A commenter asked why I thought Alex may well have committed suicide. So I'll talk about that a bit today.
I think it is important to consider how difficult it is for Alex to acknowledge in himself anything that he thinks indicates weakness. He always has to be the best, have the best, do the best. In his world, he hasn't a readily available way to deal with his deeply conflicted feelings about having bombed the madrassah. Yet it is this conflict that underlies his reason for coming to see Paul in the first place.
We know he pushed himself so hard physically after he returned to the States that he had a coronary. His refusal to attend to his body, to pay attention to what he was doing to it, can also be seen as a way of acting out his grief, anger, guilt about what he did when he flew that fateful mission. And because he cannot express those feelings, where can they go but inside, into his body where they become symptoms?
Alex has grown up in a family where repression is a way of life, seen as a means of survival. When his father essentially tells Paul that therapy, in uncovering things better left buried, caused his son's death, he is telling a truth, at least from inside that system.
But Alex had more than the bombing eating away at him. There was his relationship with his father, conflicted at best, requiring of him, or so he believed, that he keep trying to prove himself in order to win his father's approval. And his murky relationship with his gay friends. No doubt Alex was no more certain about his sexuality than we are. And in his world, with his father, what room is there for that kind of confusion?
So Alex returns to duty where he is assigned to train new pilots, younger men who test themselves by vying with him, always eager to best him in training exercises. His sense of himself, now shaken some by therapy and the feelings and issues raised in his time with Paul, may depend even more than usual on his prowess in the air. And this time, his cockiness, his certainty that he is the best fails him. He develops vertigo and instead of trusting his instruments, he trusts himself. But he is not trustworthy and he crashes.
Is it suicide as it would be had he shot himself, a conscious and deliberate act? No. But so much was falling apart for him and the fact that we know he had already pushed himself into a heart attack, that it seems inescapable to me that Alex is a suicide, if not by commission, than by omission, by failure to act to save himself.
Paul did not cause Alex to kill himself. Nor did therapy. And his therapy did not create problems in his life; it led to the surfacing of what was already there. For whatever the reason -- the confluence of an error in judgment and an inability to face himself -- Alex died before he could really buckle down and do the work in therapy, work which could have led him to a very different place.