Shooting rampages, mental health, and the sensationalization of violence

Journal/Website: 
Surgical Neurology International
Article Type: 
Article
Published Date: 
Tuesday, January 29, 2013
Source: 
http://www.surgicalneurologyint.com/text.asp?2013/4/1/16/106578

Abstract — Gun violence and, most recently, senseless shooting rampages continue to be sensitive and emotional points of debate in the American media and the political establishment. The United Nations is already set to commence discussing and approving its Small Arms Treaty in March 2013. And following the Newtown, Connecticut tragedy in the United States this past December, American legislators are working frantically to pass more stringent gun control laws in the U.S. Congress.

The American media and proponents of gun control assert that the problem lies in the “easy availability of guns“ and “too many guns” in the hand of the public. Second Amendment and gun rights advocates, on the other hand, believe the problem lies elsewhere, including a permissive criminal justice system that panders to criminals; the failure of public education; the fostering of a culture of dependence, violence, and alienation engendered by the welfare state; and the increased secularization of society with children and adolescents growing up devoid of moral guidance. I cannot disagree with the latter view, but I believe there are additional, contributing, and more proximate causes — e.g., failures of the mental health system and the role of the media and popular culture in the sensationalization of violence — that also need to be specifically pointed out and discussed in the medical literature, as I have set out to do in this review article. 


INTRODUCTION

The debate on the role of firearms in society has returned with a fury in the United States and the world with the latest shooting rampage in Connecticut. Politicians are once again calling for gun control without examining other psychosocial factors that play a tremendous role in gun violence.

The shooting rampage at Sandy Hook Elementary School in Newtown, Connecticut, on December 14, 2012 in which 6 adults and 20 children were killed, was indeed a senseless tragedy, and like previous mass shootings, words cannot convey the horror and the magnitude of the loss of innocent life. This second deadliest mass shooting in U.S. history was carried out by 20-year-old Adam Lanza, a loner with a Adam Lanzapersonality disorder — and in critical need of mental health evaluation and psychiatric treatment [Figure 1, left]. Once again, evidence mounts that these deadly rampages are the result of failure of the mental health system in association with, as we will suggest in this article, the systematic sensationalization of violence by the media and popular culture.

Let’s revisit the case of Jared Loughner, the 22-year-old disturbed individual who shot former U.S. Representative Gabrielle Giffords in Arizona in 2011. He also killed 5 people, including an innocent 9-year-old student and a judge, and wounded 14 others. Prior to the shooting, there were signs of psychiatric illness and social psychopathology that should have alerted those around him that Loughner should have been referred for mental evaluation and psychiatric treatment. But Loughner, like Lanza, fell through the obvious cracks.Jared Loughner

The case of Loughner in Arizona  [Figure 2, right] is particularly revealing because a consensus has been reached that the mentally deranged individual should have received psychiatric evaluation and treatment, which were not administered.[2] The same conclusion is being reached as more information is rapidly coming to light in the latest rampage by Adam Lanza in Connecticut.

“Convicted felons and mentally unstable people,” as I stated in a previous article, “forfeit the right to possess arms by virtue of the fact they are a potential James Holmesdanger to their fellow citizens. This has been demonstrated recently by the tragedies that took place in Arizona and in Aurora, Colorado [Figure 3, left]; and not only in the United States, but also in Oslo, Norway.”[3]

The case of the senseless massacre in Norway on July 22, 2011 is instructive. After bombing a  government building in Oslo and then taking over an island, Anders Behring Breivik, a homicidal killer, massacred 69 of his fellow citizens, systematically hunting down unarmed youths at a camp, methodically killing mostly defenseless Anders Behring Breivikteenagers [Figure 4, right]. Imagine if just one person had carried a gun and knew how to use it to defend his or her life and the lives of others! But Norway, for all practical purposes, like most of Europe, is like the schools in the U.S., a “gunfree zone,” where guns are not allowed and a deranged individual can enter and kill with impunity.

Investigation and further legal developments in these three aforementioned incidents represent cases of criminal insanity associated with regrettable failures in the mental health system, rather than the assignation of blame with the easy cliché of “too many guns” in the hands of people. In my article, “America, Guns and Freedom,” I also cite other recent cases, including the two reciprocal incidents that occurred in Aurora, Colorado, in the spring and summer of 2012. One incident was widely reported; the other, where a citizen stopped a rampage and saved the lives of others, was not.[1] In the U.S., the vast majority of citizens who hunt, participate in shooting sports, and most importantly, those who possess firearms in their homes for family protection or legally carry concealed weapons for self-protection, use firearms responsibly.[3,4,7,17,21]

SHOOTING RAMPAGES AND THE ARMED CITIZEN

In 2000 a New York Times study revealed that in 100 cases of rampage shooting incidents, 63 involved people who “made threats of violence before the event, including 54 who threatened specific violence to specific people.” Nothing had been done about the threats. Moreover, over half of the shooters had overt signs of mental illness that had gone untreated. For these troubled individuals, a precipitating event in association with failures in life and long-term mental illness finally triggers the shooting rampage, giving “the appearance of being at the same time deliberate and impulsive.”[8]Figure 5

A more recent study by Mother Jones magazine also suggests the majority of mass shooters in the past 30 years evinced signs of mental health problems prior to the killings. This conclusion is supported in the medical and legal literature. While the figures in the Mother Jones article are for the most part correct, unfortunately the analysis and conclusions are not because, like many other studies on gun violence, they are tainted by passion and ideology, resulting in overt biased and result-oriented, preordained conclusions.[10] For example, while it is true that the number of shooting rampages has increased in recent years, the rate of violent crimes and homicides for both Blacks and Whites (including those committed with firearms) has decreased significantly over the same period, despite the tremendous increase in the number of firearms in the U.S., according to both the FBI Uniform Crime Reports and the U.S. Bureau of Justice Statistics.[9,18-20] [Figure 5, above] In fact, the number of firearms has increased from approximately 200 million in 1995 to 300 million in 2012, in association with a significant decrease not only in violent crimes [Figure 6, below] but also in all property crimes [Figure 7, below] since 1990 to the present.Figure 6[18-20]

I would also be remiss if I did not point out the Mother Jones article was incorrect when it also claimed, “in not a single case was the killing stopped by a civilian using a gun.”[10] Consider the following cases:

In November 1990, Brian Rigsby and his friend Tom Styer left their home in Atlanta, Georgia, and went camping near Oconee National Forest, not too far from where I live in rural Georgia. Suddenly, they were assaulted by two madmen, who had been taking cocaine and who fired at them using shotguns killing Styer. Rigsby returned fire with a Ruger Mini-14, a semiautomatic weapon frequently characterized as an assault weapon. It saved his life.[16]

In January 1994, Travis Dean Neel was cited as citizen of the year in Houston, Texas. He had saved a police officer and helped the police arrest three dangerous criminals in a gunfight, street shooting incident. Neel had helped stop the potential mass shooters using once again semiautomatic, so-called assault weapons with high capacity magazines. He provided cover for the police who otherwise were outgunned and would have been killed.[21]

