The task of bringing true science to bear on the issue of shaken baby syndrome has proven to be incredibly difficult. Progress has been meager and slow, and for those committed to seeing that true justice is done in these cases, the work is extremely frustrating. The extant pediatric medical community continues to wrap itself ever tighter in their beliefs in the medical folklore that has resulted in so many wrongful convictions based upon rigid, unyielding diagnostic dogma that has been discredited. For background on the SBS problem, please see previous WCB posts here, here, here, here, here, here, and here.
Dr. Steven C. Gabaeff is a California physician who has specialized in child abuse cases, and is a member of the Los Angeles Superior Court Expert Witness Panel. Dr. Gabaeff is also one of those rare medical practitioners who is board certified in Emergency Medicine, and who understands the flaws in the currently prevailing views of SBS. He recently responded to an SBS online bulletin board posting concerning an article about a man who has been charged for a second time with infant abusive head trauma. I believe that his response provides an insightful view of what the situation is today, and also reveals some of the frustration that so many of the people who are dedicated to this cause have to deal with. That response is posted here with his permission.
Regarding the case … the likely etiology of the problems with the second newborn was perinatal subdural hematoma rebleed from moderate trauma, and probably other treatment failures that would never see the light of day in an article like this in the newspaper, that resulted in severe brain damage.
What can he do? He should have moved to another country… until we solve this.
Most of the time we look like Don Quixote, and unfortunately we are not addressing the issues here on the scale required. The authorities’ MO (modus operandi) has not changed an iota in 40 years: they diagnose abuse and only abuse, repress contradictory evidence, and abuse their ill-gotten authority to accuse, convict, intimidate, and to clone a new generation prescreened to be the same or better at executing the same conviction-producing MO as the old timers. There really isn’t that much evidence that what we’re doing is preventing what happened to this guy already or even what will happen to him in the near future.
We can, and do, win the ‘off case’ or even more than that now, but we’re not organized enough, big enough, or working hard enough on the specific ways to redefine the issues. Sounds like the movie Rudy…. My hope was that the Innocence Project was a “good” steroid to make our academic group, the “Evidence-Based Medical Society,” stronger and bigger … and then it wasn’t.
Our moves now are to handle the outrage and defeats, win some, hope for more. Push forward with hope and full knowledge that at times, in corrupt set-ups, we cannot win. With 80% of the judges being ex-prosecutors why should we expect fairness? Or good legal analysis? Or even a winning percentage?
We need to continue to try to organize and codify the knowledge and tactics to respond to this at the investigative and trial level, which unfortunately to me seems to be abandoned and off the agenda.
Relying on appeals to assuage the systemic failures or our failed efforts at trial just lays the foundation for the next indictment tomorrow morning (there are 10 cases a day like this filed). The appeal process is disconnected from a case like this. The DNA model of fixing things does not apply to child abuse, so how much can happen with this effort of ours on this online bulletin board if fear of damaging the brand (and it may be a legitimate fear to some) is the dominant principle?
Either the science must go on trial as a civil rights issue or things like Plano (World Conference on Infant Head Trauma to be held Nov. 15-17 in Plano, TX) if successful, could be legitimately held up as a precedent setting scientific analysis, if they come. The problem as I see it is even if they (the entrenched SBS/triad believers) are knocked out cold and bleeding; beaten by the better fighter, they’ll grouse their way out of the ring mumbling about sucker punching denialists, bamboozling the weak minded judges, and use their defeat as the red badge of courage; the symbol of the need for their forces to fight harder and more aggressively to be right. They are not retiring from the fight game.
I am pretty convinced we can’t win by trying to convince them (the child abuse pediatricians), because we can’t (we’ve been trying for 30 years). We can only get to the promised land by beating them in court, and we must do it with so much consistency that prosecutors won’t file the cases because they know they are going to lose. Then and only then, will this end (in my opinion).
Steven C. Gabaeff, MD, FAAEM, FACE