Farewell Note Research Articles

Fifty Years of Critical Care Medicine: The Editors' Perspective.

Fifty Years of Critical Care Medicine: The Editors' Perspective.

Men’s Suicide by Self-abdominal Cut and Disembowelment: A Literature Review and Analysis of Three Cases

Introduction: Suicide by abdominal cut wounds and consequent disembowelment is a modality rarely described in the literature, with rates between 1.6% and 3%. The incidence is higher in men. This type of suicide might be so unusual as the abdominal injuries are not supposed to be related to immediate death (compared to the wrists or throat, which involves rapid bleeding, for example). Considering the infrequency of suicides by abdominal self-cutting, in such cases, the main hypothesis is a homicide, especially in those with multiple injuries or occurred in a complex setting. These cases require a detailed autopsy report with the analysis of the injuries and circumstances of death (e.g., farewell note, history of depression, previous suicide attempts, defense injuries, and signs of hesitation) to allow a differential diagnosis between suicide and homicide. This study aims to highlight the characteristics of suicides through self-cut wounding, focusing on those that determine a large abdominal opening and evisceration. Methods: The authors conducted the literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, on PubMed and Scopus databases, using the following keywords: “(suicide) AND (abdominal stab wounds)”, “(suicide) AND (abdominal sharp injuries)”, “(suicide) AND (abdominal self-stabbing)”, “(suicide) AND (abdominal cut wounds)”. Results: 7 articles were included in the systematic review, for a total of 11 cases of suicide by abdominal self-cutting. Of these cases, 3 were women and 8 were men. Conclusions: The analysis of the external examination findings versus the crime scene results is essential to clarify if injuries are self-inflicted with suicidal intention. Suicide through a violent act can also be practiced by people who have no history of psychiatric conditions or other risk factors. Therefore, in cases of abdominal cut and evisceration with victims’ survival time, the forensic pathologist has to consider that the deceased himself could cause modifications to the crime scene, turning it into a complicated suicide.

Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion

Suicidal ingestion of food which the victim is aware they are allergic to is an exceptional occurrence in the forensic field. To the best of our knowledge, no cases of suicidal food anaphylaxis have been reported to date. Therefore we present the first case described in the literature. A 30-year-old prisoner was found dead inside his cell with the remains of a peach remains next to his body, and a handwritten farewell note in his pocket. The autopsy revealed only non-specific findings, while laboratory investigations (serological, toxicological, histological, and immunohistochemical) played a pivotal role in determing the cause and manner of death. In particular, a high titer of both total and specific IgE antibodies was detected, as well as an increase of the tryptase level in cadaveric blood. Moreover, a massive concentration of salicylates was measured in the gastric contents. Microscopically, cellular residues characterized by a vegetal structure were observed in the gastric contents and elements suggestive of mast cells were detected in the glottis, lungs, and myocardium. The immunohistochemical investigation with anti-CD117 and anti-tryptase antibodies showed positivity for mast cells, some of which appeared degranulated. Such findings were entirely consistent with an acute systemic anaphylactic reaction triggered by allergy. Therefore, the prisoner’s death was attributed to self-induced food anaphylaxis caused by the ingestion of peaches. This conclusion was achieved based only on circumstantial data, anamnestic information, autopsy findings, and multiple laboratory results. This integrated approach should be used to pursue a post-mortem diagnosis of anaphylaxis.

Former Editor's Farewell Note

Former Editor's Farewell Note

Reading like an Editor: A Farewell Note.