Figure 7The January 16, 2002, case of three law students at the Appalachian School of Law in Grundy, Virginia, who prevented a mass shooting, is very interesting. The media reported the incident but left out one inconvenient detail. According to the Washington Post, they “pounced on the gunman and held him until help arrived.” What the media left out was the fact that one of the students was armed, and thus they felt safer in carrying out the courageous act they  performed. In his book, scholar John Lott recounts the incident: “Mikael and Tracy were prepared to do something quite different: Both immediately ran to their cars and got their  guns. Mikael had to run about one hundred yards to get to his car. Along with Ted Besen [who was unarmed], they approached Peter [Odighizuwa, the gunman] from different sides. As Tracy explains it, ‘I stopped at my vehicle and got a handgun, a revolver. Ted went toward Peter, and I aimed my gun at [Peter], and Peter tossed his gun down. Ted approached Peter, and Peter hit Ted in the jaw. Ted pushed him back and we all jumped on.’”[13]

In 2007, a brave woman, Jeanne Assam, a former police officer who had volunteered to work security at the New Life Church in Colorado Springs, Colorado, prevented a shooting rampage when she shot and killed a man storming the building who intended to kill as many people as possible at her church.[15]

Just days after the recent Connecticut shooting, an off-duty police officer prevented a shooting rampage at the Mayan Palace Theater in San Antonio, Texas, by shooting the gunman before he had a chance to kill anyone.[15] This incident “sparks memories” of the mass slaying at “the gun-free zone” Cinemark movie theater in Aurora, Colorado, that I discussed  elsewhere.[3] I also noted then how the media did not report another shooting incident that took place 3 months earlier (April 2012) in the same town, Aurora, Colorado, where a  law-abiding citizen, an armed church-goer, shot another human predator and stopped a shooting rampage, saving his life and the lives of others in the process.[1]

OTHER INSTRUCTIVE (BUT FORGOTTEN OR IGNORED) CASES

In that same article,[3] I discussed the following additional cases that I now report verbatim since the inconvenient details of armed citizens saving lives were ignored, not only by the investigative journalists of the mainstream media, but also missed by the Mother Jones study, that claimed “in not a single case was the killing stopped by a civilian using a gun.”[10] Thus consider further the following incidents:

In 1997, in Pearl, Mississippi, 16-year-old Luke Woodham used a hunting rifle to kill his  ex-girlfriend and her close friend and wound 7 other students. Assistant Principal Joel Myrick retrieved his handgun from his automobile and halted Woodham’s shooting spree. Myrick held the young delinquent at bay until the police arrived. Later it was discovered that Woodham had also used a knife to stab his mother to death earlier that morning. Even though this shooting incident was widely reported, the fact that Mr. Myrick, an armed citizen, had prevented a larger massacre by retrieving and using his handgun was ignored by the media.

Then in 1998, in Edinboro, Pennsylvania, a deadly scenario took place when 14-year-old Andrew Wurst killed 1 teacher and wounded another, as well as 2 fellow classmates. The Edinboro shooting rampage was halted by a local merchant, James Strand, who used his shotgun to force the young criminal to halt his firing, drop his gun, and surrender to the police.

And in another unreported incident in Santa Clara, California, Richard Gable Stevens rented a rifle for target practice at the National Shooting Club on July 5, 1999, and then began a shooting rampage, herding 3 store employees into a nearby alley, and stating he intended to kill them. When Stevens became momentarily distracted, a shooting club employee, who had a .45 caliber handgun concealed under his shirt, drew his weapon and fired. Stevens was hit in the chest and critically wounded. He was held at bay until the police arrived. A massacre in the making was prevented. The deed performed by the armed employee, an unsung hero, was ignored by the press. Why are these and other similar incidents, where the tables are turned, and citizens use guns to protect themselves and others, only seldom reported by the mainstream media?[3,7]

The fact, as we have recounted here, is that many crimes and shooting rampages have been prevented or stopped by armed citizens. Consider the case at the Clackamas Mall in Oregon in December 2012, where another shooter murdered 2 people. The deranged killer, after realizing another shopper (a concealed carry permit holder) had pulled a handgun and was aiming at him, then turned the gun on himself.[12] As with all types of crimes, the police cannot be everywhere at all times to protect us. By the time the police arrive at a crime scene, most dramatically at a shooting rampage, it’s usually too late for the victims. An armed citizen could already be there, identify the shooter, and at least stop the carnage. Only if one of the intended victims already at the scene is armed, can he or she prevent or stop the shooting, as in some of the cases described above.[1,11-13,15-17,21]

The incidence of mass shootings with the usual intensive media coverage and sensationali-zation give the impression that we are about to be swamped by shooters. The truth is that the incidence of mass shootings is very low by any standard. John Fund, a former columnist for The Wall Street Journal and distinguished National Review Online (NRO) columnist, correctly notes, “The chances of being killed in a mass shooting are about what they are for being struck by lightning.” And despite the draconian gun control laws in Europe, “until the Newtown horror, the three worst K–12 school shootings ever had taken place in Britain and Germany.”[11] Moreover, the Norway massacre of July 22, 2011, described previously claimed a total of 77 lives, mostly teenagers. These statements are not repeated here to trivialize shooting tragedies nor intended to detract from the need to be concerned about them, but to place the matter in a more precise sense of statistical proportion and recognize that the rest of the world, including those with strict gun control laws, is not immune.

In the wake of the Connecticut shooting, the National Rifle Association (NRA) has called for armed guards to protect all schools in the United States. In the short term, this may be a good idea, but is it feasible? We could begin by hiring security guards and police officers, but the police are stretched to the limit as it is, and budgets are tight with the American middle class already squeezed dry sustaining a myriad of  entitlement and social welfare programs. Thus, I suggest the employment of volunteer citizens, who must be psychologically evaluated and trained in the use of firearms and gun safety, to serve as “school sentinels,” as well as allowing qualified teachers to carry guns for student protection. The extra training is a precaution. According to a study conducted between 2005 and 2007 by researchers at the University of Wisconsin and Bowling Green State University,  the police across the country were convicted of firearm violations at an 0.002% annual rate, which is about the same rate as concealed-carry gun permit holders in the states with “shall issue” laws.[11] Research conducted by  criminology professor Gary Kleck and constitutional lawyer Don. B. Kates has shown that firearms are used more frequently by law-abiding citizens to repel crime than used by criminals to perpetrate crime. Moreover, Professor Kleck has noted: “Citizens acting in self-defense kill about three times more assailants and robbers than do the police.” And so it is not surprising that in a survey of 1800 prison inmates, 81% agreed that a smart criminal tried to find out if his potential victim is armed, 74% said that burglars avoid houses when people are home because they fear being shot, and 34% admit to having been scared off, shot at, wounded, or  even captured by armed citizens.[4]

