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Archive for the ‘lethality’ Category

With a .22

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I. Fourteen Shots

He shot himself fourteen times with a squirrel rifle. “It is probably the most incredible kind of suicide I have ever seen,” says P. Boxho, reporting the case in the Journal of Forensic Science (“Fourteen shots for a suicide,” 101:1:71-77, 1999).

The man, a 56-year-old Belgian, used such a low-energy weapon (.22 LR cartridges in a 22 mm rifle) that he had to shoot himself fourteen times in the chest in order to effect his end – and, even after fourteen shots, his death was slow. He had to operate the bolt of his rifle between shots, and, most incredibly, he had to reload after the first seven shots. According to Boxho,

The last bullet was certainly the one that went through his left arm for, with a humerus fracture and the fatigue generated by developing hypovolemia, it was getting impossible for him to reload the gun and to keep shooting.

So he had to lie down in the position in which he was found and to wait for death to come.

That death was certainly very slow for, considering their trajectories, the projectiles could only go through his lung, maybe skim past his heart, causing a slow haemorrhage, responsible for death by a hypovolemical shock.

II. Christmas Money

Mychal Bell, best known as one of the Jena Six, shot himself with a .22 pistol. Bell became despondent after being charged with shoplifting, he says.

Police say surveillance video appears to show Bell stuffing merchandise into a bag in a Dillard’s store while another male seems to serve as a lookout.

Bell walked out with the bag without paying, officials said, and a security guard approached and took it from him. Police said Bell and the other male fled, and guards chased Bell because he’d had the bag. Authorities say it contained $370 worth of clothes.

Bell hid under a car in the parking lot, and as a store security officer tried to pull Bell out, he hit the guard in the face with his elbow, police said. Bell, who was charged with shoplifting, simple battery and resisting arrest, was released on bail, according to authorities.

Investigators don’t know who the other male was, and Bell “admitted to everything” to a detective, Lt. Jeff Harris said.

He decided to use his Christmas money to buy a gun, and eventually obtained the .22-caliber handgun. And then he “went awry” at his grandmother’s house, he said.

He aimed it at his head and pulled the trigger, he said, but the gun misfired. Then he pointed the gun at his chest and fired. The bullet clipped his lung, and he was taken to the hospital and treated. It is not clear who found him, or whether he was alone in the house at the time of the shooting.

Does someone who shoots himself in the chest with a .22 really mean to die? It seems that our Belgian man did. However, given the limited availability of reliable means of suicide, I think it is best not to make a hasty judgment that someone did not want to die, and was merely seeking attention and sympathy, based only on the choice of an ineffective method. Perhaps an ineffective method is all the potential suicide could access.

III. Low-Energy Weapons

The term “multiple gunshot wound suicide” is often used sarcastically – a joke, meaning that the alleged suicide was really a homicide, but was (poorly) made to look like a suicide. However, about 1% of gunshot suicides involve multiple wounds. The majority of these multiple gunshot wound suicides involve those aforementioned squirrel guns (or plinkers) – .22 caliber handguns. A .22 is such a low-energy weapon that a single shot may not be enough to bring about death.

IV. Suicide Black Widow

Terry Cottle shot himself behind his right ear with a .22-caliber handgun in 1995. His wife, Cheryl, was present at the time of his death.

Initially, Cheryl told sheriff’s investigators she heard 10-year-old Christopher shouting that Cottle had shot himself. She said she ran into the bathroom and found him on the floor with the revolver still in his hand.

In a second version attached to a coroner’s report, Cheryl said she was eating oatmeal when one of her boys yelled, “Mom, Dad has a gun!” She said she ran toward the bathroom “and saw Terry standing up and looking at her” with the gun in his hand.

“She said that she yelled something like, `Terry, wait!’, and this was at about the same time as she pushed on the door to try to get into the bathroom and at the same time she heard a shot,” the report says.

Cottle was taken to the hospital, but was removed from life support and his organs donated. 57-year-old Sonny Graham received Cottle’s heart.

