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American Association of Suicidology

I thought I’d give an update for what has happened the last few weeks:
On April 23, I flew to Denver to attend the 52nd annual conference of the American Association of Suicidology (AAS). “Suicidology” is the scientific study of suicidal behavior, the causes of suicidalness and suicide prevention. I wanted to learn how to help those left behind by suicide and help those at risk of suicide. Suicide is the 10th-leading cause of death in the U.S., so it is a major public health problem that is very complex. AAS’s slogan is “Suicide Prevention is Everyone’s Business.” I believe that.
The conference was very good, but also hard for me…because of the emotions of being a survivor of Ashton’s suicide. I am grateful for all those who are looking for ways to reduce others’ suffering. I may have heard this before, but I was especially struck by the reminder by one of the speakers (this may be a quote by an ancient physician, but I can’t find it on google): physicians should always ask their patients two questions…and then listen closely for the answer, both in what they say, what they don’t say and in their body language. “Where does it hurt? How can I help?” That is profound! And I don’t think it just applies to physicians; every one of us is surrounded by others who are hurting. If we have eyes to see and ears to hear and hearts to feel, we can reach out and lighten another’s load.
This same speaker said that one of the common elements in suicides is a loss of hope. He compared it to having to put your hand in a fire and not having the hope of ever being able to take it out. The weakness to this analogy is that, in reality, after a time, the nerves in your hand would be burned and you wouldn’t feel anything…but what if that DIDN’T happen and you continued to experience that pain…and you thought you might continue to feel that pain forever? The speaker said that a suicidal person’s past experiences is what “loads the gun”…and the future (loss of hope) is what “pulls the trigger.” So…the answer to the second question physicians (and others) should always ask (“How can I help?”) is often to help lighten the pain. You don’t have to take away the pain; that may not be even possible. But if you can lighten the pain…even a little bit…you may save a life.
For those who have an interest in the field of suicidology, I strongly recommend this conference. There is too much for me to share here, but I wanted to give my readers a glimpse of what I learned. I found out about the conference from Dr. Douglas Gray, a psychiatrist and suicidologist at the University of Utah.
On the last day of the conference, they held the 31st Annual Healing After Suicide Loss Conference. Faye attended that with me. The keynote speaker was Dr. Jennifer Ashton, an OBGYN who is Chief Medical Correspondent for ABC news. Her ex-husband took his own life in January of 2017. She has written and spoken extensively on the topic of suicide. She did a great job. Faye and I later attended a support group with other parents whose children had died from suicide (there were other groups for spouses, clinicians (etc) of suicide victims). That was a little awkward, but healing. We shared contact information with two other physicians whose children died from suicide. We emailed each other with words of encouragement and support again last week.
We came home from the conference on April 27. Ashton’s 27th birthday was April 30th. I appreciate all those who remembered him on that day. Then we attended a support group with about 20 other suicide survivors on May 2. It was held at a Methodist church in Tucson. It is facilitated by two women who lost their children to suicide many years ago. They are clear that this is not “counseling,” nor are we there to give advice. We are there to listen to each other. That was an amazingly (surprisingly) therapeutic experience for me. These people understand! They “get” what is going on in my life…because it is very similar to what is going on in theirs! I plan to go as often as I can, both to heal and to help others heal. Unfortunately, the statistics show that it takes an average of 4.5 years for survivors of suicide to find and start attending one of these support groups. It has been over 5 years for us since Ashton died; I wish we had known about this sooner! I hope that others of you who are suicide survivors will attend one of these groups as soon as you can. If you are reluctant, try one meeting, see how you feel. If it’s not helpful, you can always stop going.
So…the last few weeks have been somewhat emotionally-demanding for me. However, I’m trying to “…lean into the stiff wind of opportunity, rather than simply hunker down and do nothing.” It’s difficult in the moment at times, but I feel like I am experiencing some of what has been called “post-traumatic growth” as a result. I appreciate those who have checked on me, who have asked genuinely, “How are you doing?” and then listened sincerely for my response. I hope to emulate your example as I strive to lighten others’ loads, as well. I invite my readers to join me in this quest.
Written by Carter
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Ashton’s 27th Birthday

Good morning. Ashton is 27 years old today…in “earth years.” I appreciate those who remember his birthday. I don’t know why that means so much to me…but it does. It touches me to the center of my soul. I think about Ashton every day…EVERY day; it’s nice when others think about him every now and then.

Thanks for being my “tribe,” everyone!

Written by Carter

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Carter’s Thoughts on Self-Care

I thought I’d share some self-care things I am doing. My hope is that taking care of myself will allow me to better serve God and my fellowman. My hope with sharing this is that my readers will also take appropriate care of themselves, get help early and often, and reach out in compassion to others who are struggling with their own mental health.

