The killer inside us

Column box-Dr. Carl E. Balita-Entrepreneurs’ Footprints

Warning: This article may be very disturbing!

Yes, Covid-19 kills. From the accounts of those who fortunately survived, the symptoms are so disturbing that it would neither allow you to go to sleep nor rest.  The devil’s masterpiece virus attacks the lungs and deprives its victims of the life-giving oxygen until the immune system couldn’t recover to help the body destroy the most crude molecule, which even modern science can’t completely understand. 

To make the suffering worse, one has to die alone with a limited touch from the medical team that are the only persons authorized to come close. Then cremation will convert the body of the deceased to ashes. It will be endorsed to the grieving family and friends whose mourning will never be according to the rituals intended for the normal bereavement process.

Nothing is pleasant in death except for the completeness of a life cycle and the spiritual opportunity to be, if we deserve, in the eternal life. But to die of Covid and to have a loved one die of it is just one of the most horrifying scene one can ever imagine. The thought alone is disturbing.  Imagine the real experience of it.

The obituaries on social media as well as the screams for help by those suffering have brought to us some uncensored accounts of experiences. They are so real—as real as the families we know, our friends and acquaintances who have given to us the face of this gruesome unseen killer.  Worst is the fact that it is knocking on our door, just like a serial killer in horror movies.  Lock your car windows well because the virus might get it. Wear your mask and face shield properly to cover your face and make you unrecognizable to the invisible evil carrying the symbolic sickle of death. The thought alone is disturbing. Imagine the real experience of it.

But the fact remains that as we retreat in the safety of our homes, our lives have to continue. The quest for survival is as real as the paralyzing scare. We need to do our job, otherwise we will lose it. We need to convert our fear into productivity, our anxiety into results, and our fears into output to justify our continued purpose in our works. And as our children navigate their learning through platforms they see best as gameboards, the teachers mutually share the discomfort of the experience in a poorly established digital connectivity. The very limited home space has become a commissary and production area for survival entrepreneurs of the family. Food supply becomes widely available but remains costly. The utilities and life essentials have not become humane in their prices. The home as a refuge has expanded its dynamics to cover many aspects of our daily lives. With the convenience of space and resources, it becomes a blessing, while for those with limitations, it has become a curse. 

Any new experience makes us cope. If we are able to manage, we grow in and around it. If we are unable to cope, we suffer—psychologically, mentally and, eventually, its most holistic sense.

The scenarios painted above were intentionally exaggerated to evoke a sense of chaos and an emotion of anxiety. It illustrated in written form what is traumatic and disturbing to elicit understanding of factors that threatens the mental health of many. Here is where humanity has to listen to the core of its being—empathy, compassion, action. Having the empathy, being compassionate, and becoming (the person capable of) the action needed to support humanity—one person at a time. A simple call to check on a friend in an engaged conversation gives a cathartic feeling of relief for both parties. It begins with a little act of kindness extended to anyone in need. It has no cost but it is priceless.  

These little acts of kindness can prevent the worst response to distress—self-harm and suicide. It is anticipated that the incidence of these human actions will escalate in this crisis. Philippine Statistics Authority recorded a 25.7 percent increase in the recorded intentional self-harm, making it the 27th leading cause of death in 2020. It shifted from being ranked 31st in 2019. From 2,808 registered deaths due to intentional self-harm in 2019, this spiked to 3,529 in 2020. This is highest in 14 years.  

Globally and in recent history, the suicide mortality rate (the number of suicide deaths in a year per 100,000 population) has been increasing. Pre-Covid data showed that the rate is 2.50 in 2000 and escalated to 3.20 in 2016. It is interesting to note that based on WHO data, the following countries have recorded the following suicide mortality rates: Ukraine 22.40, India at 16.30, Japan at 14.9, Myanmar at 7.80, Vietnam at 7.30, Cambodia at 5.30, Indonesia at 3.40, Philippines at 3.20. In Japan, based on a CNN news, more people died from suicide in October 2020 than from Covid all of 2020. These data cannot make us Filipinos celebrate for having a relatively better rate. The fact is, every life matters and every death should be avoided, as much as society can.

Suicide does not regard gender, age, social, economic and educational status, although statistics may show some vulnerabilities across variables. The most established data leading to successful suicidal act is the previous attempts. Those with history of previous attempts may be more successful in their next attempts.  Suicidal act is not synonymous with mental illness. In fact, suicidal persons are ambivalent about dying—they want to die but they don’t want to die. They are not fully intent about dying. And they do it not without a warning. In almost all cases, they send out clues and express their “cry for help.” In fact, they have a plan. In their mind, they thought that suicide is the last recourse. Their indecision about dying engage them into internal resolution, which manifests behaviorally—meaning, it shows observable change. 

Sensitive and knowledgeable enough, people around a suicidal person may engage in a watchful interaction that provides for catharsis—a therapeutic relief of the anxiety—and an exploration of solution that may challenge the perceived hopelessness and helplessness. There is a suicide plan that may be revealed, and therefore may be evaluated for its concreteness. The methods may be explored so it can be monitored for its availability, accessibility and lethality. The more detailed the plan is, the more lethal and accessible the method is and the more efforts by the suicidal to block rescue, the most likely suicide will be successful. These should therefore be established and controlled. A contract for no-suicide may be forged to commit the person not to do it and instead activate the communication as help-line. Suicide escalates from ideation (when the suicidal considers and thinks about it), plan (when concretely its options are laid out), attempts (when it is tested to also send clues) and act (which is the execution to achieve death).

As humanity is trying to solve the puzzle of our effective pandemic response, our footprints should not show that we missed the sensitivity to other preventable causes of death among the people around us. And Covid is not the only killer. The most dangerous killer is inside us. 

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