November 14, 2007

The Price Of A Drink: Booze, Cymbalta, Celexa Involved In Phoenix Airport Tragedy

I don't know how many of you know about the story of Carol Gotbaum, a rich, well-connected New Yorker from an influential family who died in police custody in a holding cell at Phoenix Sky Harbor Airport in late September. She was a chronic alcoholic heading to rehab, flying alone, friends who were supposed to meet her in Phoenix weren't there to meet her. Gotbaum ends up slipping into an airport bar while waiting for a connecting flight, gets very drunk, misses the boarding call, later tries to board the plane and is denied her seat, and then she just comes unlgued. Cops try to arrest her, she fights the cops, they drag her off to a holding cell where, still behaving erratically, she manages to hang herself by the cuffs and chain behind her back, as she's been connected to a hook in the cell's wall. At least, if I remember the whole story. More details are here.

Now it comes out that Gotbaum was on Cymbalta and Celexa in addition to being drunk. One doctor who's examined her case thinks the two drugs played a part in her demise.

"'We are not talking about a drug death, but a death where drugs made her more susceptible,' said pathologist Cyril Wecht on Monday.

"Wecht says he essentially agrees with the Maricopa County medical examiner that the death was an accident, but the police should have gotten medical help soon after they encountered Gotbaum, the pathologist argued.

"Phoenix Police Department has repeatedly argued that there was no way for officers to know that Gotbaum had health problems when she was arrested."

I think the doctor, a pathologist hired by Gotbaum's family for an inevitable lawsuit, is missing a key point. Drugs like the ones she was on don't only cause oxygen transport problems (I assume he's right on this point), as the doctor argues, but they have a long track record of making some people behave very erratically. It's puzzling that he's not saying so.

Gotbaum, who was flying through Phoenix on her way to Tucson for rehab, had a blood alcohol level of .24 percent--thrice the legal limit to drive--and I'm sure that contributed to many of her problems that day. But Cymbalta and Celexa could well have made her behave even more erratically than just the booze alone.

There are so many contributing factors in this woman's death--including choices made by the woman herself and her family--that I doubt anyone can ever tease out how much anti-depressants could've contributed to her eventual death. It's clear they had a role in her death, however.

I've been thinking about her case since I first heard about it in September, primarily because I've had to write about vaguely similar deaths in holding cells and jails before and I've really had it up to here with these very preventable tragedies.

Knowing what the world knows about how booze and some anti-depressants can produce very bad reactions in some people--as in making them completely crazy and suicidal--why was this woman flying alone? And why the hell was she flying out to Arizona to go to rehab? Is New York State lacking in rehab facilities for the rich and well-connected?

What part of health problem do Phoenix cops fail to understand when confronted with the case of a woman who is clearly drunk off her ass, behaving very erratically and fighting them? Are cops in Phoenix that unsophisticated and naive to not think that a woman like that--whom I'm sure they must've backgrounded while she in that cell--without a criminal record wouldn't have something seriously the matter with her to account for all of what was happening? Why would you shackle a woman like that to the wall and not monitor her more closely? Haven't there been enough similar tragedies in jails and holding cells in this country to keep this sort of stupidity from playing out? Answer: yes.

My point isn't that the cops killed Gotbaum, it's that the cops screwed this case up badly. They were this woman's last chance and they failed. Whenever the Phoenix police do an after action report on what happened and it becomes public, it will make for interesting reading. I hope other departments review it and do what they can to prevent similar episodes because this phenomenon of people dying in holding cells or in the back seat of patrol cars has simply got to stop.

And so, too, do the bad reactions to anti-depressants and booze.

Posted by Philip Dawdy at November 14, 2007 12:03 AM
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Comments

Your post kind of reminds me of something that many 9/11 conspiracy theorists tend to use (not to say you are deluded like them, but this is a common thought process when criticizing govt/) - the omniscient, organized, infallible govt. theory.

cops arrest drunk and disorderly people all the time. they do not administer the MMPI to each arrestee that is acting erratically, and they probably thought (occam's razor and all) that they were dealing with just another drunk idiot. in this case they were dealing with a drunk who was also suffering from polydrug consumption issues, but considering she was a .24 they must have smelled the etoh on her breath and made the logical assumption.

why should they have assumed there was something "seriously the matter?" she was drunk and acting like many drunk and disorderly people do. her death was tragic. sometimes a chair is ... just a chair, so to speak.

most agencies will ask somebody before they place them in a holding cell - "are you on any medications? are you suicidal?" etc. do we know that she admitted to being on these drugs? did she say she was suicidal? etc. i personally don't know, but assuming they just thought she was a drunk idiot, - i really don't see what the police did wrong here.

Posted by: whit at November 14, 2007 12:02 AM

Before jumping on this woman for being "drunk off her ass" I would like to add the caveat that she may not have had a lot to drink. If someone's on a lot of psych drugs (and it is reported she was on 6 medications at least two of which were antidepressants so we can place bets that she was on a benzo and sleeping pill too) one drink can affect the system like several more, especially if she was on benzos. It could be that she'd only had one drink and just appeared drunk. With 6 medications in her system she wasn't metabolizing alcohol I can tell you that and her blood level could have been sky high after only a small amount of alcohol. Read Addiction by Prescription by Joan Gadsby for a moving acount of how this phenomenon works. For years Joan was accused of being an alchoholic when really she was addicted to benzos and didn't even know it -- she was just following her doctor's orders and was told she "needed" the pills. There is even a scene in the book where she goes ballistic in an airport and gets arrested. She'd had one drink. So please be careful about slandering this young woman Carol's character and accusing her of being a drunk. Let's get some slander going for the doctors who were treating her and giving a tiny slender woman megadoses of Celexa and Cymbalta when she was on other meds as well. As for the TSA in Phoenix I'd say security and police personnel need some heavy duty training in psych drug intoxication -- how to recognize it and how to handle it. It's exponentially more serious than alcohol intoxication.

Posted by: Sara at November 14, 2007 07:58 AM

first of all, it's not slander if it's the truth.

her blood alcohol was .24

period.


i did not say she was a "drunk.". i said she WAS drunk. there is a difference. also, she was going to rehab for pete's sake. pretty much 'already in evidence' that she's an alcoholic, given that.

furthermore, one is not supposed to mix alcohol with the drugs in her system.

i'm not calling her a bad person. i'm saying she was drunk. because she was.

speaking truth is not slander.

i don't recall off hand what her bodyweight was but 1) it is IMMENSELY unlikely that "just one drink" resulted in a .24 blood alcohol, regardless of her meds. cmon. you sound like an overreaching defense attorney 2) she's not supposed to be drinking AT ALL with those meds...

etc.

facts are facts. she was acting drunk and disorderly, REGARDLESS of what underlying mental health issues/drug issues she had.

it's not slander to speak the truth about her behavior and the contents of her bloodstream

Posted by: whit at November 14, 2007 10:59 AM

As a former "overreaching defense attorney" I take a very slight offense (but more of a chuckle) to Whit's points. I find Sara's points interesting as well. I don't care to discuss either, though.

Here's my contribution: My brother was seriously addicted to alcohol, lived in my house for four years, flew airplanes for a living, and I did not know about his problem until about the third year of living in the house with him. It floored me when I found out. By the time I realized what was up, he had nearly killed himself, both by wrecking his liver and his suicidal ideation. I learned the hard way about addictions; and I learned from the treatment center that when it's time to go to treatment, you don't stick somebody on a plane by themselves to go there. They're bound to think somewhere along the line: hey, this is my last chance for a buzz. Let's have another drink. And it's a long flight from NY to Phoenix.