What makes the story, though, is that a few husbands later, Cottle’s widow Cheryl married Sonny Graham.

Then Graham shot himself.

If your mind weren’t poisoned with Cheryl’s sordid history and strange behavior, you might be tempted to romantically contemplate “cellular memory” or something. But the story seems darker. There were other gun incidents involving her other three husbands. And there’s this shocking failure of proper feminine decorum and chastity:

On her MySpace account – now deactivated – her photo changed from a sweetly smiling portrait to pictures of her on a lake or drinking beer with friends. Her screen name changed, too, from simply “Cheryl” to “PrEttY LAdy,” then “BeaUtiFuL MeSs.”

Family members monitoring the account noticed that shortly after Graham’s death, she posted a man’s photo identifying him as her “new boyfriend.” A flirtatious message on the man’s Web page, from her account, was dated March 26 – six days before Graham’s death.

I find this story remarkable because it is the first time I’ve ever seen a mainstream news outlet imply that a suicide was caused by another person – rather than by, say, mental illness. “Implied” may be too soft a word:

As far as [Cottle’s sister] was concerned, Graham’s death was less about her brother’s heart than about Cheryl – the woman with whom both men had chosen to share it.

Written by Sister Y

May 13, 2009 at 1:09 am

Suicide Trends: Antidepressants, They Do Nothing

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Suicide trends in the United States: this is what they look like, in case you’re confused.

One question often asked, in reference to whether antidepressants are effective, is whether suicide rates have declined in response to widespread antidepressant use. Many authors have attempted to answer this question. One study attempted to demonstrate a time correlation between antidepressant use and declining suicides. Why did these authors cut off the data for the 1950s, and begin their analysis with data for the 1960s? Including the suicide rate data (very low, especially among women) for the 1950s would reduce confidence in the authors’ conclusion that antidepressant use is time-correlated with a drop in suicides. (The 1950 data occurred long before SSRIs were available, but undercut the authors’ claim that the 1960-1988 data represented the baseline condition from which suicide rates dropped.)

More importantly, given the data that antidepressant use is not associated with a drop in suicidal behavior, such as suicidal ideation and suicide attempts, even if time correlation were properly demonstrated, the effectiveness of antidepressants is not supported. It is difficult to imagine any way in which antidepressant medications could reduce suicides while having no effect on suicidal ideation, behavior, and attempts, especially given that the JAMA study found that “cry for help” insincere suicide gestures decreased slightly between the 1990-1992 and 2001-2003 studies.

Actually, there is a way that antidepressants could reduce completed suicides but not suicidal behavior or ideation: if they interfere with cognitive ability in general, rendering suicides clumsier or more poorly planned.

But the more likely explanation, given all the data, including the February study that the commonly prescribed antidepressants don’t work better than placebo, is that some factor other than antidepressant use is responsible for any drop in suicides. The obvious answer is that, to the extent that there has been a drop in suicide rates, it’s due to the drop in gun ownership over the past few decades. (Here’s a graphic.) As I have previously noted, gun ownership is highly correlated with suicide. Reduction in gun ownership, in addition to reduction in availability of other reliably lethal methods of suicide, such as lethal pesticides (frequently used for suicide by men and women in poor countries) and barbiturate sleeping pills, is much more likely to be responsible for the drop in suicides than increased antidepressant use. These factors – what might be termed coercive suicide prevention methods – would easily explain a drop in suicide not associated with a drop in suicidal ideation or behavior.

Thanks to Overcoming Bias poster Peter McCluskey for the pointer to the PLoS article.

Edit: Cognitive behavioral therapy (CBT), much hyped for depression, apparently doesn’t work either. From the study:

Stravynski and Greenberg suggested that all models of psychotherapy, including cognitive behavior therapy, may be “equally unsound scientifically but they energize the therapists and provide useful fictions to activate the patients to lead somewhat more satisfactory lives.” [Citations omitted.]

Written by Sister Y

June 12, 2008 at 11:30 pm