Monday Morning Crisis Quarterback

Today is Memorial Day in the United States.  Most Americans spent the day doing yardwork or barbecuing or, perhaps, going to a parade.  Summer is unofficially here, and women can wear white shoes without offending Miss Manners.  But of course none of that (except, arguably, the parades) is the point of Memorial Day.  We are supposed to be remembering those who died in the armed services.

There is one segment of the population that doesn't need much of a reminder of what Memorial Day is all about.  There are thousands of families and friends across the country who have lost a loved one in the Iraq and Afghanistan wars, not to mention those who remember those who died in the first Gulf War, Vietnam, Korea and World War II, as well as a variety of smaller conflicts, attacks, and accidents.  There are also an increasing number of people caring for severely disabled veterans, people who, in previous wars, would likely have died but who, through the miracle of modern medicine, are alive but living with significant lasting effects.

When someone you love goes off to war, you entertain the possibility that they might not come back.  The day an officer and a chaplain knock on your door is not the first time this has ever occurred to you.  In that sense, the death of a loved one in action is a little bit different than some other types of traumatic loss.  At the same time, however, sudden, violent death is traumatic no matter how much you think you're prepared for its possibility.

You've probably read stories all over the news about veterans who come home with Post-Traumatic Stress Disorder (PTSD), and how we as a country do or don't effectively care for them.  What you don't hear about is the post-traumatic stress (with or without the disorder) of those left behind by fallen soldiers, sailors, marines, airmen, etc.  As mediocre a job of treating PTSD as we do for our veterans, I can't imagine we do much better for the relatives of the dead.

The men and women who gave their lives for this country deserve to be honored today, probably more than they actually are given the competition with white sales and going to the beach.  At the same time, wherever they are we know they are not in pain.  The same cannot be said for their parents, children, spouses and friends.  We often say that those who died in war "made the ultimate sacrifice."  For that we honor them.  Let's take a moment, today, to honor those who have to live with that sacrifice for the rest of their lives, too.

photo copyright istockphoto/stephaniefrey

Guadalupe Rosas, 59, was working at her register in an Apex, North Carolina Target store this morning when a man she had once been involved with walked in and shot and killed her.  When police arrived and confronted him, he shot and killed himself.  About 150 people were in the store at the time of the incident. The Target corporation issued a statement this evening and said that the store would be closed tomorrow "so that we can focus on taking care of our team." 

Certainly there is plenty of work for counselors to do in this incident.  Aside from the obvious fact that this is a violent death, it is the death of someone at work.  While Ms. Rosas may not have been a public safety professional in the line of duty, she was nonetheless part of a team that worked together, and she, unlike her colleagues, did not survive her shift.  This will make for a more complicated set of reactions in her coworkers, from wondering if "it could have been me" to anger that she put everyone at risk to guilt that they even entertained such a thought.

In addition, there are 150 people from all walks of life who were not sure they were going to survive their shopping trip this morning.  News reports include statements from people who hid in a storage room, a man who was shopping with his young son, people who were smashed up against the doors in the panic, and someone who reported seeing flipflops and sandals strewn in the parking lot where people had run out of their shoes.  Many people ran to a nearby Lowes store where staff tended to those injured in the evacuation and waited under lockdown for police to arrive.  Every one of those Target patrons, as well as those staff and customers at Lowes who helped, potentially will have intrusive sensory images from the incident, whether they find themselves picturing the sandals in the parking lot or the shooter pointing a gun at them.  Many of those people thought they were going to die, and that is a serious risk factor for post-traumatic stress disorder.

Then there are the police officers on the scene.  Everyone is different, of course, and undoubtedly at least some of them will have no regrets that the shooter killed himself.  He was, after all, a "bad guy."  Others, however, will be troubled by the visual image of actually seeing him do it, and by the knowledge that they were right there but powerless to stop him.

This is another one of those times when having multiple different trained crisis teams responding and supporting people could be very beneficial.  Ideally, Target has either its own team or an Employee Assistance Provider with trained CISM providers available.  The police department, we can hope, has its own team with trained cops and mental health professionals and maybe a chaplain.  If we're really lucky, there's also a community response team to support the customers and the folks from Lowes.  Of course, this not being an ideal world, it's entirely possible that Target is sending in a couple of company psychologists with no trauma training at all, the police department will tell its people to "buck up," and no one will do anything for the customers at all.  That happens all the time.  I just hope folks are a little more prepared to recover in Apex.

In August, 2002, a Chicago woman who was 8 months pregnant reported that her gynecologist had raped her.  Forensic evidence, including a rape kit, was gathered, but no comparison sample was ever taken from the doctor.  This wasn't the first allegation of sexual assault against this doctor nor, as it turns out, would it be the last.  His license was suspended for several months last year after four women made allegations.  On Thursday, the doctor was arrested in the 2002 case, almost 8 years after it happened, but less than two weeks after his DNA was finally tested against the rape kit.

Now, a few disclaimers.  I don't know the alleged victim or the alleged perpetrator in this case, and obviously I don't know what happened that day in 2002.  Everyone is presumed innocent until proven guilty, and that holds for this case as much as for any.  However, for the sake of argument, I'm going to presume that this crime occurred exactly as described and the doctor is guilty.  Again, I don't know if that's true, but let's imagine it is.

When most people hear the word "rape" they imagine someone jumping out of the bushes or a dark alley and accosting a woman.  They imagine a weapon of some kind.  They imagine that the perpetrator and the victim don't know each other.  In fact, however, the rapist and victim are strangers to each other in only about 1 in 4 rapes.

Rape, regardless of the circumstance or relationship, is traumatic.  Rape violates the victim's sense that the world is a safe place and that they are in control of and can protect their own bodies.  Rape by someone you know and trust adds the extra violation of the victim's belief that they can judge character and that they are loved and cared for by those closest to them.  In this instance, there is the additional factor that the victim was pregnant.  While violence against pregnant women is certainly a known phenomenon, most of us hold the belief that pregnant women are sacrosanct, particularly towards the end of the pregnancy.  Here, a woman was raped while pregnant, not just by someone she knew but by someone she trusted to help her pregnancy be safe.  Obviously, that trust was violated in the worst way.

