TBI, PTSD Become Defenses For Veterans Facing Criminal Charges

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Posted on 24th September 2011 by Gordon Johnson in Uncategorized

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Veterans of the wars in Afghanistan and Iraq are increasingly using post-traumatic stress disorder (PTSD) and brain injury as a defense in criminal trials. And that strategy has prompted a debate in legal circles, as to whether that defense is legitimate, or an insult to vets who weather PTSD and brain injury without committing criminal acts.

There are two recent cases where the PTSD defense has been used and drawn media attention. In one of the cases, Joshua Stepp, 28, a former Army soldier who was in combat in Iraq, was charged with first-degree murder in the death of his 10-month-old stepdaughter in North Carolina. The Los Angeles Times wrote about the case in detail earlier this month.  

http://www.latimes.com/news/nationworld/nation/la-na-ptsd-20110915,0,5747778,full.story

The charges were gruesome. Stepp was accused of banging his infant stepdaughter’s head on a carpeted floor, putting toilet paper down her throat and sexually molesting her in November 2009. 

Stepp’s defense attorney argued that because of PTSD, Stepp could not have premeditated the killing, as is required in first-degree murder, which potentially carries the death penalty, according to The Times. The lawyer asked the jury to convict Stepp of second-degree murder, which is not a capital-punishment crime.

Stepp testified that he didn’t remember much about  the night of the killing, and that the slaying  “just like happened.” Stepp also talked about his duty in Iraq, which included seeing his fellow soldiers being blown up and once having to put body parts in a pizza box.     

The PTSD defense didn’t work. On Sept. 8 a jury convicted Stepp of first-degree murder and sexual assault. But the panel deadlocked on whether to impose the death penalty, and the judge sent Stepp to prison for life with no parole.

The second PTSD-defense case is in Tampa, Fla., where ex-Marine captain Scott Sciple  is charged with DUI manslaughter, according to the Associated Press. In April 2010 Sciple was driving down an interstate the wrong way when he hit another car head-on and killed its driver. He is awaiting trial on the charges.

http://abcnews.go.com/US/wireStory/marine-claims-brain-trauma-led-fatal-dui-crash-14592033

Sciple had a hero’s background, receiving three Purple Hearts and a Bronze Star in Afghanistan and Iraq. But in combat he was physically and mentally wounded, his lawyers contended. Sciple had sustained traumatic brain injury and once almost died from blood loss.   

Sciple’s lawyer is mounting an insanity defense, arguing that because of his TBI and PTSD, Stiple blacked out the night of the fatal accident.  

According to AP, the wife of the victim, Pedro Rivera, is holding the military at least partially to blame for her husband’s death, maintaining that it should have given Sciple help for his PTSD. And as AP noted, “remarkably,” in a 860-page report on the case the Marine Corps agreed that veterans need more help.

In a letter regarding that investigation, AP reported, one Marine investigator wrote, “It is folly to expect a wounded mind to diagnose itself, yet our Marines still depend on an anemic system of self-diagnosis and self-reporting.”

The Los Angeles Times, based on Joshua Stepp’s trial, wrote an editorial Thurday headlined “Perils  of the PTSD Defense.” In a nutshell, The Times came down on this defense.

http://www.latimes.com/news/opinion/opinionla/la-ed-ptsd-20110923,0,5722414.story

“Like other defendants, veterans deserve to have mitigating factors taken into account by the criminal justice system,” the newspaper wrote. “But there is the danger that post-traumatic stress disorder will become a talisman for leniency where none is justified — and a synonym for criminal tendencies. That would be unfair to other defendants and demeaning to the military.”

I’d agree that TBI and PTSD shouldn’t be used with reckless abandon as a defense. They both can have a devastatingly negative impact on behavior, and that fact should never be dismissed or downplayed, especially when talking about combat vets.  Each criminal act has to be looked at on a case-by-case basis. But the impact of TBI and PTSD should never be underestimated.        

