Even for an Expert, Blurred TV Images Became a False Reality
Edward Wyatt, New York Times- 1/8/2005

Park Dietz is certain of one thing: he never should have taken "Law & Order" into the courtroom. On Thursday a Texas appeals court overturned the murder convictions of Andrea Yates, the mother of five accused of drowning her children in a bathtub, saying that false testimony about the NBC television drama "Law & Order" by Dr. Dietz, a psychiatrist and frequent expert witness who also is a consultant to the show, might have poisoned the jury.
      In an interview yesterday, Dr. Dietz said he regretted mentioning the show because it "injected something that didn't need to be there" into the case. That would have been so, he added, even if he had testified correctly about the "Law & Order" episodes on which he worked.
      The case, perhaps more than any other recent incident, shows how the lines between fact and fiction, life and art, can become confused in the minds of even the most rigorously trained experts. It should come as little surprise that similar confusion might occur among average citizens. Dr. Dietz testified in 2002 that an episode of "Law & Order" depicting a mother who drowned her children in a bathtub and was found not guilty by reason of insanity had been broadcast shortly before the Yates children were murdered. There was no such show. But in the five months before the Yates children were killed in 2001, two episodes of the show did center on mothers who killed or were thought to have killed their children. Mrs. Yates frequently watched "Law & Order," a fact prosecutors mentioned in suggesting that she saw "a way out," thinking she could get away with murder by pleading insanity.
      But Dr. Dietz said yesterday that he never thought such a television show could have prompted a mother to drown her children. He said he was simply "being defensive on a challenge to my credentials" by Mrs. Yates's lawyer when he invoked the show, wrongly confounding the facts of three child-murder cases on which he had worked and the two "Law & Order" episodes based on them.
      After all, there is a long history -- dating to Shakespeare's day at least, said Steven Brill, the writer and founder of Court TV -- in which criminals say their actions were motivated or guided by outside forces like theater and music. Police and courtroom dramas on television and elsewhere have long used actual crimes and victims for plots and scripts. And "Law & Order" is known for episodes that are "ripped from the headlines," where fictionalized versions of real events are sensationalized and stripped of nuance, with crimes committed and verdicts delivered all within an hour. " 'Law & Order' is the best known of these types of programs that take contemporary courtroom events and weave them into fiction," said Robert Thompson, director of the Center for the Study of Popular Television at Syracuse University.
      Perhaps that is the reason no one immediately challenged Dr. Dietz's assertion that a television show could have anticipated, almost exactly, such an unthinkably horrible murder. "Up until the 1980's you wouldn't have seen a case like that on television," Dr. Thompson said. "But beginning in the mid-1980's," particularly after the advent of "Hill Street Blues," "there was almost nothing that was off limits." Dr. Thompson said it was not particularly surprising that Dr. Dietz's memory proved faulty, because television often produces a sort of vague collective memory. As examples, Dr. Thompson pointed out that few people on "Star Trek" ever actually said, "Beam me up, Scotty," and that Maxwell Smart, of "Get Smart," rarely said, "Sorry about that, chief."
      Dr. Dietz, who has consulted on more than 200 "Law & Order" episodes, said that when he learned that he had made a mistake, he sent a letter to prosecutors in the Yates case outlining the two episodes he had mistakenly conflated. One, titled "Denial," was based in part on two cases -- involving Amy Grossberg, a New Jersey teenager who gave birth in a hotel room and then, with her boyfriend's help, dumped the baby in a trash container, and Melissa Drexler, a New Jersey girl who killed her baby after giving birth in a restroom stall at her prom. That episode was originally broadcast in 1997, and again about three weeks before the Yates killings. The other episode, "Angels," was modeled on Susan Smith, who sent a car with her children inside into a lake. The episode, first broadcast in 1995, was repeated in January 2001, five months before the Yates killings, and again two days after them. In "Angels," the mother said that God had told her to kill the children, and she entered a plea of insanity. But she was convicted of murder.
      In Dr. Dietz's testimony, he said the character in the show he was thinking of was successful with an insanity defense, and the prosecutor's closing statement expanded on the assertion. His discovery of his mistake came too late, however. The jury had already voted, rejecting the insanity defense. "At no time have I ever believed or told anyone that I thought 'Law & Order' or any other television show gave Andrea Yates the idea to kill her children," Dr. Dietz said. (On CNN's "Larry King Live" on Thursday, Mrs. Yates's estranged husband, Russell, called Dr. Dietz's disavowal "too convenient.")
      So why did Dr. Dietz bring the subject up in the trial? "I was being defensive," he said. A defense lawyer for Mrs. Yates had raised the question of whether his consulting on the television show ever dealt with postpartum depression or women's mental health. Mrs. Yates's postpartum depression was diagnosed before the killings. Dr. Dietz, who does not practice psychiatry but rather acts solely as a forensic consultant, said he viewed that as a challenge to whether he was professionally qualified to render a judgment on Mrs. Yates.
      Perhaps it is not surprising that the jury appeared to believe Dr. Dietz, said Stanley A. Goldman, a professor at Loyola Law School in Los Angeles and a frequent television commentator on legal affairs. He noted that courtroom television shows had become increasingly prosecutor friendly, a factor that could well have an effect on juries. "On 'Perry Mason,' the lawyers were always working to save defendants who were wrongly accused," Mr. Goldman said. "On 'Law & Order' everybody's guilty once they take them to trial."

