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By Dr Zulfikar BuxOne who is depressed and has suicidal thoughts will often think of ways to take their life. DrinkingDr Zulfikar Buxpoison is a common way of suicide in Guyana. It is portrayed in movies as a dramatic and very fast way of taking your life. Not widely known and portrayed are the punishing effects that one has to experience once they drink lethal doses of poison.To see a patient show remorse for their actions and have a punishing death is never a happy moment for medical personnel. The suffering and pains of someone who drank poison are etched in the memories of every healthcare worker that experiences this moment of turmoil. There are those that are saved and given a second chance in life while others are not so fortunate.Today I wish to shed some light on the pains and suffering associated with drinking poison that are not often known. I will discuss the three most common categories of poisons that cause deaths in Guyana. For obvious reasons the brand names will be withheld, but these three groups represent the majority of suicide-related poisons in Guyana.ORGANOPHOSPHATESThese are used by farmers as a fast-acting pesticide/herbicide. Unfortunately they act even faster in humans. Someone who drinks an organophosphate will have a horrible experience. Think about the worst episode of vomiting and diarrhea you have ever had in your life.What if I told you that drinking an organophosphate will make your worst experience with vomiting and diarrhea look like a “walk in the park”?These patients would vomit and have diarrhea faster than a nurse can clean and change them. They will complain of terrible abdominal pains, vomit blood, urinate and defecate themselves constantly, cough and choke on their mucus (cold), and beg for help.We will try our utmost with medications and active management to prevent the worst effects of this poison which is still yet to come. Those that are saved are often scarred for life while patients that didn’t survive show a face of remorse as their body shuts down against the fight to keep them alive.PARAQUAT/ DIQUATThis is another pesticide/herbicide which is banned in most countries, but is often illegally used here. It has one of the highest death rates for poisons once ingested. There is no known antidote and it has one of the slowest and most painful deaths I have ever seen in my medical practice.Patients who drink more than a teaspoonful of this poison will most likely die. They would start feeling upset and have vomiting and diarrhea on day one. By day two their mouth and intestinal tract begin to erode and cause tremendous pain to the point where eating becomes a distasteful experience. From day 2-5 these patients have the false hope of beginning to feel better but start to have an annoying cough. Subsequently, they gradually develop shortness of breath that slowly worsens over days. The best way to describe the events after this is “the experience of being drowned in water that lasts for a few days”. All these patients can do is panic and beg and fight for their lives while they gasp for air. Death comes slowly and painfully.ALUMINUM PHOSPHIDEThis poison is used as a fumigant for commercial foods and products, preventing rodents and insects from contaminating them. Unfortunately, although not imported for rodenticide use, there are commonly used in households as the infamous “rat poison”.  Once ingested, it acts rapidly on our body depriving every organ of oxygen. This leads to toxic effects on our heart, lungs and brain causing us to die from shock.Patients will come in and be very confused and act like they are “possessed”. After a short while they may bleed from their mouth and nose and become even more restless. Their death is unavoidable, especially if they present late for treatment.As you can see, drinking poison is not a “walk in the park” and it often results in the victim having,Nike NFL Jerseys China, once taken, a life that cannot be given back. A life preserved is a chance given for redemption. We all will have good and bad experiences in our lives, the only way we will get to live the good experiences, is by picking ourselves up during the bad times. Suicide will always remain a terrible experience. Winning suicide is the best chance at getting to see the pleasant surprises that life may have waiting around the corner.(Dr Zulfikar Bux is an Assistant Professor of Emergency Medicine at the Vanderbilt University and Medical Center and holds the position of Head of the Georgetown Public Hospital’s Accident and Emergency Department.)

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