Thursday, June 3, 2010

6 reasons why people commit suicide

by Alex Lickerman, MD

Though I’ve never lost a friend or family member to suicide, I have lost a patient.

I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.

The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?


Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).

People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.

In general, people try to kill themselves for six reasons:

1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.

Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields an honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.

2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.

Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.

3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is therefore not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.

4. They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.

I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.

5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.

6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.

The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.

Tuesday, March 16, 2010

An insight into crime scenes clean up services


Crime scene cleanup companies also clean unattended deaths, damaged environments due to tear gas, and other crime and distress scenes. The larger crime scenes that involve mass murder scenes, terrorist attacks and anthrax and other biochemical damage is also taken care by these companies. Crime Scene Cleanup services may also include bird and rodent infested areas. The cleaners in this case require special experience and equipment than a typical cleaning company’s experience and equipment.

Typically, crime scene cleanups start taking place only after the coroner’s office and other government bodies releases the “scene” back to the owner or some other responsible person concerned with it. The cleaning task can not begin till the police investigation is completely finished on the contaminated scene.

In most cases crime scene cleanup is a small business activity. Mostly, small cleaning services like carpet cleaning or water damage companies add services for Crime Scene Cleanup for diversifying their activities. The prominent and recognized organizations in this field of cleaning consist of the Institute of Inspection, Cleaning, and Restoration Certification (IICRC) and the American Bio-recovery Association (ABRA).

Earlier crime scene cleanup was a loathsome job but today it has become a lucrative business. Crime scene cleanup companies can charge anywhere between $100 to $600 per hour depending on the “level of trauma” and the quantity of hazardous material that the cleaners have to deal with and dispose of.

While a crime clean up service is ultimately a business like any other, advertising and marketing your services can be tricky. In a job that involves tragic death; most companies avoid mainstream methods of advertisement. Some choose the standard phone-book route while many others advertise on the side of their vans. Most of these companies largely depend on discreet options like passing out their business cards at service-industry gatherings, police stations and funeral homes.

An important requirement for success in this industry involves being considerate towards the sensitive nature of the work. There are certain crime scene clean-up companies that provide a grief counselor to the families at no cost while others offer discount to needy people. There are many countries where this type of service is funded by government or by religious organizations.

While some people call this emerging field a social trend of commercializing death, others call it plain capitalism. But for many others it still remains an essential service, a godsend. The fact is that whether you like it or loathe it but if you ever end up with blood and brains splashed all over your bedroom walls, you will definitely be relieved that there is someone you can call to clean it up.

Friday, March 12, 2010

Trauma Cleaning: Without Standards, The Pain Can Keep Coming

by Kent Berg
National Institute Decontamination Specialist

As an instructor in crime and trauma-scene recovery and a board member of the American Bio-Recovery Association, I am often approached by attorneys, the public and insurance adjusters to evaluate the service they or their clients received from other crime-scene cleanup companies.

For the most part, these are just routine questions from people who want to make sure that the service they received was within the normal parameters of good practice. But a few times each month I receive calls that just cause my stomach to knot up and my blood to boil.

With the bio-recovery industry in its 14th year, it is mind-boggling to find individuals who still decide that they are going to start-up a new company and declare themselves “experts” in crime and trauma scene cleanup without any research or training.

It is even more outrageous to find that, although they know almost nothing about the science, chemistry, biology or laws of our industry, they are charging fees that are often four or five times the industry average.

The majority of those operating in the industry today are honest, ethical professionals. It’s the few bad apples in the bio-recovery barrel, so to speak, that amplify the problems tainting our industry.

Example 1: The Hit-and-Run Guys
A husband argues with his wife in their kitchen. As she prepares supper, he grabs a shotgun and, standing in the doorway between the kitchen and dining room, blows his head off.

It is still daylight when the police arrive. In order to see better, they open the brain-splattered dining room drapes. Splatter is on the dining room and kitchen walls, but since the body fell onto the vinyl tile floor of the kitchen, the largest amount of blood pooled there.

The family asks the police about scene cleanup, and is directed to a local company. The company tells the family that payment will have to be made in cash prior to starting the job, and that the family will not be allowed inside of the house while the cleaning process takes place.

