Saturday, June 17, 2017

Alaska Cruise Adventure: Day One - Embarkation on Radiance of the Seas!

It's here, it's here!  It's finally here!  It's sail away day!  

Today we finally embark on a cruise that has been nearly 18 months in the making, and although the day dawned cloudy and rainy, it turned out glorious, on many levels.  

We had rented a car from National in Seattle and drove to Vancouver, BC.  It turned out that the rental car return was in the parking structure at Canada Place, and all we had to do was drop the car off, walk a short distance to an elevator, and we were at the cruise port!  Easy peasy!  We arrived at about 9:45 am, anticipating boarding at 11 am.

There were agents there to direct us where to drop our bags. We then were directed to customs, where we had a short wait at several check points (way too many, really, it was quite redundant).  

First it was the cruise check in, where our sea pass cards were issued. Then on to security, just like at the airport.  X-ray machines and metal detectors and the first passport and boarding pass check. Then onto a self check in kiosk for U.S. residents for passport verification and customs.  The machine printed a voucher which we then waited in a short line, maybe 10 minutes, for a customs agent to once again check our passports and passes. He was a hoot. He figured out we were travelling in a suite, so he asked if he could join us.  It was a quick check and off we went to a holding "pen".  

It was here that the boarding process was unlike others we've experienced. Typically, depending on your level with the cruise loyalty club and type of cabin (suites), the higher level members and those sailing in suites get a private lounge to wait in and priority boarding. Not so at this port. Everyone was herded into a waiting area with seats.  But some were left to stand.  We sat there a good 45 minutes or so. 

There was no overhead PA system, so random agents said something we couldn't hear to folks on the ends of rows of chairs, and they began moving people by row of seats through a door. This magical door lead to another holding pen where we sat for another 15 minutes or so.  We were waiting for the ship to be cleared by customs.  It was not too long after that they began boarding.  It was a bit of a wait in a long line to make our way from the cruise terminal and onto the gangway and finally onto the ship. I think we finally walked on the ship at about 11:30 am.  

As we like to do, we wandered the ship to get a sense of her layout. She was small, but beautiful.  She was aptly named, Radiance of the Seas.   Most everyone went to the Windjammer, which is the buffet style resturant for lunch right away.  We headed there just before we were allowed into our cabins (1pm), after most people had gotten their lunch. 

We had booked a junior suite. One of the perks of booking a suite, and for a cruise tour (cruise plus land tour), is that we earn double points in the loyalty club called the Crown and Anchor society.  So for a 10 day cruise tour, we earned 20 points. This allows us to jump one full level with just one cruise!   When we arrived to our cabin, there was a Happy Anniversary sign on the door and decorations inside.  In a twist of fate, both my husband and I had the same idea to surprise each other with the Anniversary package! So we had two!  He also ordered us a cake, which we snacked on the entire cruise!  

Outside elevator

rock wall

mini golf

The Colony Club

Our cabn

Our door

Our bed, with anniversary decor

sitting area of jr suite

Sitting area of jr suite

Bathroom of jr suite (not shown, full size tub/shower)

Dessk/storage of junior suite

The main seating in the centrum ("lobby")

English Pub

Solarium pool

solarium hot tub

Solarium pool

sail away

Sail away

Vancouver, BC

Squeezing under the Lion's Gate Bridge

Sevens card/game room

cool globe

View of centrum bar and fancy stairs

Schooner Bar

Towel Elephant Surprise

The suite was gorgeous. Recently refurbished and much bigger than we expected. We were in cabin 1580, on deck 10, towards the aft part of the ship.  One of the benefits of booking a junior suite is instead of the tiny typical cruise ship shower, we had a tub and a larger bathroom overall. We also had  walk in closet with ample storage including shelves, top and bottom hanger space (bottom rods fold-able and storable if you do not wish to use them, a tie/belt rack on the door, plus ample storage in drawers and cabinets both in the bathroom and the main cabin.  The beds can be arranged as two twins or a king.  We also had a sleeper sofa and a chair and ottoman with two side tables.  

The balcony was smaller than others we've had, but more a function of the size of the ship overall.  There was a padded lounger and two chairs and a small bistro table.  Since we were sailing Alaska, we did not spend much time lounging on the balcony, but more sitting in front of the glass admiring the scenery as we sailed by.  

The muster drill (mandatory) was interesting. Instead of assembling at our actual muster stations (lifeboats), we were directed to Chops Grill.  Apparently, all suite guests were there. We sat at the tables and waited for the crew to demonstrate and explain what would happen in an actual emergency. Others had to stand in other common areas in the typical stand in line formation with children and women ahead of the men folk. I guess another perk of being a suite guest.  Once we were dismissed, most everyone headed up on deck for sail away.  

We sailed away at about 4:45 from Vancover.  The sun had come out and it was quite warm!  As sail away often is, it was an enthusiastic and exciting time. We chatted with several others around us, many of whom were cruising for the first time.  We had a lovely view of Vancouver a we sailed away.  As we sailed toward the Lion's Gate Bridge, it looked like we barely made it under!  In reality, I believe the Captain said we had about 14 feet of clearance! Eek!  It was pretty cool to watch.

We then retired to our cabin to actually sit on the balcony and watch the mountains go by for a while.  We then unpacked (we had gotten our bags before the muster drill!) and enjoyed our cabin until dinner time.  