People who have experienced or been exposed to trauma often experience a sense of unreality, both during and after the incident.  It's very common to hear people say, "This can't be happening" or "It isn't true."  What they are actually saying, though, is that the fact that it is true is too much for them to bear.  They can't process it.  The only thing that helps that is time spent living with the notion that it did happen, and opportunities to process what that means for them.  But in this case, as in too many cases of sexual assault, the people who were supposed to help this woman either didn't believe her or didn't care enough to follow up, or maybe they had some other motive. 

Whether the victim was actually told this didn't happen, she certainly got the message that it didn't matter.  That is an especially difficult message to receive, because it directly interferes with processing the original incident and coming to terms with it.  People already worry that they are crazy for how upset they are and how a critical incident affects them.  If they're told it didn't happen, while they still know it did they have entered another phase of the incident and their own disbelief -- not only was this woman raped, and she felt it couldn't be happening, she wasn't believed, which again must have felt unreal.  If she was told it didn't matter, that just reinforced how crazy she was already feeling.

Reading about this case, I was reminded of an exam I had during my own pregnancy with my son.  My doctor, who is male, and his physician's assistant, who is female, entered the room.  I made some wise-crack about the PA being my bodyguard, and my doctor said very seriously, "She's not here to protect you, she's here to protect me."  In fact, she was there to protect us both, and to attest that nothing inappropriate happened during the exam.  I can only vaguely imagine what it would be like to be assaulted under those circumstances.  I can't begin to fathom what it would do to me, after that, to not be believed.

Photo copyright istockphoto/jenjen42

I took my first Critical Incident Stress Management training class in 2003.  It was offered through my school district and taught by two social workers from the county department of Community Mental Health.  One of them was Gary Logan.  Gary was, among other things, the coordinator of the county community CISM team, called the Traumatic Events Response Network (TERN).  At the end of the class, he solicited volunteers who wanted to join the team.  I signed up.

I'm not sure that Gary knew what to do with me at first.  There are two categories of CISM responders:  mental health professionals and peers (some would argue that there's also a third -- clergy).  TERN, at that point, was entirely made up of mental health professionals because there was no one population it served.  Where a team assisting police officers would have cops on it as peers, a team assisting all kinds of people doesn't know what kind of peers it needs.  For the first few years, I was only tapped to respond when there was a crisis involving children or schools. 

Gary and I consulted and worked with each other more frequently when he came to assist our district team -- which needed lots of school personnel as peers -- with crises in our schools.  He was very interesting to watch and work with.  He had a calm about him in everything he did, and it put people at ease.  I learned from him how to explain complex psychological processes in language people could understand, how to grasp themes from what people were saying, and how to firmly state what you think is the right thing to do and accept that sometimes those in charge are not going to listen to you.  I never saw him sweat.

A few years ago, when I decided to pursue a Certificate of Specialized Training in schools and children crisis response, I asked Gary to please include me on more critical incident stress debriefings, and he did.  He started assigning me to respond as a peer outside of schools -- in community settings, businesses, and even responding to a group of mental health professionals from his agency following the murder of a client.  When I floated the idea of becoming a CISM instructor, Gary wrote my recommendation and told me he thought I'd be great.

Over the last couple of years, Gary has invited me to substitute for him as the coordinator on call for the county team and even allowed me to coordinate a couple of responses myself, something I do as a peer in a school setting all the time but a rarity out in the "real world."  He has expressed faith in me at every turn, strongly encouraging me to take on whatever I could, expand my consulting and, most recently, start considering earning a mental health degree myself.  His confidence in me has been astounding, and it has increased my confidence in myself.

Over the years I have needed assistance more than once with crises in which I was affected myself.  Gary was always my first call.  Watching him from the "other side" of a response was amazing, and his support was so helpful to all of us.  Whether I was responding or being responded too, Gary always reminded me to take good care of myself, and knew that I wasn't always so good at it without his reminders.

Gary retired when his department was cut at the end of last year.  He continued to coordinate TERN as a contractor.  Yesterday, he died suddenly during treatment for heart disease.  He was 63.  I doubt there will ever be anyone with as much faith in my crisis response skills as Gary.  I also doubt there will be anybody I so readily call on in my own time of need.  In fact, this morning, after I heard that he had died, I found myself wishing more than anything that I could talk it over with my friend and mentor, Gary Logan.

Transocean, the company that operated the oil rig that exploded last month in the Gulf of Mexico, sponsored a memorial service today in Jackson, Mississippi for the 11 employees who are missing and presumed dead in that accident.  Many of the 115 surviving workers from the rig, whose collapse triggered the massive oil spill still going on in the Gulf, were expected to travel from throughout the south to attend the service. 

I will admit to greeting this news with some cynicism.  My first thought was that today -- five weeks after the accident -- was a little late to be holding a memorial service.  The second was that, having allegedly tried to muscle its workers into signing waivers the day of the accident, the company had a lot of nerve inviting them to this service and saying they were a "community."

Let's take that second thought first.  I still am skeptical that the executives at Transocean are very concerned with the wellbeing of this community of theres.  Their past actions, at least as alleged in court documents, don't seem to support that.  However, the fact that they allegedly did something really awful does not actually preclude the possibility that they're doing something good.  Whatever their motivation -- be it altruism or pure PR -- bringing the workers back together and holding a memorial service is a good thing to do, and the executives at Transocean get some credit for it.

This brings us to the timing of the service.  As memorial services go, this is pretty late.  Depending on your religious tradition, services to honor the dead are usually held within a week or two of the death, and in some traditions with 24 or 48 hours.  Funerals and memorial services give a sense of "closure" to survivors, which is not to say that they are somehow then "over" the death, but rather that the death itself as an event is over and the healing can, perhaps, begin.  For the survivors of the Deepwater Horizon, there has been no formal event to mark the end of the event.  When they finished with the lawyers on the day of the explosion, they went to be with their families, some were still in the hospital, and they scattered to their home towns.  At that point, the search was still on for the 11 missing men.

By the time the search was called off, the hospitalized were out of the hospital and the dust had settled somewhat, the two week window for a service had passed.  At that point, the easiest thing to do would have been nothing.  Each of the 11 families undoubtedly held services according to their own traditions and beliefs in their own communities, and Transocean was not really obligated to do much other than possibly send a representative to those services. 

