RISK ASSESSMENT | Jeanna Ford
Grief teaches you quickly what makes other people uncomfortable. I learned that as a little girl, after my father died by suicide. In the time that followed, adults said things to me that should never be said to a grieving child. “You’re lucky he died when you were young. You won’t be so attached.” “You don’t realize this now, but one day you will be grateful not to have him around. He clearly had his demons.” “He committed suicide?” The emphasis always on committed, as though it were a crime. Some asked if I worried I would do it too, whether my future children might someday. One person told me my father was condemned to hell. I was twelve. Yet somehow, in those moments, I found myself comforting the adults around me, managing their discomfort while carrying my own grief.
It did not take long to learn that telling the truth about suicide changed the room. People became uneasy, curious, and clinical. So I started lying. I told people my father died in a car accident. People knew what to do with a car accident. They knew how to grieve that kind of loss. Loss became easier for people to hold when it could be called an accident. Suicide was different. Suicide made people search for cause, contagion, and blame. Children learn quickly which truths are safe for other people. I carried that lie for years, into adulthood, into my relationships, into my career in medicine, and even into my own medical record.
Then decades later, my mother actually died in a car accident. There is something almost cruel in that irony. The lie I had used to make my father’s death easier for others became true in another way. Her death was sudden, violent, and disorienting. It turned our world upside down and crumbled the foundation we had known. In the months that followed, grief settled into my body in familiar ways: insomnia, forgetfulness, irritability, and exhaustion. Not ordinary tiredness, but the kind where you wake up tired and go to sleep tired. A deep, profound tired that settles into your bones and permeates your core.
A few months after her death, I had a virtual follow-up with my primary care physician. Nothing extraordinary, just my annual labs, something I am diligent about, perhaps because in a life where so much can be lost without warning, routine can feel like control. My physician asked how I was doing and noted that I looked different. I told her my mother had died unexpectedly in a car accident. She offered condolences as she typed furiously, never making eye contact.
Then she shifted.
“Statistically speaking, because of the traumatic loss of your mother, and because your father died by suicide, you are at greater risk of committing suicide.”
The room changed. Not into a room of comfort, but into a room of assessment.
“Do you have a plan?”
I was taken aback. I fumbled and said, “I’m sorry?”
She asked again.
“Do you have a plan?”
Suddenly I felt like a little girl again, watching the truth alter the room. I said something I had not planned to say, and it came out more like a whisper.
“I don’t even know how you found out he died by suicide.”
For years, I had hidden it because I knew what happened when people knew. They stopped seeing grief and started seeing risk. They stopped seeing my beloved, educated, larger-than-life father and started seeing statistics. They stopped seeing me and started calculating probability. Then I said the thing I had carried for years.
“I always tell people it was a car accident because of people like you.”
It was sharp, but it was honest.
“It was never your business to reduce how he died to a risk factor. He was not a statistic. And neither am I. Or my sons.”
Her response was immediate.
“Do you have a plan?”
Not a pause. Not curiosity. Just the question again.
That was the moment I yelled. Not because she asked, but because she could not hear my answer or even see me. I slammed my hand down on the desk, aware even as I did it that I was fitting the stereotype in real time: angry, grieving, raising my voice, agitated, tears streaming down my face. The very things that could now be read as evidence of risk.
I shouted, “Do your studies and statistics and checklists tell you about the heartbreak? About the devastation suicide leaves behind for families? Because I lived it. That was my childhood. That was my truth.”
Then I told her about my sister and me, how after our father died, we made a promise to one another that we would never do that to each other, never leave that kind of wreckage behind, never do that to our future children. It was a promise we still revisit, a promise forged not from theory, but from survival.
“Tell me about those statistics,” I said as I angrily wiped my tears.
Her voice changed then, less certain, almost stammering.
“Ma’am, all I need to know is, do you have a plan?”
And suddenly the whole conversation collapsed into that single question, as though everything I had said, every wound I had described, every act of resistance I had built into my life over the past thirty years, was secondary to a binary answer.
I whispered, “No.”
No plan. Just grief as I sat back in my chair, utterly defeated.
Later, I read the note from that visit. She documented that I appeared sad, tired, and angry. She was right. I was. Grief carries an exhaustion like no other. It is not the kind of tired that sleep fixes. It is the kind where you wake up tired and go to sleep tired, a deep, profound tired that settles into your bones and permeates your core.
But what struck me was not what she wrote. It was what the chart could not hold. There was no place for the history behind my anger, no place for the years spent hiding the truth because of what follows suicide loss, and no place for how hard I had worked against the inheritance people seemed to expect. Not because achievement erases grief, but because I understood early what people expected from children like me: children of suicide, children of trauma, future risk.
So, I built my life with intention. Four college degrees. A career in palliative care, walking alongside suffering, loss, and death every day. A profession that taught me how fragile life is and how sacred human presence can be, especially in grief. A home where my children were protected, loved, educated, and safe. I was vigilant about what entered our home, what shaped their childhood, and what wounds I refused to pass down. No substance abuse. No chaos normalized. No silence around pain. I worked carefully, consciously, to interrupt inheritance.
There is no checklist for that. No algorithm for resilience. No screening tool for the daily labor of refusing to pass trauma forward. Only the enduring reminder that statistically, we remain at risk, as though all that work, all that intention, all that love still collapses into probability.
The chart captured my affect, but not the rupture. That is one of medicine’s quiet limitations. It records what is observable while often losing what is relational. To the next clinician reading that note, I am a woman who appeared sad, tired, and angry. That is true. But it is not the whole truth.
As a clinician, I understand suicide screening. I understand why we ask hard questions. I recognized the script she was following because I have followed scripts myself. I know the evidence on suicide survivorship and increased risk. The data matters. But data without context can become its own kind of harm.
Risk assessment matters. But so does timing, language, and most of all, presence. There is a difference between assessing risk and reducing someone to it. What I needed in that moment was not for my history to be ignored. It mattered. But I needed a moment to be a daughter before becoming a risk profile, a moment for someone to ask how I was carrying this, who was helping me survive it, and what this loss had been like.
Healthcare teaches us to identify danger, intervene, and document. But we spend far less time learning how to sit with grief, especially suicide grief, without rushing to categorize it and without making survivors carry our discomfort too. That was the first thing I learned after my father died, that adults often needed me to make their discomfort easier. Decades later, sitting in a medical appointment after losing my mother, I realized how little had changed. The truth about suicide still changes the room. It still invites fear before empathy, assessment before presence, checklist before witness.
Some losses do not need to be assessed before they are witnessed.
Jeanna Ford is a palliative care advanced practice nurse based in New Mexico. Her clinical work focuses on serious illness communication, symptom management and end-of-life care, with particular attention to ethical complexity, grief and culturally grounded care. Ford has spent her career walking alongside patients and families through serious illness, loss and the realities of dying, experiences that continue to shape both her practice and her writing. Ford also teaches and speaks nationally on palliative care, communication and ethics. Her writing explores grief, medicine, identity and the human experiences that live at the intersection of healthcare and loss.