Critical System Failure

 

I knew about the tragedy in Aurora, Colorado before I posted my review of The Dark Knight Rises, but I wanted to make it clear that the two were utterly and completely separate. The Dark Night Rises did not directly cause a man to take up violence against innocents. Christopher Nolan did not goad him into his actions through his portrayal of a comic character that has been around since 1937.

Not many details about the shooter, James Holmes were initially released. We now know that he was a graduate neuroscience student at the University of Colorado, Denver and was going through the process to withdraw. He was a Phi Beta Kappa, implying he was near the top of his class during his undergraduate career. He identified himself as the Joker when arrested. He obtained his guns legally.

Don’t be alarmed, this is not post about gun rights.

He killed 12 innocent people, a number that still has the potential to rise as the days progress. (Edit: My initial post said 23, which is a number I got from an online article I may have misread. As of right now, the death count is still 12)

Columbine, Virginia Tech, the shooting of Gabrielle Giffords, now this. Massacres that could have been prevented, with more attention to detail. My sister was a freshman at VA Tech, when Seung-Hui Cho shot and killed 32 people, wounding 17 others. She was working only blocks away from where Cho’s rampage began. Her then-boyfriend, now-husband, was an engineering major in his senior year and knew some of the victims. I remember the terror I felt when I turned on the television and saw that my sister was in potential danger.

Of these tragedies that have occurred in the last 20 years, they seem to have a common thread: A complete failure on the part of the local and state mental health systems to recognize, intervene, and treat when there was clear evidence of illness and instability.

Why do tragedies such as these occur? Psychologists and criminologists spend valuable time, effort, and money trying to answer that exact question, without putting enough into the prevention of the issues in the first place. As a psychologist, I’m acutely aware of how prevention is an extremely important, yet often unattainable concept in the field.

Some of these men who committed atrocious acts of sudden violence displayed clear signs of instability their entire lives. And yet they never got the help that they needed. I’m not saying that psychological treatment is infallible, in fact the treatment of many disorders is NOT effective without constant and closely-monitored upkeep. However, that constant upkeep is precisely what these men needed. Early intervention, as well as more strict policies against bullying, might have prevented Columbine. Seung-Hui Cho was identified by members of his family and professors as unstable, potentially dangerous. Similar is true of Loughtner, the Gabrielle Giffords shooter.

And yet, our system continues to fail these men, and in turn, fail the victims of their outward violence. I don’t know what to say on this matter, except that I hope one day we’ll learn the error of our ways and stop treating mental health as an optional part of the medical field, and instead treat it as an integral part of the health of the body and society as a whole.

The concept of prevention science is well embodied in the poem “The Ambulance Down In The Valley.” It has different versions and names, but the sentiment remains the same.

The Fence or The Ambulance
Joseph Malines

‘Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant:
But over its terrible edge there had slipped
A duke and many a peasant;
So the people said something would have to be done.
But their projects did not at all tally:
Some said, “Put a fence around the edge of the cliff”
Some, “An ambulance down in the valley.”

But the cry for the ambulance carried the day.
For it spread to the neighboring city:
A fence may be useful or not, it is true,
But each heart became brimful of pity
For those who had slipped o’er that dangerous cliff,
And the dwellers in highway and alley
Gave pounds or gave pence, not to put up a fence,
But an ambulance down in the valley.

“For the cliff is alright if your careful,” they said,
“and if folks even slip or are dropping,
it isn’t the slipping that hurts them so much
as the shock down below-when they’re stopping,”
So day after day when these mishaps occurred,
Quick forth would the rescuers sally
To pick up the victims who fell off the cliff,
With their ambulance down in the valley.

Then an old man remarked, “it’s a marvel to me
that people give far more attention
to repairing results than to stopping the cause,
when they’d much better aim at prevention.
Let us stop at its source all this mischief, cried he.
“Come neighbors and freinds, let us rally :
If the cliff we will fence, we might almost dispense
with the ambulance down in the valley.”

“Oh, he’s a fanatic.” the others rejoined:
“dispense with the ambulance Never!
He’d dispense with all charities, too, if he could:
no, no! We’ll support them forever.
Aren’t we picking up folks just as fast as they fall?
And shall this man dictate to us? Shall he?
Why would people of sense stop to put up a fence?
While their ambulance works in the valley?”

But a sensible few who are practical too,
Will not bear with such nonsense much longer
They believe that prevention is better than cure
And their party will soon be the stronger
Encourage them, then with your purse, voice and pen
And (while other philanthropists dally)
They will scorn all pretense, and put up a stout fence
On the cliff that hangs over the valley.

One day. Maybe one day we’ll figure it all out. Until then, we mourn.

