Suicide Watch

Health and medicine explained.
Nov. 22 1997 3:30 AM

Suicide Watch

The strange case of Air Force Capt. Craig Button.

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On April 2 this year, Air Force Capt. Craig Button suddenly went missing in an A-10 Thunderbolt fighter, finally crashing in Colorado. The evidence released by the Air Force this month indicates suicide. Why he did it is baffling, however. The case violates even psychiatrists' common notions about why people kill themselves.

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Button flew the third aircraft in a three-jet formation that left an Arizona Air Force base at 10:45 a.m. When the team reached the target bombing range, the flight leader ordered pilots to update their computers. Button confirmed the order at 11:57. Moments later, when the leader radioed in preparation for the bombing run, Button did not respond. The lead plane swung around to catch sight of Button. Despite 40-mile visibility, Button was nowhere to be found.

Ground radar, however, picked him up. Apparently, Button turned 100 degrees off his flight path and flew 500 miles straight into central Colorado. His altitude veered wildly. Sometimes he hugged terrain below 2,000 feet. Other times, he glided above 16,000 feet. Near Gold Dust Peak, he circled more than 360 degrees, then careened downward below the reach of ground radar. Reconstructed AWACs radar data showed Button briefly climbed back up to 19,000 feet, a mile above the highest mountain. Minutes later, at 1:40 p.m., he slammed into Gold Dust Peak at 13,000 feet.

Button didn't use any of his three radios. He didn't eject. He didn't attempt to land at any airports he flew over. He didn't turn on his Friend-or-Foe identification signal to let others track him. Yet Button's difficult maneuvers show that the plane functioned well and that he had full consciousness and capacity. The autopilot would have been incapable of these maneuvers. Everything indicated that Button deliberately flew into the mountain.

What a strange suicide, though. Button had hardly any risk factors. True, he was male (women attempt suicide more often, but men succeed five times more). And he had long tussled with his Jehovah's Witness parents over his abandoning the faith (organized religion lowers suicide rates). But nothing else fit.

Over 90 percent of suicide victims have a history of mental illness (most often depression) or substance abuse. Button had neither. On a recent visit to see him, his parents thought he was his energetic, driven self. Friends said he was enthusiastic about his coming assignment to Germany. He spoke of buying a motorcycle there and maybe finding a girl to bring home. He had had girlfriends before, but after three years in the desert town of Del Rio, Texas, he joked to a friend, "it was slim pickings." The night before the crash, his roommate said he'd ordered a large pizza so he'd have leftovers for the next night. During the mission briefing on the fateful day, Button was "cutting up and making his corny little jokes," just as he usually did.

Button showed no signs of substance abuse. No alcohol or drugs were found during the autopsy. He was in a stressful job, but that alone does not increase suicidal tendencies. At 32, Button was young, whereas the incidence of suicide increases with age and is highest among those over 65.

Harvard psychiatrist Martin Kelly points out, however, that in rare cases, suicide may not be motivated by emotional pain. For someone who doesn't attach meaning to death yet, suicide can be a sudden, rash way out of trouble. Button seemed like such a person. It wasn't just that he was a motorcycle-riding fighter pilot. He had a history of foolhardy judgment that suggested he didn't fully comprehend death's finality. During survival training in 1988, he was reprimanded for venturing recklessly far into uncharted wilderness. In 1996, against the rules, he buzzed Del Rio below 3,000 feet, blew a tire attempting a hotshot "short" landing, and left the authorized route during a cross-country training mission. Button was impulsive, a thrill-seeker.

When Button boarded his plane that day, Kelly suggests, suicide probably wasn't his plan, but his impulsiveness may have steered him into trouble and then into suicide. It's conceivable that he veered off on a whim. Perhaps he took a short joy ride or prematurely dropped a bomb (his four 500-pound bombs are still missing). Whatever the case, with each misstep he dug his hole deeper. As Button flew through Colorado, he may have come to see crashing as a viable way out because death had no meaning for him.

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A s unusual as Button's case is, it shares one common characteristic with nearly all the 30,000 suicides that occur each year in the United States--the victims are not in a rational state of mind. That may seem an obvious point, but it is one that we often ignore when assisted suicide is the topic. Like Mark Twain, who said that "suicide is the only sane thing the young or old ever do in this life," we imagine that the elderly and the ill desire death rationally. But our prejudices are showing. Suicidal patients, whatever their age or condition, almost always suffer from addiction or mental disease. Even when they do not, as with Button, they usually are not thinking rationally.

Button's suicide also shows how, even in peculiar cases, the desire to die arises from one's individual history and psychology. Yet, in public discussion of youthful suicide, we're often unwilling to trace it to such causes and try to place blame elsewhere--on television, music, movies. Earlier this month, a Senate subcommittee considering stricter restrictions on music lyrics heard an anguished father blame his son's suicide on shock rocker Marilyn Manson's music. The 15-year-old died with the band playing on his headphones. Numerous studies show that there is no association between music and suicide. (One found that country-music lovers had higher suicide rates, but subsequent research disputes these results.)

Of course, ideas do count. We know, for example, that one adolescent suicide can trigger others, even through media reports, leading to "suicide clusters." Had later victims not heard about the first suicide, they may not have done it when they did. But psychiatrists insist that an idea cannot compel even a child to commit suicide. It is only a proximate factor in a vulnerable person with stronger causes at work.

Usually, the causes are an addictive or mental disorder. Craig Button's case shows how much more complex they can be. And how bizarre.

Atul Gawande, M.D., writes a regular column on science and policy for Slate.

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