A year has gone by since my sister attempted suicide, and I'm stuck trying to figure out exactly how I feel about this anniversary. Has she changed? Has my family? Besides the year printed on the calendar, is anything different--or are we all set to just go again, like a hamster spinning in some infernal wheel, eyes fixed, oblivious to the world around it, and unable to know what the next catastrophe is going to be, or when it will be, or how it will happen?

So here I am, sitting at my computer, wondering if the answers to all my questions are going to just spill out onto the screen like some kind of Socratic dialogue. Somehow I doubt it.

I suppose I could pray for some kind of sign, but The Big Guy and I haven't been on speaking terms for some time, so I'm stuck answering these questions myself. Have I changed? Have I really moved past sifting through her smashed up car for her purse, while paramedics spirited her away to the closest hospital to pump the pills from her stomach?

It wasn't the first time this had happened, either.

Like most suicidal women, her favorite tool was pills--of which she had plenty, considering the volley of psychiatric conditions with which she had been diagnosed. She'd always been melancholic, but then our drunk of a mother married an asshole who had more interest in laying my sister than his wife. Things began to unravel pretty quickly after that.

I know it's totally unreasonable to blame myself, but since when did knowing anything really do much for one's emotional state? I was the big brother; I was supposed to be on top of things like this, I was supposed to shield her from the evils of this world, but I wasn't there. I was away at college, living with my Dad, focused on my future...and meanwhile, someone was nailing my little sister, night after night, quietly destroying what remained of her psyche while the woman who gave her birth lay passed out in some other room.

My sis never told anyone what was going on, and so it continued. For months.

And when she finally did work up the courage to tell her mother what had been going on, the response was decidedly unsurprising. Mom was her typical, manipulative, compassionless self. She divorced immediately and had some shrink pump her daughter full of antidepressants, but then she proceeded to spend the next year or so convincing herself that this wasn't her fault, both explicitly and implicitly blaming my sister for the destruction of her marriage.

Fast-forward a few years and my sister was in college. On full scholarship, no less. Her grades weren't stellar, but they weren't shabby, either. She was all set for a career in theatre, something she had loved ever since she was a child. All of us marveled at how well she had recovered from the abuse--we accepted her "I'm just fine and dandy" fa├žade with open arms because we so desperately wanted to believe she was okay. And besides, what can I say: she is an excellent actor.

Her first attempt came during spring break. She was spending her vacation from school working with a sound and lighting company in our home town, so she was at Dad's for most of her off-time. One weekend, she had a bad breakup with one of her boyfriends, and quietly took every medication she had in her arsenal: Klonopin, Prozac, Zoloft, Ambien, a handful of Benadryl, and some Advil for good measure. Soon the finality of what she had done struck her and she called her psychiatrist, who called the paramedics. They found her on our back porch, packed, and ready to go to the hospital.

Once she was sedated and most of the various toxins she had ingested had been safely removed, doctors began an examination that revealed horrors the likes of which none of us could have expected. Old scars and freshly-healed wounds covered her ankles, her calves, her legs, her thighs. She was a "cutter," a person who deals with emotional distress and anxiety by causing physical pain to herself, resulting in some morbid kind of catharsis.

And from the looks of the scars, this wasn't anything new--my sister had been carving herself up like a Christmas ham for years. For years, she had told us she was okay, she had smiled as if nothing in the world could be better, she had convinced us all that everything (under the circumstances) was fine, and then she had retreated to the privacy of her room to slice herself up everywhere her socks, shoes, and long pants would obscure from casual scrutiny.

She spent a week or two at the in-patient psychiatric ward of one of our local private hospitals. It wasn't the best place in the world, but it was the best we could afford. In private sessions with us, the doctors (who to this day I am certain were trained by monkeys) explained the "cutting" compulsion. They warned that we should never tell her "not to cut," as that could trigger an episode. The cutting was a "natural way of relieving stress," they said, and we were to do nothing about it, with only the hope that one day she'll just spontaneously stop. They also instructed us to avoid the temptation to invade her privacy: "Regardless of what you confiscate, she will find other ways to hurt herself," they said.

Damn them. I'm sure they had no idea about all the stuff she had hidden in her room, but damn them for discouraging us from looking anywhere or saying anything. If we had, maybe I wouldn't look back on this time so often and think, "What the hell was I doing? Why did I just sit around? Why was I studying for classes or partying with friends when I knew damn well my sister was dying?"