Drug Firms Lagging on Openness
Christopher Rowland, Boston Globe- 1/9/2005

Six months after the drug industry vowed to make its clinical trials more transparent, and three months after launching a common website to give the public ''unprecedented access" to studies both good and bad, drug companies have posted unpublished trial results on the site for just five drugs.
Pfizer Inc., the world's largest drug manufacturer with $40 billion in revenues in 2003, voluntarily disclosed unpublished study results on only one of the 29 prescription brand-name drugs it actively markets in the United States, the antidepressant Zoloft. Merck & Co. posted a listing for its withdrawn painkiller Vioxx, but clicking on the link reveals nothing but another link to the product's label and a list of two previously published studies, but not the studies themselves. There is no information posted, for example, about an unpublished, large-scale clinical trial of Vioxx performed in 2000 that showed a six-fold increase in cardiovascular risk. That study has been cited, among others, by critics who say Merck and the Food and Drug Administration ignored risks of Vioxx years ago.
      The lack of information comes amid heightened public concern about drugs similar to Vioxx, such as Pfizer Inc.'s Celebrex and Bextra. Pfizer has not posted any information on Celebrex or Bextra. A spokeswoman declined to say when the company would post past studies or if unpublished data on the heavily prescribed drugs even exist. ''It's pathetic," said Dr. Drummond Rennie, associate editor of the Journal of the American Medical Association and an advocate for mandatory disclosure of all clinical trial results. ''They get all the publicity from saying they will do it, and then they don't."
      A Globe review of websites indicates that the voluntary approach has produced limited disclosures thus far. Last year's commitment by members of the Pharmaceutical Research and Manufacturers of America, the industry's Washington lobbying organization, has resulted in a total of 26 drugs listed on the clinical trials results website (www.clinicalstudyresults.org). That is out of a total of more than 10,800 prescription medications and dosages sold in the United States. Of the 26 drugs listed, just five contain data that have been previously unpublished, according to the Globe review. The majority of the remaining 21 drugs on the website contain listings of scientific papers that were already published in medical journals and have been available to physicians.
      Some legislators, physicians, editors of academic medical journals, and consumer groups said the snail's pace of voluntary disclosure is all the more reason Congress this session should craft laws to require that companies disclose all information to the public about potentially life-threatening side effects hidden in America's drug supply. ''The drug companies just hide the negative results and hope the public can't seek them out," said US Representative Edward J. Markey, a Massachusetts Democrat and sponsor of one of several initiatives in Congress that would make disclosures of clinical trial data mandatory ''It's set up a like a poker game. The less information you give, the more likely you are to make money," he said.
      Last week, the industry launched an initiative for an international disclosure database and pledged to list the launch of more clinical trials on a National Institutes of Health website. The announcements were the latest of at least four announcements since last June about increasing the volume of voluntary disclosures. ''These sporadic, inconsistent, partial responses by a few companies have to be viewed as thinly disguised public relations efforts," said Dr. Sidney Wolfe, director of the health research group Public Citizen, a Washington consumer group that has joined the call for mandatory disclosure of trial results.
      But drug company representatives said the work is proceeding as intended. At the height of the industry's political crisis last September, its lobbying group said it would take a full year for all results to be posted. PhRMA also said it would post data from trials completed after October 2002, although in practice much of the data posted thus far precede that date. ''The progress has been fine. We gave people a full year to post things, and the companies are taking that very seriously," said Dr. Alan Goldhammer, associate vice president for regulatory affairs for PhRMA. He said he expected the pace of postings to increase this year as drug companies compile data.
      Companies generally keep the existence of unpublished studies secret. Companies notify the FDA if a trial is performed in the United States, but the data generally only have to be made public if they are part of the FDA application for an approved drug. Such rules make estimating the amount of unpublished data from clinical trials difficult if not impossible, said editors of medical journals and consulting firms expert in the field.
      Rennie estimated in a July 2003 study that 1 million late-stage, controlled clinical trials had been conducted since 1948, and that only half the results were ultimately published, although many may have been presented as a poster or paper at scientific conferences. Getting a grip on the universe of unpublished data is one of the goals of Rennie and other advocates of mandatory disclosure.
      Most of the world's 10 largest drug companies, with collective annual revenues over $200 billion, either said last week said they did not know how many drugs they would ultimately post on the common US website, or they did not respond to the question. PhRMA officials said they were unable to quantify how much data can be expected to be revealed. GlaxoSmithKline, Novartis AG, Eli Lilly and Co., and Bristol-Myers Squibb said they would place published and unpublished study information about more than 90 drugs on the website during 2005.
      Drug companies said they were taking so long to publicly post information because they are taking raw data from unpublished studies and placing them into an internationally recognized, uniform format. A Pfizer spokeswoman, Alison Lehanski, said disclosing trial results is a ''massive undertaking" that takes considerable time. Pfizer has established a team of workers to cull through studies, pull together information, make sure it fits in the PhRMA website guidelines, and make sure its postings are of ''very high quality," she said. Merck has not posted the unpublished Vioxx trial from 2000 because the PhRMA site's voluntary guidelines only call for posting data completed after October 2002, said Merck spokesman Chris Loder. ''Given the voluminous nature, we did not go back and post trials completed prior to '02," he said.
      Academics and physicians for several years had been pushing for more clinical trial disclosures before the issue gained momentum in 2004 when New York Attorney General Eliot Spitzer sued GlaxoSmithKline. Spitzer alleged that the British drug giant suppressed safety concerns about the effects of its antidepressant Paxil in children and adolescents. GlaxoSmithKline settled for $2.5 million in August 2004 without admitting wrongdoing. The FDA -- after reviewing data from trials of Paxil and other antidepressants -- subsequently required in October that all antidepressants contain a ''black box warning" on their label disclosing slightly increased risk of suicidal thinking among young people taking the widely prescribed drugs. In cases where drugs present specific dangers, the FDA requires black box warnings to alert physicians to particularly high risk of drug side effects in some patient populations.
      The New England Journal of Medicine and other prominent medical journals, meanwhile, said they will require that drug companies disclose the launch of all drug studies as a condition of publication of the eventual results. The requirement, to take effect in July, will allow physicians and the public to at least be aware of every study being conducted. The medical journals stopped short of requiring disclosure of the information gleaned from those trials.
      Members of Congress, including Markey in the House and Democratic Senators Edward M. Kennedy of Massachusetts and Chris Dodd of Connecticut, introduced legislation to make trial disclosures mandatory. Republican Charles Grassley of Iowa, chairman of the Senate Finance Committee, is considering similar legislation. Some of the initiatives in Congress could lead to the expansion of an existing National Institutes of Health website that lists current clinical trials for life-threatening diseases, ClinicalTrials.gov, to include details of the trial outcomes.
      In response to all the pressure, a PhRMA representative told a congressional panel in September that the industry had a ''commitment to transparency." The industry said it would disclose results of late-stage ''hypothesis testing" trials completed since October 2002, including trials for drugs that have already been approved but which drug companies have continued to test for potentially new uses. The industry has said it envisions the site as containing mostly information about late-stage and post-market clinical trials in which both effectiveness and safety are tested in large populations.
      Individual players in the industry have taken a variety of approaches to the website. The third-largest drug company in the world, for example, the newly merged Sanofi-Aventis, hasn't decided what to do. ''We don't have a defined policy on that yet," said spokesman Marc Greene. Lilly meanwhile, is focusing most of its efforts on creating a website of its own. GlaxoSmithKline has yet to post information about Paxil, the drug that was the focus of controversy, on the PhRMA website, although it does have extensive disclosures for Paxil on its own company website. To further complicate matters, GlaxoSmithKline has posted information on two other drugs on PhRMA's common website.
      The presentation of individual drugs on the common website falls short of industry promises for a central, easy-to-use location to find critical health information, said Dr. Jeffrey Drazen, the editor in chief of the New England Journal of Medicine. ''It's not like they fit into a template," he said. ''Everyone's kind of putting stuff in their own way. You don't know where to look, and you might miss something." The industry's performance thus far, he added, ''is not at all surprising. Their past behavior suggests that would be a legitimate reason for what's going on right now."

