Postpartum Depression Cited in Virginia Killing
Tom Jackman, Washington Post- 11/27/2001

A new Springfield mother stabbed her husband to death Saturday afternoon, then stabbed herself, apparently in a fit of postpartum depression, according to court papers filed yesterday. The couple's 10-week-old daughter was sleeping upstairs and was uninjured. Eric and Seema Rothstein both worked in the Fairfax County school system, where they had met about eight years ago while teaching at Lane Elementary School in Kingstowne. Eric Rothstein, 36, was most recently a computer trainer for teachers and students at Fairhill and Navy elementary schools and was the boys' crew coach at Thomas Jefferson High School for Science and Technology. Seema G. Rothstein, 32, is a graduate of West Springfield High School and the University of Virginia, according to a friend, Tracy Johnston. She teaches fourth grade at Bonnie Brae Elementary School but had taken time off for the birth of her first child.
    Last night, Seema Rothstein had not been arrested and was at Inova Fairfax Hospital recovering from her wounds. Hospital officials declined to release her condition. Fairfax police refused to discuss the case or even release the Rothsteins' names. Seema Rothstein's family declined to comment. But an affidavit filed in support of a search warrant said Seema Rothstein told police during a helicopter ride to the hospital that she had hurt her husband and herself.
    Neighbors in the 7400 block of Shepherd Ridge Court said they were stunned by the sudden violence from the quiet couple. Johnston, a neighbor and longtime friend of Seema Rothstein, was particularly shocked. "They're beautiful people, a wonderful family," Johnston said. "There was no fighting between them. It wasn't a domestic dispute. She was suffering from postpartum depression. He was a very loving husband and father and very indulgent and patient of her anxiety." Johnston said she spoke to Seema Rothstein several times daily. They last spoke about 30 minutes before the stabbing, Johnston said.
    Fairfax County police received a 911 call about 3:15 p.m. Saturday from the home, according to the search warrant affidavit. No one spoke into the phone, but the operator could hear someone crying and then heard a struggle. When officers arrived, they could hear the Rothsteins' yellow Labrador retriever barking. The front door was locked, and when the officers went around to the back, they found Seema Rothstein lying on the deck with blood on her shirt and one arm. Looking inside, the officers saw Eric Rothstein lying in the family room next to a large knife. "He had obviously been murdered," homicide detective Steve Shillingford wrote in the affidavit. A helicopter arrived to take Seema Rothstein to the hospital for treatment of stab wounds to her stomach and forearm, police said. When an officer in the helicopter asked Seema Rothstein what happened, she said "she had hurt herself," the affidavit states. When the officer asked whether anyone else was hurt, Seema Rothstein "indicated she had hurt her husband and that she was on medication."
    "All around, it's just a tragedy," Johnston said. She said the Rothsteins dated for about a year, then married about seven years ago. Johnston said the Rothsteins were thrilled when they learned of Seema's pregnancy this year. "They were both extraordinary teachers," said Helene Brower, principal at Lane Elementary, where the couple taught until they were engaged. "They spent a lot of time with children way beyond the school hours. They were very organized and very committed."
    Eric Rothstein graduated from Michigan State University, where he took up rowing. In a journal posted on the Thomas Jefferson Web site, he wrote, "This sport has become such a huge part of my life that I cannot imagine what I would be doing now had I not found rowing." While in graduate school at the University of Michigan, he attended a job fair and got a teaching job in Fairfax County, which he had not heard of before. He had coached at Jefferson since 1992 and was The Washington Post's All-Met Coach of the Year in 1996. "A lot of people looked to him for tips and information, including myself," said Ron Lim, a longtime co-coach and friend. "He was genuinely a very good guy."

Depression Screening Urged for New Moms
Karen Mellen, Chicago Tribune- 11/27/2001

Despite increased attention on postpartum depression over the past few years, the number of women screened and then referred for treatment has not increased significantly, a national expert on the disorder says. That's why it is so important for all social workers, nurses and doctors to be trained to look for symptoms of depression among women who have recently given birth, says Dr. Laura Miller, associate professor of psychiatry at the University of Illinois at Chicago. "The frustrating thing is it's difficult to have time to do the screening," Miller says. "Clinicians have to screen for everything." Miller says that although postpartum depression is highly treatable, untreated depression can have long-lasting effects on mother and baby. The severity of the symptoms increases with time and can lead to problems for the baby, she says.
    Women whose depression is not treated can become suicidal or suffer recurring bouts of depression later in life. Children can end up with lower IQs and depression because of the neglect, either physical or emotional, by mothers who have a mental disorder, she says. As a result, everyone who comes into contact with a family must look for signs of depression, Miller says. But she cautions that the symptoms of postpartum mental illnesses often are different from mental illness in the general population. For instance, in the case of the more serious postpartum psychosis, women can appear to be lucid for long periods of time, which can lead to their being released from inpatient facilities or otherwise not being treated aggressively enough.
    Society needs "the involvement of family and significant others," says Miller, noting that clinicians should not rely only on the woman for information. Scientists theorize that hormonal changes during pregnancy and soon thereafter can trigger a chemical change that leads to depression. About 10 percent of mothers will become depressed, they say.

Maryland Panel Urges Life Term for Some Sex Offenders
Maureen O'Hagan, Washington Post- 11/27/2001

Maryland officials are recommending life sentences for certain sex offenders with untreatable personality disorders. The proposal, along with numerous other suggestions, comes from a task force formed after a paroled rapist was charged with murdering a 9-year-old Frederick boy last fall. "We know in dealing with psychopaths [that] there is no treatment that will work on them. They will forever repeat that conduct," said Richard B. Rosenblatt, director of mental health for the state Department of Public Safety and Correctional Services. "It's our feeling they ought to be removed from the public at large since they will re-offend." But one year after the boy's death, the sex offender conundrum seems just as vexing. Some of the panel's proposals have been considered and rejected by lawmakers in years past. Others may be viewed as too costly in a time of tight budgets. And still others, like the sentencing recommendations, are untested and, task force members admit, controversial. "Everybody wants to do something, but the question is how to do something that really works and doesn't mess an already complex system up even worse," said Del. Sue Hecht (D-Frederick), who served on the task force.
    The case of Elmer Spencer Jr. brought the system's problems into sharp focus. Spencer had a long history of violent behavior, much of it focused on young children, and had served time for raping an 11-year-old Carroll County boy. On Nov. 14, 2000, Spencer was dropped off at a Frederick bus station after serving 3 1/2 years of a 10-year sentence for assault. He had no job, no place to live and few prospects of fitting in with society. He had been deemed mildly retarded and likely to re-offend, yet he had received no recent treatment geared toward sex offenses. Six days later, the body of Christopher Lee Ausherman was discovered in a nearby baseball dugout, naked and bloody, with evidence of sexual assault. Spencer is awaiting trial on murder charges.
    The task force was formed by the state secretaries of public safety and health and mental hygiene last spring after several lawmakers called for changes but the General Assembly declined to act. The task force's most controversial recommendation is that if a psychiatrist determines a sex offender to be psychopathic or have an anti-social personality that would make it likely that more violent crimes could be committed -- diagnoses that have no effective treatment -- a judge could sentence the offender to life. The sentence would be an option only upon a second sex crime conviction. The idea is similar to a proposal by Hecht to allow mental hospitals to hold certain sex offenders after their sentences, treating them until they are deemed to no longer be dangerous. That proposal was rejected by the task force, but 16 states have enacted similar measures.
    Among the panel's other recommendations:
• All sex offenders should undergo psychiatric evaluations before sentencing and before being released from jail.
• A life sentence should be an option in more sex crime cases. The task force recommends expanding the law to cover two-time offenders who have been deemed likely to re-offend. Lawmakers rejected a similar proposal during this year's session.
• Sex offenders should be prohibited from using credits that allow them to shorten their prison sentences -- the sort of credits that helped Spencer reduce his 10-year sentence by 6 1/2 years.
• Treatment should be offered to sex offenders before they are released from jail. Currently, only about 20 beds in the entire prison system are designated for such treatment.
    "A lot of discussion on the task force went into trying to understand why people do what they do," Rosenblatt said. He said there are two categories of sex offenders: those with anti-social personality disorders, and those with sexual disorders they are unable to suppress, even though they may want to. Those in the first group are untreatable and will almost certainly re-offend, Rosenblatt said, but the latter may benefit from treatment. Many of the proposals require the approval of the General Assembly, where, next year, money may present one of many obstacles. "Right now, we're in sort of a budget shortfall," said W. Lawrence Fitch, director of forensic services for the Department of Health and Mental Hygiene. "That makes more-expensive kinds of measures less realistic."

Help for Those Willing to Quit Smoking
New York Times, 11/27/2001

One might expect that smokers who decide to have themselves checked for lung cancer with a CAT scan must also be giving some serious thought to giving up cigarettes. A new study suggests that this may be the case--and urges the doctors who conduct the scans to accompany them with advice to patients about ways to quit smoking.
    Researchers from Weill Medical College of Cornell University and the Memorial Sloan-Kettering Cancer Center found that almost a quarter of smokers surveyed six months after their scans reported having quit. Twenty-six percent more said they cut back, the researchers report in the December issue of Preventive Medicine.
    Dr. Jamie S. Ostroff, a psychologist at Sloan-Kettering and an author of the study, said it was unclear how much the results of the scans contributed to the decisions to quit. But she said some smokers quit even though the scans showed that their lungs looked healthy. The findings, she said, suggest that still more smokers seeking sans could be led to quit with the right counseling. "The ground here is fertile," Dr. Ostroff said, "and we know there are proven methods to help individuals to quit."
    The study looked at the experiences of 134 smokers who enrolled in the Early Lung Cancer Action Program at Cornell. Dr. Claudia I. Henschke, a radiology professor at Cornell and the senior author of the report, said she got the idea for the study after some patients who had undergone the lung scans got in touch with her and said they had given up smoking.

