Royal Prank Fallout

Death of Kate Middleton Nurse Shows How Humiliation Can Lead to Suicide

Dr. Kent Sepkowitz on how humiliation has joined factors like depression and financial problems in pushing people over the edge.

The Further Adventures of Will and Kate, that popular long-running entertainment, took an extremely dark turn last week when Jacintha Saldanha, a nurse involved in Kate’s care at the King Edward VII Hospital, committed suicide after being sucked in by a sophomoric ruse.

The basics of the story are by now well known: the newly pregnant Kate was hospitalized for treatment of hyperemesis gravidarum, a severe form of morning sickness. While she was there receiving treatment, a pair of prankster Australian disc jockeys called the hospital, pretending to be Queen Elizabeth II and her husband, Prince Philip. They somehow got through the hospital switchboard and were connected to Ms. Saldanha, who unsuspectingly forwarded the call to the nurse caring for the Duchess of Cambridge. This second nurse, whose name is not known, then answered a few simple questions about Kate’s condition. Though royal security was breached by a pair of amateurs, no interesting beans were spilled; no naughty details or anything beyond the most boring hospital detail revealed. The hospital found the disclosure so bland that they had no plan to even bother reprimanding Ms. Saldanha.

In fact, the story seemed to be about another bit of good fun, an audaciously executed fast one that the perps had gotten away with. But then Ms. Saldanha, the mother of two teenagers, was found dead at her home. Almost immediately, the stations and other media outlets that had gloried in the trick went all Edward R. Murrow. Right, Left, and Center adopted a posture of highest moral dudgeon (another ugly ruse), calling the Australian radio station detestable and insisting everyone associated with the tragedy be fired. Yes they really showed toughness in standing up to this sort of senseless jackass (and ratings-grabbing) behavior.

This is not, however, yet another story about media hypocrisy as articulated by the media, but rather a scary reminder of just how unpredictable human behavior can be. By any account, Ms. Saldanha seemed a sturdy person. She had grown up in India and had worked as a nurse in London for 10 years or so with her husband, who also worked at the hospital and is the father of her two children.

As with all guess-work regarding anyone in the public or private sphere, ultimately, no one has a clue. Suicide, and more specifically suicide prevention, though, have been topical recently, after the suicide of a professional football player. This event was sufficiently startling that a different sport—pro baseball—appears ready to begin screening players for risk, using tools developed in academia and by the military.

According to the Centers for Disease Control and Prevention (CDC), about 100 suicides occur daily in the U.S., and men outnumber women four to one. Many of those who die have alcohol, antidepressants, and/or pain medications in their bloodstreams at death. Those who kill themselves also have high rates of physical-health problems, problems with a loved one, or problems with a job or with finances. In addition, persons with a heightened sense of hopelessness or of being a burden to others have an increased rate of suicide Indeed, the Beck Hopelessness Scale, a 20-question screen, is one of many used to identify persons at risk.

With the recent focus on bullying sparked by suicides of young people who were hectored as outcasts, a new or newly articulated risk factor for suicide has gained currency: humiliation. Though certainly related to hopelessness and to real or threatened financial embarrassment, humiliation is its own very private experience, with its own equally private triggers. How and why certain events might brutally transgress honor and dignity in one person yet the same events barely touch the next, remains inscrutable. In this particular tragedy, it seems a sense that she was being publicly ridiculed—humiliated—somehow pushed Ms. Saldanha over the edge, an edge previously defined and maintained by her tremendous pride in her work.

As the entire debacle is digested, the lessons likely to be emphasized will be that mischievous DJs, like alcoholic friends, are not worth the transient fun they might provide, and that hospital switchboards need to review their M.O. when a famous patient is on board. The real lesson, though, a renewed respect for the delicacy and tentativeness with which we all are held together, is likely to stay far from the discussion.

Yet, as the suicides of Jacintha Saldanha and the recent spate of mostly young, mostly gay, always frightened men and women have shown us, the deeper we dig into the confusing world of human behavior, the less we seem to understand. All the more reason, then, to maintain basic human decency and respect in all exchanges, even—perhaps especially—those meant in jest.