Top NYC cancer doctor, 40, 'shoots herself and her baby dead at their $1M Westchester home in horrific murder-suicide'

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Splenda88

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Another physician suicide. That is horrific!

I am not sure why $1M is placed in the title of the article.

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DailyMail.com contacted her husband Tim Talty, 37, on Saturday. An upset-sounding Talty said: 'Can you give us some time?'
JFC these reporters are both shameless and tone deaf.
 
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So tragic, I knew her from residency and she was also chief resident before doing her fellowship. She was a very hard working and caring doctor all those years. Take care of your mental health everyone.
 
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1m in Westchester gets you an entry level split level house…but this is sad nonetheless. Mental illness in medical profession is so prevalent.
 
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Article came out saying police and ambulance have been there a few times over the summer
 
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It reminds me of a mid-30s school teacher near where I live, who recently shot her two kids then herself, to spite her husband during an impending divorce.

Brutal. Sad.
 
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My first thought was postpartum psychosis.
Otherwise, what level of pure evil could drive someone of sound mind to shoot a 4 month old baby? Even the worst of the worst of serial killers don't typically shoot defenseless babies too young to even crawl. I didn't know Dr. Cascetta, but I can't imagine there's anything in her past suggesting this type of behavior was in her character. It's got to be postpartum psychosis.
 
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Otherwise, what level of pure evil could drive someone of sound mind to shoot a 4 month old baby? Even the worst of the worst of serial killers don't typically shoot defenseless babies too young to even crawl. I didn't know Dr. Cascetta, but I can't imagine there's anything in her past suggesting this type of behavior was in her character. It's got to be postpartum psychosis.
Agree this would be my suspicion as well. Post-part psychosis is commonly associated with harmful/intrusive thoughts towards the baby. Unfortunately I saw it a couple times while I was a trainee—thankfully they presented before harming their child, but it was close.

It’s unfortunate in every aspect possible. Newborn baby gone. Promising physician’s life cut short. Husband has lost his wife and child. And if it was post-partum psychosis there were likely warning signs that are clear in hindsight, but in real time are really difficult to pick up unless someone one sees/witnesses clear signs of psychosis—things the person suffering from it typically keep to themselves. This hindsight clarity only worsens the suffering of those left behind as they wonder “what could I have done to prevent this?”

We had an RN go through this a few years ago—when she started having compulsions to hurt her baby is when she thankfully sought out help. She got admitted to an inpatient psych unit, started meds. A year or two later she had another baby (planned, while under close treatment of her psychiatrist) safely while on the meds. And now she openly shares what few people want to talk about or address.

In my opinion, postpartum depression and psychosis are societal failures. In our hunter gatherer days, no mother would ever be alone without support. Now that the nuclear home is the predominant family structure in the US, women are often completely left alone with an extreme amount of stress like nothing most of us men will ever face. I think few things short of actual front-line combat approach the levels of stress, sleep deprivation, confusion, hopelessness, and forced readjustment of life goals/priorities that a new mother experiences with their firstborn.

I encourage everyone to always look out for new moms. And to not take the “I’m ok” at face value—I know my wife felt she had to say that to everyone (especially the in-laws), but thankfully she shared how she felt with me.
 
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. I think few things short of actual front-line combat approach the levels of stress, sleep deprivation, confusion, hopelessness, and forced readjustment of life goals/priorities that a new mother experiences with their firstborn.
..
how about medical school or residency or the step exams or board certs?
 
Agree this would be my suspicion as well. Post-part psychosis is commonly associated with harmful/intrusive thoughts towards the baby. Unfortunately I saw it a couple times while I was a trainee—thankfully they presented before harming their child, but it was close.

It’s unfortunate in every aspect possible. Newborn baby gone. Promising physician’s life cut short. Husband has lost his wife and child. And if it was post-partum psychosis there were likely warning signs that are clear in hindsight, but in real time are really difficult to pick up unless someone one sees/witnesses clear signs of psychosis—things the person suffering from it typically keep to themselves. This hindsight clarity only worsens the suffering of those left behind as they wonder “what could I have done to prevent this?”

