by Jennifer A. Katze, MD
[June 1996; Vol. 23 No. 2]
My best friend in high school was Brigitte, the only child of my art teacher there. We had a lot in common: unhappily divorced mothers who focused their emotional needs on us; adolescent depression expressed as cynicism, academic perfectionism and hypermaturity; disdain for our more liberated and relaxed peers; and the dream of never being in the same unhappy position as our mothers.
We went to opposite coasts for college, and after a few letters lost all contact. Years later I heard through the grapevine that Brigitte married a physician, had a daughter and a son, developed a side career in an artsy but low earning freelance field, and had just moved with her very successful husband to an area where we lived only an hour away from each other. The kids were thriving in high school, and Brigitte’s mid-life looked stable and traditional. We got together for lunch, reminisced, caught up, enjoyed that same cynical humor of yore, and glibly vowed to keep in touch.
Four fast years later a mutual high-school-era friend told me Brigitte was in trouble. Her marriage had since collapsed, a year or two after her retired mother moved in with the family. Her kids had left for college, and recently she had been psychiatrically hospitalized for a month or so with a severe psychotic depression shortly after her divorce became final. She and her mother now lived together on a tightened budget in a new townhouse in a less expensive but more isolated community. She was planning to go back to college to get a teaching credential so she could earn a living.
We had lunch. She was sad, bitter, fragile, consciously terrified of being dependent on her children as her mother continued to be on her, and consciously driving them away to prevent that. Her lifeline, her guardian angel almost, was her psychiatrist, whom she drove an hour each way twice a week to see. He had seen her through her divorce, her psychosis, her move, her loneliness, her rage at her mother for being the straw that broke the domestic camel’s back (as she saw it) by “insisting” on moving in with Brigitte. Now she felt financially forced to live with her mother if she was to return to school. I promised to call, and I did. She turned down, postponed, my invitations. She sounded depressed and isolative. I called a few more times and felt some relief that her refusals allowed me to let the distance take over. I’d seen her twice in the thirty years since high school, and her situation didn’t tempt me to see her more.
Five months after that lunch a stranger called to tell me she’d seen my name in Brigitte’s address book, was a friend of her mother’s, and the mother had said she should call me with the news: Brigitte had been found dead of a massive overdose in her bed the evening before by her mother who had been out all day at some scheduled function.
I called her mother, who’d known me as her student in high school. She wept with anger and incredulity, and begged me to come visit her so that we could talk. I went the day after the funeral. Her mother’s mind ravaged through every moment of the recent weeks: Brigitte’s initial excitement when the school year started and her optimism that made it just tolerable for her to taper her psychiatrist visits to every month in accordance with her insuror’s plan, utilization assessment, and consequent curtailed benefits. Then she sank, with emerging feelings of disappointment with school, a growing fear of failing her courses, her longing to date someone and finally having a first post-divorce blind date that she felt sure had been a disappointment to him, her discontinuation--unbeknownst to her psychiatrist--perhaps a month before of her antidepressant due to the expense of the prescription. The week of her death she had a horrible phone fight with her daughter and hung up on her, never to speak together again. She also had her first exams and was convinced she’d failed. Her mother said that Brigitte had alluded to herself as being inhabited by the devil. She wished she could see her psychiatrist, but hadn’t called him “yet”.
She’d left no note. By her bedside I found a form letter from her insurance carrier, telling her she had used up her benefits for that calendar year, now only early October. The letter had apparently come in the morning of her suicide, two or three hours before her overdose.
Her professor called while I was there to say she’d gotten all A’s.