Famous artists and athletes who succumbed to suicide:

Robin Williams (American actor and comedian) – August 11, 2014; 63 years old.

Anthony Bourdain (American celebrity chef, author, travel documentarian) – June 8, 2018; 61 years old.

Robert Enke (German goalkeeper, part of German national soccer team) – November 10, 2009; 32 years old.

Goo Hara (South Korean singer and actor) – November 24, 2019; 28 years old.

Ruslana Korshunova (Kazakhstani model) – June 28, 2008; 20 years old.

Azade Namdari (Iranian actor and television producer) – March 26, 2021; 36 years old.

Ivo-Valentino Tomas (Croatian professional soccer player) – December 31, 2019; 26 years old.

Deon Stewardson (British-South African actor) – October 27, 2017; 66 years old.

Oksana Shachko (Ukrainian artist and activist) – July 23, 2018; 31 years old.

Sushant Singh Rajput (Indian actor) – June 14, 2020; 34 years old.

Qiao Renliang (Chinese singer and actor) – September 16, 2016; 28 years old.

Tiaina Baul Seau Jr. (professionally known as Junior Seau; American NFL football player) – May 2, 2012; 43 years old.

Prominent American physicians who succumbed to suicide:

Lorna Breene, MD (medical director and emergency department physician in New York City during the height of the COVID-19 pandemic) – April 26, 2020; 49 years old.

Scott Jolley, MD (emergency department physician in Utah during the COVID-19 pandemic) – February 19, 2021; 55 years old.

Local citizen, beloved son, classmate, friend in southern Ohio who succumbed to suicide:

Tristan Nathanial Miller (talented and adored student, athlete, musician, friend in the tight-knit community of Chillicothe, Ohio) – November 12, 2017; 17 years old.

September 17, 2024, 12:01 a.m.

I was working the night shift (7 p.m.-7 a.m.) in the hospital on the evening of September 16, 2024. Just after midnight, I noticed a message pop up on my iPhone calendar acknowledging that this day, September 17, was National Physician Suicide Awareness Day. I was caught off guard as I was busy placing orders on a patient I was admitting and then hurrying to complete my documentation. But this pop-up message haunted me, stole my breath, and reminded me of a disease, an illness, a global crisis affecting all corners of the world, including the brotherhood and sisterhood of my physician colleagues across the globe.

I grew up in the 1970s and 1980s when we “kept everything in the closet.” We didn’t talk much about that which ails us. We didn’t air our dirty laundry. We locked up our emotions, our identities, our desires, our pains, our struggles. We just didn’t talk about those things back then. We didn’t confide in anyone. Locked up in the closet, we could ignore it, and it would all go away. Much to our dismay, it didn’t go away. It festered, it grew, and it tore through those closet doors and now percolates, affecting every corner of the world, every culture, all of society. Yet, we as a medical community have achieved very little over my medical career to address, educate, confront, and heal those affected by such a global tragedy.

The first time I encountered and dealt with the devastation of suicide was during my junior year in high school. My family and I moved to the suburbs of Columbus during my freshman year from our immigrant haven on the outskirts of Cleveland. For two years, I still felt like an outcast, like I did not belong, like I could not assimilate into our new surroundings. Yes, I made friends, and they were like brothers to me. To this day, they remain brothers. One friend, however, was an outsider, much like me, trying to find his niche in our new community. He was an only child. He moved to the area with his parents two years prior, much like me. His father, a truck driver, was rarely ever home. His mother, suffering from major depression, almost never saw the light of day. As such, my friend was alone. He spent much of his time at my house, eating dinner with us and helping my father and mother with household chores—much more so than my brother, sister, and I combined. My parents even claimed him as one of their own.

Then one day, between classes, standing at my locker, shuffling between books, I felt my heart pause and my soul screech as our principal announced on the overhead speaker that my friend, the one my parents claimed as their own, died by suicide that day. I fell to the ground. I was lost. I was crushed. I couldn’t contain myself. And, to this day, I still question myself … “Where were the warning signs? How could I have intervened?”

Play for 21®

Tristan was a young man who sadly lost his battle with depression and succumbed to the temptation of suicide in 2017. He and his family resided in Chillicothe, Ohio—a small, quaint town in Ohio’s gateway to Appalachia, one hour south of Columbus. Outside this town, our town, outside this county, most of society knew very little about Tristan. But in this town, in this community, among those who knew and who adored him, Tristan was a rock star, a multi-sport star athlete, an academic achiever, a friend, and a kind and gentle human being.

I had the great privilege and honor of coaching Tristan and his younger brother in the Zane Trace Youth Soccer League back in their elementary school days. He and my oldest son were classmates and acquaintances, as were his younger brother and my younger son. Tristan was a leader on and off the field; his teammates and friends flocked to him, followed him, and adored him. He befriended all of them and took many of them under his wing. He mastered the art of soccer long before I could teach or coach him on any of the skills I learned from my immigrant upbringing. Tristan was that guy … that guy everyone wanted to be, to emulate, to befriend, to call a friend.

When local news broke that our community, my children’s school, suffered the tragic loss of Tristan Miller, shock waves roared through this town—akin to the 1994 Northridge Earthquake that ravaged Los Angeles. To this day, those aftershocks still linger, reminding us of a disease state we have yet to conquer.

Play for 21® is a trademark brand concocted and designed by the family of Tristan Miller. The number 21 was his jersey number in basketball, his most passionate sport. His parents and his family, through their trademark brand, apparel sales, local music events, and sporting events, raise funds, local scholarships, and, especially, awareness in Tristan’s honor, reminding us that mental health is just as important as physical health. They have devoted their lives to bringing the topic of suicide to the forefront. Through their local efforts, our community thrives, honors Tristan, and daily tears down those closet doors while addressing the brutal reality that suicide is the tenth leading cause of death in our country and the second leading cause of death among 10–24-year-olds.

September 17, 2024, 7:17 a.m.:

I just finished signing out to my daytime colleagues, tidied up loose ends on patient orders and charts, and prepared to head home for a much-needed sleep when a dear friend and colleague approached me and asked,

“Hey. How are you? You’re quiet. You’re not your usual jovial self,” he observantly inquired.

After a long, thought-provoking night shift reminiscing about my high school friend, memories of Tristan Miller, and pondering the daily stressors, moral sacrifices, and mental breakdowns our profession endures, I replied with a smile,

“I am well. Thank you for asking … and thank you for caring to ask.”

I never had the honor or privilege of meeting or working with Dr. Lorna Breene or Dr. Scott Jolley. I never even heard of either physician until their deaths and struggles made national headlines during the COVID-19 pandemic. Sadly, most of my colleagues and I could relate to their battles. Their stories resonate with many of us at the bedside. It was through their families and their foundations that I learned and realized the sad truth that 400 physicians die by suicide every year.

I left the hospital that morning, acknowledging the great strides our medical society has made over my career in conquering disease states such as heart disease, cancer, diabetes, and obesity. But I was also saddened by the lack of progress we’ve made in the areas of mental health, depression, and suicide. I applaud the Miller family, especially Tristan’s parents, for their mission, their devotion, and their efforts to raise mental health awareness and to promote the legacy of their son Tristan.

Imagine what a wonderful world this place could be if we all reached out to family, to friends, even strangers, and just asked them if they’re OK … and really meant it.

May we all play and pray for 21.

Zoran Naumovski is a hospitalist.