We had chosen the late seating for dinner, which was 8 pm. The dining room was about 70% full for this seating, with most cruisers opting for the earlier seating or my time dining. We were actually quite surprised by the number of folks we talked to who never ate in the dining room at all.  Seriously, if you are going to cruise, at least try the dining room for dinner and lunch on sea days. It's so much better than the food in the Windjammer/buffet!  
the way finder, touch screen

from our balcony

Sun setting from our balcony

Very cool glass elevators overlooking the sea

Amazing self-leveling pool tables!

ahhhhh, balcony

We were seated at a table for 10, but there were only 3 couples assigned to the table, or the other 3 never showed up for dinner. We scored a window table for the first time ever and on two nights, we saw whales while we were dining! One pod of Orcas and a few humpbacks!   

Our table mates consisted of a couple who were Pinnacle members with Royal Caribbean. To reach Pinnacle, you must have sailed at least 700 nights on Royal Caribbean ships.  I'll let that sink in for a minute...  We are now Emerald, which requires 55 nights on a ship (we earned it faster by staying in suites, so in reality, we've only taken five 7 day cruises and a 3 day land tour that counts as cruise nights).  They were a lovely couple and were probably about the same age as our parents.  The other couple was interesting.  While nice folks, they tended to have a negative vibe, and did not really "click" with the rest of us.  This is the hazard of group seating and with a low # of couples. We prefer to sit at a larger table ourselves, as we like to meet new folks, but it also helps if there is an awkward or uncomfortable silence or presence in the group.  Still, we enjoyed our dinners and the company.  We learned from all of them.  

After dinner, we checked out the entertainment on the ship and did a bit of dancing. Then we headed off to sleep, as we were still mostly on east coast time.  Tomorrow is a sea day and I have a massage at the spa! 

Alaska Adventure: Pre-Cruise in Vancouver, BC.

It's 9:46 am EST on Wednesday, May 31, 2017.  I'm somewhere over the midwest, courtesy of Jet Blue.  

Our day began at o'dark thirty and our flight began at 6:44 am.  For those doing the math at home, that's a 4 am wake up call and we were staying at a hotel at the airport!   We live over an hour from the airport, and parking is outrageous, so it was as expensive or less to stay at the hotel and get an extra 2 hours of sleep instead of driving or taking a limo from home.

I dozed for about 2 hours of the flight, and now, 3 hours in, my neck is stiff, my throat is dry, and my body already tired of sitting, but I'm excited.  This day has been over 18 months in the making. 

Why a cruise?

My husband and I first took a cruise for our honeymoon, nearly 5 years ago. It was our first.  We were not sure if we'd like cruising.  We didn't. We LOVE it!  

This will be our 5th cruise.  All of our previous cruises have been to the Caribbean.  In talking to other cruisers and reading about destinations, everyone seems to agree cruising to Alaska is a bucket list cruise, and quite possibly one of the most beautiful one can take.  We've talked about doing it someday ever since our first cruise.  We decided life is short, so we'd make it our 5th anniversary cruise!

We are loyal to Royal (Caribbean) cruisers, so the cruise line was easy to decide upon.  We (mostly I) spent countless hours researching when the best time to sail was.  The Alaska cruise season is short, because, well, ice, cold, and darkness.  So late May through early September is the window.  Given our schedules, the kids' school and summer commitments, and the availability of my parents to be able to fly up from Florida to stay with the kids, we decided on early June.  

Planning the Alaska Adventure

I booked the cruise the day the Alaska 2017 itineraries went on sale for Crown and Anchor members (we get a one day jump on the general public), so we had our pick of cabins.  That was in February of 2016.  There was also a 30% off sale going on.  We chose a junior suite on the starboard side of the ship toward the back.  We also booked a 10 day cruisetour, so after the 7 day cruise, we have a 3 day land tour.  Royal awards double points for suite guests, and junior suites are not *that* much more expensive than a balcony cabin, especially on the smaller ships.  We'll make emerald status once we have completed this cruise!   I tracked the price of that cabin category from that day and there was never a lower price, in fact increased by over $1000 at one point.  Take home message:  Book your Alaska cruise as early as possible. 

I have spent a lot of hours researching and planning our trip.  Trying to decide what tours and excursions to take, what clothes to take, what flights to take, where to stay pre-cruise, what to do pre-cruise, and recently, potential weather we will encounter.  We will be on the 3rd cruise of the season. The range of weather we must be prepared to deal with ranges from the low 40's (with a relative wind chill on the deck of the ship) to the mid 70's.  Rain is also very likely, and looking at the 7 day forecast, very likely for much of our adventure.  Wtih highs in the low to mid-50's.  I did not expect it to be gorgeous weather every day, but I am hopeful it won't be cold and rainy every day, either.  This made packing a challenge in terms of having to pack for 13 days and two or three seasons of weather. We take far less to the Caribbean!!  

And today, it begins!  

We landed at Sea-Tac at about 10 am local time.  We rented a car from National, the only rental agency that allows you to pick up in the U.S. and drop off in Canada.  I had researched the direct vs. a more leisurely and scenic route, but we opted for the direct route.  It was less expensive to fly into Seattle and we wanted a rental car for a few days anyway, so this was how we planned it.

