No one ever told me that grief felt so
like fear. I am not afraid, but the
sensation is like being afraid. The
same fluttering in the stomach,
the same restlessness, the yawning.
I keep on swallowing.
--- C. S. Lewis, A Grief Observed

My son Cory asked me as a practical 5-year-old whether only my mother’s bones were buried or if her head was buried as well. My daughter Lila, a first-grader then, wanted to know whether my mother was still wearing clothes. I told them somewhat irreverently that she was dirt in a box. I was uncomfortable saying that my mother had gone to heaven and mumbled something about love lasting longer than death. I was not sure how to explain her death to myself, let alone to them.

When Lila was 13, she asked me, clearly scared of what my answer might be: “Would you ever kill yourself?” I assured her that I would never commit suicide and besides, I told her, giving her a hug, I wanted to stick around to see who she would become. I didn’t want her to hesitate to rely on me whenever she needed to. I didn’t want her to fear that I would leave her. Yet her intuitive worry was not unfounded; the child of a parent who has committed suicide is five times more likely to kill herself than a child who is not exposed to this loss.1

Psychiatrists have studied what can seem like the Russian roulette of familial suicide, an ominous pattern of suicide occurring from one generation to the next called “intergenerational transmission.” So far, researchers have demonstrated that children who have lost a parent to suicide are at greater risk of killing themselves if they have a mood disorder, engage in substance abuse, are “impulsively aggressive,” or are exposed to intense conflict in the family.2 Still unclear is the mechanism by which a parent’s suicide increases the risk for these children. But losing a parent this way is also not a prophetic death sentence; it takes a lot of damage to lose the will to live.3 When I met people as I was growing up, all the way to medical school interviews, if I told them that my mother died when I was 4, they were curious about how she died — the question was irresistible. Most people seemed relieved when I said barbiturates, as if death and sleep are siblings. People wanted to know why and what was the cause. Such questions are usually edged with the fear that premature death, especially a self-inflicted death, might somehow be contagious: Why would she kill herself? becomes What does this mean about you? Somehow, confessing that my mother committed suicide felt incriminating: proof that my mother’s life was out of control. I worried that they would mistakenly assume I somehow played a part in that.

Over the years my father and I have had only brief, difficult conversations about my mother’s death. Reluctantly, he offered the occasional explanation. When I was younger, he would imply that my mother became depressed after my birth. “She lost all interest in the children after you were born,” he would say with resignation. I was, after all, their sixth child in eight years. I was mystified how that might have played out in our family, and I asked my father whether he thought she had post-partum depression (PPD). He replied that he would not have known what PPD was, and he just noted that she was lethargic after I was born. In his words, “I can’t describe to you what I didn’t understand.”4 PPD, which occurs in 10 percent of new mothers, is not just the “baby blues,” the exhaustion that comes from sleepless nights and a crying baby; rather, this black mood is incapacitating, derailing a mother’s ability to care for her baby or even herself. Some women seem agitated and anxious, while others can barely move. The causes of this debilitating but treatable condition are multiple --- changes in brain chemistry and hormones, and emotional upheaval. My father’s suggestion that my mother was suffering is understandable. Seeing her as depressed and lethargic would justify his efforts to seek and maintain custody. By keeping her away from us, he might even be regarded by his children as the protector. “What if she decided to kill herself and you were all there?” he has asked me. My father’s observation about her comment felt aggressive and hurtful. It left me feeling guilty, as if he were saying that had I not been born, she would not have died.

Yet after my birth, my mother was active in many volunteer projects. She was attentive about my siblings’ education. She bathed and fed us. She threw parties and juggled social engagements. Though it’s possible that she was quite skilled at hiding her depression, my mother’s friends talk about her as someone who was genuinely enthusiastic about her many activities planned right after my birth. Mothers with post-partum depression are often withdrawn.

A secure mother-child bond is created when a mother provides her baby with the comforting rhythms of feeding, sleep, and an organized home.5 Without that gentle sense of order, children may have difficulty managing their emotions, lack self-control, and lose confidence in their likeability.6 Either I have a very active imagination, or my mother must have been able to keep her sadness at bay long enough to nurture me as a baby.

My father has also suggested that my mother took on too many responsibilities, and I suspected as a child that it was this overwhelming combination that somehow killed her. She was, he has said, a woman ahead of her time, balancing children, a public career, and political aspirations. The year before I was born, a local paper reported on my mother’s lead role in community organizations. The reporter depicted a high-energy, focused woman eager to embrace many challenges. As chairman of the United Fund she “supervise[ d] 7,000 people and organize[d] an educational program of shows, demonstrative one-act plays about soliciting, training plus making speeches and outlining a routine for the administrative aides within my scope.” My mother revealed that the “secret of her success” was her ability to organize “right to the last minute” and that she took care of a “big, old house, eight big appetites (hers included),” attended five children “with the children born about every year,” the oldest being 6, fulfilled various civic and collegiate organizational jobs, and followed a “demanding but fun” social schedule of “two nights out a week and parties once a month.” She acknowledged her mother’s help and admitted that she was willing to delegate the jobs that she didn’t like (“Mother is a big help, of course, as mothers always are. And I will admit that I have a woman to do housework, which I abhor. However, no one takes over the kitchen. I do the cooking and I administrate all the work, even when it comes to a party for two hundred at holiday time.”)7 In the photograph accompanying this article, my mother is kneeling on the floor, wearing a tweed suit, and knitting on circular needles. She has a telephone cradled on her shoulder and papers organized in neat stacks on the floor --- she is an idealized portrait of the changing status of women. The article, I realized when I first found it, could have been an early publicity effort in advance of her campaign for the Boston School Committee. Even though this picture captures the outward appearance of a productive multi -tasking woman, I am still left wondering if she also had an underlying vulnerability to sadness.

During the 1950s, my mother was unusual --- an upper-class woman who had six children and worked outside of the home.8 The prevailing cultural expectation was for women to tend to the home, not orchestrate campaigns. My mother had enough resources to hire support to care for her brood so that she could conduct a career also. Because she had grown up as the daughter and granddaughter of Massachusetts politicians, she was enamored with politics. In the decade after the end of World War II, twenty-one women were elected to Congress, nineteen of them on their own merit (only two were political widows). Many pundits of that time, however, were disparaging about women in public life.9 In 1956, Life magazine published interviews with five prominent male psychiatrists who blamed the rising divorce rate on the “fatal error that feminism propagated.”10 They warned that women were neglecting their “maternal instincts, competing with their husbands, and causing psychological damage to their children.”

My father never shared the views of those who discouraged female ambition although he continues to believe that my mother was overextended, exhausted from her monumental juggling effort. And yet, there is something puzzling about this explanation from a man who is himself an accomplished lawyer, philanthropist, real estate developer, gentleman farmer, and father or stepfather to thirteen. He, in fact, has always been able to do it all. And even if my mother had been hanging on by a thread amid all that frantic activity, depressed and managing to hold it all in, what, as doctors like me want to know, was the “precipitating event”?