The fine art of being present: A Chaplain’s call for the spiritual connection with front line cops

Sometimes being present in the moment is enough to allow feelings of vulnerability to emerge and for healing to begin. Cops, and I dare say fire fighters, are not used to being vulnerable. Often less is more when is comes to shared space, personal pain and having a connection with one or more people who understand. A quiet moment of reflection after a difficult call may be enough to diffuse the experience of trauma and provide damage control going forward. Career hardiness and satisfaction requires that some moments be recognized with a circle of shared vulnerability and authentic empathy that can be just a few seconds to minutes.

Police Chaplaincy since 1800’s

During the coronavirus after a particularly deadly shift, members of ICU teams took a moment to share the names of those who had died in their care. These were somber events that acknowledged the losses and a measure of desolation shared among team members. People undergoing enormously stressful events can unburden themselves only if they acknowledge their inner feeling state. “We’ve seen chaplains accompany COVID patients in their last moments when loved ones could not be present. The year 2020 inflicted deep wounds on many in our communities and chaplains were there offering support,” said Wendy Cadge, the project’s principal investigator and Senior Associate Dean of Strategic Initiatives at Brandeis University

“When we can feel and acknowledge our deepest fear – it can be liberating and reduce the perceived stigma of being vulnerable and in pain.”

Elissa Epel, Ph.D., UCSF, as quoted in NY Times

Police, fire, and first responder agencies across America have called upon the chaplaincy when their membership has experienced an out-of-the ordinary exposure to trauma like fatal car crash, death by suicide, death of a member, school or mass shooting, and more. Some of these are more routine like a notification of the sudden death of a family member. Meanwhile, other incidents leave a searing imprint of the entire event like the shooting of over 20 Sandy Hook elementary school students in Newtown, CT. It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. In the case of Sandy Hook how can any member of law enforcement or EMS ever forget that day? But what can be done?

Police chaplains is one part of the solution. The Chaplaincy Innovation Lab received two grants totaling $750,000 from the Henry Luce Foundation in the second half of 2020 to continue building and supporting resilience in chaplains and other spiritual care providers across the country. Chaplains often find themselves on the front line and frequently encounter operational chaos when they are called upon to minister to the troops. Yet that rarely stops them. They were there at Sandy Hook in 2012. The new program at Brandeis University in Boston aims to train chaplains to be better equipped for things like Sandy Hook or any community event that impacts large groups of people.

In Boston, the call went out that a firefighter was down. This during a 2-alarm fire in Watertown, MA. The department chaplain Father Matthew Conley was needed “now” at the Mount Auburn Hospital in Cambridge, MA for the Anointing of the Sick – known to many as “the last rites.” Fr. Matt had not been on scene during the incident as it appeared to be a routine call. But like so many calls it went south in a hurry.

Firefighter Joseph Toscano was near death from a medical emergency suffered while on duty fighting the fire. It was a hot summer day. He was 54-years old and had a large family of a wife and 5 children. The family were all members of the Catholic faith at a parish a short distance from Watertown. For many Catholics, the anointing of the sick is something to bring about reconciliation for someone who may wish to ease their suffering on the journey toward death.

Firefighter Toscano died that day while doing the job he was trained to do. The Last Rites involve prayers and the final Holy Communion known as the Viaticum. These were something Fr. Conley had done many times before. But when he arrived at the Mt. Auburn Hospital that morning he was met by a phalanx of Watertown police and fire fighters. As he walked into the emergency department of the large Cambridge, MA hospital he knew right away by the look in their eyes that this was no ordinary blessing. He was called to minister, first, to the dying public servant, his wife and children who had been brought to his bedside at the trauma center. But what’s more, he was tasked with consoling the entire brotherhood who looked to him for comfort and hope when no amount of prayer could bring back their fallen brother. But he listened, and he heard their pain, and validated their experience.

“You are here for all of them”, he would say, “and I am here for you.” Fr. Matt Conley sharing the words of former Parish Administrator Fr. Kevin Sepe at Watertown Collaborative.

The story is told that as Fr. Conley dealt with the enormity of the pain felt by all who felt the sudden loss of the career firefighter, when in-walked Fr. Kevin Sepe, the Watertown Collaborative priest administrator. The presence of Father Conley brought a strong empathic presence to the family who had lost their husband and father and to the first line firefighters who felt the loss deeply. Fr. Matt listened and he offered prayers.

From his years as a priest and police chaplain, Fr. Sepe understood what Fr. Conley was facing in the call to the hospital crisis as the department chaplain. His support was largely nonverbal that day. “You are here for them,” he would say, “and I am here for you,” bringing his presence, peer support, and understanding of the enormity the ministry at hand.

“Police chaplains aren’t there to push a religion on police officers; their role is primarily to listen and offer emotional and spiritual support” from an article in Police One, 2015. The chaplain program has been around for over 200 years and often works in the background subliminally. The military has utilized multi-denominational chaplains to minister the troops as well. These men and women are on the front lines and 3 members of the clergy have paid the ultimate price for their calling during recent wars.

