Staying Alive: Suicide Intervention "Drama"

Patience, When You Need It Most "Drama"

You are a physician who works two days a week at an Indian Affairs med-center.  This morning you put a cast on the arm of a 38 year-old woman and stitched a gash in her forehead.  She was injured in what the police described as a suspicious, single-vehicle car accident.  Her car struck an abutment on a clear stretch of road at high speed and with no apparent application of brakes.  She had not been drinking.  She was fortunate to come out of the crash with only minor injuries.  The police have told you that there have been two suicides in her immediate family, and four more on the reserve in the past six months.

You have asked her about the accident.  She says she doesn't know how it happened.  She is staring at the floor.  Her injuries do not require hospitalization and you are tempted to just let her go home.  Yet your concern leads you to try to explore further to see if these actions are invitations.  You sit down on a stool in the treatment room.  She is sitting on the table.