a lot of the questions i get from outsiders have to do with people killing themselves. is it your fault? do you feel endless remorse? the short answer to the first question, apparently, is no. beyond a certain point, if someone is sad enough, and sick enough, and wants to kill himself badly enough, he'll find a way, no matter what you say or do.

i suppose this is true, although it does also hint at a built-in justification for incompetence. it's also very hard to accept, no matter how many times you say it to yourself. sometimes people just die. i was flipping through complications, by atul gawande the other day; his thesis is that we, as society, find mistakes by doctors and nurses impermissible, and by doing so hold them to essentially impossible standards. which is true, and perhaps even necessary. there's such a fine balance here; on the one hand, health care professionals are (tragically) human, like the rest of us, and on the other, if we draw the line anywhere beneath perfection, how do you ever define the criterion point for acceptable, especially with our modern insistence that a human life is of either undefinable or infinite value?

as for remorse, that's a deeper question. on house last season, foreman screws up and kills someone, and hugh laurie tells him at the end of the episode to go home, have a few drinks, come back the next day and do it all over again, that he can't offer forgiveness because there's nothing to forgive. i think what is closer to the truth is that forgiveness isn't possible if there's no clear concept of what sin is. medicine, flawed as it is, at least attempts to define what can be cured and what can't, when it's reasonable to pull the plug. psychologists have coarse instruments, "clinical judgment", and worse still, for people who are poorly-trained, half-baked, superstitious notions of a patient's prognosis. and people kill themselves, sometimes out of an orange-colored sky, and you wonder: is there anything to forgive? do i take this guilt upon myself? and sometimes, i think, you just really, really don't know.