Sharpe's Fate Rests with Jury
Michele Kurtz, Boston Globe - 11/27/2001

LAWRENCE - A Superior Court jury held the fate of Dr. Richard Sharpe in its hands last night, as it began deliberations to determine whether the Gloucester dermatologist was insane when he killed his wife last year. The jury got the case yesterday afternoon after hearing lengthy closing arguments from the defense and prosecution about Sharpe's state of mind when he shot his estranged wife, Karen, in front of witnesses at her Wenham home. Sharpe, 47, who mounted an insanity defense, is charged with first-degree murder. Judge Christine M. McEvoy told jurors they also could consider returning a guilty verdict on the lesser included charges of second-degree murder or manslaughter. The jury was sequestered last night at a hotel and will resume deliberations this morning.
    Prosecutors argued yesterday that Sharpe faked mental illness and cunningly planned his wife's murder to later support the insanity defense. ''He sets it up so you'll think he's temporarily insane,'' Essex Assistant District Attorney Robert Weiner told jurors. ''He knew what he was doing was wrong,'' he added, noting the proof lay in ''all the secretive behavior, all the conscience of guilt, all the flight.''
    But Joseph J. Balliro, one of Sharpe's attorneys, said the cross-dressing millionaire doctor was tortured by the effects of childhood abuse. Balliro argued that Sharpe suffered from mental illness that - combined with prescription drugs and alcohol - had made him psychotic when he shot Karen Sharpe on July 14, 2000. ''You have before you an individual who I suggest is about as crazy, about as insane as any [homeless] person you would meet,'' said Balliro, who argued that his client was insane and not criminally responsible for his wife's death.
    Under the law, the burden falls on the prosecution to show that Sharpe was sane at the time of the shooting. Sharpe's two-week trial, covered in its entirety by Court TV, delved into the bizarre lifestyle of the successful doctor, who testified that he took his wife's birth control pills and wore his daughter's panties to make him feel safe. Jurors also learned that Sharpe had hatched a plan to break out of custody while he was scheduled to undergo medical tests at Massachusetts General Hospital in May. Sharpe's behavior in the courtroom was on trial, too. Twice he blurted out statements from the defense table - drawing admonishments from the judge. While testifying for two days, Sharpe squeezed his eyes shut and constantly rubbed his face. And once he refused to dress for court, alleging that jail guards had assaulted him the previous night.
    Prosecutors argued yesterday that Sharpe killed his wife, whom he'd abused throughout their 27-year marriage, because he was angry she had left him and he faced losing millions in a divorce. ''We have no burden of proving motive in this case, but I submit there were 3 million motives for killing Karen Sharpe,'' Weiner said, referring to the amount of money Sharpe had transferred to his wife's name shortly before she left him. ''He was infuriated about the money.'' Weiner methodically laid out Sharpe's actions during the days before and after the killing, suggesting he was in control of his actions. He had business meetings and went out for dinner, Sharpe had testified. And on the night of the shooting, he admitted taking a rifle from an acquaintance's home, loading it and driving to his wife's house. Sharpe admitted to shooting his wife but told jurors he was in a fog and couldn't recall pulling the trigger.
    Prosecutors suggested yesterday that Sharpe killed his wife with a gun he had obtained prior to the day of her death, because a ballistics expert testified that the rifle Sharpe said he took from a home in Gloucester the night of the murder was not the one that fired the bullet that killed Karen Sharpe. Weiner argued that rifle was actually a second gun Sharpe had obtained to create the impression that his actions were spur-of-the-moment. Police never found the murder weapon.
    Weiner also reminded jurors of the testimony of a psychiatrist from Bridgewater State Hospital, who said he believed that Sharpe feigned mental illness while staying there after his arrest in the summer of 2000. The doctor said that when he observed Sharpe from afar he appeared relaxed, but when he talked to him one-on-one, Sharpe closed his eyes, rubbed his forehead, and behaved as if he were in pain. In dramatic fashion, Weiner grabbed his own forehead to imitate Sharpe's mannerisms. ''Have you seen any evidence of that in this courtroom? Have you seen any of that on the stand?'' Weiner asked, as Sharpe sat, holding his forehead. ''He's faking it. He's trying to fake symptoms for secondary gain.''
    But Balliro, who gave his 80-minute argument first, said that Sharpe was so sick while at Bridgewater that psychiatrists increased his medications and extended his stay. ''He doesn't exaggerate his mental condition,'' Balliro said. ''He's a doctor. He doesn't want people to think he's crazy.'' The defense relied heavily on the testimony of Dr. Keith Ablow, a psychiatrist who told the court that Sharpe suffers from a wide array of mental conditions, including narcissistic personality and major depression. He also is frantically afraid of being abandoned, Ablow said, and the prospect of losing his wife -- who brought a facade of normalcy to his life -- drove him over the edge. A psychiatrist who testified for the prosecution said Sharpe might have narcissistic features, but was not psychotic and could appreciate that what he was doing was criminal.
    Balliro argued that Sharpe had to be insane because someone so intelligent wouldn't have planned a murder for which he almost certainly would be charged. ''Was he going to get his money back by shooting Karen Sharpe? That wasn't going to happen,'' Balliro said. ''Did he try to mask his identification at all by going to a house where everyone knew him? Where was the planning? Where was the premeditation?'' Balliro also tried to deflect Weiner's contention that Sharpe could have controlled himself the night of the murder because he seemed to contain himself during an incident a few days earlier. Sharpe had driven to his wife's house, peeked in the window and found her there with another man. He considered barging in, he testified, but instead smashed the headlights of the man's truck.  ''It was a big difference, and the big difference was alcohol,'' Balliro said.
    If convicted of first-degree murder, Sharpe would be sentenced to life in prison without parole. If found innocent by reason of insanity, he would be committed to a state mental hospital until he's deemed not to be a danger to himself or society. Second-degree murder carries a life sentence, but with parole eligibility after 15 years. The sentence for manslaughter can range from probation up to 20 years.

Doctor Found Guilty in Wife's Killing
Denise Lavoie, Associated Press- 11/27/2001

LAWRENCE, Mass. -- Dr. Richard Sharpe, was convicted of first-degree murder Tuesday for killing his wife last year. Members of Karen Sharpe's family clutched hands and gasped at the verdict. Her father and one of her brothers wept. ''I love Mikey and Ally. I love Karen,'' Sharpe told WCVB-TV as he was led from the courthouse, referring to the couple's two youngest children, now 8 and 5. The couple, who married as teen-agers, also have a 27-year-old daughter.
    Jurors deliberated more than ten hours over two days before dismissing Sharpe's argument that he was legally insane and disoriented by booze and prescription medications during the shooting. The conviction carries an automatic sentence of life in prison without the possibility of parole. Sentencing is scheduled for Thursday.   ''Karen Sharpe was a loving mother, the best sister anybody could have,'' Kathleen Lembo, Karen Sharpe's sister, said through tears outside the courthouse following the verdict. ''She was a wonderful daughter and a friend.''
    The case drew national media attention for its lurid details. Photographs of Sharpe wearing slinky dresses and fishnet stockings were widely published after his arrest. Sharpe, a successful dermatologist from Gloucester, taught at Harvard Medical School and ran a cosmetic hair removal business and an Internet-based business that developed medical software and lasers. He had parlayed his earnings from his businesses into millions in the stock market.
    During his three-week trial in Lawrence Superior Court, Sharpe spent two days on the witness stand. He said he didn't remember much about the night of the killing, when he shot his wife in front of her brother and other witnesses as the couple's two youngest children slept in another part of the house. ''I heard the gun go off,'' he said. ''I think the noise sort of woke me up a little bit. I heard the noise and I left.''
    A psychiatrist testifying for the defense said Sharpe suffered from a half dozen psychiatric disorders, including severe depression and intermittent explosive disorder. He said Sharpe's disorders were aggravated when he drank alcohol. Sharpe testified he had two to four glasses of wine the night of the killing.
    But prosecutors said Sharpe carefully calculated his actions before the killing so he would appear insane, and later faked symptoms of mental illness to impress psychiatrists and the jury. Assistant District Attorney Robert Weiner told the jury that Sharpe stole a gun from a friend the night of the killing to make it look like a heat-of-the-moment decision, then used another gun he had obtained before that night to shoot his wife. Neither weapon was ever recovered. Following the verdict, Weiner called Karen Sharpe ''a classic battered woman.'' She had left her husband just months before she was killed. ''It was only in the end that she was free from the yolk of Richard Sharpe, but unfortunately it was too late,'' he said outside the courthouse.
    Sharpe's lawyer, Joseph Balliro, called the killing ''a tragedy for everybody.'' ''Those three children have lost their mother and now they've lost their father,'' Balliro said. ''There are no winners as far as this case is concerned.'' One juror who would not identify himself said the jury did not believe Sharpe's defense. ''He didn't have a leg to stand on ... there's no insanity there,'' he said. Sharpe also was convicted of possession of a firearm without a license, and violating a restraining order taken out by his wife.