Because of her stay in the hospital, she missed the beginning of the next semester of college, so she had to remain at my father's house for several more months. She would later tell me that it was like a prison sentence. For some reason, staying in that room caused her a great deal of anxiety--anxiety that made her want to cut herself (or worse) every minute of every day.

Only a few weeks later, she began sporting a white bandage on her forearm. She had cut herself "a little too deeply," we were told. Everyone tried to take it as a good sign that she'd driven herself to a doctor for stitches; everyone tried to ignore that the cutting wasn't getting better, that she was getting bolder, and that perhaps saying nothing was in fact encouraging her to do more and more.

Her second suicide attempt followed briefly thereafter. It was the summer break, and I was in Atlanta on an internship. As we would later learn, she had stockpiled drugs, knives, box cutters, and razor blades throughout her room. It was if she was preparing for the holocaust, or a blizzard; it was as if she felt the need to have the ability to hurt and/or kill herself available at a moment's notice. And so one day, while Dad was at work and the house was empty, she downed another couple bottles of pills. This time it was she who called 911. And once again, she met them on the back porch, packed and ready to go.

She had a seizure on the ambulance. They told us she very nearly died. She told everyone she was glad to be alive. She assured everyone that this would be the last time.

We didn't believe her.

This time, she spent a month in a long-term care facility. The doctors worked on regulating her medicine. She cried almost constantly, begging for us to let her out. But once the papers had been signed, it was out of our hands. And as much as it killed me to see her there, I was glad she was somewhere safe--where although her freedom was gone, at least somebody would damn well stop her when she tried to hurt herself. In retrospect, it really doesn't seem like so much to ask.

A month later, with the beginning of the Spring semester rapidly approaching, the doctors felt she had been "scared straight." They felt that she would benefit more from returning to school than staying in a facility. And they felt that her bed would be better used by someone who was really sick. Like I said, she's an excellent actor.

She was released just days before school began. Miraculously, after speaking with professors and administrative staff, we were able to reinstate her scholarship despite the semester she missed. Everything seemed on track for the proverbial "second chance."

But she continued to cut herself, with each incidence increasing in severity. Her shrinks (of which, at one time, there were three) told us she had Borderline Personality Disorder, a diagnosis that made more than just a little sense. BPD usually affects young women who grow up in unloving homes; it's common to children of alcoholics and it's especially common to victims of sexual abuse.

The disorder manifests itself in many ways, but some of the biggies are: inability to hold on to stable relationships (or, rather, seeking out unstable relationships), pushing away the people who love you and then acting out in attempts to garner sympathy and attention. And the victims of this disorder usually relieve anxiety by inflicting pain on themselves.

But while at school, she became a different person. Her emails and phone calls were all upbeat. She said she loved her classes. She threw herself into extracurricular activities, auditioning and performing in several school productions. I drove down to see one of them. I even brought a date. It was as if we were a normal family again.

But, like so much of her life, it was all for show.

It's odd, but I have trouble pinpointing the date of her next suicide attempt. Maybe it was the day before Thanksgiving, and maybe it was on Thanksgiving exactly. But I tend to remember it being the day after Thanksgiving. Yes, that's right, because it was on Thanksgiving that she announced she was dropping out of college.

We were both out of school for the holiday, staying at Dad's for the standard Thanksgiving feast. During dinner she revealed that her grades had been suffering, that she was going to lose the scholarship, that she planned to drop out at the end of this semester.

I was furious. She was my sister, she was smart, she was talented, and she was going to let one bad semester be an excuse for dropping out? We argued for a bit, and she ran up to her room. Eventually, it struck me what she might be doing in that room, and so I followed her up and apologized. I assured her she hadn't let me down, that I wasn't disappointed in her, etc. The truth was, I was incredibly disappointed in her, but...well, the thought of her slicing herself open because of anything I'd said really just scared the living hell out of me. So I capitulated, although I would always wonder if I should have said more.

The next morning, she had an appointment with her shrink. At noon, the psychologist called the house asking whether my sister had returned. Apparently there had been a huge fight, she had left the office in anger, and the psychologist had overheard her muttering something about "showing us all." Of course, we hadn't seen even the slightest glimpse of her since she had left for her appointment. And as the hours passed, it seemed more and more certain we were going to find my sister lying in a ditch somewhere. We kept waiting for a phone call, but none came.