Yesterday, I met with a psychiatrist who is a medical school classmate of mine. He was also Ashton’s psychiatrist. There has been a recent emphasis in medicine to “de-prescribe,” meaning looking at each medication that our patients are taking to see if they are still indicated and, if not, “de-prescribing” those that are no longer indicated. In about November of 2012 (even before Ashton died), I saw my family doctor because I was feeling persistently and consistently irritable for several weeks or months. I have treated many patients with depression and finally said to myself when looking in the mirror one day, “Buddy, you are depressed!” My family doctor prescribed fluoxetine (Prozac), which has been around for over 40 years. It initially got a “bad rap” from the media; frankly, I think it was treated unfairly. However, I think 40 years is enough patient experience for me to feel comfortable taking it and prescribing it for my patients. I did notice an improvement in my mood over a couple of weeks. I have continued to take it since then because I didn’t want to go back to where I was before I started taking it; that was MISERABLE! However, I have wondered recently, “Do I still need it? How do I know if/when I can stop taking it?” By definition, I cannot be objective about myself, so I sought the advice of a trusted colleague. It has been said that, “Those who are their own doctor have a fool for a patient.” There is something to be said for “common sense” (which may not be all that common), but I think there are times when one should get outside input. I felt like this was one of those times.
Ironically, just two weeks ago, I got very irritated very quickly with Faye over a minor issue. It seemingly came out of nowhere at the end of a very uplifting and positive day. My outburst adversely affected how both of us felt for the next several days. Despite being on the fluoxetine, that happens more frequently than I wish it did…maybe 2-3 times per month. I mentioned this to my psychiatrist and he asked, “I know you. Is this ‘normal’ irritability and you are being overly-perfectionistic about it? Or is this truly something that is abnormal?” I acknowledge that I struggle with perfectionism, but I think these outbursts are “abnormal.” He diagnosed me with “atypical depression” (because I’m not “sad,” per se; just grumpy more often than I think is normal) and recommended increasing my fluoxetine from 20 mg to 40 mg per day. I will see him in follow up in 2 months. He also recommended a psychologist colleague for “talk therapy” if needed in the future: someone who can give me strategies to change how I think about and respond to various situations and challenges.
My psychiatrist also pointed out the following: a) Doctors have a very high-stress job, which can lead to burnout and depression; b) “If/when you do get irritable, apologize to Faye for it and learn from it so you can minimize the chances of it recurring…but also be kind and gentle with yourself! You are a good person, but you are still human!”
In conclusion, I hope that my readers are taking appropriate care of themselves. I hope they encourage others who are struggling with their own mental health to also get the help that they need. Life is sometimes hard! We need each other! 
Happy Easter!Written by Carter

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One-on-One

This video struck a tender chord for me. I love basketball. And I appreciate all those who reached out to me when Ashton died…and who continue to reach out. Just this week, one of my patients asked me at the end of the visit, “And how are YOU doing?” I could tell that he really wanted to know, so I shared briefly that our mission brought immense healing from Ashton’s death. I REALLY appreciated his asking! That meant a lot to me!

I sense that there are others who feel awkward when I continue to talk about Ashton’s death. “When are you going to move on?” is the unspoken message. That’s OK. I don’t judge them. I know it is hard to know what to say when someone is grieving.

“When will I move on?” In my mind and heart, that is exactly what I am doing. Talking about Ashton’s death is part of that process. To set an artificial timeline on when someone should stop talking about their deceased loved one is probably not realistic nor helpful. Now…if that’s ALL I thought and talked about and was not able to function BECAUSE that was all I thought and talked about, I could understand the concern. However, I feel like I am functioning pretty well. To NOT speak of my grief from time to time would probably be a reason for others to be concerned about me. Others may grieve differently than me, but I need to talk. I do try to be sensitive and not force my talking onto others who are not ready or able to participate meaningfully in that conversation.

Enjoy the video! And thanks for listening! Written by Carter

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Letter 3/25/18 – Jungle Trip

 

 

Three-toed sloth (Iquitos animal preserve)

Boating in Nanay River (near Iquitos, Peru)

Boating in Nanay River (near Iquitos, Peru)

Parrots in animal preserve (near Iquitos)

Pre-historic turtle in animal preserve (near Iquitos)

Anaconda is checking me out. The preserve worker told me to be calm (I think he didn’t want me to drop it!). It was a bit unnerving!

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Looking across Amazon River near Iquitos

Visiting jungle tribe with Pres. Li. They painted our faces as a welcome.

A bigger Anaconda that had eaten a chicken.

Alligator in animal preserve (near Iquitos)

Skewered and roasted suris (grubs that jungle people near Iquitos eat)

Member (husband is bishop and in military in Iquitos). She was our tour guide for Amazon River trip.

Pres. Li near swimming pool in their backyard.

Hermana Li in their backyard.