Unfortunately, that last drink (and I don't care how many or how much) killed this woman. Substance abuse and mental health issues are killers, just like heart disease or cancer. Unfortunately, they're not treated or respected like that, either by the majority of medical communities or by society's other institutions (like police, firefighters, jailers, etc.). This story is a sad reminder of that fact.

Posted by: Liz at November 14, 2007 11:32 AM

Dear Whit,

“i did not say she was a "drunk.". i said she WAS drunk. there is a difference. also, she was going to rehab for pete's sake. pretty much 'already in evidence' that she's an alcoholic, given that.

furthermore, one is not supposed to mix alcohol with the drugs in her system.

i'm not calling her a bad person. i'm saying she was drunk. because she was.

speaking truth is not slander.” --- Whit

Good points made on your part as to the distortions and assumptions in reply to your comments. In my opinion similar replies are often evident.

Yes, it is tragic to have a young woman’s life end in death in what appears to be a needless procession of oversights, errors and/or ignorance.


Philip what I do read in your writings is similar to what I personally see what is happening throughout the fabric of this nation. That is the laying of blame elsewhere for anything and everything and no one wanting to take responsibility for his/her actions and/or the care of others.

This is another topic supposedly dealing with mental health or lack thereof and the blaming begins. Blame the police, blame the alcohol, blame the psychotropic medications, blame the alcohol and psychotropic medications, blame the airline personnel and blame the people late to meet her, blame the support persons for not being wiser, blame the loved ones for not seeking help closer to home and be creative like many an attorney and find something novel to blame if necessary.

Why not properly place responsibility where it properly belongs in the apparent ignorance or disregard by the individual to not know about alcohol and alcohol and psychotropic medications? As Whit stated he did not call the woman a drunk, but maybe I should call her “ignorant” or someone totaling lacking consideration for anyone else. Why not place responsibility upon the individual for not maintaining some calm and reasoning to catch another flight. Why not rightfully place the responsibility upon the individual for her derisive actions toward the police.

While we only read headline information that is often distorted by the news media, in my opinion, the fact remains as a former DBSA support group facilitator that I read as part of our weekly announcements preceding the discussions that individual’s should take note that they are still responsible for their actions even while taking medications and especially while driving a motor vehicle that in the case of an accident they could be charged with DUI in my state.

It seems the blame game continues in my view, although the events of this death amongst others could have been another preventable tragedy.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 14, 2007 12:18 PM

herb and others: just to be clear, my post doesn't blame the anti-deps or the cops for killing this woman. it blames them for not doing their jobs as well as they could've--and i'm sorry any cop with brains could've worked this whole affair out a little differently. i've covered law enforcement for almost a decade, have friends who are cops/c.o.'s and any of them i've asked about this episode are just as troubled by it as i am.

but if you read carefully--and i hope you will--i lay as much blame on the woman, her family and the friends who weren't there to meet her at the airport. but feel free to read into it what you want.

Posted by: Philip Dawdy at November 14, 2007 12:44 PM

So I tried to find out more about postmortem blood levels of alcohol and how it correlates with consumption of alcohol antemortem given confounding factors of great strain on the liver with multiple drugs and didn't get as clear a picture as I might have liked. All I wish to point out, though, is that these things are rarely as simple as they appear and, while a blood level of .24 certainly suggests consumption of multiple drinks and lots of alcohol, knowing what I do about psych drugs and how they affect the system (as well as the precision or rather imprecision of postmortem blood level analyses) I would want to know the exact science before accepting that conclusion as fact. I do believe there could be other factors in this particular case besides a huge number of drinks accounting for that blood level of alcohol.

Posted by: Sara at November 14, 2007 01:15 PM

thanks for the props, herb. and i agree with your assessment that phillip is looking for "somebody to blame" when there is not necessarily anybody to blame, apart from gotbaum.

sometimes tragedies happen. the best is the enemy of the good, in regards to what the cops COULD have done. sure, the cops could have done "better.". they could have sat down with her, had a muffin and tea with her, discussed her problems with her, called for an on-duty mhp to assuage her pain, etc. etc. clearly, i'm being sarcastic here. they arrested a drunk and disorderly person and placed her in the cell. that';s what they are SUPPOSED to do. again, where's the evidence that they had good reason to believe she was suicidal? there is none that i have seen. i would hazard a guess that probably hundreds if not thousands of people have been arrested in similar circ's with no problem whatsoever. that one deranged, drunk, medicated individual chose to hurt herself must be taken in the context of you can't prevent/prepare for all possible outcomes. you act reasonably, within the law, given the fact pattern/evidence known at the time. that,. the cops apparently did.


i also find your comment about them checking her criminal record, fiding nothing in her background, should have resulted in them immediately understanding that "there was something seriously the matter with her"

it's an airport. are they supposed to do a nationwide NCIC/III check of every disorderly they arrest, then make an assement if their behavior matches their BACKGROUND based on a disorderly arrest? that's absurd. it's also kind of weirdly biased in that you are saying that this apparently well to do well dressed nocriminalrecord having white woman somehow deserved "special consideration" cause she had a clean record? she was drunk and acting like an idiot. that's a CLASSIC first timer thing.
whenever a tragedy happens, it is natural to want to assign blame. that's how prosecutors think fwiw.

regardless, this was just a tragedy. COULD the police have handled it better? in 20.20 hindsight, of course they could. but given what they apparently knew at the time, i see no problem whatsoever with what they did.

*if* they had good cause to believe her to be suicidal, etc. than probably not, but i simply see no evidence that's the case.

gotbaum is ultimately the one responsible for taking her own life, as much as that is mitigated by her depression, and medication *and* self-medication (alcohol is not known to be a substance that improves one's judgment, restrain, etc.).

the one thing i take issue with the cops is the whole 'shackle them unsupervised in a room.'

this is a weird SOP, but if it *is* the SOP for this agency, than that might need addressing.

while i respect your opinion, phillip (used to read you in the weekly), i know tons of cops too, and i don't see any lack of brains in this incident.


when cops put somebody in a holding cell, they generally have them remove anything sharp and anything that can be (easily) used to hang/hurt them - belts, shoelaces etc.

it appears that this shackling procedure clearly ALLOWS ( a deranged/determined ) person to self-asphyxiate. again, that's a policy issue. no agency i know of shackles people unsupervised inside a holding cell.

Posted by: whit at November 14, 2007 01:20 PM

"Why would you shackle a woman like that to the wall and not monitor her more closely?"

THAT right there is reason enough to get pissed, and the rest of the questions fall into place, re: questioning why she flew alone, drug-drug interaction, etc.

The last people to have human contact with a person having erratic over-the-top behavior, never should have left her alone. No, the police couldn't have known she was on meds, or how much she drank, where she was going---but they saw who they were dealing with and left her, to her own demise.

They fucked up.

Posted by: Stephany at November 14, 2007 01:48 PM

Dear Philip,

Thank you. Your response to Whit’s and my commentary illustrates my point precisely about our changing society, numerous blog of this nature and their commentators perpetuating the blame game:

“herb and others: just to be clear, my post doesn't blame the anti-deps or the cops for killing this woman. it blames them for not doing their jobs as well as they could've--…
but if you read carefully--and i hope you will--i lay as much blame on the woman, her family and the friends who weren't there to meet her at the airport. but feel free to read into it what you want.” --- Philip Dawdy


In an ideal situation humans wouldn’t make mistakes. One single drug or therapy would resolve the ills or disease and all patients would respond exactly the same achieving everlasting wellness.

Sorry, but as you know life does not work that way. I personally would rather work with a more positive attitude and not play the blame game.

How about a different approach like the continued education and educating of the patient and all concerned? I’m not qualified to speak about police procedures but certainly in stead of taking a negative approach as I see your use of “blaming,” how about making the effort to list what or how should be done to improve future police procedures. Even more importantly how about educating your readership and those patients and their support persons to have prevented this tragedy from happening in the first place and your suggestions as to how the individual should have properly and positively handled the situation.