The family agrees and stays with relatives until they get the call that the job is complete and they can return. The company is long gone, and upon cursory inspection, the rooms look contaminant-free.

It is now night and, in an effort to keep neighbors from seeing into the dining room, the wife pulls the drapes closed. To the horror of the family, the drapes had apparently never been checked and still have blood and brain matter clinging to the material.

The kitchen floor appears to be clean but, when the wife walks across the floor, bright red blood spurts up between the tiles, making little puddles and polka-dotting her shoes.

If this isn’t enough to re-traumatize the family, the wife goes to remove the now-cold pot of chili from the stove and promptly throws up when she sees a 3-inch piece of her husband’s skull nestled neatly atop the pot.

The family contacted the attorney general for their state, who then called me to review the family’s statements prior to a decision on prosecution.

Example 2: The Little-Extra-on-the-Side Guys
A man who lived alone died in his bed of natural causes, but wasn’t found for several weeks. When the authorities were finally called, the decomposition could be smelled from the street.

When a crime-scene-cleanup company was called in, the man’s relatives were told that the odor had permeated everything in the house with disease. Their recommendation was that everything in the house should be removed and destroyed.

The family, already nauseated from the smell, relied on the “professional opinion” of the technicians and agreed to let them remove everything from the good silver and china to the appliances.

In short, every piece of furniture, appliance, electronic component and fixture was removed because they were declared “not salvageable.”

The relatives were then presented with a bill for approximately $40,000! If this wasn’t obscene enough, a few weeks later the family found many of the home’s contents that were supposedly “not salvageable” being sold at a local flea market.

Example 3: The Cutting-Down-on-Overhead Guys
It is standard practice for crime and trauma-scene cleanup companies to dispose of human-blood-contaminated items that can’t be salvaged. They do this by red-bagging and boxing these items and sending them to a medical waste processing facility. This includes dismantling recliners, mattresses, and other large items to fit in these containers.

In this case, a company responded to a gunshot suicide in an apartment. The victim had sat in his favorite recliner and put a pistol in his mouth. The subsequent wound bled profusely until there was no more blood for the heart to pump. This resulted in the complete saturation of the recliner.

In an apparent effort to save on labor and disposal fees, the crew decided that they would dispose of the recliner by wrapping it in plastic, putting it in the back of their truck and then dumping it in the woods of a neighboring county.

All seemed to go well until a few days later, when hunters found the chair and called police. Thinking that they had stumbled upon evidence of a homicide, the police launched a full-scale investigation that lasted for weeks and logged many detective hours before they were actually able to review the crime scene photos of every police department in the surrounding counties.

When the mystery was finally attributed to this particular crime-scene-cleanup company, not only were they slapped with fines for littering, they were saddled with reimbursing the cost of the investigation. Every law enforcement agency that heard about this dropped the company like a hot potato, and the subsequent media attention tarnished the reputation of crime-scene-cleanup companies everywhere.

I would like to emphasize the fact that these complaints are not clients disappointed with a poorly painted wall or an out-of-true vanity top. These are abuses by unscrupulous companies that are subjecting their clients to financial greed, improper disinfection, and re-traumatizing that no one should have to endure.

Could training and certification eliminate these types of abuse? Perhaps a good portion of them, but in the end, it is the honesty and character of the companies themselves that should be monitored. I believe the way to do that is to pursue standards, as well as meeting with our state legislators to create specific regulations for our industry.

Sunday, June 28, 2009

Crime Scene Leftovers Pose Problem For Sanitation


Call it the Case of the Bloody Mattress.

City sanitation workers in southwestern Kentucky were recently left with the problem of how to dispose of a bloody mattress put out with the trash.

The mattress came from a home where police say a 37-year-old man appears to have died from self-inflicted stab wounds. The problem came when trash collectors realized they couldn't pick up a potential biohazard, but didn't want to leave it by the side of the road in a residential neighborhood in Hopkinsville.

"This was an area of concern for us because blood is considered a biohazard and not only can our trash trucks not pick it up, but it could be dangerous for people in the community," said George Hampton, a route supervisor for Hopkinsville Solid Waste Authority.

