TAKE NOTE OF THIS STATEMENT: Dr. Mark Mahowald, a nationally recognized expert on sleep disorders

who sees patients at the Hennepin County Medical Center in Minneapolis, says he has found a connection between

sleepwalking frenzy - such as driving while asleep - and some antidepressants.

After her husband's suicide, Curtis was contacted by Dr. Ann Blake Tracy, a Salt Lake City-based independent

researcher who, for eight years, has studied violent behavior and its potential link to certain antidepressants and

other drugs.

Tracy, an author and director of the International Coalition for Drug Awareness, said some medications may cause

bizarre, violent behavior.

She thinks Curtis was sleepwalking when he left his home, drove to the motel and repeatedly stabbed himself. She

believes his actions may be related to Serevent, a new asthma inhalant he was taking twice a day.

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Why did executive take his own life?

San Antonio Express-News - April 5, 1998

Author: Marina Pisano, Express-News Staff Writer

A year after John Edward Curtis Jr. took his life, the question that still hangs in the air is why.

Why would a respected man with an adoring family, bedrock religious faith and a storybook corporate career as chief executive of Luby's Cafeterias Inc. - a man who at 49 had everything to live for - end his life in a motel room out on the interstate?

Kathi Curtis has agonized over that question, searching the Scriptures, talking to counselors and physicians, scouring her own memories of the months leading up to what happened March 13, 1997, at Motel 6. She has looked for some clue in her husband's behavior, some connection to help her understand what remains incomprehensible.

With the passing of the anniversary of John 's death, Curtis is beginning to gain some perspective into "the worst thing that could have happened to this family." And she is considering a strange theory advanced by one expert - but is not supported by clinical evidence - that her husband was sleepwalking when he committed suicide.

"There has got to come something good from something like this," Curtis said. "I have a real need to see this."

Perhaps something positive may come of John 's death if it helps others recognize problems and warning signs of potential suicides, she said.

More than 32,000 people in the United States kill themselves each year, according to the American Foundation for Suicide Prevention.

John Curtis was running San Antonio-based Luby's, the nation's largest cafeteria chain, with about 230 outlets and 13,000 employees in 11 states.

He certainly faced stress at work, and Curtis thinks corporate America needs to do more to mentor executives facing such pressure.

But she doesn't blame Luby's for his despair.

" John loved Luby's. He loved Luby's integrity. There were no deep, dark secrets there," she said.

By all accounts, he was not the typical hard-driving executive who might implode from the pressure to succeed. If anything, he was quiet, calm and even-keeled.

"This was so outside his character. It was the most shocking thing in the world. It's almost as if this was a different person," said Curtis, John 's childhood sweetheart and wife of 28 years.

David Daviss, current chairman of Luby's, shares her assessment. He remembers John as self-contained, thoughtful, analytical, straight-forward, "not conniving or political."

"He really gave the impression of being laid-back and very much in control," Daviss recalled. "Everyone liked him. There was nothing not to like."

A horrific death

His death was horrific - caused by the three largest of five self-inflicted stab wounds to the neck, according to the autopsy report. The medical examiner also reported about 14 lesser stab wounds, superficial punctures and incision wounds on his abdomen and left wrist.

The suddenness of the event devastated his wife and three children, Adam, 16, Daniel, 25, and Aimee, 26. People who commit suicide often talk about it beforehand. John had not.

Dr. John Chiles, chief of psychiatric health services for the University Health System, has found that is not unusual. Many who have attempted suicide but failed have told him the act was spontaneous.

"People decide to do it, and do it right now. But if you discuss it in detail, it's also in reaction to something they've been stewing about for a long time," Chiles said.

Certainly, Curtis has experienced moments of guilt over these past months.

"I had anticipated everything about John , all our married life," she said. "I have no explanation for it. I don't know if I was just naive. I am shocked at myself that I did not see."

She recognizes now that John had trouble sleeping and felt great grief since the death six months earlier of a confidant, the Rev. Don Duncan, pastor of the Tree of Life Fellowship in New Braunfels.

More than two-thirds of suicide victims have suffered from depression or manic-depressive illness. Alcohol dramatically increases that number. But the autopsy report on John showed no alcohol or drugs in his system.

Curtis now believes her husband's suicide was not "a long-contemplated thing."

"I think John in some way punished himself, and he had nothing to punish himself for," she said.

Suicide by stabbing is rare, psychiatrists say, and may suggest feelings of shame, guilt or self- loathing.

But as a born-again Christian, an elder at Tree of Life, a faithful husband - Curtis is sure of that - and a devoted father who loved nothing better than being with his children, John led an exemplary life.

Curtis said her husband often brought home work at night and was a perfectionist.