Driving from Seattle to Vancouver was about a 3 hour drive.  It was not terribly scenic travelling Interstate 5, and there was more traffic than one would have expected going around Seattle in the middle of the day, but we did get a nice view of the city without driving through it.  Mt. Rainier was hidden in the clouds, unfortunately.  

Whirlwind tour of Vancouver's gems

It was about 2.5 hours to the Canadian border.  The roads got increasingly more scenic as we approached B.C.  Lush, green trees and a gently curving roadway.  The border crossing was quick and easy.  More like a toll booth than anything else, but instead of paying a toll, you showed your passports, answered a few questions about the purpose of your trip, and you were on your way.  We waited maybe 5 minutes for our turn.

Mt Rainier?

The road to Canada

The traffic in Vancouver was also surprisingly heavy for 2:30 or 3 pm in the afternoon.  We stopped at Van Duesen Botanical Garden, which was part of the plan.  The afternoon was increasingly cloudy and threatening with rain.  We walked around the garden for about 90 minutes, which was just enough time.  It started to lightly rain just as we were leaving.  

From there we went to our hotel.  It was in an area of Vancouver that was being rebuilt. Many tall office buildings and hotels were under renovation or being built.  We stayed at the Marriott Residence Inn.  It was easy to find (the city is a grid).  There were 22 floors, it was quite large.  More than adequate for our needs, and one of the more economical mid-range hotels from what I've read. Breakfast, which was included, was surprisingly good.  Quite a variety of options despite it's continental/mini buffet feel.

Our only full day in the city,  Thursday, we drove to North Vancouver, to Capilano Suspension Bridge park. It was raining and we arrived shortly after they opened. They provide free rain ponchos if you are not prepared.  It was $80 CDN for two of us, but worth every penny.  What a gorgeous place. It's in a temperate coastal rainforest.  Redwoods abound. Damn, they are huge!  

The park is so much more than the suspension bridge, although that is spectacular.  You do need to cross it to get to the bulk of the attractions on the other side.  Those afraid of heights will find this a challenge to cross.  

Capilano Suspension bridge.  Yikes!

Cliff walk! 

Beautiful nature walk

BIG trees!

Look up, not down! 

We were there about 2 hours. We walked across the suspension bridge first.  Holy cow. If you've never walked across one before, they are narrow, high, and you can most definitely feel the movement as people traverse it.  Most people stopped for photos along the bridge. It spans the Capilano river.  

Once on the other side, there is a gorgeous and lengthy canopy walk. It involves stairs and mini suspension bridges with informative plaques/signs along the way and gorgeous, literally bird's eye views.  There is also a nature walk along trails and boardwalks at ground level.  The rain really gave it a unique beauty almost making the green pop.  

We went back across the suspension bridge (only way back), and then did the cliff walk, which is an arched narrow (one person single file) suspension arch (no movement) from a cliff.  It offers a different perspective on the river below and how nature prevails with trees that grow out of/around the rock.  Educational signs and exhibits about water conservation and geology of the area dot the pathways to and from the cliff walk.  

Of course there is a gift shop and three options for snacks, a light meal, and beverages on both sides of the bridge and park.  Parking is self-pay for the parking lot or it's accessible but bus from the city as well.  It's well worth your time and dollars, especially if you love being literally immersed in nature.  

From there, we went to Stanley Park.The rain tapered off, although it remained mostly cloudy the rest of the day.  Stanley Park is huge, 17 miles around the perimeter which is called the sea wall.  It offers paved bike and walking pathways on the seawall and many hiking trails through the middle.  There is also an aquarium, a few playgrounds, a beach, and several areas to grab a snack or light meal as well as a few gift shops. There are even totem poles.  We spent a few more hours there, walking and exploring.  

Stanley park sea wall and the Lion's Gate Bridge

From there, we went to Canada Place. Our intent was to check out where our cruise ship would be leaving from the next day.  Canada place is interesting as it is attached to the Convention Center. There is also a Fly Over Canada movie, which we did. If you've ever been to Walt Disney World, it was Soarin' over Canada.  It was well done.  We wandered around for a while, then watched sail away for the Seaborn ship.  Given it was now about 5:30 and we had not really eaten a meal since breakfast, I was starving.  There was a bevvy of food options and we settled on an Italian place. It was okay, but at least we had food in the belly!

Canada Place

By now, especially with the time change from the east coast, we were tired.  We walked a few blocks to to get a case of water for the cruise and sea bands.  Then we went back to the hotel and crashed.

In hindsight another day at least would have allowed us to see more of the sights in the city.  It is a lovely city, and there are parts of the city I had wanted to see, but we are not city people, which you may have guessed given our choice of how to spend our time.  :-)

If you are cruising our of Vancouver, it's definitely worth your time to spend a few days exploring and experiencing this beautiful city and all it has to offer.  

Tomorrow, we cruise! 

Tuesday, December 27, 2016

Death and 2016. What have we learned? What can we do?

F*ck you 2016 is a common sentiment in my Facebook feed these days.  All related to untimely deaths of the icons of our youth.  Prince.  David Bowie. George Michael, and today, everybody's favorite Princess, Carrie Fischer.  The list goes on...