Reading like an Editor: A Farewell Note Catherine Belling (bio) “Farewell” is the usual title for this genre, the final editorial from a departing editor, but I use it uncomfortably, wanting to say “Wait, I’m not going anywhere—and anyway I’ve already gone.” I stepped down as editor at the end of 2018, and I thank Anne Hudson Jones for serving as interim editor for 2019 and for steering the journal’s transition to some important changes, described in her own update in this issue. This also does not feel like a leave-taking, just returning to being a “normal” reader and, I hope, sometimes an author. I must admit, though, that it is with some relief that I step away from the work of reading like an editor. I found it difficult. I’ll try to explain. Reading has often been our subject in this journal, and two articles in this issue continue that thread. Matthew Rubery’s study of the ghastly condition called alexia—loss of the ability to read—serves as reminder of how remarkable humans are in our capacity to make life-preserving meaning out of marks we have the cognitive magic to use as signs. Without words written and read, meaning recorded at one time and retrieved at another, what would we be? Rubery describes several alexic people assiduously pretending to read, because “reader” and “person” have become inextricable for them. This anxious pseudo-lexia reminded me of another performance of reading that echoes in this issue. In his moving account of Shakespeare’s Hamlet, Arthur Frank reveals a layering of the play’s potential effects on those who come to it vulnerable, needing vicarious compassion when sick at heart. Frank’s work made me think about my own recent experiences of reading needily, and I also remembered the deeply vulnerable Ophelia and her own act of reading at the center of the play. While Hamlet muses on whether to be or not to be, he is not alone on the stage. Polonius and Gertrude hide, spying, but Ophelia is there in the open, bait. She mustn’t look as if she’s lurking about, so her father tells her “Read [End Page 247] on this book.”1 Reading, he thinks, will make her look lonely, and that will impel Hamlet to confide in her. We, thanks to the soliloquy, can read Hamlet’s mind, but Ophelia waits in silent suspense, staring into her book. We could forget she’s there. He wrestles with his “dread of something after death” (3.1.86). She reads, until he notices her and breaks her heart. At least that’s all we can tell—but we might also imagine her finding in that unnamed book a story to sustain her through what is to come. I wondered where else reading appeared in the play, so I did a text search for “read.” I didn’t sort out the spaces precisely enough, which led to an ominous but fitting apopheny: the first several instances are all to the word dread. And then, increasingly, you have ready, leading to Hamlet’s final resigned step off the edge: “Readiness is all” (5.2.237). The lexicon seems to follow from apprehensive delay toward resolution to act, not impetuously, but in the acceptance that his story will not, in the end, be his to tell. But between dread and readiness (along with many people reading letters that were not intended for them) are two performances of reading—Ophelia’s and also Hamlet’s own. More parental spying: “But look where sadly the poor wretch comes reading,” says his mother (2.2.183–84). Polonius rudely interrupts—“What do you read, my lord?” Hamlet protects his mind by eliding the meaning in his reading (pretended or real): “Words, words, words” (2.2.208–10). Like Ophelia’s, his book remains as closed to us as it is to the paranoid parents. This deflection makes Hamlet outwardly invulnerable; his reading protects him until he’s ready to decide. Reading as an editor, I felt more like anxious Ophelia than antic Hamlet. This may seem paradoxical. The reading to which an editor...

Leaving Editor-in-Chief’s Farewell Note

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On the Erosion of ‘Passionate Scholarship’

Let me reflect for a short while on what several years of editorship at Organization Studies ‘taught’ me about the dynamics of the collective scientific enterprise in organization and management theory. In this farewell note, I will aggregate subjective impressions, everyday editorial experience and scholarly work to stimulate reflection about the possible ‘crisis’ of social sciences disciplines and the consequences of this crisis on organizational research. Nothing less. It is modestly intended to share thoughts, disappointments and hopes. The dynamics of organization studies are characterized, as in all types of scientific fields, by the configuration and the binding of its boundaries. Therefore, it partly depends on what boundaries scholars wish to establish and, subsequently, on what they wish to substantially address, on what is deemed to be legitimate research. But that is obviously not the whole story. I would even suggest that it is not what triggers changes and dynamics in this field. Those dynamics are also strongly related to the behaviours of individual members and how these behaviours influence the nature, the content and the ‘style’ of research that is going to be published and acclaimed. And that is obviously not finalized: educational and research institutions exert more and more influence, through their managerial practices and policy decisions, on what is going to be submitted to journals. A point I wish to quickly highlight here is that the present compulsion for individuals to compete for jobs and status could well be now more influential than individual willingness to tackle difficult ideas and subjects, partly because difficult ideas lead to writing complicated papers that journals do not have time to handle and are therefore inclined to neglect and reject. The outcome of that tendency is that the field of organization studies is, I am afraid, replete with low-influence and low ‘idea-intensive’ scholarship. I suggest that it is both a matter of topics and underlying ideologies, and a matter of individual and institutional behaviour. I am not going to repeat a (relatively) well-known diagnosis, although certain things should be said several times. And we also need to convey some understanding of the situation of many scholars, especially junior scholars, facing the power relations now embedded in academic careers. That said, I will rather rapidly offer a direction to move away from what I see as an erosion of what I call in this short note ‘passionate scholarship’. Passionate scholarship refers to commitment to a personally meaningful and socially relevant topic, ‘close to the heart’ (Heinrich, 2010). It is the recognition that intrinsic interest in a topic might help to break through institutional and competitive pressures to study or not study certain issues.