We had an RN go through this a few years ago—when she started having compulsions to hurt her baby is when she thankfully sought out help. She got admitted to an inpatient psych unit, started meds. A year or two later she had another baby (planned, while under close treatment of her psychiatrist) safely while on the meds. And now she openly shares what few people want to talk about or address.

In my opinion, postpartum depression and psychosis are societal failures. In our hunter gatherer days, no mother would ever be alone without support. Now that the nuclear home is the predominant family structure in the US, women are often completely left alone with an extreme amount of stress like nothing most of us men will ever face. I think few things short of actual front-line combat approach the levels of stress, sleep deprivation, confusion, hopelessness, and forced readjustment of life goals/priorities that a new mother experiences with their firstborn.

I encourage everyone to always look out for new moms. And to not take the “I’m ok” at face value—I know my wife felt she had to say that to everyone (especially the in-laws), but thankfully she shared how she felt with me.
And lots of things are due to societal failure. Hunters and gatherers had their own set of problems.
 
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. I think few things short of actual front-line combat approach the levels of stress, sleep deprivation, confusion, hopelessness, and forced readjustment of life goals/priorities that a new mother experiences with their firstborn.
..
how about medical school or residency or the step exams or board certs?
Not even close in my opinion. Internship would be the closest of them, but I still think I had it much easier intern year than my wife had it with our son. Remember--you can walk away from internship, and it would be ok. Someone else would pick up your job. Residency and having a new baby are on different emotional planes.

If you're a mother/or a father who watched your wife deal with the stresses of new motherhood and felt they are close then I'm happy for you/your spouse, as certainly some mothers seem to tackle being a new mom with ease. But whenever I've listened to new mothers talk honestly about how they're doing, they feel like a wreck inside, and they're far more sleep deprived than I was my intern year.

And lots of things are due to societal failure. Hunters and gatherers had their own set of problems.
Of course--there's a reason we're not hunter gatherers anymore. But hunter gatherer societies/small tribes of up to ~400 people or so were much more conducive to a supportive society that what we have now where we rely on large bureaucratic institutions (or volunteer ones like churches, synagogues, etc.) to accomplish the same thing. Homelessness is a great example--if we lived in a tribe of 400 people, no one would be homeless because you'd know your entire tribe and be willing to let that person whose cave/cabin/teepee collapsed/caught fire live with you until they got back up on their feet. Someone would take the person in. But in modern society where you don't know that person? It's the government's job...

One just needs to remember that despite all the advances we've had in society, knowledge, etc., we still have cave-man minds/emotions. We lived as hunter-gatherers for most of our human history. And it can be very tough to mold our ancestral cave man brain into modern society at times. We evolved to have a village support new mothers. Women weren't meant to go through it alone while the husband works all day. Per the story above, the woman's parents were in the home, so they may have been helping her, but unfortunately that wasn't even enough.
 
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Not even close in my opinion. Internship would be the closest of them, but I still think I had it much easier intern year than my wife had it with our son. Remember--you can walk away from internship, and it would be ok. Someone else would pick up your job. Residency and having a new baby are on different emotional planes.

If you're a mother/or a father who watched your wife deal with the stresses of new motherhood and felt they are close then I'm happy for you/your spouse, as certainly some mothers seem to tackle being a new mom with ease. But whenever I've listened to new mothers talk honestly about how they're doing, they feel like a wreck inside, and they're far more sleep deprived than I was my intern year.


Of course--there's a reason we're not hunter gatherers anymore. But hunter gatherer societies/small tribes of up to ~400 people or so were much more conducive to a supportive society that what we have now where we rely on large bureaucratic institutions (or volunteer ones like churches, synagogues, etc.) to accomplish the same thing. Homelessness is a great example--if we lived in a tribe of 400 people, no one would be homeless because you'd know your entire tribe and be willing to let that person whose cave/cabin/teepee collapsed/caught fire live with you until they got back up on their feet. Someone would take the person in. But in modern society where you don't know that person? It's the government's job...