2016 seems to be the year of celebrity deaths, or, perhaps, for those of us who grew up in the 70's and 80's, a bad year with a simply a heightened awareness of how death can strike at any time, and perhaps, an unwanted focus our own mortality?  Heck, many of these icons were in the 50's or early 60's.  A mere 5-10 years older than many of us who grew up listening to their music and watching their movies.  But we're still young!  Wait... so were they!

Every year, tribute reels are made to honor those celebrities and icons who have died.  Every year, it seems, we forget how much those who died 1, 2, or even 5 or 10 years ago impacted us, or a different generation.  It always seems like the current year is the worst, taking the most beloved of legends, most of them far too young and far too soon.

I totally understand how the death of a musician or actor whose work you adored and followed for years, can be a shock and create a feeling of sadness and an honest to goodness grief reaction, even though you never met them. And of course, although your experience is nowhere near that of their loved ones, it's still real. Many of them were larger than life and their music and their movies shaped who we are to some extent. We associate emotions, life events, and physical activities with them and their craft.  It's normal to feel some sadness at their passing.

I find it fascinating how the prevailing sentiment is anger at the calendar year, as if 2016 were the grim reaper itself. Maybe it's because people are unfamiliar with the feelings around loss, anger being a common one of course, and so they throw it out there on social media.  Followed closely by sadness, and reminiscing.  Posting their favorite songs or movie scenes, lyrics or quotes.  Sharing memories.  Writing beautiful tributes. These are great examples of healthy grieving though, whether people realize it or not. There is comfort in knowing you are not alone in how you feel.

I just wish everyone got the chance to see and hear these things while they were still alive.  Celebrity or not.  Seems like it would be more meaningful.  Especially if the person you so adored and will now miss, knew all that before they died. Still, it's a comfort for their family to see the outpouring of well-wishes and memorial tributes.

It would be a shame if it ended there.  With a social media post.  For there are lessons to be learned, choices WE can make now, so that we might not meet the same early fate.  OR, if we do, or rather, WHEN we do, we are more prepared.  Our families would thank us for that.  It lessens the burden on them.

So what can we learn from the deaths of so many icons of our youth?

  • Death is a mystery.  One's life can end quite suddenly and unexpectedly.  And that happens more than you think.  
  • Death doesn't care who you are or what you do.  It can happen to a celebrity, your neighbor, or someone in your family equally.  You can have the best medical care in the world, or appear to be healthy and vibrant, and still die unexpectedly.  You could be the sickest person, who "should" have died years ago, and yet, hang on well into your 8th or 9th decade.  Sometimes there is no rhyme or reason to it.  At least not on the surface. 
  • Prepare the appropriate documents now.  Health Care Proxy, Power of Attorney, life insurance, Will (especially if you have kids).  They are not hard to do, can be done online or with an attorney, but are so very important and not having one can make it a living hell for those left behind, with the state often determining how your assets are distributed, which may not be the way you wanted it and with the added cost of probate court.  Consider having those who are elderly or terminally ill pre-pay their funeral expenses (average funeral cost is about $6-8K)
  • Given we are not guaranteed a tomorrow, or even another hour, perhaps we should try to treat every day as if it might be our last.  Say I love you.  Don't hold grudges.  Forgive.  Pay it forward.  Choose love, not hate.  Spend quality time with your family and friends.  Live with no regrets.  If you can't say something nice, don't say it at all.  Give to others:  time, caring, words of encouragement and support, love, meet their needs.
  • Don't fear death.  It's going to come, one day or another, to all of us.  Prepare for it.  Talk about it.  Share your wishes with your family/friends.  CPR or no?  Breathing or feeding tube?  Burial or cremation?  Calling hours or a party? Donations in your memory to a favorite charity? What would be important to you in your last days/hours if you had that luxury?  Who would you want with you?  Who don't you want with you?  In a perfect world, how would you want to die?  
  • Be honest about the circumstances of a death when it happens.  So many people withhold cause of death when it was due to causes associated with stigma like suicide, drug overdose, murder, or a communicable disease, especially a sexually transmitted one.  If we talked about these things, if we knew about them, we could help both the person and their families better cope, and maybe, just maybe, help to break the stigma and save lives...
  • Realize that while sometimes, we have no idea what causes an otherwise healthy person to just up and die, many of the icons lost this year (and probably every year) had histories of admitted drug abuse.  Drugs mess you up.  Inside and out.  How badly depends on the drug(s) used and how long they were used.  They can damage your heart and your brain and have long term residual health impacts years after you stop.  So maybe that heart attack was not such a surprise after all, people just don't come with expiration dates.
What else can we do to help others?
  • Know the signs of a heart attack or stroke.  Take them seriously, in yourself or someone else. When in doubt, call 911.  IF you wait, thinking it's "nothing" or "indigestion" or "something you ate" you or your loved one could wake up dead.  ER's are no fun, but neither are funerals.  
  • Learn CPR and first aid.  Know where to find AED's and how to use them (the machines walk you through it, it's easy).  CPR and AED's save lives.  While not every life will be able to be saved, no lives will be saved if no one does CPR or uses an AED if available.  Everyone should know how to save a life!!
  • If you know someone who is struggling with depression, mental illness, drugs or alcohol, a chronic illness or chronic pain, reach out to them.  Offer to listen, to help, to check in on them. Call them out and show them you care. Know the signs of suicide, know where to get help, and help them get that help.  Far too often, friends and even family only learn of one's struggles with those demons after they have died.  
  • Be the change!  Honor the lives of your favorite celebrity by learning CPR in their honor, donating time or dollars to a charity related to their cause of death or one they supported, whatever resonates with you.
2017 is mere days away.  What will your resolution be?  Might it be to learn CPR?  To reach out to friends who seem to be struggling?  To say "yes" to family more often?  To vow to be positive instead of negative in your social media posts and interactions with others?  To take that dream vacation? To live even one day as if it's your last to give you perspective and insight on what's *really* important to you?  

