Elocution that would have been bewildering. He came at psychiatry from a Public Health perspective, and he began as somebody who was an advocate for Mental Health and the prevention of Mental Illness. Also for training doctors to that this is a legitimate form of medicine. People at a time when who were incarcerated in institutions where therefore reasons that were not medical illness. Many people who had tertiary syphilis had Mental Illness kinds of symptoms. Many people that chronic alcoholism, people who we would think of is to build mentally disabled, people with cerebral palsy. A great range of disabilities that made people be marked as and warehoused way. Initially his work was in the National Community for Mental Hygiene trying to differentiate tween the kind of Mental Illness he was confident that could be cured and the kinds that were caused i again it brain injury. Premrinot easy in the time. Entered the war rather late compared to the other allies. That offered him a chance to see not only what was called shell shock, this terrible sent set of mental disabilities but also the ways in which the allies screwed up the treatment of people who have those problems. He became almost and can do so with anxiety about what was going to happen to the American Expeditionary force. He studied canada, he studied france, he went to great written. Here at the indquarters at his office 1918. With a reallyn intense, beautiful, clinical mind. He was quite sympathetic as a doctor of individual people, but he also had a systematic mind treatingderstood that the soldiers was going to be an important and complex matter. This is one of the hospitals in the battle line. You can see that if you sneezed, you could probably knock them down. It says ambulance here on the righthand side. His doctors. Of they built these on the fly. The doctor on the side, he sort of towers over people. He was dubbed the net picker by the rest of the very skeptical u. S. Army medical corps and he becausehorned into this he came from a Public Health and private sector place. Anditerally forced his way and became the only psychiatrist in the army to run this hole in our miss set up. When he discovered about traumatic injury, mental injury in particular, was that it was mitigated by treating it immediately, it was mitigated by the process of leaving that people could get well, that sounds at of silly, but it is very true, and it was mitigated by intense activity to help patients right away. He devised treatment on his own with other people thinking it through. This is a map from the american front here. This is where the headquarters was. He discovered is if you put advance hospitals in the field and train doctors to see people who have these mental symptoms, that you could filter out in a triage system very quickly and get to people when they needed help. Can see,ok here, you here is headquarters. This is an active front. You hear you see here three advanced neurological hospitals. These are within five or six commenters. A very dangerous place to be. Taken whens were they exhibited the signs we associate with ptsd. What is interesting as he going back and forth not only from this headquarters here were we saw him but also to the only dedicated Psychiatric Hospital in the entire army. That is what you are looking at earlier. He is spending a huge amount of time going back and forth and he is bringing the soldiers back who are up at these advanced hospitals if they do not get well within 72 hours area do it was a very simple protocol that towns primitive but it is quite remarked will. The men who come in who were unable to hold a gun, unable to stand up, shaking so hard they , variousop, catatonic other kinds of symptoms, gives them a hot drink and a bed they can lie on by themselves. And hen empiricists watches. They sleep in average of 32 hours after they drink the hot drink. So we may not be talking about ptsd. We may be talking about simple exhaustion, combat fatigue. This is the view from the top of the chateau. This was set. They commandeered the chateau and built a hospital which started in the summer of 1918 with three patients and by january 1919, had more than 600. Than 2500 people at that hospital. These are people who got brought back. This is a monastery in the ardle of the argan forest gonne forest where on eof the one of the tents was set up. You can see that the chateau, the old chat to is sort of the officers were billeted down at the mayors house down the road. Were looking through the portcullis. Very condensed primitive conditions they lived in. He was ambidextrous and he did a lot of beautiful sketching of things. You can see that he line. Tching the exactlyactually stood where this is. Is a photograph from 1918. He was touring around a great deal and he moved around a great deal. At the end of his life, he became very worried and concerned about the treatment of for ans and he advocated Veterans Bureau which is the forerunner in the early 1920s of the v. A. He viewed it as a signal failure of his life that he was unable to get some things that we now think of as absolutely central for Mental Health. Mental Health Parity for veterans, that is that their Mental Health should be treated on a par with their physical health. You stigmatize in people with Mental Illness, the belief that people with Mental Illness, particularly from more trauma could get better, and probably most importantly, that we have to pay for what our veterans need. Wasas very upset and he caught in a huge rats nest of political problems including fighting privatization of military health care. So he feels like a very prescient person to me. I will leave it there. Im sure we will have questions. Thank you. The panelists should come up and sit now. As i was watching the pictures and thinking, ok, this has always been a problem that is with