A brother in trouble: dealing with suicide

During the spring and summer of 2007 I wrote my second novel, a comic romp called The Amateurs. The story was set in Ayrshire, Scotland, where I come from, and revolved around two brothers, Gary and Lee. Gary was a solid, dependable type while Lee was something of a ne'er-do-well, a debt-ridden amateur gangster. In the book, Gary (an obsessive amateur golfer, you're getting that title now, huh?) is hit on the head with a golf ball and sent into a coma. I wrote a scene where his family stands vigil by his bedside. I wrote about how Gary's mother's need for him to live "weighed more than her own soul". About how she wept and begged for him to pull through. In researching the book I learned things about comas, about the Glasgow Coma Scale used for measuring their depth, about the treatment of coma patients. I set the scene in Crosshouse hospital in Ayrshire, a place I was familiar with because my father (another presence in the book) had done some of his dying there. In the novel Gary recovered, with some unusual, comic side effects.

In the late summer of 2010 I found myself standing over my brother Gary's bed in Crosshouse hospital. (I borrowed his name for the solid, dependable brother in The Amateurs. Something of a wish-fulfillment exercise on my part.) He was in a coma, having hung himself in a room just yards from the nurse's station in the A&E department. I watched my mother crying and begging for him to live. I listened to a doctor telling me about my brother's score on the Glasgow Coma Scale (three – bad) and watched the staff doing the things for Gary that I'd researched. The scene was so much like how I'd imagined it on the page – how I'd seen it in my mind's eye three years before – that I felt like laughing at the ludicrous neatness of life imitating art. I looked at my younger brother unconscious in the bed and thought, as I had many times in childhood when he committed a fresh atrocity, "Oh Gary, what have you done now?"

My brother stayed like this for three days until he died, at 4pm on 3 September 2010.

After he died (over 20 minutes after the medical team extubated him – about the worst 20 minutes I have ever spent on this planet) I excused myself from my mother and sister, who were weeping in each other's arms, and went into the bathroom. I locked the door, sat down with my little Moleskine notebook, and recorded everything that had just happened: the angle of light from the window above the bed, the coiling pale blue lines of the monitors. The things my mother said to him as he died. For this is what it means to be a writer; existence, as Saul Bellow said, is the job.

Gary always had difficulty playing by the rules. As they say, any other set of rules might have done him, but the prevailing ones were no use. A difficult child ("start a fight in an empty house" was my father's catechism), then an angry teenager who became a minor "player" in Irvine's gang scene – the Ayrshire town where we grew up, which he never left. This wasn't the whole person, of course, he could be warm and funny and good company but, as he got older, the picture darkened. He was fighting a lot with my father towards the end of my father's life, still staying at home in his early 20s, hanging out with a bad crowd, having no real path in life. There were fights and arguments. Then, in April 1993, my dad died unexpectedly – a heart attack following a bout of cancer. There would be no chance for Gary to take back the things they had said to each other. His head would forever be filled with conversations he couldn't finish or resolve and his life would become a themeless narrative, one that it was impossible for him to shape.

When you are a novelist you are used to making a narrative do what you want. And, as Joan Didion said, for a writer there is nothing more natural to you than imagining the other half of a conversation. Things went easier for me with my father: both before and after he died. I hugged and kissed him every time I saw him. There wasn't anything left unsaid. After he died – to this day – I spend a lot of mental time in his company. When I was writing The Amateurs I got to go into my office and commune with him every day on the page for months, to make him come alive for me again, to talk and laugh and joke.

But things went a good deal worse for Gary. In 1997 he was sentenced to three years in prison for dealing ecstasy. I made no value judgment about this. I was working in the music industry at the time – I'd seen and done a flotilla of drugs. I visited him once, with my mother, in Barlinnie prison, a crumbling Victorian atrocity on the outskirts of Glasgow. He looked like he'd been hollowed out, like there wasn't much left of him. I promised him that I'd do anything I could for him once he got out of prison.

"Aye John, it's Gary. Listen," I remember taking the call, in the living room of my flat, in Maida Vale in west London, late in 1999. Gary was back living in Irvine, having been released from prison a few months earlier. "You know how you said you'd help me after I got out? I'm in a bit of bother…"

The bother was this. Gary had been charged with looking after "something" for a local kingpin. He'd buried the "something" in the local woods and drawn a map. He'd then lost the map and forgotten the location. Mr Big wanted his "something" back, or £2,000 in cash, or else. "Or else what?" I asked Gary. "Or else it's the wee thing with the silencer John." "Shut up." I said. "Who gets killed for two grand?" I remember Gary laughing, indulgently, as though I knew nothing of the real world. I sent the cheque.

