Debate over guns, suicide can feel personal for Colorado doctors

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6min 50sec
(Photo: Ansel Adams)
<p>Longs Peak was a shared object of affection between Dr. Frank Dumont and one of his patients, who committed suicide.</p>
Photo: Longs Peak
Longs Peak was a shared object of affection between Dr. Frank Dumont and one of his patients, who committed suicide.

This is a transcript of Eric’s story.

CPR Health Reporter Eric Whitney: Standing on the front porch of the Stanley Hotel in Estes Park, Dr. Frank Dumont takes in the view of Rocky Mountain National Park, just south of town.

Dr. Frank Dumont: You can actually see the outlines of Longs Peak up there, Mt. Lady Washington, sitting in front of it, which you have to hike around to get to the top.

Reporter: Longs Peak is a cherished part of Dr. Dumont’s life. He grew up in Loveland and has climbed Long’s many times since he was a kid. And love for the mountain is something he shared with one particular patient of his.

Dumont: I think he felt that same sense, of it being a part of his life and who he was.

Reporter: The patient, whose name we’re not using to protect his family’s privacy, was in his 70s when Dr. Dumont first started seeing him. He was active and fit and still enjoyed hiking in the park into his 80s. But then things started to change.

Dumont: So he started complaining after a few years, of his memory starting to slip, and having trouble with issues like remembering things that had happened recently, and remembering where he had placed objects, and maybe trying to think of an individual word he was trying to come up with.

Reporter: Pretty typical stuff for the many older patients Dr. Dumont sees. Also pretty typical for this patient to start feeling depressed that his mind was starting to slip, and that aches and pains from arthritis meant he couldn’t do as much hiking as he used to.

Primary care doctors treat a lot of patients for depression, actually, more people get help for that from family doctors than from psychiatrists. Dr. Dumont prescribed anti-depressant medication and scheduled visits with him every other month to keep track of how he was doing.That seemed to be helping, the patient seemed to be doing better. One particular visit stands out in Dumont’s memory.

Dumont: What in hindsight struck me about that visit is that he brought me a gift, which was a geological survey marker from the top of Long’s Peak, it was actually a replica of that, but it was one of those things that was just another reminder to me of this connection that we had had. And at the time it just seemed like a very generous gift that touched me. And what I didn’t realize at the time was that that was, I think, a farewell gift or a bit of a parting gift from him. Because I did not see him again, and the next that I had heard of him was from an emergency phone call from his wife about a month later, and she called needing to be seen. She’s also my patient, and still is my patient, and she had to come in and talk to me with how to deal with the fact her husband had committed suicide.

Reporter: Dr. Dumont says he didn’t see it coming. He says he asks every patient he treats for depression if they’re thinking about suicide, or have thought of a plan to kill themselves. This patient said no. Dr. Dumont says he took the patient at his word, and felt he knew him well enough that saw no reason to doubt him.

Dr. Matthew Miller, a suicide prevention researcher at the Harvard School of Public Health says Dr. Dumont didn’t do anything outside what’s expected of good family doctors.

Dr. Matthew Miller: He’s not making an excuse, and he actually sounds like an incredibly brave and honest caretaker.

Dr. Miller is working to help give family physicians like Dr. Dumont a better understanding of what they can do to reduce suicide risk.

Miller: He was doing everything he could to try to keep this guy from making a suicide attempt, but what he didn’t do was the second step, which is make it hard for him to die if he did make an attempt.

Reporter: The second step, Dr. Miller says, is asking patients if they have guns in the house or access to guns. That’s because if someone tries to commit suicide without using a gun, chances are a lot lower they’ll be successful.

Miller: The likelihood of their dying is of an order of magnitude lower. Instead of there being a 90-plus percent chance of death, there’s a greater than 90 percent chance that they’ll live.

Reporter: Dr. Miller wants to make it routine for family doctors to ask their patients about guns. One large study found that nearly half of all suicide victims had seen a primary care doctor within a month of killing themselves.

Miller: This is not about gun control, this is about helping people make more informed decisions that are in their own enlightened self-interest. And maybe that’s another part of the equation, that we have to get people to stop thinking about these discussions as gun control in one way or another, but rather as a way of conveying useful information, so people make decisions that protect their family.

Reporter: Dr. Miller says he can think of lots of reasons why family doctors don’t bring up guns with their patients, even ones who are depressed – everything from not wanting to offend someone, to simply being too busy, making sure they’re doing all the screenings and tests that are proven to extend their patient’s lives. Miller wants more research to help figure out how to help doctors talk more often with patients about guns.

Dr. Frank Dumont has spent a lot of time second-guessing himself since his patient shot himself a few years ago.

Dumont: Stereotypes are interesting things. This was not an individual I had ever spoken to about hunting or about shooting or anything recreational or anything. And so the things we had always talked about were the very same types of things I do and I do with my kids, it was hiking, it was spending time in the park. And so in truth, I had probably fallen into this kind stereotypical view of thinking, well, he’s probably not even a gun owner, or maybe he has a gun but he doesn’t ever even use it. And so I think it surprised me that he owned a gun. I think it surprised me that he used a gun.

Reporter: Dumont says the experience has made him more likely to ask patients about suicidal thoughts, and he’s more careful about watching their body language and facial expressions when they answer.

Dumont: And I have a lower threshold for asking follow-up questions, asking the same thing a different way. Or if I have any inkling, starting to push a little bit further, and say, well, so you’re not really thinking about it, but have you ever thought about how you would go about it if you were doing to? And I would have a lower threshold for asking about a weapon in the home as well.

Reporter: Drs Dumont and Miller both think that President Obama’s recent executive order to fund gun safety research at the Centers for Disease Control and Prevention could help family doctors with suicide prevention. The CDC offers research on best medical practices that gets shared with doctors across the country, and with the ban on studying gun safety lifted, more doctors may learn about addressing guns as part of keeping their patients healthy and safe.

[Photo of Longs Peak: Ansel Adams]