You’re the journalist and writer; try some positive reinforcement in your writings. I know it may be boring and lack the sensationalism of the numerous headlines you post but are your intentions to draw as many eyes as possible or to lend proactive assistance in helping this unique community?

My point Philip is I read numerous of these blogs bashing this and that drug and many calling for the banning of various drugs as well as treatments when in fact I am also aware of patients benefiting from the same drugs and therapies and not being arrested for whatever reason nor similarly involved in these kinds of tragedies. Naturally if all the drugs and treatments that are bashed and banned there would be few if any therapies from which to choose and when we also add to the mix the bashing of Psychiatry, it’s institutions and its practitioners and now you’re bashing law enforcement, the individual, her family and friends, boy I do I think we’re off in the wrong direction. The blame game is where the sharks earn their living and it certainly isn’t achieving wellness for our loved ones.

How’s about looking occasionally for more positive themes relating to treatments that have helped patients, of doctors who relate and have also benefited patients and of institutions that have exhibited caring and supportive efforts on behalf of their patients?

I know you too get my drift.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 14, 2007 02:22 PM

I agree with Stephanie. I blame solely the federal agents for killing Ms. Gotbaum. Every time, if a person gets hysterical, or decompensates, at an airport or at another US government property, federal agents have the right to chain you to a wall like a dog. That she was drunk and on Cymbalta and Celexa (minor medications in my mind) is irrelevant. What's relevant is that this slightly built white woman with three kids couldn't, in any reasonable mind, pose a danger to others. She could only pose a danger to herself. The cops didn't call for medical help. Rather they handcuffed her and chained her handcuffs to a wall behind her back. And now the federal agents are coming back with excuses: she was drunk, she was on anti-depressants, she was this, she was that. Irrelevant, people, irrelevant. It's a global approach to the people in this country: we must all shut up and do whatever we're supposed to, at that particular time and place. Zero tolerance for loud deviations. I wish that everyoe took a broader view of the implications of what happened.

Posted by: Red Rover at November 14, 2007 03:20 PM

The SSRs cause a craving for alcohol and I read a news article which said that Carol Gotbaum had suddenly began drinking alcohol about 2 and one-half years ago.

I imagine this is about the time she started on the Celexa & Cymbalta. Some of the inserts for these drugs even state "Alcohol Craving" in the list of adverse reactions.

Since the liver cannot metabolize both alcohol and the SSRIs effectively when both are present, then one drink could be the same as 5 or 10 drinks depending on the person's metabolism of these drugs.

The bartender at the airport said she had had one drink. This was in the newspaper.

Pharma and the docs would love to have the general public take "responsibility" for all these insane actions that happen because of SSRIs. I will have NONE of it.

Posted by: Rosie at November 14, 2007 03:25 PM

I see these posts as postive. It is so easy to find all kinds of information regarding what the professionals are doing to treat mental illness. This site is one of a very few that question the way mental health is being treated. That is very postive and really needs to be built upon.

Posted by: Jane at November 14, 2007 04:07 PM

herb and whit, while i appreciate your views intellectually, i think the whole personal responsibility trip--which i agree with in some instances--can be taken too far, as you have here. consider an analogy a cop once put to me about these sorts of cases: a harried driver makes an illegal left against the light, ends up in a crash, stuck in the car etc. do the cops and firefighters who respond say 'ah fuck this guy, he made an illegal left, let him cut himself out of the car and drive himself to the hospital'? or do they get the guy out of the car and save his life and worry about the other bs later? i think you know the answer.

and i think you guys would have no problem applying it to the case of this women if she hadn't been drunk. or a woman.

Posted by: Philip Dawdy at November 14, 2007 04:31 PM

If I recall correctly, I watched a news report that played a call to the police from the husband who in the call told the police that his wife was fragile and possibly sucidal. So the police in fact knew the women should have at least been supervised and or assessed.

Posted by: Jane at November 14, 2007 05:10 PM

Woot! Lemme get my Nomex fire suit on and fire up the flamethrower 'cause this looks a lot like a barbecue!

I am a BIG believer in being responsible for your own behavior. In the past two years, I've been on a grip of medication to treat chronic pain - some of which have included depression, ideation, etc. as side effects and all of which had nifty warning labels to alert me that consuming alcohol may alter or intensify those effects. Now, say what you will about certain pharma companies and what they may have done with off-label marketing and dancing around the suicide issue, but they are pretty good at warning users about interaction with alcohol. And fuck me with a chainsaw if I haven't stayed completely dry since this entire mess began because I really have enough problems to deal with right now.

With that said, that assumes someone is in a reasonably competent state of mind and able to make reasonable decisions that illustrate the capacity to determine which choices are harmful to them. That rules out people with a current substance abuse issue, which includes the subject of this post. I'm not saying that she wasn't partly responsible (and since I don't know whether the psych meds or substance abuse came first, I don't care to comment on the degree of responsibility or her ability to make sound decisions), but anyone around her should have had the clarity of mind to recognize that she had a problem and was not capable of making appropriate decisions given the particular set of circumstances.

My knowledge of the case is limited to what I read in People magazine (so I might as well know nothing about it, to be honest), but I seem to recall someone saying something about her independent nature. Hey, that's swell.

However, given that EVERY airport has a bar and many planes serve cocktails, I would not let someone I cared about travel alone TO GO TO REHAB. For fuck's sake, if a Republican politician can find a cock in a men's room, someone with substance abuse issues should be able to get loaded SOMEWHERE along the way. It's like throwing yourself at the ground - it takes someone REALLY special to miss.

The blame game starts at the earliest link in the chain of events that led to her death. That's her immediate family - especially her husband - letting her travel alone, friends or no. Doctors are in there too for prescribing the cocktail of prescriptions. Her friends play a part for standing her up when she needed them most. The cops will likely get all of the blame, even though they were the last people to be involved (and thus, those with the least time to do anything) and for most people, that's good enough to call them guilty of all sorts of horrible things. Did they fuck up? Sounds like it. Is it their fault? Not even close.

To me, this just another case of people who refuse to be accountable for their own fucked-up actions and dereliction of responsibility which flies in the face of common sense. God forbid that the husband admit his wife would likely be alive today if he had taken a couple of days off work to make sure she got there safely instead of entrusting his wife to the care of airlines, flaky friends and TSAs. It's far easier to avoid admitting complicity in his wife's death, no matter how unintentional, and blame it on the cops.

Jesus fucking Christ on the cross, people are goddamned morons.

Posted by: Puckett at November 14, 2007 05:33 PM

I have a few thoughts here re: this comment section.
1. Herb-If this blog followed your personal protocol for standard of treatment and care of psychiatric patients, they would all be medicated, never question why and get mindless lectures about med-compliance from you as a faciltator of your group.

2. What this blog does, that you have discovered, and I am glad you have--is like placing a piece of plastic wrap over the "psychiatric paradigm" that we have in place now [which proves itself over and over again every day that it needs improvement or none of here would be talking]. It's the truth behind how we get to Point A>B that some people want and need to read re: psych meds, how they [yes they can]affect people adversely[speaking from my own experience now].

3. As I stated in another thread here to Herb, "Depression a Mental Illness?" ; Herb has repeated this same stuff again and again, leaving no room for change or improvement in this system, to the point, where I left a comment that I was happy his wife [as he bragged]never was inpatient to a psych ward, due to her being a woman.

4. Back to the main point here: Protocol is accountability and every agency has one, to have it.
The people involved had someone die on their watch. Period.

