In the title story of Dantiel Moniz’s collection Milk Blood Heat (2021), teenage Ava plays at dying. She holds her breath in the bathtub, swings by her hands from a high branch of a sycamore tree. With her friend Kiera, she considers how it would feel to die, to be buried. Their suicidal thoughts are playful, ambivalent—“She doesn’t mean any of it, she doesn’t think.” But then Kiera acts on those thoughts, and she dies.
Reading “Milk Blood Heat,” I experienced the mix of shock and comfort I always feel when I encounter fiction that reflects an aspect of myself I’ve rarely seen portrayed on the page. I, too, played games of “what if?” Suicidal ideation felt more like a mental exercise, a philosophical question, until it shifted into an attempt. Unlike Kiera, I survived. Ava, too, survives; none of her experiments with suicide lead to a serious attempt. This makes “Milk Blood Heat” the latest entry on my short (and happily, if slowly, growing) list of stories with narrators who survive intent or attempts. It’s important to note that, according to the Suicide Prevention Resource Center, seven in eight people who consider suicide never attempt it. In addition, Suicide Awareness Voices of Education reports that ninety-six percent of people who attempt suicide survive, which means that a quarter of a million people enter the ranks of attempt survivors each year.
Despite these numbers, there are surprisingly few works of fiction in which the narrators are suicide survivors. The relative dearth of such stories does not indicate a lack of fiction featuring suicide. In Suicide Century: Literature and Suicide from James Joyce to David Foster Wallace, Andrew Bennett states, “Since Hamlet’s famous soliloquy, suicide has played a central, if mostly unacknowledged, role in the institution of literature.” Michelle Falkoff puts it more bluntly: Literature is “obsessed with suicide.” Evidence of this obsession can be found in the hundreds of titles on the Wikipedia entry “List of suicides in fiction” and in listicles such as “Thus with a Kiss: 10 Spectacular Suicides in Literature.” But the works cited are stories of completed suicides, usually told from the point of view of a bystander or loss survivor. Stories told by survivors of suicide attempts are much harder to find.
After my own suicide attempt, I searched in vain for stories with attempt-survivor narrators. I didn’t talk about my attempt with my family or friends. I was ashamed, and I lacked language to discuss or explain suicide. The only words I heard for what I’d experienced were from psychiatry—depression, dissociation, impulsivity. Suicide is referred to via euphemism: “Are you safe?” In fiction, I sought alternate language.
In the years since that attempt, I’ve found a few attempt-survivor stories. In Laura van den Berg’s story “Last Night” (2018) an adult narrator remembers her final night in a rehab facility where, at eighteen, she was admitted for treatment after “various attempts” to kill herself. In Akwaeke Emezi’s novel Freshwater (2018), the suicidality of the narrator, Ada, is the result of being an embodied ogbanje—“an Igbo spirit whose goal,” Emezi has said, “is to torment the human mother by dying unexpectedly.” Miriam Toews’s novel Women Talking (2019) is narrated by August Epp, a young Mennonite man who returns to his home colony of Molotschna, where he navigates acute suicidal intent with the assistance of Mennonite women. Moniz’s “Milk Blood Heat” is the latest entry on this short list.
Each of these stories engages directly with the difficulty of speaking and writing about suicide. In Women Talking, August lacks language to describe the distress that motivates his suicidal ideation. He remarks, half in envy, of one woman’s edema, “There must be satisfaction gained in accurately naming the thing that torments you.” In “Milk Blood Heat,” the word suicide is never used. Drowning is used instead. Kiera offers this word to Ava: “She recognized something in Ava’s face, something kindred to herself, and came to name it.” In “Last Night,” the narrator articulate an ongoing desire adjacent to suicide with the phrase, “I want a sober way to exist outside time.” In Freshwater, as Ada comes to better understand ogbanje, the language used to describe a shift toward the world of spirits changes from suicide to surrender and homecoming.