Having a memorial service sponsored by the company, however, allows the survivors to come back together, to see each other, to be with others who understand what they went through, and to reach some kind of closure.  It recognizes that the dead workers hailed not just from communities defined by their residences, but from a community of workers who were on the rig that day and most of whom were employed by Transocean. 

It has been said that funerals are more for the living than for the dead.  That is certainly my personal belief.  In this instance, a delayed but well-planned memorial service offered comfort not just to the bereaved, but to the survivors.  That is how it should be, and why Transocean chose to do the right thing is entirely beside the point.

The first of six defendants was convicted today in the murder of three young adults in Newark, New Jersey three years ago and the attempted murder of a fourth.  The dead, Iofemi Hightower, 20; Terrance Aeriel, 18; and Dashon Harvey, 20; and the survivor, Natasha Aeriel, 19, were all students or soon-to-be-students at Delaware State University, were hanging out on a Newark school playground when they were attacked with guns and machetes.  At least one of the female victims was sexually assaulted.

These murders are widely referred to as the "Newark Schoolyard Murders."  They got a fair amount of attention when they happened, and the Associated Press says they

jolted New Jersey's largest city into trying to fix its crime problem.

I find this an interesting phenomenon.  Clearly this is not the only homicide Newark has ever seen.  There were 106 homicides in Newark the year that these killings took place.  What made these stand out?

While there is plenty that is fairly typical about these murders, they also have particular aspects that propel them to the top of the front page.  First of all, while people in Newark might have come to expect homicides by the time these occurred in August of 2007, there were some caveats.  Generally speaking, there was one victim at a time, killed by one or two perpetrators.  There was gang violence, but it usually killed other gang members.  The number of murders involving unknown assailants and random violence was still a tiny percentage.  In this instance, the murders happened in a low crime part of town, relatively speaking, and the victims were college students, not gang bangers.  The motive appears to have been initiating a new gang member, with robbery as an afterthought.  In short, these murders violated all of the basic worldviews that allow people to think of violence as something that happens to other people.  If these kids could be killed, anyone could.

I think that the factor that most tipped the scales in favor of massive publicity, however, was that the killings took place in a schoolyard.  When you read the term "schoolyard murders," your first thought is probably about school children being killed, perhaps by other students.  We as a society are obsessed with school violence despite lots of evidence that school is one of the safest places for children in this country.  Sending our kids to school takes a leap of faith, because we as parents can't watch over them, so murders in schools are a big deal.  In this instance, even though it was nighttime, summer, and neither the victims nor the killers were students at the school, the simple use of the term "schoolyard murders" triggers a visceral response, and we want to learn more.

Certainly these young people did not deserve to die like this.  No one does.  And to the extent that this event was a catalyst for change, that's all to the good.  It's important to remember, though, that 103 other people were murdered in Newark that year.  Not all of them were minding their own business, not all were college students, not all happened to have been killed on a school playground.  All 106 murder victims were human beings who had people who cared about them.  As the coverage of this and the remaining trials hits the news, let's take a moment to remember them, too.

Police officers Brandon Paudert and Bill Evans were killed on Thursday during a routine traffic stop in West Memphis, Arkansas.  Some time later, their killers, a father and son, were shot and killed themselves in a shootout with police.  Two other officers were wounded.  Such stories are tragic but not all that uncommon. 

What is uncommon is the killer's motivation for shooting these officers.  Unlike your average traffic-stop-gone-wrong, where the suspect is trying to get away from police because they are wanted for a more serious crime or because they have something in the car they don't want police to find, these shooters were not on the run from the law.  They were so-called "sovereign citizen" activists.  They did not recognize the legitimacy of the government or the authority of the police.

Death in the line of duty is unbelievably complicated.  Paudert and Evans' fellow officers undoubtedly want to honor them for their service, as does the general public.  They died protecting and serving the rest of us.  At the same time, their deaths are scary, to us and to other police officers.  Cops know that any traffic stop could be their last, and when it actually happens to someone they work with it drives that point home rather drastically.  Spouses and children of cops, similarly, will look at their officer loved ones and wonder whether this could happen to them.  Add to this the fact that, while Paudert and Evans worked to protect society, they could not adequately protect themselves, and there is probably a lot of blame and guilt in the law enforcement community in West Memphis.

All of this is textbook stuff that goes on whenever a police officer is killed in the line.  But this case has a complicating factor on top of all that.  This was not, in fact, a typical cop killing.  These officers were not killed because they were trying to get a bad guy who didn't want to be gotten.  They were killed because they were cops, period.  There is no amount of training and strategy that can adequately prevent someone who wants to kill you no matter what and at any cost from doing so. 

If you read the news stories about this shooting, you'll find lots and lots of information about the shooters.  Their names are easy to find, as is information about their background.  The names of Paudert and Evans, meanwhile, are something of an afterthought.  They aren't as colorful characters as their killers.  They don't make as good a story.  And they aren't, frankly, as scary to the general public as their shooters are.  There are people out there -- the Hutaree, the Guardians of the Free Republics, or just two guys like these -- who not only don't like the government but want to take it down, and are willing to take others with them.  That makes it scary to be a cop.  It also makes it scary to be someone who thinks having cops around is a generally good idea.

Last Monday, a pipe bomb combined with gasoline exploded in back of the Islamic Center of Northeast Florida in Jacksonville.  Sixty people were worshiping inside at the time.  No one was injured, although the building suffered minor damage and filled with smoke for a short time. A $20,000 reward has been offered for information leading to the arrest and conviction of the bomber, who was captured on surveillance camera.  He appears to be a middle aged white male.

The national media has not picked up the story of the Jacksonville mosque bombing to any great extent.  If you do a Google News search for "Jacksonville Mosque" you will turn up numerous stories from the Florida press, as well as an assortment of national blogs discussing the fact that the national media has ignored this story, but not much else.  Most of these national blogs note the implied prejudice of major news outlets failing to pick up what certainly appears to be an attempted terrorist attack that could have killed 60 people, but whose victims are Muslim.

I don't disagree with these bloggers.  However, I think even they are guilty of what scholars sometimes call "othering."  They are outraged at the act itself, and at the media for failing to cover it.  But they don't go as far as to express empathy with the community that was attacked.  They are reacting to the politics, but not to the impact of the attack itself.  Someone has attacked those "other" people, and we (presumably "typical") people are outraged by the attack and outraged at the media.  But we aren't caring for the victims.