 

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46 Comments

  1. Still having a real hard time wrapping my mind around this tragedy. Your post reminded me of the tragedy. “One day. Maybe one day we’ll figure it all out. Until then, we mourn.”

    Reply
  2. This tragedy is practically unspeakable, and seeing him this morning during his first court appearance, I was struck: I hate how much of a skeptic I am. I hate the fact that I wonder if he’s a truly disturbed man, or so disturbed that he’s brilliantly plotting the way this story is unfolding. I hate that so many families have been irreversibly harmed by this one man.

    And I hate that I can use the word “hate” in the context above and absolutely mean it. I do not have hatred for people, but for the aftermath. I wish we could go back in time, see the signs, prevent the unpreventable.

    Reply
  3. This is an interesting perspective. Thank you for sharing

    http://stepstochangetheworld.wordpress.com/

    Reply
  4. Peaches

     /  July 23, 2012

    Awesome! I agreed with everything here. Do you think the lack of affordable healthcare in America is the main difference? Or something else? Because these massacres happens all over, but definitely less frequently is countries that have better supports for the mentally ill.

    Reply
    • I’m not really sure if it’s affordable healthcare or not… Mental illness is stigmatized the world over, and that stigma is most definitely not isolated to America alone.

      Reply
  5. Hey, cool post. Checkout my blog: http://holabumoid.wordpress.com/

    Reply
  6. I have to be aware with my current position within the New Mexico DOT Division of Road Safety. The Highways are a re very busy place to do business. Although we are constantly making improvements, our approach is a continuois web of preventative and cautionary implementation.
    My Heart goes out to the friends and Family members that have been affected by the Colorado incident.

    Reply
  7. Identifying hazards and preventing rampages is a very tricky subject. The shooting is a tragedy: we must remember to keep that in mind when the incident is inevitably politicized. Thank you for the great post. Looking forward to the next one!

    Reply
  8. I wonder if there might be a fence already, like the backyard fence that someone’s dog has dug a hole beneath and slipped through. When these heart-slaying events occur, we only see that event. We seldom see or hear about good work done for so many others who are teetering on the brink but are helped back to safety by friends or strangers. Someone will always slip through the fence despite efforts to keep everyone, everywhere safe.

    Reply
  9. The Smile Scavenger

     /  July 23, 2012

    Someone quite dear to me exhibits some signs of this: he has hurt his pets in fits of anger and gets maniacally angry sometimes (usually it starts as a joke but the level of enthusiasm is becoming concerning). His mother and I have struggled for some time with how to approach the matter. We have confronted him about his temper. He admits to “anger issues” but that’s as far as it ever goes.

    We are afraid of consulting/involving professionals because he is in college studying engineering and we don’t want to mess up his future if we’re reading too much into it. (Is it just me or does there seem to be a reoccurring theme here of smart people attempting the more difficult subjects and becoming belligerent due to lack of perfection?) What would you recommend, as a psychologist?

    Reply
    • Please note that I’m not licensed and anything I say MUST be taken as opinion and not scientific fact or medical advice. I’ve completed undergraduate coursework for a degree in psychology, but not higher-level clinical training. I have found through my own experience that counseling can be an extremely effective way for individuals to recognize the mechanisms underlying their own emotions and behaviors. That said, the participant must be willing to recognize flaws and not resist change. It’s my honest opinion that your friend’s health and personal safety are more important than his studies. If he is not mentally or physically healthy, he will not be able to attain his true potential in school. College counseling centers are discrete in my experience, though often over-taxed. You could contact the counseling center directly for advice on how to approach the subject with your friend, or do research online. I recommend going to the American Psychological Association website (www.apa.org) for more professional advice.

      And yes, perfectionists are often those with higher rates of anxiety and depression because they feel like they let themselves down so often, no matter what those around them tell them to make them feel better. I wish you the best of luck in getting help for your friend. Believe me when I say that it will be difficult for you, him, and his family, but it’s worth it.

      Reply
      • The Smile Scavenger

         /  July 24, 2012

        Thank you. I really appreciate your honest opinion (and the credibility disclaimer, but your advice rings true nonetheless). I will try that website and the on-campus counseling center.

        I really feel awful even thinking he’s capable of hurting himself/others. Who thinks that about a loved one? But I’d rather him hate me than something terrible happen.