The Kentucky New Era reports that the mattress disappeared by midweek, but sanitation officials didn't take it and were still trying to make sure it was properly disposed of. The location of the mattress remained a mystery at week's end.

Hopkinsville sanitation workers received an anonymous call reporting a mattress, possibly covered in blood, that had been set on a curb outside of a home. That was the concern of the anonymous caller, Hampton said, who said children in the neighborhood could start to play on the mattress and come into contact with the dried blood that might have diseases.

Because there was blood on the mattress, sanitation workers couldn't haul it off with the rest of the trash.

"It raises a question for us about where we take it from here," Hampton said. "Someone has to clean up messes like these and we can't do it."

Solid Waste Superintendent Bill Bailey said sanitation workers aren't allowed to pick up possible biohazards, including blood, from the side of the road. Instead, Bailey said, the department needs to call other landfills to see who will pick up and take the items.

"Sometimes we can process and wrap it in plastic and dispose of it that way. But other times we have to contact a company that deals with disposing of medical waste."

Charlotte Write, a spokeswoman for Stericycle, a national company that specializes in medical waste disposal, said medical waste is generally burned to kill pathogens that can live in dried blood.

"It is important to dispose of all medical waste, especially waste that comes from the body, so as not to spread diseases," Write said.

Hopkinsville Police Chief Guy Howie said the families must clean up the scene of a murder or suicide or pay to have it done.

"It doesn't sound very friendly, I know, but that's just how it has to be handled," Howie said. "Someone has to clean it up and someone has to dispose of all of this, it's just a matter of figuring out who. It's amazing that just one mattress on a curb can raise so many questions."

Someone solved sanitation's problem by taking the mattress from in front of the home. Bailey said sanitation workers didn't remove it, but finding out what became of the mattress is important. It had to be properly sterilized and disposed of.

"We can't just stick it in our landfill and be done with it," Bailey said. "Whether it's on that curb or not, it's still hazardous material."

Saturday, May 16, 2009

Why you need crime scene cleanup services

By Alex Thomson

Crime scene cleanup or trauma scene cleanup after the death of someone either violently or naturally is by and large the responsibility of the victim’s family. Even till few years ago, there were a handful of cleaning companies that specialized in trauma cleaning service. But today this niche service has emerged as a lucrative business and there are many companies who provide this service.

Trauma cleaning service requires special experience, skills, equipment and expertise to deal with different types of bio-hazardous waste and dispose them efficiently with the minimum possible emotional stress to the victim’s family.

The most traumatic form of death is violent death and leaves the victim’s family feeling both victimized and traumatized. Coming to terms with the unnatural death of a loved one is in itself an uphill task for the bereaved family, and to top it they have to deal with other practical matters like making funeral arrangements, dealing with insurance issues, contacting surviving family and friends and locating wills. Furthermore, in case of violent crimes the police and the media are also involved. This can really overwhelm any family. Here is where trauma cleaning service comes to your rescue. They lighten one of the heaviest burdens, that is of dealing with the horrid murder cleanup. They will take care of the crime scene cleanup, ensuring that the scene is restored to its pre-incidental state as far as possible and in the most quick and efficient manner thus allowing you to deal with other important matters. Most service providers work discreetly and protect the confidentiality of the sufferer and family.

Most of the times, the crime scenes are so ghastly that they can induce additional emotional trauma in victim’s friends and family. By hiring professionals for cleanup, you can reduce this emotional stress. Immediately after death the nature begins its process of breaking down the body. Unattended death scene and dead bodies can be dangerous as it gives rise to blood borne pathogens, mold spores and bacteria. You may try to clean the area by yourself but the exposure may result in flu-like diseases or direct attack on the respiratory system. So it is advisable to leave this job to professionals who specialize in bio fluid and blood remediation.

The total cost involving a trauma scene cleanup will depend on a number of factors. One of the most major factors is that how many technicians will be needed for the job, how long will the job take and the quantity of hazardous material that needs to be treated and disposed of. It can range anywhere in the range of $100 to $1000 per hour. Some people might call this business as capitalizing on death but it is still essential and indispensable in case of a death.