One just needs to remember that despite all the advances we've had in society, knowledge, etc., we still have cave-man minds/emotions. We lived as hunter-gatherers for most of our human history. And it can be very tough to mold our ancestral cave man brain into modern society at times. We evolved to have a village support new mothers. Women weren't meant to go through it alone while the husband works all day. Per the story above, the woman's parents were in the home, so they may have been helping her, but unfortunately that wasn't even enough.
Difficult to walk away from residency after putting in the years and loads of money to get there.

Students commit suicide in med school and residency too due to the pressure. I knew a few who did it due to step 1.

We will have to agress to disagree.
 
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Difficult to walk away from residency after putting in the years and loads of money to get there.

Students commit suicide in med school and residency too due to the pressure. I knew a few who did it due to step 1.

We will have to agress to disagree.
Those are also preventable and should not be happening.

I agree it's difficult to walk away after putting in the time/money. But it's a whole separate thing from walking away from a little human being who is literally relying on you to stay alive. That child will die without someone to care for it. With med school/residency we're just talking about a sunk cost fallacy.
 
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Agree this would be my suspicion as well. Post-part psychosis is commonly associated with harmful/intrusive thoughts towards the baby. Unfortunately I saw it a couple times while I was a trainee—thankfully they presented before harming their child, but it was close.

It’s unfortunate in every aspect possible. Newborn baby gone. Promising physician’s life cut short. Husband has lost his wife and child. And if it was post-partum psychosis there were likely warning signs that are clear in hindsight, but in real time are really difficult to pick up unless someone one sees/witnesses clear signs of psychosis—things the person suffering from it typically keep to themselves. This hindsight clarity only worsens the suffering of those left behind as they wonder “what could I have done to prevent this?”

We had an RN go through this a few years ago—when she started having compulsions to hurt her baby is when she thankfully sought out help. She got admitted to an inpatient psych unit, started meds. A year or two later she had another baby (planned, while under close treatment of her psychiatrist) safely while on the meds. And now she openly shares what few people want to talk about or address.

In my opinion, postpartum depression and psychosis are societal failures. In our hunter gatherer days, no mother would ever be alone without support. Now that the nuclear home is the predominant family structure in the US, women are often completely left alone with an extreme amount of stress like nothing most of us men will ever face. I think few things short of actual front-line combat approach the levels of stress, sleep deprivation, confusion, hopelessness, and forced readjustment of life goals/priorities that a new mother experiences with their firstborn.

I encourage everyone to always look out for new moms. And to not take the “I’m ok” at face value—I know my wife felt she had to say that to everyone (especially the in-laws), but thankfully she shared how she felt with me.
I was thinking post-partum depression but post-partum psychosis also seems probable.

Re: your last point--universal, paid maternity and paternity leave would help you so much with this--new parents are often rushed back to work because it's that or homelessness, so they're working full-time and caring for a newborn or, even if one parent is stay-at-home, the other one can't really help, because they have to work. My BFF and her husband are public school teachers, and she's pregnant right now. I was asking her about her plans for maternity leave, and she was like "I have no paid maternity leave at all, so I'm planning to go back to work no later than two weeks after giving birth, and hopefully I'll give birth over Christmas break." I was appalled that a full-time teacher would get zero maternity leave.
 
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I was thinking post-partum depression but post-partum psychosis also seems probable.

Re: your last point--universal, paid maternity and paternity leave would help you so much with this--new parents are often rushed back to work because it's that or homelessness, so they're working full-time and caring for a newborn or, even if one parent is stay-at-home, the other one can't really help, because they have to work. My BFF and her husband are public school teachers, and she's pregnant right now. I was asking her about her plans for maternity leave, and she was like "I have no paid maternity leave at all, so I'm planning to go back to work no later than two weeks after giving birth, and hopefully I'll give birth over Christmas break." I was appalled that a full-time teacher would get zero maternity leave.
I didn't think there was an association with harm towards the baby with post-partum depression. But if you're in the MH field (I'm guessing by your username) you would know better than I do.

