Nine years ago today, a 49-year-old woman took her last breath. She was my friend. I had known her for almost twenty years. Through medical school, residency, attendinghood, motherhood. She was quiet. Unassuming. A sharp contrast to the loud, obnoxious person I was almost thirty years ago when we met. She asked a lot of questions—to the point of seeming nosy. It was only after some time and maturity that I realized she was genuinely interested in learning about other people.

September is Suicide Awareness Month. Not only do the leaves change color in September, but kids go back to school, schedules become filled with activities, meals are eaten in the car on the way to soccer practice, and feelings of overwhelm and loneliness can set in. September is a period of change. And for my friend, and many other women, sudden change—no matter how prepared you think you are—can be jolting to the system.