Chicago Police Chaplain Father Dan Brandt

Not everyone is religious and you might believe that a goal of a department chaplain is to advocate one denomination over another. Not the case at all. The chaplain may be a Catholic priest as in the illustrated case or he or she may be an ordained Protestant minister, Muslim Imam, or a Jewish rabbi or some other ordained member of the clergy. As a police officer, I worked with a female protestant chaplain who was very helpful with members of our community. I would not have hesitated speaking with her in confidence if I were in need. The role of the chaplain is to provide support and to listen. She was good at it too. Being present with someone who is in crisis or dying can be among the most gut wrenching of all human experience. Fr. Conley once told me he never goes anywhere without the Sacramental oils for the blessing of the sick. This allows him to be ready to offer the Sacrament should he be called to do so. He felt deeply that this anointing was his duty and one of seven sacraments priests are prepared to offer.

I have given death notifications before and have witnessed the soul wrenching-anguish experienced by those receiving these notifications. It is a horrible experience and I remember most all of these events and am still bothered by several.

For line of duty deaths, chaplain’s ask if prayer might be helpful. The sacrament of the sick is one “of strengthening, peace, and courage to overcome the difficulties that go with the condition of serious illness or the frailty of old age provided by the Catholic Priest. This grace is a gift of the Holy Spirit, who renews trust and faith in God against the temptation of discouragement and anguish in the face of death” according to Michelle Arnold published in Catholic Answers in 2017.

The key to a successful departmental chaplaincy is contact — if you have enough chaplains strategically placed who are artful in “reaching out and touching someone,” two things will happen. Successful interactions will take place and the word will get around. Once calls for a chaplain begin to come directly to a chaplain from the on-scene sergeant or deputy, the chaplaincy has made its mark.  Chaplains can best serve when their role is defined and the confidentiality of their relationship to law enforcement is understood. Police One, 2015

The chaplaincy has been around for centuries in public service. It is making entry into many law enforcement agencies in earnest. Many have had chaplains riding in cruisers for decades like Fr. Dan Brandt in Chicago and his fine crew of law enforcement trained chaplains of all denominations. At some times, this has raised the issue of mixing government with religion. But there are guidelines in place. “In Lemon v. Kurtzman, the justices established the three-pronged “Lemon Test,” which, as it translates to the chaplain’s position, says he must have a secular purpose, must not excessively entangle the government with religion, and neither proselytize nor inhibit religion” said reporter Jon O’Connell in a 2017 report. The police and fire department chaplain is there for support of first responders, not as an evangelist, but as moral reminder of the “sacred nature” of their work, according to Fr. Dan Brandt, the director of the Chicago Police Ministry. In Watertown and now Scituate, Massachusetts, Fr. Matthew Conley brings forth his presence with kindness, reverence, and often good humor making the human connection with those in his purview.

Brandeis Now. Chaplaincy Innovation Lab at Brandeis University receives $750,000 from Henry Luce Foundation. January 23, 2021

O’Connell, J. (2017) Police chaplains take a stronger role in community policing. Scranton Times-Tribune. News article.

McDermott, M and  Cowan, J. Combating Pandemic Fatigue. Quoted in NY Times. October 2020.

Job, call volume, and the bodies reactions – Things you can do for the new year

The reality of what LEO’s face is the raw, chaotic, and lack of civility most humans never witness.  Over time, this can trigger a loss of purpose in life that grows from the unmitigated stench of a decomposing society. For example, when a LEO enters into a lawful arrest encounter for domestic violence and has that case released from custody and dismissed over and over, there comes a sense of learned helplessness and the question of “what purpose am I serving” ? This scenario plays out nightly and the response of judges and prosecutors during the daytime raises the spector of whose side are you on? I have posted blogs about the process of field training following academy graduation. Probationary police officers tend to be idealistic about putting into practice what they learned in their training. One job of the field training officer is to temper idealism with reality. The highs and lows of personal efficacy delivery a visceral response to the body with each call for service.  When you kick into high gear, the blood flows to your arms and legs and it flows away from your digestive track, and so it messes up with your digestion, your body’s not healing itself,” said Englert of high-intensity police work. “You’re not feeling rested. It really does potentially take years off a person’s life.”

Stress effects all aspects of how we feel. “Meditating, according to Dr. Woolery-Lloyd, initiates “the relaxation response,” which activates the body’s parasympathetic nervous system and decreases cortisol and inflammation.” This taken from a story written by Jessica Defino about the impact of stress on human skin in NY Times on 12/08/2020. The point being that the stress response is pervasive in human well-being and physical health including the integumentary system – our skin.

Dr. David Robert Englert, the staff psychologist for CMPD will begin helping recruits on the second day of the police academy. He said it’s about opening the door for tough conversations, so the officers will know it’s okay to ask for help anytime in their career.

“It unleashed a lot of emotion for me and sent me spiraling down a really, really dark place. Every day I relived that experience over and over again, and I became so reclusive and I just internalized everything,” he said of his emotional reaction.