Jim Kouri, the public information officer of the National Association of Chiefs of Police, told Fund at the time of the theater shooting in Aurora,  Colorado: “Preventing any adult at a school from having access to a firearm eliminates any chance the killer can be stopped in time to prevent a rampage.”[11] In fact police, occasionally outgunned by criminals, have also been assisted by armed citizens, although again these incidents have been downplayed by the mainstream media.[4,21]

THE DE-INSTITUTIONALIZATION OF THE MENTALLY ILL

The United States is a Federal Republic, and the 50 states of the Union have some leeway in passing and enforcing gun laws. In America, we already have 20,000 gun laws on the books. We do not need more statues. The societal failure for violence, with guns or otherwise, lies elsewhere. The killer in Connecticut operated with impunity in a state that does not easily allow people to carry guns for self protection, and most states in the U.S. already have a “zero tolerance” for guns in schools, which amount to “gun-free zones” where firearms are strictly prohibited. This is another reason for proposing that we consider allowing teachers to have special concealed carry firearm licenses to defend students. It would be a sensible and easy strategy to protect the children in this mad, dystopic world we are creating in which we are too permissive to criminals and protective of the rights of deranged individuals, while we easily blame and propose more laws and controls to limit the rights of the lawful citizens in society at large.

Guns are inanimate objects. The responsibility for crimes rests on the criminals and  those who facilitate their crimes! Elsewhere, I have discussed failures in the criminal justice system, leniency and use of revolving prison doors that allow many of the same criminals to commit the vast majority of serious crimes.[4] I would like to now elaborate on the aforementioned failures in the mental health system.

The problem with the  de-institutionalization of mental patients, which began in America in the 1960s and put  thousands of mental patients including dangerous ones back on the streets, has only worsened in recent years. This has happened not only because of the more recent drive for containment of health care costs, but also because of the decades-long, misguided mental health strategy of administering mental health care via community outreach and outpatient treatment. In many cases, these strategies have failed due to inadequate follow-up of and poor compliance by patients as well as legal restraints placed on families.

Another problem is the current privacy laws in association with the forced legal emancipation of children from their parents in educational and health care laws, which have caused difficulties for parents in obtaining confidential mental health records of their children, even those who are young adults and still dependent upon them for health insurance coverage. With the passage of the ObamaCare law requirements, children up to age 26 can be covered under the parent’s health insurance. This offers an opportunity to amend privacy laws to allow parents access to the mental health information on their dependent children. ObamaCare or not, these problems need to be corrected by relaxing privacy laws, allowing parents to exert more control of their children in the psycho-socially challenging, difficult years of adolescence and young adulthood when many cases of schizophrenia and other psychopathology first become apparent.

Family members and neighbors should not fear reporting, in good faith, individuals with a history of violence and possible mental illness to the appropriate law enforcement and mental health agencies with the removal of potential legal repercussions.

Moreover, legal impediments to medical commitment for those in need of long-term psychiatric hospitalization should be removed. Steven P. Segal of the University of California at Berkeley has shown that “a third of the state-to-state variation in homicide rates was attributable to the strength or weakness of involuntary civilcommitment laws.”[12] David Kopel, coauthor of the law school textbook, Firearms Law and the Second Amendment (Aspen, 2012), has correctly noted the detrimental drastic drop in long-term institutionalization of the mentally ill:

“In the mid-1960s, many of the killings would have been prevented because the severely  mentally ill would have been confined and cared for in a state institution. But today, while government at most every level has bloated over the past half-century, mental-health  treatment has been decimated.” Kopel then cites the dramatic statistics released by the Treatment Advocacy Center in July 2012: “The number of state hospital beds in America per capita has plummeted to 1850 levels, or 14.1 beds per 100,000 people.”[12]

THE SENSATIONALIZATION OF VIOLENCE IN THE MEDIA AND POPULAR CULTURE

Finally, there is another even more sinister and perhaps more insoluble contributing factor — namely, the problem of how the media report and how popular culture sensationalize violence, which in association with the fruitless pursuit of celebrity status in vogue today is all pervasive. What more evidence is needed for the “fifteen minutes worth of fame” phenomenon[5] than the immense popularity of vulgar “reality” television shows? It is not a big step to link  extensive coverage of shooting rampages in both the press and the colorful electronic media as a major contributing factor in the pathologic and even morbid attainment of celebrity status even in death.

I have previously reported on the excellent work of Dr. Brandon Centerwall of the University of Washington School of Public Health. Centerwall’s studies found that homicide rates in Canada were not related to easy gun availability in ordinary citizens, as he had expected, but to criminal behavior associated with watching television. He found homicide rates, not only in Canada but also in the U.S. and South Africa, soared 10–15 years after the introduction of television in those countries.

In the U.S., there was an actual doubling of homicide rates after the introduction of television. Moreover, Centerwall noted that up to half of all homicides, rapes, and violent assaults in the U.S. were directly attributed to violence on television. And that was when violence on TV was nothing compared to the rampant and graphic violence depicted today in the movies, on TV, and now on the Internet.[6]

In 2004 Loren Coleman also reminded us of the copycat effect as a social phenomenon incited by the way the media report the news and the velocity with which it travels in modern society in the information age. Serial killers and shooting rampages have also been subject to the copycat phenomenon because of the sensationalization of violence. Coleman relates that copycat incidents are not new to the 21st century. In 1774 Johann  Wolfgang von Goethe’s publication of the romantic tragedy, “The Sorrows of Young Werther,” triggered a number of copycat suicides in Europe in the late 18th century.[12]

While the media has sensationalized violence and the mass shootings of hapless victims (who are soon virtually forgotten), as we have seen they have not given defensive, beneficial uses of firearms (e.g.,  protecting or saving lives and property) the attention these positive acts deserve, which usually go unreported. By and large, to read about the cases where law-abiding citizens use firearms for self and family protection, one has to read independently published books, such as Robert A. Waters’ excellent tome, The Best Defense.[16,21] Only infrequently do these cases even get reported in the mass media or published in the medical journals by public health investigators in their “gun and violence” research.[7]

The death of innocents, particularly children, is a tragedy, and responsible journalists should be able to collect, write, and disseminate information to the public, while remaining unbiased, objective professionals who report the “news.” They should not use emotionally charged, atrocious crimes to incite even more passion to sell newspapers or television time, or to effect a desired public policy. And the media moguls, frankly, need to convene a meeting of the minds to plan and begin the systematic de-sensationalization of crime and of making morbid celebrities out of criminals.

LESSONS TO BE LEARNED

In medicine, surgeons cannot guarantee results. Complications and sometimes even bad results occur; the same can happen with misuse of guns. Firearms in the hands of terrorists, criminals, or the mentally deranged are very dangerous. Senator Dianne Feinstein (D-CA) and other politicians already plan to capitalize on the Connecticut tragedy to not only reintroduce the Assault Weapons Ban but to also pass more draconian gun control measures on the first day Congress reconvenes in 2013.[14] Never mind the fact that this ban was in force and did not prevent the infamous 1999 Columbine High School shooting in Littleton, Colorado, nor did the ban reduce crime when it was in effect. This is because gun control laws affect only the law abiding citizens — and not criminals, psychopaths, or deranged individuals, who are in need of improved crime control and/or mental health care.[2,5,11,12,22]

Alcohol prohibition in the U.S. is another telling story. The XVIII Amendment (Prohibition) had to be repealed with passage of the XXI Amendment because of noncompliance and the  mayhem created by contempt for the new law. Prohibition brought about alcohol smuggling, a black market for illegal spirits and liquor, and established in full force violence and organized crime in America. I have published a graph in one of my articles showing how crime spiked after prohibition and came down only gradually after its repeal.[3,17]

Better said than not said at all. There are already an estimated 300 million firearms in civilian possession in the U.S., a number nearly equivalent to the population of the nation. Pandora’s box has been opened, and guns are now as American as mom and apple pie.