Rangers Richards Champions NHL Rule Changes That Will Reduce Concussions

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Posted on 16th September 2011 by Gordon Johnson in Uncategorized

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It looks like the call for toughter rules to protect NHL players against concussions has gotten a new champion: The New York Rangers new team member Brad Richards.

http://www.nytimes.com/2011/09/16/sports/hockey/rangers-richards-joins-growing-call-for-safer-hockey.html?_r=1&ref=todayspaper

On Friday The New York Times, in a story headlined “New Rangers Center Joins Growing Call For Safer Hockey,” said that Richards appears ready to step forward and push action on the head-injury safety issue. It is a matter that has weighed heavily on the league this year.

Richards, who at $12  million a year is the NHL’s highest paid player, told The Times that the game could do with a ban on hits to the head. He also believes that American hockey can do without the fights that are the highlight of the game for some fans. Hits to the head are already barred in U.S. college and international hockey, according to The Times.

The repeated head injuries that so-called “enforcers” sustain have fueled speculation about a link between those concussions and the deaths of three NHL players earlier this year. Two of them took their own lives. 

“Every locker room now is talking about head shots and concussions,” Richards told The Times.

The NHL last year agreed to ban most hits to the head, “but kept legal those resulting from straight-on contact,” according to The Times. But even with that stricter rule, players are still sustaining brain injury. In January Sidney Crosby of the Penguins suffered a concussion that kept him sidelined.

Although it’s not Richards’ role to fight during a game, he is in favor of banning fighting to protect NHL enforcers. The 31-year-old has been involved in four fights and had two concussions in his career.          

It looks like he will be an eloquent spokesman for some sanity from the NHL on brain injury.

Test Halted After Stents Fail To Prevent Strokes

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Posted on 10th September 2011 by Gordon Johnson in Uncategorized

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In a disappointing development, this week it was disclosed that a stent that was being inserted in the brain to prevent strokes was a failure, with patients who had it installed actually suffering more strokes than those without it, according to The New York Times.

http://www.nytimes.com/2011/09/08/health/research/08stent.html?src=me&ref=general

A study of the stents, which were conditionally approved by the Food and Drug Administration six years ago, was halted because of the findings. The results of the study were published last week online by The New England Journal of Medicine.

http://www.nejm.org/doi/full/10.1056/NEJMoa1105335?query=featured_home

The brain stents worked the way that stents in the heart do. Heart stents are inserted to keep blocked arteries open, therefore preventing heart attacks. The brain stents were inserted in blocked arteries in the brain in order to prevent  fatal or disabling strokes.

But the study of the use of stents in the brain found that the device “doubled the rate of stroke or death,” according to The Times.

The FDA had only approved the stents for “on the basis of a humanitarian exemption,”  namely “high risk patients who failed medical management,” The Times reported. And thousands of people have had stents installed in their brains since then.

The stent in question was produced by Boston Scientific, and was very similar to stents used in blood vessels leading to the heart. It was also very expensive, costing $21,000 for the device and its insertion.

Enrollment in the test was stopped because the 30-day rate of stroke or death was 14.7 percent in the group with the stents, more than twice as high as the rate in the medical-management group, which was only 5.8 precent, according to The New England Journal of Medicine.

Those risk factors led to the plug being pulled on the study.

 

 

 

  

Do Field Hockey Goggles Protect Eyes, But Result In Concussions?

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Posted on 7th September 2011 by Gordon Johnson in Uncategorized

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It would seen like a no-brainer, pun intended, that field hockey players should wear goggles to prevent injuries. But actually, whether goggles work as a safety measure is the topic of debate. Some believe that goggles can lead to concussions.