Dearest Family,

   March 25, 2018 –  I had a head cold and felt achy Monday, so I stayed home so I didn’t spread it to others and so I could rest. Naps help me recover so much more quickly. Faye is a great nurse. I started feeling better in the middle of the night Monday.
    On Tuesday, I was back to a normal schedule. We attended a devotional from the Provo MTC from March 6. President Ballard was the speaker and he used a question/answer format, which was very insightful. A couple of questions and answers: “How do I get rid of my pride?” “Anchor your life to the Savior. However, even more worrisome than pride is self-centeredness. Your mission is all about God and Jesus Christ.” “How do I best help others at home?” “Watch for and share spiritual experiences.” “Go down the trust road, not the doubt road.” “It’s exciting to be on the Lord’s side in a world that is pushing Him aside.”
    On Wednesday, we flew to Iquitos, which is on the Amazon River! (Who gets to do stuff like this?!) It was neat to get to know President and Hermana Li (his great grandfather came to Peru from China), who are amazing people. Their conversion story was very inspirational. She was looking for a church with a modern prophet and apostles…and she found one when the sister missionaries knocked on their door! We taught at a 4-zone conference Thursday. The mission president wanted Faye to say a few things, so she prepared and did an amazing job…in Spanish! They loved her (no surprise there)! They gave me 2 hours for my presentation! The missionaries seemed to enjoy it…and I had a ball! One of the things I covered was, “How do you know if abdominal pain you are having is something that you might need to go to the ER for (e.g. appendicitis)? Well…the day we left, a missionary went to the ER because he was having the symptoms I described…and they removed his appendix! While I was at the zone conference, I evaluated a missionary with diarrhea, but no abdominal pain. Well…two days later he developed abdominal pain and had his appendix removed, also! I don’t think it was a coincidence that I covered that topic…so the missionaries (and their companions) knew what to watch for. Speaking of companions, I have been very impressed with how loving and attentive most missionaries (elders and sisters) for their companions when they are sick. It has been very touching to me to see their concern. Their mothers would be proud (and their companion’s mothers would be grateful to know their companions were taking such good care of them)!
    On Friday, we had lunch with the Li’s and then they took us on a river boat ride up one of the tributaries to the Amazon (the Nanay River). We stopped at an animal sanctuary, where we saw sloths, an eagle, ocelots, parrots, toucans, alligators, turtles, monkeys, boas, etc. I didn’t think I could do it, but I held an anaconda that was about 6 feet long! The most nerve-wracking part was when he bent his head back and started moving it toward my face. The employee coaxed me to stay calm, which I tried to do. Wow!
    Then we visited an indigenous tribe on the banks of the river. They performed some of their traditional dances for us. They also showed us how to use a blow-dart gun that was about 6-feet long. The chief blew a dart, which hit a wooden parrot that was sitting on a pole. Then he gave it to me…and I hit it, too…from about 15 feet away! I’m an honorary Amazon Indian now (just kidding)! Then we went back downstream where the Nanay joins the Amazon. The Nanay is clearer and the Amazon is murkier. We could see the line where the two rivers converged. We also saw some of the pink dolphins that live in the Amazon. At that point, the Amazon was at least a mile wide and they said it was 300 feet deep…and it still had a long way to go to enter the Atlantic! That is a LOT of water! When we returned to shore, I saw some “suri,” grubs that they skewer and roast and eat. I’ll send you some photos. When we returned to Lima, we told the taxi driver who brought us back to our apartment about the suris and, as he lifted my suitcase out of his trunk, he teased me that it was heavy because of all the suri we brought back!
    The senior couple who will replace us when we leave were in Lima Saturday and Sunday. He heads a foundation who helps women (and their caregivers) in the remote areas of Peru during their labor and delivery. We showed them our apartment (where they will probably live). They also attended church meetings with us on Sunday. On Sunday, Faye and I spoke on Charity and Love. I sure learned a lot on that subject. I’m grateful for how the Lord is helping to achieve more charity and love…poco a poco (little by little). We taught classes in the afternoon to the missionaries on “True Disciples,” using mainly Moroni 7:47-48. That evening, we watched Elder Bednar’s devotional, “Be Good Boys and Good Girls,” which is always a treat. One of the missionaries is a 3-year-convert from Australia. After the devotionals, the missionaries discuss what they learned and felt. He was very impressed with how simple yet profound is that teaching from a apostle of the Lord. It’s neat to see someone who “gets” it like he does. Another missionary in the newest group has the last name of “Sabin” and is from Mesa. His family has been in Arizona for 5 generations…we HAVE to be related!
    A funny story: When Faye and I were traveling a couple weeks ago, she went down to eat breakfast, and when she returned, I thought she said, “Breakfast was good, but they didn’t have ‘skinny eggs.'” I then said, “Skinny eggs?! What are those?!” “No, I said, ‘They didn’t have ANY eggs!'” We had a good laugh with that…and I even had my hearing aids in!
Written by Carter
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Celebrating

Thursday, March 29, 2018

At Christmas time I had the thought: Maybe if I don’t celebrate, it won’t be so hard. I am having the same thoughts now as the Easter season is coming.

