Having spent a few minutes doing a Google search I find that the word “shagreen” means a kind of rough leather.  Be it so, but if memory serves it was not always so.  I thought it meant a kind of Irish ghost, a specter, a warning, something that scares you.  In fact once in a radiology lecture I swear the professor said something like, “… the shagreen of contrast reaction.”  “Contrast material” is a chemical that contains substantial amounts of an element with high atomic number, like iodine, making it an efficient absorber of x-rays.  A simple x-ray of your abdomen will show subtle hints of what your abdominal organs are doing but swallow an appropriate barium based drink and your stomach and bowel become very conspicuous; the technique was once more popular than it is now.  You can’t inject barium into the blood stream safely, but iodine based contrast agents are injected.  In the old days – less commonly now – there could be idiosyncratic reactions to the contrast, occasionally lethal.  So it was something to be avoided if one could do so.  Hence the professor’s choice of a word that sort of means a threatening ghost.

The shagreen has apparently faded from existence.  That’s all right.  It was only a ghost anyway.  But I summon it now because there is one thing that scares me above all others.

Sure there are demographic issues that are terribly dangerous, but by and large they are Not My Fault.  I may fail to lay them to rest through stupidity, laziness and incompetence, but I have no doubt that my intentions are clean. 

On the other hand, there is this shagreen.  It’s called loss of self esteem.  And there is a lot of it.  (Making Sense of a Senseless Act SCIENCE vol. 338 no. 6110 November 23, 2012 page 1025)  The article does not use the phrase “loss of self esteem,” but in medical school that was offered to us as the cause of depression, which in turn was generally the cause of suicide. 

Mind you, I do not deny that under some circumstances suicide might be a reasonable choice.  Put me in a burning skyscraper and I might well leap to my death rather than be burned to death on the windowsill.  I would not consider that to be a sign of pathology on my part, just a choice between poor alternatives.  I see no loss of self esteem there. 

To me it is regrettable that the article does not address the question, even though it purports to seek answers and offers some statistics.  Read it yourself, but my take home message is that in the US more men commit suicide than women because women are able to survive their attempts more often.  And in China the suicide rate is higher because the women have a high mortality rate from their attempts as the men do.  So my bottom line is that we are all pretty much alike in this regard.

This is not a new insight.  Herodotus reports that the Persian king Xerxes (yes, we’ve been at loggerheads with Iran off and on for quite some time) was reviewing his immense army as it approached the crossing into Greece and burst into tears.  Questioned as to why he said that all those men were so numerous and strong and magnificent but in only a hundred years they would all be dead.  His companion said yes, and what’s worse every single one of them will wish he were dead many times before he actually gets there. 

Loss of self esteem is rampant.  So far as I can make it out I have had enough friends commit suicide, so that if the American rate is 12 per 100,000 per year, my friends have averaged some 1,500 in any one year.  Now I’m a sociable kind of guy, but that seems like a lot of friends.  I have had a couple dozen, maybe, possibly a hundred.  But no more than that as close as the ones I lost to … well it had to be loss of self esteem. 

So going into this from the get go, I’m not good at building the self esteem of my friends.  The last thing I need is to lose some more.

So I try to be kind, patient, supportive, encouraging and so forth.  I really do.  I would rather walk away then pick a quarrel, unless of course some helpless person was being victimized and I could prevent it.  And I could do that with a good conscience.  The one against whom I would be doing the defending, were he to carry out his design, would upon reflection feel very guilty.  So I have done no harm in thwarting him.

But then we must consider mating strategy.  The standard American mating strategy is utterly insane.  Well anyway, it’s biologically unsustainable, which to me means about the same thing.  And I am making a career of pointing this out.  So far little or no harm is done.  I don’t know anybody I’ve depressed.  Pretty much I get ignored.

But the day may come when that changes.  Then come the self recrimination, the guilt, the loss of self esteem, the suicides, and it’s going to be all my fault. 

But what I tell anybody who has lost a friend to suicide is this: “There is nothing you could have done.  By the time a person gets to that stage no power on earth can turn events.  Professionals do try, but at the end of the day nobody can accept responsibility.”  And if I must, I am prepared to say that to myself.

But I doubt that happens.  Remember those numbers?  Conditions in the US and China are quite different and are changing in different ways.  Yet the suicide attempt rate seems not to be so different.  The risk is part of the human condition.  

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