A farewell note from Charu

A farewell note from Charu

Father Turns Family Tragedy Into Promising New Law

Back to table of contents Previous article Next article Professional NewsFull AccessFather Turns Family Tragedy Into Promising New LawEve BenderEve BenderSearch for more papers by this authorPublished Online:15 Oct 2004https://doi.org/10.1176/pn.39.20.0390013“Dear family and friends, I have wanted to do this for years,” the suicide note stated. “There will most likely be a lot of people who will wonder why, but just not understand. The one thing I have done is given up. I can't handle it anymore....”These are the last words of Utah Valley State College student Garrett Smith, who took his own life a day short of his 22nd birthday on September 8, 2003, in his apartment in Orem, Utah.On what would have been his son's 23rd birthday, Garrett's father, Sen. Gordon Smith (R-Ore.) stepped forward to accept an award from the National Alliance for the Mentally Ill (NAMI) commending Smith and his wife, Sharon, for their legislative accomplishment to prevent teen suicide. The presentation was part of the opening plenary session at NAMI's annual conference in September in Washington, D.C.It was a bittersweet occasion for Smith, who before recounting some of the difficulties Garrett experienced as a youngster with bipolar disorder, announced the progress of legislation he introduced and named after his son.“Today, on his birthday, the House of Representatives in an overwhelming and bipartisan vote passed the Garrett Lee Smith Memorial Act,” Smith told attendees.The bill, which President George Bush is expected to sign, would expand suicide-prevention programs and improve counseling services on college campuses (Original article: see box).“This piece of legislation is a modest beginning.. .and on this legislation, you and I can build into the future to help people who, like Garrett, have mental illnesses like bipolar disorder, which can be lethal if left untreated,” Smith said.The Smiths adopted Garrett a few days after his birth, and Smith remembered him as an “unusually happy and playful baby boy” but noted that his “exuberance for life dimmed in his elementary years.”It was during this time that Garrett began to struggle in school. Although tests showed that he had a high I.Q., he also had learning disabilities, including dyslexia.“His struggles in school increased, while his self-worth decreased,” Smith said, and his son would “cry himself to sleep out of fear that he could not compete in school.”Although Garrett accomplished two of his major goals—to graduate from high school and fulfill a two-year mission for his church—his parents saw Garrett experience bouts of “dangerous mental darkness,” Smith noted. “He would withdraw from us, and no rational persuasion could draw him back.”Garrett sought help from school counselors, psychologists, and a psychiatrist, but did not recover.“Garrett's bipolar condition was a cancer to him, as lethal as leukemia to another,” Smith said. “It filled his spirit with hopelessness and clouded his future in darkness.”Garrett's mother, Sharon, also spoke about her son in a later session on mental health advocacy on college campuses.She remembered her son as a “happy, outgoing young man” with“ a very gentle soul” and said, “to think of him taking his life when I can't imagine him ever hurting anyone is very difficult to understand.”Although Garrett fought for many years to overcome the challenges in his life, Sharon Smith said, college presented new challenges that “we as his parents did not expect, and in hindsight, I don't even think Garrett believed he would encounter.”College, she noted, “is a time when young people may lack the supports they once had” and sometimes feel isolated or alone.“Like you, I am working to find ways to improve mental health resources available to college students, with the goal of putting an end to suicide,” Sharon Smith said, “but we have a long way to go.”She pointed out that there are more than 30,000 suicides each year in the U.S. and that suicide is the second leading cause of death on college campuses.“We can work together to ensure that a network of providers exists to provide treatment so students can either get or continue receiving mental health care while they are away at school,” she emphasized. “Most importantly, we need to train students and faculty about the proper response necessary to intervene when a student is in crisis.”Smith concluded by reading part of the farewell note Garrett wrote shortly before he committed suicide: “Mom and Dad, if it is any consolation, your love is the only thing I knew would not change. I just wish I could feel the same about myself.”More information about the Garrett Lee Smith Memorial Act can be accessed online at<thomas.loc.gov> by searching on bill number, S 2634. ▪ ISSUES NewArchived

From the Legal Notes Editor: A Farewell Note

From the Legal Notes Editor: A Farewell Note

Attempted suicide in the Accident and Emergency department

The following situation is not unusual in the Accident and Emergency (A & E) department: A young man is brought in by his girlfriend. She says that she came home unexpectedly and found him in a drowsy state, with an empty bottle of paracetamol and a farewell note left by the bedside. With the help of a neighbour she brought him to the department. The patient is not unconscious and resists any attempt to be given a stomach wash-out. Staff know that if this does not take place he is likely to suffer serious internal harm and his life could be in danger. He does not seem capable of listening to rational argument, but is shouting to be allowed to go. What is the legal position? As a sequel to this question, if he eventually does have a stomach wash-out and is able to leave the hospital but staff fear that he may repeat the suicide attempt, can he be compelled to stay?

From the Editor A Farewell Note

From the Editor A Farewell Note

From the Editor—A Farewell Note

From the Editor—A Farewell Note

Western History: A Dialectic on the Modern Condition

n his widely acclaimed essay, The Idea of West, Loren Baritz singled out powerful influence on American scholarship of extraordinary but mythical world that lay beyond the point sun crossed horizon, place earthly glory and power tended. That collective scholarly effort, according to Baritz, suggesting a unilinear progression to ever-higher stages of civilization, presented West as a land of promise, the last refuge for man and God, an environment where woe and wail would be no more. More recent scholarship has questioned those exceptionalist verities (as did Baritz), arguing that they are fraught with error and tend toward ahistorical. In a farewell note to his profession, William Appleman Williams underscored problem, suggesting that exceptionalist view presented real difficulties for American historians: We seem to be driven by a kind of compulsion to prove professionally as well as politically and socially, that we have been right from beginning to end.2

A FAREWELL NOTE

Back to table of contents Next article ArticleNo AccessA FAREWELL NOTEDonald W. HammersleyDonald W. HammersleySearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ps.31.12.805AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "A FAREWELL NOTE." Psychiatric Services, 31(12), p. 805 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Psychiatric Services $35.00 Add to cart PPV Articles - Psychiatric Services Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited bySSRN Electronic Journal Volume 31Issue 12 December 1980Pages 805-805 Metrics PDF download History Published online 1 April 2006 Published in print 1 December 1980