Op-Ed: An open letter to President Hennessy

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Op-Ed: An open letter to President Hennessy

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May 14, 2007
By Lisette Rimer

Dear Dr. Hennessy,

Thank you for your op-ed piece May 4th on preventing future tragedies such as Virginia Tech. It was forwarded to me byone of your students who suffered the loss of a friend, my son Patrick Wood. Patrick graduated from Stanford in 2005 with distinction in math. He loved the school, had many friends there, and was even treated for depression there. In January before he graduated, he was hospitalized for, as he explained to me, "having thoughts of suicide." He was committed to the Stanford hospital for five days, but proclaimed that he was OK, mostly bored, and didn't belong there. The psychiatrist in charge at the hospital agreed that Pat was OK and should be permitted to return to school as long as he continued therapy. He saw a therapist and a psychiatrist on campus and renewed his medication. His mood was up and down, but he continued an active social life and good communication with us. He was excited about an internship at Siemens in Berlin, Germany, which he began after graduation. He had applied for the internship through the Stanford Center in Berlin. He suspended his therapy for the summer with plans to return in September for the computer science co-term program, but he loved Berlin too much to leave just yet. Another friend from Stanford was arriving to work in the American Embassy there, and so Patrick obtained a leave of absence and continued to work at Siemens through the fall.

All the while, he made many friends, spoke and wrote fluent German, went to concerts with colleagues at Siemens, and maintained close contact with the Stanford Center. He could often be heard playing the piano there just as he had done at Haus Mitt. He wrote about a "mini-depression" before he came home to Connecticut for Christmas vacation. We thought a medication refill would be the answer. His twin sister and older brother were home, along with cousins, aunts, and uncles. It was the usual busy but fun time. Pat later told friends it was "relaxing" and that it was good to get away from the city for a while. On December 27th, he went to New York City to see another good friend from Stanford. He returned to Berlin on the 28th. In January he wrote about a "mini-breakdown." We had many emails. I called, but could not contact him by telephone. His last email to me was on January 26th. Humboldt University had requested additional information on his application as a grad student there. He took it as rejection, told me he might be returning to Stanford, and asked me to wish him luck. He answered no more emails after that. He saw friends on the weekend of the 28th and 29th. He did not return phone calls after Tuesday the 31st. His friend, who worked at the American Embassy and who lived a block away, became worried. He called and went to Pat's apartment several times the following weekend. He called the Stanford Center on Monday morning. They called the police to break into the apartment. By that evening, the police found Pat. He had died of carbon monoxide poisoning on Tuesday, January 31st.

Patrick was one of many graduates that June. He was one of many more who were going on to graduate school. The school cannot be responsible for every student on campus or every new graduate. I am under no illusions about who was responsible for his treatment and for what he did. It was Patrick alone who decided to stay in Germany, who decided to suspend treatment, and ultimately who decided that suicide would relieve his depression. I have tried to retrace his steps continuously in my mind ever since we were notified on February 6, 2006. On that day, his friend and others from the Stanford Center identified him. They called a Stanford residential housing director in Palo Alto, and he called us. Both the Stanford School in Berlin and Palo Alto had memorial services for him in February and March of last year. As you can see, the school was very much involved in both the life and in the death of my son.

Please do not mistake my comments for blame. Maybe no one could have prevented his loss, but I have learned that it is the very nature of his disease, and of Cho's at Virginia Tech, that should cause us to be hyper-vigilant. Students who are depressed, even brilliant and loving students like Pat, cannot function reliably because the source of their decision-making process is under attack. They are making flawed decisions because the very same mechanism used to make these decisions is malfunctioning. There is an anatomical difference between a healthy brain and a depressed brain. It is a detectable, visible difference, and yet it is only a part of the brain, for many decisions appear "normal." It is those normalities which lulled me into thinking that Pat would get help, that he would take care of himself, that he would certainly see how magnificent he was, that he had just graduated from Stanford with a 3.9 average and a major in math, that his friends loved him, that he had had the best childhood we could provide, that he had the brightest future of anyone. How could he not be happy? The answer is because depression does not operate on the same assumptions.

