Hickam’s Suicide: A Case of Carbon Monoxide Toxicity, Compartment Syndrome, Rhabdomyolysis, and Renal Failure From Attempted Dual Suicide

Suicide pacts among elderly couples afflicted by a terminal disease process present a significant challenge to emergency clinicians. If one member of the pair aborts their attempt, the surviving member of a dual suicide attempt can present a complex case with numerous clinical issues reflected by Hickam’s dictum rather than by Occam’s razor. Thus, emergency clinicians must keenly search for a multitude of concomitant but compounding conditions, potentially projected onto pre-existing comorbidities in an elderly population. The authors present a case of a suicide pact in which one member of the couple completed the attempt while the surviving member experienced carbon monoxide toxicity, compartment syndrome, rhabdomyolysis, and renal failure following her aborted suicide attempt.