Progress Is Seen in Yates
Anne Belli, Houston Chronicle- 1/9/2005

It was the day after Christmas and Debbie Holmes was visiting her best friend, Andrea Yates, in prison. Separated by glass and talking through telephones, the two nurses were reminiscing about past holidays spent together when the conversation turned to Yates' children and the special gifts they gave Holmes one year. "Did you put up the same glass ornaments the kids made for you?" Holmes said Yates asked her. "I told her I had, and that I would put them up every year until the day I die." Yates, who is serving a life sentence in a prison psychiatric ward for drowning her five children in 2001, paused. Then she looked back at her friend and smiled.
      Holmes was relieved. A year ago, such talk likely would have led to uncontrollable sobbing, or worse, the beginning of another downward spiral into psychosis for Yates. But over the past several months, those who know her best say, they've noticed some important changes. They say she seems to be getting stronger and more optimistic about the future. She's beginning to accept that she's been severely mentally ill for years and that that illness led her to kill her children. She is starting to believe that perhaps some good could come of the "tragedy," as she calls it, and that although shy and private, she may one day be a public advocate for the mentally ill. She's also beginning to express disappointment in her husband, Rusty, who six months ago filed for divorce. "Her hands used to tremble and shake, and she used to move the phone from ear to ear, back and forth," Holmes said of visits last year. "She is much more calm now. Actually, I thought she was very good, considering it was the holidays and we talked about how excited the kids would get at Christmastime."

Tension over husband
Meanwhile, as Yates, her friends and her family wait for the legal fallout, she will remain at the Skyview Unit in Rusk, where she spends her days mopping floors, gardening, attending prayer groups and writing letters to friends and family. On alternating weekends, she is visited by her attorney, George Parnham; her mother and brothers; Holmes and her husband, Bob; and Rusty.
      The Holmeses and Kennedy said Rusty Yates recently asked his wife to agree in their divorce to give him 60 percent of their remaining assets, while she would receive 40 percent. In addition, he asked her to give up any of his income since June 2001 because she has not been a contributing member of the household, they said. That attitude has not sat well with her friends and family. Kennedy said her daughter is resisting Rusty's request. "Before, it didn't bother her," Kennedy said. "But now all of a sudden she thinks (the settlement should be) 50-50." The divorce is set for trial in Harris County state district court on March 28.
      Rusty Yates' attorney, David Salinsky, said the simple characterization of a suggested 60-40 split "is somewhat misleading." "It could be possible for some assets to be divided disproportionately because of other assets being used," Salinsky said. He declined to elaborate. He said he was fielding interview requests for Rusty Yates and would forward a request from the Houston Chronicle. Rusty Yates did not return the call.
      Parnham and others say Yates still loves her husband and looks forward to his visits. For his part, Rusty Yates has steadfastly defended his wife, saying she should have never been convicted and that he will always love and support her. But over time, Yates, who home-schooled her children and once agreed with Rusty to move the family into a converted bus, has expressed doubt about whether her husband always supported her. Her friends and family have maintained he did not. In a letter written to Bob Holmes in September 2003, Yates wrote: "Maybe sometimes I do wear rose-colored glasses regarding my husband but I have to 'wake up and smell the coffee.' "I'll ask him what was I like when I was sick? 'Oh, like you usually are, just quieter,' " Yates wrote. "Little Mary couldn't bear to look at me — she'd cry," the note continued. "I'd hold her outward so she didn't see my face. So heartbreaking and tragic."
      After signing the letter, she asked Bob Holmes in a postscript to show Rusty compassion. "He has lost so much," she wrote. "All the 'factors' that contributed to the tragedy are complex and it wastes energy to assign 'blame' (ultimately I was the one who did it) but Rusty and I have lost our beautiful children," she wrote. Ten months after writing the letter, and shortly after her husband asked her for a divorce, Yates suffered one of two major psychotic relapses while in prison. She refused to eat for weeks and was transferred to the University of Texas Medical Branch prison hospital to receive intravenous food and fluid.

A desire to help others
Since her return to prison shortly after, friends and family say, she has remained mentally stable and is interested in the efforts of the Yates Children Memorial Fund for Women's Mental Health Education. The fund was established by the Mental Health Association of Greater Houston. In a letter to Debbie Holmes written shortly after their Christmas weekend visit, Yates expressed a hunger for more information about a statewide symposium the association had in November.
      Holmes said that over the past three years, she and her husband have tried to convince Yates that she was severely ill in the months leading up to the children's deaths. She said Yates only vaguely recalls that period and has been wrought with guilt. "I told her, 'Your speech, your breathing, your hygiene, your walk, your talk, your approach to your kids, everything wasn't normal. There was nothing normal about you,' " Holmes said. John would raise his hand over his eyes when he would talk to his mother, and Mary often cried in her arms, Holmes recalled.
      Those memories make Yates sad to think what her children's lives were like during those months, Holmes said. But they also have empowered Yates to think about ways she can help prevent similar tragedies for other families. She and Yates have talked about collaborating on articles about her mental illness, and Yates would like to eventually speak out in favor of better treatment for the mentally ill, Holmes said. Parnham said Yates has expressed the same desire to him. "She's beginning to appreciate the fact that her situation could be possibly used as a learning tool for women across the world who suffer from the same kind of mental illnesses," he said. "All of this is looking at the lives of those five children and realizing that they will forever be wasted unless something good can come out of what happened at 942 Beachcomber on June 20, 2001."