I have had to change my own notions of well-being because they failed Pat. He did not get help in Germany because he could not. The decisions he needed to make were not possible with the oppression and pain he was feeling. Although he was physically able to get to a doctor or call a therapist, just as he had done at Stanford, those functions needed motivation, and it was his motivation which had been destroyed. All the drive, the talent, the brilliance that had won him a full scholarship to Pomfret School, that had gotten him perfect SAT's, that had made him a valedictorian, that had made him a merit scholar, that had gotten him into Stanford, that won him a scholarship there, that had gotten him into the Krupp Internship program in Germany and then into Siemens—all the motivation he needed to achieve academic and social success was no match for this disease. He had sought treatment, and it had not worked, so he turned inward until he isolated his thoughts, his wants, and his pain, until he was feeling nothing but the sense of control which suicide brings.

I think your comments about psychological services are a welcome response. Pat's life was saved the first time he had major depression and was hospitalized by one of the counselors on campus, and I am deeply grateful. But I would hope, in the wake of Pat's agonizing loss and the frightening possibility of another Virginia Tech, that we come away with a few additional realizations. I have spent every day trying to do the same thing.

Mainly I hope that we understand that suicide victims are not insane. They function as well as they need to function. Almost everything about Pat was normal on the outside, even the relationship problem that preceded his death.

A truth I have learned too late is that we have to go to them. Pat needed someone to take him for help. Just because he did it the first time didn't mean he would do it again. As a matter of fact, there was less chance he would get help because he was weakened from the first depressive episode.

Because I have learned that depression is a terminal illness, I would hope that we could change the meaning of the term from a saddened state of mind, to the dangerous, insidious threat that it is. Most people who commit suicide have been depressed and have attempted it beforehand. As I think Patrick and the Virginia Tech incident made abundantly clear, we are ill-equipped to detect the severity of the disease and, therefore, the likelihood that these victims will complete a suicide. Anatomical detection would give us empirical data that we need to make a more accurate diagnosis, certainly more accurate than relying on a patient to rate himself on a depression scale as is now commonly the case. How many other diseases have to be self-diagnosed when a patient is least able?

And finally, a thought about treatment. A newspaper article last year pointed out that patients who were "cured" had to endure an average of four combinations of medication and therapy before finding one that succeeded. That means a great deal of trial and error at a time when any failure can be misconstrued as a reason for hopelessness and self-harm.

The implications for a university are complex. How much do you reach out, especially if the patient does not seek treatment? How do you know the severity of the depression? If we are relying on averagely intelligent people to pick up on the cues, we will never succeed. I know because I am one of those failures. I will hate myself forever for what I did not know about depression, for what I missed, for what I did not do for my son, but I also know that there are a lot of people saying the same thing about Cho. They are all blaming themselves, just as I am, because what passes for non-threatening behavior before suicide becomes pockmarked with danger signs afterward. I should have gone to Berlin. I should have called his friends. I should have done a lot of things and so should they who knew Cho. But we don't because we don't know they are necessary. We don't know they mean life or death, and we will not know until we have reliable detection.

Maybe the lesson that arises from Patrick, a favorite son of Stanford, is that students within Stanford programs should be better monitored no matter where they are. Whether they are in Palo Alto or Germany, follow-up and care (and this is most important) should be initiated by the school. Why? Because seriously depressed students are less likely to seek treatment. They consider themselves to be defective instead of legitimately sick because that's what depression does. It convinces them that there is no hope, and therefore no cure, but that is really depression talking. We have to break through that. We have to go to them, physically and mentally. If you go to the website for The American Federation for Suicide Prevention, you will see their advice for preventing suicide. The suicidal person cannot be expected to independently seek treatment. Somebody must take them.