Trying to blame, register, ban, and confiscate (one step usually follows the other) over 300 million firearms owned by Americans would bring about a tinder box situation an order of magnitude worse than Prohibition — for Americans obey just and moral laws but not capricious or tyrannical laws, and a veritable police state would be required to enforce the draconian gun laws that would be necessary to put a dent in the problem.

Thus, those politicians who are sadly already using this latest tragedy (and the emotionalism and the passions elicited in its wake) to push for another round of gun control — while ignoring the accumulated objective research published in the social sciences and the criminological literature[1,7,17] — are not sincerely lamenting the deaths of the innocents or sympathizing with their families, but attempting to score points, political points at the expense of the victims. They are also polarizing America and possibly tearing apart the fabric of this great nation by using emotionalism rather than true scholarship to bolster their unwise, political actions.

Let’s stop demonizing guns and end the shootings by incarcerating the  criminals and healing the sick, for much work needs to be done in the mental health arena and in the task of de-sensationalization of violence by the media in our dumbed down popular culture.

REFERENCES

1. Banda PS. Suspect in Aurora, Colo. church shooting identified, had been in prison. Available from: http://www.huffingtonpost.com/2012/04/24/suspectin-colo-church-sh_n_1450... [Last accessed on 2012 Apr 24].

2. Faria MA Jr. The tragedy in Arizona — A mental health challenge failure. GOPUSA.com. Available from: http://www.gopusa.com/commentary/2011/01/12/faria-the-tragedy-in-arizona... [Last accessed on 2011 Jan 12].

3. Faria MA Jr. America, guns and freedom: Part II — An international perspective. Surg Neurol Int 2012; 3:135. Available from: http://www.surgicalneurologyint.com/text.asp?2012/3/1/135/103542 [Last accessed on 2012 Nov 16].

4. Faria MA Jr. Women, guns, and the medical literature — A raging debate. Women and Guns 1994; 6(9): 14-17, 52-53. Available from: http://www.haciendapub.com/articles/women-guns-and-medical-literature-ra... [Last accessed on 1994 Oct 1].

5. Faria MA Jr. California: Another lesson about children and guns. Newsmax.com. Available from: http://archive.newsmax.com/archives/articles/2001/3/11/192712.shtml [Last accessed on 2001 Mar 12].

6. Faria MA Jr. TV violence increases homicides. Newsmax.com. Available from: http://www.haciendapub.com/articles/tv-violence-increases-homicides [Last accessed on 2000 Aug 17].

7. Faria MA Jr. Public health and gun control — A review (Part I): The benefits of firearms. Med Sentinel 2001;6:11-3. Available from: http://www.haciendapub.com/articles/public-health-and-gun-control-review... [Last accessed on 2001 Apr 12].

8. Fessenden F, Glaberson W, Goodstein L. They threaten, seethe and unhinge, then kill in quantity. The New York Times, April 9, 2000. Available from: http://www.nytimes.com/2000/04/09/us/they-threaten-seethe-and-unhinge-th... [Last accessed on 2013 Jan 2].

9. Fischer C. A crime puzzle: Violent crime declines in America. UC Berkeley NewsCenter. The Berkeley Blog, June 16, 2010. Available from: http://blogs.berkeley.edu/2010/06/16/a-crime-puzzle-violent-crime-declin... [Last accessed on 2012 Apr 24].

10. Follman M. More guns, more mass shootings — coincidence? Mother Jones, Sept. 26, 2012. Available from: http://m.motherjones.com/politics/2012/09/mass-shootings-investigation?p... [Last accessed on 2012 Sept 26].

11. Fund J. Facts about mass shootings — It’s time to address mental health and gun-free zones. National Review Online, December 16, 2012. Available from: http://www.nationalreview.com/articles/335739/facts-about-mass-shootings... [Last accessed on 2012 Dec 16].

12. Kopel D. Guns, mental illness and Newton. Wall Street Journal, Dec 17, 2012. Available from: http://online.wsj.com/article/SB1000142412788732372310457818527185742403... [Last accessed on 2012 Dec 17].

13. Lott J. The Bias Against Guns. Washington DC: Regnery Publishing; 2003. p. 24-7.

14. Newton shootings: Democrats Malloy and Feinstein seek gun controls. BBC News, December 16, 2012. Available from: http://www.bbc.co.uk/news/worldus-canada-20749167 [Last accessed on 2012 Dec 16].

15. Pavlich K. Mass murder prevented by off-duty cop. Townhall.com, December 18, 2012. Available from: http://townhall.com/tipsheet/katiepavlich/2012/12/18/mass-murder-prevent... [Last accessed on 2012 Dec 18].

16. Personal communication and interview with Brian Rigsby, 1996. Also cited in Waters RA. The Best Defense — True Stories of Intended Victims Who Defended Themselves With a Firearm. Nashville, TN: Cumberland House; 1998. p. 125-8.

17. Suter E. Guns in the medical literature — A failure of peer review. J Med Assoc Ga 1994;83:137-48. Available from: http://www.rkba.org/research/suter/med-lit.html [Last accessed on 2013 Jan 2].

18. United States Bureau of Justice Statistics. Homicide trends in the U.S. Available from: http://bjs.ojp.usdoj.gov/content/homicide/race.cfm [Last accessed on 2013 Jan 2].

19. United States Bureau of Justice Statistics. Office of Justice Programs, 2012. Available from: http://bjs.ojp.usdoj.gov [Last accessed 2013 Jan 3].

20. United States Crime Rates 1960-2011. Source: FBI, Uniform Crime Reports. Available from: http://www.disastercenter.com/crime/uscrime.htm [Last accessed on 2013 Jan 2].

21. Waters RA. The Best Defense — True Stories of Intended Victims Who Defended Themselves With a Firearm. Nashville, TN: Cumberland House; 1998. p. 23-40.

22. Wheeler T. Heal the sick and stop the shootings. The GunMag, December 17, 2012. Available from: http://www.thegunmag.com/heal-the-sick-and-stopthe-shootings/ [Last accessed on 2012 Dec 17].

