Hannah’s short story

Prologue: The bathwater, initially clear blue, gradually takes on a pinkish hue. Like rose water…or fresh henna, that’s come off of tattooed hands and feet immersed in a bath tub. The water overflows onto the pristine white tiled floor, making it blush. Mesmerized by the changing colors, my mind unsuccessfully tries not to focus on the source of that color. Blood. That oozes out of deep slits in both forearms of a beautiful young girl. Hannah sobs quietly and sighs deeply – but refrains from screaming despite pain from incised sinew, nerves, arteries and veins.

[Random thought: they say arteries and veins don’t have pain receptors…]

Hannah’s muffled groans eventually die down; so does her body as her life takes flight. And thus Hannah Baker dies at age 17. She takes her own life and she does so in an extreme manner.

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“What if Hannah’s parents had discovered her in the bathroom a tad bit earlier? What if 911 had been called and she’d been rushed to the nearest ER; she might have survived…” I wondered.

Needless to say, Hannah’s violent demise shook me. And I think it’s because I was forced to reflect upon my own profession. I happen to be a pediatric ER physician. Although I have never had to deal with children presenting to the ER with deliberate self harm-related goriness to Hannah’s extent, I have had my fill of young people with suicidal ideation. I can recall children who had intentionally overdosed on tylenol, motrin, rat poison, sleeping pills, alcohol, kerosene, dettol, phenyl, and so on…either singly or in any number of combinations, depending on availability of substances. In a busy ER practice, I had convinced myself that there was little time to spare talking to the confounding teenager and adolescent. If medically unstable they didn’t really have the capacity to talk - to tell me why they had done what they did. In the acute phase it didn’t really matter to me because time was against me to save their lives. Conversely, once medically stabilized, or if not that unstable to begin with, I would generate a psychiatry consult. For ER physicians, suicidal kids after initial stabilization / medical clearance are generally meant to be handed over to the psych team so the latter may delve into the talking. The same goes for the sexually or physically assaulted teenager who would end up in my ER.  We just do what needs to be done. We aren’t into talking to young people as it takes too much time and effort. Or does it?

“What if Hannah’s school counselor really heard her out? Or her parents? Or her closest friends? She might have survived” 

My heart cried. But my mind screamed, “Wait! Weren’t her closest high school friends anything but that?” Her so called friends in one way or another crushed her spirit and her soul. In a very graphic depiction of bullying, verbal abuse, ‘slut shaming’ through social media or otherwise, stalking, physical and sexual assault, Hannah was victimized by her high school peers. And this was an affluent school in the US, mind you; not a ghetto one. For all intents and purposes, Hannah was alone, and therefore the outcome was perhaps not all that surprising.

It wasn’t only my patients that Hannah reminded me of, because those were a relatively more recent lot. She made me reminisce about my own high school from a life time ago. My high school was not in the US. It was in Karachi, Pakistan. Regardless, it had the same type of “somewhat arbitrary, though equally inane” hierarchical structure with jocks, nerds, cheerleader types, victims, perpetrators, jokers, bullies, and so on. Hannah helped me recall a dear friend from high school who took his life, and I never could understand why he did so. Maybe I can speculate more meaningfully now, after thinking long and hard about Hannah. And while I’m still on the topic of high schools, I am reminded of my own child currently in high school. I wonder if he’s having to deal with unrealistic peer pressure, and if so will he be able to transcend it at some point? Because I couldn’t. Hannah also shed light on various incidents, thankfully sporadic, of young people I had known who attempted, both successfully and unsuccessfully, to take their lives while in medical school, graduate school, residency / fellowship, and later. So the list goes on…

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Epilogue: The coup de grace, for those of you who don’t know, Hannah was not “for real”. She was the young 17-year-old protagonist and narrator from the recent TV series “13 reasons why”. When I first started watching, she got me thinking. And I can’t stop. While she lived she certainly made me think, although not as much as after she had died. But I knew of her death the moment I started watching the show. Can it be that a mere character in a TV series have such potency? Yes. It is possible, I tell myself. If you thought at the outset that I would have answers for you - to bullying, harsh realities, how to prevent suicides, how to reduce adolescent angst, and so on, then sorry to burst your bubble. All I want to say now is that Hannah disturbed me from the get go. And she continues to do so. In a mere 13 hours over a span of a few weeks, Hannah revealed herself to me. Although I never met her, I got to know her strengths and her vulnerabilities, as if I had created her. There are times when I feel I have.

[from Narrative Medicine]

CREDITS:

Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20^th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of  AKU. 

Acknowledgment: First published by the Express Tribune.        

DISCLAIMER: Copyright belongs to the author. This blog cannot be held responsible for events bearing overt resemblance to any actual occurrences.