For the religiously affiliated among you, try to imagine how you might feel if your church or synagogue were attacked.  How safe would you feel at the next service?  How confident would you feel parking in the parking lot?  How much sleep would you lose?  How much grief might you feel for actual damage done?  And how much anticipatory grief might you feel at the thought of damage that might yet be done?

Now imagine that the bulk of those who support your congregation expressed that support by insisting that the news cover the incident.  Surely you'd appreciate that.  There's nothing wrong with taking a firm stand that such attacks are unacceptable regardless of who the victims are, and that media should report them without bias.  But wouldn't you want some of those same folks to stop by your church or synagogue or your house?  Wouldn't you want them to try to understand your fear and how very personally you took this attack?  Wouldn't you want people to stand up, not just for you, but also with you?

I have nothing against the bloggers who have pointed out the media's bias.  It needs to be done.  But it is only the first step.  I challenge my blogging brethren not just to cover the politics of this attack and its coverage, but to really try to understand how it feels to be a victim of it, and bring that experience to their readers.  Until we are able, as a blogosphere, to see victims of anti-Islamic violence as "us" rather than "them," it will continue to be easy for people to turn that othering to violence.

It has been a month since the Deepwater Horizon oil well started spewing millions of gallons of oil into the Gulf of Mexico.  A few days ago word came that they had managed to start capturing some of the oil, but they haven't managed to stop the spewing -- this is a temporary solution.  Now part of the spill appears to be rounding Florida and heading up the east coast.

A critical incident is usually defined as any event which has the potential to overwhelm usual coping skills and cause significant distress and impairment.  A trauma is a deeply emotionally or physically distressing event.  While it's not part of the definitions, the events that tend to be identified as critical incidents or traumas are also very sudden.  The suddenness is often part of what overwhelms us.  It all happens so fast that we don't have time to process things as they happen.

Aside from the folks on the oil rig that exploded itself, this spill is not a sudden event.  There was plenty of time between when the well started leaking and when the oil started to impact people's lives on shore.  No one in Louisiana, for example, was killed or maimed by the sudden oil spill that came out of nowhere.  Folks on the east coast, who may be about to be impacted, have plenty of time to prepare. 

So is this a critical incident? Is it a trauma?  I think, for at least a subset of the population, it is.  There is a reason that suddenness is not part of the official definitions.  If you think about it, there are other traumas that are not sudden.  People may know for days or even weeks, for example, that a hurricane is headed their way.  That time to prepare may mitigate the impact of the storm, but the storm still can be traumatic -- just look at Hurricane Katrina.  Traumatic incidents can also happen over a long period of time, as happens with childhood abuse.  Critical incidents don't have to come out of nowhere.

Returning to the oil spill, if you are a fisherman in the Gulf of Mexico, the fact that when the well started leaking you knew you were in big trouble didn't help a whole lot.  If your livelihood has been wiped out by this disaster over the last month, it is relatively little consolation that it was oil contaminating the ocean over a few weeks rather than, say, a sudden storm that destroyed your boat.  You did not start the year expecting this to happen, and it happened in a way that was utterly destructive to your ability to earn a living.  In addition, there is a pretty good possibility that you were just getting back on your feet from Katrina when this happened.  Watching it happen in slow motion might make it easier to deal with, or it might make it harder.  But this spill certainly has the potential to overwhelm your usual coping mechanisms.

For people on the east coast, this might even be a little more traumatic.  That's because people whose livelihood depends on clean water in the Atlantic saw this spill happen and thanked their lucky stars it wasn't near them.  They identified with those on the gulf coast, but they also separated themselves from them.  This was happening to "them" not "us."  Now, they are us, and most people on the eastern seaboard have probably not used the intervening time to figure out what to do.

Others with more expertise than I can expound on the causes of this catastrophe and the implications for future energy policy, the environment, and the like.  When the damage is tallied, the monetary losses to the fishing and tourism industries and others that rely on the ocean will be included.  I hope that those in the know will include, somewhere in there, the psychological damage to the people in those industries and communities who may very well lose their entire way of life.

Aiyana Jones was asleep on the sofa of her Detroit home early Sunday morning when police executed a warrant and came looking for her aunt's fiance, who was wanted for a murder earlier in the weekend.  Accounts differ about what, exactly, happened when officers entered the home.  Everyone agrees that, within seconds, Aiyana Jones was dead, shot by a police bullet.  She was 7 years old.

You might imagine that there's a fair amount of crime and trauma discussed in my family.  My tween daughter has heard it all -- probably much more than she should.  As a result, some things that would horrify other kids don't really faze her.  She knows that bad stuff happens, and she also knows, for the most part, that it doesn't happen to her.  My husband and I try, when we can, to make sure that we are the ones to tell her scary news so we have the opportunity to put it in some context, be reassuring, and answer any questions.  That's not always possible, of course, because sometimes we're getting the news at the same time she is.

That's what happened this morning.  News of Aiyana's death came on the radio, and my daughter and I heard it at exactly the same time.  My first thought was, "Ugh, that's going to be messy."  Then I looked over at my daughter, whose mouth was hanging open.  She finally said, "That's -- that's -- that's so sad!!" 

Instantly, I knew that her reaction was the right one, not mine.  Yes, this is going to be messy.  No matter whose version of events you believe -- did the grandmother tussle with a police officer whose gun went off?  Did police fire from outside the house?  Was the girl burned by a flash grenade before she was shot?  Had neighbors warned officers that there were children in the house? -- this is not a good situation.  Police, in the course of their jobs, killed a little girl.  That has the potential to ignite huge problems between police and residents and certainly will trigger a big investigation, as it should.

But whether it's messy or not is really not the main issue.  A little girl died.  Her father and grandmother have just lost an important member of their family, a child.  Whatever anyone inside the house did or did not do, they didn't intend for this to happen.  No parent tucks their child in at night and contemplates the possibility they won't be alive in the morning, at least not due to this kind of incident.

Why did my daughter and I have such radically different reactions?  To some extent, it has to do with age and experience.  I look at things from a crisis point of view, and she looks from a human point of view.  Still, you'd think I would have keyed into the trauma the family experienced a little better than I did.  I've also heard stories like this before, while she hasn't.  Thankfully they aren't common, but they do happen and probably don't shock me the way they shock my daughter.