Article written by: Dr. Miguel Faria

Miguel A. Faria, Jr., M.D. is Clinical Professor of Surgery (Neurosurgery, ret.) and Adjunct Professor of Medical History (ret.) Mercer University School of Medicine. He is an Associate Editor in Chief and a World Affairs Editor of Surgical Neurology International (SNI), and an Ex-member of the Injury Research Grant Review Committee of the Centers for Disease Control and Prevention (CDC). 2002-05; Former Editor-in-Chief of the Medical Sentinel (1996-2002), Editor Emeritus, the Association of American Physicians and Surgeons (AAPS); Author, Vandals at the Gates of Medicine (1995); Medical Warrior: Fighting Corporate Socialized Medicine (1997); and Cuba in Revolution: Escape From a Lost Paradise (2002). 

This article was originally published in Surg Neurol Int 2013;4:16.

Copyright © 2013 Miguel A. Faria, Jr., MD

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Shooting in Nevada

Obama Plugs for Gun Control in Wake of Nevada Shooting

Stockman bills would repeal “gun free zones”

Dear Helen,

President Barack Hussein Obama is picking a fight with gun owners once again. As reported by The Blaze on Tuesday:

One day after a deadly middle school shooting in Nevada, President Barack Obama “remains committed” to pushing for stricter gun control laws and will “keep at it,” White House press secretary Jay Carney said Tuesday.

This was the second conspicuous shooting in two months -- although the shooting this week did not garner nearly the amount of press that the Navy Yard shooting did in September.

Regardless, the Nevada incident was truly tragic -- especially given the fact that Congress has done nothing to let teachers come to the defense of students. The Blaze reports:

Police say a 12-year-old boy at Sparks Middle School near Reno, Nev., shot and injured two classmates and killed math teacher Mike Landsberry, a former Marine who served in Afghanistan and who had been trying to talk the shooter out of harming others. The 12-year-old boy also killed himself.

Okay, what’s wrong with this picture? Can you spot all the ridiculous scenarios that are presented in just that one sentence alone? This story raises several serious questions:

* Why is a former Marine like teacher Mike Landsberry “trying to talk” the shooter out harming others? Why can’t he have a gun?

* Why shouldn’t a Marine, who has been trained in weaponry, be able to protect himself and his students? Why can’t he have a gun?

* Moreover, why does Congress continue to ignore the 80% of police officers who favor “arming teachers and/or school administrators” who volunteer to carry at their schools? Why wasn’t Landsberry allowed to be armed?

* Finally, why isn’t Nevada following the example of its neighbors -- in Utah and Idaho -- which are arming teachers at schools?

While several schools in Idaho are now in the process of implementing this policy, Utah has been doing this for several years.

Thankfully, Rep. Steve Stockman (R-TX) has an answer to this insanity -- the kind of craziness that keeps our teachers unprotected at schools, or for that matter, that keeps our servicemen unprotected when they are at work.

That’s why Rep. Stockman has introduced:

* HR 35, which would repeal the gun ban that keeps teachers and school administrators defenseless. The bill would thus protect heroes like Assistant Principal Joel Myrick who have actually used a gun to stop a school shooter.

* And HR 3199, which would repeal the ban that keeps servicemen defenseless on military bases.

With ObamaCare “glitches” giving the President headaches, don’t be surprised if he tries to shift the debate at some point after the next shooting.

It’s time to start pushing back -- proactively!

Gun Owners of America
8001 Forbes Place, Suite 102
Springfield, VA 22151 Ph.703-321-8585
www.gunowners.org

Guns in the Old Wild West!

Why Americans Love Guns by Lisa Hix, published in CW Collectors Weekly October 2, 2013, has caused significant discussion. She writes: "Americans have always had a romantic notion about the frontier, how we arrived with our guns and honor, and settled the land in a fair fight. The passion extends to firearms themselves, which seem to possess a magic power to turn us into sharp-shooting heroes defending the homestead from any danger. But today our relationship with guns is in turmoil, as the bleak reality impinges on the myths we’ve come to hold dear. The better the weaponry, the more people started dying in the Old West.”

She goes on to discuss the history of the gun in the Old West with excellent illustrative and rare photographs of the “Wild West” — i.e., the Dalton Gang, Wyatt Earp, Bat Masterson and other vigilantes, Annie Oakley, and some of her rare pistols, kept in museums. “Firearms were such an important part of the history of the American West, so they have always been featured quite prominently within the museum,” Hix quotes Jeffrey Richardson, the curator of the new “Western Frontiers: Stories of Fact and Fiction” exhibition. “In the past, the museum had treated firearms no differently than any other object, be it a saddle, spurs, or a painting. But as we move forward, we’ve begun to question that particular thinking. The reasoning being that every so often, we have a terrible tragedy that occurs in America, and it gets us debating these national issues about gun control and gun rights...”

The article failed to go into other reasons why Americans love guns — namely the preservation of liberty and protection from government tyranny!

A poster, Al Geholtz, asked about the genesis of mass shootings, which would be difficult to ascertain. How does one separate random shootings by mentally deranged individuals 50 or 60 years ago from planned organized crime massacres, which incidentally began in earnest with the violent history of American Prohibition in the 1920s. This is well demonstrated in a graph illustrating Part 2 of the same article, "America Guns and Freedom: Part II — An International Perspective."

At this point we should also mentioned a book that has gradually been forgotten. I refer to Violence on the Frontier. By Roger D. McGrath. (Illustrated, 291 pages) published at Berkeley, University of California Press. Prof. McGrath's conclusion: ''The violence and lawlessness that visited the trans-Sierra frontier . . . took special forms: warfare between Indians and whites, stagecoach robbery, vigilantism, and gunfights. These activities bear little or no relation to the violence and lawlessness that pervade American society today. Serious juvenile offenses, crimes against the elderly and weak, rape, robbery, burglary and theft were either non-existent or of little significance. . . . There seems to be little justification for blaming contemporary American violence on violence and lawlessness in our frontier heritage.''

As the New York Times noted: ''With few exceptions, lethal violence was limited to gunfights over ''who was the better man, affronts to personal honor, careless insults, challenges to the pecking order in the saloon, and loyalty to friends.' This description reveals the true ancestor of frontier violence - the exaggerated code of male honor that produced duels in 'civilized' Europe well into the 19th century.

"Time and again, his research produces evidence of a powerful set of shared values that rigorously limited such violence to consenting adults. Those values did not include an exaggerated sympathy for the criminal or due process. Bodie's newspapers were constantly exhorting citizens to give burglars 'a good dose of lead.' ''

If there was a flaw in this limited scope article, it is that this scholarly book , so relevant to this piece, by Professor Roger D. McGrath, historian at the University of California, was not mentioned or discussed.

Dr. Blaylock on mental illness, violence and collectivism

We have received this communication from the neurosurgeon, nutritionist and scholar Dr. Russell Blaylock:

I became acquainted and then developed a close friendship with Dr. Miguel A. Faria while I was a neurosurgical resident in Charleston, South Carolina. Our deep friendship grew out of our mutual love and understanding of human freedom and its enemies. I had been a lifelong student of collectivism and Dr. Faria lived under and escaped from Castro’s communist hell. Over the years, drawing on his personal experience in a totalitarian system and an extensive knowledge of the literature of freedom, Miguel has written some of the most important papers and books on the enemies of freedom in print.