Judge Stalls Woman's Divorce From Abusive Spouse
Sam Howe Verhovek, Los Angeles Times- 1/9/2005

SEATTLE — The day she was granted a divorce from her abusive husband, Shawnna J. Hughes said, was "the happiest day of my life." But barely a week later, the 27-year-old medical assistant was back before a judge, who rescinded the order after learning Hughes was pregnant by another man. "Not only is it the policy of this court, it is the policy of the state that you cannot dissolve a marriage when one of the parties is pregnant," Superior Court Judge Paul A. Bastine told Hughes on Nov. 4.
      The ruling has provoked outrage among women's rights groups and provided ample fodder for local talk-radio hosts and newspaper columnists. Experts said there was no blanket prohibition in the laws of this or any other state against pregnant women getting divorced; several Seattle-area family law practitioners said that they had obtained divorces for pregnant clients.
      The law states that any Washington resident who files for a no-fault divorce may get one. Hughes' husband did not respond to her petition, and a divorce was granted. But Bastine said the divorce was invalid because Hughes did not learn she was pregnant until after the papers were served, so her husband was not aware of all the facts. Hughes is appealing Bastine's decision.
      The judge said in a telephone interview that the case involved a thicket of other legal issues — especially because she was receiving public-aid benefits, and the state had an interest in determining paternity. But several legal scholars questioned his reasoning, saying that the law provided for paternity issues to be settled separately from a divorce. In Washington, a child born as many as 300 days after a divorce is legally presumed to have been fathered by the ex-husband unless a paternity test proves otherwise. Hughes said she and the man with whom she became pregnant planned to have such a test after the birth. "I cannot think of any policy that would require this woman to stay married to a person who was in prison for abusing her," said Carol Bruch, a law professor at UC Davis.
      In any event Hughes, who lives in Spokane and is due to give birth in March, remains married to her abuser — a situation she describes as psychologically devastating. She said her six-year union with Carlos Hughes was "more like a prison than a marriage." When she got pregnant in June, Hughes said, her estranged husband was serving time for domestic assault. She said she has had no contact with Carlos Hughes, who recently was transferred to a jail in Montana to await trial on federal drug charges, for two years. But, she said, her husband called her grandmother from the jail and told her that he was taking the pregnancy as "a sign from God" that the couple should be together. "It made my stomach turn," Shawnna Hughes said. Although there is a restraining order preventing Carlos Hughes from initiating any contact, Shawnna Hughes said she was terrified by the prospect of him coming back. She has custody of their two boys, ages 5 and 3.
      The American Civil Liberties Union and the Northwest Women's Law Center, an advocacy group in Seattle, have joined in Shawnna Hughes' appeal. If the ruling is upheld, they say, it not only amounts to discrimination but also could establish a perverse incentive for an abusive husband to get his wife pregnant in order to force her to stay married. And it could prompt some women to terminate their pregnancies to obtain a divorce. "You can't use a woman's status as a pregnant person to discriminate against her," said Lisa Stone, executive director of the women's law center. "You simply can't say, well, everyone else in the state is entitled to get a divorce in a timely fashion, except this one group of people."
      Bastine, who retired Friday after 10 years on the bench, is well-regarded among family-law practitioners in Washington state, known for his efforts to expand access to legal services for low-income clients and his pro bono work, among other things. A former Peace Corps volunteer in Brazil, he served as chairman of the Spokane Legal Services Board before he became a judge. Some lawyers expressed puzzlement over his blanket statement that pregnant women could not get divorced. "My personal view is that what Judge Bastine did is not necessary under the law," said J. Mark Weiss, a Seattle lawyer and former chairman of the state bar association's family law committee. "In this type of situation, forcing her to remain married, that's a real problem."
      Further roiling controversy in the case, Bastine told Shawnna Hughes that she had forced a prolongation of her marriage on herself with the "intentional act" of getting pregnant. "You have created the situation by your own actions that delay your opportunity to dissolve your marriage," he said in the Nov. 4 hearing. Getting pregnant with a friend from her high school days was unintentional, Hughes said, the result of failed birth control. Regardless, said her lawyer, Terri Sloyer, the standard right to obtain a divorce after the 90-day waiting period should not be affected by a pregnancy. "What are we telling women here?" Sloyer said. "We're not living in 15th century England."
      Carlos Hughes did not return requests for comment submitted to him at the detention center in Montana. A reporter for the Stranger, an alternative weekly newspaper in Seattle that first wrote about the case, met briefly with Hughes last month. But he declined to discuss the controversy, saying: "I want to talk to Shawnna first."
      Shawnna Hughes has a houseful of responsibility, with her two young sons as well as her own brother, 8, and sister, 16, whom she looks after. She has said that she and the man she says is the biological father plan to name the child they are expecting Jazmine Aurora. Asked whether she had any wedding plans, Shawnna Hughes said, "Oh, I just don't know about that. "With everything I'm going through right now, I don't know if I ever want to get married again."

Sale of Spanking Tool Points up Larger Issue
Patricia Wen, Boston Globe- 1/10/2005