Here's to a happy, healthy, joyous and peaceful New Year for all.  

Saturday, September 17, 2016

Helping someone who is suicidal, a true story

This is a true story.  The reality is it could be your story or that of someone you know.  It probably already is, whether you know it or not. It’s a story everyone needs to hear.  

It’s the story of how last Friday changed my life and that of a dear friend.  A story quite literally about life and death.  A story that could save the life of someone you know, work with, or love.  

It's a suicide story.  

And you need to know what to do if someone you know tells you they want to kill themselves, or have a plan to commit suicide, or have actually tried to end their own life.  This is a great resource if you ever need it:

Last Friday was like any other day, until I met up with a friend in the evening.  She struggles with depression, but is on medication and sees a therapist regularly.  Over the past several months, she has shared with me things about her life and her struggles that she had never told anyone else, other than her therapist.  It was clear from her behavior, it was a bad day for her.  I could tell she was “off”.  She appeared on the verge of tears and more sad than I’d seen her in a long time.  

I asked her what was going on.  At first, she dismissed it.  “I’m just having a bad day.”  But I pushed her on it.  “Sweetie, I can tell you are having a hard time today, what’s going on?”  

She fought back tears.  We hugged. Finally, she said, “I was at your house today.”

Me: “Oh, really?  Why?”

Her:  “I brought you a box… for safe keeping.”

Me:  “Where did you put it?  I didn’t see a box.”

Her:  “I came back to get it.”

Me:  “Why?”

Her:  “I didn’t want to scare you.”

Me:  (alarms going off in my head) “What was in the box?”

Her:  “Letters… dreams.”

Me:  (Thinking holy crap, this is way worse than I thought.  Putting my arms around her and hugging her as she started to cry)  “Tell me what happened”

Her:  With tremendous pain, fear, and profound sadness in her eyes and her voice, “I… (she told me the story of her suicide attempt that afternoon)”  The details of the day omitted to protect her identity, but she tried deliberately to take her own life through carbon monoxide poisoning. She didn’t want to live with the emotional pain any more.  She did not see any other way out.  She didn’t want to be a burden to anyone.  She was “done”.  And she was absolutely 100% convinced it was her only option.

Me:  (doula mode) “Oh, sweetie.  I’m so sorry you are hurting so much.  I’m so glad you didn’t go through with it.  Why did you stop?  What made you change your mind?”

Her:  “I didn’t want to hurt anyone”

Holy freaking crap.  She almost died today.  By her own volition. And I’m the only one who knows.  

What does one do at this point?  When a friend isn’t just depressed, doesn’t “just” express suicidal ideation (“I wish it would just end” or “When I’m gone, this won’t be a problem anymore”), but actually has a plan to end their life, or worse, in this case, has actually made an attempt, it’s a mental health crisis.  You MUST take it seriously.  It is truly a life or death emergency.         

It’s a very delicate dance.  One between getting them to the help they need and driving them further into their depression and a future attempt, one that very well could be successful.

I knew she was in a mental health crisis.  Obviously.  While she stopped her attempt that day, she was in no way out of the woods.  She was still in crisis.  She needed intervention and help. Yet at that very moment, only me and her therapist knew about her “baggage” and I was the only one who knew she had attempted suicide that day.

She needed to go to the ER.  She needed crisis intervention.  Her life was literally in the balance.  She wouldn’t go.  We talked for over an hour.  Her therapist was out of the country on vacation.   It was Friday night. Of course.  Late.  Her doctor was not the one on call, and even so, they would have told her to go to the ER.  

I tried to get her to come home with me for the night.  She refused.  I tried to get her to let me go home with her for the night.  She refused.  Adamantly.  She was going home to her husband, who was sleeping and had no idea how depressed and suicidal she was.

I told her I loved her, that we’d get through this together, and that she needed professional help.  I made her promise that she would not make another attempt that night, and if she wanted to, she was to call me ASAP.  No matter what time it was, and I’d talk to her, come to her, do whatever she needed to get through those feelings.  Or she could call the suicide prevention hotline or 911.  She agreed.  I knew it could be an empty promise, and she’d never call 911, but I also felt I had to walk a very fine line between trust and intervention at this point.  We made a plan to get together the next morning and she agreed.  

In retrospect, I should not have left her alone that night.  Neither of us slept very well.  I should have insisted on staying with her.  The anxiety I had all night was nothing compared to what she was experiencing.  By the grace of God, she kept her promise to me.

The next day, which I later learned, was actually national suicide prevention awareness day,  we spent almost the entire day together.  It was eye-opening.  We talked.  A lot.  She shared openly and honestly about how she was feeling, some of the things in past and her current life that were contributing to her emotional pain.  Some of which I had not heard before. She shared about the history of her depression, what her thought process was on Friday, the planning, the letter writing, how she went about her day, the attempt, what stopped her, and that she regretted turning off the engine.  (more alarms in my head).  The only thing keeping her from going through with it then or again, was that she didn’t want to hurt the people she loved.  