Gun control, that is confiscation of guns, has always been an essential part of the early solidification of a police state. Disarmed people are essential helpless. I always wondered why the Jews, when herded in the thousands into train yards, guarded by only a handful of armed military, did not overwhelm their guard and fight for their freedom and lives. I learned why from one of those standing in the herd—he stated that each person thought as an individual and did not want to be the one to sacrifice his life for the others. This is human nature.

Most importantly, they each believed that if they followed the soldiers’ orders, everything would be alright in the end. The writer of this experience stated that if they had known they would die by the thousands in the cattle cars and later would be murdered in mass numbers they would have resisted—but they did not know. Had the Jews been well armed, as Ben Shapiro stated during an interview with Piers Morgan, “many of my ancestors would not have ended up ashes.”

In "Shooting rampages, mental health, and the sensationalization of violence," Dr. Faria makes some critical points on a lesser scale than being afraid of government tyranny. Importantly, he points out that one set of laws made in the heat of passion can result in associated social cost in the future. The “plan” of releasing tens of thousands of mentally ill into our communities led to rapes, murders and many violent acts against innocents. Laws, strongly supported and proposed by such leftist organizations as the ACLU, made incarceration of known dangerous psychopathic individuals extremely difficult and a number of these individuals committed violent acts, including multiple murders. There is some evidence that Adam Lanza’s mother tried desperately to have him treated and even committed.

The proponents of gun confiscation have consistently ignored that the gun is only one among many tools available to the violent psychotic. If one examines the history of school killings, the greatest loss of life was not from guns but the use of fire and explosives. The psychopathic individual is usually considered very bright and creative. Do those proposing confiscation of “assault rifles” really think that the psychopath will then just give up his plans of mayhem? Is a child killed by other means not just as dead?

Dr. Faria make an very important point when he states that these psychopathic individuals plan these rampages for a long period and are not impulsive acts where a gun is the nearest instrument of death available. In addition, he makes the critical point that violence in television, movies and especially video games is playing a critical role in these events. Many of the more recent video games involve the use of “assault rifles” and we should be aware that many of these games are the same videos that are used by the military to train soldiers to kill.

He mentions the reality TV programs. If you watch these disgusting shows, you are struck by the level of violent threats and absence of even the most basic civil human behavior—even toward women. Most of us who are older and grew up in a more civil society are shocked by the level and widespread lack of even common decency and civility in society today, especially among the youth. What our young people watch and read molds their thinking and ultimately their behavior. This is why Madison Avenue executives spend billions on advertisements every year. As advertising giant Eduard Bernays, author of the book "Propaganda," knew these same techniques can be used to mold all human behavior.

While the vast majority of young people will not become mass killers from watching this violent material, the violent psychopath and the borderline psychotic can be pushed toward committing such violent acts. Martha Stout, in her book "The Sociopath Next Door," states that one in twenty five persons are sociopathic (psychopaths). Only a small number of these are violent psychopaths, yet, in terms of numbers of individuals, it is significant—and the number of these violent, consciousless individuals is growing.

I have also noticed a drastic change in how evil people are portrayed in the movies and television. Movies such as Bonnie and Clyde, Natural Born Killers and The Godfather, all portrayed violent, cold-hearted murders as heroes and individuals to emulate. In many cases their violence was perceived as “cool” and “manly.” Movie heroes do not hesitate to “terminate” a person or “off them,” terms which dehumanize the victims.

Dr. Faria, once again has written a classic paper that makes critical observations and re-defines the debate by careful analysis and not just pure emotion. The proponents of gun confiscation always assume an air of moral superiority, suggesting that those who disagree with their solutions are uncaring, cold-hearted soulless people. They live by the old adage — “If you cannot answer a man’s arguments, all is not lost — you can still call him vile names.” To the collectivist there is always only one solution to a problem — theirs.

Dr. Russell L. Blaylock is President of Advanced Nutritional Concepts and Theoretical Neurosciences in Jackson, Mississippi. He is written numerous path-blazing scientific papers and several books, including Excitotoxins, The Taste That Kills (1994) and Bioterrorism: How You Can Survive (2001). He is Associate Editor-in-Chief and a Consulting Editor in Basic Neuroscience of Surgical Neurology International (SNI).

Lucid arguments!

I have had a lively correspondence with the eminent neurosurgeon Dr. Russell Blaylock in the last several days about a series of my papers published in Surgical Neurology International (also posted here). I will be posting this correspondence in this website under the relevant articles over the next few days. Enjoy them!

Dear Miguel,

This paper — Shooting rampages, mental health, and the sensationalization of violence— is truly a classic. I agree with every word of your essay. The intellectual left’s (a strange term) attempt at making a case for widespread gun control and eventual confiscation could appeal only to a small (borderline retarded) child, a dictator or a criminal. You have destroyed each of their arguments with great flare, intelligence, well thought out discussions and lucid, glaring examples. I am convinced, as is Lyle H Rossiter, Jr, MD (The Liberal Mind) and Theodore Dalrymple, MD (Life at the Bottom) that those who espouse the liberal/left doctrines and mental eruptions are clinically insane. There is no other rational explanation...

Keep up the great work.

Your Friend,

Russell

Dr. Russell L. Blaylock is President of Advanced Nutritional Concepts and Theoretical Neurosciences in Jackson, Mississippi; and author of Excitotoxins, The Taste That Kills (1994) and Bioterrorism: How You Can Survive (2001). He is Associate Editor-in-Chief and a Consulting Editor in Basic Neuroscience of Surgical Neurology International (SNI). Many of his articles are posted in this website.

Dear Russell,

Thank you for your kind words. I always learn something from your remarks, and it is always gratifying that we remain in agreement about these important issues facing us in the social and biological sciences...

Your friend,

Miguel

Criminal fanatics!

30 killed in school attack in northeast Nigeria
The Associated Press - By ADAMU ADAMU - Associated Press
July 5, 2013

POTISKUM, Nigeria (AP) — Islamic militants attacked a boarding school before dawn Saturday, dousing a dormitory in fuel and lighting it ablaze as students slept, survivors said. At least 30 people were killed in the deadliest attack yet on schools in Nigeria's embattled northeast.
Authorities blamed the violence on Boko Haram, a radical group whose name means "Western education is sacrilege." The militants have been behind a series of recent attacks on schools in the region, including one in which gunmen opened fire on children taking exams in a classroom.

"We were sleeping when we heard gunshots. When I woke up, someone was pointing a gun at me," Musa Hassan, 15, told The Associated Press of the assault on Government Secondary School in Mamudo village in Yobe state.He put his arm up in defense, and suffered a gunshot that blew off all four fingers on his right hand, the one he uses to write. His life was spared when the militants moved on after shooting him. Hassan recalled how the gunmen came armed with jerry cans of fuel that they used to torch the school's administrative block and one of the dormitories.

"They burned the children alive," he said, the horror showing in his wide eyes. He and teachers at the morgue said dozens of children from the 1,200-student school escaped into the bush but have not been seen since...