Vermont to Allow Methadone Treatment of Some Prisoners
Associated Press, 11/28/2001

BURLINGTON, Vt. -- The Vermont Corrections Department plans to allow some inmates to receive methadone in jail, a policy shift from this summer when the department fought the issue in court. Under the new policy, inmates who are in jail on short sentences, probably less than 90 days, and were successfully participating in a methadone program before jail will be eligible. The rule change has not been finalized. The department is waiting for a methadone clinic to open in Vermont, which could happen in Burlington as early as February.
    Methadone is a drug taken by heroin addicts to ease withdrawal symptoms. Addicts often take methadone daily, so being denied the drug for even a short stint in jail can be agonizing. ''You want to minimize the withdrawals as best you can,'' said Thomas Powell, who directs health services for the Department of Corrections. The change will avoid forcing people to go through methadone withdrawal in jail when they are going to go back on methadone as soon as they're out.
    Last summer inmate Keith Griggs was serving a 15-day sentence for violating the conditions of his parole. He had taken methadone for two years but was denied the drug in jail. The Department of Corrections said that under state law, only hospitals were allowed to dispense methadone. Griggs took the question to court where a judge ruled that Griggs was entitled to his methadone. The state chose to release Griggs early rather than bring methadone into the jail.
    Powell said the department changed policy after consulting with national and state experts on methadone. The Department of Corrections also wants to work with a Vermont methadone provider, not the Greenfield, Mass., clinic, which is the primary option for Vermonters. The program is not for inmates who walk in as heroin addicts, only for those who are methadone patients. Inmates who are in for long sentences will be withdrawn from methadone. No one knows how many inmates would qualify for the new policy.

Florida Sex Offenders May Go Free Because of Challenge Law
Amanda Riddle, Associated Press- 11/28/2001

WEST PALM BEACH, Fla. -- Scores of rapists and child molesters could go free in Florida because of challenges to a state law that allows them to be kept behind bars indefinitely, even after they have served their sentences.  Around the country, similar state laws are also being tested, and one such case is now before the U.S. Supreme Court. A child molester in Florida has already been released because of a recent state appeals court ruling, and perhaps 200 others could get out of prison because of the decision, too.
    At issue is the Jimmy Ryce Act. Under the law, when the prison sentence of a violent sexual offender is about to end, prosecutors can ask for a civil trial to decide whether the offender is likely to strike again and should be kept locked up until a doctor determines he is no longer a threat. The 1998 law was named after a 9-year-old Florida boy who was abducted, raped and murdered in 1995. His killer has been sentenced to death.
    The problem is this: Scores of offenders who have completed their sentences but are still awaiting their civil trials are being held behind bars in the meantime based on evidence from prosecutors that they would be a danger to society. Earlier this month, however, a state appeals court in Lakeland ruled that such pre-trial evidence must be given under oath.
    On Monday, Thomas Hurte, 21, was freed in Palm Beach County on the basis of that ruling. He had completed a 3½-year sentence in January for having sex with two girls, ages 13 and 1l, and was being kept in prison, pending his civil trial, based on evidence that was not given under oath. Palm Beach Assistant Public Defender Ken Johnson, who represented Hurte, said keeping offenders in custody for months without sworn evidence violates their rights. Some offenders wait as long as 1½ years for a civil trial, he said. More than 200 offenders in Florida awaiting civil trials are covered by the Nov. 16 ruling, Johnson said. Defense attorneys have filed requests for release of at least 60 of them.
    Assistant Florida Attorney General Richard Polin, who is in charge of defending the Ryce Act, said the state plans to fight the appeals court ruling. He said that before any of the inmates are set free, prosecutors should be given the opportunity to submit sworn statements from psychologists
    In 1997, the U.S. Supreme Court upheld a similar Kansas law, ruling that states may keep violent sex offenders locked up beyond their prison terms. But the high court is now revisiting the issue. The latest issue before the high court is whether states must prove that offenders are unable to control their behavior. The Kansas Supreme Court said states must show an utter lack of control, but the state attorney general argues that that hurdle is too high. More than 1,200 sex offenders are confined in 18 states. The laws have survived numerous challenges and Florida's act will withstand the latest attack, too, Polin said. Jimmy Ryce's father, Don Ryce, said he and his wife fought to make sure Jimmy did not die in vain. ''We are not going to sit back and let a major part of his legacy get tossed in the trash can,'' he said Tuesday.

Underrated Bullying May Be at Root of Massachusetts Shootings
ABC News, 11/28/2001

Authorities say a planned massacre at a New Bedford, Mass., high school could have been another Columbine — or perhaps even worse — if police hadn't gotten wind of a group of students' alleged plot to detonate explosives, shoot classmates, and then kill themselves. The students have pleaded not guilty, but according to police reports, the five teens who allegedly planned the attack had complained of being picked on and called names. A note found by a janitor at the school spoke of "getting everyone back for calling us names and beating us with ugly sticks."  The statement is reminiscent of the suicide note left by Eric Harris, one of the two attackers at Columbine High School in Littleton, Colo: "Your children who have ridiculed me, who have chosen not to accept me, who have treated me like I am not worth their time, are dead."
    Experts say bullying is a serious and widespread problem that can lead to school shootings and suicide. At the same time, they say, it is dangerously underrated, as schools and adults are not taking the problem seriously enough. "For the child who's been targeted by a bully, their life is a living hell," said Glenn Stutzky, a school violence specialist at Michigan State University. "Bullying is probably the most frequently occurring form of violence in American schools today and it's really the engine that's driving the majority of violence. It's a huge problem."
    Even though several states have now passed anti-bullying legislation, Stutzky said the American school system is 10 to 15 years behind countries like Australia, Scandinavia, Great Britain and Japan, all of which deal with bullying as a serious social problem. "We have allowed a culture of abuse to thrive unchecked in our nation's schools," said Stutzky, "and we are paying for it with the bodies of our children."

Physical and Emotional Toll
Though it seems so hard to understand the anger that would fuel children to plot a massacre at their high school, sadly, many children can relate to the feelings of loneliness, abuse or resentment. "Once I got teased, I could see where that anger comes from and what can make someone want to kill," said Stefan Barone, a 14-year-old from Staten Island, N.Y., who said he was bullied during seventh and eighth grades. "Even though I never got to that point, I could understand where it was coming from." Day after day throughout the country, kids wake up terrified to go to school, knowing they will be the victims of teasing, taunting, name calling or physical abuse.
    For Rachel Fannon, 16, being abused by her classmates in Littleton, Colo., for 5 ½ years took both a physical and emotional toll. "They had actually a contest: They'd high-five each other if they come up with the best name how to describe how ugly I was," she said. "They'd kick me in the back of the knees and give me small bruises or they tripped me." Fannon, who has a heart condition, would suffer attacks of rapid heartbeats after being harassed. Her grades dropped. She became withdrawn and had no friends. After school she would lock herself in her room and cry.
    "All day, every day, they kept harassing me," she said. "Everywhere I went, there they were." Fannon said teachers told her to "tough it out" or to "just ignore it." She said she was too embarrassed to tell her parents, but she finally confided in her mother. Principals of her school say the complaints never reached them, but they admit that despite their anti-bullying policies, Fannon somehow fell through the cracks. Fannon — who now goes to a new school where she says she is treated "like a human being" — is hardly alone.
    Despite being 6 feet 11 inches and 280 pounds, Chris Velasquez, now 14, said he was beaten so badly at his middle school that one time he was taken to the emergency room. "They caught me in the stairwell and jumped me and I couldn't see anything," he recalled. "I had one kid punching me a lot of times in the face, and one just repeatedly hitting me in the back." Though the incident was reported to school authorities, Velasquez said the boys who beat him up were not even suspended. His family is now suing the school district.
    "We have a whole generation of adults in the educational system that still view bullying as 'just that's the way it is,'" said Stutzky. "It's a rite of passage, it's boys being boys … stop whining about it, life is tough, you just have to put up with it and make your own way through."

Possible Consequences: School Shootings and Suicide
To deal with being bullied, some children seek revenge. Velasquez can understand. "I do think about going into school and doing something," he said. "But then I think what will that make me look like? A criminal." Other children turn their anger inward. Each year, one out of 13 kids under the age of 19 attempts suicide, a rate that has tripled over the last 20 years. Last year, more than 2,000 of them succeeded — a staggering number Stutzky blames largely on bullying. "We're not even realizing the fact that suicide is bullying's quiet little secret," he said. "It's picking off our children one at a time."
    Twelve-year-old Tempest Smith was one of them. From the time she was in the second grade, said her mother Danessa Smith, Tempest was the brunt of cruel jokes and constant humiliation. One time, recalls Smith, a group of kids pretending to be Tempest's friends came over to her house, only to ransack her room. Tempest would also be pushed in the lunch line, and her classmates would purposely knock things off her desk. Smith said the school wouldn't even acknowledge there was a problem. "If it was not done in front of them, there's nothing they could do," Smith said she was told. By the time Tempest reached the seventh grade, Smith was so fed up that she planned to home-school her daughter. But she never got that chance. On Feb. 20, Tempest took her own life. Smith is now suing the school district, which has denied any wrongdoing.
    Though Tempest cannot benefit from her peer's advice, Stefan Barone wanted to share advice with others who feel isolated and alone: "I'd like to say that there's going to be an end to it sooner or later … One day it's going to end and everything's going to turn around … you have to have hope."

The Dark Side of Group Identity
Melinda T. Willis, ABC News- 11/28/2001

B O S T O N— Preps, jocks, and goths -- when do such teen cliques go from being a positive to a destructive force?  In the wake of charges that a group of New Bedford, Mass., teenagers planned a local high school killing spree that officials said targeted "thugs, preps, and faculty," many may be left wondering about the extent to which an "us versus them" belief system can spark violence in American schools. Cliques and groups are common to school age children and do not necessarily mean trouble, agree experts. But as past events have demonstrated, it is also critically important to acknowledge when such group identity becomes a threat.

When Cliques Click
"Particularly in American culture, peer crowds are a very common phenomenon and they do serve a purpose," says Mitch Prinstein, assistant professor of psychology and director of clinical training at Yale University. According to Prinstein, these groups can help adolescents navigate through social networks and categorize peers, especially during times when many students move into larger schools such as in middle school and high school. "These groups are also sort of a shortcut for adolescents to develop friendships and romantic relationships," says Prinstein. Overall, groups play an important role in identity formation. "That children identify themselves with a group is part of deciding who they are and having a feeling of belonging," adds Linda Madison, a child psychologist and director of family support and psychological services at Children's Hospital in Omaha, Neb.