At Christmas I didn’t decorate. I used the excuse that I was too busy. But really…. I just didn’t want to. If I saw all the Christmas stuff in my apartment, it would make it harder. I didn’t want to participate in Christmas.

Maybe if I didn’t celebrate… maybe if I didn’t decorate…. maybe if I didn’t participate …. I could get through it easier.

I was singing with the MTC Choir, practicing for the Christmas program…. LOVING IT!…. when the thought came to me: How can I not celebrate!? How can I not remember Him….the one who brings the hope I rely on? Thankfully we got to celebrate Christmas with our family in the US. I did celebrate Christmas after all. I just started a little later than most.

And today…. resisting the celebrating…. I decided to listen to an Easter special from the Mormon Tabernacle Choir. Much of the music was from Handel’s Messiah. I was reminded that “surely He hath born our griefs and carried our sorrows” and “even so in Christ shall all be made alive.”

I heard:

“Why is it that the most significant, beautiful moments in life so often come just after periods of darkness and sorrow. The birth of a new child is always preceded by a mother’s pain and travail. The joyful colors of spring are most inspiring because they come on the heels of a dreary winter. And glorious sunrises would be meaningless if they didn’t follow the darkness of night. Perhaps there’s a message for us in such patterns. Nothing is ever hopeless. When things seem the bleakest, when all seems dark and despairing, it may be that a great light of hope is just about to shine forth. After all, such new light cannot come if life is always sunny.”

I was reminded that:

“In many ways the story of Handel’s Messiah exemplifies the light of hope. While the music and lyrics abound with hopeful messages, the Messiah was written in a dark and dismal time in Handel’s life. He was in debt and out of favor as a composer. Public taste for his work was dwindling and he struggled with crippling self-doubt as a result. But then a friend gave him a text he had prepared with hopes that Handel would set it to music. Taken from scripture, it included lines like these, “lift up thy voice with strength, lift it up; be not afraid.” “Arise, shine, for thy light is come” and “the people that walked in darkness have seen a great light and they that dwell in the land of the shadow of death upon them hath the light shined.” The result was one of the most popular and enduring pieces of music ever created. Combining  his talent with hard work and divine inspiration, Handel composed his master work in just 24 days. Heaven clearly shined upon his effort and the person and the moment came together in a powerful way. The work itself and its miraculous creation remind us that the great light of hope shines for all, but in particular for those who walked in darkness. Even when everything seems bleak and hopeless, new life will come. Light will always chase away darkness. That is the abiding truth and message of the Messiah.”

After that hopeful inspiration…. I WILL BE CELEBRATING WITH YOU!!

I don’t have any Peeps, Easter eggs or chocolate bunnies, but I do have a renewed hope in my soul that Christ will make everything right. I’m grateful for His life, His death and resurrection. He lives! I want to celebrate that!  I just might make some deviled eggs.

“The message of Easter is a message of freedom. Victory over death, freedom from doubt and despair, and the bright light of hope. Hope that good will ultimately conquer evil, that all wrongs will be righted and that we will be set free to live again.”

“Blessing and honor, glory and power be unto Him!”

Written by Faye

 

 

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Look At Me – Look At Us

Look at me – Look at us.                            December 23, 2017

Some members of Carter’s family have what they call the “look at me” gene. It’s fun for me to watch the ones who have it have so much fun in the limelight. I don’t have that. Carter doesn’t either. But looking back, as I still do sometimes, I can see that we started to exhibit  a little of that family trait a few months after Ashton died, in a different kind of way, and it lasted for a few years.

I believe it was a plea in an unconscious way saying, “Look at me (Please notice that this is hard for me)…Please help me…..I need help from you…I can’t handle this alone.” We were unknowingly reaching out in a big way because it was just too hard to bear by ourselves. Knowing that others knew seemed to help us.

We are in Salt Lake City, Utah for Jacob’s wedding. Candace’s family arrives tonight and then everyone will be here, together again for a week. We’ve all been in our own isolated world connected by instant messaging. What a blessing for that. We are soaking in the grandchildren and just met our new little Ashton last night. He is 3 months old with big brown eyes…..sweet and pure from heaven.

Coming out of Costco today, I saw raspberries in someone’s cart. Ashton’s favorite. It reminded me that it’s not so important this year that we have Ashton’s favorite things. What is important is that we are together.

Many people we meet on our mission….missionaries young and old, members, mission presidents… have a heartache of some kind. It seems that our focus has changed now to “look at us”. Look at all of us. Look at how many people struggle. Let’s help each other through them.