“You need to get here now!” The nurse whispers anxiously. It’s after midnight. One of our hospice patients has just died at home, and her husband is threatening to shoot himself when the funeral home shows up.
“Has the funeral home been called?” I ask.
“Does he have a gun or weapon?”
“We’re out in the country. There are deer heads on the wall.”
I try not to stereotype, but deer heads are a giveaway. There are probably lots of guns.
“Has he threatened to hurt anyone else?”
“He says he might take one of the funeral guys with him, but I don’t think he’s serious.”
“Anyone — a family member, a friend, a minister — we can call who might be a calming influence?”
“He says there’s no one.”
We agree not to call the funeral home yet. Before leaving, I check my records for any mention of self-injurious behavior or psychiatric issues in the husband. There’s just a note describing him as a “loner” and retired career Marine.
Heading into the night, I mentally click off the suicide-risk factors: male, significant recent loss, verbal threats to self and others, ex-military, access to lethal means, little or no social support.
As I drive, my questions percolate: How serious is this guy? Will he have to be hospitalized? Should we call the police? How will he react when a social worker he’s never met shows up?
I map out what needs to be assessed — as if that can pinpoint the odds that a man I’ve never met, with his heartbreaking, will kill himself or someone else before the night is over.
My mind turns to a winter night years ago. I was a graduate student, unaware that there was a profession called social work, much less that I would one day join it. I was sitting in a bar with friends, embroiled in one of those intense conversations about death that students have had forever.
“You know what helps me when I think about death?” Claude asked. “I think of that psalm about the valley of the shadow of death.”
He must be joking, I thought. Claude, a philosophy professor, was an inveterate atheist.
He recited Psalm 23:4: “Though I walk through the valley of the shadow of death, I will fear no evil: for Thou art with me; Thy rod and Thy staff, they comfort me.” Softly, he added, “Those words have helped me over the years.”
My cell phone rings, dragging me back to the present.
“He’s drinking,” the nurse says curtly. “What should I do?”
“I take it you’re not talking about ginger ale.”
My joke falls flat.
“He’s getting drunk. It looks like hard stuff. How far away are you?”
“Fifteen minutes. Do you feel comfortable asking him to put the stuff away?”
“I did. He told me it’s his house.”
I ask her to hand him the phone.
“I ain’t gonna talk with no damn social worker,” I hear him growl.
“Tell him he can talk to me or to the cops,” I say.
Taking the phone, he says, “She’s overreacting … I’m just blowing off steam.” His name is Pete; his wife’s name was Jimmie.
“Y’all think I’m nuts, don’t you?” he asks.
“No, Pete. We think you’re hurting, and we care about you. That’s why I’m coming.”
“You ain’t gonna try to put me away, are you?”
“No. We just want to make sure you’re safe. If you keep drinking, I’ll have to get the cops involved to make sure nothing bad happens.”
“All right, I’ll put the whiskey away,” he says gruffly.
We talk about Jimmie and their life together.
“What do you think Jimmie would say to you right now if she could see what’s going on?” I ask.
He starts crying. “She’d tell me to shut my damn mouth and let people help me for a change.”
He hands the phone back to the nurse.
Partly to calm my own nerves, I say, “The guy is in a universe of hurt. We need to respond to the pain without being thrown by the behavior. Let’s take it slow and do our best to respond with love.”
Pete’s exit comes up fast. Within minutes, I’m turning onto a dirt road with a “no trespassing” sign. My mind returns to my old buddy Claude.
Until then, our conversations had skated along the intellectual surface. That night, I’d sensed that Claude, an older guy who’d been knocked around by life, was making himself uncharacteristically vulnerable by inviting us into this conversation.
Wanting nothing to do with it, I scoffed: “Aren’t you the guy who’s always dismissed that stuff as wishful thinking?”
Wistfully, he studied his empty beer bottle. “It just comforts me to think that I won’t be alone down in that valley — that someone will be with me, whether it’s God, a friend, even a stranger.”
“That’s it?” I replied sarcastically. “Platitudes?”
He smiled and raised his bottle: “Here’s to platitudes, boys.”
Then he turned to me, his face oddly serious.
“Maybe you’ll be the one lending a hand down in the valley someday,” he said.
That was thirty years ago, and I can hear his words like it was yesterday.
When I enter Pete’s home, he’s in the bedroom with Jimmie’s body. The door is shut. Concerned that he might have a gun, I quickly knock on the door and call his name. No answer.
I open the door and quietly walk in.
He’s sitting on the bed stroking her hair. Without looking up, he whispers, “I’m so sorry, Baby.”
“Pete,” I say softly. “Is it OK if I sit with you and Jimmie?”
He nods, and I sit beside him. He’s a big, rough-looking man with a crooked nose and muscular, tattooed forearms. I wait for him to break the silence.
“I let her down,” he says. “Spent my time working. Never told her I loved her.”
Rather than get sucked into a narrative of guilt and regret, I ask what he did do. He describes spending long days at the oncology clinic, building a wheelchair ramp so she could smell her rosebushes, working extra shifts to pay for her medications.
Using memories like these, we zero in on how he’d expressed his love — not through words but through gestures of affection and acts of loyalty and sacrifice. As we speak, I feel a connection to the big heart beating beneath Pete’s intimidating exterior.
We talk throughout the night. Eventually, Pete lets me call his buddy, Tank, who shows up on his Harley just as the funeral-home people arrive.
Pete, Tank and I discuss Pete’s threats, and what’s driving them. I help them to develop a safety plan; I talk about coping strategies and optimizing support. But these textbook recommendations take a backseat to the simple imperative to open my heart and be fully present to someone who’s hurting.
I’ve come to believe that this is what Claude meant by his prediction. He was talking about the simple power of moving toward another’s suffering, rather than away, when that person’s world has shattered.
We lost touch over the years, and I regret that he doesn’t know how much his words have meant to me.
Before I leave, Tank and I step outside.
“It means a lot, you coming out here,” he says earnestly, catching me off guard. “You got him through the night, Scott. Me and my wife’ll take it from here. I promise.”
I’m exhausted. Driving home, I feel sad at Pete’s loss. Reflecting on the difficult path he faces, I visualize him surrounded by a protective field of loving energy.
And, in my mind’s eye, I see Claude lifting his beer bottle and giving me one of his crooked smiles.
Scott Janssen is a social worker. This piece was originally published in Pulse — voices from the heart of medicine.
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