Dangers of Group Identity
Experts also acknowledge that there is a dark side to cliques as well. "The downside is that there are some groups that are valued more highly than others," says Jay Bass, a counselor and violence prevention consultant based in Washington, D.C. Additionally, "those who cannot latch into groups are somewhat disenfranchised." In other words, those who do not fit into a specific group may feel neglected or hostile towards those who do and have a higher profile as a result. These individuals may then establish a group identity that is purposely set apart from what they see as being widely accepted.
    "Research shows that when children's identity with other children focuses around emotional support rather than activity or positive purpose, they tend to be more destructive," explains Madison. "When they are in a group that defines themselves so rigidly that it excludes other groups, then there is more competition with other groups." "As the group goes down the road to more destructive behaviors, it may be difficult for the kids not to go along with them," she adds.
    Social groups can begin to demonstrate their hostile feelings in a wide variety of negative and harmful behaviors. Teenagers may act out emotionally by teasing, harassing or verbally attacking schoolmates, or physically by pushing or hitting. The most extreme, and experts say very rare, form of acting out is the use of guns or other weapons.

Preventing Destructive Consequences
What steps can parents and educators take in making sure that healthy group behavior does not become destructive or victimize those who do not fit in? "Modeling is number one," says Madison. "It's really important [for adults] to model appropriate inclusive type behaviors." For example, if children repeatedly witness behaviors in adults that appear to place importance on certain racial, ethnic, or social groups and exclude those who do not belong, they will likely emulate these behaviors.
    Parents should also give their children lots of venues for social involvement, maintain interest in their lives and foster involvement in extracurricular activities, say experts. This will ensure that there are many different settings in which a child can find friends and social support. And most of all, an important part of keeping group dynamics from taking a tragic toll on children is for adults to try to instill a sense of belonging that is not limited to a social group. "Connectedness with parents and identification with school are two of the most protective factors for kids," says Madison.

Illinois Man Says Ex-Wife Suffered Depression, 'But She's Sane'
Flynn McRoberts & Jeff Coen, Chicago Tribune- 11/29/2001

David Lemak held jurors rapt Wednesday as he recalled the morning he rushed to his family's Victorian home in Naperville, only to find it swathed in police tape, a helicopter hovering overhead. As Lemak approached the house, a police officer stopped him from going inside and told him that his three children--Nicholas, 7, Emily, 6, and Thomas, 3--were dead. "I asked to go in. I said, `Maybe there's a chance they're still alive. I'd like to check on them,'" said Lemak, an emergency room physician, in his second day of testimony in the murder trial of his former wife, Marilyn. "They said no." Prosecutor Joseph Ruggiero later handed him autopsy photographs of the three children, oldest to youngest. Lemak's composure slipped away as he pronounced each name. By "Thomas," his voice broke and tears fell.
    As Lemak recounted the morning of March 5, 1999, several family members and friends wept quietly in the packed DuPage County courtroom. Some wore clusters of ribbons on their lapels--two blue ones for Nicholas and Thomas, a pink one for Emily. Lemak's voice was steady again when Ruggiero asked him whether he thought his then-wife was unable to appreciate the criminality of her actions because of "mental defect"--the legal definition of insanity. "No," Lemak said sharply. "She was sane."
    But on cross-examination by Marilyn Lemak's lead defense attorney, John Donahue, David Lemak acknowledged that he thought his estranged wife was suffering from "major depression." After Donahue repeatedly asked Lemak about her state of mind on the day of the slayings, Lemak said she had "a major depression, but to a mild degree ... mild to moderate degree, yes."
    Marilyn Lemak's state of mind is the crux of the case, which began with opening arguments Tuesday. (Though the defendant now uses her maiden name, Morrissey, she is referred to in criminal court as Marilyn Lemak.) Defense attorneys say she was legally insane. Prosecutors contend she killed her children to spite her husband after she discovered he had begun dating another woman as their divorce was being concluded.
    David Lemak testified Tuesday that he had made no attempt to hide the relationship and had taken the girlfriend to a hospital function. But two days before the children were killed, he said Wednesday, the girlfriend had stayed overnight in his new home just down the street from the family home. He said he had her park the car out front so it couldn't be seen from the children's nearby grade school.
    Prosecutors used that relationship to underscore their theory that it sent Marilyn Lemak into a jealous fit that culminated in the killing of their children. The day before the slayings, Lemak testified, his estranged wife brought the kids over for a scheduled visitation and asked to use the bathroom. When she came out, he said that she told him "she was glad that the two of us [Lemak and his girlfriend] had a chance to shower before the kids came over." He added that she was "angry, but mostly sarcastic."
    In questioning Lemak, Ruggiero brought out that his estranged wife allegedly had scrawled a message on the bottom of dresser drawers before he moved out. The message accused him of being "an adulterer and abandoning your children." Naperville Police Detective Mike Cross testified that Marilyn Lemak repeated those sentiments when he interviewed her in Naperville's Edward Hospital the morning the children were found dead. When he asked her why she killed her children, Cross said that Lemak replied: "Because her husband was not keeping them No. 1 on his priority list." After he first identified himself as a Naperville police detective, Cross recalled, "She said, `I did it."'
    He then read Marilyn Lemak her Miranda rights and asked her to describe what had occurred. She told him that she drugged the children with three tablets of Ativan, an anti-anxiety drug she had been taking, Cross testified. When those had "no effect," she allegedly told Cross, she gave them three more, and they started to hallucinate. "They were reaching for things that weren't there," Cross said she told him, then demonstrated for the court by repeatedly grasping at the air with his right hand.

911 tape played
Contradicting the defense description of a peaceful death scene, Cross testified that Marilyn Lemak told him Emily and Thomas, who were killed first, struggled for breath as she covered their mouths and noses. To illustrate, the detective reared his head back several times, audibly gasping for air. After the killings and her own botched suicide attempt, Lemak awoke several hours later to find the children dead. She dizzily crawled to the bathroom to find the X-acto knife she'd used to slash her right wrist, Cross told DuPage County State's Atty. Joseph Birkett, who is leading the prosecution. Unable to find the knife, she called 911.
    Prosecutors played the 911 tape for jurors, who used copies of a transcript to follow the recording. Many spectators in the courtroom's packed gallery focused on David Lemak as the taped sounds of his ex-wife's wailing filled the room. Lemak stared intently at his ex-wife as she dabbed her eyes and wiped her nose with a tissue. "My three kids are dead, and I ... I wanted to be dead too, but it didn't work," she said on the tape, deliberate at first. "I did it." And then, between heavy breaths and moans: "I didn't want to wake up this morning, but I did. But the kids didn't."
    Birkett worked to tear down the version of the children's deaths presented in opening statements Tuesday by Lemak's defense. Her lawyers had told the jury that Marilyn Lemak wanted to go with her children in death to a "happier place," free from emotional pain, that she didn't know she was committing a crime, but thought she was performing an act of love. Birkett put the question to Cross: Had Lemak ever told him that she killed her children and tried to kill herself so they could all "go to a happier place together"? "No, she did not," he answered.
    In his cross-examination, Donahue picked at the detective's recollection of the interview, concentrating on Marilyn Lemak's response to Cross' question about how she felt after slashing her wrist and hitting an artery. "She said that made her happy," Cross testified. "Why?" Donahue asked. "Because she was going to die," came the reply. Donahue also asked Cross if he had asked Marilyn Lemak whether she knew killing the children was wrong or criminal. The detective said he had not.

Drug combination
Much of Donahue's cross-examination of David Lemak seemed to be an effort to portray him as out of touch with issues of his wife's mental health. In doing so, Donahue suggested that Marilyn Lemak was affected by the combination of drugs she was taking. Describing what he said were Marilyn Lemak's swings in weight of as much as 60 pounds after Emily's birth, Donahue suggested she was affected by taking both the anti-depressant Prozac and the weight-loss cocktail "fen-phen," which David Lemak had prescribed to his wife. Fen-phen, or fenfluramine-phentermine, gained wide attention after the federal government pulled it from the market in 1997 because some people using it suffered heart-valve damage. According to a pharmaceutical database, abruptly stopping the use of fenfluramine by itself can lead to a depressive episode. "Were you aware she was taking fen-phen at the same time she was taking Prozac?" Donahue asked. "No," David Lemak replied.
    Prosecutors also called a series of medical personnel who treated Marilyn Lemak the day her children were discovered dead. An emergency room nurse and doctor from Edward Hospital and two paramedics all testified they found Lemak to be alert and lucid during her treatment. Nurse Sandra Clow was asked by prosecutors whether Marilyn Lemak ever told her she killed her children to take them to "a happy place." No, the nurse answered. Donahue countered by asking Clow whether Lemak ever told her she killed the kids to spite her husband, the state's allegation. Again, the nurse said no.
    Paramedic Phillip DeMik, testified he was the first emergency worker to reach the children and quickly determined they were beyond saving. He said Marilyn Lemak asked to kiss her children goodbye as she was taken from the house on a stretcher. "I consulted with a police officer," DeMik said, "and the answer was no."

