March is Brain Awareness month: Someone tell the legal and health systems.

Brain awareness

March in Brain Awareness Month, but this didn’t stop the March 2015 execution of Cecil Clayton, who became violent after the loss of 20% of his frontal lobe after an accident in 1974.

His personality changed immediately, and Clayton became depressed, violent, and paranoid. He sought medical care, but he was not helped, and his downward trajectory continued, culminating in the murder of a sheriff’s deputy in 1996. It was this delay of 20+ years between injury and murder that convinced a jury that brain injury could not explain his actions and could not protect him against a guilty verdict and execution.

The law lags far behind the understanding scientists have of the brain.

At the “Neuroscience and the Law” session at the 2012 AAAS meeting in Vancouver, with a panel and an audience of lawyers, scientists, and other civilians, the differences among the panel and audience became clear to me.

The non-scientists could not really conceive of a brain’s decision based entirely on neurons and other cells, somehow still seeing a black box of individualism, morality, and character that was separate from the rest of the brain and did not follow the same rules. The vestige of religion, and the belief that mankind is more than animal are challenged by the reality of how brains work.

Neurobiological evidence is being considered at sentencing, but the entire legal system would have to change to encompass the biology of behavior and crime. It would become clear that poverty or abuse or injury does not merely make one crabby, but changes the brain in a fundamental way. The system would have to redefine culpability and free will- and admit that there is no equality in the ways different people live and in the ways they think.

And then, there is war and the effect of traumatic brain injuries (TBI) and Post Traumatic Stress Disorder (PTSD). Neither is understood by the public, and the military minimizes the effect of TBI and PTSD on its people perhaps to maintain machismo, or prevent people from realizing another huge cost of war. There is no cure for PTSD, and the Army determined that each young vet with PTSD would cost about 1.5 million dollars over a lifetime. The response to this at Madigan Army Medical Center? 40 % of the PTSD diagnosis were reversed by Madigan health care workers after orders from above.

Ivan Lopez killed 3 other soldiers and wounded 12 at Fort Hood in 2014 . Even though he had been in a convey that was blasted by a roadside bomb in Iraq and said he suffered a TBI, the military said in an investigation that there was no proof  that or the PTSD that he was being evaluated for, or the anxiety and depression he was being treated for  had any part in the shooting.

One “success” (success in that knowledge is leading to change in policies) story in brain injury prevention has been the realization of the harm that repeated concussions cause in football players.

Over the past few years, increasing knowledge and awareness of chronic traumatic encephalopathy (CTE) resulting from head injury has involved dozens of football players and multiple scientific teams, and many football players have donated their brains for research: 76 out of 79 brains donated by former National Football League (NFL) players have shown evidence of CTE. Within a year, 3 former football players who showed symptoms of CTE, killed themselves by shooting themselves in the chest rather than the head so research on their brains could save future players. This astounding and generous act i.

Machismo perhaps prevented earlier impact of brain research- as did the monetary interests of team owners. But once football players themselves starting going public with their stories and scientists with their research, awareness of CTE is now is changing regulations in high school and collegiate football as well as in the professional leagues.

In March 2015, San Francisco 49ers linebacker Chris Borland, age 24, became the most prominent football player to retire because of worry about CTE. Although he has no symptoms, Borland consulted with scientists, players, and family, and decided to be proactive and leave his lucrative career and save his life. His action, with the donations and activism of other players, will undoubtedly save more lives.

Talk about brains.

May 2015 update:

Awareness of the seriousness of concussions has spread, and other college athletes- including elite women soccer players– are stopping the game. Many of these students are speaking openly about the many months of recovery, and  huge effect on memory, focus, and emotional stability, that even one concussion can have.

 

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