Some thoughts about the death of John's friend G. (1978-2014)

[i carry your heart with me(i carry it in]

i carry your heart with me(i carry it in

my heart)i am never without it(anywhere

i go you go,my dear;and whatever is done

by only me is your doing,my darling)

i fear

no fate(for you are my fate,my sweet)i want

no world(for beautiful you are my world,my true)

and it’s you are whatever a moon has always meant

and whatever a sun will always sing is you

here is the deepest secret nobody knows

(here is the root of the root and the bud of the bud

and the sky of the sky of a tree called life;which grows

higher than soul can hope or mind can hide)

and this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart)

-- E. E. Cummins

At the funeral John and I attended last weekend, M. (at that point a widow of less than a week) included this poem in the front of the program to G., her late husband. I knew this poem and had read it many times before. I’ve always loved it—its construction of the beloved as moon, as singing sun, as root of the root, as passenger carried so carefully in the lover’s heart—but on Saturday, I couldn't read it. At least, not all the way through. It became unbearable that morning just minutes after seeing M. walking leaned over, heavy-limbed as if the earth were pulling her down, as if she might fall were it not for the two women holding her up on either side with their arms hooked around hers. I had been thinking about M. all week. And since the funeral, I've found myself wondering what that poem with its roots of roots, buds of buds, and deepest secrets had meant to them. Had she read it to him often? Was it one she’d possibly read to him at their wedding? (The photo of G. in his obituary and on the funeral program, standing at the front of a church wearing a dark suit with his calla lily boutonniere and expression of love and anticipation on his face, was likely taken on that day).

G. died on March 9; he was only 36.

G. was John's supervisor.

But more than that, G. was John's friend.

He was someone John could talk big ideas with, someone who made John laugh, someone John knew he would become even better friends with later, once the formality of their work relationship had changed.

John was looking forward to knowing G. for many years to come.

I was lucky enough to meet G. a couple of times. And had the fortune of meeting M. too last November at L.'s wedding in Chattanooga. The four of us spent the afternoon and evening together. After the wedding, the reception, a number of celebratory drinks, and some unexpected moves on the dance floor after L. managed to get even G. and John to join in, we all said good-bye with hugs. In the spirit of new-found couple-friendship we talked about getting together and meant it. The four of us—as a small group—had clicked.

G. was incredibly intelligent, sharp, and had a wonderfully dry (and rare in its dryness) sense of humor. Since working at his job, John had come home with so many great stories about his conversations with G. that even before meeting him, I felt I already had. And even before meeting him, I knew how important he'd become to John.

G. killed himself on March 9.

He was only 36. No one saw it coming.

Ironically, G. was the one in the office who was notorious for staying calm—the glue that held the clinic together. His colleagues at the mental health facility (yes, G. was a mental health therapist) never imagined or anticipated that suicide would be the way he died. When it comes to the facility where he works, John worries about things like clients with psychosis, clients with rage issues, and clients who have stopped taking their meds. He worries about clients coming in with guns or knives and clients who live with the kind of anger that continually seethes just beneath the surface who might one day suddenly leap at him from across the desk because its all boiled over and they don't feel like sitting through another session, don't feel like looking at yet another authority figure, and don't want to be there at all. John had never even considered losing a co-worker to suicide, especially not G., who seemed able to deal with anything.

"Out of the blue" in response to G's suicide would not only be a cliché, but an understatement. Yes, G. in everyone's eyes was seamlessly put together—the one known for keeping his wits about him when everyone else in the building had turned inside-out into a ragged pile of frayed ends and probably (if they had a minute to stop and think about it, if they weren't so overworked) wanted nothing more than to go home, crawl in bed, and curl up under the covers and stay there for days.

The organization John works for is the largest behavioral health center in the nation, with clinics and treatment centers throughout Tennessee. The location in Madison where John works (G. worked) is known as the worst of the worst from any angle you could measure. It’s notorious among the organization's employees for being the most difficult facility to work at—in terms of both volume and population. Its reputation even extends beyond the organization itself. Basically, it's a place a lot of mental health therapist in town wouldn’t want to work at. You have to be tough to do it. And the therapists there are strong. In a lot of ways the clinic is the last stop—a repository for the people society's left behind and tried to shove to invisibility under the carpet.

John spends his days with clients who don't have homes, hope, prospects, jobs, or much education; clients who've actually never had secure or good homes, hope, prospects, the opportunity for a decent job, much chance at a decent education, or dared hoped for much at all; clients who've been abused in any and every which way you could imagine and even worse; clients who recover from some trauma only to be abused again; and clients on federal probation for all sorts of crimes who are fresh out of prison and now free but pissed off and most of the time only in therapy because the probation officer says it'll look good in front of the judge. All of this in a cultural and political climate where we're told to buck up, suck up, get a job, try harder, and if you don't have a home or healthcare or a place to lay your head or you're addicted to drugs it's your fault. (Translation: no one with power really gives a shit and empathy and compassion are in short supply.)