Seven or so years later I put this exact scenario into The Amateurs as a subplot for the Lee character. He hides a shipment in the woods and loses it. Consequences follow. The book was published in 2009. I know my brother read it because my mum said he thought it was "very funny, but a bit too close to home in places". In the early summer of 2010 (when Gary had just a few months left to live) he rang me again and asked to borrow some money, something that was getting to be fairly routine by this point. I asked what he needed it for. "Well," he said, "I hid this stuff in the woods and – "

"Gary," I cut in. "We've been here. This exact conversation? We had it in 1999 after you got out of jail. I mean, I put it in the book."

"Did you?" Gary sounded astonished.

"Yeah. Now either you're so wasted you can't remember that ever happening or you just can't be arsed making up a new reason to borrow money and just thought you'd recycle the old one. Which of these guys do you want to be?"

"Fuck. Ah don't remember that. Honest."

"And you still owe me the two grand!" There was a huge pause. "Shit John. You should have reminded me about that." As the Chinese are fond of saying, no good deed goes unpunished.

The Cluster Headaches. If you don't know what cluster headaches are, if you've never heard of them, never experienced them, count yourself very lucky. Doctors have been known to call them "suicide headaches". The pain is so severe that women sufferers have described them as "worse than childbirth". They only affect 0.1% of the population and afflict men more than women. My brother had been complaining of severe headaches for a few years. My mother would describe them as "migraines" on the phone to me, because that's what his doctor was telling him. Then, out of the blue, in the winter of 2004, I suffered a bout myself. I was woken from sleep in excruciating pain. It felt like someone was driving a spike into my left eyeball. This happened every night at the same time night after night. I wondered if it might be stress-related. I had recently left the music industry after 10 years and was trying, unsuccessfully, to write a novel about the experience. I went online and researched. I went to my GP and got a referral to a headache specialist. I did all the things a relatively articulate middle-class person does. All the things my brother didn't do. I was diagnosed with cluster headaches. I rang my mother and told her, "These migraines of Gary's? They aren't migraines." Finally he began to get proper treatment.

Thankfully my cluster headaches have remained, so far, episodic in nature. Gary – for Gary only seemed to deal in extremes – became a chronic sufferer. That is to say he had them every day and every night for weeks, sometimes months, on end. You cannot sleep, for the pattern of sleep triggers a headache. You cannot eat. You cannot think straight. Now Gary had been properly diagnosed he was getting better treatment, but he was on a complex regime of medication that he was finding difficult to manage properly. He wasn't working. He was getting very thin. He and his girlfriend split up, perhaps his last anchor outside of my mum to a routine life. He was falling into debt. The phone calls to borrow money became more frequent. He was giving up.

My brother rang the emergency services at 4.13am on the morning of 31 August 2010. I have the transcript of his 999 call in front of me. (It only took me three attempts to obtain it through the Freedom of Information Act.) I won't quote from it extensively except to say that he sounds very calm. He keeps calling the operator "dear" – a strange archaism from someone of 42. He says that he's been trying to kill himself. He's been trying to cut his wrists with a Stanley knife and he's set up a noose in his garage. He wants help. The ambulance crew arrived 14 minutes later and spent around a quarter of an hour at his house before my brother willingly went with them to Crosshouse hospital. (I know all this because I have his medical records in front me, a separate feat requiring a lawyer. This is the thing about writers – we want to know everything.)

It's a 10-minute drive to the hospital from where my brother lived and I often picture him on this, the last ride of his life – conscious, lucid (his arm lacerations were "superficial"), talking to the paramedics. It would have been around 5am on the last morning in August as they drove through the Ayrshire countryside. The sun would have been coming up. Did he notice that? The day ahead was going to be a beautiful one. Later on the sky was heartbreakingly clear and blue as I flew through it, en route from Heathrow, having got the call, the call part of me had been waiting for since we were children.

("Oh Gary – what have you done now?")

I cannot go into too much detail about what happened in the hospital because the matter is still being investigated and may be subject to legal proceedings. My suicidal brother was triaged as non-urgent and placed in a room with the door open for observation while he waited to see the doctor (a room we later discovered had been deemed unsuitable for psychiatric patients). At some point he managed to close the door and hang himself using his sweater as a ligature and a door frame as a makeshift gallows. He was just yards from a nurse's station.

