Life's Gumbo: What Did We Do to Save Her?

TL;DR: Two years ago, I lay in bed suicidal and wondered why we work so hard to keep people alive without working just as hard to change the conditions making their lives unbearable. Learning about Alexandre Baril’s concept of compulsory aliveness brought that question back, along with a harder one about autonomy. I believe in saving lives. I also believe people have a right to agency. I’m sitting with what happens when those two beliefs collide.

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Two years ago, I was lying in bed suicidal when I had a thought I couldn’t shake.

Why are we forcing people to continue living in hell while doing so little to change what is creating the hell?

I wasn’t making an argument about suicide.

I was tired.

I had reached a point where life felt like something I was surviving instead of living. People wanted me to get better. I wanted to get better too.

Still, I kept wondering what exactly better meant.

Better enough to go back?

Better enough to function?

Better enough to tolerate what had become intolerable?

I eventually did get better. My life today contains things I could not imagine from that bed.

I’m grateful I stayed.

I still think the question I asked was a fair one.

What did we save her to?

I recently came across a post about Alexandre Baril’s concept of compulsory aliveness, the expectation that staying alive is always the desired outcome, even when a person says otherwise.

Baril’s work goes much further. He writes about suicidism, the oppression suicidal people can experience through stigma, pathologization and the loss of autonomy. His work also raises questions about assisted suicide and whether a person should ever have the right to decide that they no longer want to live.

That last part has me wrangling.

I believe in preserving life.

I believe people deserve autonomy.

Those beliefs get complicated when someone chooses something I desperately do not want them to choose.

It is easy to believe in agency when we agree with the decision.

The harder question is what agency means when we don’t.

I don’t have an answer yet.

I do know Baril’s work brought me back to something I understood from the other side of crisis.

We put tremendous energy into keeping people alive.

What did we save them to?

We diagnose people. What about the conditions?

Someone reaches a point where they cannot cope and we have language for what is happening inside them.

Depression. Anxiety. Trauma. Suicidal ideation.

We diagnose the person.

We rarely diagnose the conditions surrounding them.

I believe systems can cause and exacerbate mental illness.

Poverty does something to a person.

Racism does something to a person.

Violence, instability, isolation and environments that require us to stay in a constant state of survival do something to us.

We experience the consequences in our bodies and minds. Then we treat the person without necessarily changing what keeps making them sick.

Therapy can help.

Medication can help.

Coping skills can help.

None of those things can make an unhealthy system healthy.

Sometimes I wonder how much of what we call dysfunction is a human being responding exactly as a human being might respond to conditions that are dysfunctional.

That doesn't make the suffering less real.

It changes where we look for responsibility.

Maybe prevention starts earlier

We know how to mobilize when someone says they want to die.

I understand the urgency.

I want us to have that urgency sooner.

What would suicide prevention look like if it included changing the conditions that make people feel trapped, hopeless and unable to imagine another way of living?

What if we cared as much about whether a life was livable as we cared about whether it continued?

This is where the idea of compulsory aliveness unsettles me.

Saving someone's life cannot mean simply returning them to the circumstances they were trying to escape.

We pulled her out of the water.

Good.

Now what?

Do we ask why she was drowning?

Do we change anything?

Or do we make her well enough to survive the water again?

I’m still sitting with this

I am alive today.

That matters to me.

There are people I love whose lives would be different if I weren't here. There are things I have experienced, created, learned and loved that the woman lying in that bed never would have known were coming.

I can hold that truth without pretending the question of autonomy is simple.

I can be grateful that I survived and still question a system that sometimes defines success as survival.

Maybe saving a life is the beginning of our responsibility, not the end of it.

Maybe suicide prevention should begin long before someone wants to die.

Maybe we should spend less time asking people how much more they can endure and more time asking what we have built that requires so much endurance in the first place.

I want us to save people.

I want us to care about what we save them to.

What’s in the Pot

What would change if our measure of success wasn’t simply that someone stayed alive, but that they had access to a life they could actually live?

Where does care end and control begin when protecting someone requires overriding their autonomy?

I don’t know.

I think they’re questions worth sitting with.