1. The Elephant on the Moon
E L A I N E W H I T F I E L D S H A R P ,TLC ‘98
There is no greater assault on American families by the State than the current use of junk science to
accuse and convict mothers, fathers, brothers, sisters, grandparents, friends and babysitters of abusing
babies by so-called “shaken baby syndrome” (SBS).
This article is the first in a series presented to suggest ways to first understand the history and
background of the scientific disputes about the SBS diagnosis and then, in turn, defend cases of
alleged shaken baby syndrome (SBS). Part I is about some of the major scientific flaws in the theory
of shaking as a cause of pediatric brain injury. Part II is about alternative theories of causation, such
as, accidental short falls, as explanations for the signs and symptoms commonly attributed to shaking.
Part III is about how to make a (state) Daubert or Frye motion to challenge the State’s science in
cases of alleged shaken baby syndrome.
PART I of their theories to see if they are false. Courtroom scientific evi-
dence critic Peter Huber describes some of the problems plagu-
THE ELEPHANT ON THE MOON1 ing this myopic approach:
Sir Paul Neal, the renowned 17th century astronomer, couldn’t [P]athological science often depends on experiments at the
believe his eyes. He had been peering through his telescope at thresh hold [sic] of detectability, or at the lowest margins of
the dimly-visualized details of the moon when he spotted an ele- statistical significance. The claims frequently emerge from
phant on the lunar surface! As a highly-regarded member of the a body of data that is selectively incomplete; wishful
Royal Society, he felt it was his obligation to announce his find- researchers unconsciously discard enough “bad” data to
ing to a world in which the possibility of men living on the make the remaining “good” points look important. That
moon had developed into a topic of serious debate among mem- the measurements are at the very threshold of sensitivity is
bers of learned societies. Neal was publicly humiliated and an advantage, not an obstacle: data that don’t fit the theo-
ridiculed—and the Royal Society with him—when it turned ry are explained away; those that fit are lovingly retained.
out that, in fact, what he had taken for the trunk of an elephant Professional statisticians call this “data dredging.”2
was actually the tail of a mouse
The medical literature upon
that had crept into his telescope.
which the diagnosis of Shaken
News of Neal’s illusory elephant Baby Syndrome (SBS) is based is
on the moon sent a thunderclap replete with more than half a cen-
through the scientific community tury of confirmation bias of the
of the day forcing scholars to sit kind that caused Sir Paul Neal’s
up and take note of the fact that, demise. It is composed of a patch-
when one sets out to prove a work of “studies” each often con-
hypothesis, the truth may be the sisting of less than a handful of
first casualty of the quest. cases which include suspect “con-
fessions” to shaking and inconsis-
Truth is often the casualty when
tent methods of analyzing the
junk science is used in the court-
‘science.’
room. Junk science or, as it’s
sometimes called, “pathological The “data” that have been cob-
science,” relies heavily on faulty bled together to support the
scientific methodology where hypothesis that shaking causes
researchers set out to prove The Elephant and the Moon: Sir Paul Neal announced his brain injury to children has a sta-
hypotheses they have prejudged as finding to the world. But, in fact, all he had found was a tistical significance of zero. And,
correct (as did Sir Paul Neal) mouse trapped in his telescope. “bad data” that outright disprove
rather than first testing the limits or challenge shaking as the cause
28 T H E W A R R I O R • F a l l 2 0 0 3

2. of brain injury in children are routinely ty of the philosopher. For the next 2,000 tific method sets out to disprove the
discarded and explained away because years, the validity of any particular “sci- hypothesis rather than by confirming it
they do not fit the prevailing misdiagno- entific” claim was based upon the reputa- (as did Sir Neal). This is the process of
sis of Shaken Baby Syndrome (SBS). In tion of its proponent in the established “falsification” proposed by 20th century
this area of medicine and forensic pathol- scientific community and his rhetorical philosopher Karl Popper.
ogy a mere hypothesis has become a sci- reasoning skills.3
entific conclusion without a reliable sci-
entific basis. THE MODERN
In the United States alone, where there
SCIENTIFIC
may be as many as 5,000 to 6,000 crimi- METHOD
nal prosecutions annually involving shak- Science began to
ing as the claimed cause of brain injury to prevail over reason
babies, it is critical to understand whether with, for example,
shaking a baby is, indeed, the cause of Francis Bacon
brain injury, or merely a mouse trapped (1561-1626), an
in a telescope. English philoso-
But first, a little history. pher and a pioneer
of the modern sci-
THE GREAT DEBATE: entific method.
REASON VS. SCIENCE Bacon taught that
truth was derived
The debate over junk science in SBS res- not from the rea-
onates in the age-old debate between rea- soning ability of
son and science. It’s a debate that has an authoritative
raged in many scientific circles about one person, but from
hypothesis or another throughout histo- experience, obser-
ry. For example, the Greek philosopher vation, and testing,
Aristotle (384-322 B.C.) reasoned that i.e., experimenta-
matter was continuous and that it could tion.
be subdivided indefinitely, without ever The debate between reason versus science has raged for millennia,
How does a partic- such as that between aristotle and Democritus over whether
reaching any limit. He argued that matter
ular scientific matter was continuous.
had no ultimate underlying structure.
proposition come Copyright 2003 by Sidney Harris. Reprinted with permission.
Another Greek philosopher, Democritus into being? While
(about 460-370 BC), reasoned that mat- every discovery has its own path, one that
ter was discontinuous, i.e., that it did is frequently twisted and full of wrong SCIENCE GOES TO COURT
have an underlying structure so that at turns, what follows is the basic map. First,
some point matter could no longer be someone notices some thing, such as, a In Daubert v Merrell Dow, 509 U.S.
subdivided. He called this smallest unit of phenomenon, and based on that observa- 579, (1993) the U.S. Supreme Court
matter the “atom” (from the Greek word tion develops a theory or hypothesis relied heavily on the work of Karl Popper
a tomos, meaning “not cuttable”), a basic about what it may mean or how it’s and others to redefine the meaning of
unit that he believed was indestructible. caused. Take, for example, Newton’s ‘science’ that is deemed sufficiently reli-
falling apple and his hypothesis of gravi- able for a jury’s consideration. Justice
Having now split the atom, we now ty. He saw the apple fall (observation and Blackmun wrote for the majority:
believe we know who was right in this experience) and he formed a hypothesis
area of what is called “particle physics.” about the cause (gravity). To test the Ordinarily, a key question to be
But, at the time, the problem with the validity of the theory or hypothesis, answered in determining whether a
Greek philosophers’ approach was that it Newton had to design an experiment or theory or technique is scientific
was based only on a debate between com- have a measuring tool: He developed an knowledge that will assist the trier of
peting reasoning. The battle of competing area of mathematics (now called “calcu- fact will be whether it can be (and
reasoning could not resolve the scientific lus”) to help him test his hypothesis. has been) tested. ‘Scientific method-
dispute about the continuity of matter. In ology today is based on generating
the times of Aristotle and Democritus, However, as Sir Paul Neal and the Royal hypotheses and testing them to see if
experimentation was not used in any sys- Society learned, it is futile to set out to they can be falsified; indeed, this
tematic way to decide between alternative prove a theory and run the risk of con- methodology is what distinguishes
theories or hypotheses. Observations led firming a fallacy, rather than first investi- science from other fields of human
to hypotheses, but the process, in general, gating, testing and identifying reality. To inquiry.’ …Id., at 593. (Italics
ended there. As a result, the acceptability avoid the danger of announcing ele- added.)