He didn't kill himself immediately. Rather, as a doctor pointed out to me and my sister two days later (his silver pen as it glided over the smoked glass of the brain scan, Gary's lobes standing out in white. "What goes on in your bloody head, Gary?" I remembered my dad saying to him once, in anger. Here it was, Dad, all laid out like a split cauliflower), he'd succeeded in effecting a massive stroke. A ventilator was breathing for him. All upper-brain function had been wiped out. If he did somehow come out of the coma, there would be nothing left of the person we'd known. A person, I remember thinking (and God help me), who had ever but slenderly known himself.

We made the decision to take Gary off the ventilator. A possibility, it was explained to us, was that his lungs would fill with phlegm that he would be unable to clear on his own and that he would effectively drown. Gary started crashing immediately.

There is no other way to describe it: it is a genuinely out-of-body experience to watch your mother watching her child die. It is too raw to be believed. It feels like the skin has been peeled from your eyeballs. If you have children, picture yourself doing this and feel the tingling rush in your feet, the whoosh of vertigo, as though you have suddenly found yourself teetering on the edge of a sheer cliff. I do not know how my mother survived those minutes with her sanity intact. Gary made great, rasping, honking sounds as the breath slowly left him, like the worst snoring imaginable. My sister wept. My mum wept as she bent to him and said, "I love you." She ran a trembling hand over his face as she said, "You were my beautiful wee boy." And she said over and over again "Goodbye. Goodbye son. Goodbye."

I approached the head of the bed and whispered my own last words to him. I kissed his forehead. It was surprisingly warm, almost feverish.

I only wept once. The following day I had to go to his house, to straighten things up. His door had been smashed in and replaced with a temporary one (a police raid, we later found out). It was cold inside, even though it was a warm September day. The electricity had been cut off for some time. I pictured my brother, lying in bed, wrapped up, his breath misting above him. His house was the usual kind of place for someone like Gary: wood-laminate floors and black faux-leather sofas. There was a plastic-framed poster on the wall: Al Pacino from the movie Scarface, his gun blazing. "Say hello to my little frien…" It was spotlessly tidy. I looked in the garage: an aluminium stepladder and a noose dangling from the beam, a thin cord of blue nylon rope. I took it down and walked back inside. There it all was, on the dining table in the living room: the heartbreaking pile, the sad drift of brown envelopes and their hellish contents: "If you do not pay by… If you are unable to pay… Final reminder… Please contact us immediately…" The rent arrears, the maxed-out credit cards, the overdraft, the gas and electricity bills. And how much of this was archetypal in the tableaux of suicide, I wondered. That drift of mail surely featured.

He had taken his life for a sum somewhere in the low five figures. Not an inconsiderable sum, but I could have written a cheque for it all there and then. I remember leaning against the wall and sliding down it and bursting into tears and saying, "Oh Gary, you stupid bastard. You stupid, stupid bastard." For I was remembering saying to him, "What do you want it for this time?" And saying, "For God's sake." And saying, "You still owe me £2,000."

Me, saying things like that. Things I cannot unsay. Things that follow me down the rabbit hole of sleep every night now.

Suicide is a cluster bomb. A daisy-cutter. It levels everything around it. Actually better to say it is a nuclear bomb – for it entrains a chain reaction with an incredibly powerful half-life. A chain reaction of questions that go on forever: "Why? Could it have been different? Better? Could I have done more? If I'd sent that cheque, transferred more money. What if, what if, what if…"

These questions will never be answered of course, because the only person who could answer went up with the bomb, riding it into ground zero like Slim Pickens at the end of Dr Strangelove.

Gary had no estate, no legacy, but there are things his death has bequeathed me – regret and guilt. Not useless for a writer, obviously. They can be pressed into service; can be made to help attack the towers of blank pages that offend us every day. The last thing I said to him as he lay dying was this – "I could have done more for you. I'm sorry."

And you do try. Death energises you. You try to do more. You try to get the work done as honestly as you can with whatever talent you have available to you. I wish he could have lived to see the dedication page of my new novel. It reads:

For my brother, Gary Niven (1968–2010)

Of course, if he had lived to see it, I wouldn't have written the book. And it wouldn't have had that bracketed pair of dates below his name. Those twinned bookends that await us all.

Straight White Male by John Niven is published by William Heinemann at £12.99. To order a copy for £9.99, with free UK p&p, go to theguardian.com/bookshop

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