5. I work in a school district. Protocol says I cannot stand in front of a weapon, to save children. Let's say I did. I died, and the child lives. Someone could complain who knew me that I died, against protocol.

6. Basic barbaric treatment of an individual, is exactly why, you, Herb should be outraged. Because one day, if your wife wasn't under your control, and she did something to be that woman cuffed to the wall and die, we would sure be hearing you sing a new tune.

I also, placing this into personal perspective that Herb likes so much:

Herb, I drove a car on Seroquel. No doctor warned me I would have double-vision and slow response time. I learned on my own and told the doctor that Seroquel was a rx that I like to call driving: "LEGALLY BOMBED."

I think I've said enough, except one more thing--Herb, you DO appear to be a flamer. [and like it].You love the attention and provoking people into thought--but it's your way or no way.

I you ever saw the inside of a psych ward and saw women strapped to gurneys you would have a new view of this woman, and she was just in an airport~! because this is a mental health awareness blog--and new people might be reading here--women are restrained and shot up with antipsychotics more than men. I saw it for my self and over so many months, and years have witnessed the women being silenced due to crying.
Yes, that's all they were doing.

Including my daughter!

Posted by: Stephany at November 14, 2007 05:55 PM

Whenever someone brings up the personal responsibility argument, it's always someone else's personal responsibility they are discussing. These drugs are dangerous and for many of us they haven't worked. I've looked into it and not only is medical evidence lacking that they work for other people but medical evidence regarding the entire biopsych paradigm we were sold is non existent. And it looks like I've got company, in fact the concensus of sciene and medicine.

Furthermore, it looks like there's evidence to support my suspicions that biopsychiatry, biopsychology, and psychopharamy do more harm than good for many people. So it would not juts be irresponsible not to speak out, it would be immoral.

The woman was responsible for drinking but ssri's cause increased thirst which causes faster ingestion of alcohol - I know there are other ssri alcohol interactions but that's the one I've experienced.

The police brutality was completely unnecessary and I think had more to do with post 911 security measures which are largely ineffective and harass citizens, and, as police officers are state actors and many of us readers are US citizens, it would be irresponsible for us not to speak out.

When you take away one person's civil rights, you harm us all. There was an unnecessary use of force here, an inappropriate extension of police authority, again, us US citizens have duty to speak out.

And of course any doctor that would prescribe an ssri to a woman who is a self professed alcoholic is a criminal but we don't know which came first, the ssri's or the drinking which admittedly doesn't take much heat off of the doctor.

So chill Herb and Co.

Posted by: Sally at November 14, 2007 06:23 PM

Puckett, you are a real mensch.

I did rehab, and I had to drive myself to it shaking with the DT's.

I wish I knew people like you in real life. It would have made it easier, but then, nothing in life worth having, like sobriety and recovery from mental illness is easy.

Take care.


(Sober 11 years! It can be done)

Posted by: susan at November 14, 2007 06:46 PM

Concern trolls, ever notice a police state on the march? Didn't think so.
I'm just the messenger, don't taze me, bro!

Posted by: flawedplan at November 14, 2007 08:56 PM

""God forbid that the husband admit his wife would likely be alive today if he had taken a couple of days off work to make sure she got there safely"-Puckett

THAT statement applies to any person who knew the woman, and yeah, the husband had his head up his ass, and looks like a concerned fucking saint now.

Susan-- Don't depend on others to get you to and from A>B, you are stronger than you think, because you say you are 11 yrs sober, you proved a point of personal strength--think about it.

Flawed-- people may not get what a "concern troll" is. Say it.

Posted by: Stephany at November 14, 2007 09:36 PM

Dear Stephany,

You posting is full of what I am and what I am not. How’s about sticking to the discussion simply because you don’t have the slightest idea of anything about me?

“1. Herb-If this blog followed your personal protocol for standard of treatment and care of psychiatric patients, they would all be medicated, never question why and get mindless lectures about med-compliance from you as a faciltator of your group.” --- Stephany

What the hell in the world are you rambling about? “They would all be medicated.” Are you too intoxicated? Where or when did I ever discuss having a “personal protocol for standard of treatment?” Please don’t put your words into my mouth or my writings. You don’t have the slightest idea or have you probably ever read what I advocate but you certainly are good at pointing fingers and making accusations.

The only one making statements about “bragging” are you when you stated “[as he bragged].” A fact is not bragging; it’s a fact and my statement that my spouse was not a patient in a psych ward is a statement of fact. It seems you’re easily offended when you read something that makes you uncomfortable.

Or am I to take your statements as to your experiences or that of your child as “bragging” because you have familiarity with psych wards?

“4. Back to the main point here:” --- Stephany

What gives with you? Consider staying on point and quit with telling me what I am or am not.


“Herb, I drove a car on Seroquel. No doctor warned me I would have double-vision and slow response time. I learned on my own and told the doctor that Seroquel was a rx that I like to call driving: "LEGALLY BOMBED." --- Stephany


Well bravo for you. Are you bragging or what? Are you proud of being DUI so you can “brag” or blame the doctor if something happened by telling us what you did? Did you ever think of educating yourself before ingesting any drug like reading the literature first? Or are you too trying to illustrate a lack of sensibility to get a point across? It seems to me your action was as irresponsible as the young woman in the Phoenix Airport. Obviously and fortunately the results were not the same. Maybe we’ll also find out at a later date that you were on other medications that you could then also lay blame that it didn’t allow you to read or ask the physician about potential side-effects or one’s ability to drive or not drive under the influence of these medications.

“Herb, you DO appear to be a flamer. [and like it].You love the attention and provoking people into thought--but it's your way or no way.” --- Stephany

No Stephany, I’m not interested in gaining any attention other than the opportunity to speak my mind when appropriate or in opposition to some of the BS I read based upon my experiences and knowledge. The fact that I may disagree and possibly provoke some thought is no different than someone disagreeing with me and stimulating ideas or skepticism in my head. I guess I would have to thank CL PSYCH and The Last Psychiatrist amongst a few for stimulating my skepticism about a number of issues as opposed to what I consider unsubstantiated dogma and hearsay from others.

I welcome differences of opinion. What I don’t welcome and feel is totally out of place is yours and several others attempted derisive comments directed toward me as a person especially when you obviously do not have the slightest idea who or what I am but then again if I disclosed factual information I would be “bragging” as you seem to read things.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 14, 2007 09:51 PM

herb, how come you have no answer for my response to you and whit? do you only slam women? just curious.

Posted by: Philip Dawdy at November 14, 2007 10:17 PM

The summer of 1997, my woman friend was walking hand in hand with her husband along the wooded road behind my house.

Earlier in the day, my neighbor in my old neighborhood, a notorious drunk, and I say that to be blunt--women neighbors, and teachers all reported her 24/7 extreme alcholism and prior DUI/DWI record, as she drove her mini van with her little kids in it[drunk].

Her husband had connections to keep her out of jail for years. He was aware of his wife's serious danger to self and others via her drinking.

The weekend he left to go to Vegas, he knew who he was leaving without a doubt--in charge of his children.

The woman hit my friend with such a force, it ripped her hand from her husband's and she was hurled through the air 150 ft. landing face down, dead.

Dead.

The husband, though not her keeper, did know what he was dealing with, and that being said, I went to the trial, we all grieved, for all of the children who lost mothers--dead and jailed--

She died behind my house.

I'm writing this w/out even reading any other comment since I left the other.

I apologize for my rant to new readers, and regular readers. Clearly this story reaches far into the depth of my soul, more than I had realized.

Who the fuck would let their wife fly unattended to rehab across country? a fucking asshole, or a person who didn't give a shit, passive aggressive--woe is me when it's time to look good to others as a fake and concerned ass.

Posted by: Stephany at November 14, 2007 10:52 PM

Herb,

Fuck off.

