I was 36 when I finally became a doctor. I say finally because the eight years I spent working toward my PhD were the longest, most painstaking years of my existence. Depressed and overwhelmed both with life and the impossible expectations I had set for myself and others, I thought constantly about quitting. I agonized over writing my dissertation, crafting the words so torturously some days that I felt I was using a scalpel to chisel down deep into my bones. At home, in front of my computer, I prayed daily for the courage to quit and also, simultaneously, for the strength to continue. I told myself that quitting would haunt me for the rest of my days, and come at too great a cost. I said these words as I relentlessly purged and starved myself, as I cut and scratched and left marks on my skin, and as thoughts of suicide bloomed big and warm and bright in my mind. I worried over and feared the costs of quitting. I had absolutely no concept then of just what it was costing me to persevere. 

Lately, I have been thinking a lot about what it means to quit, and about the complicated and often conflicting valuations society tends to place on that. If I am being honest I will tell you there is a whole host of things I have wanted to quit in my life, and some (like smoking) I’ve done successfully and without regret. It’s been my experience that praise is generally handed out when the thing one is attempting to quit is deemed a bad habit or else seen as not serving in a good or productive way. In those instances it seems there is endless space for conversation for thinking about and sharing strategies, and offering and receiving encouragement and support. When, however, the desire to quit centres on something as monumental as “life itself,” then the room typically goes quiet. We struggle to name it and to say the words, meanwhile, too often, our witnesses sit composed and in judgment, protected by their silence. 

On bad days I dream about and find comfort in, the thought of quitting life, my final gasp for air. And yet, I also worry over the ways that sharing these thoughts and voicing my desire may impact the people who love and care about me. On my worst days can I tell you that I desire to die and will you respond with something other than a gasp that echoes my last gasp, the one that permeates and haunts my dreams? Will you acknowledge my pain and not look upon me with pity, derision, skepticism, condemnation, accusation? Will you say something thoughtful as opposed to showering me with platitudes: You should be grateful. You are beautiful. You have everything. If words escape you will you be there anyway, sit with me in silence, and allow yourself to feel something? Can we be less afraid to feel something?

Recently, I have noticed a post circulating on social media sites that has given me pause for thought. Attributed to the graffiti artist known as Banksy, the quotation reads, “If you get tired, learn to rest and not to quit.” I understand the appeal of these words, the way they can help to encourage, uplift, and propel us through hopeless and despairing times. I hear in them an insistent plea to keep going, to not give up, and a promise that if we can commit and discipline ourselves just enough, and not overdo it, then things will get better. These words remind us that we are, each one of us, our own best resource, that we all have an intuitive internal voice waiting to be tapped into and listened to when life becomes too much and is in need of rebalance. 

What they seem not to touch, however, is the extent to which, for many of us, a compulsion almost always speaks more loudly than, and often bullies that calm and caring inner voice of reason. While in the vice grip of my eating disorder, for instance, and thus convinced that I have gained significant weight over night, I will punish and purge myself the next day with exercise. Running to the point of near exhaustion, I will perform excruciating penance for yielding to appetite and indulging my physical hunger. On a low day, in the hope of feeling better, I will wander outside and take a walk. Yet suddenly hand in hand with the thought of suicide, I will forget the beauty of my surroundings and instead focus on the sweet relief, the deep dark nothingness I imagine will overtake my body as it meets with oncoming traffic. On these days I am so tired that resting does not seem a possibility. On these days I am so despairing that I desire only to quit.

How do we meet ourselves halfway? Perhaps it is the reference to “learning” in the quote from Banksy that holds some possibility for me. After all, learning, while it can be, and often is, a solitary endeavour, does not happen in isolation. As a foundation for community, it requires that words, ideas, and experiences be circulated and shared. It should not be news to anyone these days that mental illness flourishes in environments of secrecy and silence. And yet we should not easily assume that “talking about it” in every instance is enough, or that words, by virtue of their ability to excavate, reflect, and enlighten, necessarily save lives. Indeed, I have been both witness to and participant in too many conversations about mental health and recovery lately which have claimed to foster openness and meaningful dialogue yet have, in the end, accomplished something quite the opposite. 

A critical part of learning to live with mental illness involves, in my view, being honest about and feeling supported in not just our desire but our fundamental need to speak about and to name – regardless of how difficult it may be for others to hear – how it feels to live and, equally, to not want to live in a body that suffers here and now in the present. The hopeful but seemingly ceaseless and distracting focus on the future and the promise of better things to come through eventual recovery diverts necessary attention away from the energy required for grappling with the hard truths and the hard work of living now. 

As Toronto-based trans artist Vivek Shraya chronicles in her brave new short film, I Want to Kill Myself, one of the most difficult things about suicidal ideation involves coming to terms with and ultimately finding a means to express “the ways that living [are] often...connected to not wanting to live.” Asking “how do I make art in relationship to suicide?” Shraya demonstrates, through a breathtaking essay and companion series of photographs, the ways in which saying the words ‘I want to kill myself’ has in fact been productive of this very project and sustaining, ultimately, of life. States Shraya: “Saying ‘I want to kill myself made my pain explicit. Saying ‘I want to kill myself’ to the people who love me meant I was shown an immediate and specific kind of care that I desperately needed. Saying ‘I want to kill myself’ kept me alive.”

Powerful beyond words, Shraya’s film implicitly acknowledges the hurts of its viewers and at the same time gives us permission. The profound lesson it teaches is that it is okay to feel we want to quit, and that giving voice to those feelings, bringing them out into the open and letting them be known may actually save lives. For those of us who have been encouraged and even compelled to be silent about the abuses and traumas we have suffered at the hands of those who claim to love us, the authorization to finally speak feels so much like sweet, ecstatic relief. That the channel for such authorization is provocative, beautifully contemplative, and uncomfortable art makes that sense of relief for me all the more potent. 

Indeed, in our time of social media, where instant but inherently superficial virtual connections have been widely established as a reasonable substitution for the meeting of real, material, flesh-and-blood bodies, and as the new cornerstone of community, the diligent task of making art reminds us that there does still exist other, more thoughtful, genuine, and enduring possibilities for connection, communication, and even love. I have long known from my own work that to make art requires a particular kind of patience and care. Yet, it occurs to me now, in light of the film, that the patience necessary to make art may well teach other types of patience. Like the patience to love oneself always, as much as we love others and to keep at it no matter what; to rest if, at times, that’s what we need, but never, ever to quit.


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