I like the idea that judges continue to be appointed by the governor but every two years they have to re-elected. That would eliminate egregiously bad judges. No one should get a life-time appointment without SOME review.
Things will only get worse, but, then, of course, they'll get better. For a while. Then, they'll get worse in slightly more disgusting ways, but things will perk up all of a sudden, usually during the Spring and early-Summer months, and then something more awful will happen and you'll find yourself shaking your head in astonishment. After which time, the blood rain will start and you and your progeny will be well-and-truly fucked and the signs are cloudy from that point on.
But one verity remains, as the fog rolls in - you will never get that jet-pack you were promised and you will die bitter...
Hmmmmm a judge ... doing exactly whatever the hell he feels like reason be damned ... I was told by the non commenting lawyers here that such a thing is unpossible.
I am a longtime supporter and reader of Wonkette. I am also a pediatric intensive care physician.
I find that Robyn Penacchia has written a lot of good columns about subjects such as abortion rights. However, I have been increasingly dismayed by her repeated columns on the topic that "shaken baby syndrome is bullshit." I have taken care of many shaken/abusive head trauma babies, many of whom died and most of the survivors had permanent neurological damage. The fact is that, in the pediatrics community (including pediatricians as well as pediatric subspecialist such as pediatric neurosurgeons), there is a group that claims that shaken baby syndrome does not exist, but they are very much on the fringe along with the anti-vaxxers and anti-conversion therapy types. Robyn could have determined this with minimal googling if she was willing to step outside the sources that reaffirm her opinion. I suggest she and Wonkette readers start with "Consensus statement on abusive head trauma in infants in young children" found at https://pubmed.ncbi.nlm.nih.gov/29796797/ (free access is allowed by clicking on the "White Rose Research Online" tab on the right of the page). This is a consensus statement by an international group of pediatricians and pediatric radiologists that has been endorsed by multiple pediatric medicine-based organizations including the American Academy of Pediatrics, which is the mainstream pediatrics professional organization in the US (there is an American College of Pediatrics that is run by the anti-vaxxer, pro-corporal punishment types). This paper is dense but I think readable by non-medical people. It does include a lot of delving into child abuse, so be forewarned. Following this paper I will refer to "abusive head trauma" instead of "shaken baby syndrome."
I have avoided making comments on these columns before on the principle of not getting into arguments on the internet. However, after reading Robyn's latest piece today, "Nashville Judge Decides To Keep Man In Prison Because Too Many People Think He's Innocent," I have hit my limit. She has now personally attacked my friends and colleagues in the established pediatric subspecialty of Child Abuse Pediatrics, which Robyn describes as "self appointed 'child-abuse' experts. She also takes a swipe at "ICU doctors or regular pediatricians," as they apparently don't "actually know what they are talking about." This sent me through the roof, as a pediatric ICU doctor, who has, I repeat, taken care of many (I don't even know how many at this point) patients with abusive head trauma. Everyone in pediatrics has taken care of these children. We. See. Them. All. The. Time.
I am going to try to be fair here. I know Robyn is passionate about miscarriages of justice, and good for her for covering this area. But abusive head trauma is not some questionable forensic science like bite marks. It is not made up by villainous district attorneys. It is a medical diagnosis with huge and hugely bad implications for children. I can't speak to what happens in the court system as I am not a lawyer. I wish Robyn would have had the same caution when talking about medicine.
I would like Robyn to know what it is like to manage a baby with abusive head trauma, as a pediatric ICU (PICU) doctor. These babies have decreased level of consciousness and often seizures. If they go long enough without medical care they have inadequate and then no breathing. If we can intubate them at this point we can keep them from proceeding to cardiac arrest, but they often end up requiring CPR, often prolonged. So we have a baby with major brain injury and often severe seizures that are difficult to control. If there was prolonged CPR there will often be dysfunction of other organ syndromes. Sometimes neurosurgeons can intervene but usually there is no surgical option. Patients with shaking related injuries make up 45% of deaths related to child abuse. They die from severe brain injury, uncontrollable seizures, or multiorgan failure, even with the ICU team performing every intervention we can think of. I have to explain the severity of this to the family, and tell them when the child is dying (we treat the family like we treat any other family; decisions on whether family members are allowed to see their child are made by child protective services and law enforcement). If these babies survive, they often have severe neurological injuries and depend on technologies like tracheostomies and feeding tubes to live. These children haunt me, and they haunt everybody who works in the PICU.
