Those acquainted with the history of suicide at the Golden Gate Bridge say the romantic and aesthetic appeal of the bridge and its vista can be seductive to a mind seeking escape from excruciating reality and particularly conducive to an impulsive act of self-negation.

It was apparently so for pathologist Phillip Holsten, M.D., who jumped to his death from the bridge in October last year.

A friend and former medical school classmate, psychiatrist Anne Fleming, M.D., believes it was an impulsive, unpremeditated act that led Holsten, who had been depressed, to jump. He was a cyclist in full cycling gear and had ridden his bike across the bridge when he stopped half way.

"I think he was just in the wrong place at the wrong time with the wrong impulse," Fleming said. "When it happened, there was a feeling among his friends that if there had been a barrier, he wouldn't have died."

That conviction, and a determination to memorialize her friend's life, led Fleming to become involved in the effort to have a barrier erected. She is an assistant clinical professor of psychiatry at the University of California, San Francisco, and attending psychiatrist on the consultation-liaison service at San Francisco General Hospital.

"The bridge is such a part of suicidal thinking in San Francisco," said Fleming. In the hospital she has seen countless patients whom the police brought in from the bridge or who walk into the emergency room saying they want to jump off the bridge.

Fleming said that when the notation "BIBP from GGB" appears on a patient's chart, everyone in the hospital knows what it means: brought in by police from Golden Gate Bridge.

"We are a major trauma center in the county, and I see a lot people who make serious attempts at suicide and then regret it and are glad to be alive," she said. "I feel very convinced from my work that suicide is frequently impulsive and that reducing access to means can reduce suicide."