A Letter from Jay Lee & Ali Dunagan

Church Family,

In the aftermath of our senior pastor Bryan Dunagan’s passing on October 26, 2023, many of you have asked, “How did Bryan die?” In an often confusing world, we naturally seek certainty.

From the beginning, medical doctors in our congregation observed that we might never know with 100% accuracy what caused Bryan’s body to shut down, and even if we were to find out, his autopsy would take several months.

Just recently, Ali Dunagan received the results of the autopsy and asked that I share it with you. Like her husband, she is a model of openness, and we all marvel at Ali’s strength and her deep trust in Jesus throughout this time.

What we’ve learned is that the Medical Examiner deemed the manner of Bryan’s death as accidental, which is a category that includes an extensive range of ways that loss of life can occur.

But as followers of Jesus, we know that nothing happens by accident. In the kingdom of God, we fully trust in God’s sovereign plan. God is the giver of life, and every good and perfect thing comes from the Lord. God gave us Bryan as a treasured gift here on earth; then God took Bryan away according to His divine timing.

What I’m absolutely certain about is that one day, Jesus will remove all tears and pain, and death shall be no more. I claim that promise; I loved Bryan as a dear brother. I encourage everyone to claim that promise, too, and please continue to pray for Ali and the Dunagan family.

Here is a letter from Ali that I’d like to share with you now:

Dear Church Family,

Thank you for the ways you have shown such tender care for our family these last few months as we have mourned the loss of Bryan. Your prayers, kind words, generosity, and stories of Bryan’s impact on your lives have carried us through this devastating time. Many of these stories point out Bryan’s unique ability to lead from a place of authenticity by embodying both grace and truth. Bryan was an engaging leader not only for our family but also for this church and within the Dallas community.

Many of us have been asking a variation of the same question: “Bryan, what happened?” That someone so young, vibrant, healthy, and full of life suddenly passed away has shocked and confused us all. And while I have certainly asked, “Why?” I’m rooted in the firm foundation of the One who is with me.

So, as I share with you some news that we have learned about the manner in which Bryan died, news that may become more public in the coming days, I invite you to hold the tension of mystery with me. Look with me to the One who is with us, who numbers our days, and who was with Bryan, holding him gently as he passed from this life to eternal glory.

On any given day, you might have found Bryan working out at the gym or running in the neighborhood. From the early days of pushing the double stroller to more recently chasing Collier Jane to the Day School for drop-off, Bryan was always on the move. He was an avid athlete who suffered a knee injury playing lacrosse at Stanford and had struggled off and on with knee pain ever since. But one of his favorite ways to connect with people was running side-by-side. Bryan ran with a good friend the day he passed. That night, he iced his knee and took tramadol, a medication that had been prescribed for as-needed use for pain.

That same evening, we hosted a family dinner at our house. Bryan grilled his specialty dish of salmon on the Big Green Egg. He enjoyed drinks with the family while playing with the kids and monitoring the grill. It was Bryan at his best: hosting with his head on a swivel as he tossed the football with Wheeler, encouraged Annie on her piano skills, and played tickle monster with Collier Jane. We’ve remained so thankful that Bryan got to spend the last night of his life with those closest to him.

Finally, you may recall the sermon in which Bryan let us all into his struggle with anxiety. He was passionate about leading the church authentically, and he knew that if the church was going to be serious about addressing the mental health pandemic of our age, he had to share his journey. In that sermon, he described his own struggle of being stuck when he first accepted the job to come to Highland Park Pres. Bryan continued to take a low dose of a prescribed anti-anxiety medication, sertraline. This medication, combined with accountability and counseling, led to his strong mental fitness and resilient joy.

Tragically, the combination of tramadol, alcohol, and sertraline interacted in a most harmful way that night. We’ve all been warned about the possible side effects and interactions of medications. Unfortunately, Bryan is in the small statistic of folks for whom these interactions were fatal.

This news has been challenging to process. The last few weeks, I’ve had to walk through another trauma as I’m again tempted to ask God, “Why?” I’ve spoken with countless doctors who are also puzzled as to how therapeutic levels of commonly prescribed medications could interact in such a way.

However, I return to the One who walks with us through the uncertainty. God was with Bryan during his tragic passing, and He is with us as we grieve.

As the children and I keep moving forward in our journey ahead, we ask for your continued compassion and discretion as you process this news with us.

We remain so thankful for this Church family. We love you. Bryan loved you.

Ali Dunagan

I’d also like to share with you a statement from HP Pres Elder Robert J. Burke, M.D., offering his expert opinion on the Medical Examiner’s Report:

The following statement may be attributed to Robert J. Burke, M.D., on behalf of the Dunagan family to provide additional context regarding the Dallas Medical Examiner’s Cause of Death Report. Dr. Burke, an anesthesiologist, is an Elder on the Highland Park Presbyterian Church Session.

“Bryan, a lifelong athlete, suffered a knee injury while playing lacrosse at Stanford. As an adult, he continued to participate in many other athletic activities, including regular running. Because of the college knee injury, and decades of wear and tear from other athletic pursuits, Bryan developed knee pain, for which he was prescribed the common pain reliever Tramadol. Following a run the afternoon before his death, Bryan took a Tramadol to relieve soreness in his knee.

“Additionally, Bryan had often mentioned—and even preached about—his anxiety. To help address this, Bryan was also prescribed a low dosage amount of sertraline, a generic version of Zoloft. The evening before his death, Bryan hosted family at his home for dinner and drinks. Early the next morning, Bryan was found unresponsive in his home.

“Bryan’s wife, Ali Dunagan, requested an autopsy, which was performed by the Dallas Medical Examiner’s office. After the autopsy, and a subsequent careful review of the report by a boardcertified toxicologist as well as another forensic medical expert, it appears that a combination of alcohol and the two commonly prescribed medicines, in their regular therapeutic amounts, resulted in a completely unexpected and unintentional cardiac and/or pulmonary event/reaction.

“The Medical Examiner’s use of “mixed drug toxicity” in the cause of death findings is a medical term that merely attributes the cause of death. It does not mean that drugs or alcohol were abused or overdosed, or anything untoward or improper occurred. For inexplicable reasons, Bryan’s otherwise healthy body reacted in a surprising, sudden, and abnormal manner, resulting in his death.”

Resources for You

• Medical Background Statement – Statement from HP Pres Elder Robert J. Burke, M.D. on the Medical Examiner’s Report.
• Under the Waterline – Sermon from Bryan Dunagan on the topic of mental health.
• Anxious for Nothing – Sermon from Max Lucado on the topic of anxiety.
• Care & Counseling – HP Pres offers several resources to you for grief care, pastoral counseling, and licensed counseling.