As an army psychiatrist treating soldiers returning from Iraq and Afghanistan, Major Nidal Malik Hasan had a front row seat on the brutal toll of war. It is too early to know exactly what may have triggered his murderous shooting rampage Thursday at Fort Hood - Hasan is accused of killing 12 people and wounding 32 others before he was wounded by a police officer - but it is not uncommon for therapists treating soldiers with Post Trumatic Stress Disorder (P.T.S.D.) to be swept up in a patient's displays of war-related paranoia, helplessness and fury. (See pictures of suicide in the recruiters ranks.)
In medical parlance it is known as "secondary trauma", and it can afflict the families of soldiers suffering from P.T.S.D. along with the health workers who are trying to cure them. Dr. Antonette Zeiss, Deputy Chief of Mental Health Services for Veteran Affairs, while not wishing to talk about the specific case of the Fort Hood slayings, explained to TIME that: "Anyone who works with P.T.S.D. clients and hears their stories will be profoundly affected."
It's entirely possible that other factors may have acted as a trigger for Hasan's alleged killing spree. The army major was a devout Muslim who reportedly had been harassed because of his religion and had developed strong objections to the wars in Iraq and Afghanistan. But he was also due to be shipped out to Afghanistan, drawing him closer to the terrible scenes described in detail by his patients. At army hospitals dealing with P.T.S.D. patients, the staff is required to periodically fill out a 'resiliency' questionnaire that is supposed to gauge how well they are coping with the burden of their patients' emotional and psychological demands. "It takes its toll on people," says one officer at a Colorado military hospital. "You cannot be un-affected by the terrible things these soldiers have undergone." (See pictures of the aftermath of the Fort Hood shootings.)
Most army psychiatrists now have a full caseload of men and women returning from combat zones with P.T.S.D.. A survey by the Rand Corp. last April revealed that one in five service men and women are coming back with post-traumatic stress and mental depression. Previously known as "combat fatigue" or being "shell-shocked", P.T.S.D was only diagnosed as an illness in the 1980s, but it has been around for as long as men have been killing one another and undergoing fearful experiences. It can lead to outbursts of rage, emotional numbness, severe depression, nightmares, and the abuse of alcohol and pain-killers. In extreme cases, P.T.S.D. sufferers have committed suicide and murder. Since the late 1980s, doctors have also learned that over time, along with drugs and therapy, P.T.S.D. is curable.
As part of their therapy, PTSD sufferers are typically asked to dredge up their worst wartime memories. Hearing these nightmarish experiences can stir up powerful reactions in even the most seasoned therapists. One Colorado sergeant, diagnosed with P.T.S.D., who had served as a dog-handler in Iraq, told me how his psychiatric counselor had broke down sobbing after the soldier described how he had been sent out to find the remains of his close friend, a helicopter pilot, shot down in southern Iraq. "I looked up, and there she was crying," the sergeant says. "I didn't want that from a shrink."
But there is a major difference, says Veteran Affairs' Zeiss, between a therapist being moved by combat horror stories and being traumatized by them - though it can happen. "Psychiatrists are trained to notice their own reactions and emotions, and if there's something hard to deal with, they should turn to their peers," she says. But according to some news reports, Hasan's unprofessional conduct was red-flagged early on; at Walter Reed he was given a poor performance report, but that did not hinder his transfer to Fort Hood.
And for even the most hardened army psychiatrist, that would be a grueling assignment. Fort Hood has the highest suicide rate of any army base in the country, largely because so many service men and women stationed there have undergone severe trauma while deployed in Iraq and Afghanistan. At Fort Hood, in other words, there was no shortage of horrific tales that could have set loose the demons in Hasan's mind.
Monday, November 9, 2009
China bans physical punishment for Internet addicts
BEIJING (Reuters) - China's Ministry of Health has banned the use of physical punishment to wean teens off the net, months after a boy was beaten to death at an Internet boot camp.
Chinese parents have turned to more than 200 organisations offering treatment for Internet "disorders" as the government increasingly warns of unhealthy Internet habits among the young.
Many of the camps are imbued with a military atmosphere. Patients are forced to replace hours in front of the computer with arduous physical drills or even more extreme "treatments".
"When intervening to prevent improper use of the Internet, we should ... strictly prohibit restriction of personal freedom and physical punishments," the ministry said in a draft guideline for Internet use by minors, posted on its website (www.moh.gov.cn).
It appeared to have dropped the term "Internet addiction", widely used in earlier ministry documents, perhaps in a bid to calm worried parents who fuelled a mushrooming business of harsh camps to prevent teens from spending hours online.
