Easing trauma

When I was a suicide first responder one of my tasks was to help educate those who had just lost a loved one to suicide about how the coroner system worked in the county where the death occurred. There are certain procedures and processes that must be followed in investigating an unattended death in order to gather as much information as possible about what happened. This process can be very invasive and frustrating for grieving family members. They have just experienced a major shock to their entire world and now officers, often uniformed, are swarming their space and preventing them from attending to the body of their loved one. Often there is a period of time when families need to be out of their home and wait for the investigation to take place.

In the United States, there are two main different systems of investigating deaths that occur outside of a medical setting with a physician attending. The medical examiner system emphasizes the medical training and qualifications of the examiner. Medical examiners are board certified physicians with special training in examining bodies for evidence of how death occurred. They are generally appointed and follow a specific investigative routine to determine the manner in which a death occurred.

Coroners are elected officials, and have been trained in criminal investigation and special techniques for preserving evidence. They are not physicians. When there are questions that require medical expertise they employ the assistance of forensic pathologists who perform autopsies and other medical examinations.

In the United States whether a death is investigated by a medical examiner or a coroner depends on the jurisdiction. South Dakota, where I worked serving families who had experienced suicide loss, has the corner system. The belief is that in matters of answering questions about how death occurred having those who are investigating subject to election holds them accountable to the people they serve.

Elections, however, are far from the minds of the people who are experiencing the trauma. Often when working with grieving families, I needed to gently explain that the process was one of learning as much as possible about the circumstances of the death so that as many questions as possible could be answered. The big questions on the minds of the grieving families, however, are ones that cannot be answered. They are wondering why the death occurred. “Why did this person do what was done?” While some information about the circumstances of the death, such as a recent change in financial status or the threat of an arrest or some other things can be known, the real answer to the question is not evidence that can be collected. The evidence died with the victim.

To make matters more difficult for families, in many jurisdictions across the country suicide has been historically seen as a crime with a full criminal investigation taking place. While coroners try to be sensitive to the needs of family members, they feel the need to document as much evidence as possible and preservation of evidence means excluding others from entering the place where the death occurred. This can be especially traumatic for those whose lives have already become defined by the trauma of the death of their loved one.

My role in all of this often was to assist the investigators by providing support and information to grieving family members. This meant trying to explain procedures to people who were not in a position to retain the information I was giving them. The shock and horror of losing a loved one means that grieving individuals are not in a position to listen to a lecture or observe what is being told to them. Often they don’t remember any of the content of what we have said to them during those first traumatic hours. Gentle repetition can be helpful. Often, I would allow family members to have control of what I said. Instead of just giving them the information I had, I waited until they asked a question and tried to respond as directly and succinctly to their question as possible. Sometimes, I simply sat in silence with them as they processed the early stages of their grief.

My experiences taught me a great deal about how resilient humans are. I met remarkable people with incredible courage and grace in the face of deep trauma. People didn’t fall apart. They might have a period of uncontrolled sobbing, but the continued to breathe and within a short amount of time began to regain composure. My experience is that people don’t fall apart even under the great stress of the loss of a loved one. They deal with the unthinkable in their own unique way, and call upon resources deep within themselves to find ways of moving on from the trauma.

It isn’t easy. Those who have experienced the suicide of a loved one are themselves more vulnerable to suicide. The unthinkable has become something about which they think constantly. Without proper support and often professional help, they can become immersed in depression and despair following their loss. The follow-up after a suicide loss is critical to the long process of recovery.

Grief is not something that people “get over.” It remains with them. I used the words, “get through” when talking with grieving families. Your life has been forever changed. You will not forget. You will not get over this event. But you can get through it. And you don’t have to do it all by yourself. There are others, some of whom have experienced a loss similar to yours, who are there to be with you in this process.

When I hear of calls for police reform, I think of how functions, such as learning as much as possible from a death, might be performed by people with different skills and roles than that of uniformed officers. Differences in training and in the way we identify those entrusted with such examinations might go a long way towards easing trauma. Sometimes in suicide situations my response team would be the only strangers in a situation who weren’t carrying weapons - sometimes we were the only ones who weren’t wearing body armor. All of those weapons can add unnecessary trauma to a trying situation. Many changes are possible if we work together and always keep the victims in our minds as we work with our neighbors.

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