On a one-year search for answers to two inexplicable deaths, I stumbled on solace by talking through private pain.
Jorge Sanchez was giddy about meeting new people. His smiling eyes sparkled with secrets he wanted to share. Within hours of meeting him, I felt he was my soulmate. But pretty soon I realized everyone felt that way about him.
Even as the college-student sister of a friend, I was showered with familial affection. At 28, Jorge’s black hair was already receding from his forehead, but that Jorge, spry and light, would greet me by jumping into my arms so I’d have to catch him or let him drop.
That was San Francisco in 1998. When I moved to Oakland from New York City 10 years later, he seemed just the same, inviting me to everything, even hosting a small gathering in his apartment to welcome me to town.
Fast forward to the pandemic. The Friday preceding California’s first shelter-in-place order, Jorge and a mutual friend visited the rental house where my husband and I lived with our two toddlers. COVID-19 was sidling up to California, but as Jorge put it to me later, there was “a little foreshadowing but not enough to scare one.” He danced up to me and squeezed my shoulders, covering my face with kisses. He lyricized about my husband’s Manhattan-making skills. We said good night and promised to reconvene.
But then we were in lockdown. In May, we exchanged texts about pandemic isolation. Still in denial about the trauma that was transpiring in real time, we both confessed to drinking more than before. Jorge checked in on me.
Miss you Landau. How is it going?
Ups and downs per usual. So uplifting to get a message from you, confirmation of my actual existence! You?
I think I’m relatively well. With the exception of my liver taking a hit from Zoom happy hours.
I didn’t worry about happy-go-lucky Jorge. I remembered an intimate email conversation seven years prior, when, without warning, he had left town for Florida (rehab or resort, he wouldn’t say), then his native Columbia, vaguely citing his dependence on “little pink pills.” Benzodiazepines, not a weakness of mine, seemed harmless enough – as long as he wasn’t buying them on the street. Anyway, he had a million friends and a partner of 14 years.
But the pandemic, along with painful social realities, would water old weeds of depression and anxiety, and allow new ones to sprout.
The week of George Floyd’s murder, he texted at 7:30pm:
“Do u have time to talk or are things crazy?”
I responded grimly that my evenings were exhausted — my toddler was sleeping in my bed.
“Oh sweetpea. Miss you. I’m getting plastered.”
I asked whether he was alone or if his teetotaling partner was there.
“I’m alone. Too hard getting plastered when Miguel is around. It’s a passing thing don’t fret. The Minneapolis thing is such a reminder of ugliness behind the face masks. Kind of broke my heart in a strange way. But I’m resilient. So says the Italian wine at least.”
I remember thinking it was uncharacteristic of Jorge to speak of his own heart – the wine and texting disinhibited him. But, like many mothers of young children in 2020, I was battling the emotional toll of private parenting during a pandemic, and let friendships fall away in favor of TV shows and sleep.
On Friday, December 11, our mutual friend Jessica, a busy attorney who never gets in touch during the workday, called me at 3pm. My first thought was her elderly father. I answered, my stomach quickening, “Jessie?”
“Do you know what’s going on with Jorge?”
“His sister called me. I don’t know exactly what happened, but” – she paused — “Jorge died.”
I felt a forceful current in my brain, a rush of appeals to reverse the course of time. “No,” I heard my voice say.
“Miguel found him in his apartment. It looks like – maybe… suicide?”
I folded to the floor in the quiet, sunny kitchen. A clatter of half-formed thoughts competed for the front of my brain. Jessica had to field another call. I had a strange thought: Nothing matters now.
Pioneering Swiss psychiatrist Elisabeth Kübler-Ross sought to frame the baffling experience of confronting death – as well as living through the loss of a loved one – by dividing up the tangle of emotions that comprise what we call grief into five common reactions: Denial, anger, bargaining, depression, and acceptance. “But,” she clarified, “they are not stops on some linear timeline.” They might approach all at once, competing with nothingness, clamoring for attention.
I checked my recent phone exchanges with Jorge: had he said goodbye? There is a voicemail from December 6, the day before Georgia declared Biden president after its third and final recount. We had played phone tag but didn’t meet up. Dammit, my last chance to see him.
A surreal three weeks followed. Hundreds of people attended two Zoom memorials. People took turns talking, although it was hard to hear without being able to make eye contact with anyone. No one mentioned the cause of death; the coroner’s report would not come until May.
It seemed important to believe it was probably an accidental overdose, not suicide. Copious drinking on top of sedating prescriptions had to be common behavior; this was an underreported danger – doctors, public health people, everyone should know about it.
Uncertainty about the moments before his death pervaded the story we told about Jorge in his absence. I clung to the idea that he didn’t want to die; he was self-medicating his anxiety and depression. It seemed better, for a moment, if it were an accident. Jorge didn’t survive, but he wanted to.
Then, three weeks later, I heard that Tommy Raskin, the 25-year-old son of a lifelong family friend, had died by suicide. The family had not yet gone public with the manner of death. In my mind he was still a boy.
I felt all but knocked down by this terrible knowledge, and a little ashamed to feel so devastated – though I now know that many people who did not know him personally were impacted by Tommy’s suicide.
