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On The Front Lines Of PTSD Research

By Bill Glauber, Milwaukee Journal Sentinel (TNS)

MILWAUKEE — Picture a trauma victim, someone who has endured a gunshot wound, a car crash or an industrial accident, a person whose body is broken and is rushed into surgery to be mended by physicians racing against the clock.

But what happens during recovery, when thoughts ricochet through the mind of the victim? What happens if symptoms of post-traumatic stress disorder take hold?

This is where clinical psychologist Terri deRoon-Cassini steps in.

Working alongside surgeons at Froedtert & the Medical College of Wisconsin, deRoon-Cassini is deeply engaged in research that identifies neurological, biological, and psychosocial markers for PTSD. She also provides psychological care to injured trauma patients.

It’s not just soldiers in combat who can suffer from PTSD. Civilians who encounter trauma in their daily lives also can get PTSD, which can lead to severe mental health problems.

DeRoon-Cassini said PTSD is the biggest predictor of quality of life in trauma patients. A 2010 study conducted at Froedtert showed that up to 40 percent of civilian survivors developed PTSD.

“Why is PTSD important? It’s important because if people can no longer engage in their everyday lives, they can’t support themselves, be there for family and loved ones,” she said.

Ultimately, she said, untreated PTSD “creates a large health burden on society.”

Froedtert is among only a few hospitals in the country that routinely screens trauma patients for PTSD symptoms. It also is unique for having a clinical psychologist like deRoon-Cassini working in the surgical department.

The American College of Surgeons Committee on Trauma recommends PTSD and depression screening at Level I trauma centers like Froedtert. According to deRoon-Cassini, the hope is that in five years such screening treatment will be mandated and more psychologists will be embedded in trauma centers.

The hospital also has started a trauma mentoring program. Four former patients who have been through the system, and then received training, volunteer their time to talk with new patients about recovering from a traumatic event.

“Our psychological intervention is targeted to people at risk,” deRoon-Cassini said. “PTSD can’t be diagnosed until 30 days after a trauma. We want to prevent that diagnosis.”

Stephen Hargarten, chief of the Emergency Department at Froedtert Hospital, said deRoon-Cassini plays a vital role.

“She’s an expert at understanding how a traumatic event affects an individual and she is an expert at recognizing and intervening before debilitating post-traumatic stress takes over,” Hargarten said.

“People generally associate PTSD with military engagement but they don’t often associate this with day-to-day events that are similar in quality, a kinetic energy exchange from a car crash or a bullet,” Hargarten said.

At 36, deRoon-Cassini is deep into a career centered on detecting and treating PTSD.

Born and raised in California, she attended the University of Wyoming, where she studied zoology and physiology. While in college, she got an internship at a domestic violence shelter.

She recalled helping one client, a woman who suffered abuse at the hands of her husband, a member of the military. The woman, a mother of four, had cuts on her face. She needed dental care because several teeth had been knocked out. But before she could get her teeth fixed, she had to undergo a magnetic resonance imaging test to see if there were any fractures.

The clicking sound of the MRI triggered a flashback for the woman. DeRoon-Cassini later learned why. The woman told her that one weekend she had been kept in a box in the basement of her home, and anytime she made a noise her husband hit the box with a baseball bat.

DeRoon-Cassini said that woman’s story pushed her toward her life’s work.

She earned her master’s and doctorate degrees in clinical psychology at Marquette University. During an internship at the Zablocki Veterans Affairs Medical Center, she focused on health psychology and PTSD after combat trauma.

DeRoon-Cassini completed postdoctoral work at the Medical College of Wisconsin, where she is now assistant professor in the Department of Surgery, Division of Trauma & Critical Care.

She and her colleagues are involved in several studies that she hopes “can give us a more complete picture of risk for PTSD.”

“Can we look at the biology of a person at risk? Can we look at their neurological state?” she said.

Just as important, she is in the trenches, trying to help patients cope with trauma. Others are, too.

The Trauma Peer Mentor Program was unveiled at Froedtert in October. Former patients talk with current patients, imparting advice and listening. The initiative grew out of the Trauma Survivors Network, which works to connect patients and families after serious injury.

“We visit patients who are newly injured,” said Chris Prange-Morgan, who fell 30 feet at a local climbing gym in 2011. Three years later, her right leg was amputated just below the knee.

“One of the things I’ve found in connecting with people is there is a great network of very old souls out there who know what it’s like to suffer,” she said.

Prange-Morgan did not suffer PTSD after her injury, but said she knows what to look for in patients who might be in distress.