  10. “Sane” people with no common sense prevailing. Sounds like a plan! Oh wait…

    Reply
  11. This is all so complex, and it involves so many factors…our society is profoundly sick and I can’t help but wonder that those guys are not the exception, but the rule. Maybe the only difference between them and us is that we are more resilient whereas they’re more fragile and have broken up…

    Reply
  12. (of course, it’s undeniable that having firearms easily available contributes to such tragedies…it takes much more guts and cold blood to get a knife and stab 50 people than to press a button and make believe you’re in some kind of video game where everybody’s your enemy and should be eliminated. I don’t think we can escape the gun debate just like that…or even the influence of the culture industry! Sure, no movie and no video game technically “makes” anyone kill anyone, and even if you put a gun in the hands of a person that won’t mean they’ll shoot anyone, but that’s not always the case, is it? There are some very powerful undercurrents going on and I don’t think we can say we’re not daily brainwashed by the press or the television or publicity or or or!)

    Reply
  13. The entire western medical field works only on bandaging things… hearts, livers, and minds alike. No prevention. The problem is so large, intricately detailed within our lives as a whole in the society we live in now. The outcome is greater than the sum of all the causes. It’s an ice burg situation.

    Reply
    • Absolutely. I’m not saying that this is a problem that our society can easily fix, because it’s going to take time. But the first step to change is recognizing the problem!

      Reply
  14. I liked your post and I think your choice of the poem went perfectly with your content.

    Reply
  15. Christopher Simpson

     /  July 23, 2012

    It was a tragedy, and I’m not sure what the answer is, but I worry about the intrusion of “psychological experts.” Why is something that only a few decades ago almost unheard of now becoming almost a monthly occurrence? We weren’t carefully watching our neighbours for signs of insanity back in the ’50s.

    Your figures are also quite off. The Aurora gunman killed 12 people, not 23.

    Reply
    • You’re right, the death toll is still at 12. I must have misread something yesterday. Perhaps a combination of death toll and critical conditions? I don’t know, but I did edit the post to reflect the correct number, so thanks for pointing that out.
      This isn’t about watching our neighbors. This is about those in our intimate friend and family circles having the guts to speak up when they know in their gut that something is wrong with their friend, child, sibling, significant other. Do you have another suggestion that would not involve psychological intervention and evaluation?

      Reply
      • Christopher Simpson

         /  July 24, 2012

        No, I get your point. (And your figure was probably the number injured, although to check that I’d have to open a tab and Google, and that would be, you know…work.) What puzzles me, though, is how these things become epidemics. it’s like some kind of contagion that strikes one person, and the a little while later it jumps to another, and then it jumps to three or four, and before long it’s become a part of our societal background. The one thing I keep coming around to is that the simple fact of reporting on it spreads the disease.

        Consider — the media seldom reports on suicides because we know (we KNOW) that doing so tends to spark more suicides. Now think about that. Simple reports of people killing themselves can lead to more people killing themselves. If that’s true, then what about reports of people killing other people? (It’s also why I view “awareness” programs with great suspicion.)

        Of course, if this is true, the only solution is to censor the media, which I am deathly against. It’s a Catch-22.

  16. freeamericans

     /  July 24, 2012

    I have a big issue with more psychology. We have psychologists prescribing all sorts of drugs to teens these days to control behavior. In my blog, I write about what I think causes such things, and how I feel about psychology, these days.

    http://freeamericans.wordpress.com

    Reply
    • Actually, the biggest reason that there is an overmedication problem, especially in psychology, is due to insurance companies. “Managed care” is what was created in an attempt to prevent the abuse of the mental health system (e.g. an individual seeing a therapist for an indeterminate period of time without getting any real help, but rather just going as a habit), but in reality all it did was force psychiatrists to diagnose their patients with something (usually depression or bipolar disorder) in order to get reimbursement for their services. And when you get diagnosed with something, insurance companies ask for prescriptions to “cure” the problem. Because their logic tells them that when you are “cured” they don’t have to pay for you anymore. The same rings true for physicians who will prescribe powerful antibiotics for something that will clear up on its own.

      Reply
      • freeamericans

         /  July 24, 2012

        Makes sense, and I am not surprised.

  17. As a person who has suffered on and off with debilitating mania and depression since I was a child, I can tell you that no amount of money, drugs or doctors can make your life livable. During various segments of my life, I’ve designed parts for satellites, built a world-wide semiconductor company with over 3K employees, as a matter of habit – spent 2-3 days awake in a row (most of my life), then crash for a day, and start over, self-medicate, took prescribed drugs, committed myself, been committed, taken part in studies, spoken to college med students as a prop for a wonderful psychiatrist, lived in my car, and woke-up to police and paramedics saving me from myself.

    No hospital, doctor (including teaching staff from the Albert Einstein College of medicine, no slouch), family member nor friend has been able to help me keep it together. I piece my life together from one broken moment to another, with fleeting moments of happiness and success.

