Escaping the Shadow of Suicide: A Journey from Heartbreak to Freedom

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This is the story of my sister Liz and how her suicide took me through heartache and grief and now pushes me towards freedom and contribution. Considering suicide? Dial 988.

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September is National Suicide Prevention Month. Need help? Dial 988 to reach the 988 Suicide & Crisis Lifeline

Introduction

I’m now over twice as old as she was when she died.  Twenty five years ago, her name was Liz and she was my older sister. 

We were born about a year apart. As the eldest sibling, she was the one who forged the path, allowing me to blithely follow along in her wake.  Since she was smart, all my teachers assumed that I was smart as well.  That assumption brought me the privilege of assumed academic excellence, which smoothed my school life in many ways. 

When I saw her academic achievement, I saw what was possible. This made it easier for me to follow in her footsteps. I didn’t appreciate the pressure at the time, but it’s easier to run fast when you’re following a strong pacesetter. I kept up as best as I could.

Her shadow grows

She started to pull away from me in high school. By junior year, Liz had exhausted the available AP math courses at our public high school.  Rather than just calling it a day, she enrolled in more advanced coursework at the local junior college. 

Liz was also talented with musical instruments in a way that I was never able to match. By senior year, she was one of the best young clarinetists in the northeastern US.  I remember how I grew annoyed when she picked up my flute, which was my instrument of choice, and within a couple of weeks played it with more technical proficiency than I could muster after years of practice.  It was the same with the saxophone, the piano, the xylophone, and the guitar. 

MIT

I knew that she found high school stressful, especially when she graduated as salutatorian instead of valedictorian as she had hoped. But when she got into MIT, her dream school, I assumed that all would be well. She struggled in her freshman year though, finding the sudden competition at MIT a rude awakening. 

Again, I tried to follow in her path and applied early to MIT the next year. I was waitlisted and in the spring took a spot at Yale instead.  It was a good consolation prize, though, as was graduating valedictorian of my high school class.  I secretly relished that I made it to the top, which is something that even my perfect older sister couldn’t do.  

Yale

As I started my freshman year, I basked in that sudden expansive experience of being amongst thousands of interesting new peers. 

I wasn’t at the top of my class at Yale, but I was happy and content in the same way that had characterized the majority of my childhood. Even through my family’s financial troubles in middle school and into high school, I retained that unearned carefree optimism that is characteristic of middle children everywhere.

Even though money remained tight as I entered college, my sister was at MIT!  She would surely be successful at whatever career she had in mind. In my mind, financial stability for our family was a foregone conclusion.  Liz would make sure of it.

The dream becomes a nightmare

My rose colored glasses shattered in the last month of my first year at Yale. On a cool April morning, I got a call from a reporter asking for my reaction to the news that Liz had been in a fire and was in the hospital. It was the first I had heard about it, and when I called my parents, they confirmed the news. All of a sudden, I was thrust into a gasping-for-breath fever dream that wouldn’t end.

My family learned that Liz had been depressed for some time. She had been receiving help from the psychiatry department at MIT for this, but despite their care, she worsened. She spiraled to the point where one night, she lit herself on fire in her dorm room. When she passed away days later in the hospital with burns over most of her body, her suicide was complete. Due to the blanket of doctor-patient confidentiality, my parents and I had little knowledge about her mental struggle until her death.  

The next year was a blur. I had no idea how to handle the grief. Instead of taking time off from school, I requested that my parents leave me in school so I could keep the normalcy of classes and the support of my friends. But my classes were a disaster and I ended up withdrawing or dropping most of them sophomore year.  

Loss and anger

The loss of my sister was horrible in all the ways that you’d expect. A person that I loved was suddenly gone from our lives, permanently, in a way that made little sense to us either intellectually or spiritually. 

Looking back, I went through all the expected reactions to Liz’s death, with an extra helping of denial, depression, and anger. So much anger.

I was angry that we were kept in the dark about the gravity of her struggle.  I was angry at myself that I hadn’t called or visited her as much as I should have.  Finally, I was angry at Liz for keeping all her turmoil locked away, instead of leaning on me and my family for help. Of course, it’s impossible to know if that would have really helped.

After that anger faded, I was mad at Liz for leaving us behind to pick up the pieces. 

Damaged goods

After the acute grief ran its course, I was left with a raw wound that wouldn’t heal.  It wasn’t quite grief anymore and wasn’t quite depression.  My mind just felt damaged and wrong in a way that felt permanent. 

As I struggled to cope with her loss, my body also went haywire. I developed a recurrent fever illness that was resistant to antipyretics and relapsed literally every month.  I’m fairly certain now that this was a physical manifestation of disordered grieving.  

I eventually got back on track mentally, physically, and academically, but it took about two years.  

Mourning time

As I think back to those days, I was mourning so many things at once.  

I mourned the loss of my confidante and one of the few people who really shared the pressures and memories of growing up as a first generation Asian in a family with little money and lots of expectations.  Together we persevered through the tough years.