If I'm honest, though, I have to say that, because of my age and experience and the society in which we live, I have an expectation that "things like this" happen in Detroit.  I would be shocked if it happened in Ann Arbor, but not in Detroit.  My daughter, either because her mother does a better job of teaching compassion than of living it or because she just hasn't been steeped in the negative expectations of Detroit and its citizens the way I have, knows that a child is a child, no matter where you live.  It's one of those moments in parenting when you realize your kid embodies your values better than you do.  I'm very proud.  I'm also a little ashamed.

Before this week, Jerry Joseph had a pretty good life.  He was a 16-year-old basketball star at Permian High School in Odessa, Texas -- the high school where Friday Night Lights takes place.  This week, however, he was arrested three separate times.  It turns out that Jerry Joseph is actually Guerdwich Montimer*, and he is 22 years old.  He was arrested first on a misdemeanor charge of failing to identify himself to a police officer, next for falsifying his birth certificate, and today for sexual assault.  It turns out that last summer Montimer had sex with his high school girlfriend, who was 15 at the time and thought he was too.

Most people understand that sexual assault of any kind is traumatic to the victim.  We as a society have come a very long way since the not-so-distant past where "date rape" was not recognized as being "real" rape, for example.  We understand that rape and other forms of sexual assault do not have to be a stranger dragging someone into the bushes, but can involve alcohol or drugs, underage victims, and/or romantic partners or spouses.

This case raises an interesting issue, however.  Montimer's girlfriend consented to the sex at the time (although in Texas you can't legally consent to sex if you're under 17).  Chances are she did not feel traumatized at the time, and probably didn't between then and this week, either.  Because of her age she may well have experienced long-term effects of this experience, but in the immediate she was probably OK.  This week, however, she is definitely not OK. 

So what changed?  The only difference between then and now is that then she thought the boy was her age, and now she knows he wasn't.  Why should that make such a difference?  What happened hasn't changed -- only what she knows about what happened.

It does make a difference.  We experience our lives not just based on the straightforward facts of what happens as we perceive them in real time, but also through our understanding of what those events mean.  We are constantly interpreting the world and processing what impact events have on our identities, our sense of self worth or safety, and about a zillion other things. 

The physical facts of what happened to the girlfriend haven't changed, but her understanding of what that means have changed radically.  She now knows that she was manipulated by a significantly older person -- an adult -- who got her to consent by lying.  She knows she would not have consented if she had known.  She knows that, while she wasn't aware at the time of the inherent power differential that was caused by him being an adult, he was, and he used it to his advantage.  Using a power differential to get sex is a crime, and that's why he was arrested. 

This constitutes sexual assault just as having sex with someone who is too drunk to know what is going on is sexual assault.  If they wouldn't consent if they had all the facts (and could process them lucidly), the sex is not consensual.  When they "come to," either by sobering up or by finding out you lied, they are going to be traumatized, and the person who got them drunk or lied to them or manipulated them in any way will  be looking at jail time.

* As you know, I don't usually identify perpetrators by name.  In this instance, it was relatively difficult to tell the story in an understandable way without doing so, so I've made an exception.

photo copyright istockphoto/Stockphoto4u

The Centers for Disease Control has just come out with a comprehensive 16 state review of violent deaths in 2007.  This may sound about as thrilling to you as watching pain peel off a barn (or perhaps a comprehensive study of paint peeling off a barn), but there's actually some very interesting information contained in this report.  In particular, it challenges some of our assumptions about people who die violently.  This is interesting (at least to me), because part of what helps us deal with the threat of violence is convincing ourselves that it happens to other people.  On the flip side, to the extent that we believe it does happen to people like us, it raises our anxiety level quite a bit.  This report allows us to work off of facts rather than assumptions, which is generally a good thing.

One of the first things that lept out at me from this report is the fact that you are less likely to die by murder than you are by suicide.  I guess as I think about it that makes sense, but it certainly wasn't my gut-level prediction.  Most of us see suicide as a risk we can avoid -- we probably overestimate how much this is true.  We see murder as something that just happens, and that scares us.  But this report tells us that the thing we think we can control is actually more likely.  This may give some of us a (perhaps false) sense of security.

Another thing that struck me is that people who die by both suicide and homicide have about a 1 in 3 chance of having alcohol in their system when they die.  People who kill themselves, however, are about 250% more likely than people who are murdered to have other drugs in their systems.  Again, these are risks that we can control -- don't drink, don't do drugs, and maybe you won't die.

Not surprisingly, people who kill themselves have a very high incidence of mental illness, with more than 40% of them having a depressed mood before they died.  What might surprise you is that about 30% of people who die by suicide are taking antidepressants, compared to about 4% of those who are murdered.  Does this mean that antidepressants cause suicide?  Not necessarily.  People who are depressed are at risk for suicide.  People who are depressed are also more likely to be taking antidepressants.  That doesn't mean antidepressants are a risk for suicide.

Perhaps the most startling finding in this study has to do with the age at which people are most likely to be murdered.  The highest risk age group for men is 20-24.  Men are, overall, 3 times more likely to be murdered than women, so, generally, being female is a protective factor.  What is shocking (at least to me) is that the highest risk age group for females is less than one year.  The time of a woman's life when she is most likely to be murdered is in infancy.  She is twice as likely to be murdered then as when she is in her 20's.  That very much goes against the core belief many of us have that children don't die and that people don't hurt children.  Apparently, they really do.

Finally, the look at precipitating factors for homicide in this report brings home rather strongly that murder is not, in fact, random.  For men, the most common precipitating factor to their murder is an argument or other conflict about something other than money.  For women, more than half of murders are the result of violence by their partner.  Arguments about money or property, gang violence, and even drug violence are much less likely.  About 1/3 of murders happen as part of another crime such as robbery.  Random violence accounts for less than one percent of homicides.

So, now that you've read all about the peeling paint, why does this matter?  It matters because we make assumptions every day about what is dangerous in the world and what is not.  We pick which neighborhoods we will or won't walk through at night and how many locks to have on our doors based on our perception that the danger will come to us if we make the wrong choices.  Certainly, doing things like these lessens our risk.  We spend much less time and psychological energy, however, thinking about how to protect ourselves from the much more likely dangers -- the people we live with or spend time with, the substances we consume, and our own mental health.  Maybe it's time for a little attitude adjustment.

