30 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Cause of Death is Unconfirmed It is with great sadness that I have to tell you that one of our residents, [NAME] , has died. All of us want you to know that we are here to help you in any way we can. The cause of death has not yet been determined by the authorities. We are aware that there has been some talk about the possibility that this was a suicide death. Rumors may begin to circulate, and we ask you only share information known to be factual since inaccurate information can be hurtful to those coping with this loss. Please also be mindful of the use of social media in discussing this event. We’ll do our best to give you accurate information as it becomes known to us. Each of us will react to [NAME] ’s death in our own way, and we need to be respectful of each other. Feeling sad is a normal response to any loss. Some of you may not have known [NAME] very well and may not be as affected, while others may experience a great deal of sadness whether you knew him/her or not. All types of emotions are common following the loss of someone you know — sadness, confusion, guilt, anger, numbness. Some of you may find you’re having difficulty concentrating, and others may find that diving into your work is a good distraction. We have counselors available to help our community deal with this sad loss and to enable us to understand more about suicide. If you’d like to talk to a counselor, just let us know. Sometimes physicians, when confronted by the death of a colleague, feel responsible. They wonder if there was “something that they missed.” First, remember, that [NAME] was a colleague, a friend, and that [NAME] was not your patient. No one has the ability to predict death. We do know that talk saves lives. If your gut instinct tells you something is different about a fellow resident’s behavior, have a conversation with them. If you are concerned, encourage them to seek help and consider letting [NAME OF APPROPRIATE LOCAL PERSON] know. This is a time to take a moment to be together, to remember [NAME] in our grief, and to support one another. Please remember that we are all here for you. Cause of Death May Not Be Disclosed It is with great sadness that I have to tell you that one of our residents, [NAME], has died. All of us want you to know that we are here to help you in any way we can. The family has requested that information about the cause of death not be shared at this time. We are aware that there has been some talk about the possibility that this was a suicide death. Rumors may begin to circulate, and we ask you only share information known to be factual since inaccurate information can be hurtful to those coping with this loss. We’ll do our best to give you accurate information as it becomes known to us. Since the subject has been raised, we do want to take this opportunity to remind you that suicide, when it does occur, is a very complicated act. It is usually the culmination of several health and life factors that converge in a person’s life during the same period of time, including mental health conditions such as depression, which lead to overwhelming mental and/or physical pain, anguish, and hopelessness. Sometimes these risk factors are not identified or noticed; in other cases a person with a disorder will show obvious changes or warning signs. One thing is certain: there are treatments that can help. Suicide should never be an option. Each of us will react to [NAME]’s death in our own way, and we need to be respectful of each other. Feeling sad, upset, confused, angry, or numb are normal responses to loss. Some of you may not have known [NAME] very well and may not be as affected, while others may experience a great deal of sadness whether you knew