We talked about how maybe her meds needed adjusting.  It can happen that over time, they become less effective.  Suicidal ideation can be an ironic side effect of antidepressants.  

We talked about others I knew who had struggled with the same situation.  Depression, suicide attempts, intensive hospitalization and therapy, and where they are today in terms of coping, thriving, and how they are feeling emotionally.  How important support and understanding is for family and friends, but that they need to know to be able to support and help you.

We talked about how she needed more intense therapy than once a week or every two weeks to get through this rough patch. Maybe even an inpatient program for a few days to help her through this until her therapist was back.  Or a daily outpatient program.  I was trying to plant seeds gently, that she really needed more support and professional help, what the options were, and gently nudge her toward it.

Her therapist had NO Idea she was suicidal. No one did, except me and now my husband, also a friend of hers, who she shared with as well.  She hadn’t told anyone else.  My friend still did not understand why all of sudden, she was so overwhelmed on Friday that she tried to end her life.  She admitted to thinking about suicide before, but this time she had a plan, took the time to write goodbye letters, bring them to me, and then follow through with an attempt. This was a big, scary change for her, and for me.

I have had basic suicide prevention training in the past and my doula training and grief support work and experience all came in handy in this situation.  I had done some research for her that morning (she is not technologically savvy and in her current state of mind, would not have thought of or had the energy or motivation to seek help or information on her own) and printed some articles specifically directed to those considering suicide.  They were excellent articles.  She looked at one and said, “Yes!  That’s it.  That’s how I feel!”  They were written by people who had attempted and recovered.  Others were written by professionals, but specifically to the suicidal person.  I also lent her some books I thought would be helpful for her.  I gave her the suicide prevention hotline numbers and resources.  All in a purple folder, which she drew a heart on.

I reminded her she was not alone.  She wasn’t alone in feeling this way.  She wasn’t alone in needing help to get through it.  And that she could and would get through it.  Suicide is a long term solution to a short term problem.  The problem is our brains, when we’re depressed, because of the chemical imbalances in there, can’t see that it’s a short term problem, and suicide becomes the only apparent way out.  But it’s not!

One of the articles included a safety plan or contract.  I guided her through it, helping her to make her safety contract with me.  I reminded her I loved her.  I was there for her 24/7, and she was absolutely to call me if she felt overwhelmed, wanted to talk, couldn’t sleep, or felt like she wanted to attempt again.  She still was not willing to share her pain and feelings with anyone else.  She still felt like she was a burden to everyone, especially me.  But she also didn’t want to disappoint me.

She was still not willing to go to the emergency room.  She would still not stay with me or allow me to stay with her.  Her husband was home though and they had plans together for the evening that she didn’t want to change.  She wouldn’t be alone, even if he had no idea what was going on.  She said she felt much better if she was not alone or busy. She was adamant, ADAMANT that he not know.  

She did not understand how dire a crisis she was in.  The depression was too profound and overwhelming.  She did agree to contract for safety with me.  We did it together.  It concerned me that the part of the contract that said “these are the things I have to live for” was the hardest box for her to fill out.

Yet, something in her eyes, her voice, told me she was in a slightly better place than she was 24 hours earlier, but still at huge risk.  It was probably the fear of breaking a promise to me that kept her alive that day. Again, I should not have left her alone, but I was still walking that tightrope of trust vs. forced intervention.  I wanted her to get to the point of being willing to get the intervention.  

We kept in close contact via text and phone that evening through the next day.  She went to church and spent the day with her husband and working, she said being busy was good and helpful.  She felt a little better.  But woke at night scared and panicked not knowing why.  She struggled when she was alone.  She was not going to be alone at all that day or night.  This was a good thing.

I called a friend who is a physician to talk about the situation in confidence and protecting her identity.  She was very helpful.  She, too, said close observation was really important until we could get her to the doctor or ER.

I realized my goal, what I’d been doing all weekend,  was that I was trying to keep my friend alive until Monday morning, when her doctor would likely be the one to convince her she needed the hospital.

Monday was an incredibly stressful day.  My friend went to church in the morning, then was going to work.  I texted with her from the time I got up at 6, all morning, until she heard back from her doctor.  In the meantime, I was managing a rather emotional crisis at work, as well.  

Then I got the text, “My doctor can’t see me today.  She told me to go to the ER.  I can’t go.  I have to go to work!”  I excused myself from an important meeting I was in and called her.  We talked.  She was in a panic about work.  I gently said, “if the doctor thinks you should go sweetie, you should go.  We’re all worried about you.  At the hospital, you can see a doctor and a therapist.  They’ll help you figure out what you need next.  I’ll come get you.  I’ll go with you.  I’ll stay with you.  I won’t leave you alone.  We’ll do it together.”

We talked for a while.  Finally, we reached a compromise.  She agreed to go after work.  She agreed to let me meet her at her work so I could go with her.  When I got there, she said the doctor’s office had called a few hours ago to ask if she had gone yet.  I said that’s because they care and are worried about you, too.  We sat in my car and talked for about 45 minutes.  We talked about how she was feeling, what might happen in the ER, and why I really, really, felt this was important and necessary, even though I wished it were easier and didn’t involve an emergency room.  While we were sitting there, her actual doctor called to see if she had gone yet and to try to compel her to go if she had not yet.