“Why don’t we come up with a program in which we try to make people more resilient before bad things happen?” asked Dr. Englert. “Bad things are going to happen. When they do, the person, the individual, and their family will be more resilient, more able to recover quickly from that event.” said Alexa Liacko ABC News interview. It is in being vulnerable that we are able to stretch our emotional experience that brings forth growth and reduces stigma.

The Psychological Impact of Pandemic: The best and worst of human behavior

On November 11, 2020, I presented a program on the Psychological Impact of Pandemic sponsored by Whittier Rehabilitation Hospital.  It was well attended with a mix of nurses, midlevel practitioners, social workers, and nonclinical participants. The program was presented on the zoom platform. I am now going to put to paper my perspective narrative espoused in my 90 minute presentation.  I had also invited members of law enforcement with whom I have regular contact as the information was drawn from the growing literature on mental resilience and its positive impact on coping with exposure to trauma.

ca-times.brightspotcdn

According to the PEW Research Group, 4 in 10 Americans know someone who has either been afflicted with Coronavirus or someone who has died from the virus. My mother was infected with the Coronavirus in mid April in the same nursing facility where I lost my 93-year old aunt in the first wave of the virus in May, 2020. My mother survived the virus but it has taken a significant toll on her physical and cognitive well-being. We were not permitted to see my mother during her illness and my aunt was alone on May 1 when she succumbed to the virus. Both living on a nursing unit that was doing its best to render compassionate care under extraordinary conditions, in some cases with nurses, aides, and therapists working round the clock. Both of these loved ones received extraordinary care. Nursing units across the country suffered unimaginable loss of life including over 70 elderly veterans at the Soldier’s Home in Holyoke, Massachusetts.  We all saw the images of refrigerated trucks holding victims in expiated purgatory hidden behind hospitals. It may bring horror to those who lost loved ones and never saw them again.

I saw my mother on November 12. She looked frail and disheveled.  The nurse practitioner had ordered a blood draw out of concern for her physical well-being. She is 92 and may have a blood disorder. They had three staff people hold her in place to obtain the small sample of blood which took over and hour.  She has always had difficulty having her blood drawn and this has gotten worse as she has gotten older. She fought and screamed from pain, and fear, I was told. It was torture for all those involved, including me.

Little did anyone realize the extent of disease, contagion, and trauma this pandemic would bring to the United States and the world. We waited in February and March with curiosity and vague forewarning from our leadership. We were led to believe the virus would dissipate once the weather became warm and it would essentially vanish in the heat of summer. This did not happen and public health officials at CDC and WHO were spot-on in terms of the contagious spread of covid-19 and the deaths it would bring.  Now with the approach of winter our fear borders on panic.

This virus poses significant stress and emotional challenges to us all. It raises the specter of both an overwhelmed medical system as well as increasing co-occurring emotional crisis and a collapse in adaptive coping, for many. Sales of alcohol went up 55 percent in the week of March 21 and were up over 400 percent for alcohol delivery services. Americans were in lock-down and many made poor choices. The link between stress and physical health and well-being is well documented and will be a factor as American’s find their way free from the grip of Covid-19. 

“The human mind is automatically attracted to the worst possible case, often very inaccurately in what is called learned helplessness”

Martin Seligman

Whenever human beings are under stress they are going to utilize skills they have learned from other times when they felt under threat. Chronic stress has been shown to have negative effects on health including autoimmune functions, hypertension, inflammatory conditions like IBS, and pain syndromes. Many find it impossible to think about anything but the worst case scenario. Marty Seligman described the concept of “catastrophizing” that is an evolutionarily adaptive frame of mind, but it is usually unrealistically negative.” This leads to a condition known as learned helplessness. In another book, Dr. Seligman writes about learned optimism published in 1990. His cognitive strategies hold true today.

So many use the same coping mechanisms over and over, whether they are effective or not like drinking or gambling to let off steam. These things may help in the short term but can cause further health and social problems later on. They are not adaptive strategies. Stress is unavoidable and the best thing we can do is to understand its physical impact on us and adapt to it in healthy, adaptive ways. Stress raises the amount of cortisol and adrenaline in the body activating the fight-flight response. For many, that meant an uptick in the procurement of spirits in late March to help bring it down. Others think differently. Many began a routine of walking or running or cycling. Regular exercise contributes to reducing stress and when kept in perspective, is an adaptive response to the threat of coronavirus.

Many people in our hospital were afflicted with the virus or some other health concern and became immersed in loneliness and isolation that can lead to disconsolate sadness. It is hard not to be affected by this suffering. Most reviewed studies reported negative psychological effects including depression, anxiety, post-traumatic stress symptoms, confusion, and anger, according to Brooks, et.al. Lancet 2020. At Whittier, we had many cases of ICU delirium where patients became confused and frightened by healthcare providers wearing PPE including face shields, masks, and oxygen hoods. Many thought they were being kidnapped or that the staff were actually posing as astronauts. This made it hard to help them feel safe and to trust the core staff including doctors, nurses, and rehabilitation therapists.

