The death report was asking the wrong questions — whether the patient had drunk four to eight glasses of water daily, whether his diet was low in saturated fats and salt. Death had not been a result of junk food; it had been a result of suicide.

When it is your patient who has died, there is a fugitive quality to it: someone has fled, and you were unable to capture or return him alive. Diet and fluids are the least of the problem.

My patient had been an educated man, full of yearning. He wanted a mate and a job. Schizophrenia made both hard to find. I knew about his voices, and sometimes knew what his voices told him, but had come to believe that voices and patient coexisted in a delicate yet stable ecosystem. It was a false belief.

No one is immune from contemplating suicide. Demographic studies show that the population most at risk is single, urban, substance-abusing older white men with physical illness, few supports and low incomes.