ARLINGTON -- On a spring day, Susan Lawrence was flipping through a magazine, Home School Digest, when she came across an advertisement that took her breath away. In it, ''The Rod," a $5 flexible whipping stick, was described as the ''ideal tool for child training." ''Spoons are for cooking, belts are for holding up pants, hands are for loving, and rods are for chastening," read the advertisement she saw nearly two years ago for the 22-inch nylon rod. It also cited a biblical passage, which instructs parents not to spare the ''rod of correction."
      The ad shocked Lawrence, a Lutheran who home-schools her children and opposes corporal punishment. She began a national campaign to stop what she sees as the misuse of the Bible as a justification for striking children. She also asked the federal government to deem The Rod hazardous to children, and ban the sale of all products designed for spanking. Lawrence says striking children violates the Golden Rule from the Gospel of Matthew in the New Testament: ''In everything do to others as you would have them do to you."
      Her effort exemplifies the passionate debate among Americans over the role of corporal punishment in modern child-rearing and highlights the clashing interpretations of religion that underlie many cultural divisions in the United States. Where some see a time-honored form of discipline, others see a sanctioned type of child abuse. Both sides cite biblical passages and scholarly pediatric research to back their views, as well as anecdotal evidence of children who went astray because of too little -- or too much -- spanking.
      Though corporal punishment is on the decline in the United States and the American Academy of Pediatrics strongly opposes the practice, spanking children remains common. National polls in 2002 indicated that two-thirds of American parents approved of spanking, and more than 20 states sanction corporal punishment in schools. Most parents said they use bare hands if they spank a child, though roughly one-third of parents in a 1995 Gallup poll said they had used ''a belt, hairbrush, stick, or some other hard object" to strike their child's bottom.
      To draw public attention to the issue, critics of corporal punishment in Brookline proposed a resolution considered at Town Meeting two months ago denouncing the practice, a measure that ultimately failed by a narrow margin. When Lawrence spotted the ad for The Rod, she began collecting online petition signatures protesting the device, eventually amassing more than 500 supporters, and set up a ''Stop the Rod" website. With support from US Representative Edward J. Markey, a Malden Democrat, Lawrence appealed in the fall of 2003 to the US Consumer Product Safety Commission to ban the sale of The Rod. But last month, the commission said it had found ''no basis for determining that the product constitutes a substantial product hazard."
      She has argued that products designed to administer corporal punishment of children ought to be taken off the market, as flammable sleepwear and some toys deemed choking hazards have been. ''People are making money off these devices to beat children," she said in an interview last week. ''You have to respect children's bodies and their rights."
       Lawrence's campaign has reached Clyde Bullock of Eufaula, Okla., the creator of The Rod. Bullock told the Globe last week that he has decided to voluntarily halt production for now, in part because of pressure from Lawrence and her supporters. ''I feel it's run its course," said Bullock, an auto mechanic who said he had sold hundreds of rods through his small-business venture, Slide's Manufacturing Co. Another reason he is halting production, he said, is that the company that makes the cushioned grips for the rods has pulled out of the venture. But Bullock, a Southern Baptist, said he stands by the virtue of The Rod, which, he said, is safer than a belt or paddle. He said he believes his product is in keeping with biblical teachings that rods be used only as a ''last resort" to train children. He opposes its use on babies. He said he sold the device at a rate of ''a few a week" over the last six years or so. Many of his customers returned for more rods, and cited the Scriptures when they made their purchases, he said. ''I'm one of these simple people," Bullock said. ''The Bible is what it is -- I'm not trying to change it. God is right. We have to have faith in that."
      Bullock's convictions about corporal punishment are shared by many religious leaders. James Dobson, founder of the group Focus on the Family, one of the nation's prominent Christian evangelical organizations, has written about the proper use of spanking for children who willfully disobey parents, sanctioning the use of a ''neutral" object such as a paddle in order for the hand to be reserved as ''an object of love." When used ''lovingly and properly," Dobson wrote on his website, corporal punishment is an effective tool to instill discipline and does not bring about lasting emotional damage to a child. ''God created this mechanism as a valuable vehicle for instruction," he wrote.
      Critics of the practice say parents do not recognize the harm they can do when striking their child. Dr. Eli Newberger, a Boston pediatrician who has written extensively about child abuse, said corporal punishment hinders the trust between a parent and a child and can cause children to become more aggressive and violent. The use of devices to deliver punishment, such as The Rod, can easily lead to bodily injury, he said. ''There is no question that physical damage can be done by this object," he said.
      Some countries, such as Sweden and Germany, have made spanking children illegal. But in the United States, a parent's right to use physical punishment is ''deeply built into American culture," said Murray Straus, a sociology professor at the University of New Hampshire in Durham and a critic of corporal punishment. Straus said states do not interfere with parents' rights to punish their child unless it causes physical injury.
      Lawrence said she plans to continue her crusade against corporal punishment in an effort to halt sales of The Rod for good. She said she wants to be sure that Bullock's manufacturing operation is legally shut down. She said she will continue to press her case before the Consumer Product Safety Commission. Markey said that this week he plans to ask the commission for an additional review of The Rod, insisting that it ''poses an unreasonable risk of injury." Lawrence, a former church musician who grew up in Wisconsin, said she regrets that the religion she holds dear is being used to justify corporal punishment. While many Christians cite lines in the Bible's Book of Proverbs that speak of the disciplining force of ''the rod" and repeat a line from a Samuel Butler poem, ''Spare the Rod and Spoil the Child," she prefers to cite Jesus Christ's teachings in the New Testament about nonviolence. ''I'm a Christian too," she said. ''And I don't want anyone to be harmed."