Tommy’s father, Maryland Congressman Jamie Raskin, was like extended family to me – Jamie’s parents introduced my parents in 1973. Tommy’s grandfather, Marcus Raskin, was my dad’s closest friend and colleague; our two families were connected through their work in progressive policymaking and decades of friendship. As a child, I spent countless Saturday evenings at Raskin dinner parties, falling asleep on the pile of coats in the bedroom.
Beneath my shock in the aftermath of their tragedy was a longing for my childhood, my house in Washington, D.C., a sense of grasping backward at my life’s beginnings, as if a chance at a different future were buried there.
I imagined Tommy while I observed my 2-year-old and wondered how I could keep living without him; the instinct for my children’s survival is knitted into my own. I watched him play. He doesn’t mind me crying as long as I am looking at him. When does imagining the pain of others become one’s own pain?
Death, especially an unexpected death, obliterates the line we draw between emotions. Reason exits abruptly through a glass window; overwhelmed by confusion, the mind becomes a small, messy room. During what Julian Barnes called “the psycho-chaos of grief,” emotions swing wildly back and forth, assume disguises, retreating and then making surprise appearances at inappropriate moments. After some arbitrary period post-death, every moment of grief is viewed as inappropriate.
In the Kubler-Ross pathway, developed to light our way through an unbearable time, I picked up bargaining before anger. I waited for the toxicology report to become available, preparing to see a cocktail of legal drugs mixed with alcohol, as if knowing precisely what killed him would somehow redeem his death as useful.
Researchers tend to study drug overdoses and suicides separately, though the slippery role of mental illness in so-called “deaths of despair” links them in public health lingo. Some common mental illnesses and types of early trauma are associated with both substance use disorders and suicide; like physical illnesses, mental illnesses are complex, co-occurring and myriad. Some combination of genetic predisposition and environmental factors might eventually explain an overdose death or a suicide but uncovering the origins of these deaths is as fruitless as it is captivating.
The toxicology report lagged behind months of Covid autopsies. I went back to anger — humans need facts, some story to hold, to move on from death. In hindsight, I resented Jorge’s habit of playing cheerful and keeping his depression from his friends. If I were to blame him, he allowed his traumas to haunt and damage his self-esteem. Why didn’t he tell his partner of 14 years that he was abruptly separated from his mother at the age of 4, when his parents divorced? Is this the kind of thing one waits to be asked: “So, where does your deepest insecurity come from, exactly?”
Jorge dismissed talk therapy as too expensive out-of-pocket and placed no faith in SSRIs — I don’t have to travel far on my grief map to blame him for “not getting help.” But I don’t want to blame him. I just want him to be alive again so I can tell him that he is cherished, exactly as he is. I know the image of Jorge I am trying to revive – a man who needed to hear he was loved, and then would be all right – is a mirage.
Each suicide survivor holds a private catastrophe. Their grief is complicated by the ambivalence pervading suicide; they must grieve not only the person who died, but the loss of a chance to connect with him. Perhaps to change his mind. At suicide’s heart lies the most rhetorical of questions: Why?
“Each way to suicide is its own: intensely private, unknowable, and terrible. Suicide will have seemed to its perpetrator the last and best of bad possibilities, and any attempt by the living to chart this final terrain of life can be only a sketch, maddeningly incomplete.” —Kay Redfield Jamison, Night Falls Fast
“Deaths of despair,” a term that suffices if you don’t think about it too carefully, originated from a 2015 paper from Princeton University economist Anne Case and her colleague and husband Angus Deaton, a Nobel laureate in economics. Examining U.S. death statistics near the end of the century, they found that white, working-class people “were drinking themselves to death, accidentally overdosing on opioids and other drugs, and killing themselves, often by shooting or hanging. Vanishing jobs, disintegrating families and other social stressors had unleashed a rising tide of fatal despair” – much like the trend of deaths among inner-city Black people in the 1970s and 1980s, they later observed, according to an article in Science News.
Deaths of despair rose dramatically during the coronavirus pandemic; compound casualties married forever to a national mental health crisis. But I wonder if they resemble each other more in their associated stigma than in their epidemiology. Grief is complicated enough; to accept a loss, it is difficult to simultaneously blame loved ones for their own death.
“It is hard to imagine two more stigmatized deaths than an overdose and a suicide,” Stephen Hinshaw, a clinical psychology professor at UC Berkeley remarked, when I told him about December of 2020.
Hinshaw, a leading expert on stigma and mental illness, acknowledges that public figures coming out about their mental illness and drug use has eased stigma somewhat. “So, what’s the answer to stigma? I get asked all the time. Narrative, storytelling,” he says. When people we respect tell their stories publicly, they show us “it’s a sign of strength, not weakness, to reach out for help.”
But Hinshaw warns there’s a long way to go before that openness is bolstered by policies and institutions. “We don’t really have a public health approach to mental health,” Hinshaw say. “I guess we are better at saying, ‘Oh my god, Julia, you are feeling so awful, go see a shrink.’ Good, people are coming out of the closet about that. And yet we are still a stiff upper-lip society. If you admit that you are depressed on the job, well, what good are you as a worker?”