'I Didn't Know I Did Shooting,' California Man Testifies
Stuart Pfeifer, Los Angeles Times- 11/29/2001

Speaking publicly for the first time about the seven people he killed, former Cal State Fullerton janitor Edward Charles Allaway said Wednesday that delusions led him to believe he was one of the victims--not the killer. Even as seven people lay dead and two wounded at the campus library in 1976, Allaway thought he was calling police to report that he had been assaulted when he actually was confessing, he testified in a Santa Ana courtroom.
    "I thought I explained to them that I was hurt," Allaway told a judge who will decide whether to release him from a state mental hospital. "I was beaten up and I wanted to press charges. I didn't know I did the shooting. I couldn't accept it or have a real understanding of what I had done." Allaway told Judge Frank F. Fasel that he initially planned to call in sick on July 12, 1976, but instead found himself at the library, lying on the ground and feeling a pain in his neck. "I thought I got shot in the back of the neck," he said. He was not actually injured.
    Allaway said he knows he went into the library but does not remember shooting anyone. Instead, he has visions of running behind victim Debbie Paulsen, thinking they were both fleeing an enraged assailant. Allaway said he has since learned that he shot Paulsen in the back while the 26-year-old woman fled.
    As Allaway spoke, Paulsen's brother, Paul, removed his glasses and began to cry in the back row of the courtroom. Paul Paulsen is among a group of victims' relatives who are opposing Allaway's release from Patton State Hospital near in San Bernardino. Hearing Allaway describe his memories of the shootings made some of those relatives angry. "I don't believe that; he's never said that before . . . not for 25 years," said Patricia Almazan, whose father, Frank Teplansky, died in the rampage.
    But one victim's widow seated in the front row of the courtroom said it's time to set the 62-year-old Allaway free. "I don't believe in vengeance and that's what this is all about," said Judith Herzberg, whose husband, Paul, died in the shootings. "What we're trying to do is take an insanity plea and turn it into life imprisonment." Herzberg, who works as a real estate lawyer in Long Beach, said she believes Allaway was never mentally ill and that it would be inappropriate to keep him locked up in a mental hospital when he's psychologically fit. Allaway's lawyer, Deputy Public Defender John Bovee, welcomed Herzberg's support. "I'm glad to hear that some people are thinking it's time to do away with revenge and move on with the healing process. That's really what this is all about," Bovee said.
    As a way to make amends with his victims, Allaway said he has tried to remember each of their names. His voice trembling, Allaway named eight of the shooting victims from the witness stand. He forgot the name of Seth Fessenden, a retired professor, until his memory was jogged by a prosecutor who is opposing his release. Allaway later described Fessenden as "the sweetest man I ever knew."

Two Previous Bids for Freedom Failed
   A judge found Allaway not guilty by reason of insanity in 1977. The former Marine and Detroit auto factory worker has spent nearly a quarter-century in state mental hospitals. He has twice previously lost bids to gain his freedom, but this time, doctors and staff at Patton say they consider him safe for release. Several doctors say Allaway's schizophrenia is in remission. His case has attracted international attention. Mental health experts said no killer in U.S. history with as many victims as Allaway has been released from a mental hospital.
    Orange County Deputy Dist. Atty. Daniel Wagner focused his cross-examination Wednesday on Allaway's history of violence. The former janitor said he has been involved in numerous fights, including an assault on his ex-wife before the shootings, and some skirmishes in state hospitals afterward. Wagner also questioned Allaway about whether he's truly remorseful, noting that he has done nothing to support his victims' families, including the three children of Allaway's best friend, Donald Karges, who died in the shootings. "I don't have anything," Allaway replied, saying his maintenance job at Patton pays 30 cents an hour.
    The soft-spoken Allaway remained composed during Wagner's questioning. He said his mental health has improved remarkably during years of therapy, but he could not pinpoint the date he believes he was cured. "It takes time. Nothing happens overnight. It's not like the flu," Allaway said. "I'm the best I can be. I feel good about my improvement." Allaway is scheduled to begin his third day of testimony today.

Ecstasy Use May Differ in Effects on Men & Women
Emma Ross, Associated Press- 11/29/2001

Ecstasy, the increasingly popular party drug, may cause more brain damage in women than in men, new research suggests. A study published this week in The Lancet medical journal compared brain scans of people who had taken 50 or more Ecstasy tablets in their lifetimes with those of a group who had never taken the drug. The findings indicated women -- but not men -- lost a significant number of brain cells, even though the men had taken more Ecstasy over the years. Fifty tablets is considered the threshold for increased risk of developing psychiatric problems. Experts said the preliminary findings raised an interesting possibility but that larger studies are needed to confirm the results.
    Ecstasy, also known as XTC or E, affects serotonin, a brain chemical that regulates mood, emotion, sleep, appetite, memory and sexual behavior. The drug typically induces feelings of euphoria, increased energy and sexual arousal, and makes people feel a need to be touched or hugged. The illegal drug, known scientifically as MDMA, is also said to suppress the need to eat, drink or sleep, making it possible to endure parties for two or three days. However, in high doses it can cause a sharp increase in body temperature, leading to muscle breakdown, kidney and heart failure, and death.
    Studies have shown it also kills brain cells that release serotonin. Scientists are now trying to find out how long the brain damage lasts and its long-term consequences. So far, studies have found heavy users have persistent memory problems and preliminary research suggests they also have trouble with verbal reasoning and sustaining attention.
    In the latest study, Dutch scientists compared the brain scans of 69 people, who were divided into four groups. One included people who used drugs but not Ecstasy, the second comprised those who had taken fewer than 50 tablets during their lives. The third, the heavy users, had taken 50 or more Ecstasy pills and the fourth group included people who used to be heavy users but had given up Ecstasy at least a year before the study.  The researchers found that compared to the brains of women who had never taken Ecstasy, the brains of heavy Ecstasy female users had weaker concentrations of serotonin transporters, the sites on brain cell surfaces that mop up serotonin from the space between cells after it has finished acting on other cells. If the chemical is not mopped up, further brain signals are prevented from getting through.
    MDMA gets into the brain cell through the serotonin transporter. A missing transporter means a dead cell, said the study's leader, Dr. Liesbeth Reneman, professor of radiology at the Academic Medical Center at the University of Amsterdam. The decline in serotonin transporters was not seen in the men's brain scans, she said.
    Kathryn Cunningham, professor of pharmacology and toxicology at the University of Texas Medical Branch in Galveston, said it makes sense that men and women would respond differently to MDMA. One reason is that amphetamines are cleared from the body more quickly in the presence of testosterone, she said. Also the female hormone estrogen regulates the serotonin transporter, said Cunningham, who was not involved in the study.  "Estrogen-dependent changes in the serotonin transporter might regulate the brain response, and thus toxicity, to MDMA. And it's conceivable that women may be more vulnerable to brain damage at certain times of the month," she said.

Center Seeking Better Treatments for Mood Disorders
Deborah Mann Lake, Houston Chronicle- 11/29/2001

Most people think of depression as an adult disease. But as research generates knowledge about mood disorders and their biological links, more therapists are treating children and adolescents -- some as young as age 5 -- for these conditions. To develop better treatments for children with mood disorders the University of Texas Medical Branch at Galveston has opened the Mood and Anxiety Center for Children and Adolescents.
    The first of many research projects the center will undertake is a study on adolescents who were unsuccessfully treated with a mood disorder medication, said psychiatrist Dr. Karen Dineen Wagner, the center's director and director of UTMB's division of child and adolescent psychiatry. Wagner is the lead investigator for this five-site medication study funded by the National Institute of Mental Health. "We're going to be looking at what you do next. Do you try another psychotherapy drug or a combination of another drug and psychotherapy?" Wagner said. "We found that the response to medication in children varies and the rate of medication failure is higher than in adults."
    Mood disorders include depression, bipolar disorder and anxiety disorders, which include obsessive-compulsive disorder, social anxiety and post-traumatic stress disorder. "Mood disorders have been under-recognized in children because the symptoms might confuse parents. The child may not be crying all the time or acting sad. He might be irritable or have sleeping problems and parents may think it's just a stage he's going through," Wagner said.
    Signs of a mood disorder in children also include performing poorly at school, weight changes, drops in self-esteem, social isolation, expressions of hopelessness and "saying they wish they were dead," she said. "A 5-year-old might be crying all the time and doesn't want to be with anyone," Wagner said. "A 6-year-old might say they wish they were never born."
    Sometimes a stressful event can trigger a mood disorder, such as a loss of a relationship (especially for teen-agers) or the loss of a parent. Even children who may not have experienced an event firsthand may still exhibit a mood disorder -- the reaction among some children to the terrorist attacks of Sept. 11 is an example. "If they're concerned it could happen to them, it could lead to anxiety," Wagner said. "Something like our recent flood was a life-threatening event out of normal. Being in a severe motor vehicle accident, being injured by an animal or being physically or sexually abused can cause post-traumatic stress disorder." In other cases, a mood disorder comes "completely out of the blue," she said, particularly if an illness such as depression runs in the family.
    Once the disorder begins, it can snowball quickly. "Children are labeled as being `moody' or `hard to get along with.' They complain about everything and don't like anyone," Wagner said. "They start to fail in school and their friends don't want to be around them because they're so irritable. Then they start to withdraw from activities."  As many as 5 percent of children and adolescents suffer from major depression and an untreated episode lasts, on average, nine months. This could impact an entire school year for a child and delay his academic and social development, Wagner said. He may find it difficult to re-establish friendships, and other children at school may begin to pick on him. "They can be tormented by their peers and become even more depressed. A lot of children don't realize what they're doing when they tease or torment other kids. Children with mood disorders have low self-esteem anyway and that daily verbal assault just lowers it more," Wagner said.
    Older adolescents commonly turn to drugs or alcohol, she said, to relieve the symptoms of the depression or anxiety. But that can make the illness worse and even lead to suicide. "We encourage parents with depressed children to remove all guns from the house. They can pick up a weapon without thinking and it can be lethal," she said.
    In bipolar disorder (also called manic depression), children will swing from an elevated mood that is almost euphoric to a deep depression. "When their mood is elevated, they don't need to sleep and (they) get involved in a lot of activities or risky behavior. Their speech might be very rapid," Wagner said. "That will alternate with periods of depression."  With an obsessive-compulsive disorder, children worry nonstop about an event such as a parent dying. Feeling they have to do something to alleviate the worry, children with this condition perform an action over and over again.  "It's like that nagging feeling that you have sometimes about whether or not you locked the door or turned off the coffee pot," Wagner explained. "Except for these children, they'll check the door 100 times. Checking it once doesn't relieve their nagging feeling."  A child who has a social disorder may be terrified of being in a situation where he thinks he'll be judged. Often mislabeled as shy, Wagner said, a child with a social disorder may have difficulty reading out loud, raising his hand in the classroom or participating in sports.
    Wagner said parents should use their own gut instinct about whether their child might have a mood disorder. "What we tell parents is that if they are worried about the child, that's a good sign the child should be evaluated," she said. "Parents are pretty good judges of their own children." Wagner is hopeful that the center will help encourage parents to get help for their children before the depression becomes severe. "The stigma is starting to go away." Wagner said. "Parents want their children to be healthy physically and emotionally. The educational efforts are improving to raise awareness of mood disorders."