Wednesday, May 13, 2009

Crime Scene Cleanup: What It Involves


A crime scene cleanup service is not without its complications. Crime scene cleaning encompasses restoring the crime scene to its original state. When a crime is usually discovered, crime scene cleaners are not called until after officers of the law, like the crime scene investigators, have done their jobs first and have given the go ahead for the cleaners to come in. If you intend to hire a crime scene cleanup company, you must make sure that they are well equipped and fit right to get the job done. A crime scene presents challenging conditions.

The Use Of Protective Gears:
Crime scenes can very well involve the use of hazardous or deadly substances. For safety reasons then, it has become imperative that crime scene cleaners use protective clothing, in addition to protective tools and gadgets. You must see to it that they have all the necessary protective gears and gadgets. The protective clothing can consist of disposable gloves and suits. A disposable gear is preferred nowadays since it offers the best protection against contamination. You use it one time and get rid of it. That way, the dangers of contamination is virtually brought down to zero percent. Protective clothing extends to respirators and the use of heavy-duty industrial or chemical-spill protective boots.

Among the gadgets that a crime scene cleaning company must have are special brushes, special sprayers, and wet vacuum. These special tools ensure added protection against getting into contact with the hazard could very well be present in the crime scene. There is large, special equipment such as a mounted steam injection tool that is designed to sanitize dried up biohazard materials such as scattered flesh and brain. You would also need to check if they have the specialized tank for chemical treatments and industrial strength waste containers to collect biohazard waste.

Of course, any crime scene clean up must have the usual cleaning supplies common to all cleaning service companies. There are the buckets, mops, brushes and spray bottles. For cleaning products, you should check if they use industrial cleaning products. A crime scene cleaning company must have these on their lists:

1 - Disinfectants including hydrogen peroxide and bleaches - The kinds that the hospitals used are commonly acceptable.

2 - Enzyme solvers for cleaning blood stains. It also kills viruses and bacteria.

3 - Odor removers such as foggers, ozone machines, and deodorizers

4 - Handy tools for breaking and extending such as saws, sledgehammers, and ladders

Established crime scene operators also equip themselves with cameras and take pictures of the crime scene before commencing work which. The pictures taken may prove useful for legal matters and insurance purposes. You never know which.

Needless to say, a specially fitted form of transportation and proper waste disposal is also needed. These requirements are specific. As you can imagine, crime scene cleaning is in a different category on its own. A home cleaning or janitorial service company may not be able to cope up with the demands of a crime scene. A crime scene cleanup service requires many special gears and tools that a home cleaning or a janitorial service company does not usually have or does not require. Crime scene cleaning if not done correctly can expose the public to untold hazards.

What Else To Look For In A Crime Scene Cleanup Company
You may also want to hire a company that has established itself. An experienced company with a strong reputation is always a plus but it could be expensive too. You will do well to balance your needs with what is your budget. There are several companies that offer specific prices such as for death scene clean up categories and suicide clean up categories. Most companies own a website and have round the clock customer service as receptionists.

When looking for a suitable crime scene cleaning service, among the first things you need to do is to scout for price quotes. Crime scene cleanup services usually provide quote after they have examined the crime scene and then they give you a definite quote. Factors that are usually considered include the number of personnel that will be needed to get the job done. It also includes the amount of time that might be needed. The nature and amount of the waste materials that need to be disposed will also be factored in. You can be sure that the more sophisticated equipments needed the more expensive it will get.

Crime Scene Cleanup And Your Insurance
For homeowners, the best approach is always to make sure that crime scene cleanup services clauses and provisions are written down on the contracts or policies. The inclusion of crime cleanup services clauses is very common and has become standard clause in most homeowner’s policy. Make sure that you are covered for this unforeseen event. Make sure that your policy directs the crime scene cleaning company to transact directly with the homeowner insurance company. A crime scene cleaning service is usually a standard clause in many homeowners’ insurance clause. These companies often do the paperwork in behalf of clients.

If for some reason you do not have such coverage by any policies relating to crime scene cleanup on your home, there are ways to keep your expenses controlled.

Finding the right company can be very taxing, especially that you have to deal with the emotional stress stemming from the crime itself, especially with a crime scene involving death.