Posted by: Stephany at November 14, 2007 10:53 PM

"If I recall correctly, I watched a news report that played a call to the police from the husband who in the call told the police that his wife was fragile and possibly sucidal. So the police in fact knew the women should have at least been supervised and or assessed. "

my understanding is that by the time they got the call, she was already dead.

as for the (imo) ridiculous comment ...

"What's relevant is that this slightly built white woman with three kids couldn't, in any reasonable mind, pose a danger to others"

first of all, race has nothing to do with it.

second of all, i have made personally hundreds of arrests. i don't treat "slightly built white women" differently from "buffed out black women", "ripped asian men" etc.

she was handcuffed because that's PROCEDURE. the idea that a "slightly built white woman" is not even remotely a threat (and thus shouldn't be handcuffed etc.) is absurd, contrary to most agencies policies, and arguably bigoted, and at least prejudicial.

i train in weightlifting with a 'slightly built' woman who can squat (butt to the ground) over 300 lbs (former olympian weightlifter) and clean and jerk close to double her bodyweight. cops are supposed to treat people with respect, but not make exceptions for 'slightly built women' of ANY race. i've arrested MANY drunk women and they can put up QUITE a struggle. try arresting a 110 lb woman who REALLY doesn't want to go to jail. it's not easy. and i'm a 210 lb competitive weightlifter with martial arts background.

this idea that the cops should look at this (deranged, and intoxicated) woman and ASSUME she is "clearly not a threat" goes against every realistic officer safety training theory.

she was (by all indications) treated fairly and respectfully. i am NOT a fan of shackling ANYBODY in a cell alone. that may be a policy issue with this PD.

what carol gotbaum did to herself is a tragedy. but i have yet to see any evidence the cops are to blame for any aspect of it.

and i see tons of posts about how this is some kind of fascist security state. look, thousands of times a week, people pull various tantrums in airports after missing flights, etc. the vast majority do not rise to the level where they need to be arrested (as any check of arrest records show), but some DO, and gotbaum apparently met that threshold.

people do not have to fear being pushed to the ground and arrested next time they go to the airport and say something rude to a ticket agent. cmon. get real. i've personally seen that happen dozens of times in my travels. this was clearly more than that.

by the way, my wife is a rather "slight woman" and also a competitive martial artist. if you were trying to arrest her and ASSUMED that as a "slight (whatever race) woman" that she was CLEARLY not a threat, and she wanted to knock you on your butt, she could.

equality means exactly that. we don't handcuff men and not women. we don't handcuff buff guys but not skinny guys. we don't handcuff one race and not the other. we don't make assessments that people are "clearly not" capable of harming us based on race, ethnicity, gender, sexual orientation or any other such claptrap. clearly, there are indicators that ELEVATE apprehension and threat assessment (bladed fighters stance, cauliflower ears (sign of a boxer or wrestler), etc.) but any cop that ASSUME somebody is clearly not capable of causing them harm because of the person's race, gender, or build DESERVES to get their butt kicked. and yes, i have seen that happen.

Posted by: whit at November 14, 2007 11:26 PM

thanks whit. yep the cops do have to arrest everyone in pretty much the same manner, depending on levels of resistance, etc. and yep some small women--regardless of race--can put up a heck of a fight. or so i hear! i just wish the phoenix pd--i'm not sure where people have gotten that this was tsa or the feds arresting her--had done a better job here. i mean where the heck was that cop who always calms down even the most unhinged people? you know the one i mean.
truth is i've reported on too many of these accidental deaths in holding cells stories over the years to not wonder why we can't do a better job. after all, we don't use chokeholds anymore. and so on.

anyhow, thanks. and thanks for your service.

Posted by: Philip Dawdy at November 14, 2007 11:46 PM

J00 noez (had to shift into 1337-5p33x for a moment there), I'm no stranger to flame wars. I cut my teeth on them in the early 1990s when the Internet was young, Usenet and email were how we communicated and MOSAIC was a tickle in the back of Marc Andreesen's head. In those days, you had to be smart and technically inclined to use the net, and those very smart and technically inclined people also had acerbic, cutting senses of humor. They would post thoughtful, measured responses to a discussion subject and when a troll got out of line, the resulting fallout wound up getting cross-posted to other newsgroups for decades just to keep a historical record of how awesomely baked a troll can get.

Herb, you're trolling. You're engaging in personal attacks (most recently suggesting someone is intoxicated).

So I'll dissect the few semi-valid semi-points you made and hand the tatters of your arguments back to you. I suggest you use the remaining shreds to make a hobo stick with a small meal tied up at the end of it and hit the road to parts elsewhere, because any arguments you make after this will have the weight of George Michael denying his homosexuality after being arrested by the Beverly Hills Police Department because he tried to fondle a cop's off-duty weapon.

So. Let's begin.

1. First and foremost, I have yet to find any information on which came first - the psych meds or the substance abuse issue. What we do know is that she was on two high-powered psych meds which in itself can cause potential interactions that her doctor(s) and pharmacist(s) should have let her know about as a requirement of their professions. What we also know is that she was heading to rehab, which suggests to even the most weak-minded dullard in a sea of stupidity that she had made some bad decisions which put her in a position in which she was more likely to make poor decisions which supported her abuse than good decisions which would get her the care that she needed. At that point, it is clear that she did not have the capacity to make a good decision such as breathing deeply and taking a later flight. It's clear because she was arrested for running around the airport with her shoes off in an agitated state, causing a public disturbance. When someone pulls a Whitney Houston, it can be generally accepted that they are not of sound mind and are therefore LESS responsible for their actions, provided they don't cause harm to another in the process. Not knowing the full history of interactions - and we may never know, but very few people go to rehab after only a few months so this was likely an issue that had been ongoing over the course of years, regardless of what gets publicized in the next weeks - we also do not know how long she was unable to make good decisions due to the substances - prescribed and imbibed - in her system. My point here is simple. Arguing that someone in that state should be held accountable for their decisions is dumb on its face because they really aren't capable of making a decision at that point. Their decisions are more accurately described as a series of lizard-brain impulses and reactions under stress which typically exist at the fight or flight level, and we saw both of those. So. Point 1, personal responsibility on her part, out the window. She wasn't capable of it by the time all this shit hit critical mass. If you need to experiment just to make sure, please be my guest - just don't drive during the couple of years of ruining your life that it will take.

2. Noting that you're a former DBSA support group facilitator sounds impressive. Please describe your clinical training, educational background, medical studies, relevant degrees and certificates and any other background information which indicates that, as a support group facilitator, you did more than find a room in a church basement, put a pot of coffee on, hand out a flier or two, turn on a video titled "Bipolar Disorder And You: The Workplace" which featured staged enactments of situations bipolar might find themselves in at work (or whatever videos were at your disposal) and ask who had something to share with the group this week. See, I just looked at the DBSA page and - purely on a lark - entertained the idea of starting a chapter since being able to click a link on a Web site clearly qualifies me to provide mental health services to the community. In the absence of any training of any kind, anyone who clicks on http://www.dbsalliance.org/site/PageServer?pagename=support_startsupport can have the EXACT SAME QUALIFICATIONS THAT YOU DO. Which is to say, at this point, pending your response, none. And I say that as an ordained minister in the Universal Life Church so clearly, as a member of the clergy, my opinion and words carry weight, particularly with respect to mental health.