of a hypothesis was based on the authori- phants on the moon, the modern scien-
T H E W A R R I O R • F a l l 2 0 0 3 29

3. THE ELEPHANT ON THE MOON
admissibility of scientific field in which it belongs.” Id., at
evidence was whether the 1014.
alleged “science,” was “gen-
Today, under Daubert, the fact that a par-
erally accepted in the rele-
ticular scientific proposition is “generally
vant scientific community.”
accepted” is only one criterion for what
Frye v United States, 54
makes something reliable science for pur-
App. D.C. 46 (1923).
poses of admissibility. General acceptance
In 1923, James Alfonso Frye is subject to the fallibility of human poli-
was on trial for murder in tics, and is to be viewed with great cau-
Washington, D.C.. Frye had tion. For, as Galileo’s experience taught
taken a systolic blood pres- us, the powers that be may generally
sure test that supposedly accept and sponsor a belief, such as, “the
measured his physiological world is flat.” General acceptance in the
responses to questions to Holy Roman Empire and elsewhere did
determine truth or falsehood not, however, make it so.
(innocence or guilt). Frye
argued that the test results SHAKEN BABY SYNDROME
would prove his innocence. AND GENERAL ACCEPTANCE
The device was invented by
Most state courts admitted testimony
William Marston, creator of
about SBS in the days when physicians
the comic book character
generally accepted shaking as the cause of
Wonder Woman and her
a certain group of head injury symptoms
truth-inducing lasso. The
with which the children came into the
systolic blood pressure test
hospital. While the science of head injury
Aristotle’s authority carried the day because he was was actually a crude precur-
has advanced, many judges and doctors
more authoritative in the days when experimentation sor to the modern poly-
are impervious to these advances. The sci-
was not used in any systematic way to resolve disputes graph. The defense offered
ence of head injury causation, developed
over competing hypotheses. to have Frye take the test
by biomechanics over the last 30 years,
Copyright 2003 by Trevor Goring. Reprinted (and converted to right in front of the jury.
has slipped through the cracks in our jus-
black and white) with permission. But, the trial judge reasoned
tice system and our medical schools.
Quoting Popper, Justice Blackmun con- that the blood pressure test
tinued: “[T]he criterion of the scientific was not generally accepted in the relevant It is time to judge the science by which
status of a theory is its falsifiability, or scientific communities of physiology and we are being judged.
refutability, or testability.” Id., 593. psychology and refused to admit its
Popper said this criterion was the defin- results. When convicted, Frye filed a sin-
WHAT IS SHAKEN BABY SYNDROME?
ing characteristic of empirical—i.e., gle-issue appeal of the judge’s ruling on It is claimed in medical literature, med-
good, reliable and, therefore, relevant— the systolic blood pressure results. ical records and, consequently, in crimi-
science. If a hypothesis has not been falsi- Affirming the trial judge’s refusal to
fied despite searching inquiry, then its admit them, the D.C. Circuit in a two-
scientific proposition is accepted. page opinion made what is probably the
most famous, (or infamous) statement
In addition to the falsifiability question, about the admissibility of scientific evi-
the Daubert Court gave other criteria for dence in American law:
the trial judge to use on remand to evalu-
ate the scientific reliability of the plain- “Just when a scientific principle or
tiff ’s claim that the prenatal, anti-nausea discovery crosses the line between
drug Bendectin caused plaintiff-Jason the experimental and demonstrable
Daubert’s horrendous birth defects. This stages is difficult to define.
list, which necessarily changes depending Somewhere in this twilight zone the
on the area of science being offered as evi- evidential force of the principle must
dence, includes whether the scientific be recognized, and while courts will
tests being proffered have known or go a long way in admitting expert
potential rates of error, whether the testimony deduced from a well-rec-
results have been peer reviewed, and ognized scientific principle or dis-
whether the science is generally accepted covery, the thing from which the
deduction is made must be suffi- English statesman and philosopher Francis
in the relevant scientific community. Bacon (1561-1626) pioneered the modern sci-
ciently established to have gained
Before Daubert, the sole standard for entific method teaching that scientific truth is
general acceptance in the particular
derived from experimentation, not argument.
30 T H E W A R R I O R • F a l l 2 0 0 3

4. THE ELEPHANT ON THE MOON
nal indictments and parental rights ter- An untested syndrome that is both a State continues to sponsor and promote
mination proceedings, that another diagnosis and a statement of causation, shaking as a cause of pediatric brain
human being, by violently shaking a made by someone in the medical profes- injury by prosecuting mothers, fathers,
baby, can inflict one or more of the fol- sion untrained in the science of injury brothers, sisters, grandmothers, friends
lowing injuries: causation, is hardly the way of reliable sci- and neighbors for injuring or killing
• Subdural hematomas (SDH’s), bleed- babies by violently shaking them.
ing beneath the dural covering of the The real science available about SBS sug-
brain over the convexities of the gests that one prosecution for allegedly
brain. This is termed “intracranial inflicting brain injury on a child by shak-
injury”; ing, alone, is one too many, just as it was
• Subarachnoid hemorrhages (SAH’s), 21 too many when 19 men and women
bleeding beneath the arachnoid cover- and two dogs were falsely accused of, and
ing of the brain over the convexities of hanged for witchcraft in 1692 in Salem,
the brain. This is also termed intracra- Massachusetts.
nial injury;
Yet, shaken baby syndrome (SBS) as a
• Diffuse axonal injury (DAI) (tearing cause of brain injury enjoys institutional
and sheering of nerve fibers in the support from the American Academy of
brain, itself ). This is termed “cerebral Pediatrics (AAP), and the National
or intercerebral injury”; Association of Medical Examiners
• Contusions or bleeding in the body of (NAME), among others. The AAP,
the brain, itself (also termed intercere- Philosopher Karl Popper (1902-1994): which receives substantial federal grants
bral injury); and “The criterion of the [modern] scientific to devise programs to recognize and pre-
• Retinal hemorrhages (RH’s), such as, status of a theory is its falsifiability, or vent child abuse, including so-called
bleeding in the vitreous inside the eye, refutability, or testability. “shaken baby syndrome,” recently
and/or between the retinal layers received such a grant for $1.5 million,
behind the eyes. ence. Nor is this helpful in our system of which it announced on its web site. The
justice where one is supposed to be inno- AAP’s committee on child abuse for
Other alleged ‘diagnostic signs’ of SBS cent until proven guilty. It only makes 2000-2001—through which the AAP
include bruising to the neck, shoulders, matters worse that people are prosecuted affirmed it’s belief in SBS as a real form of
torso or arms where the child was alleged- for this form of child abuse in spite of the child abuse—is composed of several
ly grabbed and shaken, broken ribs, and fact that the
broken arms and legs, i.e., fractures of the hypothesis that
‘long bones.’ shaking alone
This article focuses on cases involving injures babies’
injuries to the head only, that is, on the brains has now
baby who is brought to the emergency been falsified
room with bleeding above the brain or (disproved) by
damage to the body of the brain, itself, experiments in
retinal hemorrhages, or all of these. biomechanical
(Injuries to arms, legs, ribs and other testing using a
areas raise other forensic issues that can’t model baby and
be covered here.) by other corrobo-
rating works.