She was right there when our childhood home was repossessed by the bank. Later in the rental home, she was there as we overheard our mother crying when there wasn’t enough money to buy food that week.  Together, we waved goodbye as our father traveled out of state on a new business venture. Later as latchkey kids, we babysat our younger sister as our mom went back to work to help pay the bills.  And together, we looked hopefully to the future when it looked like higher education was going to finally deliver on the promise of the American Dream.  

More to mourn

Aside from losing my childhood confidante, I also mourned the loss of Liz’s mind and talents. I always felt that she was destined to make a mark on the world.  Whether as a doctor or a scientist, I had always been blinded by her white-hot potential. When she got into MIT, I felt that she was just starting to deliver on that promise.  To have that suddenly gone from the world hurt me on some visceral level that is still difficult to verbalize. 

Finally, I mourned the sudden death of my identity as a middle child.  As my older sister, Liz was the vanguard. She got to do everything first and report back to me about her experiences.  All of a sudden, that was gone. Worse, that suddenly became my job for my younger sister!

My younger sister did not know Liz as well as I did. After all, she was about 8 years younger than her. But I know Liz’s death affected her just as deeply.  Even now, decades later, I haven’t been able to have THAT conversation with her; about how Liz’s death affected all of us, and how these echoes shape our lives still. 

The weight of responsibility

Once I started to come to grips with the reality of my sister’s suicide, I had the jarring realization that the long term security of my family’s finances was going to have to come from me. This helped firm up my decision to go into medicine, which seemed a good match for my talents and temperament, but also a reliable way to jump up the socio-economic ladder.  Through medicine, I’d be able to help people and stabilize my family’s future, all in one fell swoop. 

I got serious about my academics and scored in the 99.7th percentile on the medical school admissions exam (the MCATs).  This high score smoothed over the bumpy parts of my undergrad transcript and vaulted me into medical school.    

A decade later, I finally delivered on that promise as I graduated residency as a urologic surgeon. 

Big goals, big burnout

The problem with big goals is that they can leave a big void when you finally achieve them.  After only a couple of years into my job as an employed physician, I felt unsettled.  With my paycheck and earning potential, my family’s financial future was secure.  I was delivering on my potential by helping hundred of patients with their medical issues.  I was well liked, skilled, and humble enough to avoid scorn. 

Eventually, I realized that after so many years of grinding away, I was burnt out.  The price of financial security seemed to be 60 hour work weeks and 10 hours of commuting in the SoCal traffic.  It didn’t take long for this schedule to take its toll.

For most people, burnout leads to some changes in work hours and hopefully a better balance between work and life.  For me, the phenomenon led to a more extreme change.  I eventually seized on a new goal of financial freedom.  This led me to real estate investment, which I came to understand is the fastest and most tax advantaged way to achieve true financial freedom in life.  

I’ve recorded my journey here on The Darwinian Doctor blog for the past five years.  Now after years of investment, we’ve amassed a significant real estate portfolio and took the gamble on a new life in Memphis, TN.  Although it’s getting hard to keep track, I think we’re about halfway to our goal of financial freedom, years ahead of schedule.

I still practice medicine, but it’s as a locum tenens and much more firmly under my own control.

One life to live

Most of my readers only know my story of financial scarcity and burnout to financial freedom via real estate investing. But now you know that there’s more to the story.

After years of healing, I can see some lessons from my sister’s suicide. I know now that every minute of life is precious and that we aren’t meant to be toiling away in jobs that don’t bring us joy.

For me, this has manifested in a career transition and newfound purpose: to spread the goal of financial freedom so everyone can live lives of growth and contribution. My sister’s suicide has given me the perspective that there’s no time to waste in this grand adventure called life.

I’d give it all back

But make no mistake.  I was damaged by my sister’s suicide.  My younger sister, mother, and father have endured such heartache because of her death.  Even worse, the world will never know the brilliance that Liz could have achieved.  

If I’ve achieved anything today as a result of her death, it wasn’t worth it.  I’d give it all away in a heartbeat to have her back.  Think of what we could have achieved as three siblings instead of just two.

Conclusion

Please stay connected to your friends and family.  Communicate openly and watch for the warning signs of suicide, which can include talking about wanting to die, feeling hopeless, withdrawing from social activities, and exhibiting extreme mood swings.  

If you or someone you know is struggling with suicidal thoughts, please seek professional help immediately. In the US, the National Suicide Prevention Lifeline is available 24/7 by dialing 988.  (This three digit number replaced the old 10 digit number in July of 2022.)

If you do experience suicide, I’m sorry.  Just remember that your life is valuable too.  After the grief, anger, and depression fade away, one day it will be time to live again.  You deserve to make your life as amazing as it can be.  I hope it’s a life of financial freedom, perpetual growth, and contribution.  

— The Darwinian Doctor

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It only took me five years of baring my soul on the internet to feel ready to share the story of my sister’s suicide. Feel free to comment below, or perhaps just call that person who could probably use a friend right now.

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