3. It's wonderful to work with a positive attitude. Really, it's swell! And your suggestion of "making the effort to list what or how should be done to improve future police procedures. Even more importantly how about educating your readership and those patients and their support persons to have prevented this tragedy from happening in the first place and your suggestions as to how the individual should have properly and positively handled the situation"? Brilliant! I'm duly staggered by your analytical genius! Here's the problem. Gotbaum is dead. We can't prevent this tragedy from happening in the first place because SHE'S ALREADY DEAD. Just to make sure you're clear on current events here, because, at best, your syntax errors suggest that we can somehow fix this particular problem. Which we can't. Because, just to ensure you're up to speed, she's dead. Therefore, the only thing that can be done in the wake of this situation is a literal and procedural post-mortem to find out where systems broke down. Post-mortems are, by definition, not positive things. They are about figuring out what went wrong, why it went wrong and who is responsible for it going wrong. It is about disciplining people who fucked up to send a message to the others around them that fucking up can result in crazy-ass drunk white women dying in holding cells which leads to bad press, lawsuits and other bad things. Post-mortems are necessary in an organization because they are about accountability and making sure that everyone is aware that not following procedure leads to dead mothers in jail, and that is not a desirable outcome.

***I'll break this part out for Whit, who seems like a decent dude - if one who uses terse wording - to note that I mostly agree with your points. A crazy-ass drunk woman in an airport needs to sober up in a place where she can't hurt anyone else and hopefully can't harm herself either. No priors doesn't mean anything because plenty of first-time offenders out of their gourds on something have hospitalized or killed law enforcement officers, no matter how sad or regretful they may feel about it later, and a 110-lb. middle-aged white woman on angel dust is trouble no matter how you slice it. I feel bad that the cops are going to take this one on the chin, because while they might have been able to do something, I think they're being assigned FAR too much responsibility for this.***

4. Bashing. You read posts and news articles bashing drugs and treatments and it's all so terrible because these pharma companies marketing medications for all sorts of off-label treatments and making billions of dollars per quarter in the process really just have our best interests at heart. They really just want to help us, which is why atypical antipsychotics are being used off-label to treat bipolar disorder and depression in teenagers, not because these name-brand drugs increase the bottom line and make shareholders happy. That's why short clinical trials, suppressing data about effectiveness vs. placebos and especially sweeping black box information about - purely for example, kidney and liver dysfunction as well as high incidence rates of suicidal ideation, attempts and successes - harmful side effects under the rug is okay - they really just have our best interests at heart. And you're right. We should be more positive about a multi-billion dollar industry pushing Abilify to housewives because it obviously needs our support and good vibes. I'm glad you're aware of people that these treatments help, but pony up some numbers to support your anecdotal (at best) evidence because stating "when in fact I am also aware of patients benefiting from the same drugs and therapies and not being arrested for whatever reason nor similarly involved in these kinds of tragedies. Naturally if all the drugs and treatments that are bashed and banned there would be few if any therapies from which to choose and when we also add to the mix the bashing of Psychiatry, it’s institutions and its practitioners and now you’re bashing law enforcement, the individual, her family and friends, boy I do I think we’re off in the wrong direction" not only makes you sound like a PollyAnnic apologist for big pharma, it makes you sound like you're positioning yourself as a credible expert when you have failed to provide any evidence that supports that idea. In short, until you provide some level of information about your background and credibility beyond being a volunteer who has seen some treatments work in some people, any claim you make is suspect because anyone else can make a similar claim and also claim similar expertise, which really means that you have no more useful or credible information or experience in this field than the guy who jerks the shots for my morning espresso and observes that caffeine tends to life people's spirits. And again, I say this as an ordained minister in the Universal Life Church, so my position in the clergy clearly shows that I have expertise in this field.

5. After those points, you resorted to ad hominem attacks (generally an indication in debate that you got your ass kicked and now have nothing to stand on but calling the other person a goat-fucker to try to win your point) and your reasoning - which was already pretty shoddy - went to shit. Sure, Stephany drove on Seroquel. What I'm reasonably sure she omitted in her concise and appropriate response to you is that she probably didn't notice the effects until she was already driving and didn't repeat the mistake. However, where I disagree with Stephany is the idea that you provoke thought. You don't. I'm responding to your posts not because they inspired thought, but to out you as the unqualified, inexperienced, untrained and clueless troll that you have revealed yourself to be so that people don't get sucked in by your vague assertions of expertise and experience in the field and buy your bargain-basement line of subpar bullshit. I can say this because you didn't start off by informing us that you were, for example, a fellow research psychopharmacology at Johns Hopkins. You started by letting us know that you're a volunteer facilitor for a support group which lets people start chapters over the Internet and the only advantage that gives you over a cat in being able to diagnose or treat mental illness is opposable thumbs (the cat, being cute and furry, likely still has the overall edge).

I'm not a dogmatic person. I don't buy the party line or take rumors as gospel. Having known Philip for the best part of two decades now, I'm sure he'd be extolling the virtues of a medicine that wasn't toxic enough to shut down internal organs, induce suicidal thinking, cause extreme weight gain, sedate people to the point of being extras in Romero films and so on and so forth. However, clinical trials and medical evidence being gathered as these medications are in widespread use indicates that they are that toxic, that they do have those effects, and that at least some of these meds will wind up costing Big Pharma more than it made off them in massive judgments that will likely make the COX-2 inhibitor settlements look like milk money.

Are my comments derisive? Bet your ass. Just in case you had any doubts remaining. So brag away, dude. Explain to us exactly why any of us should listen to someone who displays no ability to perceive FACTS (i.e. the mounting medical evidence mentioned above which, at the moment and as purely one example, indicates that Cymbalta impedes and can in fact permanently harm liver function) that are in front of them, regardless of any academic or clinical background you may have. You are correct in that I don't have the slightest idea who you are, but you would also be correct in assuming that - based on your comments, I could really give a shit because you've provided no reason to think of you as source of reliable information or opposing viewpoints, but have in fact given most people here a reason to think of you as some who speaks in broad platitudes that are completely disconnected from the reality of the psych world.

In short, Herb, it's put up or fuck off time. Either brag about your qualifications - and rest assured, I'll likely hunt those down and verify them so unless you're prepared to be embarrassed, don't lie - or shut the fuck up already because while farts may be jazz to assholes, the shit you're spewing just smells like a self-important little man who wants to be seen as someone significant and noteworthy and might as well achieve it on the Internet since that level of recognition is so elusive for a volunteer support group facilitator in real life.

Posted by: Puckett at November 15, 2007 01:43 AM

on the note of thanking police for service; i will also say thanks to-- so far 3 separate cities--that have cops that watch for my daughter, and have treated her with respect&dignity, as well as myself--they kept me calm while she was missing, and remained calm while i sat in the back of the police car looking for her. they wasted no time looking for her too.

for which i will be forever grateful.

Posted by: Stephany at November 15, 2007 01:52 AM

Dear Philip,

“herb and whit, while i appreciate your views intellectually, i think the whole personal responsibility trip--which i agree with in some instances--can be taken too far, as you have here. consider an analogy a cop once put to me about these sorts of cases: a harried driver makes an illegal left against the light, ends up in a crash, stuck in the car etc. do the cops and firefighters who respond say 'ah fuck this guy, he made an illegal left, let him cut himself out of the car and drive himself to the hospital'? or do they get the guy out of the car and save his life and worry about the other bs later? i think you know the answer.

and i think you guys would have no problem applying it to the case of this women if she hadn't been drunk. or a woman.” --- Philip Dawdy

"herb, how come you have no answer for my response to you and whit? do you only slam women? just curious." --- Philip Dawdy

Sorry, but I didn’t know a response to your first post quoted above was necessary but in response to the quote I tend to agree with Whit’s explanation to this board as to the responsibilities of a law enforcement officer that is until the ordained minister Puckett researches and attacks Whit’s credentials.

As to an additional response I’ll answer you in the following manner. In the 44 years that I’ve been married I’ve attended almost all meetings with my spouse’s physicians, therapies and hospitalizations knowing the nature of her illness.