My Comment: Guns, knives, fertilizers, drugs, explosives, matches combustibles, etc.... Must we then control or ban them all, end liberty for security, and live in a giant world maximum security prison or should we preserve freedom and our way of life — and fight fire with fire? — MAF

On gun violence and mental illness

When psychiatry was a relatively new medical subspecialty its main focus of treatment was the various forms of what used to be called insanity and what is now referred to as psychosis. With the arrival and spread of psychoanalysis there came about the notion that even “normal” people demonstrated a wide range of psychopathologic phenomena – hence the title of Freud’s famous book “The Psychopathology of Everyday Life”. Eventually, psychoanalytic ideas declined in popularity, to be replaced by various biological notions of mental illness. However, despite the change in thinking about what caused mental illness, large numbers of existing patients had to be accommodated in the new psychiatric treatment model. And so, rather than restricting its practice to those disorders in which biologic factors were most strongly implicated (i.e. what used to be called insanity and is now referred to as psychosis) the psychiatric establishment retained the psychoanalytic notion that mental illness was widespread in the population. Population studies now indicate that the rates of major depression, anxiety disorders, ADHD, and substance abuse (which, it is stressed, really is a disease!) in the general population are very high. Mental health awareness campaigns have found a very receptive audience in the general public all too eager to seek chemical solutions for the existential problems inherent in the human condition. As a result psychotropic medications are among the most frequently prescribed, even by non-psychiatrists and everywhere one reads about celebrities proudly disclosing their psychiatric diagnoses in a society-wide effort to reduce the “stigma” associated with mental illness.

It is not that mental illness is a myth as was famously suggested by Dr. Thomas Szasz, it is that in a society in which various forms of mental illness are said to be extremely common, being afflicted with some form of mental disturbance has now become the norm. In a way this has even been reflected in our language, as the previously common word “sad” has been replaced by the more clinical “depressed”. In a society such as this, any campaign to identify “mental illness” in order to judge fitness for possession of firearms is inevitably going to backfire, if you forgive the pun, as great numbers of people will be discovered to have received psychiatric services. And so we have found ourselves in quite a conundrum. In order to identify people with mental illness we have to make psychiatric records available to all kinds of authorities – and this will make the very many recipients of mental health services quite unhappy. Even if we are successful in identifying everyone and anyone who has or has had a mental handicap of some sort, we will have to conclude that large numbers of people are simply unfit for possession of firearms – and this violates our cherished second amendment sensibilities. If we do nothing, we accept the simple fact that life is unpredictable and that by some infernal coincidence we or our loved ones may find ourselves dead at the hands of a gun-wielding maniac – but this is absolutely contrary to the current zeitgeist that life ought to be made predictable, safe, and profitable, preferably by the government. Finally, banning guns altogether will be practically very difficult in a country with 300 million firearms.

We are a society that wants everything while sacrificing nothing. We are told that we can have what we want when we want it and, moreover, that this is a human right. There are few guides to help people negotiate the perils of being a human. The function previously fulfilled by religion has been taken over by a profession that has redefined issues of living in terms of dysfunctioning neurons. The trouble is that we are attempting to treat a single body part when in reality the whole organism is diseased. Gun violence of the sort discussed in Dr. Faria’s article is not akin to a case of pneumonia, or an MI, or a stroke, it is a symptom of multi-organ failure. In such cases, it might be better to just call for a priest.

Astute commentary!

Once again a well-thought out and loaded commentary! There is very little I disagree with Dr Tisbe. Please allow me to quote some salient lines in your astute comment to reply:

"As a result psychotropic medications are among the most frequently prescribed, even by non-psychiatrists and everywhere one reads about celebrities proudly disclosing their psychiatric diagnoses in a society-wide effort to reduce the 'stigma' associated with mental illness."

Indeed, as you will recollect in my article I mentioned the universal yearning for celebrity status and "the 15 minutes' worth of fame," even in death, and the celebrities themselves are leading the pack, not only in seeking well-publicized rehabilitation, but also in morbidly leading self-destructive lifestyles that media sensationalists in their turn further sensationalize!

"...but this is absolutely contrary to the current zeitgeist that life ought to be made predictable, safe, and profitable, preferably by the government."

I have corresponded with Dr Szasc in the past, incidentally, and he agrees that government paternalism is frequently the culprit. A disciple of Dr Szasc, Dr. Nelson Borelli, has commented on many of his views in letters that have been posted here.

"We are a society that wants everything while sacrificing nothing. We are told that we can have what we want when we want it and, moreover, that this is a human right. There are few guides to help people negotiate the perils of being a human. The function previously fulfilled by religion has been taken over by a profession that has redefined issues of living in terms of dysfunctioning neurons. The trouble is that we are attempting to treat a single body part when in reality the whole organism is diseased. Gun violence of the sort discussed in Dr. Faria’s article is not akin to a case of pneumonia, or an MI, or a stroke, it is a symptom of multi-organ failure. In such cases, it might be better to just call for a priest."

Excellent summation, and true! And not only are many people increasingly demanding a completely risk-free world, but we have an excess of 20 million lawyers playing lottery litigation to enforce it. Everyone expects to live in their nineties with obesity increasing and exercising not at all! And when bodies and minds give out, blame the doctors and call the lawyers!

I think you will enjoy my series on the history of psychosurgery. Part 1 was published in SNI and is now also posted here. Part 2 is in the process of being peer reviewed in SNI, and hopefully will be accepted and published soon.

http://www.haciendapub.com/articles/violence-mental-illness-and-brain-%E...

Regarding some of my views on religion, ethics, and history, I invite you to peruse my Random Notes on the subjects. I know I would enjoy your reply comments. — MAF

http://www.haciendapub.com/philosophyandhistory

Mass shootings!

In case you missed these stories, read them here:

"Liberal Gun Control Advocate Goes on Shooting Rampage

"As the police in Southern California spread out a multi-county dragnet for a former cop seeking revenge on the people he blamed for his firing, the mainstream media were suspiciously silent on some key points. Usually when some crazy goes on a shooting spree, the media leftists look for any scrap of information that can be used to make the case that the killer is somehow a political conservative and that gun control laws must be tightened. That might be harder to do this time.

"Former Los Angeles Police Department officer Christopher Jordan Dorner was being sought Thursday in connection with five shootings, including those of three police officers in Riverside County. Unlike most sociopaths, Dorner left behind a Facebook manifesto that spells out very clearly what motivated his shooting rampage as well as provides many clues to his twisted thought processes.

"Dorner accused specific officers in the LAPD of retaliating against him after he reported what he saw as abuses by fellow police. But that’s not the only interesting part of the story. Reported to be heavily armed, Dorner was believed to be in possession of, or have access to, a .50-caliber rifle, a 25-pound gun that normally must be used with a stand or some sort of mount, along with other weapons.