If mental health data are used creatively, he said, the pandemic could create an opportunity for reckoning with the costs of continuing to neglect mental health: “The optimistic side of me says, if we realize that when a social species, like Homo sapiens, are deprived of social contact, people are going to get a lot more anxious and depressed, then we’re all in the same boat together. That might actually ease stigma.”
Numerous people used the word “magic” to describe Tommy Raskin, including his parents, who wrote that he had “a perfect heart.” At his memorial, a high-school friend spoke about his extraordinary capacity, even as a teenager, for platonic love and earnest attention: “When I stood in Tommy’s gaze, I glimpsed a version of myself I could love. And in our conversations, I felt myself traveling closer and closer to that person.”
In fact, almost all who spoke said Tommy’s profound empathy had a direct effect on them. This returning theme, of his closeness to the pain of others, now had a permanent double-edge. To friends, it could seem like his inexhaustible empathy exhausted him – was it a symptom of an affliction, or the affliction itself?
In his eulogy, Michael Anderson, a close family friend, described Tommy’s anarchist politics colliding with the codes of an elite law school. He imagined Tommy’s internal struggle as the betrayal of his love for the world – by the law, by human nature, and by the contempt shown towards vulnerable beings. “If we’re in agony now, that we couldn’t rescue our beloved Tommy, then maybe we are discovering how Tommy felt about the world,” he said. “You and I might read about baby calves crying out for their mothers in factory farms and we might say, ‘I would vote to reform that practice,’ but Tommy felt it, like a hand over a flame.”
Anderson, who housed and mentored Tommy during his first year at Harvard, tried to articulate depression as existential weight, and wondered aloud whether Tommy’s exceptional goodness explained his suicide. “I wish I could have saved him,” Anderson said in his eulogy. “But Tommy was too polite, too unwilling to pollute his surroundings, to breathe his pain out.”
Thoughtful survivors cross-examine their own grief. They question whether their stories depict reality or are ego-made to assuage their guilt. In our conversation later, Anderson wondered if his attempt to characterize Tommy as too private about his own pain was “self-justifying,” excusing him and others from detecting signs of Tommy’s suffering. “I keep thinking of what they say about multiple sclerosis,” Anderson told me. “People who have MS don’t have any myelin sheathing, so their nerves are just naked and exposed.”
Nine months later, Anderson was still grappling with his own narrative for Tommy’s suicide. “There’s this sense that Tommy didn’t fully grasp how important he was to the people that loved him. It’s not just that people loved him because we are good and giving and loving people, it’s that we needed him in our life, you know?”
If we understand that truism of suicide – that one believes they are burden to their loved ones and the world would be better without them – how could Tommy’s genius in moral reasoning never consider the real outcome of his suicide? He was too alive in his torment to consider such an exercise in rationality, or to puzzle out Latin origins: gravis = ‘heavy,’ grever = ‘to burden’; grief, by definition, is a burden beyond measure.
Anderson sighed. We both grasped by now that suicide eludes such intellectual clarity. “At some point the world of a depressed person is like a black hole; things happen beyond the event horizon.”
The San Francisco Medical Examiner replied months later to my inquiry into Jorge’s autopsy findings. Reading the report – AGE: 50. RACE: WHITE HISP – I felt a sharp turn of nausea. I still thought of Jorge as “here.” How he could be “here” and then – like that – gone? “Lividity was blanchable. Rigor was not present.” If you are having a problem believing someone is dead, read the report on their death.
For months, I had assumed that he died of some combination of alcohol and prescription pills. Now I read the toxicology report. It found normal levels of his prescribed antidepressant and sleeping medications, and no alcohol. But there was something else. Cause of death: “acute fentanyl intoxication.” Jorge overdosed on fentanyl. The goalpost of acceptance shifts again. Most likely, we won’t ever know how he got the fentanyl, or why, or whether he thought it was something else.
When the Raskin family made the decision to go public about Tommy’s manner of death, they did a service not only to the public but specifically to families –including their own – who have experienced suicide. They conveyed, in their moving statement on Tommy’s death, that suicide can happen in any family:
“Despite very fine doctors and a loving family and friendship network of hundreds who adored him beyond words and whom he adored too, the pain became overwhelming and unyielding and unbearable at last for our dear boy, this young man of surpassing promise to our broken world.”
For most of us, acceptance is dependent on a narrative, a story of a loved one’s death, but some kinds of death will not give you the kind of answers you seek. Some of us, on the outer circles of grief, will keep cobbling together clues for this unsolvable mystery. To know something, however small, feels better than to know nothing at all.
When I look at a picture of Jorge, which is often, I still don’t believe his overdose was a suicide. But if I had the chance to speak to him on the day he died, I would have asked him – as I now ask anyone I meet who is feeling poorly, or who struggles with depression or anxiety: “Are you thinking about ending your life?” At the very least, they will know that someone sees them, or is trying to, and compassion is always good.
So far, two have said “no,” and one has said, “yes, but not tonight.” All three have thanked me for asking.