SBS: AN UNPROVED HYPOTHESIS (More on this
MASQUERADES AS ‘SCIENCE’ later.)
The central forensic fault with the theory A fair number of
or hypothesis that people can injure physicians now
babies’ brains by shaking alone is that, challenge shaking
from its inception, the hypothesis was as the cause of
based on reason and inference, rather brain injury in
than reliable testing. It has been “con- babies, and the
firmed” solely by further reason and theory of shaking
inference. If, for example, a baby is has come under
brought to the emergency room with serious attack in
SDH’s and RH’s, the diagnosis is “shaken cases and medical
baby syndrome.” The symptoms are used literature since Infant head exposing the veins in the subdural space.
to infer the cause. 1987. Still, the Copyright by John Harrington, CMI, 2003. Reprinted with permission.
T H E W A R R I O R • F a l l 2 0 0 3 31

5. THE ELEPHANT ON THE MOON
physicians whose writings reflect more So, for him, the association between the reported in Newsweek. A photograph of
medical anecdote and ideology than brain and long bone injuries he suggested her carried the cutline:
knowledge of serious science or evidence- was an exciting development.
Size and strength: The brutal and
based medicine on the subject.
The Virginia Jaspers case in 1956 was to tragic career of nurse Virginia Jaspers
THE ORIGINS OF SBS increase his excitement. It cannot be is tied to her massive physical traits.
entirely blamed for the beginning of the Now 33, she is an ungainly 6 feet,
Where did it all begin? The origins of modern nightmare called “shaken baby weighs 220 pounds, has a 52-inch
“shaken baby syndrome” lie in the early syndrome,” for Caffey and others bear waist. Police concluded that she
writings of a radiologist, John Caffey, responsibility for failing to scientifically probably had no idea of the strength
M.D. In 1946, Caffey reported four cases scrutinize Jaspers’ claims. However, of her cruelly big arms and hands.
of children who had broken bones and Jaspers’ story was partly responsible for
opening floodgates The cat about shaking was out of the
that are still not bag—or so it seemed. The problem was
closed. The daugh- that whether it was possible under the
ter of a New Haven laws of physics for Jaspers to inflict these
railroad executive, injuries by shaking alone—despite her
Jaspers was vicious- confession—was never even questioned.
ly described in the Confessions do not a science make. Even
national media as Galileo confessed at his Inquisition to
an “ugly duckling” teaching heresy when he knew that, in
and a “large and fact, the world was round. (Had some of
ungainly girl” with us represented Galileo, we may have
“ham sized hands” advised him to do the same.)
who, with limited No doubt the confessions of the shake-
options, left school prone nurse (as she was later called by
at age 19 to study Caffey) emboldened one doctor, C.
pediatric nursing, Henry Kempe, M.D., to announce in
then the ghetto of 1962 that any child with subdural
the field. hematomas and retinal hemorrhages had
Five years later, 11- been abused by shaking. Writing through
week-old Cynthia the institutional voice of the American
died suddenly of a medical establishment, the Journal of the
cerebral hemor- American Medical Association (JAMA),
rhage while Jaspers Kempe urged doctors to look for subdu-
was her nursemaid. rals and retinal hemorrhages in children
Doctors suspected with broken bones, and to diagnose shak-
abuse because there ing as the cause of these injuries if they
were signs that were found. While Caffey was to call it
baby Cynthia had the Parent-Infant Traumatic Stress
An infant subdural hematoma (intracranial injury) shown on been dropped or Syndrome (PITS), Kempe called it “the
CT scan. The white, long concentric shadow on the left thrown. Still, battered child syndrome” inflicted by
represents the subdural hematoma. Cynthia’s parents parents on their babies. There was never
chronic (old) subdural hematomas and trusted their nurse- any question about the matter. The chil-
retinal hemorrhages. He wondered maid and asked Jaspers to return when dren had been abused. All critical think-
whether there was an association between their next child was born. (Jaspers also ing about other possible causes—such as,
the broken arms and legs (i.e., long cared for the children of several other accidents, short falls, birth injuries and
bones) and subdural hematomas. He was families.) Three years after baby Cynthia’s genetic defects—had ceased.
later to suggest they had been shaken. death, another child in Jaspers’ care— Kempe also claimed that if there was a
But, of the four cases, none were autop- three-month-old Jennifer—asphyxiated marked “discrepancy between clinical
sied, and so there was no information on her own vomit and died. Jaspers findings and historical data as supplied by
about whether any of these children suf- protested that she had done nothing to the parents” this was a “major diagnostic
fered internal or external blunt trauma to harm the child and, in fact, had tried to feature of the battered child syndrome.”
the head—either by accident or intent— save her by shaking her to get a “bubble” He was referring to parents’ claims that
to otherwise explain the brain injuries. At up. Then, in August 1956, Jaspers admit- their children were injured from short
this phase of his career, Caffey was con- ted to shaking one of her charges, 11-day-
falls or other impacts. Despite the fact
cerned to establish pediatric radiology as old Abbe, when she refused to take her
that there had been reports in clinical
“a respectable and valid medical entity.” formula. Abbe died. Jaspers’ story was
neurosurgical literature for more than
32 T H E W A R R I O R • F a l l 2 0 0 3

6. THE ELEPHANT ON THE MOON
100 years in which short falls caused skull aged their colleagues to jump to the con- no autopsy, and this was before the days
fractures, subdural hematomas and reti- clusion of child abuse in cases where the of CT scans. As part of the process of
nal hemorrhages related either to brain children had SDH’s, RH’s and no evi- diagnosis, physicians must attempt to
swelling or impact, Kempe claimed that dence of external trauma to the head. rule out, that is, disprove or falsify, a diag-
parents’ stories about short falls causing nostic theory, and fail to do so, before
The role of the doctor is to diagnose and
these injuries to their children were cate- accepting it as the cause of a condition. If
treat. It is not the role of a physician to
gorically false. Kempe had no foundation a doctor sets out to prove rather than fal-
accuse others, at least not without reliable
for such a claim. He had conducted no sify his or her first diagnostic impressions,
science. Nothing could be more harmful
research to determine the minimum he or she risks treating the patient for
to a child than to have his parents falsely
impact velocity required to cause these something the patient does not have.