The radical reframing of suicidal thought and intent offered by these stories is clearest when they’re contrasted with a story of suicide completion. For this, I turn again to Toews, who has written about suicide completion in All My Puny Sorrows (2015), a novel that employs a structure common to tales told by suicide-loss survivors. Narrated by Yoli, whose sister Elf dies of suicide after repeated attempts, the book opens in the hospital after Elf’s second attempt. In the first scene, and throughout the novel, Yoli uses an array of strategies to keep her sister alive. She demands that Elf live. She begs. She organizes medical home-care teams. She makes use of emergency responders and hospitalization. She’s joined by her mother, whose attempts to keep Elf alive amount to “a full-time job.” In spite of their work, near the end of the novel, Elf dies.
Having experienced suicide loss, I recognize the necessity of a narrative focusing on the acute sense of responsibility that accompanies that grief, but, as an attempt survivor, All My Puny Sorrows brings me to despair. If Elf—a pianist of world renown, bolstered by a loving family, a steady partner, and the Canadian health-care system—cannot survive her ideation, how can anyone? Clearly, Yoli and her mother could not have prevented Elf’s death. The sheer number of novels that have this structure can make death by suicide seem inevitable for anyone who has lasting suicidal thoughts. Elf’s death is foreshadowed in the novel’s first image: Elf as a girl, leaning out over ocean cliffs, holding on to a thin rope. The novel’s very structure —three acts, three attempts, the last fatal—sets us up to expect Elf’s death. I read with dread, understanding from the start that the only outcome for Elf is to die.
Elf’s story is the one we have come to expect from suicide on the page. It’s the kind of story that makes “Last Night,” Freshwater, and Women Talking stand apart. In these three works, suicidal ideation does not lead to suicide completion. For example, in Women Talking, August’s suicidal thoughts lead not to his death but to the creation of the novel. The book is made up of minutes Ona, a woman in the Mennonite colony, asks August to be minute-taker after she sees him walking toward an empty field carrying a loaded gun—August “had been crying, again, wandering around the fields . . . determined that day to shoot [him]self.” When Ona asks him to take the minutes, he thinks “What could I tell her? That unfortunately I wouldn’t be able to take the minutes because I’d be fatally wounded from a self-inflected gunshot to my head?” Only at the end of the novel does August realize that “maybe there was no reason for the women to have minutes . . . The purpose, all along, was for me to take them . . . the minutes. Life.”
“Last Night” and Freshwater also suggest that suicidal thoughts can be a motivating, generative force. In “Last Night,” the narrator’s drive to “find a sober way to exist outside time” leads her to swim five mornings a week. Her desire to cultivate a “noisy” life motivates her to volunteer at a women’s shelter. In Freshwater, Ada’s suicide attempt propels her toward gender-affirming surgery and eventually toward an exploration of who she is, of the ọgbanje. Each of these stories ends with the narrator intent on survival at a significant cost. Van den Berg’s narrator reflects on “those ghosts I killed to survive.” Toews’s narrator lets go of a dream of life with the woman he loves and instead dedicates himself to teaching young men in his community. Emezi’s narrator shifts into a liminal space—“here and not here,” “human and spirit.” These endings offer a hard yet necessary hope of a kind rarely encountered in stories narrated by loss survivors: the hope that life after an attempt can be like any other life—fulfilling, difficult, long.
Most stories told by loss survivors end the way All My Puny Sorrows does: some time after the suicide. That these stories continue after death echoes one central distortion common to suicidal ideation. Individuals experiencing suicidal ideation often “seem to think they will continue to live after their death,” the social psychologist Roy Baumeister writes, “able to see events on earth,” including one’s funeral and “the effect of one’s suicide on others.” The ending of All My Puny Sorrows replicates this fatally incorrect belief that death by suicide is an incomplete death. Elf dies, and I—who have in spite of my best efforts identified all along with Elf—continue to exist. Elf receives letters from fans. I experience her family’s grief, their remembrance of her. I exist for the space of sixty pages within a sorrow that feels like love. For me, these are dangerous pages.