It was suggested that we report her car stolen. Regardless of the circumstances, people aren't officially "missing" until they're gone for more than three days, but since the car was in my father's name, we were able to get a search going that evening. In a couple hours, they'd found her.

She had parked off the expressway, locked the doors, downed all her meds and a bottle of OTC sleeping pills. When the police found her, she was already convulsing; they had to break one of the windows to get inside and get her to the hospital. When my father and I showed up, they had just taken her away. He left to go to the hospital, while I was left to find her insurance card, clean up some of the broken glass, and drive the car back home.

Again, she lived. Again, just barely.

You might be fair to criticize, saying, "How in the world could you let it get this far?" Hell, maybe that's even an appropriate assessment. But with me still in grad school and my sister's health insurance threatening to drop her coverage, my middle-class family had very few options at our disposal. We were told that there was an excellent private facility in Louisiana--one that specialized in Borderline Personality Disorder and focused on women who cut themselves--but the up-front cost was enormous and the program only lasted ten days. And the alternative--signing her off to a state mental facility--wasn't something any of us wanted to consider.

Eventually, with my sister threatening to leave the hospital AMA unless we did something fast, my father went to Probate and filed papers to have her civilly committed to a mental institution.

My mother refused to sign the papers. She had joined AA several months back and was claiming to be clean, so she was uncommonly sober as she raised her objections. She said that she didn't think my sister was that sick, that she didn't warrant constant supervision, locked doors, et al. But it always seemed to me that what she was most worried about was what the neighbors might think.

Fortunately, it only takes one person to request a commitment hearing. And despite his faults, my father can be stoic when he needs to be. The judge looked at my sister's medical records, the scars covering her body, and the testimony of her family and doctors, and placed her in the custody of the state for the next four months.

My father cried. He had just signed away his daughter's freedom. He had done the legal equivalent of throwing his arms into the air and asking the state to take care of his child for him. He would never again be the same.

My sister languished in the institution for some weeks, refusing to work with doctors or talk with visitors...except me. She accepted visits from me for several months until it came out that I had supported her commitment. She asked, I told her the truth, and soon I was locked out as well.

For weeks, the only information we had was second-hand. Since she was no longer a minor, my sister had the right to prevent doctors from discussing her treatment with us, but a gracious social worker filled us in when she could.

Eventually my sister left the institution, collected her prescriptions for multiple antipsychotic and antidepressant drugs and hit the road. She stayed with some friends for a while, got a job, found her own place, and eventually began to live her life again.

This Thanksgiving would mark her first return to my father's house, the place where so many terrible things had happened. We got through lunch, we got through dinner, she stayed a couple of nights and then the next day she went home. Although the tension was palpable the entire 36 hours she was here, things actually went off without a hitch.

The problem, of course, is that this story is nowhere near over. You would have to be blind not to notice the new scars on her arms and legs. She thinks wearing pants and long-sleeve shirts protects her secret, but by now we all know what signs to look out for. She's a time bomb, and even if she makes it through next Thanksgiving, or the Thanksgiving after next, there is little doubt that the other shoe will drop one of these days.

Effectively locked out of her life, I feel a grotesque emotional combination of impotence and relief. When we were close, I felt it my duty to defend my sister from the Big Bad World. But how do you protect someone from herself? I'm to the point now where I've had so many frantic calls on my cell phone--"quick, you have to get to the hospital now"--that I feel truly unable to affect anything in her life, or in anyone else's, for that matter. Oddly enough, all of these experiences have combined such that when and if it ever does happen, I think I will be much less apt to blame myself than I would have in the past.

Certainly, I will do my best to support my sister in the future. Absolutely, I will serve as a brotherly shoulder to cry on when she requests one. Of course we'll continue to swap jokes back and forth over email. But the nagging truth is, we all know she's going to do it one of these days, and even if she never does, we will never stop expecting it to happen. We will never see her in the same light, we will never act the same around her; what we had is gone and ten years from now, I'll still feel like I'm walking on eggshells every time I say a word to her.

And so the horrible question remains: If and when she finally does take her own life, how will I feel? Will I be devastated over the loss of the sister who used to be my best friend--or will I be relieved that all of the waiting is finally over?

As terrible as it sounds, I honestly don't know the answer. But, for what it's worth, I'm glad I haven't yet had to find out.

And that is what I am thankful for this Thanksgiving.

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