accused and taken away. Since Kempe’s
injuries to the head. Probably, he had not Indeed, in Kempe’s first reported case, the
medical profession would not accept
even considered that in a drop of only parents explained that another child had
explanations of short falls or other condi-
three or four feet, one hits the ground at thrown a toy hitting the one-month-old
tions as the cause, and since the parents
10 miles per hour. Parents’ protestations baby on the head. Their account was dis-
could not explain why the child had
of innocence and denials of wrongdoing counted as part of the denial associated
SDH’s and RH’s, parents were doomed
were just part of the battered child syn- with “the syndrome.”
by Kempe and others who inferred and
drome, he inferred.
reasoned that they must have had a hand Kempe did no experiments to test the
Kempe advocated that physicians material properties of the pediatric
ask questions that were designed skull or of the underlying material
to trap the parents into admitting properties of the pediatric brain,
they lost control and lashed out, and no analysis of the impact veloc-
such as: “’Does he cry a lot?’; ‘Is ity with which the toy may have hit
he stubborn?’; ‘Does he obey the baby’s head to see if he could
well?’; ‘Does he eat well?’; ‘Do rule out the parents’ account as the
you have problems controlling cause of the injury before he ‘diag-
him?’.” Kempe also urged doctors nosed’ (accused) them of abuse.
to delve into the parents’ own
In the second case Kempe reported,
family history—had they been
there was evidence of blunt trauma
abused?—and, worse, advocated
to the head—a skull fracture. Brain
that “nurses or other ancillary
injury by shaking alone was incon-
personnel,” watch (spy?) on the
clusive even on Kempe’s own exam-
parents while in the hospital with
ples. As has happened so many
their injured child.
times in the sordid history of
Things were taking a really nasty humanity, reason had prevailed
turn. In the Salem witch trials of over science and had done so with
1692, it was said that as suspicion The vasculature (arteries and veins) of the brain with the
the help of the members of the
escalated, people began to “break brain tissue removed. when the brain rotates, it tears and medical establishment.
charity” with one another, accus- sheers these vessels.
ing and naming each other as ANOTHER VOICE:
witches. By advocating that physi-
in injuring their own children.
THE SCIENCE OF HEAD INJURY
cians go beyond diagnosis and treatment
While the child abuse doctors were busy
and become investigators of injury causa- Facing accusations of being a witch when
beating the drums about shaking, at least
tion, against a child’s own parents, he could neither explain strange phenom-
one physician was trying to develop and
Kempe was, in effect, telling the medical ena nor recall all ten commandments in
apply the science of head injury biome-
community to break charity with its 1692, John Proctor, the character in
chanics to determine what forces it actu-
patients. Auther Miller’s classic play, “The
ally takes to cause brain injuries from
Crucible,” put it this way: “I never knew
THE DARK SIDE OF DIAGNOSIS what later became popularly-known as
until tonight that the world is gone daft
“whiplash.” Whiplash is rapid movement
Hippocrates’ ideal was “First, do no with this nonsense.” The night, like the of the head back and forth without
harm.” In “Ancient Medicine,” he wrote daftness, was only just beginning. Kempe impact.
that those who leap to conclusions about gave scant ‘proof ’ that his theory of shak-
the origin of an illness are “clearly mis- ing as the cause of these injuries was sci- Whether rear end car crashes could cause
taken in much that they say.” If entifically valid. He reported only two whiplash injuries was controversial and
Hippocrates were alive today, it is not cases in his article. disputed in the 1960’s, even more so than
much of a stretch to believe that the In the first case Kempe reported blunt today. Beginning in 1966 and 1968,
Father of Medicine would have had harsh trauma to the head could not be ruled Ayub K. Ommaya, M.D., a Pakistani-
words for Kempe and others who encour- out because the baby survived. There was born and Oxford-educated neurosur-
T H E W A R R I O R • F a l l 2 0 0 3 33

7. THE ELEPHANT ON THE MOON
geon, set out to determine the amount of In 1971, yet another doctor weighed in the brain as the quick bending of the
force it takes to cause certain types of on shaking. Citing Caffey’s 1946 article infant skull occurs from sudden impact.
brain injuries ranging from subdural on the association between broken bones
The work of biomechanicians show that
hematomas (intracranial bleeding) to and SDH’s, Kempe’s 1962 article and
slow changes in skull shape, such as those
bleeding in the body of the brain, itself Ommaya’s 1968 monkey data as proof
occurring in the birth canal, allow the
(e.g., intercerebral contusions). Ommaya that human shaking causes brain injuries
brain to adjust its internal pressure and
wanted to test the hypothesis that rear in children, A.N. Guthkelch, M.D.,
make accommodation for the external
end car crashes could cause such injuries announced in the British Medical Journal
squeezing on the skull. Blood flow and
when the occupants were (1) not that when a child with subdural
flow of cerebral spinal fluid are regulated
restrained and (2) did not bang their hematomas (SDH’s) and retinal hemor-
to decrease or increase volume. But, as
heads. rhages (RH’s) and no external marks on
with a precipitous birth, there is no time
his or her head comes to the ER, one can
Ommaya’s experiments were gruesome for this adjustment of blood and cerebral
infer (reason) that the child had been
and unpopular, and later ones by other spinal fluid pressures in the fast bending
repeatedly shaken, rather than being a
scientists were to be shut down under of the skull that happens when an infant
victim of impact.
pressure from animal rights groups. But, falls and hits his or her head.
in the research climate of the mid-to-late This doctor made no distinction between
According to Ommaya and others who
1960’s, Ommaya was able to use Rhesus the power that a human being can gener-
have studied the material make up of
monkeys in place of humans to mimic car ate versus the power of a machine, even
brain tissue, it consists mostly of water
accidents by accelerating them on chairs citing the case of a “prominent American
fixed to a track and decelerating them neurosurgeon who
without impacting their heads at all. developed a SDH
after his head had
After these grisly experiments, the mon- been jerked by the
keys were anesthetized, killed and autop- violent motion of
sied. Ommaya’s 1966 and 1968 experi- the bobsled which
ments showed that it took between he was riding at the
35,000 to 40,000 radians per second fun fair,” as an
(squared4) of angular or rotational acceler- example that
ation to cause intracranial and intercere- human shaking
bral bleeding in the monkeys. That was injures babies’
the equivalent of forces not merely in a brains. Nor did this
straight line (so-called “linear”), but doctor appreciate
forces occurring as the monkeys’ heads that blunt impact,
The 1968 Ommaya rhesus monkey experiments. The cars were shot
rotated or arced on their necks. as with an acciden-
forward and quickly stopped causing whiplash injury at about
tal fall, may leave
To compare what would happen to 120-G forces, more than 10 times the 11-G forces a human being is
no telltale marks,
human brains during the angular or rota- able to generate by shaking, alone.
especially in the
tional acceleration-deceleration of a car
case of an infant.
