“I’m not trying to kill myself.” Though his expression was flat, Nigel McGowan’s color—at least how it appeared on my laptop screen—

was whiter than the wall behind him.

How many times have I heard those words? Another patient had sworn the same to me only two days before, during my week- end on call for the Anchorage Regional Hospital. That patient had begged me to free him from his involuntary confinement in the ER. But the raw ligature burns around his neck—from where the noose had yanked the hook free from the ceiling at the last moment—were far more persuasive than any of his pleas.