If we can come away with any insight from Patrick and Cho, it is that follow-up was woefully lacking. I shudder to mention their names in the same sentence, but similar questions in their aftermaths compel me. Why didn't the school follow up on Pat's treatment in Germany even though he was in a Stanford internship program? The answer: Stanford was relying on Pat, and so was I. That cannot continue. When students become patients, the school must monitor them as long as they are connected to the school and wherever they are connected. Depressed students — even the best, like Pat — are simply not capable. Depressed students don't seek treatment because they are, not surprisingly, depressed. This is how depression kills, and in the process, it robs functioning until there is very little on which to rely. How do we know when that functioning is gone? We don't, and that is why it is up to us to know more. It is simply in our own best interest to detect and treat more actively and accurately. If I have come away with anything from the loss of my beautiful son it is this: Depression will kill anybody, but the burden is on usto know whom.

When Pat graduated in 2005, our whole family came to Stanford to wish him well: my husband and I from Connecticut, his older brother Colin and Colin's friend Julie from Washington State, his twin sister Libby from Vermont, and his grandparents Dr and Mrs. David Rimer from Los Angeles. We all came to congratulate him, and we were impressed with the beautiful ceremonies and meaningful events, but as I read your op-ed piece, the memory of meeting you at graduation stood out the most. You seemed like a caring person, even during the brief moments in which we had our photograph taken with you. We commented afterward how welcoming you and your wife had been, even though you were probably exhausted from shaking hands and posing for several hours. And now I write to ask you to bring that caring sensibility to the forefront of this issue. Suicide is the second leading cause of death for college students. It weakens parents' confidence in the safety of their children on campus — parents, who, by the way, are already feeling excluded from the well-beings of their children because of confidentiality. We cannot see grades, get psychiatric records, get tuition bills directly, or intervene on students' behalf. Everything is left up to the student, and, as we have seen with Patrick and Cho, we risk too much isolation.

Again, thank you for your interest in this issue, and thank you for promoting the psychological well-being of your students. I appreciate your focusing Stanford's public attention on these avoidable catastrophes. Patrick loved Stanford dearly. He was grateful for the services you did provide, and now, in his stead, we are grateful for your continuing efforts to protect our children.

I invite you to visit the memorial blog set up for Patrick by his Stanford friends at: http://patrickwood.blogspot.com/

Sincerely,

Lisette Rimer, Pat's mom
Pomfret Center, Connnecticut

<b>Comment on this article </b>

<b>Jon Bell</b> - 5/14/07

Ten day ago, a newly-admitted Freshman to Stanford went on yet another in a long-time-series of verbal abuse tirades against all the people who loved her; wished that they were all dead; that she hated all people, especially the rich--and that after Stanford she wanted a career in public relations. This person is now getting help--if she allows it. The University has been informed and has been fabulous.

<b> Ted Rudow III,MA </b>- 5/14/07
There is no reason to doubt the generous impulse behind the work of professional psychologists and social scientists. Most of the experts who guide the psychological society have good intentions.

But there may be reasons to doubt the competence of psychological helpers. A willingness to help does not guarantee a helpful result. Sometimes, as Thoreau wryly observed, the result is the opposite: "If I knew for a certainty that a man was coming to my house with the conscious design of doing me good, I should run for my life."

The fact that psychologists are trying to help people often keeps us from asking whether they know how to help. We think it&#39;s bad manners to ask a man who is trying to help us if he really knows what he&#39;s doing. Of course, it&#39;s not just manners that prevent us from questioning psychology. It&#39;s also faith--the kind of faith that makes us believe that school teachers are doing what is best for our children. Or the kind of faith that tells you that the man in the clerical collar won&#39;t knock you down and steal your wallet. Just the same, we ought to be asking if psychologists really do know how to help. A good deal of research suggests that psychology is ineffective. And there is evidence pointing to the conclusion that psychology is actually harmful.
The first indication that psychology might be ineffective came in 1952 when Hans Eysenck of the Institute of Psychiatry, University of London, discovered that neurotic people who do not receive therapy are as likely to recover as those who do. Psychotherapy, he found, was not any more effective than the simple passage of time. Additional studies by other researchers showed similar results. Then Dr. Eugene Levitt of the Indiana University School of Medicine found that disturbed children who were not treated recovered at the same rate as disturbed children who were. A further indication of the problem was revealed in the results of the extensive Cambridge-Somerville Youth Study. The researchers found that uncounseled juvenile delinquents had a lower rate of further trouble than counseled ones. Other studies have shown that untrained lay people do as well as psychiatrists or clinical psychologists in treating patients. And the Rosenham studies indicated that mental hospital staff could not even tell normal people from genuinely disturbed ones. It is possible to go on with the list. It is quite a long one. But I hope this is sufficient to make the point that when psychologists rush in to help, they are not particularly successful.