The ER system for depression and suicidal ideation is horribly broken

What happens next is a horror story of sorts.  Our emergency mental health system is fucked the hell up.  I’ve been in emergency rooms before, and this particular hospital's ER is one that personally, I’d avoid like the plague, but it was not my choice.

And truth be told, from people I’ve talked to, this is the way mental health emergencies are handled in most ER’s.  It’s a freaking nightmare, especially for people like my friend, who are *just* depressed and suicidal, not suffering from drug addiction (and combative, restrained, and psychotic), schizophrenia, violent, or otherwise socially disruptive.  Unfortunately, nearly everyone else in the ER that night was like that.

We arrived about 6:15 pm. She was triaged, and that was the only point at which we were separated.  It was about 15 or 20 minutes.  Then I was allowed to join her in the ER bay.  Unfortunately, we were brought to the psych ER.  Which was packed.  

Because it was a psych ER, and they had no idea how much of a danger to herself she was, they took everything away from her.  This is protocol. She had nothing but her clothes, which they also eventually took in exchange for the sexy hospital johnnie and pants and socks.  You couldn’t have curtains pulled unless the doctor was with you, so we were forced to witness the craziness that was happening around us.  It was downright scary for her.  I’d seen much of it before in my 25 years in health care, but I was horrified that this was the system.  It was painfully eye-opening.

Who the hell ever thought it was a good idea to bring someone who wants to end their life into an ER for “help”, where they sit for 8+ hours, alone, frightened, held against their will even if they wanted to leave (she was section 12’d, which is a precaution for anyone who is suicidal, which means with a doctor’s order they can be held against their will for 72 hours), and have to witness things that you normally would only see in scary movies?   How is that helpful?  How does that make them want to see that there is something to live for?  How does that convince them an inpatient stay on a mental health unit (which they assume is just like this) is a good thing or something they would want to do?!  Seriously?  How can anyone think this is a good or helpful thing?  Why can’t it change?

We saw a woman kicking, screaming, swearing, being held down by 3 people, 4 point restrained and then actually break leather restraints.  She was then handcuffed to the stretcher.  We saw a man come in with a huge backpack, and then the police officer confiscate 3 knives from him.  He later escaped the ER.  There was yelling, screaming, swearing, chaos, gawking and commenting by the other patients, and it was in overflow.  It was noisy.  It was loud. The energy was negative and chaotic. There was no way anyone could rest who was not flat out unconscious.  It was horrible. It was exhausting to witness, let alone be in crisis yourself and having to process and cope with all that.

Neither she, nor I, are likely to ever go to an ER for a mental health crisis again.  Certainly not that one.  And that’s really sad.

It was close to 2 hours before she saw a doctor, who was not at all compassionate, and came in to say “It’s my job to medically clear you”  put a stethoscope on her chest for 10 seconds and said, “You are medically clear, but you have to be seen by our crisis team.  They’re busy, it could be a while. I’ve signed a section 12, so you’re not leaving.  Then we’ll try to find you a bed here, but it’s really busy.”  And she walked away.  WTF?

My friend looked at me, eyes wide and full of fear, “I don’t belong here”  She was right.  She belonged where she could get immediate mental health support, yet unfortunately, in a mental health crisis, the ER is the gateway to *real* help.  There are no direct admits to inpatient mental health programs.  There are no direct admits to intensive outpatient programs.  Or if they are, they are for those with established histories, not for people like my friend.  

And it was the only place for her to go to get TO the help she needed.  Every other person in a position to help (therapist, MD) told her she had to go to the ER.  

She allowed me to call another friend (the doctor friend) to join us.  We distracted her from the chaos around us, we talked, we hugged her when she cried, we watched DWTS (a nice distraction), we praised her for doing this incredibly difficult step to helping herself to get better, we asked for water for her (they never once offered), we fed her a snack when she was hungry, because she never had dinner and barely ate lunch.  

We kept asking the staff when the crisis team would come.  They kept saying they’d call and then we heard nothing.  “Might be 2 or 3 am…”  Seriously?  When she’s friggin exhausted and scared and has been here for over 8 hours?  How is this helping her?  No wonder the other guy escaped.

The other friend left around 11. I stayed with her.  I was the only visitor still in the psych ER.  At one point, a nurse or sitter came by and rudely said, “You’re going to have to leave, no visitors”  But she never came back.  I think someone saw that my friend was not like the others, and really, she wasn’t.  They saw how scared she was, how “simply” depressed she was, and how much having me there was helping her to cope.  I was quiet and so, I stayed.  I’d have put up quite a fuss if they tried to kick me out. Maybe they knew that too?  

Finally at about 12:45 am, after asking AGAIN, when the crisis team was coming for her, the social worker came.  They went off to a private room to talk for about an hour.  I did some work.

They returned about 45 minutes later.  The social worker asked to meet with me.  We went off to the private room together and talked for about 15 minutes.  She was very kind.  She asked me about what had happened to make me bring her here, thanked me for being a good friend and for quite possibly, saving her life.  She expressed her concern for her, mostly for the level of planning that went into it and the fact that she had actually attempted suicide.  She recommended an inpatient program.  Said there were no beds at that hospital, so she’d be in the ER for a while, and then either go upstairs or somewhere else for inpatient.  