“I think it can help people to know there is hope, particularly when faced with not just a physical injury but the emotional scarring of knowing they have been violated in their home or a victim of a serious car accident outside their control,” she said. “Having someone come and help you feel you can get control back is pretty important.”

(c)2015 Milwaukee Journal Sentinel, Distributed by Tribune Content Agency, LLC

Photo: Joe Shlabotnik via Flickr

Diplomat John Tefft Navigates Sticky US-Russia Relations

By Bill Glauber, Milwaukee Journal Sentinel (TNS)

So, what exactly is the state of U.S.-Russian relations?

“Difficult,” said John Tefft, the Madison Wisconsin-born, Marquette University-educated U.S. ambassador to Russia.

In an interview this week with the Milwaukee Journal Sentinel, Tefft reflected on his Wisconsin roots and diplomatic career and provided some insight into the often testy relationship between the United States and Russia. He is in Washington, D.C., this week for a series of meetings.

Tefft, 65, has been on the job in Moscow since September, when he was pulled out of a brief retirement by President Barack Obama’s administration.

A veteran with more than 40 years in the Foreign Service, Tefft is well-versed in the nuances of diplomacy.

Earlier this month, Russian President Vladimir Putin wasn’t seen in public for ten days, touching off rumors about his whereabouts. When he finally reappeared last week, Putin downplayed the controversy and told reporters, “It’s boring without gossip.”

Tefft said that what he had been told was that Putin had the flu.

“It’s kind of hard to understand why they don’t just say the boss is sick,” Tefft said.

Relations between the U.S. and Russia may be chilly, but Tefft presses on. He said he has been well-received by diplomatic pros plus many others he knew from a previous tour in Moscow.

“It’s obvious the relationship is not an easy one at this point and I work hard at it every day,” he said, adding that he gets out often to represent the United States and bring its message to Russia.

Tefft said the U.S. may get criticized in the Russian press but that “deep down Russians still have affection for Americans.”

The diplomat’s down-to-earth style is part of his Midwestern roots.

There’s still a lot of Wisconsin in him. Tefft collects hats from around the world and displays them in a room at his residence in Moscow. Amid dozens of baseball caps, he has not one but two cheeseheads.

“Most people who know me know what they are,” he said. “My reputation as a hat collector has already spread among most of the people I work with.”

The oldest of five children, Tefft’s father was an attorney and his mother was a social worker. As a child, he recalls his mother reading books and stories aloud, including the Russian folk tale of the witch, Baba Yaga.

At Edgewood High School in Madison, Tefft recalled how he had to choose between taking a course in physics and a course in Russian history.

“That was a no-brainer when it came to my science ability,” he said.

Tefft studied history at Marquette University, where he also met his future wife, Mariella Cellitti, a biology major. They married in January 1971 and Tefft graduated later that spring.

Tefft said his career in the Foreign Service, which started in 1972, is very much a shared partnership with his wife, a biostatistician and nurse. All told, they have made around 20 moves, including Tefft’s stints as an ambassador in Lithuania, Georgia, and Ukraine, as well as a posting as the chief of mission in Moscow in the late 1990s.

“When you look back on this it all looks like it has been planned,” Tefft said of his career. “But in fact it wasn’t. I just kind of followed my instincts and what I really liked.”

Through his long career, he has seen the ebb and flow of U.S.-Russian relations. Tefft joined the Soviet desk at the State Department in 1983.

“The first week I was there was the week the Korean airliner was shot down,” Tefft said, recalling the downing of a Korean Airlines passenger jet that went off its intended route and ventured into Soviet airspace.

“Not long afterward, the Soviets pulled out of arms control talks,” Tefft said. “So it was a very difficult period. All you can do is try to work through these periods and hope you can find some common ground to build things back.

“But you know, this is a relationship based on heavy competition as well as, I would argue, some serious cooperation over the years. It’s not always easy and the current situation isn’t.”

The current U.S.-Russia relationship has been on the rocks for more than a year since Russia annexed Crimea, which was part of Ukraine. Russia hasn’t backed down, despite facing economic sanctions from the West. The crisis has continued with fighting between pro-Russian separatists and Ukraine government forces.

In late February, Russia was rocked by the murder of a prominent Putin critic, opposition politician Boris Y. Nemtsov. Russian authorities arrested five ethnic Chechens. The larger question looms: Who ordered the murder?

Tefft, who met with Nemtsov’s mother, wife, and children, called the murder “such a terrible tragedy for Russia….He has done so many good things over his life for Russia and the Russian people. Those of us who knew him, I knew him in the 1990s, it just breaks your heart to see talented guys like this cut down.”

Photo: Federation Council via Flickr