That's unfortunate about your friend. My wife did not feel ready to go back to work after 2 weeks. Even my sister, who had a child via surrogate, was not ready after two weeks. It's sad that so many feel forced to go back to work and miss out on bonding with their baby.
 
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I didn't think there was an association with harm towards the baby with post-partum depression. But if you're in the MH field (I'm guessing by your username) you would know better than I do.

That's unfortunate about your friend. My wife did not feel ready to go back to work after 2 weeks. Even my sister, who had a child via surrogate, was not ready after two weeks. It's sad that so many feel forced to go back to work and miss out on bonding with their baby.
Thoughts of harm towards the baby are fairly rare in PPD but not unheard of--it's hard because you don't want to give people the impression that all mothers with PPD are going to harm their baby (because that's not accurate and may lead to mothers not disclosing for fear of stigma/CPS involvement), but it is something providers should know about so they can ask about for it. Personally, I like the idea of pediatricians screening for PPD (with, say, the PHQ-9) and then referring moms to emergency or psychiatric care as needed.
 
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@RangerBob @futureapppsy2

If postpartum psychosis can be managed with medication, I’m assuming some neurotransmitters get thrown way out of whack? are there hormonal imbalances as well (beyond what would be expected)?

Can people come off the meds eventually after a certain amount of time or are the issues long lasting?
 
Not even close in my opinion. Internship would be the closest of them, but I still think I had it much easier intern year than my wife had it with our son. Remember--you can walk away from internship, and it would be ok. Someone else would pick up your job. Residency and having a new baby are on different emotional planes.

If you're a mother/or a father who watched your wife deal with the stresses of new motherhood and felt they are close then I'm happy for you/your spouse, as certainly some mothers seem to tackle being a new mom with ease. But whenever I've listened to new mothers talk honestly about how they're doing, they feel like a wreck inside, and they're far more sleep deprived than I was my intern year.


Of course--there's a reason we're not hunter gatherers anymore. But hunter gatherer societies/small tribes of up to ~400 people or so were much more conducive to a supportive society that what we have now where we rely on large bureaucratic institutions (or volunteer ones like churches, synagogues, etc.) to accomplish the same thing. Homelessness is a great example--if we lived in a tribe of 400 people, no one would be homeless because you'd know your entire tribe and be willing to let that person whose cave/cabin/teepee collapsed/caught fire live with you until they got back up on their feet. Someone would take the person in. But in modern society where you don't know that person? It's the government's job...

One just needs to remember that despite all the advances we've had in society, knowledge, etc., we still have cave-man minds/emotions. We lived as hunter-gatherers for most of our human history. And it can be very tough to mold our ancestral cave man brain into modern society at times. We evolved to have a village support new mothers. Women weren't meant to go through it alone while the husband works all day. Per the story above, the woman's parents were in the home, so they may have been helping her, but unfortunately that wasn't even enough.


Great post. Our primitive brains are no match for the modern consumeristic world and the mindset of more (accumulating and consuming). Access/addiction to too many dopamine hits are part of the issue. Increasing disconnect from the analog world (humans, nature, pets etc) is also an issue.

Horrific story and don't know enough details to really comment aside from that once one is able to over-ride the innate, strongest hard-wired drive to survive at all costs and actually commit suicide, all bets are off (in my opinion) with respect to who else is joining them.
 
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once one is able to over-ride the innate, strongest hard-wired drive to survive at all costs and actually commit suicide, all bets are off (in my opinion) with respect to who else is joining them.
Murder-suicide is incredibly rare compared to suicide. The vast, vast majority of people who die by suicide don't hurt or try to hurt anyone else in the process, Thoughts of harming others are worth screening for in suicidal patients, especially those with PPD, but let's not jump to assuming that homicidality is common among suicidal people, because it's very much not.
 