us. With the work that he was able to do, you went to france and had to dig this out of archives. How widespread for the Lessons Learned question the Lessons Learned across the military . There was a lot of resistance within the army at the time that there is a huge reckoning in the immediate aftermath. In 1920, 1921, and there is a an interest in all the lessons that one could get. There was a huge set of volumes in which they put all their insight and a lot of what he has written is in those. Anxiety as theof army goes down after the war and there is a lot of this interest in continuing to fund veterans and military health. It gets dismantled. One of the final ironies was a great deal of his patient records were poked during the vietnam war. They were in san antonio. At the Army Medical Corps i cut core archives. Knew we had better weapons so we would never have ptsd again and i said youre joking, right . He said not about the pulping. That underscores this is a perennial problem. He would want us to build on the knowledge that we have and not dismantle it in peace time in the hopes we did not have to pay for it. Us we allll need to talk loud. I want to know more about the moving. M of there was a lot of befuddlement about what caused shellshocked. That somehow it was the reverberation of exploding shells that caused this jitteriness. What was his understanding . His locution was worn euros is. He is picking up the most advanced of the british doctors. I never heard that word used in that context. What do you mean by his locution . They are trying to frame what is this new iteration of behavior that they are saying and soldiers. Youre right. Many of them have never been suggested subjected to artillery. They are aware that there are mood changes that have been with dramatic rain injuries that might not be the same thing as what we would call ptsd. And so he viewed worn euro as a perfectly rational, curable response to the conditions of combat. He remarks that it is a surprise that more soldiers do not have it. He understands it as an unconscious phenomenon. He is aware of for it but uninterested in freudian ofaratus of individual ways developing an psychosexual behavior. He is a pragmatist. Theas this idea that mechanical qualities of the thet world war were somehow instigator of this. It is probable we have had Something Like this in the civil war as well. Sought as something that was emerging out of modern conditions. Historyn go way back in even to see evidence of what we now call ptsd. Shayslook at jonathan work and the idea that if you read homer you can see some of this. He was interested in making sure that the people are injured get treated and get better. He is not a philosopher of the longterm, but he does notice that they have a huge incidents of this. It is hard to know whether statistics actually bear out but a quite low incidence of suicide amongst the people he treated. There was a quite low incidence relative to the brits and the french. He thought would he was empirically getting better. We still use it. P. I. E. Right at thele front and working them back as they need more treatment. Any military person, the idea of curing soldiers is to get them back in fighting shape. Were not talking about trying to get them out of the army or out of fighting. Were trying to get them so they are all in a facility and continue combat. 50 have ato did he have a hierarchy of what caused the worst shellshocked with everything from being too close to the . Xplosion to injury if he does not differentiate family and maybe that the American Experience was so interested time that is not get to play these things out. What he does do that is interesting is he insists on longitudinal studies of the people who were affected. So and a study iney 1920 and another in 1924 and if he had not died in a loading accident in 1927, that would have gone straight through. Them up. To follow he followed them back in the states. He fought hard for nonprivatization of medical facilities and he was furious that the first thing that the Veterans Bureau to did to save money was ask all of them, which you like to be in a Mental Hospital or would you like to go home question mark theyll said we would like to go home. They said problem evaporated, no need for this. His teachers in the early 1920s are unbelievable, but you will have to read my book to know more. What i want to know is what did he find out in those longitudinal studies . The last one was in 1924. He found that people get better with treatment. That is what he found out. Which means that is what we an army medicine. 80 of soldiers who are treated , if they complete the treatment. So many of them do not complete treatment. What we have seen is five to 10 of soldiers will meet the diagnostic criteria for posttraumatic stress disorder. That is a sizable number. 10 to 15 will have other Behavioral Health conditions that require some kind of treatment. With the army has done since 2007 is with some appropriated money from congress, has developed the Behavioral Health service line that coordinates and synchronizes Behavioral Health care delivery into a system that really builds on p. I. E. Have embedded Behavioral Health teams that are right in the brigade combat teams and those are primarily in the garrison. There are other Behavioral Health aspects that are part of the organization when they do play. Even in garrison we have these Behavioral Health clinics, specialty clinics that are in the reggae footprint. What we found is that makes it more likely that a soldier will come in and get help. He does not have to get as much time off work. He does not have to get a right to the hospital. Here she can come right in and see a Behavioral Health congressional. But we have done is we aligned those professionals with a specific battalion and the gate so that if there