Robyn repeatedly implies that no one ever considered other causes for the head bleeds in this child, or presumably any child with abusive head trauma. This is absolute bullshit. The standard of care for the diagnostic workup for children presenting with head bleeds included screening for bleeding disorders or other potential causes of bleeding, thorough review of the medical and family history, complete head to toe exam, X-ray of all the bones to look for fractures, and thorough imaging of the brain and in some cases the spine. We work closely with the Child Abuse Pediatricians for this workup.
I will deal with some of Robyn's statements in detail. First of all, the "self-appointed 'child abuse'" expert, which I presume refers to Dr. Suzanne Starling who was mentioned in Robyn's previous article. Dr. Starling is board certified in Child Abuse Pediatrics (I checked) which is an established pediatric subspecialty. To be board certified, you have to have completed a specialized fellowship after pediatric residency, passed a subspecialty board exam, and continue to meet requirements established by the American Board of Pediatrics. The American Board of Pediatrics provides certification for all pediatricians and subspecialty pediatricians in the US, so in fact Dr. Starling is in fact a child abuse expert, unless you are questioning the knowledge of every pediatrician in the country. You can find more information at https://www.healthychildren.org/English/family-life/health-management/pediatric-specialists/Pages/What-is-a-Child-Abuse-Pediatrician.aspx.
The consensus statement I referenced above addresses the greatest hits of the anti-shaken baby syndrome/abusive head trauma crowd, including some of Robyn's statements, so I will not address all of them. A few key points:
-the question of biomechanics is a big topic, but I would emphasize that there is NOT a good animal model for shaking in human babies because human babies have much bigger heads in relationship to their bodies than any other species.
-The fact is that it is rare for babies to show up with an unprovoked brain bleed. Even patients with genetic bleeding disorders like hemophilia rarely bleed in their heads. Premature babies (as in this case) are at risk for bleeding in their brain early in their life due to immaturity of blood vessels in the brain, but by the time they are big enough to discharge home they are not at any higher risk to bleed than non-premature babies.
I really enjoy Wonkette as a refuge of sanity and like-minded people in this current dumpster-fire landscape. But I am really struggling with supporting people spreading medical misinformation. I hope that this can be educational for Robyn and the readers. I know full well that doctors are not infallible and there are plenty of issues with the American legal system, but there is not some cabal of pediatricians making these cases up (why? who knows?) in cahoots with the local courts.
And Tennessee takes the lead in the "stupidest, cruelest" state justice system. Don't judges like this guy have to face recall elections every so often? If so, his cannot come quickly enough. Then again, the voters of Tennessee don't have a very good record themselves, they'll probably re-elect him
I'm not a biomechanical engineer, but I know enough to know that retinal hemorrhaging due to trauma is going to have included severe, and I'll state that again, SEVERE g forces. Like, high speed car accident, getting punched right in the eyeball, or ejecting from a jet aircraft at significant speed.
Any of those things would like have killed an infant immediately and caused multiple broken bones and extensive soft tissue injuries.
Or it's a symptom of any one of several serious disorders or syndromes.
But a judge is supposed to understand that they don't know and that's why experts are involved.
I like the idea that judges continue to be appointed by the governor but every two years they have to re-elected. That would eliminate egregiously bad judges. No one should get a life-time appointment without SOME review.
Errrrrrrrrrrrrrrr....p.
Things will only get worse, but, then, of course, they'll get better. For a while. Then, they'll get worse in slightly more disgusting ways, but things will perk up all of a sudden, usually during the Spring and early-Summer months, and then something more awful will happen and you'll find yourself shaking your head in astonishment. After which time, the blood rain will start and you and your progeny will be well-and-truly fucked and the signs are cloudy from that point on.
But one verity remains, as the fog rolls in - you will never get that jet-pack you were promised and you will die bitter...