accident, Ommaya mathematically scaled and fat. As such, it would take about
the size of the monkeys’ brains to human Head injury biomechanics was not even 100,000 square inch pounds of pressure
brains and determined that it would take part of the question about whether shak- to compress it to a smaller size. To under-
between 6,000 and 7,000 radians per sec- ing could cause the so-called SBS head stand the magnitude of this force, imag-
ond (squared). Relying on this and other injuries. For example, as with Caffey and ine a woman wearing shoes with a one-
head-injury data, Ommaya concluded Kempe, Guthkelch did not appreciate square-inch heel. If she weighed 100
that forces generated by some rear-end that the infant skull is pliable and is capa- pounds and stood on one foot with a heel
car accidents caused whiplash brain ble of bending on impact and, in some that size, she would exert 100 square inch
injury to humans. cases, leaves no evidence of injury as it pounds of pressure on the ground.
resumes its shape. There was little excuse
To put in perspective some of the rota- Under pressure, like water, the brain fol-
for failing to appreciate this situation, for
tional or angular forces that must be lows the path of least resistance. On
the pliable nature of the infant skull was
exceeded to cause human head injury impact, when the skull indents or, as bio-
described in the medical literature as far
without impact, there are a few reports in mechanicians say, when it “transiently
back as 1888. Still, when one is set on
the Japanese neurosurgical literature deforms,” some computer models show
proving a hypothesis, contrary informa-
claiming that some riders exposed to the that the brain tissue rotates inside the
tion is discarded and supportive data is
massive angular forces created by roller skull. To visualize this, imagine that
lovingly retained.
coasters as they climb, dip, corkscrew and under the pressure of impact to the head,
turn, have developed SDH’s diagnosed Nor did Guthkelch, or any other physi- the brain behaves a bit like toothpaste in
after experiencing “roller-coaster cian claiming that shaking injured babies’ a capped tube which when squeezed from
headache.” brains, consider what might happen to the outside rotates under the pressure.
34 T H E W A R R I O R • F a l l 2 0 0 3

8. THE ELEPHANT ON THE MOON
Because the toothpaste is relatively ments, Guthkelch and Caffey also read gleams,
incompressible, it cannot get any smaller. Ommaya’s 1968 monkey experiment
It’s stretch, squeeze, stretch; not bash, hit
But it can get relief from the pressure by article. Because he was traveling along his
batter,
turning or rotating in the tube. own “scientific” track intent on reaching
a preconceived destination, Caffey con- Which bloody your bones and dura
The rotation of the brain caused by skull
cluded that just as acceleration-decelera- mater.5
change on impact would be harmless if it
tion, without impact (i.e., free shaking or On one level, given the development of
were not for the fact that the brain is a
‘whiplash’) damaged the monkeys’ brains, the modern scientific method by Bacon,
labyrinth of blood vessels (as are found in
this also explained how parents inflicted Popper and others, it is amazing that no
the subdural and subarachnoid spaces)
brain injury on their babies. He actually one at the time questioned or challenged
and of millions of connections (such as
telephoned Ommaya to thank him for the assumptions and conclusions reached
neurons and their axons) that cannot be
the 1968 article. Today, Ommaya is by Caffey, Kempe or Guthkelch, especial-
stretched beyond their limits. Once these
adamant that he told Caffey that the ly when the liberty of other human
structures are stretched by rotation, they
acceleration-deceleration forces involved beings, and the love between parents and
will shear, tear and die causing excessive
in the monkey experiments were much children were at stake. Instead, as with
bleeding and, often, lethal swelling of the
greater than he believed could be generat- the debate between Aristotle and
brain.
ed by a human. Indeed, Ommaya recent- Democritus, it appears that the authority
In the early days of the SBS diagnosis, the ly affirmed that communication in the of these prominent physicians, who were
science of head injury biomechanics was British Journal of Neurosurgery in 2002. publishing their hypotheses about pedi-
still in its infancy. The development of
Caffey’s subsequent misapplication of the atric head injury causation in the estab-
this science would have to await, among
1968 Ommaya monkey data to alleged lishment medical journals, rather than
other catalysts, the advent of products lia-
shaken babies was to further compound any true claim to reliable science, carried
bility cases against manufacturers of auto-
the problem of “shaken baby” theory, the day.
mobile companies, playground equip-
already a hopeless house of cards con- In terms of the medical culture of the day,
ment, bikes, helmets and toys. For exam-
structed of unproved hypotheses fueled it is not surprising that there were few
ple, in attempts to design more crashwor-
by Kempe’s call to physicians to cultivate challenges, if any, to these physicians.
thy vehicles and minimize liability and
suspicion of patients’ parents. They were publishing their theories at a
damages, the auto makers would employ
biomechanicians to start working out the In 1972, Caffey wrote and published, time when the practice of medicine was a
thresholds and causes of head injury at “On the Theory and Practice of Shaking more refined and ostensibly gentile
crash test facilities, and later with com- Infants.” By then, Caffey and Kempe endeavor, when learned men published
puter-generated models. shared the limelight with the newly iden- case studies in journals, and gave defer-
tifiable form of child abuse being called, ence, rather than challenged, one anoth-
Guthkelch and other physicians advocat-
among other names, “the Caffey-Kempe er’s assumptions and conclusions. It was
ing human, manual shaking, alone, as the
Syndrome.” Their careers as discoverers all very gentlemanly and polite, but rarely
cause of brain injury to babies also did
of the new scientific frontier had taken scientific. Most senior physicians then,
not know that their hypothetical descrip-
off. And, Caffey’s publicly-expressed and even now those currently in practice,
tions of parents injuring their babies by
desire that pediatric radiology become a were trained under the old system that
shaking them from front to back was to
“respected and valid medical entity” was started with an undergraduate degree in
be further questioned by later head injury
being realized. From Caffey’s viewpoint, almost any field followed by years of
research. In 1982 biomechanician
it was through the magical eye of the X- intense training by professors of medi-
Lawrence Thibault and neurosurgeon
ray (then called the roentgen) that the cine. The professors taught by imparting
Tom Gennarelli (and others) showed that
shadows of pediatric head injury abuse their years of anecdotal experience and
brain injury occurs more easily from side-
were being exposed. Caffey was later to their beliefs to the new medical students.
to-side rotation, like the tick-tock of a
call the X-ray “the pristine probe,” and in Experimental medicine (evidence-based
metronome, that is, in the coronal plane,
a 1972 address to Boston- and Harvard- medicine) used to be mentioned only
and not in from front to back like a
based radiologists read them this poem he occasionally, and the conclusions of the
child’s swing, that is, in the sagittal plane.
penned: limited number of experiments (clinical
And this was in an experimental situation
trials) often were of limited validity or
where the forces far exceeded what a Poor shaken babe, guileless tyke, were even incorrect because of poorly
human being can generate. It’s a question
Rocked by love and hate alike, designed clinical trials and poor under-
of magnitude.
standing of the statistics of clinical trials.