<b> Ted Rudow III, Scientologist </b> - 5/14/07
Hey Ted, what exactly do you mean by, "psychology is actually harmful." That&#39;s a pretty nice blanket statement there. What you&#39;re meaning to say is, clinical psychology isn&#39;t always effective. The studies you list aren&#39;t indictments of psychology as a discipline, but specific methods of treatment. And none of them conclude, "Therefore, nobody should trust any psychologists, because of what we have tried to show." Seriously. Neurosis is not as widespread or specific as depression. Psychotherapy was always hackery and has little to do with modern-day depression treatment methods. Children&#39;s developmental processes are also moot in this discussion, be they abnormal or normal or whatnot. There are lots of studies showing a lot of things. You have to look at the whole body of the discipline and then inform yourself, not take the good and pointed studies relating to specific areas and discount the entire field.

<b>Why did you even give her space?</b> - 5/14/07
At some point, you just have to let go, lady. Get a grip. Stop projecting your woulda-coulda-shoulda parental replays to compensate for everything you didn&#39;t do, just to make yourself feel better and ignore what really did happen, most of which probably wouldn&#39;t have changed even with all the nannying you suggest.

<b> The Real BadgerNation </b> - 5/14/07
I agree...
and President Hannessy&#39;s fake smile and politically correct image are a clear sign that he cares. Same way G.W.&#39;s visits to Iraq and shaking of those people&#39;s hands, taking pictures and putting up a big baboon smile show that he also cares... about sending America&#39;s sons to die.

<b> Why is this letter in the Daily? </b>- 5/15/07
I agree with WDYEGHS - it&#39;s not very helpful to expect that CAPS could be able to &#39;follow-up&#39; on GRADUATES (who aren&#39;t eligible for their services any more, anyway...*ahem*), not to mention when they are 9 time zones away. Aside from the logistical (think personnel, funding, time and money spent tracking down Stanford students abroad) impossibility of this operation, how would that be funded? A third of Stanford undergrads go to CAPS at some time in their career here - keeping tabs on them to follow up is just not feasible with the way the service is set up at the moment.
Also, when would treatment end? If we were to promote a regime of following up on everybody after every psychological event had been resolved (something that closely resembles nannying...which health services can&#39;t do to people once they are of age without their consent) then it risks wasting the time of professionals who are already over-stretched and underpaid.
Finally, CAPS psychologists are not permitted to practice in Germany because they are licensed in the state of California. This guy&#39;s story is really tragic and it makes me really sad to have read this piece, but the answer, if there was one, would not have lay at Stanford no matter what obligations the mother wants to impose on the university.

<b>A more sympathetic response...</b> - 5/15/07
I think the three posts above me are not giving this well thought out article enough credit. I don&#39;t think she&#39;s advocating for a CAPS conselour to commute to Germany to make sure a graduate is doing ok, but some sort of follow up with the family or student to make sure they are getting some sort of help. Yes, a third of the student body may go to CAPS, but a much smaller fraction of the student body would require this follow up - - those who attempted suicide, were committed to the hospital against their will, etc.

While this article does suggest that Stanford should have remained involved in Pat&#39;s mental rehabilitation, I think the more important thing to take away is the author&#39;s useful view into the life of a mentally depressed student, and hopefully raises awareness of what our peers are going through - peers who you see next to you at dinner, walk by in white plaza, sit next to in class. while pat did not take his life while at stanford, many others have, and that fact needs a lot more attention from ALL OF US at stanford.