Michael Sefton

We have had some very difficult cases including a man who found his wife on the floor without signs of life. He fell trying to get to her and both lay there for over 2 days. He was unable to attend her funeral because of his broken hip. We had another man who pushed us to be released from the hospital. He worried about his wife who needed him to assist in her care at home. She has Parkinson’s disease. He was discharged and died shortly after going home. His wife fell while getting ready for his funeral and is now in our hospital undergoing physical rehabilitation and receiving support from our psychology service. The table below is a list of observations from recent admissions:

  • Anxiety – what will my family do while I am here?
  • Deep felt sense of loneliness
  • Depression – loss of support; loss of control 
  • Exacerbation of pre-existing conditions i.e. sleep disturbance, asthma, uncontrolled diabetes, hypertension
  • Slower trajectory toward discharge
  • Debility greater than one might anticipate to diagnosis
  • Subtle triggers to prior trauma – changes in coping, regression, agitation, sleep and mood

What is left for us to do? Have a discussion about what it means to be vulnerable – talk about family members who have been sick with non-covid conditions like pneumonia or chronic heart disease, COPD, etc. It is important to be ready to work from home again such as when schools switched to remote learning this spring and when governors’ call for closing things down. Consider the return of college kids as campus dorms everywhere are likely to close this winter.

The 1918 Spanish Flu pandemic killed 50 million people worldwide. 500 million people were infected with the virus that lasted 2 years. The virus was said to have been spread by the movement of troops in WW I. The website Live Science reported that there may have been a Chinese link to the Spanish flu as well due to the use of migrant workers and their transportation in crowded containers leading to what we now call a super spread event. We know a lot more about this virus than we did in March 2020 when it first took hold but we need to understand the eradication will be a herculean task driven by science.

“The coronavirus has profound impact on the emotional stability of people around the world because of its unpredictability and lethality. It evokes fear, and uncertainty as it spreads unchecked. Later, the virus can serve to trigger long hidden memories in a way that can sabotage healthy human development leading to vague anxiety, physical symptoms, loss, and deep despair” said Michael Sefton, Ph.D. during a recent Veteran’s Day presentation. People must have resilient behaviors that foster “purpose in life, to help them survive and thrive” through the dark times now and ahead, according to police consulting psychologist Leo Polizoti, Ph.D. at Direct Decision Institute in Worcester, MA.

 

Covid-19 pandemic: No more important time for resilience

It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. Especially in these pages, I make an effort to point out that the cumulative impact of traumatic exposure slowly whittles away one’s capacity for mental health, empathy and emotional efficacy. “There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.” (Dillon, Johnstone, & Longden, 2012). The conundrum has always come down to just what constitutes a “traumatic” event in childhood? Sometimes there is no single identifiable event that a child brings forth that may later become a trigger of serious emotional instability later in adulthood.

The Covid-19 virus has the potential for creating traumatic events depending upon the degree of exposure and a child’s understanding of the narrative brought forth by parents and other trusted adults during the pandemic. “Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health from the coronavirus is real. I see it in my own family as nerves become frayed 8 weeks on.” according to the blog post from May, 2020. Trauma informed therapy supports the model of early traumatic experience being the underpinning of many mental health outcomes we see later in life. The biopsychosocoial model identifies physical abuse, sexual abuse, exposure to violence, chronic substance abuse as the substantive reasons for many mental and physical illnesses years later. When we look in the rear view mirror at this virus we will see the litter of emotional wreckage that may leave its hooks in many people around the globe.

Coronavirus. Ise.ac.uk

There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.

(Dillon, Johnstone, & Longden, 2012).

“The more adverse events a person is exposed to in childhood, the greater the impact on physical and mental health and well-being, with poor outcomes including early death” (Anda, Butchart, Felitti, & Brown, 2010; Anda et al., 2006; Felitti et al., 1998). There was a time in my training that I collected data on childhood fire setting and the psychodynamics of pyromania. I saw 50 children in my fellowship year who came because of fire setting. Without a doubt, there was marked early instability in the childhood homes in these kids that likely germinated into fascination with fire play and perhaps more directly, physically aggressive behavior. Many of the children I assessed were suffering from early onset trauma.

Depending upon the age of onset using fire as an expression of internalized conflict suggests a serious emotional disorder in need of expert assessment and treatment. The interest in fire may appear normal but slowly interest foments in homes where a prevailing emotional vacuum permits – decreased emotional warmth, access to fire starting materials, an absent parent, and frequent domestic violence.  

The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior as children become adults. Often without direct knowledge of a specific trigger, trauma activates brain circuits that drive fear and emotional behavior including substance abuse, domestic violence, and assault. What is more, these absorb community resources as psychological needs grow.

The coronavirus has profound impact on the emotional stability of people around the world because of its unpredictability and lethality. It evokes fear, and uncertainty as it spreads unchecked. Later, the virus can serve to trigger long hidden memories in a way that can sabotage healthy human development leading to vague anxiety, physical symptoms, loss, and deep despair.