Lastly, I’ve disagreed with you on several of your opinions. Is Philip a male or female? Should Philip be a female then yes I’ve had differences of opinion with a number of your female readership which may or may not also include Puckett. “Slam” is your word; differences of opinion are my word. I shared my experiences and knowledge and opinions in response to postings and in turn I’ve been greeted with being called delusional, controlling, told to f’off etc, etc and having an “Ordained Minister?” speak his/her kind words and rather than instilling calm, peace and tranquility, I wonder about the value of his/her contributions too and would that be considered “slam” Herb?


Dear Minister Puckett,

“And I say that as an ordained minister in the Universal Life Church so clearly, as a member of the clergy, my opinion and words carry weight, particularly with respect to mental health.” --- Puckett

And so too does the words and opinions of the President of the United States “carry weight” and as thinking individual that I am I won’t discuss my strong disagreement with him on many issues but that’s a subject for a different time and place.

What you can’t see at the moment of my reading your commentary is my pointer finger pointing skyward swirling in circles above my head.

Were Jim Jones, Jim Baker, Jimmy Swaggart, Jerry Falwell, both the Robert’s and the other boys and gals currently under investigation “ordained ministers” too?

Why is it your commentary and the fact you’re an “ordained minister” or “[as he bragged]” suddenly remind me of reading that religion and gods have accounted for more deaths than all the wars combined?

Minister, I’m happy you’ve got all the facts down pat from your reading or viewing the news media. Its does my soul good to know your truth comes by way of a number of reporters. I’ll wait to read if there is a trial and then I’d prefer to read the minutes from the proceedings before I’ll determine the truth. Until then…

“Jesus fucking Christ on the cross, people are goddamned morons.” --- Puckett

Does that statement exclude you because you’re an “Ordained Minister?”

Oh by the way, my formal training as a support group facilitator was under the tutor ledge of a young woman who was both a registered nurse and an attorney with emphasis placed upon moderation and conciliation.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 15, 2007 05:47 AM

Oh, least I forget in any of my commentary as I read these postings of fingers being pointed that maybe, just maybe her husband was a real good guy because he was not “controlling” as has been stated about me.

There is one important fact to be cited to those who “slam” and attack me and made these statements about my efforts and concerns for my spouse's wellness…my spouse is still alive, depression free despite many numerous challenges and having a reasonable quality of life.

She is also not an alcoholic or drug addict to boot.

As always I wish you all wellness.

Warmly,
Herb
VNSdepression.com


Posted by: herb at November 15, 2007 06:14 AM

Puckett,

Thank you for clarifying what I did in fact leave out re: Seroquel use; was finding out without doctor warning, how Seroquel caused me to feel,while driving, and promptly and quite painfully did a fast cold turkey withdrawal of that med.

The side effects were not acceptable, and one of them was needing to be in control to drive a car, think and function.

Posted by: Stephany at November 15, 2007 08:48 AM

"thanks whit. yep the cops do have to arrest everyone in pretty much the same manner, depending on levels of resistance, etc. and yep some small women--regardless of race--can put up a heck of a fight. or so i hear! i just wish the phoenix pd--i'm not sure where people have gotten that this was tsa or the feds arresting her--had done a better job here. "

thanx.

"i mean where the heck was that cop who always calms down even the most unhinged people? you know the one i mean."

sure. Bumper Morgan (see: Wambaugh) :)

seriously, there may have been such a situation. was there a cop who sat down and talked to her and tried to figure out the problem? could be. do any of us KNOW whether or not this happened?

i don't.

i certainly would. but then i have a background in psychology and im always interested in the "why" as much as the "what" when people act all whack.

the problem (as is so often the case) is that whenever there is an information vacuum, that people naturally fill in stuff based on their preconceptions, biases, assumptions, past experiences etc. step in to fill that void.


Posted by: whit at November 15, 2007 09:37 AM

Dear Whit,

I just wanted to pass along, based upon your writings, that in my opinion you are credit to your profession and more importantly a concerned and caring fellow human being with a different and another interesting perspective.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 15, 2007 10:30 AM

Not trying to flog a dead horse here but regarding the issue of responsibility, personally I do not really blame Carol, her husband, her friends or the TSA (and I'm pretty sure it was airport security that locked her up, not the Phoenix police). Sure hindsight is twenty twenty and maybe her husband was a bit naive to send her off to rehab by herself, but she did change her flight from a non-stop to Tucson to a layover in Phoenix at the very last minute because she wanted to accompany her kids to school. I know all too well the inertia and denial that sets in when a beloved is addicted or in emotional trouble. You want so very much for them to help themselves and not be treated like babies as they seek help. I'm sure a lot of rationalizing was going on about a layover not making much of a difference if there was even time to think about it. Not sure what they were thinking when they lined up a friend to meet her at the airport since Carol was on one side of security and he would have been on the other. We do not really know how much Carol was drinking even though her blood level was sky high because of the confounding effects of the medication. The bartender at the airport was quoted as saying she'd only had one drink. How many drinks could she have had on the transcontinental flight? I guess one too many that's for sure. But it was also reported in the media that she had only started drinking impulsively and excessively in the last two and a half years (maybe since she started being treated for postpartum depression with antidepressants which can induce a craving for alcohol -- called dipsomania?) I know her husband has said that it was the third kid that pushed her over the edge. The point is she was being "treated"; she was under the care of probably some pretty highly paid docs in a fancy neighborhood of NYC. She was listening to them and taking her meds, all six of them, probably according to directions. How was she or anyone else close to her supposed to know that far from being healing and helpful, these drugs were poisoning her and making her very sick? That's not something that's even on the radar screen in this situation. So how can you defend against it? Yeah, I think the blame falls on something much bigger than the individuals involved in this particular case. Maybe it even falls on all of us here who have allowed this sort of thing to come to pass by being complicit. Even the docs and the drug manufacturers don't "get it". They're being fed a story about illness and treatment that works for them and that their patients apparently want -- why should they question it? All I can say is when drugs are being consumed as a healing agent when in fact they are toxic, bad things happen, really bad things. And it's going to take a sea change in our society to make it stop.

Posted by: Sara at November 15, 2007 11:23 AM

Dear Herb,

1. Buy a dictionary.
2. Look up sarcasm.
3. GTFO.

Since your body of knowledge is limited to your personal experience with your wife (which is a questionable use of the word knowledge, at best) and your training is limited to some vague amount of "tutor ledge [from] a young woman who was both a registered nurse and an attorney with emphasis placed upon moderation and conciliation," I will state, for the record, that the process you went through to become a facilitator sounds as rigorous and exhausting as my ordination.

As for your tutor, while law school takes three years and becoming an RN also takes training and education, neither of those claims, on their face, indicates that she was qualified to train, tutor or mentor people in facilitating mental health support group sessions. In fact, her background provides exactly as much support for your credibility as my assertion that Philip, having formal training in journalism and accounting, mentored me as a guitar player (really, he did - he and I met up at Guitar Center, he told me he'd kick my ass if I bought anything other than a Fender or Gibson and I don't think we've talked about it since) would have if I were posting on a guitar forum about music theory. Philip is clearly qualified in some areas - NONE of which have anything to do with providing formal mentoring services to me as a guitarist (although he is a hell of a guitarist). In the absence of knowing your tutor's legal specialization and what focus her RN training had (which may or may not have included ANY mental health issues), the "tutor ledge" she provided you may have been equally as irrelevant. Furthermore, regardless of her "tutor ledge," her qualifications do not confer any expertise upon you (but don't let my poor guitar playing reflect upon Philip - he just made sure I didn't start off with a Jackson; nothing that has happened since is his fault).