In contrast, stories whose narrators survive suicidal intent recognize the propensity to think of death as impermanent but don’t indulge that belief. In Freshwater, Ada swallows pills, convinced that the action is unreal, part of “floating lands and split selves,” that “none of this is happening.” “If you die in a video game,” she asks, “do you die in real life?” In “Milk Blood Heat,” Kiera, too, imagines the moments after dying as in a video game, as if “she’ll be asked, Continue? while flickering numbers on a screen count down, prompting her to restart.” Near the beginning of Women Talking, August, alone and suicidal, hears music when he is falling asleep. Eventually he realizes that “the song I heard at night, when I felt that my head was going to explode, was ‘Great is Thy Faithfulness,’ and that I was listening to my own funeral.” However, the reader never experiences the funerals of any of these narrators. Theirs is the work of surviving.
Narrators recounting suicide loss are preoccupied with reasons. Narrators who survive don’t offer reasons for their attempts and ideation. The three women in “Last Night” give no rationale for the fantasies of death they spin together on the train tracks. When the adults in “Milk Blood Heat” ask why Kiera took her own life, Ava tells us Kiera “chose to fall” because “she wanted to know what it felt like.” The question in these stories is not “why?” but “how?” How will August keep himself safe after the women leave? How will Ava survive the loss of Kiera? How can Ada’s flesh continue to house the ogbanje, that “village full of faces”? Yoli offers Elf reasons to live in parables, through memories, as metaphors. Elf offers reasons to die—she is in pain, she is exhausted, her mental-health struggles amount to a fatal illness. Elf’s arguments are compelling enough that Yoli nearly decides to help Elf die. All My Puny Sorrows asks whether Elf can escape suicide—why might she live, why might she die. We ask “why?” in grief. We ask “why?” when we are suicidal. We ask “how?” to survive.
Perhaps the most striking difference between stories narrated by loss survivors and those narrated by survivors of ideation and attempt is the degree to which they focus on suicide. All My Puny Sorrows is about suicide. Suicide suffuses every scene, every action. Yoli is terrified of losing Elf, and this terror is present on each page of the book. Even Yoli’s reprieves—sex, a cigarette with a friend, family dinners—are haunted by the specter of Elf’s suicide attempts, Elf’s hospitalization. I felt grief, but also relief, when Elf died. At least the constant dread, the constant worry, the waiting, was over. (This, I’d add, is a suicidal thought.) Elf’s family is not better off after Elf’s death. There is another option, one in which Elf recovers and joins her family in the messy scramble of life. But given the inevitability of All My Puny Sorrows, that option is unreachable.
Books like Freshwater and Women Talking aren’t about suicide. Most reviews of Women Talking don’t mention August’s suicidality. The book is billed by the Times as “a Mennonnite #MeToo novel.” Suicide is present in August’s extreme and critical self-consciousness—“I don’t have a catchy method of conversing and yet, unfortunately, suffer on a minute-to-minute basis the agony of the unexpressed thought”—yet many reviewers either missed August’s suicidal thoughts or considered them beside the point. Similarly, reviews of Freshwater center on Ada’s multiple selves and her coming-of-age journey. These novels are not perceived as being about suicide. In them, living is central.
“Milk Blood Heat” does center suicide. In this way, it is akin to stories narrated by loss survivors. Moniz, through Ava’s narration, reminds us that the experiences of those people who must carry on after death and those who survive their intent aren’t mutually exclusive. Many of us, like Ava in “Milk Blood Heat,” have had suicidal thoughts and also have lost someone to suicide. She recognizes the devastating effect of suicide loss on friends and family while resisting the narrative that suicidal thoughts inevitably lead to attempt or to death.
When I tell friends I wish there were more stories written from the point of view of people who have suicidal thoughts or have survived an attempt, they often say they imagine that these would be depressing narrations of nonfatal attempts or portraits of minds overrun with constant thoughts of suicide. But I’m seeking stories, like “Milk Blood Heat,” “Last Night,” Women Talking, and Freshwater, that remind us that people who think about suicide don’t live lives devoid of joy and humor, of connection, beauty, and wonder. In the minds of these narrators, suicide flares and recedes, flares and recedes. We need more works like these, which upend the narrative that there is a single, fatal version of what it means to be suicidal. We need these stories to remind us that death by suicide is never inevitable and that suicidal thoughts are only a part of the lives of those who experience them.
We need these stories not because they will prevent suicide. None of them are about prevention. Not because they offer reasons to live. They eschew reasons. We need these stories because we need more than one way for a story that includes suicide to end—in fiction as in life.