There are many crime scene cleanup companies in operation nowadays. There are reliable professionals that you can hire and prices are relatively competitive. As of recently, crime-scene cleanup services can cost up to $600 for an hour of their service. A homicide case alone involving a single room and a huge amount of blood can cost about $1,000 to $3,000.

In recent years, crime scene cleaning has come to be known as, "Crime and Trauma Scene Decontamination or CTS. Basically, CTS is a special form of crime scene cleaning focusing on decontamination of the crime scene from hazardous substances such as those resulting from violent crimes or those involving chemical contaminations such as methamphetamine labs or anthrax production. This type of service is particularly common when violent crimes are committed in a home. It is rare that the residents move out of the home after it has become a scene of a crime. Most often, the residents just opt to have it cleaned up. That is why, it is very important to hire the best crime scene cleaning company out there. The place needs to be totally free from contamination of any kind. You have to make sure that the company is able to remove all traces of the violent crime that took place. This includes cleaning biohazards that are sometimes invisible to the untrained eye.

Legally speaking, federal laws state that all bodily fluids are deemed biohazards and you should make sure that the cleanup service company you hire understands this and includes it in the cleanup. These things appear as blood or tissue splattered on a crime scene. You must be able to hire a company that is equipped with special knowledge to safely handle biohazard materials. The company must have the knowledge what to search for in any give biohazard crime scene. For instance, the company should be able to tell clues such that if there is a bloodstain the size of a thumbnail on a carpet, you can bet that there is about a huge bloodstain underneath. Federal and State laws have their own laws in terms of transport and disposal of biohazard waste. Make sure that the company you hire has all the permits necessary.

It will also be a huge plus if you could hire people who not only has the special trainings but also who have the nature to be sympathetic. If you are close to the victim and have the cleaning done at the behest of the victim’s relatives, it would matter that the cleaners tread the site with some level of respect. It is a common site that family members and loved ones are often there at scene. In general, when looking for a suitable crime scene cleaners, you would take into considerations the kind of situation that the crimes scene presents and the demands that it require. Crime scene cleaning companies handle a wide variety of crime scenes and prices may vary from one to the other crime scene and one to the other company.

Each type of scene requires its own particular demands not only to make the crime scene look clean and neat on the surface but to make it germ free, and clean inside and to make it free from all deadly and infectious substances. The cleanup cost for biohazards may vary depending on degree of the bio hazard(s) on the scene. There may even be a category that changes the cleanup pricing which usually involves decomposing bodies and carcasses. Likewise, a cleanup of chemical hazards vary, depending on the amount of chemical hazards as well as the grades i.e. how hazardous the substance is in terms of human contact. Prices are also determined by the number of hours and personnel that it would to get the crime scene cleaned. In addition, the "gross factor" from crime scene involving death and gore needs to be taken under consideration regarding the chemicals that will be used as opposed to those crimes' that do not have gore involved.

Wednesday, May 6, 2009

Man arrested for alleged meth lab

Wednesday, May 6, 2009

UPDATE-Clyde Logan Hoff, 55, of Mountain Home, was arrested Tuesday and charged with manufacturing a controlled substance after Elmore County Sheriff's deputies found what they believe to be a methamphetamine lab in the camp trailer where he was living at 4590 Airbase Rd.
When deputies from the Elmore County Sheriff's Office entered the trailer at approximately 2 p.m. Tuesday, they observed what they believed to be an operational meth lab.

Idaho State Police Detectives and Idaho State Police Forensic Lab personnel were summoned to the scene to gather evidence.

Also, two HAZMAT personnel came to the scene from Salt Lake City.

"These are very complicated crime scenes and take a great deal of manpower and resources to clean up and properly dispose of the chemicals," a spokesperson for the sheriff's office said.

Spokesperson also mentioned that "we were on the scene till 3 a.m."

"Mountain Home Fire Department and Ambulance service were with us because of the hazardous materials we were dealing with. It was a state joint effort. We appreciated all the support we got."

Hoff was scheduled to be arraigned today, in Elmore County Magistrate Court on the charges.

The investigation is continuing.