Your mother’s tongue locked in silence,
HEAD INJURY SCIENCE SLIPS THROUGH The development of “evidence-based
Hush untold tales of guilty violence, medicine”—large medical studies, apply-
THE CRACKS OF MEDICINE
ing the scientific method in study design,
But when we flood your flesh with radi-
As the automobile companies and other testing and interpretation of results—was
ant streams,
manufacturers were studying the science still at least two decades away when
of head injury to minimize money judg- Bruised bones shine through in truthful Caffey published his 1972 paper.
T H E W A R R I O R • F a l l 2 0 0 3 35

9. THE ELEPHANT ON THE MOON
baby syndrome.” Many of them (AAP’s) reliance on Caffey’s work to justi-
joined the parade by reporting fy the existence of “SBS” is at best negli-
their own anecdotal and self- gently misplaced and at worst ideologi-
confirmed theories in the med- cally infected. Caffey’s article contains
ical literature. Today, there are within itself an absence of reliable and
several hundred such articles. complete data to support his hypothesis
Most of them refer and rely on and conclusions about Virginia Jaspers’
Caffey, Kempe and Guthkelch. alleged shakings:
It is a legal and moral outrage “The most gruesome and, at the
that even though the SBS “diag- same time, the most significant
nosis” is a statement of causation examples of proved…whiplash-shak-
pediatricians are not required to ings and of burpings are recounted
study the science of head injury in the story of an infant nurse…She
causation either in medical is reported to have killed three
school or in their pediatric resi- infants and maimed 12 others dur-
dencies. This is also true of ing a period of eight years, largely by
forensic pathologists who are fre- shaking and jolting infantile brains
quently called to testify about and their blood vessels…. In one
The scattergram from the 1987 Thibault study shows the issues of force. instance she was invited back by the
thresh hold for injury from human shaking, alone. Note parents to care for their second
that by shaking the model baby without impact, the One forensic pathologist testify-
ing in a murder trial in a case of infant after she had shaken their first
researchers were not able to generate the forces Ommaya child to death.” (Emphasis added.)
reported are necessary to cause brain injury. The circles alleged SBS haughtily told a
in the bottom, left corner are the measurements from the Kansas jury in November 2000, Caffey ignored the fact that the first
accelerometer on the baby’s neck from the pure shaking “I have no interest in infant showed evidence of blunt trauma
experiment. No one got over 11 G forces. But, when the [bio]mechanics. I am a doctor.” and continued: “Eventually, she admitted
model baby was slammed (the slams are represented by Yet she was there to testify about killing three infants and maiming two
the triangles) the force generated was about 50 times head injury causation in relation others.” Not only was Caffey’s 1972 arti-
greater than pure shaking. to the manner of death: cle heavily dependent on Jaspers’ descrip-
Homicide by violent human tion of how she believed (once accused)
Even today, a bias toward reliance on shaking, alone. She was there for the State that she injured the babies, but it also
anecdotal rather than on evidence-based to refute the defendant’s account of the lacked any detailed autopsy (then called
medicine continues in this field. Only in child who fell head first down concrete “necropsy”) information on which any-
recent years has the concept of medicine steps. The child’s injuries were caused one could make an independent judg-
as a research science (evidence-based when the defendant violently shook him ment about the validity of the scientific
medicine) been introduced into the med- and then slammed him down, the med- hypothesis, i.e., that by shaking a child
ical school curriculum. Current medical ical examiner claimed. The SDH’s, the violently, an adult could inflict brain
training, on the other hand, emphasizes RH’s, could not have been caused by this, injury.
the science of medicine (evidence-based she further reasoned before the jury. She
medicine) and addresses the validity of had not even bothered to calculate the In 1974 Caffey wrote more about Jaspers
specific clinical trials and of different impact velocity (if she even could) with “whiplash shaken” baby cases and this
types of clinical trials in making medical which the child would have hit the time included some autopsy information
recommendations. ground to rule out foul play. She had about one of the babies. One very haunt-
read the medical literature about SBS and ing problem about the case of the (11-
The entire concept of “shaken baby syn- week-old) baby whom Jaspers was
was confident and satisfied that she was
drome” arose when most physician-train- accused and convicted of killing is that,
an expert in shaking as a cause of brain
ing was based on the medical culture of based on the autopsy information that
injury in babies.
the mid-twentieth century, a time when was provided, this child may well have
new ideas did not require rigorous scien- The Kansas forensic pathologist had, of had birth injuries. (Obstetricians know
tific validation to survive. The same con- course, read Caffey’s 1972 article. That only too well that even babies born by
cept, if introduced de novo today, would article now forms part of the “scientific” normal birth sometimes have subdural
not survive scientific evaluation and foundation of the American Academy of hematomas.) In that autopsy of the 11-
would not have become established as Pediatrics’ [AAP] technical report affirm- week-old, shaking was not ruled out by
part of our medical and legal folklore. ing that human, manual shaking, alone, examination of the brain stem or upper
without impact, causes baby brain injury. cervical spine. The age of the subdural
The biomechanics of head injury was not
The AAP reaffirmed its position as blood was not tested to see if Jaspers
considered by pediatricians who contin-
recently as July 2001. could be ruled out as a killer by compar-
ued to rely on Caffey and others and to
“recognize” their own cases of “shaken The American Academy of Pediatrics’ ing the age of the initial injuries with the
nursemaid’s care of the child. And, blunt
36 T H E W A R R I O R • F a l l 2 0 0 3

10. THE ELEPHANT ON THE MOON
impact was not conclusively ruled out. able to generate was a mean of 1,138 RECENT STUDIES DEBUNK SBS
There was a clear effort to prove the radians per second (squared). That was a
hypothesis that the baby had been shak- far cry from the required 6,000 to 7,000 Other more recent studies have also refut-
en, and shaken by none other than radians per second (squared) which ed that shaking is the cause of brain
Jaspers, rather than to falsify it by search- Ommaya established were needed to injury. In June, 2001, two British neu-
ing inquiry. In some of Caffey’s reported cause brain injury by whiplash to man, ropathologists, Jennian Geddes and
cases were there was no evidence of skull i.e., shaking without impact, in the 1968 Helen Whitwell, announced their find-
fractures or external scalp injuries and, monkey experiments. ings after studying a number of children
based on this, he reasoned that these who, it was claimed, had been victims of
Secondly, the experimenters asked the shaking. They found that there was a sig-
babies were victims of whiplash shaking
athletes to slam the model baby on three
(WLS). On the “data” provided by
different surfaces. Only when it was
Caffey, it is clear that no one investigated
slammed on hard metal and padded sur-
whether there were internal injuries to the
faces did the accelerometer on the model
scalps of those children. Certainly, no one
baby’s neck register the forces needed to
mentioned the fact that some blunt
cause concussion, SDH’s and diffuse
impact injuries do not cause external or
axonal injury. In fact, the forces generat-
internal scalp damage. And no one men-
ed by impact were 52,475 radians per sec-
tioned the pliable nature of the infant
ond (squared).