In the Grip of GHB
Linda Marsa, Los Angeles Times- 11/29/2001

Despite reports linking it to dozens of deaths and thousands of overdoses, the illegal supplement GHB just won't disappear. First banned in this country more than a decade ago by federal regulators, the substance--best known as a party drug used on the rave scene--remains popular with fitness buffs, insomniacs and the depressed, who buy it on the Internet and from underground sources.
    Now medical experts report another troubling problem: GHB is highly addictive and can be more difficult to kick than heroin. But unlike opiate addiction, most doctors are unaware of the stranglehold that GHB has on users. Consequently, medical treatment is often ineffective. GHB, which severely depresses the nervous system, has sent more people to emergency rooms than a more highly publicized club drug, Ecstasy--about 12,900 at last count--and has been blamed for 71 GHB-related deaths since 1990, according to federal statistics. "This is the most addictive drug I've ever seen," says Dr. Stephen W. Smith, an emergency room doctor at Hennepin County Medical Center in Minneapolis who has treated about 50 patients for GHB addiction problems since 1998. "People are desperate to get off of it because it's destroying their lives," he says, yet only about one in 10 of his patients has successfully kicked the habit.
    No one knows exactly how many Americans are addicted to GHB, or gamma hydroxy butyrate, because the federal government did not begin monitoring GHB abuse until after the drug was declared illegal in March 2000. No statistics have yet been released. GHB use is also difficult to track because the chemical is excreted from the body within 12 hours, and most emergency rooms don't test for the presence of the drug. Consequently, GHB use often goes undetected. Trinka Porrata, a retired Los Angeles Police Department narcotics detective who has investigated GHB for more than five years, believes that the statistics on emergency room visits and deaths linked to GHB understate the problem. "These figures are just the tip of the iceberg and the actual numbers are probably much higher," says Porrata, who advises law enforcement officials on GHB's dangers.
    Most GHB abusers are not street junkies looking for a new high, however. Typically, they are people who have turned to the drug, which is promoted as a natural, nutritional supplement, to build buff bodies, lose weight or to fight insomnia, premenstrual pain and depression. Some professional athletes have used the substance--usually sold as a salty-tasting liquid--to improve performance. Phoenix Suns basketball player Tom Gugliotta, for instance, nearly died in 1999 after ingesting a GHB supplement to help him sleep.
    Some users know the drug is illegal and buy bootleg brews over the Internet or from the back rooms of health food emporiums. Others stumble across ads on the Internet and purchase what they believe is a natural remedy to beat the blues or get in shape. While there's no evidence that it helps increase muscle mass, "GHB seems to help users sleep better," says Smith, an assistant professor of clinical emergency medicine at the University of Minnesota School of Medicine. "If they suffer from depression, they tell me that GHB makes them feel normal for the first time in their lives."
    Medical experts don't have a clear idea of how GHB affects the body because no definitive research has been done. Based on physicians' observations of how it affects people, however, they speculate that it alters levels of brain chemicals like dopamine and serotonin, which regulate mood and impulse control. In small doses, GHB is a mild stimulant that produces a feeling of intoxication or euphoria and releases inhibitions, which is why it's a popular party drug. In higher doses, however, anecdotal reports indicate it seriously depresses the central nervous system. Even a small increase in the dosage can push the sedative effects to a lethal level, causing unconsciousness, slowed heart rate, respiratory depression and coma, doctors say. And habitual use, even for just a few weeks, can cause people to become physically and psychologically addicted, according to doctors who've treated GHB addicts. "These are often not people with an addiction history," says Dr. Karen Miotto, a psychiatrist at UCLA School of Medicine. "They stumble on GHB and have the hardest time staying off. I've had people cry, 'I've never abused drugs. I'm a monster. What happened to me?'"
    Tony Young, 39, of Seattle, saw an ad in a bodybuilding magazine for a product touted as an all-natural supplement that would help boost muscle mass. He ordered a two-month supply for $75. The supplement, whose active ingredient is a form of GHB, made him feel more relaxed and improved his sleep. But if he missed a dose, "I'd get cranky and severely depressed." He knew he was hooked. His addiction escalated to a $4,000-a-month habit. He sipped capfuls of GHB virtually around the clock. He tried drug rehabilitation twice but relapsed both times because he felt swallowed up in a depression when he stopped taking GHB. Young struggled to maintain his normal routine, but he'd sometimes black out while driving. He was arrested several times for driving under the influence, and he crashed two cars, including one belonging to his employer, which cost him his job as an elevator mechanic supervisor. About a year ago, Young, a husband and a father of two young boys, was sent to jail after a DUI conviction. "GHB ruined my life," he said in a telephone interview from the King County Jail in Kent, Wash. "I've let everyone down."
    Despite the federal ban, GHB and its various chemical cousins, including GBL (gamma butyrolactone) and BD (1,4 butenediol), remain popular at gyms frequented by serious bodybuilders. It is passed around weight rooms, sold out of cars in parking lots and dispensed from behind juice-bar counters, according to those familiar with its sale and use. For bodybuilders, GHB's allure comes from the scientifically unproven claim that its use will help people build bigger, leaner physiques. Promoters of the drug contend that it helps to release growth hormones, boosting muscle mass and trimming fat.
    GHB was first developed in the 1960s as an anesthetic, but research was discontinued when high doses in animals caused grand mal seizures, says Dr. Wallace D. Winters, a former UCLA pharmacology professor who has studied GHB. In the 1980s, GHB was sold in health food stores as a sleep aid and nonsteroidal performance enhancer for bodybuilders. In 1990, however, the Food and Drug Administration yanked GHB from the market after the agency received dozens of reports of adverse affects, ranging from nausea and vomiting to seizures, comas and death.
    Supplement manufacturers circumvented the federal ban by developing chemically similar products. When people consumed these products, which had legal uses as industrial solvents or cleaners, the body metabolized them and converted them into GHB. Thus, the products had the same effects as those of GHB. These products were marketed under such brand names as Blue Nitro, Enliven, Thunder Nectar and Serenity. In March 2000, federal regulators stepped in again to close a legal loophole and extended the ban to include chemical analogues of GHB.
    But that action still hasn't halted trade in GHB products. The Internet is rife with thinly disguised products containing GHB and similar compounds that sell for $50 to $75 a bottle. And while the manufacture and sale of GHB and similar compounds is against the law, the drug easily can be made with two legal ingredients: gamma butyl lactone, an industrial solvent used for degreasing engines and as a floor stripper, and sodium hydroxide, or lye. Recipes for making bootleg GHB are available over the Internet, and the street version is potentially hazardous because of uncertain quality control in underground labs, according to the National Institute on Drug Abuse. In fact, there have been several cases in which users burned their mouths, throats and esophagi with what is essentially lye because the GHB wasn't formulated correctly, according to Porrata.
    GHB seems to "constantly keep reinventing itself" and attracting new groups of users, says Dr. Alex Stalcup, an addiction specialist in Concord, Calif., who first noticed in the late 1980s that habitual GHB users suffered withdrawal symptoms. He was medical director of San Francisco's Haight-Ashbury Free Clinic at the time. He said he is now treating GHB addicts who have worked in Silicon Valley's technology companies and who have used the drug "to come off of amphetamines."
    To be sure, GHB isn't addictive for everyone. "The people who get addicted are not the partyers who take it occasionally," says Smith, of the University of Minnesota. "The GHB addicts are the ones who use it regularly for health reasons--bodybuilders or people who suffer from depression." Several recovering GHB addicts said in interviews that they initially felt great when they started taking the drug. They said they would take a capful at night and wake up feeling refreshed and energized after four or five hours of sleep. But these people, who asked not to be identified, said that their GHB use eventually became more frequent and that they needed more of the drug to produce the same feeling.
    Addiction experts said that withdrawal from GHB is worse than kicking cocaine. Typical symptoms include insomnia, nausea, vomiting, tremors and seizures. Some sweat profusely and ooze a waxy, oily liquid from their hands or soles of their feet. Blood pressure and heart rates soar to dangerous levels, and many have mini-seizures in which their heads snap forward suddenly--a syndrome habitual users call "carpeting out" or "throwing down," says Smith. "It's similar to severe alcohol withdrawal where there's an outpouring of adrenaline and epinephrine--two hormones that spike the heart rate and blood pressure." Compounding the problem is that most doctors don't know how to treat GHB addiction--or even recognize that GHB is the problem when addicts are undergoing withdrawal symptoms. "Unless the person tells them they're on GHB, doctors don't know what they're dealing with," says Stalcup.
    Unlike drugs or alcohol, which can be detoxified from the body within a few days, the acute phase of GHB withdrawal lasts up to two weeks, addiction specialists say. Delirium, disorientation and hallucinations can sometimes last for days. Some patients are in such a state of agitation that they are sedated with drugs or must be placed in restraints. Patients often are released after three days, even though they are still experiencing withdrawal symptoms, because most addiction centers don't realize they need to stay longer. "Many people have protracted symptoms where they are anxious and depressed for months," says Miotto. "They self-medicate with alcohol and all kinds of drugs when they get off GHB--and end up dependent on opiates like Vicodin in an effort to make themselves feel right. Some don't get back to normal for a year, and a few never do. That's why so many relapse; the withdrawal is so debilitating that they get stuck in a vicious cycle where they can't get off."
    Patti Trovato-Ragano says her son, Matthew Coda, might still be alive if he had received adequate medical care after he became addicted to GHB in the early 1990s. Coda became addicted to GHB in 1998 after years of taking what he initially believed to be natural, herbal supplements to help him get fit. At the height of his addiction, he was rushed to the emergency room in a coma 18 times in two years. "He'd fall asleep standing up," recalls Trovato-Ragano, an oncology nurse in Naples, Fla. "If he didn't have his bottle of GHB, he couldn't sleep. He'd have terrible stomach pains and vomiting; he was severely depressed; his heart rate would jump to 120, and his blood pressure was off the charts." In August 1999, Coda, then 26, entered a detoxification program. But a week later, he was back on the street, even though he was still suffering from serious withdrawal symptoms. Apparently, in his quest for relief, Coda accidentally overdosed on other drugs. On Sept. 1, he was found dead in his bed. "He was begging for help for months," says his mother. "But the doctors didn't have a clue about GHB."

