I remember the first time someone threatened my life as a physician. It was my day off, so I was not in the clinic that day; a Children’s Hospital specialty group was working there instead, and after a staff member called the police, she notified me. A father had walked in saying he wanted to kill me for “taking his children away from him.” Wracking my brain as to this man’s identity, I drew a blank.

The police found him in a local park a short time later and judged him to be “harmless.” Somehow, I did not share their reassuring sentiment. I figured out who the individual was, tracked down his mother, and promptly explained the situation. She provided a recent photograph so my staff could be trained to recognize him and contact the authorities the moment he entered our building. That photograph still hangs in our “Most Wanted” section of my front office, amongst other pictures which have been added. Occasionally, I request an updated picture to make sure we are keeping our office environment safe.

The second time a parent threatened my life was over the phone. I was taking call on the weekend for a group of pediatricians. One of them had evaluated a child for a finger injury and had not quite done their due diligence. It sounded infected and in need of repair as the father described its appearance over the phone. I recommended he take his daughter to the local Emergency Room. He threatened to stab me instead. I called to warn the ER staff and then notified the other practice. The response was less than vigorous from my call partners, “you must have done something to upset him.” Their reaction astonished me; “blame the victim” is an unacceptable response to a colleague in this situation.

When a patient or disgruntled coworker threatens to kill us, that threat should be taken very seriously. Physicians must become less tolerant. Tolerance is defined as an objective or permissive attitude toward opinions, beliefs, and practices that differ from our own. In my opinion, the administration of hospitals and some large clinics are far too permissive of violent threats against their staff. I have heard numerous stories from across the country of physicians being told the “patient is always right” as patient satisfaction scores reign supreme.

We have been taught when a patient threatens to commit suicide, we take them at their word. Why is it any different when our very own lives are at stake? The idea that physicians, nurses, pharmacists, and ancillary medical staff are expendable is ridiculous and policies must be enacted to protect the lives of medical personnel.

As I reflect on the tragic events that unfolded inside the Bronx-Lebanon Hospital last weekend, it is difficult to comprehend. My first thoughts are for the victims and their families, in particular those who knew Dr. Tracy Sin-Yee Tam. She was a family practice physician in the hospital that day by chance, filling in for a colleague. My second thought is to recall a quote from Maya Angelou, “When people show you who they are, believe them the first time.”

According to the New York Times, Dr. Henry Bello had a background which spelled trouble right from the start. His life story reveals a chaotic trajectory of bankruptcy, alleged addiction, workplace difficulties, homelessness, and brushes with the law. He declared bankruptcy in 2000. In 2004, Dr. Bello was charged with unlawful imprisonment and sex abuse involving a 23 year old woman in Manhattan. In 2009, there were allegations of unlawful surveillance when he was caught using a mirror to look up the skirts of two women.

In 2014, he was hired by Bronx-Lebanon Hospital as a family practice physician with a limited medical license and in February 2015 was forced to resign in lieu of termination after an allegation of sexual harassment. After his resignation, Dr. Bello warned former colleagues he would return someday to kill them. On Friday, June 30, he exacted his revenge, entering the Bronx-Lebanon Hospital carrying an AR-15 rifle and opening fire — fatally shooting a physician and wounding six others before killing himself. Something more should have been done about this man to protect the hospital staff and patients.

This post was not penned to “Monday-morning-quarterback” the events of last Friday. I want to emphasize in the future, these threats should be taken seriously and closely monitored to keep those inside the hospital, medical facility, or clinic walls safe. Two hours before the shooting, Dr. Bello emailed the New York Daily News to say the allegations that ended his medical career were “bogus.” He stated, “This hospital terminated my road to a licensure to practice medicine.” In addition, a week prior to the rampage, he was reportedly fired from his job assisting AIDS and HIV patients by the city. This was a clear sentinel event and foreshadowed the possibility of something ominous.

Physicians on the “front-lines” are facing a battle for their survival, literally and figuratively. Friday, June 30, I lost a physician colleague in a senseless tragedy. We do not handle threats haphazardly when they occur in airports, schools, or police stations. We cannot properly care for a patient when we are in fear for our lives. It should not be tolerated any longer. There are many valuable lessons to be learned from the events of June 30th. We need to sit up, pay attention, and make changes. The loss of Dr. Tracy Sin-Yee Tam and injuries to the other victims should not be in vain; physicians and other medical staff deserve to feel safe in their work environment while trying to save the lives of others.

My sincere condolences go out to the friends and family of everyone inside the Bronx-Lebanon Hospital that day. May you find peace, hope, and healing and may we, as collective communities of healers, refuse to tolerate serious threats to our lives, those of our colleagues, and those of the patients we serve.