Survivors, Counselors Overwhelmed
Jehangir S. Pocha, Boston Globe- 1/10/2005

MULLAITIVU, Sri Lanka -- As far as the eye can see in this northern coastal town, shards of brick, asbestos roofing, and glass from destroyed houses litter a once-pristine beach. Uprooted trees, strewn with shreds of clothing ripped off people's bodies as the water engulfed them, lie half-buried in the sand. Deeper still lie the invisible scars of those whose families, homes, and livelihoods were swallowed up by the angry sea. The despair and emotional trauma of survivors in Mullaitivu, where more than 2,000 people perished, and across the region are likely to linger long after the aid shipments have stopped, according to health specialists and relief workers. Among the most overwhelming feelings is guilt. ''I wonder why I remain. I want God to take me, too," said Annalaxmi, 57, a fisherwoman who like many Sri Lankans uses one name. She lost two of her four children when the water came rampaging into her living room. ''I struggled to find them. I swam, I shouted, but gave up because I had to use all my strength to cling onto a pillar." She breaks down in grief, and another woman refugee rushes over to comfort her.
      While such community bonds are proving to be a salve for shell-shocked communities, many survivors are in dire need of professional psychological care, said the Rev. Edmund Reginald, a Catholic priest and founder of a local counseling center called Annai Eelam, or Mother's Home. ''Right now, they're so shocked their emotional recovery could take years," he said. ''We're trying our best to reach people, but we're overwhelmed, both by the numbers and by the experience itself." Dr. Unnikrishnan, a medical adviser with ActionAid International, a nongovernmental organization working in Mullaitivu, estimated that up to 75 percent of people affected by the tsunami may end up suffering from post-traumatic stress disorder that could linger beyond the 10 years it is expected to take to rebuild the most devastated areas.
      In Galle, a tourist and fishing town in southern Sri Lanka, the pain of seeing the city under 30 feet of water was compounded by news that numerous infants had floated out to sea when the giant waves struck. ''How does one make sense of something like this?" demanded S. Jayasingha, a Galle shopkeeper who says his wife is haunted by the cry of their 5-month-old daughter, who was also lost that day. ''What did these infants ever do to anyone?"
      The burden of such despair hits especially hard in northern Sri Lanka, where residents already were dealing with losses and displacement from the 20-year civil war between ethnic Hindu Tamils and the Sinhalese-Buddhist dominated government. More than 60,000 people have been killed in the conflict and more than a million directly affected by the fierce fighting. Although a cease-fire has been in effect since 2002, ''real normalcy has never been achieved here, and the shock of the tsunami is bringing old wounds to the surface again," said K. Jesuthas, one of only 18 mental health counselors helping Reginald provide succor to 35,000 refugees in the Mullaitivu district. Annalaxmi is at least able to discuss the trauma. ''Some people can't even talk. They just sit, still, like statues," Jesuthas said.
      Thousands more have also been diagnosed with psychosomatic symptoms of trauma, such as chest pains, listlessness, headaches, nightmares, and personality disorders, Reginald said. In Indonesia, doctors from an Indonesian medical team that set up the military hospital in Banda Aceh, one of the worst-hit cities on Sumatra, were amazed at the lack of emotion displayed by victims -- the result, they believe, of the emotional toll from the disaster.
      Dr. Edison Sitorus, a neurosurgeon who helped restart the military hospital in Banda Aceh in the days after the tsunami hit, recalled how relatives of the injured would knock on the door of the hospital conference room where he slept to say someone was dying. ''There was no expression," he said. ''No tears. Some patients just wrap the body in a blanket, and then they continue talking with their neighbor. . . . Maybe they don't cry because if one cries, another will say, 'I lost more than you.' "
      Latifa, a psychiatrist who goes by one name and who has counseled survivors in Aceh Province, said such behavior was a sign of severe mental trauma, suffered by 75 percent of the 180 patients she has seen. Several of her patients suffered from what she called ''disassociated amnesia." One 6-year-old Indonesian boy orphaned by the tsunami acted as though he were blind after he was rescued, although doctors could find nothing wrong with his eyes. After five days, when a woman from the refugee camp adopted him and began treating him like her own son, the boy said he could see again, doctors said. A 7-year-old boy who escaped the wave in a car and watched it approaching through the back window could not unclench his fists several days later. He also became frightened by a bottle of water.
      Dharitri Patnaik, a fellow at Harvard's Kennedy School of Government taking time off to work with ActionAid in northern Sri Lanka, said the key to helping victims rebuild their lives was ''long-term . . . interventions that emphasize empathy and empowerment." ''Right now, we are at the 'heroic phase' of the relief, and help is plentiful," she said. ''But in the long run, communities must learn how to get those affected to speak. Children especially must be encouraged to act out their feelings and fears through games, theater, and paintings, or else we could be looking at a lost generation." Such an initiative will take time, expertise, and money. Unfortunately, international nongovernmental organizations, which have rushed to bring material relief to refugee camps, can play only a limited role in providing emotional relief, Reginald said, because of language barriers and other challenges. ''In the field, it's essential that counselors speak Tamil and know the local culture," Reginald said. ''So the most foreign psychologists can do is help us help our people by training us."
      The Tamil Rehabilitation Organization, an arm of the Tamil Tigers, says it has appealed to the Tamil expatriate community to help counsel survivors. But despite volunteer nurses and students coming in from all over the world, including the United States, Australia, and India, Reginald worries that locals will remain reluctant to seek such help because mental-health issues carry a stigma, ''not only with prejudice, but also misunderstanding."
      When tsunamis swept into the Senthalir Eelam children's home just off the beach in Mullaitivu, killing 114 of the 150 children, teachers thought it best to hide the grim news from the survivors, a tactic that counselors discourage. ''Every day, some children ask for their friends, but we're telling them there're either in the hospital or gone to live with family members," said Suvarna Thavaraja, 26, deputy director of a Tiger organization called Center for Women's Development and Rehabilitation, within whose jurisdiction the home falls. Reginald shook his head with a grimace when he heard about this tactic. ''The children should have been told the truth right away," he said. ''Right now, the whole population is grieving, and instead of being part of this, they are being isolated."

Psychiatrist in Yates Case Working on Similar Colorado Case
Associated Press, 1/10/2005

LAMAR, Colo. -- A psychiatrist who gave false testimony in the botched conviction of a Houston woman accused of drowning her children has been working with Colorado prosecutors on a similar case. Long before the Texas case was reversed, Prowers County, Colo., prosecutors had hired Dietz to evaluate Rebekah Amaya, who pleaded innocent by reason of insanity in the bathtub drownings of her daughter and infant son.
      After his evaluation, Dietz told prosecutors he believed Amaya was insane at the time of the drownings. Doctors at the Colorado Mental Health Institute in Pueblo also concluded she had mental problems, and the judge ruled Tuesday she was not competent to stand trial. She is scheduled to return to court Jan. 31, where she is expected to tell the judge that she killed her children. She faces an indeterminate commitment to the state Mental Health Institute. Neither prosecutors nor the defense lawyer would comment on whether Dietz's role would affect Amaya's case, citing the judge's gag order.
      Dietz, of Newport Beach, Calif., and a consultant for Law & Order, blamed his testimony in the Texas case on confusion about a conversation with prosecutors. He said they had told him there was an episode with a drowning plot. Harris County prosecutors said blaming them was a stretch. freed.
      In the Colorado case, Amaya is charged with two counts of first-degree murder in the deaths of Grace Headlee, 4, and Gabriel Amaya, 5 months, on Oct. 16, 2003. Police say Amaya told them she killed the children after getting a sign from a spider that crawled across her hand but also gave other accounts.