Scott D. Jones of Arlington, MA was a decorated paramedic who responded to a mass homicide in 2000 in which 7 people were shot in an episode of workplace violence. He would go on to kill his second wife and 2 children 14 years after repeated episodes of severe depression and suicidal behavior and domestic violence toward his first wife.  These behaviors were the first red flags of an impending emotional breakdown and terminal rage. Paramedic Jones certainly had problems but the repeated exposure to trauma – especially the mass shooting, activated his fight-flight response intolerably and may have been one of the demons he faced in the end.

Michael Sefton, Ph.D.

Trauma can be triggered by loss due to Coronavirus in two ways. First, by direct contact with a family member who is hospitalized and may have died. Nearly every person who contracted the virus had someone left behind that was worried about their health and eventual recovery. Many had family members who communicated with patient via text messaging and FaceTime – until the loved one could no longer do so. Families relied on the updating calls of first responder nurses, chaplains, social workers, and physicians.

Next, through secondary exposure to similar cases and media coverage that assails efforts at closure and engrains the narrative of fear, guilt and shame by reporting ever increasing case numbers, hospitalizations and deaths survivors are left feeling numb and unable to mourn. Funerals were deferred or could not be held at all as some jurisdictions required the cremation of the remains of coronavirus victims. This has a negative impact on survivor health and well-being often evoking a religious and moral crisis of faith. Survivors have enormous guilt and sadness not being with a loved one who died from the virus or waiting to go for medical at the onset of symptoms. They mourn to mourn and are left feeling numb at the lack of closure.

So whether it is early trauma associated with domestic violence or trauma from repeated exposure to work-related experiences, there is a resilience that resides within most people that guides the rise from being overwhelmed again and again to move forward with courage and hope and feelings of hardiness. These are learned responses to high stress events like a pandemic, but people who are positive thinkers, optimistic, physically fit and emotionally insightful rise up, controlling the lives they lead.

We are offering a zoom platform event entitled The Psychological Impact of the Cornavirus Pandemic: Common sense answers on November 11, 2020 at 5:30 EDT and again in December 10, 2020 at 7 PM. It is free and to be sent the zoom link contact: jswiderski@whittierhealth.com or call the Whittier Rehabiltation Hospital at 508-870-2222 in the U.S. If you plan on attending the 12/10/2020 session please drop me an email at: msefton@whittierhealth.com

Michael Sefton, Ph.D.