His hard work was rewarded. Over an 18-year career, John , an accountant, had steadily climbed the corporate ladder to become president of Luby's and, in January 1997, just two months before his death, its CEO .

Daviss said John faced the heavy responsibilities of any new CEO , plus some challenges.

"The company had found itself in a period of softer customer counts," Daviss said. "But the company was healthy and in good financial shape."

Daviss said an audit carried out after the suicide disclosed nothing wrong. A spokeswoman said Luby's is projecting revenues of about $505 million for this fiscal year, slightly higher than the $495 million last year.

Curtis believes corporate matters figured in John 's state of mind. He was nervous about the next day's board meeting in Phoenix.

"But this is not enough to explain what happened to John ," she said.

'You can't understand'

Sitting in their bedroom, Curtis looked back at her life with John for possible answers.

She and John prayed together and went to bed that night before his scheduled flight. It was the last time she ever saw him. A large portrait of John hangs nearby.

"I literally fell for John when I was 12 years old and waited for him to grow up," Curtis said, recalling that she first spotted her husband when they were in the sixth grade at Wilshire Elementary School.

"He was, of course, adorable. He was such a good-looking kid. But as we grew up, one of the things I found he had was a morality in him - a reverence for life. I did not see (that) in a lot of young men. This was the '60s - a radical time. I really did keep my eye on him throughout his high school years."

They grew closer after high school. John first went to Texas A&M University and was admitted into the Corps.

"He hated it," Curtis said.

He switched to Texas Tech University, and she later enrolled there to be near him. The couple married the spring of his senior year.

After graduation, he worked for an accounting firm and Tejas Airlines before moving to Luby's. Until three years ago, the couple lived in a modest house in New Braunfels and he commuted to San Antonio. His six-figure salary made a new home possible, but Curtis said he was never ostentatious about money. The new house in a gated community north of Loop 1604 is tasteful. His jewelry consisted of a James Avery keychain and a Seiko wristwatch.

From the start, Curtis, who never completed her degree, chose to keep a comfortable home, take care of the children and do volunteer work.

In the note Curtis found at her desk in the kitchen that fateful morning, one of the things John wrote was, "You can't understand."

"And he was right," she said. "I couldn't understand the pressures he was feeling. I had never worked."

A humble, quiet man

While John was no workaholic who neglected his family, there were issues of temperament.

" John was an extremely quiet man - very reserved, very private," Curtis said. "He kept a lot inside - never talked badly about people - always a leader but a very humble, very quiet man."

Not unlike other men.

"Men get caught up in that stiff- upper-lip thing," said Dr. Fred Goodwin, who was director of the National Institute of Mental Health from 1988 to 1994 and now directs the Center on Neuroscience, Medical Progress and Society at George Washington University Medical Center. "Women share their feelings more."

Women also attempt suicide twice as often as men. But men succeed at it four times as often as women.

"That was probably the one area of our marriage that I fussed at John about," Curtis said about his demeanor. "I wanted to know more about what was going on in him. John found that difficult. I craved that, but I sort of just quit nagging."

John did open up to pastor and close friend Duncan, who was his age, a Vietnam War veteran, married and the father of three children.

John served on the Tree of Life Fellowship advisory board for 10 years, and the two men talked often and candidly about many issues in their lives. The families socialized together.

The Rev. Karen Duncan, who has taken over as Tree of Life's pastor since her husband's death from a sudden, massive heart attack, recalled how deeply John mourned.

" John just cried and cried for days. He missed him a lot. I think it was because Don was more than a friend to John . He was his pastor, his spiritual adviser, so John confided in him. Don prayed for him whenever he had a big decision to make," Duncan said.

John kept volunteering at church and loved being with the family - Aimee and husband Mitchell; Daniel and wife Holly and 21/2-year- old granddaughter Alexandria in Dallas; Adam, still at home, a high school junior at Castle Hills First Baptist Church School.

The couple never had pursued the party circuit. They liked quiet, getaway weekends alone instead. Looking back, she said, he was pulling inward.

Sleep disorders, suicide

In searching for answers, Curtis believes some chemical or medical factor was involved.

After her husband's suicide, Curtis was contacted by Dr. Ann Blake Tracy, a Salt Lake City-based independent researcher who, for eight years, has studied violent behavior and its potential link to certain antidepressants and other drugs.

Tracy, an author and director of the International Coalition for Drug Awareness, said some medications may cause bizarre, violent behavior.

She thinks Curtis was sleepwalking when he left his home, drove to the motel and repeatedly stabbed himself. She believes his actions may be related to Serevent, a new asthma inhalant he was taking twice a day.

A spokeswoman for Serevent- maker Glaxo Wellcome in North Carolina said its researchers have not observed in clinical trials any psychosis or depression induced by the drug. She said no connection was found to suicide or sleep disorders.