The Secret Lives of Just About Everybody
James Carey, New York Times- 1/11/2005

One mislaid credit card bill or a single dangling e-mail message on the home computer would have ended everything: the marriage, the big-time career, the reputation for decency he had built over a lifetime. So for more than 10 years, he ruthlessly kept his two identities apart: one lived in a Westchester hamlet and worked in a New York office, and the other operated mainly in clubs, airport bars and brothels. One warmly greeted clients and waved to neighbors, sometimes only hours after the other had stumbled back from a "work" meeting with prostitutes or cocaine dealers. In the end, it was a harmless computer pop-up advertisement for security software, claiming that his online life was being "continually monitored," that sent this New York real estate developer into a panic and to a therapist.
      The man's double life is an extreme example of how mental anguish can cleave an identity into pieces, said his psychiatrist, Dr. Jay S. Kwawer, director of clinical education at the William Alanson White Institute in New York, who discussed the case at a recent conference. But psychologists say that most normal adults are well equipped to start a secret life, if not to sustain it. The ability to hold a secret is fundamental to healthy social development, they say, and the desire to sample other identities -- to reinvent oneself, to pretend -- can last well into adulthood. And in recent years researchers have found that some of the same psychological skills that help many people avoid mental distress can also put them at heightened risk for prolonging covert activities. "In a very deep sense, you don't have a self unless you have a secret, and we all have moments throughout our lives when we feel we're losing ourselves in our social group, or work or marriage, and it feels good to grab for a secret, or some subterfuge, to reassert our identity as somebody apart," said Dr. Daniel M. Wegner, a professor of psychology at Harvard. He added, "And we are now learning that some people are better at doing this than others."
      Although the best-known covert lives are the most spectacular -- the architect Louis Kahn had three lives; Charles Lindbergh reportedly had two -- these are exaggerated examples of a far more common and various behavior, psychologists say. Some people gamble on the sly, or sample drugs. Others try music lessons. Still others join a religious group. They keep mum for different reasons. And there are thousands of people -- gay men and women who stay in heterosexual marriages, for example -- whose shame over or denial of their elemental needs has set them up for secretive excursions into other worlds. Whether a secret life is ultimately destructive, experts find, depends both on the nature of the secret and on the psychological makeup of the individual.
      Psychologists have long considered the ability to keep secrets as central to healthy development. Children as young as 6 or 7 learn to stay quiet about their mother's birthday present. In adolescence and adulthood, a fluency with small social lies is associated with good mental health. And researchers have confirmed that secrecy can enhance attraction, or as Oscar Wilde put it, "The commonest thing is delightful if only one hides it."
      In one study, men and women living in Texas reported that the past relationships they continued to think about were most often secret ones. In another, psychologists at Harvard found that they could increase the attraction between male and female strangers simply by encouraging them to play footsie as part of a lab experiment.
      The urge to act out an entirely different persona is widely shared across cultures as well, social scientists say, and may be motivated by curiosity, mischief or earnest soul-searching. Certainly, it is a familiar tug in the breast of almost anyone who has stepped out of his or her daily life for a time, whether for vacation, for business or to live in another country. "It used to be you'd go away for the summer and be someone else, go away to camp and be someone else, or maybe to Europe and be someone else" in a spirit of healthy experimentation, said Dr. Sherry Turkle, a sociologist at the Massachusetts Institute of Technology. Now, she said, people regularly assume several aliases on the Internet, without ever leaving their armchair: the clerk next door might sign on as bill@aol.com but also cruise chat rooms as Armaniguy, Cool Breeze and Thunderboy.
      Most recently, Dr. Turkle has studied the use of online interactive games like Sims Online, where people set up families and communities. She has conducted detailed interviews with some 200 regular or occasional players, and says many people use the games as a way to set up families they wish they had, or at least play out alternative versions of their own lives. One 16-year-old girl who lives with an abusive father has simulated her relationship to him in Sims Online by changing herself, variously, into a 16-year-old boy, a bigger, stronger girl and a more assertive personality, among other identities. It was as a more forceful daughter, Dr. Turkle said, that the girl discovered she could forgive her father, if not change him. "I think what people are doing on the Internet now," she said, "has deep psychological meaning in terms of how they're using identities to express problems and potentially solve them in what is a relatively consequence-free zone."
      Yet out in the world, a consequence-rich zone, studies find that most people find it mentally exhausting to hold onto inflammatory secrets -- much less lives -- for long. The very act of trying to suppress the information creates a kind of rebound effect, causing thoughts of an affair, late-night excursions or an undisclosed debt to flood the consciousness, especially when a person who would be harmed by disclosure of the secret is nearby. Like a television set in a crowded bar, the concealed episode seems to play on in the mind, attracting attention despite conscious efforts to turn away. The suppressed thoughts even recur in dreams, according to a study published last summer.
      The strength of this effect undoubtedly varies from person to person, psychiatrists say. In rare cases, when people are pathologically remorseless, they do not care about or even perceive the potential impact of a secret on others, and therefore do not feel the tension of keeping it. And those who are paid to live secret lives, like intelligence agents, at least know what they have signed up for and have clear guidelines to tell them how much they can reveal to whom.
      But in a series of experiments over the past decade, psychologists have identified a larger group they call repressors, an estimated 10 to 15 percent of the population, who are adept at ignoring or suppressing information that is embarrassing to them and thus well equipped to keep secrets, some psychologists say. Repressors score low on questionnaires that measure anxiety and defensiveness -- reporting, for example, that they are rarely resentful, worried about money, or troubled by nightmares and headaches. They think well of themselves and don't sweat the small stuff. Although little is known about the mental development of such people, some psychologists believe they have learned to block distressing thoughts by distracting themselves with good memories. Over time -- with practice, in effect -- this may become habitual, blunting their access to potentially humiliating or threatening memories and secrets. "This talent is likely to serve them well in the daily struggle to avoid unwanted thoughts of all kinds, including unwanted thoughts that arise from attempts to suppress secrets in the presence of others," Dr. Wegner, of Harvard, said in an e-mail message. The easier it is to silence those thoughts and the longer the covert activity can go on, the harder it may be to confess later on.
      In some cases, far stronger forces are at work in shaping secret lives. Many gay men and some lesbians marry heterosexual partners before working out their sexual identity, or in defiance of it. The aim is to please parents, to cover their own shame or to become more acceptable to themselves and society at large, said Dr. Richard A. Isay, a psychiatrist at Cornell University who has provided therapy to many closeted gay men. Very often, he said, these men struggle not to act on their desires, and they begin secret lives in desperation. This eventually forces agonizing decisions about how to live with, or separate from, families they love. "I know that I did not pursue the orientation that I have, and know that I have always been as I am now," one man wrote in a letter published in Dr. Isay's book "Becoming Gay." "I know that it becomes more difficult to live in the lonely shell that I do now, but can see no way out of it."
      When exposure of a secret life will destroy or forever poison the public one, people must either come clean and choose, or risk mental breakdown, many therapists say. Dr. Seth M. Aronson, an assistant professor of psychiatry at Mount Sinai School of Medicine, has treated a pediatrician with a small child and a wife at home who was sneaking off at night to bars, visiting prostitutes and even fighting with some of the women's pimps. At one session, the man was so drunk he passed out; at another, he brought a prostitute with him. "It was one of those classic splits, where the wife was perfect and wonderful but he was demeaning these other women," and the two lives could not coexist for long, Dr. Aronson said.
      In a famous paper on the subject of double lives, published in 1960, the English analyst Dr. Donald W. Winnicott argued that a false self emerged in particular households where children are raised to be so exquisitely tuned to the expectations of others that they become deaf to their own longings and needs. "In effect, they bury a part of themselves alive," said Dr. Kwawer of the White Institute.
      The pediatrician treated by Dr. Aronson, for example, grew up in a fundamentalist Christian household in which his mother frequently and disapprovingly compared him to his uncle, who was a rogue and a drinker. Dr. Kwawer's patient, the real estate developer, had parents who frowned on almost any expression of appetite, and imprinted their son with a strong sense of upholding the family image. He married young, in part to please his parents. Both men are still getting psychotherapy but now live one life apiece, their therapists say. The pediatrician has curtailed his extracurricular activities, returned home mentally and confessed some of his troubles to his wife. The real estate developer has separated from his wife, but lives close by and helps with the children. The break caused a period of depression for everyone involved, Dr. Kwawer said, but the man now has renewed energy at work, and has reconnected with friends and his children. The secret trysts have stopped, as has the drug use, and he feels he has his life back. "Contrary to what many people assume," Dr. Kwawer said, "quite often a secret life can bring a more lively, more intimate, more energized part of themselves out of the dark."