Now, if you had said, for example, that you took a three-month long seminar in support group facilitation which met for three hours twice per week and involved clinical research, mentoring, some form of student facilitation akin to student teaching in the teaching profession, weekly one-on-one meetings and instruction from an LCSW over the course of a year - any sort of rigorous process which involved actual training under the careful supervision of a state-licensed, qualified mental health professional - then your claims would have some weight and some form of merit.

As it is, your claims have exactly the same weight as any other untrained, uncertified non-professional with questionable qualifications, which just speaks to my original point that you have yet to demonstrate ANY particular expertise in the field which required you to do ANYTHING more than "find a room in a church basement, put a pot of coffee on, hand out a flier or two, turn on a video titled "Bipolar Disorder And You: The Workplace" which featured staged enactments of situations bipolar might find themselves in at work (or whatever videos were at your disposal) and ask who had something to share with the group this week."

Herb, you seem perfectly willing to challenge people's authority, background and positions, but the second someone pushes back, your points fall apart in a morass of irrelevant argumentation, ad hominem attacks, logical fallacies and insinuations which have nothing to do with the subject. Great job, twinkletoes.

You failed to respond in any significant way to any of my points. You tried to shift the focus from you and your lack of qualifications to me and completely failed to address anything else I brought up, so I'll just keep pointing out that your comments have no professional, medical or clinical merit, that you have no real qualifications to speak of, and that your words lack any sort of authority that could be conferred through any sort of state licensing or scholastic merit.

The reason I'm doing this is to make sure that no one gets confused and starts to think that you have a clue. I'm taking your arguments apart to show anyone willing to take the time to read a post or two that you are, in fact, clueless.

And I'm qualified to do this because, like Philip, I was a journalist, I've spent over a decade in management consulting and I'm heading to law school. My life experience, education, formal training, professional experience and personal interests have all revolved around what I used to think was the single focus of asking difficult questions that people don't want to answer (and which may still be true) but may instead be ensuring that the truth comes out.

Oh, one more thing - I don't need to wait for trial documents to know that the husband should have gone with his wife to make sure she got to the clinic without incident once it was decided that she'd go to rehab across the country. That's one of the things a spouse is supposed to do to support their partner. Hell, even you managed to make it to your wife's doctor's appointment(s).

Posted by: Puckett at November 15, 2007 12:46 PM

Hi there ordained minister Puckett,

I have no need to buy another dictionary as you being the skillful journalist I’m getting a first hand education into sarcasm so I’ve have no need to look it up.

Sorry but your advanced journalistic skills eluded me with the acronym “GTFO.” I guess it took years of education on your part to acquire this knowledge.

My finger is still pointed skyward and twirling in circles above my head with another of your diatribes and as you relate:

“And I'm qualified to do this because, like Philip, I was a journalist, I've spent over a decade in management consulting and I'm heading to law school.” --- Puckett

And the question in my mind isn’t you good at any of these endeavors? At least have some class and try not to associate your journalism along side Philip’s. I already think little of your ministry skills or apparent poor education in that endeavor so what now leads me to believe you’re qualified under any of these hats. Management consulting now I’ve heard of that profession often referred to as unemployed. Law school…hmmm…what an interesting choice based upon your writings as I read them.


“Herb, you seem perfectly willing to challenge people's authority, background and positions, but the second someone pushes back, your points fall apart in a morass of irrelevant argumentation, ad hominem attacks, logical fallacies and insinuations which have nothing to do with the subject.” --- Puckett


You’d have to say I learn quickly. I’m learning from you. But with your apparent light weight abilities and personal affronts I don’t think you can rattle a piece of paper on a windy day. You might even occasionally divert your attention once and awhile to the discussion of mental health and its related issues or even the topic at hand.

“I used to think was the single focus of asking difficult questions that people don't want to answer (and which may still be true) but may instead be ensuring that the truth comes out.” --- Puckett

Another good one…was that your truth, someone else’s truth or the truth?

“Oh, one more thing - I don't need to wait for trial documents to know that the husband should have gone with his wife to make sure she got to the clinic without incident once it was decided that she'd go to rehab across the country.” --- Puckett

Personally, I don’t think you know sheeeeeit from shinola and I’ll also opine based upon your above statement, without facts and rushing to judgment, you may have difficulty getting through law school.

I’ll leave you with another one for you to mull over while practicing your “argumentum ad hominem” journalistic talents and preparing for law school. I also hold or held a state appointment as a Guardian Advocate.

Warmly,
Herb
VNSdepression.com

Posted by: herb at November 15, 2007 02:55 PM

Dear Herb,

1. Hold or held? Which is it? You are either currently a GA or you were a GA. It cannot be both.

2. Again, sounds impressive. However, being appointed a GA requires very little but declaring someone non compos mentis, having a lawyer and, generally speaking, being a blood relative or spouse. Again, not valid as experience in providing mental health services because it doesn't require training, education, a clinical background or anything else that indicates you have any more knowledge or insight in a field than any random person on the street. No mulling necessary. Next.

3. Strunk & White's Elements Of Style. Please read it because while it may not improve your arguments, it will certainly improve your grammar.

4. You might wish to research the Universal Life Church. It is a highly respected church with a long history of ordaining eminently qualified people to administer the faith and rigorously training them. Learning more about the Church would enable you to more effectively critique my positions instead of floundering about in the murky, tepid waters of half-assed insults that really aren't that insulting.

5. I am focused on the issue of mental health. At the moment, I'm focusing on your claims of expertise in the field which you use to support your arguments. None of those claims of expertise have held up under even the slightest scrutiny, so I'm continuing to hold a really bright light over them as you try to draw attention away from how poorly your background in the field has held up.

6. GTFO (from http://www.urbandictionary.com/define.php?term=gtfo):
GET THE FUCK OUT

An easy to use acronym when dealing with moronic incompetents in the online world.

Use when not particularly interested in thinking up a some new glib witticism.

7. I wish img src was enabled right now. I wish, I wish, I wish.

Posted by: Puckett at November 15, 2007 04:14 PM

Here’s another journalists perspective on the Gotbaum incident…

Gotbaums got hatred, are owed thanks

http://www.azcentral.com/arizonarepublic/news/articles/1115montini1115.html

Warmly,
Herb
VNSdepression.com


Posted by: herb at November 16, 2007 04:53 AM

Much nonsense has been opined here. No one has all of the facts regarding this woman's prior medical history or details of the post-mortem exam and exactly what happened. What is certain is that she should not have died. Her blood alcohol concentration (BAC)is not what is important - it is probably no grater than most people achieve on a Sat. night of partying.

It is reported that she was prescibed Celexa and other psychoactive drugs. It is well known that SSRI drugs may induce alocohol abuse.

sara makes good comments - Herb you should take a break and sit back and listen - you might perhaps learn something.

neil

Posted by: neil at November 16, 2007 06:32 PM

I heard Puckett was serving warm herb-roasted ass on a platter today. Let's not forget to say grace.

Posted by: thememoryartist at November 17, 2007 12:38 PM

GRACE!

Posted by: Stephany at November 17, 2007 03:59 PM

I think it's pretty clear that the police in this instance could have done a lot more to help this woman. As most of you know, we're dealing with our own tragedy in Vancouver where a disoriented and frightened immigrant was tazered to death at the airport by our boys in blue. I've been in plenty of altercations throughout my life but the only people who have ever physically assaulted have been wearing their uniforms and "just doing their jobs." These incidents are shameful.

Posted by: Francesca Allan at November 17, 2007 04:43 PM

GRACE!
and Amen.

Posted by: thememoryartist at November 17, 2007 05:59 PM

You little ladies leave Herb alone. He's a warm-hearted advocate for you mentally ill people.

Posted by: iamthebrain at November 17, 2007 06:35 PM
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