On May 4, 1970, members of the Ohio National Guard opened fire on unarmed students during a protest at Kent State University against the United States' invasion of Cambodia.  They fired 67 shots, wounding 9 and killing 4.  Eight Guardsman were subsequently indicted, but the case was dismissed.

On May 4, 1970, my mother was pregnant.  The baby was due on May 15.  My parents lived in Concord, Massachusetts, but my mother was slated to deliver the baby at Mt. Auburn Hospital in Cambridge, about 20 miles away.  My father also worked in Cambridge.  Their last baby had come rather quickly, so my mother spent the last days of her pregnancy at my father's office so that, if she went into labor during the day, she would be close to the hospital and my father would be with her.

On May 4, 1970, my father walked into his office and found my mother sitting by the radio, distraught.  News of the Kent State shootings had been reported.  She told my father, "We can't bring a baby into this world."  My father, in his ever-helpful way, responded, "It's a little late for that."

On May 11, 1970, their baby was born.  For the record, although the 11th was a Monday, the extra precaution of my mother going to work with my dad turned out to be unnecessary.  She went into labor on Sunday, Mother's Day, and the baby was born less than half an hour after midnight on Monday morning.

As in many families, the story of the day each child was born was told and retold as I was growing up.  Different people told different versions with different emphasis.  The story about my mother listening to the radio in my father's office was often part of the tale.*  Growing up, "Kent State" was not a university in my mind, but an event, and because it was part of a family birth story it was, somehow, our event.

Last week marked the 40th anniversary of the Kent State shootings.  Anniversaries of traumatic events are hard for the survivors and family members -- most people recognize that.  In its own way, this anniversary was hard for the collective consciousness of the country, as we wonder what, if anything, we learned 40 years ago.

I found myself oddly affected by the news stories about the anniversary last week.  On the one hand, the shootings did not affect me or my family directly.  At the same time, Kent State is part of my family, part of our lore.  So today, May 11, 2010, I honor the students who died at Kent State, 40 years and one week after my mom heard of their deaths on the radio and wondered about having this baby, and 40 years after she did, in fact, bring me into the world.

* As with many family stories, this one has been filtered through the years.  I undoubtedly have parts of it wrong, and no doubt someone in my family will let me know about it.

Philip Pagano, age 60, of Crystal Lake, Illinois, died on Friday.  He intentionally walked in front of a Metra Commuter Rail train in one of the many suicide-by-train incidents that occur every year on our nations tracks.  This is sufficiently common, actually, that it might not have made the news outside of the Chicago area at all were it not for two factors.  First, Philp Pagano was under investigation for giving himself a $56,000 bonus at work.  Second, his job was Executive Director of Metra.

Some would say it is ironic that Pagano killed himself with one of his company's own trains.  Others might call it some kind of poetic justice.  Both of these characterizations treat Pagano's method of suicide as random, but of course it was not.  He chose to kill himself using a Metra train.  That choice was neither ironic nor poetic.  There are, however, at least two possible explanations for it.

First of all, people who die by suicide tend to choose methods that are easily available to them.  The most glaring example of this is that police officers who kill themselves very disproportionately use firearms, with the attendant result that police officers who attempt suicide very disproportionately die.  People who do not have access to guns do not kill themselves with guns.  Very few people go out and buy a gun to kill themselves with.  Police officers wear a highly lethal method of attempting suicide on their belt every day.

Similarly, people who do not ride commuter trains or live near a track are unlikely to kill themselves by stepping in front of one.  Pagano, on the other hand, rode the train to work every day and was around them at work all the time.  He had been placed on leave and so was not riding the train on Friday, but he knew when and where that particular train would be because, until the end of April, he rode it every day.  Being in the business he was in, furthermore, he had lots of exposure to suicide by train.  It's hardly surprising that, when he chose to kill himself, he chose a method so easily available and with which he was so familiar.

Secondly, conventional wisdom suggests that people, at least sometimes, choose a method and/or place to kill themselves as a way to send a message.  The most obvious examples of this are terrorists who use their death as a political statement by killing themselves and taking others with them.  The man who flew his plane into an IRS office earlier this year clearly had a statement to make.

People don't necessarily have to have something political to say when they choose how to kill themselves, however.  Many people who attempt suicide give quite a bit of thought to who will probably find them and how they will feel about it.  It's not uncommon for people to choose to kill themselves in a particular location as a way of showing how negative they feel about that place and the people in it.  On the other hand, it's also not uncommon for people to choose to kill themselves away from the people they love in an effort to spare them some anguish.  This is not always true, certainly -- sometimes people kill themselves in a place that is convenient for them without any particular message -- but it undoubtedly happens.  It's not too much of a stretch to imagine that Pagano had some kind of negative message for Metra or the people there which he conveyed by using a Metra train to kill himself, or that he wanted to say, "This train was responsible for my successes and my failures, and now it's responsible for my death."

Philip Pagano had a wife, children and grandchildren.  He chose not to kill himself at home, and, in fact his wife was out of town.  Perhaps he wanted to spare her in some small way.  If there is any irony in these situations, it is that not only is that probably small comfort to her and the rest of his family, it may actually make things worse.  It is one of the hardest things about suicide that someone could think their actions through enough to know they shouldn't die where their family is, but not enough to know they shouldn't kill themselves at all.

As most of us know by now, on April 20, an oil rig exploded in the Gulf of Mexico, killing 11 workers.  The well in question belongs to BP, but the oil rig was owned by Transocean.  Allegations have now surfaced that, after the surviving workers were rescued from the rig, they were kept at sea for 15 hours and then brought to a hotel where they were asked to sign pre-printed statements indicating whether they witnessed the accident and whether they were injured.  Only after this were they allowed to see their families. 

Workers who have now filed lawsuits against the company are now finding that Transocean will be using those statements against them. The survivors argue that their statements were coerced.  No one but the lawyers and the survivors really know what happened that night.

When we think about a statement being "coerced," we usually imagine some B-movie crime drama.  Bright lights shine in the person's face.  Threats are made.  Perhaps torture is used.  The New Oxford American Dictionary defines "coerce" as:

persuade (an unwilling person) to do something by using force or threats.