    While committing someone who is obviously psychotic would work, I don’t think there is any way to stop someone who is mentally unstable, but not necessarily noticeable psychotic, from harming themselves or someone else. Fortunately for me and everyone else, I’ve never been a danger to anyone but myself. I’m not and have never been psychotic. But I have considerable experience knowing what it is to have little control over the instability in my brain.

    One thing I do question, is whether anyone was sufficiently close to him to recognize that he was losing touch with reality.

    As do many, I hurt for all sides. Everyone touched by this is losing.

    Reply
    • I’m not really sure if someone did notice his disconnect from reality. Though I’m willing to bet that if he was withdrawing from school, he should have gotten some support from someone, maybe his family, I don’t know. I’m also not exactly saying he should have been immediately committed, but maybe intervention of some sort would have prevented this specific outbreak of violence. Of course, who’s to say that it wouldn’t have just delayed the inevitable… A depressing thought, but a possibility.

      I’m so sorry that the system has also failed you in so many ways. I count myself among the lucky who was able to find help in medication and therapy, but I’m acutely aware that it doesn’t work for everyone. You don’t deserve such a difficult time just trying to live. I hope that one day you’ll find your balance.

      Reply
      • I don’t consider myself all that unlucky. The odds of having been born to have any life whatsoever are astronomical. This is the life I have, so to the degree possible, I try to enjoy it. Much more difficult for some than for me.

        Thank you for your post and thoughtful comments.

    • Richard, I’m also sorry that the system has failed you in the sense that you do not have lasting results but continue to cycle around again and again. I can relate to your reported symptoms and the cycle. I think that a lot of creative people can relate as well. There appears to be something in the creative leap to solutions that seems to be part and parcel with this set of symptoms.

      One of the things that does help is to have people around you who do care and provide that challenge to problem solving that appears to keep one sane. Without these problems, it seems that it is eaiser to be ‘off the cliff’ No amount of fence will keep some people from the cliff.

      Keep blogging.
      Henry

      Reply
      • Thank you for the kind words Henry. What many people do not realize, is that people in my position, typically “wear-out” family members and friends. Quite often, they cannot withstand the lifelong cycles of mania and depression. I’ve actually had a sister tell me that I make it difficult for them to love me.

        Could you imagine telling someone who was say, being treated for cancer, that their condition made them “difficult to love?”

        I understand the sentiment, but understanding provides little solace.

    • Have you tried alternative treatments? Like acupuncture, yoga or meditation? (ok I know this sounds silly but hey…): http://janusaureus.wordpress.com/2012/03/30/o-que-e-felicidade-what-is-happiness/

      Reply
  18. What an excellent poem! Regardless of how complex everything can be and is I think that your basic idea from a couple comments is true. When we are intimately acquainted with someone that seems to be falling apart we need to help them. Isn’t that what love is? Regardless of how difficult it may be, you put their interests ahead of your own and do what needs to be done. Like searching for reliable help. They need it. Don’t shirk!

    Reply
  19. What upset me so much here is that when the killer’s mom was told of the events, she didn’t seem surprised at all; she knew her son was in some kind of emotional trouble. Where are the killers’ families in all this? Our family is our first line of defense, they need to take their heads out of the sand and step up.

    Reply
  20. kaushik

     /  July 24, 2012

    hekli

    Reply
  21. I am still in shock and mourning. I feel for the Holmes family and those families of this innocent victims. What if this happened to your son that he went crazy and killed innocent people? Are there signs we all can see in people so that this doesn’t happen again?

    Reply
  22. Thank you for posting this. I’m very new to the wordpress world and I’m glad to have stumbled upon a moving, thought-provoking post like this one (not to mention, a blogger passionate about feminism and Joss Whedon). You have one happy and interested new follower.

    Reply
  23. Thank you so much for posting this. There has been all this dustup about guns and gun rights and gun control, when the gun here is really a red herring. The gun was completely incidental to the real issue, that of willful blindness that occurred long before all of the horrible incidents that you’ve mentioned here. There was a trail of signs that surrounding people could not, or worse, would not see. A little more intervention early on could have saved a lot of pain.

    Reply
  24. Choice of poetry thoughtful and inspiring. Brought a tear to my eye. There are definitely too many ‘if only…’ moments when something like this happens. If only he spoke up. If only we read the signs. You are right, prevention is better than cure.

    Reply
  25. Beautifully written and well thought out…and loved the ending poem.

    Reply
  26. I really enjoyed the poem and your article was well written. Very well thought out as far as your goals go. Thank you for not ranting, its hard to create a good piece on current news and tragedy.

    Reply
  27. Sounds like a plan!

    Reply
  28. Alyssa

     /  July 25, 2012

    Really a great post; you just catch my attention with your words pretty well. Love the poem and this line: “One day. Maybe one day we’ll figure it all out. Until then, we mourn.”

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    Reply

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