The death of 15-year-old Deng Senshan, just hours after he checked into an Internet bootcamp in the southwestern Guangxi region in early August, caused a media storm in China.
Days later another teenager, Pu Liang, was taken to hospital with water in the lungs and kidney failure after a similar attack in Sichuan Province.
The government in July had already banned electro-shock therapy as a treatment for Internet addiction, after media reports about a controversial psychiatrist who administered electric currents to nearly 3,000 teenagers.
The latest guidelines suggest officials in Beijing do not think that those with unhealthy Internet habits should be forced offline permanently.
Chinese parents have turned to more than 200 organisations offering treatment for Internet "disorders" as the government increasingly warns of unhealthy Internet habits among the young.
Many of the camps are imbued with a military atmosphere. Patients are forced to replace hours in front of the computer with arduous physical drills or even more extreme "treatments".
"When intervening to prevent improper use of the Internet, we should ... strictly prohibit restriction of personal freedom and physical punishments," the ministry said in a draft guideline for Internet use by minors, posted on its website (www.moh.gov.cn).
It appeared to have dropped the term "Internet addiction", widely used in earlier ministry documents, perhaps in a bid to calm worried parents who fuelled a mushrooming business of harsh camps to prevent teens from spending hours online.
The death of 15-year-old Deng Senshan, just hours after he checked into an Internet bootcamp in the southwestern Guangxi region in early August, caused a media storm in China.
Days later another teenager, Pu Liang, was taken to hospital with water in the lungs and kidney failure after a similar attack in Sichuan Province.
The government in July had already banned electro-shock therapy as a treatment for Internet addiction, after media reports about a controversial psychiatrist who administered electric currents to nearly 3,000 teenagers.
The latest guidelines suggest officials in Beijing do not think that those with unhealthy Internet habits should be forced offline permanently.
Landmark health bill passes House on close vote
WASHINGTON (AP) - The Democratic-controlled House has narrowly passed landmark health care reform legislation, handing President Barack Obama a hard won victory on his signature domestic priority.
Republicans were nearly unanimous in opposing the plan that would expand coverage to tens of millions of Americans who lack it and place tough new restrictions on the insurance industry.
The 220-215 vote late Saturday cleared the way for the Senate to begin a long-delayed debate on the issue that has come to overshadow all others in Congress.
A triumphant Speaker Nancy Pelosi compared the legislation to the passage of Social Security in 1935 and Medicare 30 years later.
Obama, who went to Capitol Hill earlier on Saturday to lobby wavering Democrats, said in a statement after the vote, "I look forward to signing it into law by the end of the year."
"It provides coverage for 96 percent of Americans. It offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," said Rep. John Dingell, the 83-year-old Michigan lawmaker who has introduced national health insurance in every Congress since succeeding his father in 1955.
But minority Republicans cataloged their objections across hours of debate on the 1,990-page, $1.2 trillion legislation.
"We are going to have a complete government takeover of our health care system faster than you can say, 'this is making me sick,'" said Rep. Candice Miller, R-Mich.
In the run-up to a final vote, conservatives from the two political parties joined forces to impose tough new restrictions on abortion coverage in insurance policies to be sold to many individuals and small groups.
The legislation would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government's mandates.
Insurance industry practices such as denying coverage because of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. The industry would also lose its exemption from federal antitrust restrictions on price fixing and market allocation.
At its core, the measure would create a federally regulated marketplace where consumers could shop for coverage. In the bill's most controversial provision, the government would sell insurance, although the Congressional Budget Office forecasts that premiums for it would be more expensive than for policies sold by private companies.
The bill drew the votes of 219 Democrats and Rep. Joseph Cao, a first-term Republican who holds an overwhelmingly Democratic seat in New Orleans. Opposed were 176 Republicans and 39 Democrats.
From the Senate, Majority Leader Harry Reid of Nevada issued a statement saying, "We realize the strong will for reform that exists, and we are energized that we stand closer than ever to reforming our broken health insurance system."
To pay for the expansion of coverage, the bill cuts Medicare's projected spending by more than $400 billion over a decade. It also imposes a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families.
Republicans were nearly unanimous in opposing the plan that would expand coverage to tens of millions of Americans who lack it and place tough new restrictions on the insurance industry.
The 220-215 vote late Saturday cleared the way for the Senate to begin a long-delayed debate on the issue that has come to overshadow all others in Congress.
A triumphant Speaker Nancy Pelosi compared the legislation to the passage of Social Security in 1935 and Medicare 30 years later.
Obama, who went to Capitol Hill earlier on Saturday to lobby wavering Democrats, said in a statement after the vote, "I look forward to signing it into law by the end of the year."