It seems unlikely that thumbscrews were literally applied to the oil workers.  It does not appear that anyone is alleging that the workers were threatened if they didn't sign.  So were their statements coerced?

Putting aside the semantics of the word, I think it's safe to say that their statements are not reliable.  One of the things trauma survivors experience is difficulty making decisions and appreciating the consequences of their actions.  Their judgment is impacted.  That's why we routinely tell people not to make life-altering decisions in the days or weeks following an incident.  People shouldn't be deciding whether to quit their job when there's just been a horrible incident at work -- they can't think it through clearly.  People who have just been rescued from an exploding oil rig where 11 of their coworkers have died don't have the cognitive capacity to decide whether to sign something, or even really to assess whether it's true.

In addition to this, Maslow argues that you can't attend to higher order needs until more basic needs are cared for.  In Maslow's hierarchy of needs, the most basic level is physical needs, the second is safety and the third is love/belonging, which includes family.  The evacuated oil workers were, at best, concerned about this third level when they were asked to sign those statements, and probably still pretty concerned for their safety as well.  Problem solving and morality (which would include telling the truth) are on level five, self-actualization.  The workers were in no condition to worry about that.

Were they coerced?  If they thought that signing the statements was the only way to get out of there, then they were.  Otherwise, it's not so clear.  What is clear is that those statements shouldn't hold up in court any more than if the workers had been drugged when they signed them.  What's more, the Transocean lawyers almost certainly knew that.  They were hoping to scare people out of suing.  Apparently, it hasn't worked. 

Earlier this week, I blogged about what I referred to (with tongue somewhat in cheek) as "the great water crisis of 2010," the Massachusetts water main break that left 2 million people without safe drinking water.  I also used the term "catastrophe," although I said it wasn't a very catastrophic catastrophe.  A Quarterbacker calling him/herself I'm Just Musing wrote an interesting comment:

Do you really feel this was a "crisis" or a "catastrophe"? What has happened to this country when something like this causes panic and people fighting in supermarkets to get bottled water. You could drink the water if you boiled it first, that isn't so hard to do. The power going out, I can see that being a problem, although even with that, you would be surprised how well people can function without it, it's just that we would rather complain than try to make do without.

I responded briefly to this reader in the comments, but I think this deserves a more thorough explanation.  Is a water main break automatically a crisis, or automatically not one?

What Musing is actually arguing here is not so much that the water incident in Massachusetts isn't a crisis, but rather that it shouldn't be a crisis.  People should not react strongly to this.  It's a little inconvenient, but it's not a big deal.  We should not be upset.  But whether something should be a crisis probably isn't the major factor in whether it actually turns out to be one.

I am reminded of a scene in one of my favorite movies, The American President, in which the President (played by Michael Douglas) says, "This is not the business of the American people," and his Chief of Staff, played by Martin Sheen, responds, "With all due respect, sir, the American people have a funny way of deciding on their own what is and what is not their business." In a similar vein, it is all well and good to say we shouldn't be upset about something, but our minds have a funny way of deciding for themselves what is and what is not upsetting.

From the point of view of early crisis intervention, it is completely irrelevant whether we should or should not be upset by something.  The only thing that matters is whether we are.  If something impacts us so significantly that it overwhelms our usual coping skills, it is a crisis.  There is no "should" about it.  There is only "is."

One of the biggest mistakes overly enthusiastic responders make, particularly when they're new, is to come at a situation with all the intervention tools they've got based on what they think people are probably feeling. On the flip side, it is equally bad to fail to notice that something is a crisis for the people involved because it wouldn't both most people. Experienced teams listen carefully to how people are doing before planning their response.  That doesn't mean you can't use the event to predict who might be upset and what they may be feeling, but this shouldn't prevent you from noticing people who are impacted whom you didn't expect, or from discerning that everyone's actually doing OK.

So should the water incident in Massachusetts have been a crisis for people?  I think Musing makes a compelling case that it should not have been, at least for your average citizen.  For your average crisis responder, however, anything big can be a crisis, and we know that, for someone out there, this probably was.

This weekend someone packed a bunch of explosive and flammable material into an SUV and parked it in Times Square in New York.  The investigation of this is the number one most popular story on Google News today, and I am not going to blog about it.  President Obama gave the commencement speech at the University of Michigan here in Ann Arbor, and I'm not blogging about that either.  Thousands of gallons of oil are threatening the Gulf Coast, and I probably will blog about that tomorrow.  Massachusetts is still without drinking water, and I blogged about that yesterday.  You probably knew about all of these things (perhaps not the U of M story, but you would if you lived here).

Early this morning, Detroit police officers responding to shots fired in a vacant apartment were ambushed.  Four were wounded, one was killed.  Officer Brian Huff became the first line of duty death in the Detroit Police Department since 2004.  The national press barely covered it.  The Ann Arbor press, 40 minutes from Detroit, didn't cover it at all.  Neither did the Michigan-wide public radio affiliate.

Certainly a lot more people are affected by the Massachusetts water situation and the oil spill in the Gulf.  The President speaking in town is pretty rare.  The bomb in Times Square affected a lot of people directly, and scares a lot of people vicariously.  All of these things are important.

In a typical year, there are less than 70 police officers nationwide that are killed by suspects.  Michigan has had two this year, but had none last year.  This isn't terribly common.  It may not affect as many people as some of the other stories, but those it does impact are affected much more severely.  Frequent Quarterbackers may recall that there is a whole Critical Incident Stress Management course just on responding to the 5 most serious types of incidents.  Not only is death in the line of duty one of those, but there is actually an additional course just on that.

So why did Officer Huff's death and his colleagues' shootings get so little attention?  I think there are two reasons.  First, there was a lot of news affecting a lot of people this weekend, which meant that this story had to more actively compete for coverage.  Second, Detroit has a lousy reputation for high crime.  In other words, people think that this sort of thing is about par for the course in Detroit.  This is especially ironic since, although Detroit's crime rate is high, its rate of line of duty deaths for police officers isn't.  By any objective standard, this ought to be a big story.  We just don't make those judgments by objective standards.