In its clinical trial data, Glaxo Wellcome lists headaches, tremors and nervousness among Serevent's possible neurological reactions.

Tracy's belief in prescription drug-related violence and sleep disorders has some support, but an Express-News inquiry was unable to find any instance linking the drug to violent behavior or suicide.

Dr. Mark Mahowald, a nationally recognized expert on sleep disorders who sees patients at the Hennepin County Medical Center in Minneapolis, says he has found a connection between sleepwalking frenzy - such as driving while asleep - and some antidepressants.

Serevent is not an antidepressant. Mahowald said he has not seen any link between sleepwalking and the asthma inhalant.

Still, Curtis, struggling to explain her husband's suicide, finds Tracy's arguments plausible. "I may never know why John did it," she said. "But I think I know a couple of things now that I didn't know before."

Chiles, Goodwin and other psychiatrists said they are not aware of any studies associating asthma inhalants with suicide. They also note that claims a few years ago about the antidepressant Prozac causing suicides have not been supported in research.

But based on her examination of cases, Tracy maintains certain antidepressants and asthma medications can be dangerous in some people. She thinks John 's inhalant caused a REM (rapid eye movement) sleep-behavior disorder and an abnormality in his level of serotonin, the brain's so-called "coping" chemical.

Chiles and others agreed that abnormal serotonin levels have been linked with repetitious impulsive behavior, suicides and violent suicide attempts.

Tracy believes John was sleepwalking when he drove to the Motel 6. "(Sleepwalk state) means you act out whatever you're dreaming, which is usually a nightmare," she said. "I do not believe this (suicide) was done in a conscious state."

Not as far-fetched as it sounds, said Mahowald, who has seen hundreds of cases of REM-sleep behavior disorder and sleepwalking.

REM-sleep behavior disorder is a central nervous system disorder, cause unclear, that Mahowald said mainly strikes men 50 and older. In normal REM sleep, all the muscles of the body are paralyzed, except for the diaphragm. Meanwhile, the brain is more active than it is in the waking state. That allows people to act out dreams and nightmares.

About 10 percent of the population has a sleepwalking disorder; 0.5 percent has REM-sleep behavior disorder. There are effective treatments.

Mahowald regularly is called in cases in which people accused of violent crimes claim they were asleep and not responsible. He asked: "Is it possible? Yes. Is this what actually happened? You can't answer that."

Speaking generally, Dr. Lanny Berman, executive director of the American Association of Suicideology, said violent, gruesome suicides often are linked to a "psychotic break."

Curtis feels John was in just that kind of panic state the night he left their bed and drove off.

A father's legacy

In the police report, the motel employee on duty said he checked in at 10:30 p.m.

"But we had packed for his trip. We hadn't even gone to bed by then," Curtis said. "It had to be more like 1:30 (a.m.)."

Sometime during the wee hours, he returned to leave a note on her desk in the kitchen.

She knew something was wrong when she woke at 6:30 that morning and saw his suitcase still there and his car gone. She read the note and dialed 911. John , who was found wearing blue jogging pants over his blue pajamas, was pronounced dead a few minutes after 7 by an EMS technician.

Curtis is sensitive about making the entire note public, but she said her husband did not mention killing himself. He simply expressed love for his wife and family and said he was at the motel - send an ambulance - don't come. To the end, John tried to protect his family from the pain.

"I fully expected EMS would find John alive," Curtis said, sadly.

Now, her great hope is that people will look more closely at loved ones for the warning signs she missed.

Curtis also wants to see more mentoring of top corporate executives and professionals who find they have no one to talk to - who can't confide in staffers below them and have few or no corporate peers. Many rarely admit problems, because it might be seen as a sign of weakness.

"I'm not even sure how corporations could do it," she said. "But John had talked about that - about how he needed a mentor he could talk to."

Luby's, which brought in industrial psychologists to assess the need for employee counseling after the suicide, does not have a formal mentoring or a counseling program outside of its health plan.

"But if John had only come to me and talked about what he was feeling, I would have been happy to do all I could," Daviss said. "I would have seen it as a sign of strength, not weakness."

Karen Duncan, who led John 's memorial service, said questions surrounding his death may never be answered. But "the Bible says in Deuteronomy, 'The secret things belong to God.' Some things we will never know. That's why we believe in God."

For now, Curtis takes comfort in her faith that John is in heaven. But she worries about Adam, who has his father's quiet temperament. Depression, experts say, runs in families.

On the other hand, Adam's reply to a counselor suggests that, at least for now, he has reached his own place of peace in all this.

"Do you think your father's suicide was his legacy to you?" the counselor asked the boy.

Adam, always thoughtful, took a long time to answer: "No, I think my father's legacy to me was his life."