skull or considered what might happen to
the underlying brain on impact. The experiment had falsified the
hypothesis that a human being, by
Although shaking as a cause of injury is
manual shaking, alone, could injure a
blindly accepted by segments of the med-
baby’s brain. The results of the experi-
ical establishment, this hypothesis of how
ment have never been invalidated, but
babies’ brains are injured has never been
prior and subsequent studies are consis-
validated by pediatric head injury biome-
tent with them.
chanicians, i.e., by the relevant scientific
community to whom the science of injury Critics of the 1987 Thibault experiment
causation belongs. claim that the results are invalid because
the baby was not real. But, that was not
Quite the contrary.
the point. The 1987 Thibault biome-
SBS FALSIFIED BY chanical experiment focused on the ques-
tion of whether it was possible, as a mat-
RELEVANT SCIENTIFIC COMMUNITY ter of physics, for the shaker to generate
It would be 15 years after the 1972 the forces Ommaya determined were nec-
Caffey article before an experiment essary to cause brain injury without
would be performed that would prove impact. Football players capable of inflict-
that a human being could not possibly ing tremendous physical violence could
generate the forces necessary to cause not do so.
internal head injury by human, manual
If anyone really wants to reproduce this
shaking, alone. It appeared that Jaspers
experiment with biofidelic models, it can
had confessed to something she had not
be done using finite element analysis, a
done or, more sinisterly, she had done
technique through which head injury can
more than that to which she confessed.
be simulated on a computer. It’s a tech-
Unlike physicians, biomechanicians nique based, in part, on US military pro-
experiment with the forces needed to grams released into the public domain,
cause human injury. In 1987, a biome- and has been used by the auto industry,
chanician and a group of neurosurgeons among others, to make safer products.
set out to prove that SDH’s and other But, the cost of this is high, and funds for
brain injuries in babies were not caused alleged child abusers are not.
by shaking, alone, but by impact.
Following the release of the 1987 Nursemaid Virginia Jaspers: when she confessed
The biomechanician was Lawrence E. Thibault study the hypothesis of “shaken in 1956 to shaking a number of infants in her
Thibault. The Thibault team members baby syndrome” has sometimes been care, Jaspers opened floodgates that are still dif-
made a model baby and attached an recycled as the “shaken-impact-baby syn- ficult to close, despite the fact that the 1987
accelerometer to its neck. First, they drome” (SIBS), but pure shaking is often Thibault study conclusively invalidated the
asked some burly “Penn State” football still used as the theory of causation in Caffey-Kempe-Guthkelch hypothesis that shak-
players to shake the model as hard as they criminal indictments regardless of ing, alone, injures babies’ brains. Did she really
could. The most force these hulks were whether there is evidence of impact. do what she confessed to doing?
T H E W A R R I O R • F a l l 2 0 0 3 37

11. THE ELEPHANT ON THE MOON
nificant association between shaking and CONFESSIONS DO NOT articles. A person, perhaps like Jaspers,
brain stem injury or upper cervical spine EQUAL SCIENCE might confess to shaking alone, because
injury. The term “association” in medi- the impulse behind it is emotionally
cine is loaded. It means that if one sees A common theme in SBS cases is that the understandable. Hitting or slamming a
“A,” one will expect to see “B.” If a child accused confessed to shaking. baby’s head is much less forgivable. A
has been shaken, there should be corre- Even though Virginia Jaspers confessed in confession to shaking, alone, is more like-
sponding brain stem or upper cervical ly to help in plea negotiations and at sen-
1956 to shaking some of the babies in her
spine injury. The physics of this proposi- tencing than if the defendant were to say,
care, it is clear she did not kill them this
tion make sense and are supported by “I shook the baby violently then slammed
way, if at all. After being told by a pedia-
other head injury research by Ommaya, her head against the mattress.” Simply
trician that she murdered the infants in
and others. At least one biomechanician put, as with other areas of criminal law,
this way, she may well have believed she
has compared the neck to a straw, and the many confess out of sheer terror—or
did. However, the science of head injury
head to a grapefruit. When shaken, the because they are actually made to believe
developed since her confession tells a dif-
more fragile neck is the first part to be they did cause the injury. A sentencing
ferent tale. Today, after serving many
injured. This analogy is consistent with deal gets a defendant a lower sentence,
years in a State prison, Jaspers still lives instead of risking life without parole or
the work of Ommaya and others who with her “crimes,” an elderly woman who
found that the tolerance criteria for neck the death penalty after jury conviction.
is afraid and wants to slam the lid on the
injury is exceeded long before that for coffin of her past. She actually believes Others, who have found a baby not
head injury. So, if there is intracranial or she killed the babies, and in this she is not breathing and blue (cyanotic) confess to
intercerebral injury and RH’s, but no alone. Many people are actually made to shaking the baby to revive them. One
upper cervical spine or brain stem injury, believe they killed. The doctors told them young father in Erie, New York wept
one has to assume another cause, such as so. before grand jurors in 1999 telling them
blunt impact. British neuropathologists that when he shook his baby boy to revive
Geddes and Whitwell found that brain Some of these, like Jaspers’ confessions, him on finding him not breathing, he did
stem and upper cervical spinal cord are included the medical literature and not know he was causing the terrible
injury were rare findings. If shaking is so are used to provide ammunition against brain damage the doctors told him killed
common, one must wonder why the others. Jan E. Leestma, M.D., a Chicago- his son. In fact, the father’s own injuries
finding is not more common. based forensic neuropathologist, recently corroborated that had fallen down the
reviewed 324 cases of allegedly abused stairs with the child and the baby’s head
Proponents of SBS also claim that diffuse infants whose cases had been variously had been banged. But, no one wanted to
axonal injury (DAI)—axons injured dif- reported in more than 100 medical arti- rule out SBS. Why bother?
fusely in the brain—is a “diagnostic cles about shaken baby syndrome. Of the
marker” for shaking. As with shaking as 324 cases, Leestma analyzed 57 of them The fact is no one has ever confessed to
the cause of intracranial and intercerebral specifically because they involved confes- shaking a baby with force equivalent to
injuries, the DAI-by-human-shaking sions to shaking. These cases had enough more than 6,000 to 7,000 radians per
hypothesis was also falsified in 1998 by “data” on which he was able to make an second (squared) necessary to cause brain
German pathologist Manfred independent judgment about the author’s injury in the absence of impact. If they
Oehmichen. He studied the brains of claim of scientific and medical reliability. have confessed to injury by shaking,
252 people, some of whom had been Of those, Leestma found that only 11 alone, the 1987 Thibault study proves
deprived of oxygen, a common, second- had both a confession to shaking and no they are lying or have been manipulated.
ary effect of head injury referred to as evidence of impact. Eleven cases, which In fact, some biomechanicians and neu-
hypoxic or anoxic insult. Oehmichen were gleaned from three decades of med- rosurgeons believe that because the baby’s
found that people who had been on res- ical literature, hardly add up to enough brain is smaller than an adult’s, it would
pirators to help them breathe all had evidence-based medicine to prove the take even more force to injure a baby’s
damaged axons, which he termed “axonal hypothesis that the babies were injured brain by “whiplash.”