Holy freaking mind fuck, Batman🤯
The United States of America is teetering on the edge of a precipice. How will the Supreme Court rule?
https://www.rawstory.com/trump-supreme-court-warrant/
What then caused the injuries to and death of this child?
Hmmmmm a judge ... doing exactly whatever the hell he feels like reason be damned ... I was told by the non commenting lawyers here that such a thing is unpossible.
Tennessee. Gee, man, I don’t know.
I am a longtime supporter and reader of Wonkette. I am also a pediatric intensive care physician.
I find that Robyn Penacchia has written a lot of good columns about subjects such as abortion rights. However, I have been increasingly dismayed by her repeated columns on the topic that "shaken baby syndrome is bullshit." I have taken care of many shaken/abusive head trauma babies, many of whom died and most of the survivors had permanent neurological damage. The fact is that, in the pediatrics community (including pediatricians as well as pediatric subspecialist such as pediatric neurosurgeons), there is a group that claims that shaken baby syndrome does not exist, but they are very much on the fringe along with the anti-vaxxers and anti-conversion therapy types. Robyn could have determined this with minimal googling if she was willing to step outside the sources that reaffirm her opinion. I suggest she and Wonkette readers start with "Consensus statement on abusive head trauma in infants in young children" found at https://pubmed.ncbi.nlm.nih.gov/29796797/ (free access is allowed by clicking on the "White Rose Research Online" tab on the right of the page). This is a consensus statement by an international group of pediatricians and pediatric radiologists that has been endorsed by multiple pediatric medicine-based organizations including the American Academy of Pediatrics, which is the mainstream pediatrics professional organization in the US (there is an American College of Pediatrics that is run by the anti-vaxxer, pro-corporal punishment types). This paper is dense but I think readable by non-medical people. It does include a lot of delving into child abuse, so be forewarned. Following this paper I will refer to "abusive head trauma" instead of "shaken baby syndrome."
I have avoided making comments on these columns before on the principle of not getting into arguments on the internet. However, after reading Robyn's latest piece today, "Nashville Judge Decides To Keep Man In Prison Because Too Many People Think He's Innocent," I have hit my limit. She has now personally attacked my friends and colleagues in the established pediatric subspecialty of Child Abuse Pediatrics, which Robyn describes as "self appointed 'child-abuse' experts. She also takes a swipe at "ICU doctors or regular pediatricians," as they apparently don't "actually know what they are talking about." This sent me through the roof, as a pediatric ICU doctor, who has, I repeat, taken care of many (I don't even know how many at this point) patients with abusive head trauma. Everyone in pediatrics has taken care of these children. We. See. Them. All. The. Time.
I am going to try to be fair here. I know Robyn is passionate about miscarriages of justice, and good for her for covering this area. But abusive head trauma is not some questionable forensic science like bite marks. It is not made up by villainous district attorneys. It is a medical diagnosis with huge and hugely bad implications for children. I can't speak to what happens in the court system as I am not a lawyer. I wish Robyn would have had the same caution when talking about medicine.
I would like Robyn to know what it is like to manage a baby with abusive head trauma, as a pediatric ICU (PICU) doctor. These babies have decreased level of consciousness and often seizures. If they go long enough without medical care they have inadequate and then no breathing. If we can intubate them at this point we can keep them from proceeding to cardiac arrest, but they often end up requiring CPR, often prolonged. So we have a baby with major brain injury and often severe seizures that are difficult to control. If there was prolonged CPR there will often be dysfunction of other organ syndromes. Sometimes neurosurgeons can intervene but usually there is no surgical option. Patients with shaking related injuries make up 45% of deaths related to child abuse. They die from severe brain injury, uncontrollable seizures, or multiorgan failure, even with the ICU team performing every intervention we can think of. I have to explain the severity of this to the family, and tell them when the child is dying (we treat the family like we treat any other family; decisions on whether family members are allowed to see their child are made by child protective services and law enforcement). If these babies survive, they often have severe neurological injuries and depend on technologies like tracheostomies and feeding tubes to live. These children haunt me, and they haunt everybody who works in the PICU.