is a unit that has an exercise coming up or more pointedly, if they had certain experiences while they were deployed, the Behavioral Health professional knows what that experience was and can take that into account and treatment. We find that in those cases, we have fewer risky behaviors and soldiers who have those Behavioral Health teams embedded. We have fewer Psychiatric Hospitalizations. Fewer suicide attempts in those organizations. She Behavioral Health provider grow to have a sense of trust if they have to share information about the safety of a soldier, that command team will use the information responsibly. Similarly, the commanders and First Sergeants trust that the Behavioral Health providers will let them know if there is a soldier who is in danger. That is thes been, hallmark of this Behavioral Health service line is the embedded Behavioral Health teams that are right there with the units, even in garrison. Is a little bit awkward. There is still stigma. But embedded Behavioral Health teams we find have gone a long way toward addressing that. We had several leaders in the army who have come out and said i have posttraumatic stress disorder or i am in treatment. And i have in at different Treatment Facilities where even general officers would come in and say i do not want special treatment. I want to sit in the waiting room so that everybody can see that having some kind of an impact from being in combat is not dependent on your rank. I think that is helping a lot. We still have a ways to go on that as well. There are still the whispers. The moment someone, especially a senior officer admits to having ptsd, there are problems with the next promotion. And then it becomes the issue with the promotion, if we do not promote him him a or her now that they have admitted to having this issue, if we do not promote them for some other reason, everyone will think it is because of that stigma. I do not have firsthand experience. When carter ham, and amazing general, admitted that he was suffering from posttraumatic people thought, he will not get another star interview does not we will know we cannot talk about it. When he got the next star, people were like, he is his detractors. Like every major organization, there are there is a hierarchy and pecking order and the caddy mean girls. They were saying, he just got this because now the army has to give it to him. That was one of those issues. I do not know how much you are hearing. They had me over to europe to speak to their team so i really tracked his career. I think it is the case that if you go seek any kind of , i think it isth i have spent almost my entire career with what i call a workingclass military. Officers,isted junior the people that make things happen, get their hands dirty. If you goe folks, seek Behavioral Health help, Everybody Knows it and then its like the next time you deploy, you want to take this guy, you if i can not sure depend on him. Better leave him at home. There is that problem, i think. Ando you think that is more i am asking this generally. Is that really the case or is that more and urban myth that that happens. I do not have any data to back this up and i think it is probably half and half. People believe it, it is likely alligators crawling out of new york city subways. Everyone know someone who has seen it. Among thethere is grants, the workingclass military the fear that if they go seek help, it will somehow impact their career and the impact will not be good. It is a continuing fight. Really odierno has been adamant about this saying if you have a problem, go to get help. I will guarantee it will not impact your career. I did a thing for the Huffington Post on suicide prevention. We had michelle obama, and videotape a short forest where she basically said the same thing and i tried to get obama say i guarantee you will not suffer. He would not do that. It is a continuing struggle. In the seal community, they found the best way to get care outhe operators was to send roving counselors who write nothing down. And they meet them in coffee shops, they do not meet them at the office. Out in the field what the chaplains do is they buy these amazing coffee makers. Everybody in the camp gets the espresso and the chaplains stores right there. And the doc is a couple of doors down. That is the way to make it ok. He wasthe things that struggling with was he had managed to fix for the special operators the system where the clearance would not be affected if they admitted to having had posttraumatic stress disorder counseling. All the support, when people say of therk 30, you think seals. If it is 10 people on the mission it is Something Like 200 people supporting them. The intel officers who are socomith so come are under fire just as much, having the same issues with combat stress. They could not go get the ptsd counseling because it still would affect their clearance. The clearance could get hold that has not been my experience at all. Admiral craven talked about it quite openly and he just left command the summer. My research for the past three the cia, dia, some of the other you talked to people who have had their clearance revoked . Ice i talked to special operations officers who worked on rescuing someones career who had gone into the field with them. Went to get counseling emma and a large reinvestigation because they had trouble with combat stress. Once you have a reinvestigation that can derail your career. Toi think its important differentiate between issues that come from not being able to treatment. Ough for example, just because somebody goes to treatment doesnt mean that their clearance will be revoked. But if theyre not successful in getting through treatment and theyre not getting better, that might be the reason that their clearance gets revoked. Have to leave the service. But its not because they