Tuesday, July 14, 2009

Run to Failure - Pt 1

Originally published in Blog Them Out of the Stone Age on December 9, 2005

Left: Anne Buechner and her husband, Rigoberto Alpizar

Two days ago the couple in the photo were returning to Florida after a brief missionary trip to South America. The international leg of the flight was behind them. They had cleared customs, boarded a second aircraft, and faced only the final, brief trip from Miami International Airport to Orlando. Suddenly the man, 44-year old Rigoberto Alpizar, began acting in a way that attracted the attention of the flight crew and an air marshal on board the craft. The marshal became convinced that Alpizar had a bomb and, when he bolted from the plane rather than heed the marshal's command to halt and lie down, the marshal shot him dead.

The story has been international news for a couple of days now. The dominant theme has been that it was a "good shoot" -- that is, the air marshal behaved properly in the circumstances -- and serves as evidence that security measures entrenched since 9/11 are working as they should. But it soon transpired that Alpizar was not, in fact, carrying a bomb. His behavior owed not to lethal intent but rather to his medical condition: He suffered from bipolar disorder and, in medical terms, had "decompensated," apparently because he was off his medication.

The fate of Rigoberto Alpizar has begun attracting comment within the mental health segment of the blogosphere. Shrinkette, a psychiatrist in Eugene, Oregon, poignantly juxtaposed a news excerpt with a passage from Kay Redfield Jamison's famous memoir of her struggles with bipolar disorder:
Witnesses aboard an American Airlines jetliner say that Rigoberto Alpizar's wife pursued him, saying he was mentally ill, just before federal marshals shot and killed him. Air marshals said Alpizar had announced he was carrying a bomb.

Later, no explosives were found. The incident remains under investigation.

"She was chasing after him," said fellow passenger Alan Tirpak. "She was just saying her husband was sick, her husband was sick." When the woman returned, "she just kept saying the same thing over and over, and that's when we heard the shots."

"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering..."

-Kay Redfield Jamison, Ph.D., An Unquiet Mind, 1995, p. 6.

One of Shrinkette's readers left this comment:
I understand 100% why the air marshall did what he did. I really do. But I can seriously imagine the turmoil and pain the man was in. I'm bipolar. I've been in a psychotic state, I've heard things, seen things, nearly cut off my own hand because something in my head was telling me it would be a good experiment. Being bipolar we have a responsibility to take our medication, but even then it can be difficult, a daily struggle. I am not saying that the air marshall was wrong: he discerned a threat to the larger group and was doing as he was trained. But I have an incredible amount of compassion for the man and his wife. NO ONE knows, nor will they ever, what that couple went through, both at that moment, and the days leading up to it.

But Becky, a 22-year old Indiana woman who blogs about her struggles with bipolar disorder at Tidal Moods, was less sympathetic -- in fact, not sympathetic at all:
Some people are suggesting that the air marshals behaved inappropriately. Those people are wrong. A clearly insane person can still have a bomb and just because someone is behaving bizarrely does not mean they aren't dangerous. This man said he had a bomb and authorities have no choice but to take him seriously.

As a person with bipolar, I'm outraged by the media's obsession with the fact that the man's family claimed that he suffered from bipolar disorder. It's irrelevant. It doesn't factor into the air marshalls' deliberations about whether or not the man is a threat and the only reason the media even mentions it is because it makes the air marshalls look like assholes when they aren't.

At the risk of sounding like a heinous bitch, I have little sympathy for this man and his family. By the time you're 44 years old, you know what it's like to live with bipolar disorder and you know whether or not you're one of those people who requires medication to maintain sanity. Clearly, this man could not behave normally without his medication and there is absolutely no reason for him not to take it. It's not like a bipolar person is going to fly off the handle if they miss one dose of their meds. For his wife to be aware of his failure to take his meds, he had to have missed more than a dose and at that point, my sympathy dies. Even if he lost his bag and his medication was gone, he could still go to a hospital or contact a pharmacy and his psychiatrist to get more. There is no excuse for not taking your meds if you know that you pose a danger to others without them. None at all.

Becky's post has so far attracted 21 comments, though most of them are off-topic -- early in the thread someone criticized her for being foolish and "narcissistic" to write publicly about her bipolar disorder. (That little gem of idiocy generated a spate of coments and counter-comments from Becky, the idiot, and several of Becky's readers which is worth reading for its own sake.) But of the responses that addressed her post directly, opinion was about evenly split between those who thought Becky was being harsh on Alpizar and those who thought she had a point.

My personal view is that Becky has a point and also that her stridency on the subject stems from fear. Anybody with bipolar disorder -- me, for instance -- can't help but reflect that in the right circumstances, we ourselves could suffer Rigoberto's Alpizar's fate. One way to deal with this fear is to blame Alpizar for what happened: Alpizar had bipolar disorder. Alpizar did not take his meds. Alpizar got in a situation where he was killed. I myself will take my meds and therefore I will never get in such a situation.

Actually, you can take your meds and still get in precisely that situation. Six years ago I was hospitalized for acute mania exactly one day after a blood test showed that the correct level of lithium was present in my body.

No: meds alone aren't a guarantee. The strategic problem of survival is more complex than that.

It is no coincidence that in the last decade, a significant amount of my research as a military historian has focused on situations in which people have tried to frame workable strategies for resistance in an intractable environment, when the odds are stacked heavily against them. I live that situation every day of my life. And over time I've brought my military training as well as my historical training repeatedly to bear on the problem.

Let me tell you some of the tactics I've evolved to address it.

Part 1 - Part 2 - Part 3 (coming)

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