pathology.” In cases of oxygen depriva- by human shaking, alone. And, keep in
tion, there is no way to tell whether the
DOCTORS DESTROY
mind that not all blunt impact injuries
person’s axons were injured by the pri- THE PRESUMPTION OF INNOCENCE
result in evidence of external or internal
mary trauma, such as, by whiplash, or by impact, especially if the baby’s skull “Confessions” to revival shaking are usu-
the cascade of events following primary changed shape on impact and resumed ally recorded and repeated in medical
trauma known as secondary injuries, such normal shape after. records by doctors and nurses who,
as, anoxia or hypoxia. It’s critical to note because of their training that
To any serious scientist or physician, and
that in forensic medicine, the finding of SDH’s+RH’s=SBS, are presuming foul
to judges, it should be common sense
axonal pathology is “non-specific,” mean- play when the child comes to the emer-
that confessions are not reliable indica-
ing that one cannot infer anything about gency room. Most states—as a require-
tors of the science head injury causation.
its origin or cause. British neuropatholo- ment of federal funding for all kinds of
gists Geddes and Whitwell also con- The circumstances of the confessions in child-centered programs—have enacted
firmed this in another study in 2000. the eleven cases were not included in the statutes mandating that doctors and
38 T H E W A R R I O R • F a l l 2 0 0 3

12. THE ELEPHANT ON THE MOON
nurses (and others) report child abuse. In The federal and state governments and fatal brain injury. The evidence is that
most states, the standard for reporting private foundations currently pump mil- there are many other causes of intracra-
abuse is a mere “suspicion” that an injury lions of dollars every year into “recogni- nial and intercerebral injury and retinal
was caused by abuse. A mere suspicion is tion and prevention” programs to stop so- hemorrhages in babies that are just being
dangerous to report when it involves a called SBS. It has become a self-perpetu- ignored and that other potential causes
“syndrome” like SBS that is both a state- ating industry of child abuse ‘expertise.’ are not being researched.
ment of diagnosis and a statement of Money for much-needed research into
Instead of applying the scientific method
injury causation. As the machinery of the the actual cause of pediatric head injury,
to this area and using the evidence, many
State gears up, this mere suspicion-cum- the results of which could end the risk of
physicians seem content merely to gaze
diagnosis quickly morphs into probable false accusations and, possibly, free some
upon the elephant in the moon. As
cause and, by the time of trial, has moms and dads from behind bars and
lawyers, it is our job to expose the
become a diagnosis to a reasonable degree reunite them with their children, is fun-
mouse’s tail in the telescope. q
of medical probability or certainty. In neled into the wrong pockets for the
effect, what frequently happens is that wrong cause. Physicians who have staked ENDNOTES
this systemic glitch allows self-appointed their careers on SBS being a real diagno-
judges and jurors wearing white coats to sis, who have published, received grants, 1 This is part of a book currently being written
by Elaine Whitfield Sharp. Copyright by
pull the plug on the presumption of and who have testified in countless trials Elaine Whitfield Sharp, July, 2003. Permission
innocence. are understandably reluctant to buck the to publish given to The Warrior.
system that feeds them. And, in face of 2 Huber, P. W.,“Galileo’s Revenge—Junk
A QUESTION OF INTENT this powerful lobby, accused and convict- Science in the Courtroom,” p 27, BasicBooks,
1991.
Why, in face of the increasing scientific ed child abusers are not much of a match. 3 Credit for this excellent discussion of the
flap about shaking, doesn’t the State just When Illinois Governor George Ryan development of the scientific process goes to,
drop the “violent shaking” language from “The Five Biggest Ideas in Science,” Chapter
freed some of that state’s death row 1, Wynn, C.M and Wiggins, A.W., (Wiley,
its indictments, opening statements and inmates and commuted the death the 1997).
closing arguments? Why, like the Salem sentences of others in January, 2003, he 4 Squared: With each passing second as an
witch trials, does the State insist on spon- said: “I started this issue concerned about object falls the force of gravity, which is
soring only one side of the scientific approximately 32.2 feet per second, is doubled
fairness. Fairness is fundamental to the or “squared.” Thus, for the first second, the
debate? The answer lies in the need for American system of justice and our way speed of the fall is 32.2, and for the next
intent. The argument goes that there is of life.” second, it is 64.4, and so on.
no way a person could accidentally and 5 The “dura mater” is a meningeal covering of
violently shake a baby to death. And, just Unfortunately, the topic of SBS, while no the brain beneath which “sub” dural bleeding
more important, is much more complex occurs.
in case someone should claim diminished
intent for such an act, in at least one than ruling someone out as a culprit by Next Issue:
state, parents of newborns are now made DNA testing. And, there may be more
people in prison wrongly convicted of When it comes to protecting children, it
to watch a video in which they are taught
child abuse than any other segment of the might seem like scientific sophistry to argue
at the hospital—and sign a declaration
prison population. Nevertheless, when it that only impact is capable of causing brain
that they understand—that shaking caus-
comes to the relationship between par- injury to a baby. But, it has critical impli-
es brain injury to babies. Should their
ents and children, as well as questions of cations. Many accused of shaking a child
child appear in the ER with injuries “con-
liberty, it is perhaps even more important have explained that the child suffered a
sistent with SBS,” the prosecutor’s cross-
to be patient in unraveling this mess as it short fall. According to the 1987 Thibault
examination of the testifying defendant-
is with DNA innocence cases. experiment, and all the other head injury
parent with this document is not hard to
research, these accused people were telling
imagine. Fairness is fundamental, and junk science the truth about one thing: they had not
Philosopher Thomas Kuhn in his book, used to convict is fundamentally unfair. caused these injuries by shaking. Blunt
“The Structure of Scientific SBS is a ‘diagnosis’ from Hell for it sets in impact, on the other hand, could just as
Revolutions,” explains that scientific rev- motion the machinery of the State well be caused by an accidental fall from a
olutions happen when people start think- against parents and others who merely short height as it could from being hit. It
ing outside the box, in what he calls “new went to the hospital desperately seeking one falls three to four feet, one hits the
paradigms.” help for a sick child and ended up in ground at 10 miles per hour. This intro-
prison and, more often than not if the duces the notion of accident in an area
In the area of SBS, we are locked in an
child survives, with their parental rights where the State claims only intentional
old and destructive paradigm that, as in
terminated. shaking caused the injuries. In the next issue
the times of Aristotle, is promoted by the
in Part II, the science of blunt impact and
authority of the speaker—in this case If you have a case of alleged SBS, there is issues of timing of the injury will be dis-
some ideological segments and members a defense. The evidence is that human cussed. Part III will outline how to chal-
of the medical establishment—and not shaking, alone, does not injure babies’ lenge the State’s ‘science’ using the state ver-
the quality or reliability of the head brains. The evidence is that short falls sions of Daubert and Frye.
injury science. may cause catastrophic and sometimes
T H E W A R R I O R • F a l l 2 0 0 3 39