Robyn repeatedly implies that no one ever considered other causes for the head bleeds in this child, or presumably any child with abusive head trauma. This is absolute bullshit. The standard of care for the diagnostic workup for children presenting with head bleeds included screening for bleeding disorders or other potential causes of bleeding, thorough review of the medical and family history, complete head to toe exam, X-ray of all the bones to look for fractures, and thorough imaging of the brain and in some cases the spine. We work closely with the Child Abuse Pediatricians for this workup.
I will deal with some of Robyn's statements in detail. First of all, the "self-appointed 'child abuse'" expert, which I presume refers to Dr. Suzanne Starling who was mentioned in Robyn's previous article. Dr. Starling is board certified in Child Abuse Pediatrics (I checked) which is an established pediatric subspecialty. To be board certified, you have to have completed a specialized fellowship after pediatric residency, passed a subspecialty board exam, and continue to meet requirements established by the American Board of Pediatrics. The American Board of Pediatrics provides certification for all pediatricians and subspecialty pediatricians in the US, so in fact Dr. Starling is in fact a child abuse expert, unless you are questioning the knowledge of every pediatrician in the country. You can find more information at https://www.healthychildren.org/English/family-life/health-management/pediatric-specialists/Pages/What-is-a-Child-Abuse-Pediatrician.aspx.
The consensus statement I referenced above addresses the greatest hits of the anti-shaken baby syndrome/abusive head trauma crowd, including some of Robyn's statements, so I will not address all of them. A few key points:
-the question of biomechanics is a big topic, but I would emphasize that there is NOT a good animal model for shaking in human babies because human babies have much bigger heads in relationship to their bodies than any other species.
-The fact is that it is rare for babies to show up with an unprovoked brain bleed. Even patients with genetic bleeding disorders like hemophilia rarely bleed in their heads. Premature babies (as in this case) are at risk for bleeding in their brain early in their life due to immaturity of blood vessels in the brain, but by the time they are big enough to discharge home they are not at any higher risk to bleed than non-premature babies.
I really enjoy Wonkette as a refuge of sanity and like-minded people in this current dumpster-fire landscape. But I am really struggling with supporting people spreading medical misinformation. I hope that this can be educational for Robyn and the readers. I know full well that doctors are not infallible and there are plenty of issues with the American legal system, but there is not some cabal of pediatricians making these cases up (why? who knows?) in cahoots with the local courts.
And Tennessee takes the lead in the "stupidest, cruelest" state justice system. Don't judges like this guy have to face recall elections every so often? If so, his cannot come quickly enough. Then again, the voters of Tennessee don't have a very good record themselves, they'll probably re-elect him
I'm not a biomechanical engineer, but I know enough to know that retinal hemorrhaging due to trauma is going to have included severe, and I'll state that again, SEVERE g forces. Like, high speed car accident, getting punched right in the eyeball, or ejecting from a jet aircraft at significant speed.
Any of those things would like have killed an infant immediately and caused multiple broken bones and extensive soft tissue injuries.
Or it's a symptom of any one of several serious disorders or syndromes.
But a judge is supposed to understand that they don't know and that's why experts are involved.
What mixes well with whiskey that isn't stimulating? I don't want to be awake anymore. Besides more whiskey. Or ice.
I've got like nothing. I guess it's over ice with a splash of cola.
Oh, that reminds me. Aren’t there still mass school pedophiles in NC prisons based on testimony of 3- and 4-year olds under hypnosis?
From your fingertips to Justice's scales. Thank you, Robyn.
OT: LOL! As if Stinky would dare debate any live human.
𝗧𝗿𝘂𝗺𝗽 𝗥𝗲𝘀𝗽𝗼𝗻𝗱𝘀 𝘁𝗼 𝗕𝗶𝗱𝗲𝗻 𝗗𝗲𝗯𝗮𝘁𝗲 𝗣𝗹𝗲𝗱𝗴𝗲 𝘄𝗶𝘁𝗵 𝗦𝗲𝗿𝗶𝗲𝘀 𝗼𝗳 𝗣𝘂𝗲𝗿𝗶𝗹𝗲 𝗜𝗻𝘀𝘂𝗹𝘁𝘀
https://www.mediaite.com/opinion/just-in-trump-responds-to-biden-debate-pledge-with-series-of-puerile-insults/
This is all an argument against states rights (TM).