The Star-Ledger of Newark published a story Wednesday about the impact of a national safety rule that now mandates that field hockey players wear eye protection while on the field. “When It Comes To Goggles, Field Hockey Experts Don’t See Eye To Eye” was the headline.

http://www.nj.com/hssports/blog/fieldhockey/index.ssf/2011/09/field_hockey_coaches_players_are_torn_over_goggles_rule.html

The first paragraph of the story is about woman who has played field hockey for at least two decades, and says that she has never seen an injury that would have been avoided if the player had been wearing goggles. And according to The Ledger, many veteran coaches in New Jersey are taking issue with the goggle requirement, which was instituted by the National Federation of State High School Associations. 

What the beef with goggles?

Not only coaches, but USA Field Hockey has voiced its objection to the mandatory goggle rule. It contends that more concussions take place when players wear goggles. The contention is that if a ball or stick hits the goggles, this hard plastic safety gear itself will injure a player’s head and brain.

USA Field Hockey told the The Ledger that it is doing research on goggles and concussions, and hopefully that will shed light on the matter. In the interim, this season 62,000 high school field hockey players in America will be wearing the goggles, according to The Ledger.  

 

 

With Three Players Dead, NHL Needs To Study The Impact Fighting Has On ‘Enforcers’

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Posted on 5th September 2011 by Gordon Johnson in Uncategorized

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On Aug. 31 I wrote a blog about the death of a Winnipeg Jets hockey pl;ayer, with the headline “Rick Rypien’s Death Should Be A Wake-Up Call To The NHL.”

 https://waiting.com/blog/2011/08/rick-rypiens-death-should-be-a-wake-up-call-to-the-nhl.html

Well, now you can add another co-called “enforcer” to the list of young hockey players, athletes who essentially made their living throwing fists, that have been found dead since this spring. Coincidence? I don’t believe in such coincidences.

Last Wednesday Wade Belak, 35, was found dead in a condo in Toronto. The Associated Press reported that it was a suicide.

Earlier this year, on May 13, Derek Boogaard, 28, was discovered dead in his apartment in Minneapolis. And on Aug. 15, Rypien, 27, was found dead in his apartment in Alberta. News reports labeled it a suicide.

http://www.nytimes.com/2011/09/02/sports/hockey/deaths-of-three-nhl-players-raises-a-deadly-riddle.html?_r=1&ref=hockey

Last week The New York Times took a look at this trio of deaths in a story headlined “A Deadly Riddle.”  That story noted that Belak alone was involved in 125 fights during his career with the National Hockey League.

In pro hockey, enforcers such as Belak and Boogaard, who was reportedly one of the most feared of his kind in the league, “go to war every day,” as sports agent Scott Norton told The Times. Enforcers are designated warriors, expected to intimidate opposing teams, and physically lay hands on rivals who take cheap shots at team mates.

Obviously that violent role takes a toll emotionally, as well as physically, on even the brawniest, toughest men.

Case in point: One former enforcer, Brannt Myhres, recalled being “curled up in a ball in a hotel room, scared to death for the next fight,” according to The Times.

So the question is to what extent, if any, serving as hockey enforcers contributed or lead to the deaths of Boogaard, Rypien and Belak. Some say it’s not a cut-and-dried issue.

The Times noted that while all three men were enforcers they were very different, as were the circumstances of their deaths. Boogaard, who sustained at least 12 concussions during his career, died of an accidental overdose of painkillers and alcohol.   

His family, suspecting that Boogaard may have been suffering from the same brain disease as a number of pro football players, sent his brain to Boston University for testing. A research center at that school has already determined that nearly two dozen former NFL players had a brain disease, a condition called chronic traumatic encephalopathy (CTE),  that’s been linked to concussions they suffered while on the field.

The results for Boogaard aren’t out yet, but BU has already found evidence of CTE in the brains of two retired NHL players.

Rypien had a history of depression. Belak was married and the dad of two daughters, and didn’t appear to have a history of problems.

The NHL needs to commission scientific research, and take a hard look at enforcers and the physical and mental impact that role has on them. Then the league needs to find ways to save the lives of these young men.