There is no community in this country for which a police officer shot in the line of duty feels normal.  The Detroit press is covering this story closely.  It's the rest of us, outside (but not all that far outside) of Detroit that are turning a blind eye.  We think "those people" in "that city" expect this sort of thing.  Unfortunately, we think wrong.

About two million people in the greater Boston area are under a boil water order for the second night tonight, after a massive water main break in Weston, about 15 miles west of the city.  The vast majority of communities in the Boston area are part of the Massachusetts Water Resources Authority (MWRA), which provides water and/or sewer service through a centralized system.  All communities in the MWRA east of I-95/Route 128 were affected by yesterday's break.  The backup reservoirs that are being used while the break is fixed are not as large as the one that usually feeds the system, and are largely untreated, so in addition to the water being unsafe to drink, people are also being asked to minimize their water usage.

In the history of catastrophes, certainly there are many more catastrophic than this one.  It is unlikely anyone will die from this water emergency, at least if they follow the boil order.  At the same time, this kind of story grabs our attention, or at least it grabs my attention.  As a native of the Boston area, I feel a particular connection to this situation.  In a more general way, however, this is also impressive because of the sheer number of people affected.  It  draws our attention to how much we take for granted the phenomenon of turning on the faucet and getting drinkable water. It also serves as something of a dry run for a truly life-threatening emergency.  We all figure we'd manage if something failed at our house -- we could always go to the neighbors or a hotel or the next town over.  Something like this makes you realize what happens when everyone is affected at the same time.

Because this isn't a life-threatening disaster, it's easy to think that people shouldn't be too upset.  That might sound logical, but the human mind isn't all that logical.  There are all sorts of signals -- from the tone of the news reports to the disruption of normal routines -- that something big has happened, and it's understandable that a lot of people find themselves feeling hyped up for what seems like no good reason.  Some people will even find themselves disappointed that this wasn't scarier or bigger or more important.  That's understandable, too, because they're actually wishing that events would justify their gut reactions.

There is something about a situation like this one that brings people together.  This is the sort of thing where people will say, "Do you remember the great water crisis of 2010?" and people will swap their stories.  In that sense, there is something of the feeling of adventure to this type of incident.  It is just serious enough to make us really pay attention, but not so serious that it will be too scary to reminisce about it.

The last such that fits this description for me was the Northeast Blackout of 2003.  A massive succession of failures in the power grid on August 14, 2003 blacked out much of the mid-Atlantic and southern New England, as far west as Lansing, Michigan.  I bring this up because not only is it the same kind of event, but, for my family, it had a similar effect.  We live in a township without access to municipal water, so our water comes from a well in our backyard via a pump -- an electric pump.  With no electricity, we had only the water in our pressure tank, and no idea how long we would have to make it last.

I have great stories about those couple of days.  There are some about neighbors helping neighbors.  Some about the crazy things that people did to get what they needed.  Some that would embarrass my child if I told them publicly.  That's how this sort of thing goes.  When this is over, the people of Eastern Massachusetts will have good stories, too.  In the meantime, they've got a major nuisance to deal with, and possibly a gut reaction to it that seems embarrassingly strong.  They might be surprised to know how many of their neighbors have that reaction, too.

Quarterbacker Deborah has children in the Santa Monica-Malibu Unified School District.  This week, she passed along a letter from Superintendent Tim Cuneo:

Dear SMMUSD Parents and Staff,

On April 28th, the Santa Monica Police Department released information that one of our middle school students died last week as a result of “self strangulation,” also called the “choking game.”

Students, parents, and SMMUSD staff are shocked and grief stricken by this loss. This tragedy also heightens our awareness of the prevalence of children nationwide engaging in this extremely dangerous activity.

The choking game is an intentional activity in which children suffocate each other by various methods, including: strangling themselves or others with belts, ropes, their bare hands, or placing great pressure on their chest in an effort to induce hyperventilation.

What many youth are unaware of is that maintaining a strangulation technique too long may accidently [sic] cause death and/or brain damage.

The popularity of the choking game may boil down to one simple fact: children and adolescents believe it is safe.
We encourage you to talk to your child about engaging in this dangerous game. Below are some websites with information about the choking game and how to discuss this critical topic with your child.

www.gaspinfo.com
www.family.samhsa.gov
www.guidancechannel.com
www.tweenparent.about.com

Sincerely,
Tim Cuneo, Superintendent

I wish I could tell you that Santa Monica-Malibu is the only school district having to send out such letters these days, but they aren't.  The "choking game" seems to be impossible to eradicate and affects every part of the country.

Superintendent Cuneo's letter is a good one.  It is informative and helpful for those families -- and it's probably a lot of them -- who have never heard of the choking game.  It doesn't deal with the traumatic grief that the community is dealing with, but I have no way of knowing if he, or the school, are dealing with that in other ways. The other thing it doesn't deal with, because it can't, is the thought running through most parents' minds when they read it:  If this kid didn't get the message, how can you guarantee that my kid will?

My 11-year-old and I have had many conversations about various dangers of adolescence over the years.  I'm a big believer in having the conversation well before you think the kid needs it because a) they will need it earlier than you think they will and b) when they need it, they won't want to have the conversation.  One of the earliest ones was about inhalants.  I pointed out to her that sniffing things makes you feel high because it replaces the oxygen in your brain with the chemicals in whatever you're sniffing, and she immediately saw that that could be a bad situation -- your brain needs oxygen.

The choking game presents a whole new issue in prevention, however.  In order to engage in the choking game, you need to be willing to intentionally deprive your brain of oxygen.  It's hard enough to get kids to see the dangers of inhalants.  How do you get them to stop doing something (or not start doing something) that ought to be much more obvious?

I know that, as my daughter enters adolescence, she will undoubtedly make choices that are not what I want for her.  She will do things that I could tell her would turn out badly.  That is part of growing up.  I have to hope that the discussions we've had -- about drugs, eating disorders, inhalants, alcohol, sex and, yes, the choking game -- will prevent her from trying those particular things.  Mostly, I have to hope that when she makes her bad choices, they aren't so bad that they're irretrievable.  I have to hope that they aren't so bad she winds up dead.  When I read something like this, however, I find myself wondering if this boy's parents had all those conversations too, and if they had the same hopes.  Our best as parents is not necessarily enough, and I don't know about you, but it scares me.