John and the other therapists spend their days trying to help their clients get out of pain, find some modicum of stability, and begin moving toward better (and happier) lives. The therapists do what little they can, even when many of their clients never even get the hour of counseling they're due, let alone the degree of therapy they need, since the therapists at the clinic are overworked, exhausted, and have so many clients assigned to them that most of the time they can’t do anything but scratch the surface of their clients' needs. The problems at the Madison facility are exacerbated by the fact that the organization, in its desire to earn as much as possible, has figured out that double- or triple-booking hour-long sessions means two or three times the pay (of course, for the organization, not the therapist). Bill each client's payer source for an hour, but have the therapist see three clients in that same hour, and .... well, you do the math. Add to this scenario caseloads of some 450 clients per therapist and you have clients who need intensive therapy—at minimum a full hour every week—and therapists who want to give them that but can only offer twenty- to thirty-minute sessions that happen no more than once a month. Given the circumstances, there's not too much in-depth, psychological work a therapist can do.

Imagine spending your days powerless to do all the things that were the very reason you sought the career in the first place. To me, it seems like it would be akin to someone drowning in front of you, while you stand just inches away, finding yourself suddenly paralyzed, and all you can do is watch. At John's clinic it's also like watching from inside an endless, recurring loop where you're also never allowed to sleep. Or even sit.

G., of course, worked there too—in that place where miserable stories, tales of incredible suffering and trauma, and raw, urgent, human need line the floors, the furniture, the walls; the place where the grueling work never ends; where at the end of the day you can count on more work, and where most of the time you don’t get longer than 15 minutes to stop and scarf down lunch and that's the only time in nine or ten hours that you get to stop. G., who was a supervisor in charge of several big programs and also had his own clients to see, was, it turns out, regularly working late through the night and on the weekends too. Apparently, he had been doing this for a long time. It was the only way he could keep up. In the week since G.'s death, John has heard stories: The Saturday when a colleague came in and saw G.'s car in the morning and then noticed it was still there when he left that afternoon; the co-worker who heard G. on the phone during too many late afternoons telling M. that he couldn't come home yet, to go ahead and have dinner or take their son to the movies without him; the clinic director returning to the office late one Friday night for something she'd left behind in the building who saw the light glowing from G's office window. The week before he died, G. told John he'd been staying at the office sometimes until 2:00 in the morning. John has also heard that there were occasions when G. even spent the night there.

I am not suggesting any causal link between the organization and G.'s suicide. G. didn't leave any letter or note, so no one will really know why he decided to kill himself, but the irony is glaring: A mental health facility that doesn't take care of its employees and has them working so hard there is little time for anything else, including family, rest, reflection, one’s own personal health and well-being, and the ability to do one's job with the care in which it needs to be done. However, as someone on the periphery of the situation, I don't think it's too much of a leap to suggest that whatever problems G. had—whether depression, anxiety, or other emotional issues—they certainly weren't helped by the fact that he was working too hard, too many hours, while the work thrown at him continued to balloon to monumental proportions.

I want to hope that the organization will be jarred enough to take time out to self-reflect and ask how it could take good care of the employees still there. But so far that hasn't happened.

The higher-ups say they're listening, but John and many of his co-workers aren't convinced and it seems like more of an act. In the wake of G.'s death, in the midst of not even being given the time to grieve, the workload for the remaining therapists is swelling fast as they're already being asked to take on more. Everyone, of course, was filled to beyond the brim as it was. And as someone on the periphery, I can’t say for sure how G. was affected by the work or how much it hurt him, but I look at John and I can’t imagine G. not being affected by the circumstances. What I can say is that I have never seen my husband (who is stronger than anyone I know and so good at what he does) as exhausted or stressed as he has been over the past few years during his time there. It’s a stress that grows—like some monstrous, horrible blob or some terrible whack-a-mole game where the moles just keep popping up. Each month seems to get worse—more clients, more needs, more obligations, more tasks, more despair seeking a fix. Exhausted therapists aren't good for anyone—their clients or themselves—but somehow, this doesn't seem to matter to the organization. Profit matters more.

John hangs on because he's trying to get his license, and the organization offers the supervision he needs to do that (finding supervision isn’t easy). Add that to the fact of a terrible job market in general, which leaves him with little options. Anyone who wonders: "Why don't these therapists just quit and get new jobs?" needs to take their blinders off and refrain from asking such questions again; it's not that simple.

I keep imagining the way G. likely spent his last days and months—at the office late into the evening and on the weekends. I don’t really have the words to describe how imagining this makes me feel. Other than to say, it makes me ache deep down through my body.

At the cemetery on Saturday, there was a moment when I happened to turn and see G. and M.'s son standing by himself just past the tent where G.'s casket was. I saw G. in his face and knew instantly who the boy was. He looked confused, lost, and hesitant to take a step while still caught in the one before. He looked as if he didn’t know which way to go as people walked past him to G.'s grave.

Everything has changed for him. Just as everything has changed for M.

I continue to wonder about the moment when [i carry your heart with me(i carry it in] became the poem that reminded M. of G. I want to end with that thought, because the depths of those moments are so incredibly important. Those are the moments worth savoring and holding on to—the moments, the love, the life, the touch, and the days woven from poems that we need more than anything.

Tragically, they're the very same ones we're so often forced to leave behind.

I wasn't lucky enough to know G. for very long, or even very well, but I know he will be missed.

And I know that friends like John and the other therapists will never forget he was here. Even if his time on this earth was always far too short.