.”

Every little task becomes a huge undertaking, so people check out. They’re like, “Well, I’ve got three bucks. I could spend it on a sandwich at the gas station. Or, I could spend it on a forty of Olde English, and then I’ve got a painkiller. I’ve got something in my belly, and the ground becomes a lot softer.” What kind of existence is that, once you get to that point?

I see it all as just very, very connected. I see it all as leaving people trapped in something unsustainable. If we can’t be compassionate enough to lift somebody up off the street, can we be compassionate enough to let them decide that they’re tired of fighting for it?

Des: Talk more about the resources here in Eugene, and why there’s such a large transient population.

Emily: Being right on the I-5 corridor, we get a lot of travelers moving between the various hotspots in California—Los Angeles, San Francisco—Portland and Seattle. This funny little hippie town was pretty full of idealists, and at one point, a fairly large anarchist community. Strangely enough, they’re some of the more compassionate towards people that are in need. Food Not Bombs is a huge example. I think a lot of the resources that we do have came from those groups of people, and their realization that they were losing their friends and family.

This is a weird little town with not an awful lot to do. It’s a very wet town. People either drink heavily or are recovering from drinking heavily. We’ve got a lot of church organizations. We’ve got the Egan Warming Center. We had a gentleman freeze to death some winters ago because he had nowhere to go on a cold night. His body was found in a snowbank. We don’t get an awful lot of really cold nights, but when we do, people aren’t equipped. We’ve got resources to keep people just on the living side of the brink. If you’re in dire straits, Eugene’s a great place.

We have a diner down here, over by the WOW Hall, that is run by FOOD for Lane County. They provide free hot meals. It’s like going to a restaurant. They don’t operate on Sundays, so I have this group of friends who started this thing called Burrito Brigade. They get together and make vegan burritos. I think they’re making something like 200 burritos now. I think the first time they went out, they did 80. They’ve since gotten more volunteers and it’s all just personal donations, donations from food banks, and community garden stuff. They wrap it all up and they come out here. The first Sunday they went out, [my friend] was sleeping over there across the street and woke up to a burrito on his accordion case. Made his day, man. The diner wasn’t open, and he got to eat that day.

You can treat the symptoms of that sort of existence. You can ease a little bit of the pain, but a lot of the people that you see are actively drinking themselves to death on the street. They’re self-medicating existential pain. A lot of them are suicidal. But when it comes down to it, going and laying on the train tracks is, in that moment, just as big of an undertaking as finding somewhere to sleep it off, or just getting another beer. It’s all just a huge undertaking, and sometimes people do make that decision.

Des: Talk more about work. You made that comment earlier about losing your credibility.

Emily: In the past year, I’ve had probably two specific points where I felt like I just couldn’t handle it myself. But because I work at the hospital, I don’t feel like I can go into the emergency department and say that I’m having a crisis.

I was actually talking to one of the nurses I work with yesterday about it. How, if I felt like I really needed to crack, I would have to go somewhere else. I’d have to go visit my mom in Colorado or something and have my breakdown there. I don’t feel like I could go sit in the psych ward and do arts and crafts next to somebody, and then the next week come through and take their blood. Would they even let me if I was sitting there with an armband on the week before?

I don’t feel like there’s a way to “go back to normal,” specifically for those of us that work there. I had a co-worker a few years ago who tried to overdose and ended up in the hospital for a few days. She ended up having to take a long time off of work just to be able to come back and be around us. It’s automatic; if you fall to the pressure of not wanting to live your life anymore, people are like, “Oh, you’re unstable! You’re crazy!”

If someone is wheelchair-bound, you offer help. If somebody is having emotional problems, it’s said with derision: “You need help.” Period, not question mark. It’s awful. It’s kicking somebody when they’re down. It’s passive-aggressive.

Des: If you could talk to someone reading your story, what would you want to say to them?

If anything I say makes you want to treat me gently, remember that when you are having those feelings, and treat yourself gently as well.

Emily: If anything I say makes you want to treat me gently, remember that when you are having those feelings, and treat yourself gently as well. It’s really easy to beat yourself up and kick yourself when you’re down. It’s funny how it’s so much harder to be compassionate toward yourself than it is to be compassionate towards other people.

I think I specifically came out today wanting to address that I feel like we need to treat suicidal ideation like a terminal thing, and not an acute crisis. That’s where I personally feel like the resources fail. Interventions are supposed to change lives. I feel like there’s so much rush to put this sort of thing behind you that you sweep the broken pieces under a rug and go, “Okay, that’s dealt with.”

That’s not real. The wound is still under the bandage.

In Oregon, we’re a little more progressive about it, but we’re very slowly changing the way we deal with end-of-life care in general. As a society, death has become so taboo and sterilized. We’re so far removed from it all. We want to stop talking about it as soon as we can, because it’s uncomfortable. It should be uncomfortable, but we shouldn’t be in denial of its existence. There are so many different ways that we try to pretend like it doesn’t exist, or that it’s appalling for somebody to throw it in your face. I think that’s wrong.

Having [conversations about death] be a part of your day-to-day existence really makes it easier to talk about, of course. It makes it easier to understand other people’s feelings about it. I used to split my time between our two hospitals. At the bigger hospital, I worked in the emergency department and I would see people, sometimes multiple people, die in a day. Like, actually in the room when the doctor calls time of death. It affects you deeply, but I’ve never felt like it affected me in a bad way. There were some that were traumatizing and I definitely needed to process a little bit, but I don’t consider myself any worse off for having seen what I’ve seen. When we’re all elbow deep in it, we can talk about how it affects us.

I feel like more communication about what makes us uncomfortable is a good thing. I feel like being able to make that human connection about death helps us make a human connection about life.