We went back to my friend.  The social worker told her she was going to have to stay.  She cried.  But by then, she realized she needed the help and had given in.  She really didn’t fully understand she couldn’t have left if she wanted to.  She just wanted the hell out of that ER.  IF she needed to stay inpatient, they let’s get this show on the road.  

We hugged. She asked if she could have her phone to get a few phone numbers. The social worker got her phone, allowed her to write down the numbers and then took the phone away.  She could use the house phone on the wall.  The social worker said I could stay as long as my friend wanted me to, they would not make me leave.  They would call her husband for her.

We talked for a bit more.  She was tired.  I encouraged her to try to get some sleep.  She told me to go home.  I offered to stay, reminding her I’m a doula, I’m used to and good at this all nighter in a hospital thing.  Besides, I was now overtired and wide awake.  It was 2 am.  She said she really wanted me to get some sleep and she was going to try to do the same.  I asked for another pillow and blanket for her, turned out the light in her bay, tucked her in with a kiss, told her I loved her and I’d be in touch.  I got home about 2:30 am, but couldn’t really sleep.  

The next morning she called from the wall phone to update me.  She called again that afternoon to tell me they were transferring her to another hospital’s adult mental health unit.  From what I’d heard about it, it was a good place for her.  I thought it would be better than the unit at the hospital where she was.  

We’ve kept in touch via text messages.  She gets to use her phone a half hour in the am and pm, and can use the house phone other times to call.  I finally got to visit her yesterday.

She’s in a better place emotionally.  She has a new med and it seems to be helping.  The education and support on an inpatient unit is proving to be  insightful and helpful for her.  Her husband and family and some friends now know at least some of the story.  They are visiting her as well.  Her support network has gone from two people to double digits.  There is relief in that for her.  She doesn’t have to carry it herself.  She doesn’t have to hide her feelings.  And of course, everyone is supporting her, not saying she’s a burden or a “horrible” person like she feared they would.  She is grateful.  Even though the work is hard and the process is long.

Yesterday, she said it was the first day she woke up and thought that she actually wasn’t ready to go home.  She realizes now, with the distance, clearer head, and perspective of seeing what other people with mental illness struggle with, and the benefit of the group work and hearing other people’s stories, what a bad place she was in and that she didn’t see it at the time.  She doesn’t want to feel that way again.  She wants to live.  She wants to get better.  She believes she can now.  She knows she needs more coping strategies, med management, and talk therapy.  She knows she still needs a safety plan when she gets home.  She is glad she is where she is, as hard as it is.  She thanked me over and over. I told her the best gift she can give me is to get herself well so we can go out and celebrate the amazing person she is and her life, together.  

Hopefully, she’ll be home by the end of next week. She’s already getting support systems in place with the help of the staff there.  They asked her if she wanted me to be a part of her discharge planning family meeting, because I was the one who saw the need to get her to this level of help and she apparently told them how much she valued my support.  She doesn’t want to bother me or make me miss work.  I told her if she wanted me to be there, I would be. Not a problem.  And even if I wasn’t there, I am still a part of her team as long as she wants me to be.  That contract doesn’t expire.  Ever.

Caring for the Caregiver
Now that it’s been a week, and I’ve had the chance to talk with her for the first time since that nightmare in the ER, I realize how incredibly stressful it’s been for me.  When you are in crisis management mode, you are in that mode.  The emotional impact of that often hits you later.

I barely ate or slept all week.  Work has been insanely stressful as well, which of course, did not help.

I realize now, I spent 3 full days last weekend, desperately trying to keep her alive and get her to the help she needed. I did so without the full support of my husband, who disagreed with me on how at risk she was and taking her to the ER (despite the fact every therapist and doctor on the planet would likely say the same thing).  And that was hard.  I knew I was doing the right thing by trying to get her to the ER, but still, I felt very alone.

I realize now, I took a tremendous chance by not insisting I stay with her or taking her to the ER the day she told me, or the next day, or the day after that.  And I feel guilty about that.  She was incredibly unstable and that contract could have easily gone out the window in a heartbeat. It could so easily have ended differently… and this story could easily have had a much more tragic ending.  Easily.  And that scares the bejesus out of me.  I’d never forgive myself if that had been the outcome.  

And so I share this story, because it’s not just mine, or my friend’s.

It’s the story of far too many people every day.  Statistically, 117 people commit suicide every single day.  Over 42,000 people a year in the U.S!  It’s the 10th leading cause of death in the United States.  For every person who succeeds, 25 attempt suicide,  like my friend did.  While men are at higher risk, women are certainly not immune.  

If you are worried about someone, here’s what you should do

How a safety plan can help and the suicide prevention lifeline

Please, if anyone shows signs that they may be at risk for or ever confides in you that they are considering suicide, don’t dismiss it.  Don’t think you alone can help them.  Know the warning signs.  Help them to get the help they need.  Don’t tell them not to feel the way they do, they can’t help it.  Get them help.  Immediately.  It could literally save their life.

September is suicide awareness month.  I hope in sharing my story and that of my dear friend, your awareness of suicide signs and prevention is greater than it was.  Reach out to someone who is struggling.  No one needs to go through it alone.