<b> Alyssa O&#39;Brien, PWR Instructor</b> - 5/16/07
As a Stanford instructor who knew Pat as a student years ago in PWR "Comic Rhetoric," I am deeply saddened to hear of his death. My heart goes out to Lisette and to all Pat&#39;s friends and family members. I still remember his gentle smile and quick wit. I hope anyone reading this realizes that suicide is a lonely and terrible solution -- there are people who will grieve and miss you with a deep ache. May 17 is the first annual Stanford Wellness day. Make a pact on this day to reach out to others and not give in or give up.

<b> Grateful</b> - 5/17/07
Thank you for sharing your painful and most personal experience. Your letter points out the difference between sadness and depression. Don&#39;t ever let go of your search for meaning and your determination to help others. Even if some miss the point (as evidenced by a few of the responses), to me and to others your words are precious. No man is an island. Thank you.

<b> Lisette Rimer</b> - 5/20/07

Dear Mr. Hohmann,

Thank you for being so generous with space in the Daily for Pat&#39;s picture and story. You gave prominence to an issue which has apparently troubled Stanford both on and off campus and, judging by the responses to Pat&#39;s story, drawn the full range of reaction. I found it interesting that I shared all views at different times in my life. Before Pat died, I agreed completely that schools cannot be traipsing all over the globe to protect students from themselves, that we could not make students live if they didn&#39;t want to. As a matter of fact, it is probably that kind of thinking that put me in this situation today.

Now that he&#39;s gone, I can only say from experience that the nature of the disease demands more from us. There is no better proof than Pat that depression is a terminal disease and that it operates outside the realm of logic. How do we know when a student has crossed that line? We don&#39;t, and so it stands to reason that we should take a conservative approach. As my doctor has told me many times since Pat&#39;s death, depression is like cancer, only worse in the sense that it attacks the very decision-making ability that students need to seek help. If you can&#39;t depend on the students, and the parents are three thousand miles away and getting the "I&#39;m OK" side of the story, who is left? It is only the professionals who know that depression does not "heal" after the first "episode" Even on medication, it takes longer to recover with each setback. Severely depressed patients do not "learn" from past failures. They get worse. They become more vulnerable. They are chronically ill, and even if they sought hospitalization once, as Pat did, they may be less likely to do it again because they will think they are beyond hope. My therapist tells me we can assume one thing about suicide: the person is in so much pain that death is a mandate. It&#39;s not like they went to a psychological shopping mall and unexplainably picked that choice. I have learned that it is a severe, agonizing, psychological torture, which constricts them internally but allows enough external composure to carry out their plan. Pick up any book on the subject and then think about it as I have done every day for fifteen months. If the school is sincere in improving its psychological services, follow-up after hospitalization is essential. Nobody else is equipped to do it, and the consequences may be fatal.

I am not removing blame from myself or from Pat, and I appreciate those who wrote and understood that. My letter is not about finding fault. It is simply stating a fact: the school must be proactive. The psychiatric services are excellent on campus. As a friend once told Pat, "Stanford is one of the best places to have a breakdown." Extending those services is simply a matter of a phone call, in Pat&#39;s case, to the Stanford Center in Berlin.

Most importantly, thank you to "A more sympathetic response," "Alyssa O&#39;Brien," and "Grateful." You knew Pat (Was it you, Mrs. O&#39;Brien, who nominated him for a writing prize for his paper on Juvenal? He was touched that you liked it.), and you knew how depression works. It&#39;s a thief, and it robs you blind. You cannot see your prospects unless professionals pry your eyes open. Thank you, Stanford, for the wonderful care you did give, and thank you again for continually working to improve those resources.

Lisette Rimer, Pat&#39;s mom
Pomfret Center, CT 06259

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Original Source: <a href="http://daily.stanford.edu/article/2007/5/14/opedAnOpenLetterToPresidentHennessy"> Stanford Daily - May 14, 2007</a>

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Lisette Rimer, "Op-Ed: An open letter to President Hennessy," in The April 16 Archive, Item #514, http://www.april16archive.org/items/show/514 (accessed July 31, 2014).