‘I went on a walk and returned to find my husband dead’ — (The Guardian)

SSRI Ed note: Physician feels bad over a complaint is filed against him, is prescribed antidepressants twice, the 2nd time they make things worse, he dies by suicide.

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The Guardian

Kate Harding

Sat 24 Feb 2018 06.00 GMT

After her husband’s suicide, Kate Harding was overwhelmed by guilt and shame

Kate Harding: ‘Widowhood sucks.’ Photograph: Francesca Jones/The Guardian

I have been a widow for 11 weeks. It seems surreal to be writing that sentence and yet it is true. I was there; I know. Richard killed himself at home while I was walking the dog with my daughter, while my son was lying metres away in his bedroom. As a consultant anaesthetist and intensivist (a specialist in the care of critically ill patients), Richard knew exactly what to do. He was 47.

I can report that a state of calm really does descend in such extreme circumstances, even in someone who fears emergencies as much as I do. As a hospice doctor, I am far more comfortable with death in its more expected, gentle forms. Nevertheless, it seemed perfectly normal to be attempting to resuscitate my husband – at one point with my foot – as I talked to the emergency operator. To be applying shock paddles once the community defibrillator had arrived. To be discussing adrenaline with the paramedics. To be putting a duvet over him and a pillow under his head and to be kissing him goodbye. To be helping the children to do the same, before he was taken away by the ambulance. To be giving my statement to the police. To be shutting the door on them, late at night, and for a moment teetering between my former life and the one to come, a darker version of the stroke of midnight separating the old year from the new.

Richard had been living with depression and was three days away from his first appointment with a psychiatrist for a medication review. His illness was triggered last year by a complaint about him to the General Medical Council (the first he had received), just as we packed the last of our possessions into a shipping container bound for New Zealand and signed away our house. Although the complaint was thrown out in due course, as we expected it to be, it took five months. The strain this put him under was immense.

He was unable to work abroad until the GMC could issue him a “certificate of good standing”, so we had to claw back the jobs from which we had resigned and tell our children they were returning to the schools they thought they had left. Finally, the all-clear was given and the paperwork completed. We boarded our flight to Auckland, vowing never to work in the NHS again.

But once we had made the move to Northland, the stress of the previous few months caught up with Richard and he entered a period of depression. He had had an episode in his early 20s, which had lasted for months, but there had been no recurrence.

He did well on antidepressants and made a positive impression on his new colleagues. He threw himself into his new coastal life and regained his energy and verve. In rapid succession, he acquired a boat, fishing rods, a fishing kayak, three types of roof rack and an unspeakably tight-fitting open-water swimming wetsuit, accessorised with a dapper hood. He was, for a time, a happy man.

Then, in July last year, his depression recurred. This time, the medication didn’t work; in fact, it may have made things worse. Insomnia was a central feature, worsened by the frequency of his night-time call-outs, although he enjoyed his job and continued to perform well at work.

Privately, however, he worried a lot more about his clinical decisions. “I don’t think I will ever be the same person again,” was a recurring phrase of his, in relation to the GMC complaint. Week after week, we waited for the drugs to start working. He consulted a psychologist. We waited some more. The psychologist suggested a psychiatrist. Another wait ensued. Richard lost patience with the process and took matters into his own hands. This is what anaesthetists do. Somehow, I had overlooked this, as well as his impulsiveness and his impatience – character traits that had further heightened his risk of succumbing to his illness.

Richard and Kate Harding in Wellington, New Zealand, 2017. Photograph: Courtesy Kate Harding

I am still in a state of disbelief much of the time. To say I feel overwhelmed by guilt and shame is an understatement. As his wife and as a doctor, I am appalled that I let him go this way. The phrase “I have lost my husband” could not be more accurate – it feels like carelessness to me, like he slipped through my fingers while I looked the other way. I went on a walk; I returned to find my husband dead.

The first week after his death is a blur. Sleep was possible only with hypnotics. I lost 5kg. I worried about the children constantly. Every night, I crept into my daughter’s bed. Eventually, she kicked me out, claiming that, at 16, this was not a viable long-term proposition. (I disagreed and still do.) We slept beside a small shrine that she had created: a picture of her father holding her on his lap years ago; his hospital name stamp; a smooth, orange-tinged pebble that he had liked to keep in his pocket for luck. Known as Boiled Egg, or Boiled for short, this got endlessly lost in our bed, causing several irritable late-night exchanges. (It turns out there is a limit to maternal patience and compassion after 11.30pm, even in the event of a terrible bereavement.)

My son, aged 14, chose to sleep in his own room, but often came into ours and slept on the floor on an emergency mattress kept there for this purpose. He opted to return to normality as soon as possible, going back to school after just a day at home. He found comfort in his daily routine and in time spent with friends. My daughter, on the other hand, did not return to school at all, deciding she wanted to be home-schooled, with a view to returning to the UK. This decision is one that the three of us arrived at together, the day after Richard’s death, during a debrief while sitting on the floor where he died in our guest studio, a light and peaceful room that I wanted us to be able to enter freely, despite what had happened there.

People came and went endlessly. The house was overrun. I could eat nothing, yet food appeared at hourly intervals, along with flowers. The kindness of our friends and neighbours was, and continues to be, extraordinary. I have been told repeatedly that there was nothing I could have done; I know that this is untrue, but it is easier to nod and agree.

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Widowhood sucks. There isn’t much time to grieve, for starters – the first few weeks were dominated by a bewildering array of administrative tasks. If I wasn’t at the lawyer’s office, I was at the bank or the funeral director’s or dealing with builders (the house we had bought only six weeks before needed considerable work) or setting up schooling for the kids in the UK.

We have now returned to Britain – to rain and Brexit and the crisis-ridden NHS. To general practice, a profession I try continually to escape, but which beckons yet again, in view of my need to make a living. To the hospice work that I love and wish I could afford to do more. To our friends and family, and to the lush Herefordshire countryside. I love New Zealand and Britain and could live in either. What I am pondering is how to remain in medicine. The fear of a complaint looms large, given the consequences for my husband, one of the best doctors I have known. How to remain a doctor, when I couldn’t even keep my husband alive?

Richard, you were such a vivid presence in our lives. You were funny, impulsive, adventurous, kind. You swore often, with feeling. You loved your wife, your children and your dogs. You were frequently infuriated by your wife and your children, much less often by your dogs. You were always dashing off to swim around an island, go sea-kayaking or fit in a power yoga class. I feel you should be coming home about now, from an overseas conference, perhaps, one that has lasted longer than usual. I can’t begin to imagine how we are going to live without you, as it seems that we must. But we have made a start and I promise that we will do our best to keep going.

I know about mortgage rates now, and how much that boat of yours cost. I have sold the boat, along with much else. I can change a printer cartridge and talk cladding with the builder. I have a lot more to learn, not least how to raise two teenagers on my own, but I will give it all my best shot.

We miss you desperately. We miss infuriating you. We miss being loved by you.