The common man who left no foot prints

“I’m looking for people to stop fights before they happen and I want people to be more aware of the common man”. Juston Root, 41 – from posted video just one day before his death
Hospital video of BPD officer initial encounter with Juston Root on February 7, 2020
On February 6, 2020 Juston Root posted a few minutes of video in which he espoused a disjointed series of thoughts espousing the importance of being aware of the common man and using friends for support. Was Root speaking about himself, perhaps in need of someone? He died one day later in a frightening series of events that lasted seven chaotic minutes leaving this common man dead. Juston Root had a long history of mental illness. On the day of his death, he was seen at a local hospital in Boston displaying what appeared to be a firearm. Interestingly, his parents reported he liked to carry replica handguns sometimes using a should holster. This bespeaks an attraction to firearms and yet he did not own a real weapon. It is not clear why he chose the hospital district on Longwood to make his initial foray. He was said to have made threatening statements to law enforcement officers who he first encountered. What was said? Did Mr. Root threaten the first BPD officer seen in the video? Did the officer get a look at the weapon shown and could he have been expected to recognize it as a replica? Our training and experience set the stage for this level of acumen. Video of the scene showed Root parked in the middle of traffic wandering in and out of the frame. 4 -way hazard lights activated. Was Root so rule bound that even on his last hurrah he had the provision of thought to set his hazard lights? This seems unlikely for someone in a terminal state of homicidal or suicidal rage. What was his state of mind once shot? At some point shortly after this initial encounter a parking lot valet was shot in the head and critically injured. Mr Root did not shoot the parking attendant but this was not clear amid the next moments of radio traffic. The fact that the attendant was injured by friendly fire simply was not reported and likely, was not clear at this point in the investigation. This set the stage for manhunt that quickly came together looking for someone who had shot a parking lot attendant and pointed a weapon at the police officer. It is at this point that Root made a run for it setting into action an all hands on deck police gauntlet that he had little chance of evading.
“There will always times when police officers encounter those with mental health needs especially in times of crisis. Training and education offer the best hope for safe and efficient handling of cases. A continuum of options for detox, dangerousness assessment, and symptom management must be readily available – but here in Massachusetts they are not”   Michael Sefton, 2017
What happened next triggered a chaotic police response that led to his death just minutes after he displayed a handgun aiming it toward a Boston Police Officer. It may have ended right there had the first responding officer rightfully met force with force. The physical reaction of the first officer almost looked as though he was expecting Root’s replica to go “boom”. But he held fire. An officer 20-30 feet further away saw this and fired upon Mr. Root wounding him and hitting someone down range of the incident. Officers are responsible for where the rounds go once they leave their weapon so it is always best they hit an intended target on the range or in the street. It is likely that area police agencies were put on tactical alert. When this happens, adjacent cities and towns clear their call screens and have available units staged at intersections watching for the suspect vehicle. In the end, the weapon he carried was determined to be a replica or toy. In his preamble on February 6, he suggested that people should not call police because they often are not aware of what was happening and 911 calls often result in police “storming in” in an effort to eliminate a threat to the public. Root seemed aware that “a lot of bad things can happen in the name of justice” when people call police in what he says are “fabricated phone calls”. This presentiment may be his experience living with mental illness for decades of his life. Juston Root was known to stop taking prescribed medication aimed at keeping hallucinations and delusions at bay and regulating his mood. The body worn video is chaotic and has been edited. Multiple officers can be heard shouting instructions at Root, a 41-year-old with a long history of mental illness who had brandished a fake gun at an officer earlier in the day. When situations like this occur the adrenaline often drives officers into elevated state of arousal that requires keen environmental awareness to assure actions taken are lawful. The county D.A. in the case has determined that, given the totality of the circumstances, the degree of lethal force directed at Juston Root was lawful. In the moments before he was killed by police gunfire an off duty paramedic made an effort to care for root but was ordered to back away by police. The crash was caught on video tape from the traffic light camera on Route 9 in Brookline. It was sensational and Mr. Root was obviously traveling at a high rate of speed when he crashed. He was attempting to flee. “Moments later, he walks onto the mulched area where Root was shot, approaching an officer standing over an object that appears to be a gun.” Video that is released reveals police officers warning each other about talking openly on tape. Some say there was bravado and even laughter after the threat was gone. ”Is it fake?” the first officer asks. Yes, was the answer and officers at the scene began to understand that Root may have died as a result of officer-assisted suicide. Something no officer ever wants to encounter. Someone so distraught that they put themselves into the line of fire by acting as if they are holding a firearm or other weapon forcing police to use deadly force. It is not clear that this was his intention given the remarks he recorded one day earlier. Mr. Root had grown up with mental illness that was first diagnosed when he was 19-years old. This is quite typical of the major mental illnesses like schizophrenia or bipolar depression that present themselves in late adolescence. The National Alliance on Mental Illness described Schizoaffective disorder as having clinical features of both schizophrenia and major depression. They can be unpredictable and often exhibit signs of hallucinations, delusions, poor impulse control, and suicidal behavior. Among these patients, officer-facilitated suicide would not be unheard of. But Root’s father said he had been stable over the preceding five years although he had a history of carrying fake guns. He was quick to point out that his son often stopped taking his prescribed medication. But in his taped preamble he was not angry and made no threats toward law enforcement. In fact, he indicated that he had friends on the police force although it is likely the friends of whom he speaks were officers he encountered over the years but I am being conjectural. If Mr. Root intended to die by police officer gunfire he may not have activated his hazard lights which can be seen blinking as he staggered away from the wreckage of his Chevrolet Volt. In his video statement he started by saying he had friends on the police force. There was no obvious animosity toward law enforcement. If he had had a genuine firearm and intended to go out in a blaze of glory, he may have made a final stand either at the wreckage of his vehicle or somewhere nearby like behind a tree. That was not the case. Root was trying to get away. No final stand. No “fuck you” to the world. He was down when he was shot and there was a person there to help him who was ordered away. An officer can be heard saying “he is still moving” after the barrage of rounds over 30 in all. Juston Root was mentally cogent enough to activate his 4-way hazard lights after the high speed crash and in video that could be seen when he first entered the Longwood hospital district. Why? A formal psychological autopsy that is transparently guided might find an answer to that question. Hospital Police were on guard and had been victim of a homicide that took place inside the hospital itself in January 2015. Juston Root was here for 41 years living in what he perceived was a dangerous world. He came and grew to have an affinity for law enforcement he left without leaving any foot prints or last words.

The coming of winter

The coming of winter points to the chance of both influenza and the coronavirus to come together and overwhelm the medical system across America. “Resilience in the face of unprecedented challenges matters more than ever” was the final point made in a Globe column on emotional well-being of hospital patients’ published in today’s Boston Globe. Hospitals everywhere, including the one at which I consult, are starting to see more and more signs of stress and emotional reactivity among patients who are undergoing physical rehabilitation. Many people are feeling alone and isolated. I have been told that had they known that visitors were being limited they may have elected to forego the stop in rehab – often necessary after stroke, cardiac surgery, traumatic brain injury and many other physical afflictions.

Resilience in the face of unprecedented challenges matters more than ever 

Boston Globe 9-20-20

Some people, including the CDC, are worried about the collision of the Coronavirus and the winter influenza and are strongly urging that we should all get the flu shot. Agreed. “New research in the Journal of Internal Medicine now shows a strong association between mental health symptoms and medical care avoidance according to Healthcare Finance. Many are worried about a resurgence in the Covid-19 and a worsening of the pandemic, now with 200,000 American lives lost. All these factors play on the collective psyche as we approach fall and winter and many are avoiding routine healthcare visits and elective procedures in hospital.