Ob-La-Di, Ob-La-Da, Amygdala: Word as Earworm
James Gorman, New York Times- 1/11/2005

My infatuation with the amygdala has led me to wonder where aphasia and amusia overlap, a subject that neurologists have been investigating for many years. Damage to the brain can interfere with spoken language -- aphasia. But it can also harm the ability to hear and produce melody. All this goes on in some part of the temporal lobe, not the amygdala, which is an almond-size structure in the brain (the word comes from the Greek for almond) that is involved with fear, emotion, sexuality and other aspects of humanity that lie below or behind the conscious mind.
      But this is off the point. I am infatuated with the word "amygdala," not the brain structure, although I suppose the meaning and the science contribute to the word's appeal. But I like its sound, you might say its musicality. And that has made me wonder about how speech and music overlap. For example, can a word be an earworm? An earworm is a tune that lodges itself in the brain and will not be moved. Songs like "It's a Small World" or "Ob-La-Di, Ob-La-Da" can become earworms. In a different class, "Là ci darem la mano," from Mozart's "Don Giovanni," might insinuate itself into every waking moment, although it seems wrong to compare such a lovely aria to an invertebrate.
      Words are not music, however, even though they may work their way into corners of our brain and then insist that they be pronounced, often, sometimes at inopportune moments. A friend who is given to word fixations once fell into the grip of the word "vomeronasal," as in, "In humans, the vomeronasal organ that is so important for other mammals in the perception of pheromones appears to be vestigial." It was some kind of worm, certainly. Vomeronasal is vaguely unpleasant. Amygdala has a deep and mysterious sound: uh-MIG-duh-luh. For all I know, its allure may touch neurons in the very structure it denotes.
      I've been thinking of it in a variety of contexts. I like it as the given name of an ethnically indecipherable femme fatale in a James Bond movie - Amygdala McBain. As she sways into the laboratory of the evil neuroscientist on curare-tipped spike heels, Sean Connery cracks a crooked, predatory smile and says, "Amygdala, my dear, what an unexpected pleasure." It's the juxtaposition of the hard and primitive "myg" with the more liquid "la" that gets you. And in between, of course, is the alveolar stop, the "d" that does indeed stop the word if you let it. Amygdala is not an easy word. It doesn't say itself. You have to speak it, with a conscious effort, like a spell or imprecation.
      It's pretty close to music, but not quite. Music and speech are similar and somehow linked in the brain, but they are also separate. One can have amusia, for example, and be unable to perceive melody, but have no difficulty with speech. One can have aphasia and yet keep one's musical abilities intact, as in the case of Vissarion Shebalin, a 20th-century Russian composer who lost some of his ability to speak and understand language because of strokes, but was still able to compose music. Some people are born with various degrees of amusia. Not only pitch is involved, but timing as well. Some people cannot keep time or dance to music.
      Lesions in the brain can cause terrifying losses, like the one described in The Journal of Neurology, Neurosurgery & Psychiatry in 2000 about an amateur musician who suffered aphasia that receded, leaving speech intact but depriving him of something that had previously enriched his life. "Sounds are empty and cold," the paper quotes him as saying. "Singing sounds like shouting to me." Music made him feel uncomfortable, the researchers reported. And yet, he was able to understand language and the changing tones of language. The paper did not report whether he was able to savor language, to enjoy the pleasures afforded by words that seem similar to the pleasures of melody.
      How strange that words and melody, which can be married so completely, can sometimes be severed. How odd that a person could appreciate poetry and not melody, that somewhere in the brain a line is drawn between the lyrics and the tune. It seems wrong, because all the best words are musical. I know amygdala is. I have evidence. There are several bands called "Amygdala" that I found on the Web. And I was tempted by a CD on a German label by an artist named Laszlo Hortobagyi titled "Traditional Musik of Amygdala," which was described as "an imaginary journey throughout the entire Amygdala Empire in the spirit of the ethno-musicology expeditions at the turn of the century." Well, not that tempted.
      Musicians, by definition, have an ear for music. Someday, perhaps, we will replace the word almond with amygdala. Then we could have a candy bar called Amygdala Joy. And perhaps some aspect of joy actually resides in, where else, the amygdala.