"It provides coverage for 96 percent of Americans. It offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," said Rep. John Dingell, the 83-year-old Michigan lawmaker who has introduced national health insurance in every Congress since succeeding his father in 1955.
But minority Republicans cataloged their objections across hours of debate on the 1,990-page, $1.2 trillion legislation.
"We are going to have a complete government takeover of our health care system faster than you can say, 'this is making me sick,'" said Rep. Candice Miller, R-Mich.
In the run-up to a final vote, conservatives from the two political parties joined forces to impose tough new restrictions on abortion coverage in insurance policies to be sold to many individuals and small groups.
The legislation would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government's mandates.
Insurance industry practices such as denying coverage because of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. The industry would also lose its exemption from federal antitrust restrictions on price fixing and market allocation.
At its core, the measure would create a federally regulated marketplace where consumers could shop for coverage. In the bill's most controversial provision, the government would sell insurance, although the Congressional Budget Office forecasts that premiums for it would be more expensive than for policies sold by private companies.
The bill drew the votes of 219 Democrats and Rep. Joseph Cao, a first-term Republican who holds an overwhelmingly Democratic seat in New Orleans. Opposed were 176 Republicans and 39 Democrats.
From the Senate, Majority Leader Harry Reid of Nevada issued a statement saying, "We realize the strong will for reform that exists, and we are energized that we stand closer than ever to reforming our broken health insurance system."
To pay for the expansion of coverage, the bill cuts Medicare's projected spending by more than $400 billion over a decade. It also imposes a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families.
The Ft. Hood Hero: Who is Kimberly Munley?
The west side of Killeen, Texas, is like countless other places in the heart of America, freshly dug in the prairie grasslands with wide streets in neighborhoods like bucolic "Sunflower Estates" and "Bridgewood. But a glorious day cloudless autumn, the colors in the center of home sales are close to half mast in honor of fallen Fort 13. Hood, victims of a sniper attack in which the killer was arrested with a small , mother longhaired blonde neighbor
Sgt. Kimberly Munley, 34, a civilian Department of Defense police officer at the base, is credited with stopping the firing rampage of U.S. Army Major Nidal Hasan at the Soldier Readiness Center within a few minutes after he launched his attack. The center is a quick five minute drive from Munley's home, past the new strip centers and the high school football field along wide Cross Creek Boulevard, but a world away from the horrors inflicted in one of the worst incidents of soldier-on-soldier violence in U.S. Army history. (Read TIME's report: "Stresses at Fort Hood Were Likely Intense for Hasan")
Munley, described by neighbor Brooke Beato, as "very petite, with long blonde hair and a strong personality," was credited by base officials with preventing further carnage by aggressively engaging Hasan as he shot at her. She rounded a corner, took aim at Hasan and brought him down, officials said. "It was an amazing and an aggressive performance by this police officer," base commander Lt. Gen. Robert Cone said. It also was a tactic straight out of recent lessons learned from the 2007 Virginia Tech shooting, when first responders waited for additional backup before engaging the shooter.
"She walked up and engaged him," said Lt. Gen. Cone told Associated Press. As a member of the base Special Reaction Team, Munley had learned that "if you act aggressively to take out a shooter, you will have less fatalities," Cone said.
Soon after Munley fired at Hasan, taking him down, she herself fell wounded and police radios quickly sent out an "Officer down" call. Wounded three times in the arm and leg, Munley is in stable condition after undergoing surgery Friday to repair damage to an artery. Base officials said she wishes she could have acted even faster and saved more lives, and she spent Thursday evening calling friends and colleagues, expressing those regrets.
While Thursday's shooting sent a shockwave through the tight-knit Killeen community, Beato, whose husband is an Army captain, said she was not surprised when Munley's name surfaced as the police officer who ended the shooting. "It was just like her - she carries herself with confidence," Beato said.
Beato is a 30-year-old mother of four whose children often play with Munley's daughters, ages 12 and 3, in the quiet cul-de-sac. "I couldn't believe what happened, but when I heard what she did," says Beato of her neighbor, "I believed that because of who she is - I know her."
Munley, who worked as a police officer for five years in North Carolina where her father, Dennis Barbour, once served as mayor of Carolina Beach, is a talented shooter and member of the base's Special Reaction Team which trains for the possibility of events like Thursday's shooting rampage. She also is a passionate fan of Twitter and once news of her actions spread, her followers began to blossom in number - among them country singer Dierks Bentley who posed for a photo with the petite police officer at the fort's annual July Fourth FreedomFest. The photo is posted on her Twitter page along with a brief biographical quote: "I live a good life...a hard one, but I go to sleep peacefully at night knowing that I may have made a difference in someone's life."
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