The Farmer’s Almanac has predicted a snowy winter in the Northeast. We will see. But people tend to be indoors and hunkered down under normal conditions and the menacing threat of increased rates of Coronavirus infection can raise anxiety and make things worse. The rate of infection remains to be seen. Same goes for the upcoming influenza season beginning in December. What is known, and factual, is the need for social distancing, limiting the community spread by using face coverings and avoiding big crowds such as those currently being seen on college campuses everywhere. In Illinois, Florida, North Carolina, and elsewhere large parties on college campuses have seen spikes in cases of Covid-19. In Maine, a small wedding party of 25 resulted in the community spread to over 300 citizens and 7 deaths due to the coronavirus. None of the 7 deaths had attended the wedding. The virus does not care who is infected.

The anxiety and depression being felt in hospitals everywhere has to do with the loss of control and the uncertainty of the future health of Americans, the discovery of a vaccine, and re-establishing trust in the science and faith in its leadership.

A Failure to thrive: Learned Resilience

Resiliency training has been shown to be a viable professional development and may better inoculate the police officer and paramedic against the range of emotional contagion faced on a regular basis.Books and papers have been written about resilience. In Dexter, Maine, at least one public service employee is at high risk for post-traumatic stress and its potential to corrupt long-term health. Containment and harm reduction should be the focus of the legal system and social service agencies alike in order to bring the importance of emotional resilience and DV orders of protection to life for those other than victims. 

The judiciary and political machinery in states throughout America must speak out about protecting victims and families by not saying “there is nothing that can be done” to stop DVH and citizen well-being.  When calls for service become solely a transaction between first responder and customer it may be a sign that professional resiliency is over taxed and career burn-out may be rising from the proverbial ashes of the calls we did before.

Michael Sefton Blog Post 2018

Containment and harm reduction should be the focus of the legal system and social service agencies alike. I have heard from many that the system of bail is broken. In some states, like Maine, the system of bail has not changed in over a century. The judiciary and political machinery in the states throughout America, must speak out about protecting victims and families and never say “there is nothing that can be done to stop DVH”. The Maine Law Review has espoused in the 2012 issue on DV and Bail conditions that there are important changes that should take place to safeguard potential victims. These include GPS tracking and no bail holds for repeat violators of orders of protection. These changes add both security for potential victims and offer law enforcement agencies some degree of deterrence against those “who prowl the world looking for the ruination of of souls”.

Death by First Responder by Michael Sefton, Ph.D.

“You can’t watch this appalling video posted by brave eyewitnesses on social media without seeing police officers’ callous disregard for a black man’s life,” ACLU of Minnesota Executive Director John Gordon said, calling the death “both needless and preventable.” ACLU of Minnesota Executive Director John Gordon
The death scene in Minneapolis, MN was horrific. I am sickened by the bull shit police work that brings forth justifiably angry people who are themselves suffocating in a society who does not regard them as human. I get that and I share the anger they espouse toward law enforcement. That is not how I was brought up and it was not how I was trained. But not all cops are murderers. First off, there was no need to kill this suspect – George Floyd. No urgent call to control his life and ultimately end it. Mr Floyd had not committed a felony nor was he trying to escape or attack the police. The African American male was suffocated to death by the officer placing his body weight upon the carotid artery of the human being who was in custody. It is well known that once someone is under control and in handcuffs the need for such restraint is reduced appreciably. 
“There will always times when police officers encounter those with mental health needs especially in times of crisis and social disorder. Training and education offer the best hope for safe and efficient handling of cases. A continuum of options for detox, dangerousness assessment and symptom management must be readily available – but here in Massachusetts they are not”  Michael Sefton, 2017
I have had previous posts about the use of force continuum. Officer’s can get off the suspect once control has been established. A law enforcement officer can let up the fight and assuredly, most do so when the fight is over. Whether or not suspect X fought the police after being identified as a suspect in a check forgery scheme or not he did not deserve to die. Even if he were the ringleader in the check forgery scheme and cashed thousands of dollars worth of bad checks, he did not deserve to die. He did not deserve to die. The police will say that the suspect fought until his death – trying to hurt or kill police. Perhaps they will say he was thrashing about and kicking – just off camera. Even if he was the use of deadly force would not be allowed. Bystander video tape will prove or disprove this theory. There is also the body worn camera footage that will surely be published into evidence. From the video released so far, it does not appear that Mr. Floyd was continuing to threaten law enforcement after he was handcuffed. It would appear that the police officer whose full weight rested upon the neck of George Floyd did not reduce his use of force to meet the resistance put forth by Mr. Floyd in kind. That is a serious abuse of power and the officer is now being held on the charge of murder in the second degree. 
“It emphasizes accountability, making amends, and — if they are interested — facilitated meetings between victims, offenders, and other persons like the police.” Center for Justice and Reconciliation
Community policing requires not only programs bringing community members together with police officers in various ways including block meetings, police athletics leagues, and “coffee with a cop” but also developing a mutual trust between law enforcement and the people they are sworn to protect. How does this happen? Police chiefs, deputy chiefs, superintendents, command staff, and patrol officers need to press some flesh out in the neighborhoods. Trust and visibility brings forth accountable and transparent policing. By doing so it opens the doors to community membership by inviting input and honest dialogue.  Restorative justice is a process that slowly repairs the harm caused by crime and malfeasance through ongoing dialogue, respect, and genuine contrition even as it pertains to police abuse of power. Community members, including police officers, and victims of abuse meet for talks aimed at transforming mistrust and anger.  Policing reforms are being introduced from coast to coast Most cities have (again) banned the choke hold that was taught but not permitted in 1982 when I first went through police training. On June 22, 2020, a NYPD officer was put on unpaid suspension for again choking out a suspect who was black. The suspect survived the arrest and was checked out at a local hospital. Meanwhile, the work of the police must continue especially now as Americans learn what to expect from the new normal and beyond. Call 911 if you have an emergency and need the police. 

