Depression is a serious systemic disease with psychological and physiological expression, of which suicide is very much a part. The diagnosis of despair is a difficult & elusive one, & we must listen attentively with “the 3rd ear” to tune it in. The doctor must pay attention to his patient’s social nutrition & to the feelings the patient arouses in him. Once convinced that the patient wants to die & is making plans, secrecy should be swept away & the patient’s isolation attacked.