From a letter written in July 1961 by the psychiatrist Howard Rome, who treated Ernest Hemingway at the Mayo Clinic, in Rochester, Minnesota, before the writer’s suicide earlier that month. The letter is addressed to Hemingway’s widow, Mary. Ernest Hemingway, a biography by Mary Dearborn, will be published in May by Knopf.
As you might imagine, I’ve asked myself the same questions. A discussion of suicide was threaded through all of our talks from the very first day. He said that I could trust him; in fact, he pointed out that I had no alternative but to trust him. In demonstration of this, he then pointed out that if he really wanted to destroy himself there were mirrors of glass, belts, ways in which he could secrete medications and the rest. Unless I could trust him and he trust me, we had not the beginnings of a means to work effectively. I said I needed his word, which would be good enough for me, and he said I had it, and we formally shook hands to seal the bargain.
From that time on, he was on his own. He went out almost daily for walks, swims, target shooting, meals, trips to the Mississippi, and was meticulous about announcing his comings and goings to the nurses.
Our conversations repeatedly got back to the future: what were the pros and cons of a permanent residence in Idaho against someplace in Europe or Africa?
I was convinced that the suicidal risk was minimal. It was this that prompted me to say to you that I felt I had to trust him, that if he were ever to get back to work, which was life for him, he had to get to it free of doctors, nurses, and all of the encumbrances which were a perpetual reminder of sickness.
I felt that he was being absolutely frank with me; particularly was I convinced of this when he freely talked about his fears. They weren’t the usual kind. For the most part they centered on a deep concern about doing things the right way.
When we talked about his writing, I came to be convinced not only of his need but also of his desire to get back to work.
This is why I felt his discharge from the hospital was necessary. He was keen to go but, as I said, didn’t push it, and the decision was mine. Before you came back from Chicago he was enthusiastically involved in sorting his papers, and there was an air of expectation to all of the preparations, which he undertook with gusto. He talked to a variety of people about various routes; he weighed the pros and cons of flying versus driving; as far as I could see, this was hardly the activity of a man bent on suicide.
The core question is what more could or should have been done. Should he have gone to a mental hospital for safeguarding? What more signs would one have to have to tell that he had recovered? Thinking about these has led me to the conclusion that had I to do it over again today, I would do again as I did then.
I think I can appreciate what this has meant to you; the whole ghastly, horrible realization of its finality. All of the endless echoes of why, why, why, why. And the totally unsatisfying answers.