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These views are becoming harder to discount. People age 65 and older are roughly 50 percent more likely to commit suicide than the rest of the population. White males over the age of 80 are at the greatest risk, killing themselves at six times the average rate. In Broward County, 51 seniors committed suicide in 1999. Many were lonely or depressed individuals who might have been aided by psychiatric care or counseling. But the majority of those who took their lives suffered from terminal or chronic illnesses and faced futures filled with pain, suffering, and staggering hospital bills.
One man who is exposed to the brutal reality of elderly suicide on a daily basis, Broward County Medical Examiner Joshua Perper, says he has come to support doctor-assisted suicide, if properly regulated. Seeing hundreds of grisly elderly suicides has influenced that decision, he says.
"Sometimes a person suffers beyond belief, and relief is not available," Perper says. "The life of that person is a living hell. Families suffer with the patients. It causes great emotional grief. People are tortured, and I don't believe people should ever be tortured."
In state houses and in Congress, debates are raging over doctor-assisted suicide. As baby boomers go gray and technology advances, more lives will be prolonged, often unintentionally adding to the suffering. Poll after poll shows that a majority of Americans support a terminal or chronically ill patient's right to die with a doctor's help. And yet such suicides are legal in only one state, Oregon, and a hotly debated federal bill threatens to make all doctor-assisted suicide illegal.
That means seniors such as Kantofsky will continue to take matters into their own hands. David McIntosh, a psychology professor at Indiana University and a leading expert on suicide among the elderly, says the media's tendency to ignore elderly suicides exacerbates the problem. While McIntosh agrees that a contagion effect can arise among adolescents, in the case of the elderly, he says, "talking about suicide doesn't cause suicide. It's just the opposite. People need to talk about it."
George Julian was a World War II hero who flew glider planes on missions behind enemy lines. He was also an accomplished pugilist who taught both boxing and judo in the military. But his lifelong love -- from the time he was a 14-year-old jockey -- was horseracing.
After years of traveling the country with his wife, Elsie, he settled down in Florida to work full-time training horses at Calder Race Course when it opened in 1971. Julian was headstrong and opinionated, making him a favorite in The Miami Herald sports pages, where he was quoted through the years on everything from the quirks of his horses to the history of racing. In 1990, when Julian's best horse ever, Run Turn, failed to make the Kentucky Derby, he told reporters: "I've been in the game since the 1930s. I never got to ride in a Derby or a Preakness. Now I wonder if I'm good enough to bring a horse there. Do you know what that would've meant to me? To my wife?"
Julian never did make the Derby, but he also never lost his love of racing and remained a fixture at the track, as did his dog, Benji, who Julian would fit with a bombardier's jacket on chilly mornings. Earlier this year when Benji was no longer allowed at the track by Calder's new owners, Julian feared his beloved dog might die from loneliness. About the same time, Julian himself became sick. Doctors found lesions on his liver. It was feared the 83-year-old had cancer. Within weeks the once-robust trainer was weak and thin and unable to make it to the track. Before tests were done to see if it was cancer, Julian crouched beside his bed and shot himself with a rifle. His wife, awakened by the blast, found his body in the corner of the room.
"He knew it was the end," Elsie Julian says. "He said, 'You know, I'm not going to get through this.' He always had to be on top. And killing himself was the easiest thing to do." She says people sometimes ask her, "How could he have done that to you?" Instead of dwelling on that unanswerable question, she likes to remember that her tough husband was also tender and brought her fresh-cut flowers every week for decades. He was 83 years old when he died. Benji is living out his old age at a farm.
What Elsie Julian saw when she walked into that room is too graphic to describe here. She doesn't like to talk about it -- in fact she, like many other survivors of suicide in the family, was reluctant to talk about her husband's suicide at all. The trauma of her husband's death, in fact, puts her -- and Horn in Kantofsky's case -- at risk for serious emotional problems, says psychology professor McIntosh.
They aren't alone. In Oregon, where a terminally ill patient can legally decide to take his or her own life, the method of death is decidedly peaceful. They take Pentothal, a powerful sedative. In a matter of minutes, the patient, often being comforted by loved ones, quietly dies. But in Florida and other states, the unavoidable consequence of suicide is carnage.