"Yet in his manifesto, Dorner praises gun control and cites a Hollywood celebrity for support of his viewpoint: 'Who in there right mind needs a f***ing silencer!!! who needs a freaking SBR AR15? No one. No more Virginia Tech, Columbine HS, Wisconsin temple, Aurora theatre, Portland malls, Tucson rally, Newtown Sandy Hook. Whether by executive order or thru a bi-partisan congress an assault weapons ban needs to be re-instituted. Period!!!'"

— Liberal gun control advocate goes on shooting rampage, Godfather Politics, Feb. 8, 2013

"Despite Gun Control, Dutch Shooting Rampages Becoming Common

"Two men were shot dead in Amsterdam after a shooting spree involving automatic weapon fire. Dutch authorities have released little information on the incident. Amsterdam’s mayor, Eberhard van der Laan, called the automatic weapons shooting spree a 'wild west situation.' The information released stated that two men, ages 21 and 28, were traveling in a Range Rover that was rammed by a silver Audi. The victims were then killed in a rain of automatic weapons fire from a man wearing a balaclava who got out of the Audi. The authorities said the two victims were “known to police.”

"Two motorcycle police officers gave chase to the shooter’s car after the incident and the two officers were also injured by automatic weapons fire. Dutch authorities stated the Range Rover had French license plates and that the Audi-driving shooter was able to flee without a trace. This shooting occurred ten days after another shooting spree that left two men dead. The Netherlands has restrictive gun laws and the automatic weapons used in the December 29, 2012 incident were outlawed and unavailable to law-abiding citizens."

— Dutch Shooting rampages becoming common despite gun control, Breibart, Dec. 30, 2012

Immunotherapy & violence —SNI update!

Dear SNI Colleges,

...In December 2011, Drs. Russell Blaylock and Joe Maroon wrote one of SNI's most popular papers, on the topic of immunoexcitotoxicity, which proposed that continued injuries to the brain will lead to chronic traumatic encephalopathy (CTE) -- a disease that we are increasingly seeing in professional football players in the U.S.A. More is being written about immunoexcitotoxity as a cause of CTE, CNS diseases, and other organ system disorders. For this issue, I asked Russell to write a two-part series on the immune system for neurosurgeons, so that we all can understand the tremendous advances in knowledge in this area. The advances in immunology have been very rapid. It may take a bit of time to read his primer on immunology, but your time will be well spent. This information is becoming the key to many diseases. In Alzheimer's disease, recent studies show a malfunction in the microglia, which, if normally functioning, would clear cell debris and amyloid protein (N Engl J Med. 2013; 368(2):117-27). As Neumann and Daly suggest in the same issue of the NEJM, "we therefore suggest that the degeneration of neurons … in Alzheimer's disease is driven by a chronic inflammatory process with dysfunction in the microglial phagocytosis or inflammatory pathway."

In a second article, Dr Blaylock has written a comprehensive review of the immunoexcitatory mechanisms in glioma proliferation, invasion, and occasional metastasis. There is extensive work now indicating that progress is being made in treating gliomas, melanomas, and small cell lung cancer by immunotherapy, with significant increases in survival. Using immunotherapy on patients with GBM, Linda Liau has found that some are living beyond 5 and even 10 years (J Immunother. 2013; 36(2): 152-7). Read Russell's first paper on the basic principles of immunology, then read the second paper on the immune system and glioma proliferation. If you read only one article this month, it should be the primer on immunology.

...Dr.Miguel Faria has added a new editorial entitled "Shooting rampages, mental health, and the sensationalization of violence." The reaction to the deaths from gunshots in the U.S.A. has been sensationalized. These events are being used by the government and the press to create a crisis with a plan to restrict the ownership of guns by the public -- a violation of the United States Constitution, which guarantees the right of the public to bare arms. This crisis mentality leads to conclusions based on emotion, rather than facts. Faria previously wrote a two-part paper published in SNI in January 2013 (part 1, part 2), that provide facts behind the problem. The causes include "the permissive criminal justice system that panders to criminals; the failure of public education; the fostering of a culture of dependence, violence, and alienation engendered by the welfare state; and the increased secularization of society with children and adolescents growing up devoid of moral guidance."

In addition, he states "the failures of the mental health system and the role of the media and popular culture in the sensationalization of violence contribute to this problem." WHO statistics indicate that the U.S.A. ranks 100th on the list of murder rates in countries around the world, and those countries ahead of the U.S.A. all have a ban on guns. The ban on guns in England has led to increasing violence with knives and shootings by those who would have obtained guns -- now, some doctors are campaigning to ban long knives, which are being increasingly used in violent crime. Guns are not the problem -- certain people behind them are. As citizens, doctors need to be informed of the facts in this controversy. Neurosurgeons see these patients on the operating table. Faria has stated that "When the public has guns, governments are afraid of the people, but when people have no guns, they are afraid of the government." Rahm Emmanuel, an advisor to President Obama said, "You never let a serious crisis go to waste. And what I mean by that is it's an opportunity to do things you think you could not have done before."

What we are witnessing is the application of that principle to change the Constitution of the U.S.A., and to give the government more power over the people. Unfortunately, in the U.S.A. over the past 5 years, we have seen that principle applied to panic the public into changing legislation to gain more power for the government, all with the consent of the press, which is supposed to protect the rights of the people. We do not practice medicine by such rules. Crisis thinking rather than reasoned analysis and solutions will lead to disastrous conclusions in medicine and politics.

James I. Ausman, MD, PhD,
Editor in Chief,
Surgical Neurology International
February 2, 2013

Mental health, de-institutionalization, and murder

Mental illness, gun control, and murder by John Hayward

"Writing at the Wall Street Journal [2/5/13], Dr. E. Fuller Torrey provides a brief summary of the themes explored in his forthcoming book, American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System:

"On Feb. 5, 1963, 50 years ago this week, President John F. Kennedy addressed Congress on “Mental Illness and Mental Retardation.” He proposed a new program under which the federal government would fund community mental-health centers, or CMHCs, to take the place of state mental hospitals...

"President Kennedy’s proposal was historic because the public care of mentally ill individuals had been exclusively a state responsibility for more than a century. The federal initiative encouraged the closing of state hospitals and aborted the development of state-funded outpatient clinics in process at that time.

"Over the following 17 years, the feds funded 789 CMHCs with a total of $2.7 billion ($20.3 billion in today’s dollars). During those same years, the number of patients in state mental hospitals fell by three quarters—to 132,164 from 504,604—and those beds were closed down.

"As this process continued, it became clear that 'the open warmth of community concern and capability' meant 'release the mentally ill into the wild, and hope for the best....'

"As for those who don’t do well…

"According to multiple studies summarized by the Treatment Advocacy Center, these untreated mentally ill are responsible for 10% of all homicides (and a higher percentage of the mass killings), constitute 20% of jail and prison inmates and at least 30% of the homeless. Severely mentally ill individuals now inundate hospital emergency rooms and have colonized libraries, parks, train stations and other public spaces. The quality of the lives of these individuals mocks the lofty intentions of the founders of the CMHC program..."(1)

Reference

1. Hayward J. Mental illness, gun control, and murder. Human Events, February 5, 2013.