Earlier I had been preparing for sleep when the nurse called from Emergency: "The ambos are bringing in a woman who tried to hang herself. They cut her down." The person I saw was not young, not old, not weeping but composed, her face set tight. She sat upright, rigid, her arms pressing down hard on the mattress, her gaze unseeing, a woman coming to terms with the shock, the factuality of remaining alive. "My name's Howard. I'm new here. What's your name?" "Lucy*, Doctor." Clear speech, no alcohol on the breath, no tears, just a stillness.

"What is your work, Lucy?" "I'm an intensive care paramedic. At least I was." A quiver of a smile, subtle acknowledgement of a role reversed. Anxiously I examined Lucy's neck: all intact apart from minor rope burns. Her upper limbs moved normally. She felt a light touch down to her fingers. I asked, "Lucy, was it an impulse?" "No." A shake of the head, full focus on my question, a considered reply, quietly emphatic. '"Have you been depressed, Lucy?"

The head nodded in affirmation, the neck moving with alarming freedom. "I've been fighting it for 20 years." The answer, calm and rational, the expression pregnant. "After fighting it for so long can you say what triggered your action tonight, Lucy?" Quietly Lucy told me the story. Afterwards it was her quietude that stayed with me. A voice that traversed less than one metre seemed to cross a great distance. I had to concentrate hard to hear: "It was the photo of my nephew in his new police uniform that did it. When I looked at that photo I saw another police officer, one I didn't save ... " The voice slowed, dropped: "He was my friend. I didn't save him. I cannulated him, I intubated him, and I lost him. He died in my arms." A pause. I waited.

"He was shot. We were friends. Earlier that same day we drank coffee together. It comes back to me ... "Other things too ... " Another pause. Lucy's head sank upon her chest. Softer than ever I caught her whisper, "I know I've harmed my relationship with the person I love most." Our conversation took place in the hustle and bustle of the Emergency Department. Present too were Lucy's paramedic colleagues, the young man and a young woman who brought her in. And a couple of police officers, likewise junior. The ambos told me of the tree branch from which Lucy had jumped, its height, details of the cord and its knots: "When she jumped the rope gripped momentarily then snapped. She fell to the ground."

The police officers, soft-faced like teenagers, told me: "She left a note for her family. She called 000 herself. She left the wrong address, but we found her. She said she waited until she heard our sirens." I saw these people, our guardians - professionally trained for the unexpected - seeing themselves anew in Lucy. Two boys, two girls, deeply disturbed by questions never before contemplated, questions they were now asking themselves. The guardians' faces registered an anxious tenderness. Out west here, our hospital* handles small problems. Big problems call for Flying Doctors and Big Problem Hospitals. Psychosis is a big problem, too big for us. Imminent suicide risk likewise. In the course of our talking Lucy has spoken directly, simply. Neither grief, nor anxiety has overwhelmed her. Neither has she enhanced or dramatised her story, nor has she minimised or denied the presence of great pain. A question pressed me: "Lucy, do you want to die?"

A slow shake of the head, a steady gaze. "Lucy, do you think you'll be safe here with us?" Not naïve to risk, Lucy looked up. "I'll be safe here." In the morning Lucy greeted me with a smile. Her skinned neck was less angry. With more to hear and Lucy alert and keen to tell we walked to shaded seats in the hospital gardens. "Lucy, you said you'd hurt your most precious relationship. Which is that?"

"With my son. After harming it with so many years of anxieties and depression I was sure I'd finally destroyed it by trying to take my life. I wrote him a letter. I said, It is not your fault I am doing this. You are not to blame, I am. You are the best thing that has ever happened to me. If it weren't for you I would have done this years ago. You could not have prevented this. You could not have saved me. Please try to understand. Please forgive me." "And does he understand? Has he forgiven you?" "Yes, yes!" Another Lucy smile. "You mentioned other events that haunt you. Do you feel up to talking about them?"

"Yes. I want to. You know no one trained us to look for support after trauma. Emergency services never imagined today's counselling and support. We did our work, and buried our pain. "Anyway - here goes: The worst experience was a call to a road accident. I pulled up at the address and I got out. I followed a trail of blood and some grey material. I found a young woman weeping. And a man standing to one side, silent, stunned. They wouldn't have been older than 25, an Asian couple, maybe Thai. The woman held a baby in her arms. I looked and I saw: the baby had no head. I reached to take the baby to examine it but she would not let go. I sat with her and held her. We sat like that for a long time. A long time. She wouldn't let the baby go. "There were speed bumps on the paved driveway. The woman drove to buy food when she felt a bump. She thought it was the speed bump. She had to do a three-point turn and she felt the bump again. She thought the toddler was inside with her husband. It was only the screaming of the neighbour that told her something was wrong. She held that baby ... "I saw both parents wore crucifixes. I asked do you want me to call a priest? They said yes. I called the ambulance chaplain. He came and while he said the prayers for the end of life the young mother let me hold the child. She was a little girl, their only child. "After a long time I remembered my ambulance: I'd left it open at the roadside. Open – with all its equipment and the emergency drugs, those opiates ... I was shocked at myself.

"I went back to the family. At the end the mother trusted me to take her baby to the hospital for a doctor to certify life extinct. She wanted me to hold the baby, only me ... I went to the vehicle and brought back a bunny rug for the little girl. "I sat in the back holding the baby in her rug during the trip to the hospital. I remember I held her and I was praying. "A doctor came out and certified the death. Someone else took her to the morgue. I couldn't do that." I listened to this account, like her story of her friend the policeman, experience recalled as of one alone. I asked, "You'd have worked with a partner on those jobs?" "Always. There was always a partner but that didn't mean you weren't alone. That morning - the morning of the baby – my partner was new, very junior. I'd been in the service 14 years. It was our first morning together. We arrived, he saw there was no life to save so he wandered off. He spent those hours chatting up the pretty police officer at the scene. He didn't see anything to be done for the parents.

"I wasn't a drinker but I bought a bottle of wine on the way home. When I got home and looked in the mirror I saw the blood and the grey. I washed the uniform and I drank the bottle. I was drunk for two days. I washed my uniform again and again, I couldn't get it clean ... " "I drank too much for too long. Later I got hooked on benzos. Finally I broke free of them." The woman who spoke of these unspeakable things has an ordinary face. Normal: that's the word that comes to mind, normal. Fair skin, the face a little lined in the ordinary way of people in their 50s. Lucy smiles readily. The sun and shade in the garden dappled her face, a face trained to this immensely costly, ostensible calm. This so nearly fatal calm. *Names and locations have been changed. Lifeline 131 114 and SuicideLine 1300 651 251