Journal Logo

Special Report

Special Report

Breaking the News

Doty, Christopher MD

Author Information
doi: 10.1097/01.EEM.0000503371.38692.88

    Christopher Doty, MD, wrote this letter to the emergency medicine team at the University of Kentucky after the suicide of a young person in the residency program there.

    Dear colleagues,

    The unbearable has happened at the University of Kentucky. Last Friday we discovered that one of our residents was tragically taken from us. It appears that the resident took his own life in response to acute grief over a moribund family member.

    As you might imagine, the residency, the faculty, the department, the institution in general, and certainly I have been devastated by this loss. I will not be sharing many details of his death except to say that this was completely unexpected by me and his resident peers. There was not an obvious history of depression or warning signs of impending doom. He was struggling with some significant family stressors, but appeared to be processing those with support from the program.

    This is a catastrophic loss for our program and for his family and friends. I am immensely embarrassed that I lost a resident on my watch and guilty that I didn't see this coming. Honestly, I have struggled with whether I should write this email at all. I make this information public to shine a bright light on a problem that often lurks in the dark. Suicide, and specifically suicide in our trainees, is a significant risk, and we are at higher risk than the general public. To face this issue, we must acknowledge its existence. We must speak its name. We must learn about it and talk about it.

    I am absolutely devastated that one of my residents felt so alone and so afraid that he chose to end his life. I am even more devastated to learn just how common this is. It is one or two physicians a day in the United States alone. These are remarkable numbers to me. I send this email to turn our attention to ourselves and our trainees.

    I am a relatively experienced program director. I had mentioned mental hygiene resources for the residents this past week in light of the conference Philip Shayne just reported on for us and the recent ACGME focus on wellness. This resident was already on my radar screen. I was looking out for this. I knew he was struggling and undergoing stress, but I thought he was managing it. I missed it.

    I say all this just to increase your awareness of your own residents who are struggling. This resident had many people who cared about him, and he was universally liked. Several residents made efforts to support him during this stressful time. He was very successful in the program. None of us saw this coming.

    I encourage all of you to renew your efforts on resident wellness and to assess your residents who appear to be struggling or appear to be depressed. I will be renewing my efforts to focus on resident wellness for my trainees and EM residents across the country. Perhaps that will be the legacy left by the tragic loss of this caring, promising, handsome, smart, successful, young man.

    I would like to thank the efforts of my institution, my DIO, the other program directors at the University of Kentucky, my faculty, and my residents. Most especially I want to thank my leadership team, which has demonstrated the excellence, compassion, and professionalism to which I have become accustomed. Without all the support, I fear we all would have buckled.

    Please take care of each other.


    Warning Signs of Suicide

    The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide.

    • Talking about wanting to die
    • Looking for a way to kill oneself
    • Talking about feeling hopeless or having no purpose
    • Talking about feeling trapped or in unbearable pain
    • Talking about being a burden to others
    • Increasing the use of alcohol or drugs
    • Acting anxious, agitated, or recklessly
    • Sleeping too little or too much
    • Withdrawing or feeling isolated
    • Showing rage or talking about seeking revenge
    • Displaying extreme mood swings

    If someone you know exhibits warning signs of suicide:

    • Do not leave the person alone.
    • Remove any firearms, alcohol, drugs, or sharp objects that could be used in a suicide attempt.
    • Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255).
    • Take the person to an emergency department or seek help from a medical or mental health professional.
    Wolters Kluwer Health, Inc. All rights reserved.