While You Decide Who Is Worth Saving

[Content Warning: Suicide attempt and drug use/overdose references]

Yesterday I wrote a tweet about something that is part of my life: performing CPR on someone I love. I didn’t name her, I didn’t explain her history, I didn’t say what her relationship was to me, I didn’t even say whether it was drugs or suicide, and yet overnight thousands of people decided they knew exactly who this person was, what she thought about me and the situation, what she’d done, and what I should do about it. "Leave", "Dump her", "Let her die". That last one, especially, said so casually, so confidently, like they were giving advice about cancelling a subscription rather than telling me to abandon a person I love to death.

Most of the people saying it were strangers, and that’s one thing; the internet is a moral cesspit where nuance and humanity goes to die and people feel entitled to flatten anything complex into something they can process in a single, cruel, self-satisfied sentence. But some of them weren’t strangers, and that is what sticks. Some of them were friends; people who campaign for mental health rights; people who would tell you they care; people who, in other contexts, are kind, understanding, even advocate for radical harm minimisation strategies for self-harm - until drugs enter the picture, until suicidality stops being abstract and starts being inconvenient, and then suddenly the person you love is no longer someone in pain but a problem to be removed, a liability, a bad choice you should correct by walking away.

I asked someone, if she had cancer or Parkinson’s, would you tell me to leave? "That’s different." Yes. That’s the point. It isn’t different in the way that matters; it is still a body that can stop breathing, still a life that can end, still a person I love. The only difference is the story you tell yourself about why it’s happening. Cancer is allowed to be tragic; Parkinson’s is allowed to be inconvenient; suicidality is granted a thin layer of sympathy until it becomes chronic or recurring; and drugs seemingly aren’t tolerated at all.

So when you tell me to leave, what you are really saying is this: some lives are worth trying to save, and some are not, and you expect me to agree with you. You expect me to stand there, watch someone I love die, and call it "healthy boundaries"; you expect me to abandon them and call it self-respect; you expect me to translate your discomfort and moral judgement into neglect. 

I won’t.

What I asked for was simple: how do you cope with doing CPR on someone you love? How do you live with it? There are endless resources about CPR for heart attacks, but none for this - nothing for the people who are cutting down bodies or stemming the blood; kneeling on the floor, counting compressions against breaths; realising you’ve run out of naloxone; wondering if this time it won’t work - nothing for what happens after. Instead of actually answering me, you told me to leave. Not because you didn’t understand, not because you actually care about me, but because you had judged this stranger as someone unworthy of care.

This is what that response is built on; bullshit stripped-down individualism, dressed up in therapy speak, where "healthy boundaries" and "protecting your peace" have become bollocks catch-all justifications for withdrawal the moment someone becomes uncomfortable, inconvenient, or difficult to be around. It presents itself as neutral, healthy even - dividing up the "toxic" behaviours and illnesses we’re all supposed to avoid in order to "honour our needs".

But it isn’t applied equally; there is a hierarchy to who is allowed to need care and for how long. Illnesses like cancer are given a wide margin. People understand they are not chosen, not controllable, and so the expectation to stay, to care, to endure, remains intact, often for the entire experience. Mental illness is afforded far less; sympathy thins quickly once it becomes chronic, once it disrupts, once it refuses to resolve quickly and neatly. And substance use sits at the bottom, where the prevailing belief is that it's a selfish choice, something willed into existence and therefore something that can be willed out of it. The more responsibility you are perceived to have for your condition, the stronger the pressure becomes to "set boundaries", to withdraw, to leave, to abandon the person you say you love.

What gets obscured in all of this is that the outcome does not change; the body still stops breathing, the life still ends. The only thing that changes is whether you believe that person deserves to be saved.

This isn’t just about individuals saying cruel things on the internet; it reflects a broader cultural shift, where "personal responsibility" has steadily replaced any meaningful sense of collective or community care. The expectation now is that people should manage themselves, regulate themselves, contain themselves, and if they fail to do so, then others are not only permitted but encouraged to step back, to withdraw, to "show up for themselves first". But where exactly are people supposed to go for help?

There is no NHS or social care left to absorb this. Not in any meaningful sense, and certainly not for mental health or substance use. Services are stripped back, inaccessible, or actively harmful; Trust after Trust falling into statutory public inquiries as the numbers of the dead become too high to ignore or cover up. So people turn, as they always have, to those closest to them; to friends, to family, to their communities.

And now that, too, is framed as wrong.

Now it is "trauma dumping".

Now it is being a "narcissist".

Now it is "toxic", a "red flag", something to be cut off and managed at arm’s length.

So again, where are people supposed to go?

The only option left is the private sector, an option reserved for the privileged or for those so desperate they sacrifice food, heating, stability; watching the bills mount in exchange for something resembling care. And even then, it is conditional, time-limited, precarious.

That is not how I was brought up. I was brought up in a community; mutual aid not as an abstract concept, but as something lived and practised every day. Cooking meals for elderly neighbours; doing shopping for people when they were ill; fostering children who needed somewhere safe to land; making food and clothes parcels; giving what we had when someone else needed it more. At one point my mum gave our car to a family who had been housed miles out, because without it they were stranded. Our door was always open. We were expected to start volunteering by the time we were at least 7 or 8 years old, because that was simply what you did.

And it worked both ways. When things went wrong, I was picked up, fed, clothed, comforted, given somewhere to stay. Care was not something you earned by being easy to love; it was something that existed because you needed it, because you were part of the community. 

I was born years after Margaret Thatcher declared that there is no such thing as society. But that idea, quietly, persistently, insidiously, has shaped the world we are now living in, where care is conditional, where responsibility is individualised, where the expectation is not that we hold each other up but that we step away the moment it becomes difficult.

In my life, that has never been true. Society exists. And within it, people, within their means, hold responsibility for each other. That doesn’t mean it isn’t difficult, or that we don’t need support to do it, or that everyone can always carry the same weight. It means recognising that none of us survive alone…

So don’t insult me by telling me to leave. I’ll be where I’ve always been; on the floor, counting compressions, refusing to decide whose life matters. And if you don't like that, you can sit with it and keep your opinion to yourself, or go fuck yourself and hope you never find yourself needing the kind of care you’re so quick to withdraw from others.

Wren