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@RangerBob @futureapppsy2

If postpartum psychosis can be managed with medication, I’m assuming some neurotransmitters get thrown way out of whack? are there hormonal imbalances as well (beyond what would be expected)?

Can people come off the meds eventually after a certain amount of time or are the issues long lasting?
I’m not an expert in this area as I’m not a psychiatrist—I’m a rehab physician.

My understanding is post partum psychosis is essentially considered bipolar disorder and not necessarily it’s own distinct entity. At least that’s what a psychiatrist explained to me. He said PPD is sometimes the initial manic episode of bipolar disorder.

If so, I imagine some would need lifelong mood stabilizers and others may be safe to come off them if they never have any recurrence of severe disease—all monitored under the watchful eyes of their psychiatrist/psychologist/therapist.
 
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Murder-suicide is incredibly rare compared to suicide. The vast, vast majority of people who die by suicide don't hurt or try to hurt anyone else in the process, Thoughts of harming others are worth screening for in suicidal patients, especially those with PPD, but let's not jump to assuming that homicidality is common among suicidal people, because it's very much not.
Understood. Certainly next level...I am not a psychiatrist and do not know what diagnosis/treatment she had. My point however is that once you are in such despair that you are offing yourself voluntarily, you are no longer dealing with a rational mind. Probably technically not considered "psychosis" but I would argue that suicide is in fact a break from reality
 
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Not even close in my opinion. Internship would be the closest of them, but I still think I had it much easier intern year than my wife had it with our son. Remember--you can walk away from internship, and it would be ok. Someone else would pick up your job. Residency and having a new baby are on different emotional planes.

If you're a mother/or a father who watched your wife deal with the stresses of new motherhood and felt they are close then I'm happy for you/your spouse, as certainly some mothers seem to tackle being a new mom with ease. But whenever I've listened to new mothers talk honestly about how they're doing, they feel like a wreck inside, and they're far more sleep deprived than I was my intern year.


Of course--there's a reason we're not hunter gatherers anymore. But hunter gatherer societies/small tribes of up to ~400 people or so were much more conducive to a supportive society that what we have now where we rely on large bureaucratic institutions (or volunteer ones like churches, synagogues, etc.) to accomplish the same thing. Homelessness is a great example--if we lived in a tribe of 400 people, no one would be homeless because you'd know your entire tribe and be willing to let that person whose cave/cabin/teepee collapsed/caught fire live with you until they got back up on their feet. Someone would take the person in. But in modern society where you don't know that person? It's the government's job...

One just needs to remember that despite all the advances we've had in society, knowledge, etc., we still have cave-man minds/emotions. We lived as hunter-gatherers for most of our human history. And it can be very tough to mold our ancestral cave man brain into modern society at times. We evolved to have a village support new mothers. Women weren't meant to go through it alone while the husband works all day. Per the story above, the woman's parents were in the home, so they may have been helping her, but unfortunately that wasn't even enough.
Many physicians can get nannies including night nannies to help them during this time
 
Those are also preventable and should not be happening.

I agree it's difficult to walk away after putting in the time/money. But it's a whole separate thing from walking away from a little human being who is literally relying on you to stay alive. That child will die without someone to care for it. With med school/residency we're just talking about a sunk cost fallacy.
It's a major sunk cost. And some people can get nannies if they don't have relatives to assist.
 
It's a major sunk cost. And some people can get nannies if they don't have relatives to assist.
I don’t disagree with you. But it’s still not on par with a human life.

Physicians can afford nannies, but most of the population can’t.

Not that a nanny is always the right choice—it’s not uncommon for babies/children to bond more with the nanny than their parents. They bond the most with whoever spends time/plays with them the most.

My wife decided she preferred to be the one with our son. Her loss of income hurt, but after he was born her priorities changed. Six years later she still feels she made the right decision (though she works about 10hr a week now)
 
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Post-partum psychosis/depression is no joke. Some of the worst depression and psychosis cases I have ever seen were women who recently gave birth.
 
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