Trading Places in the Psych Unit
Elissa Ely, Los Angeles Times- 11/29/2001

BOSTON, Mass.--One difference between staff and patients on the psychiatric unit is supposed to be this: Staffers can function when patients cannot. On our unit, though, all that has gone topsy-turvy. Staffers are supposed to be healthier, luckier and the owners of stronger psychological defenses. These defenses are a measure of mental health; they prevent indefensible anxiety. The more successful among us use altruism, intellectualization and humor to get a great deal done. The less successful use delusions and hallucinations. Throughout the course of a lifetime, we place our particular sandbags against the advancing enemy world.
    After the terrorist attacks of Sept. 11, we held a community meeting at the state hospital where I work. The usual hierarchy had collapsed. Doctors knew no more than anyone else about what had happened, which meant there was unity in fear. And, for a moment, the sickest were wrenched straight into sanity. One patient, who usually spoke in word-salad, asked with perfect diction when Boston would disappear. Another pointed out that all the soap operas had been canceled. A new patient wept and said, "I was the leech between the legs of Desert Storm. I hope I'm not involved in this." Her neighbor, a schizophrenic, reassured her that this was a ridiculous idea, a crazy idea. His lucidity was astounding.
    Since then, with few exceptions, the patients are functioning--at least, in their ways. No one has needed more sleep medication, the restraint beds are no fuller than usual, and even individual delusions have not been updated. The man convinced that he has been on the hit list of the Hells Angels for years, has not fitted his persecutors with turbans. The hand-washing patient, rubbing her skin off each morning "in order to decontaminate it," is not worried about anthrax. You might expect that the sick would grow sicker, the paranoid more vigilant and the depressed suicidal. But their defenses--those dense, reliable buffers--are working again. Ours are not. The nurse who took an annual trip to an unpronounceable place, while the rest of the staff vied for her postcards, is no longer flying. The social worker forgets names in the middle of meetings and gazes out windows when people are talking to him. We are all more irritable and less tolerant. Our adaptive defenses are missing.
    Why are the healthy undone and the sick unchanged? Psychosis is not a serene place to live, but it is utterly involving, utterly self-absorbed; a state of mind that fiddles while the universe goes up in flames. In this paradoxical moment, the defenses of the very ill are stronger than ours. They go about their business; we cannot. A recent memo from the chief of psychiatry circulated among staff. It was meant to reassure. In case of bioterrorism, it said, there was no need to panic. If evacuation was necessary, the local Fire Department would direct all hospital actions. A senior nurse copied the memo. She went from staff member to staff member, reading it aloud and laughing. "The Fire Department," she said, "That makes me feel good. They'll know just where to put 170 locked-door patients." With each reading, her laugh was a bit shriller. Humor is a higher defense, but there was no humor in the sounds she made.
    Yet, for the patients, life goes on much the same. Their questions and concerns are unchanged. It is remarkable. The young woman, Ms. K, who exfoliates each hand each morning in order to remain pure, has been in the hospital for years. She does not know where she ends and someone else begins. A pregnant nurse recently began to work on the ward. On her first day, Ms. K. approached and circled her. She took two pas de deux steps near, three pirouettes away, two near, three away, two near again, peering all the while at the belly in front of her. "Hello," she said. "Are you pregnant?" The nurse nodded. "I am," she said. You could hear the joy and, given the times, fear in her voice. Ms. K. mulled, stepping back and forth. Many of us would be thinking about this double-headed blessing, the poignancy and the danger of bringing life into the present world. But Ms. K. wasn't. She had something far more important to clarify. "I see," she said, and did a little dance. "Well, if you're pregnant, am I?"
    Elissa Ely is a psychiatrist at a state hospital in Massachusetts.

Dartmouth Murder Suspect Will Argue Insanity Defense
Harry R. Weber, Associated Press- 11/30/2001

CONCORD, N.H. -- A teen-ager accused of killing two Dartmouth College professors will use an insanity defense at his trial, his lawyer said in court papers Friday. Robert Tulloch, 18, of Chelsea, Vt., will argue he suffers from a ''severe mental defect or disease and that his acts were the direct result of the mental defect or disease,'' Richard Guerriero said in the filing. Tulloch's trial is set for April 8.
    Tulloch and his friend James Parker, 17, are charged with first-degree murder in the Jan. 27 stabbing deaths of Half and Susanne Zantop in their Hanover home. Neither a motive for the crime nor any connection between the Zantops and the suspects has ever been given publicly. A law enforcement source has told The Associated Press the Zantops were probably killed during a burglary gone awry. A trial date for Parker has not been set. Prosecutors are seeking to have him tried as an adult. He was 16 at the time of the slayings. Parker won't use an insanity defense, but will re-evaluate his strategy given Tulloch's decision, Doug Brown, one of his lawyers, said Friday.
    Prosecutors allege fingerprints and footprints in the Zantops' home link the teens to the murders. Court documents say two military-style knives stained with the victims' blood were found in Tulloch's bedroom.  Guerriero said the defense had a psychiatrist evaluate Tulloch.  It was difficult at first to recognize the illness due to ''Robert's intelligence and his particular personality,'' the filing says. Prosecutor Kelly Ayotte said she learned of the planned insanity defense late Thursday, and ''the state is fully prepared to meet this at trial.'' Judge Peter Smith will review the defense request next week, said Grafton County Superior Court Clerk Bob Muh.

Counseling Sought by Many New York City Firefighters
Malcolm Ritter, Associated Press- 11/30/2001

NEW YORK --For many New York City firefighters, Sept. 11 is still taking a toll in nightmares, sleepless nights, anxiety and other psychological stresses, say mental health professionals who are helping them deal with their reactions. Social workers, psychiatrists and psychologists have rushed to help the fire department handle the counseling workload, and the International Association of Fire Fighters aims to raise about $3.5 million to pay for more help.  Firefighters are not required to get counseling, but many have done it anyway, said Tom Manley, health and safety officer for the city's 9,000-member Uniformed Firefighters Association. ''Everybody is getting drained psychologically,'' Manley said. ''It's taking its toll.'' Some firefighters can't bring themselves to go to ground zero any more, he said, because ''mentally they can't deal with it.''
    In an interview, one fireman recalled being curled in a fetal position Sept. 11 in the collapsing lobby of the Marriott World Trade Center Hotel. Cement dust and smoke choked the room. ''You had to throw up to clear your throat,'' he said. Eventually he was able to pick his way out of the remains of the collapsed hotel, leading some others to safety. But even now, the experience isn't over. ''I don't sleep at all at night without medication,'' said the 20-year veteran, who asked not to be identified because he doesn't want his colleagues to know what he's going through.  He suffers nightmares about being caught in another collapse. For a while he had bizarre out-of-body experiences when he was with his family, feeling like he was dead and viewing the scene from above. He'd known about 70 firefighters who died, including two he'd spoken to just minutes before their deaths. One morning, the day after going to the funeral of one and the wake of another, ''I found myself sitting in the crotch of a tree outside my house. I was out of it. I knew I needed help.'' He found the names of a psychiatrist and another counselor in a directory, and now he's seeing them a couple times a week.
    At the midtown Manhattan firehouse of Battalion 9, a couple firefighters sat around the kitchen table in the firehouse Friday, talking to counselors who show up a few times a week from a local hospital. The firehouse lost 15 men an entire shift on Sept. 11. The final funeral for them will be Saturday. Joseph Nardone, commander of Battalion 9, said some of his men need counseling while others are resisting. ''But I think that after the last funeral the guys might need it more,'' he said.
    The city's firefighters ''have been through a terrible ordeal and we want to support them,'' said psychiatrist Dr. Spencer Eth, medical director of behavioral health services at St. Vincent's Catholic Medical Center in New York. St. Vincent's is lending manpower to the department's counseling effort. After all, they have been attending funeral after funeral, and given their close-knit culture, it's like losing family members, Eth said. In the firehouse, ''your buddies aren't there anymore, and these are deaths of young people who should not have died,'' he said. The World Trade Center disaster claimed 343 city firefighters; before this, the largest department loss was 12 in a 1966 fire.
    Apart from the grief and the trauma at the site, there is also guilt over having survived when friends died. And because so many died, the surviving firefighters have not been able to fully carry out their traditional roles as surrogate parents for the families of the dead, Eth said. So ''on top of everything else, there is an understandable feeling of having let down their buddies,'' he said. The goal of counseling is to keep normal reactions to all this like nightmares and anxiety from growing into worse problems like drinking, accidents and heart attacks, Eth said.
    The psychological support must continue long-term, said Therese Rando, a psychologist and clinical director of the Institute for the Study and Treatment of Loss in Warwick, R.I. As a specialist in traumatic loss, she has been consulted by some mental health professionals who are working with the firefighters. For many in the fire department, she said, the shock of Sept. 11 won't really wear off until next spring and summer. Then, when reality fully sets in, the firefighters used to taking action to solve problems will be unable to do anything to change the terrible reality of their losses. They will need to take some positive steps, like memorializing their friends or even just embarking on a new exercise program, Rando said.
    Eth said St. Vincent's plans to continue helping the department conduct counseling for at least a year. ''The memories don't go away when the headlines do,'' he said. ''So we are going to be there for the long run.'' Mental health counseling will be offered for the 55,000 members of the New York Police Department, to help them cope with post-Sept. 11 trauma, police officials said. ''Ultimately, our goal is to do everything we can to help the members of the NYPD and their families make it through these difficult times,'' Police Commissioner Bernard Kerik said in a statement.