Risky business: Faucci will not vote against the virus

The Corona virus has taken over 120,000 American lives since it began its tornadic viral defoliation of senior citizens and others with preexisting conditions in the Spring of 2020. The virus caught Americans unprepared. Everything has changed. The impact of the virus has been like a tsunami wave around the world whose point of origin is the giant industrial city of Wuhan, China. Only now are countries like Brazil being decimated and will soon top the United States in total cases and deaths. Countries who went into immediate lockdown were less effected like Norway, New Zealand, and Canada. The United States waited too long and the virus took hold. 

States here in North America, like Georgia, Arizona, and California, who grew weary of the economic impact of the virus and put forth ambitious reopening plans are now seeing record numbers of cases for the first time. The rate of infection is now being felt among younger citizens without pre-existing infirmity. 

Concerns about negative secondary outcomes of COVID-19 prevention efforts should not be taken to imply that these public health actions should not be taken,” wrote the CDC in one of its briefing statements. Secondary outcomes include the broad range of emotional responses to the virus including depression from loss of loved ones, sudden unemployment, increasing substance abuse, threat of homelessness, anger and existential anxiety from loss of control and loss of purpose in life. “However, implementation of supports should include a comprehensive approach that considers multiple U.S. public health priorities, including suicide prevention.” 

The Psychological toll of pandemic is beginning to show after festering for 3 months. The loss of employment, fear of foreclosure, food shortages, price gouging, addiction, and family conflict each increase the bonifide stress associated with the disease and its impact on the human family. People are becoming rattled. The President understands this and wants to exploit the opportunity by holding a campaign event. Trump brushed off concerns about the virus ahead of his highly anticipated rally in Tulsa, Oklahoma, because the number of cases there “is very miniscule”, despite the state’s surging infection of according to a report in the Boston Globe.  Instead, the rally was miniscule and embarrassed the President. 

Top physician and epidemiologist, Anthony Faucci has stated that given the unprecedented and unpredictable nature of Covid-19 that lessening of current social distancing protocols, the use of masks in public, and contact tracing are the best hope for keeping the number of new infections trending downward and to lessen the number of people who die from Covid-19. States who reopen for business without these same precautions are at risk for spikes in cases and more death. Since mid May we have heard from Dr. Faucci less and less as the White House has tried to imply that these concerns are unwarranted and there is “very little of the virus left”. 

President Trump, himself something of a germophobe, has put the needs of the campaign before public health and safety for the sake of his raucous and fervent base. In doing so, he will create a campaign spike that will be measured by new cases and deaths in the next 3-6 weeks time. That is on him and the courts who failed to put limits on the event or cancel it all together in Tulsa, Oklahoma on Saturday June 20. Since February, the president has not taken the pandemic with the kind of leadership that demonstrates his understanding of the virus and respect for those who have succumbed to the disease. 

Meanwhile states like Georgia, Texas, California, and Florida are having thousands of new cases because governor’s of those states have failed to heed the warnings of Dr. Faucci and others. The sudden conflagration of new cases is not the second wave that we have been warned about. The jump in cases correlates with opening businesses without any adherence to protocols. See Tulsa, OK. 

In Florida, the average age of new cases who are hospitalized has dropped to 37-years old. “Those thousands of new cases also signal that, in a week or two, some portion of those people will show up in the hospital, and, about a week after that, a number of them will be dead, even as clinicians have learned more about treating severe Covid-19” said the Boston Globe. For his part, albeit in a greatly reduced capacity, Dr Faucci predicts that a tidal wave of infections is coming unless we do what most medical experts agree starts with respect for social distance recommendations, sanitary hand hygiene, and mandatory quarantine for those who test positive for the virus or are feeling unwell.  

We all know this by now, and it is hard to swallow unless you are among those people who claim to have super immune functioning and refuse orders to wear a mask in public?  Sadly, many will become infected and go on to infect others, unwittingly, all the while they feel nothing and are emboldened by the President who insists the risk of getting the virus at a campaign event is miniscule. Perhaps some readers of this post or others like it do not believe the numbers and chalk it up to fake news.

The emotional impact of the virus has yet to reach its peak. But the racial unrest may be one indication that many are becoming unhinged including a small number of law enforcement officers who lack empathy and understanding of the human effects of stress on unconscious bias and veiled bigotry.  Faucci is getting on the virus. Let us leave the prognosticating to the scientists who are watching the numbers and tracking those who are carrying the virus without symptoms, and may not know it yet.