Daughter Speaks Out After Sharpe Gets Life Sentence
Michele Kurtz, Boston Globe, 11/30/2001

She says her father, Richard Sharpe, used to punch her in the eye and then order her to tell people that she had fallen down the stairs. As a child, Shannon Sharpe, now 28, watched her mother live in terror of the mean and controlling man she'd married. She saw her cover for the man who beat her, paralyzed by threats he would kill her father or brother if she left him.  Though petrified, Karen Sharpe decided in the winter of 2000 to leave Richard Sharpe, her husband of 27 years and the father of her three children. What finally forced her out the door was that their son, then 7, was old enough to recognize the abuse that had come to rule her life, Shannon Sharpe said. ''It was like living with a terrorist,'' she said in a telephone interview with the Globe from her home in New York. ''He held her prisoner.''
    Shannon Sharpe remained silent during her father's murder trial and wasn't in court yesterday when he was sentenced to life in prison without parole for killing her mother on July 14, 2000. But within hours of her father's arrest the next night, Shannon Sharpe issued a statement urging prosecution ''to the fullest extent of the law.'' Her father later evicted her from the family's Gloucester property. Shannon and Karen Sharpe's other relatives have filed a $100 million wrongful-death lawsuit against Richard Sharpe.  This week, Shannon Sharpe offered a first-hand account of what she called years of physical abuse, in hopes that exposing the violence that both she and her mother suffered would help other women escape abusive relationships.  ''I just wish people wouldn't be ashamed,'' she said. ''It happens everywhere. It's amazing.''
    The cross-dressing Richard Sharpe, who testified that his own father physically and verbally abused him as a child, contended he was so mentally ill that he didn't know what he was doing the night he killed his wife. Prone to outbursts during the four-week trial, Sharpe yesterday grew angry and frustrated that he hadn't been allowed to speak at his sentencing. His lawyers thought it was a bad idea. ''I have a right to talk,'' Sharpe shouted, turning to a television camera and gesturing wildly, after court had recessed. Court officers quickly surrounded him and held his shackled arms. When he stood up from the defense table, his face was wrinkled into tears - the first he'd shed during the trial. ''I loved Karen. I'm sorry for what happened,'' Sharpe cried, leaning over court officers to be in sight of the camera. ''I loved Karen. I loved Karen.''
    Afterward, Karen Sharpe's close-knit family scoffed at his protestations as they huddled in the rain outside Essex Superior Court. Karen Sharpe's sister, Kathleen Lembo, said she and her family over the years occasionally puzzled over Sharpe's behavior but didn't know he was abusing her oldest sister. ''Everybody sort of saw everything come together in a big bundle at the end,'' said Lembo, who wept in court earlier yesterday as she spoke about the effect Karen's death had on the Sharpes' young children, Michael, 9, and Alexandra, 6, who live with Lembo and her husband, Victor, in Connecticut. ''I just tell women out there you have got to speak up, you have got to not take it anymore.''
    In a letter to the court, Sharpe's sister, Lauri Monopoli, said she and Richard Sharpe's other siblings only thought their brother had a rocky marriage. She and her brothers filed letters with the court yesterday praising Richard Sharpe's brilliance and asking for leniency in imposing additional sentences on convictions for violating a restraining order and illegally possessing a firearm. Superior Court Judge Christine M. McEvoy ordered that Sharpe serve those sentences concurrently with his life sentence for murder.
    Shannon Sharpe, who is engaged to be married and works in medical sales, came to court for a few days of the end of the trial. She sat calmly and composed, a furrowed brow the only sign of her anxiety. But she returned to New York and did not come back for the verdict or yesterday's sentencing because her father had tried to speak to her in court. He previously had been disciplined in jail for calling her on the telephone.  Born in Connecticut when her parents were just teenagers, Shannon said her father frequently slapped and punched her - particularly when she tried to protect her mother, Sharpe's main target of abuse. ''And he'd break things of mine of sentimental value,'' she said. Once, when she stood up to him, Richard Sharpe picked up a treasured and fragile ''Precious Moments'' memento Shannon's aunt had given her for being in her wedding, and smashed it against the wall.
    Shannon Sharpe said she ''pleaded and begged'' for her mother to leave her father. ''The woman was so pure and so kind and so generous and so passionate,'' she said. ''He is just the opposite. He is an evil, manipulative, cowardly man.'' Still, Karen Sharpe tried to steal bits of happiness where she could. When Michael was born, Shannon was in college, and Karen became a full-time mom again. She was thrilled. Alexandra arrived three years later. Even after she left her husband, Karen Sharpe remained ''deathly afraid'' of him, her daughter said. A few weeks before the murder, Shannon and her mother briefly discussed hiring a bodyguard.
    With the trial behind her, Shannon said she's getting on with her life. She spends several days a month with her younger brother and sister, who play soccer and basketball and have many new friends. Still, Shannon, who's planning a fall wedding, won't have a mother to help her pick out a gown. Last year, a relative visiting Alexandra's school spotted a bulletin board of students' Christmas wishes. Alexandra's: ''I wish my mommy didn't die.'' ''You go through all this and you think it's an end to something,'' Shannon Sharpe said. ''And you get the verdict you needed - and the sadness is still there.''

Insanity Defense Has Poor Success Record in New Hampshire
J.M. Hirsch, Associated Press- 11/30/2001

CONCORD, N.H. -- Former state prosecutors say the insanity defense historically has rarely if ever worked in homicide cases in New Hampshire. John Kissinger, a former assistant attorney general, and Charles Putnam, the former head of the attorney general's criminal bureau, said Friday they don't recall the insanity defense ever being used successfully at trial. ''Historically in New Hampshire, the defense of insanity has not frequently been successful. Indeed to my knowledge it has never been successful,'' said Putnam, whose tenure with the office dates to the early 1980s. Kissinger said that may be because juries don't seem to give them much credibility. ''I don't think New Hampshire juries are particularly receptive to an insanity defense and I think where there has been a legitimate issue of insanity the state has been very willing to stipulate to someone's insanity,'' Kissinger said.
    The issue was raised late Friday when one of two Vermont teen-agers charged with killing two Dartmouth College professors indicated he would use insanity as a defense at trial. Robert Tulloch, 18, of Chelsea, Vt., is charged with first-degree murder in the Jan. 27 stabbing deaths of Half and Susanne Zantop in their Hanover home. Kissinger, who tried three homicide cases where insanity was used, said it isn't an uncommon defense in New Hampshire. He said it can indicate what defense lawyers think of their chances at trial. ''It is raised pretty frequently in homicide cases, particularly in cases where there is very strong evidence of guilt,'' he said.
    In 1990, Robert McLaughlin, a Hampton police officer, unsuccessfully argued insanity and was convicted of first-degree murder for shooting a man in 1998. In 1992, a jury didn't buy the insanity defense when James Colbert blamed the murders of his wife and three daughters on a troubled childhood. He was sentenced to four consecutive life sentences. And insanity hasn't worked in non-homicide cases, either. In 1998, William McCallum, a former assistant attorney general, was convicted of possessing hundreds of stolen artworks, books and computers, despite having argued insanity.
    Kissinger said an insanity defense can be handled several ways: The state can agree with the defense, in which case there is no trial. The defense can admit guilt, in which case there is no criminal trial, but there is one to determine sanity. The defense can maintain innocence and insanity, requiring two trials, one to determine guilt, and one for sanity. The defense can maintain innocence and insanity and ask that the jury determine guilt and sanity during the same trial.
    Kissinger said the defense must prove insanity by ''clear and convincing evidence,'' a lesser standard of proof than the ''beyond a reasonable doubt'' by which prosecutors must establish guilt. One risk of insanity defenses is that they can force the accused to maintain innocence at the same time as claiming to have been insane when committing the crime, Kissinger said. ''You're trying to argue that he's innocent at the same time that you're arguing that he's insane,'' he said. ''There's a danger that you lessen the credibility in your innocence argument.''
    In Tulloch's case, the insanity defense may help prosecutors another way, as well. It could give prosecutors an opportunity to indirectly question the teen about the murders, Kissinger said. Because defendants are not required to talk to investigators, or to take the stand during their trial, cases can go to court without prosecutors ever having an opportunity to question the person charged. But Kissinger said if the defense argues that Tulloch was insane at the time of the killings, an expert witness for the state such as a psychologist would have to be allowed to question the teen about the murders. Tulloch's trial is expected to begin in April, though this development could delay that.