sought care. Can i just change the subject . Absolutely, because we have to move onto other other presentations. Mechanism ofe injury of ptsd . Ptsd . People get what causes it . I dont know the neurological reasons. Can i explain how it was no. Want the doctor to explain. What is ptsd . Well, ptsd is a typically said, its a simon horrificaction to a incident. So it could be rape, it could be combat, if you have some fear of normalyour life, its a reaction to something terrible like that. Okay. It, i wasi understand trying to think about ptsd, thinking have you ever just stumbled and started to fall and me the firste thing that happen is your face flushes, and i always thought was embarrassment. But actually its the beginning of that involuntary physical causesn that i think ptsd where your body goes, uhoh, falling, push the panic button and everything, theres this huge physical reaction which is adrenaline spurts into your muscles, blood stream, you know, your heart rate goes up, improves, you can do great things, you can fight your way through a battle or out of a car wreck. And thats all good. I think where the problem comes when you go through this cycle over and over again as you zone, when you come home that reptilian part of your brain that kicks off the panic doesnt know youre at home. So youre at dinner with your wife and the waiter drops the dishes, you know, panic, and all that stuff starts happening which in the war zone is good and in the restaurant or a library or when youre sleeping not so good. So the way i have thought about have described it to me happens and when that happens you got to burn off energy, so people get angry and punch walls, or theyre worried to happen. Oing so lots of guys, you know, for example, a guy comes home, outing tons an walmart, its going to be a big deal, kids have been looking forward to it for weeks, they walk in and a veteran goes i can do this. Hes afraid hes going to have one of those things happen and itsnt control it because unvoluntary. So he goes i can do this. Goes whats wrong, weve been planning this for weeks, and then they get into the happen. And bad things well, actually i dont know with charlesiliar hogues book and he talks about that phenomenon and what is adaptive in a combat environment, thats the problem come back. And he talks about it as those kinds of physician why logic becoming hard wired when it repeated again and again. Of how ite theory comes to be. Can you talk about the relationship between ptsd and the work that youre doing right now . Yes, so i want to talk about in myinjury which i think experience is something thats suffered byor almost everybody who goes to war. Itsi say moral injury, not in the finger wagging sense that you did something wrong or, were not talking about atrocities. Were also not talking about disabled orre broken or scary or mass or anything like that. Heres the thing, and again this ive learnedthat 35m 35 years of spending years basically reporting wars, goodat we all think were people, right . Im a good person. I dont always live up to it, in fact most of the time i dont. Know whaty ideal, i good is ask when i do good i feel good. And i sort of expect other people to be that way. When we walk out of here not going toe expect, except well expect it saying it, but were noting about to expect a suicide bomber out there because people and we expect other people to be booed and we expect the world to be pretty good as well. Thats how we grow up here. So whatever moral codes we have, do unto others and all this learned at church or synagogue or mosque sort of adds code. Ur moral so now we go to war and guess stuff happens. It just does. Happens, what happens to our picture of ourselves as good people. Sense, ours to our moral foundation. Let me give you an example, this is kind of a hard concept to grasp, but it took me out. G time to figure this named nick rudolph, a marine, in afghanistan, ill go through this kind of quick, but long story and ive written about it. And you can look it up if you want. Fight, a talibaner in an adobe farm compound firing are out marines that there, trying to take cover. And at some point nick sees a running around the corner of a building spraying machine or fire at them, and he getss his m4 carbine and this person in his sights and realizes its a kid. Alabama. Dead. Him happened. N what we collected up the weapon and kept on chasing the taliban. Because in that moment he stop to think about it. But heres the thing about nick rudolphs story. In afghanistan, theing that person was tactically right thing to do, thing to doright and the morally right thing to do, right . Because tactically, hes the firing at you, you take him out. Thats one. Legally because, you know, i know actually legally, lets skip over that part. Obama andy, president president bush before him had wars. Ed these are just and so killing is okay. Killing the enemy is fine, no consequence, you can do that and its fine. So nick rudolph did the right thing, right. He comes home, and he killed a child. You know, he kill a child, theres no way around that. Of himself he think now, that good person who went off to war and did a bad thing. People kill children . Not really. Moral injury. And i picked kind a dramatic example, because it fairly easy understand and we can ought situation. Es in that the people who experience moral injury like that raise some pretty serious i feel bad. T i know a lot of people who signed up, got into the military, went to iraq or afghanistan not to kill the good. But to do because those were wars of battlefield victories, although there was a lot of fighting, needless to say. Being there was we were helping people. Went tow a chaplain who iraq and for that very purpose, were going to go help people. Then he realized halfway through yearlong tour, not only were we not helping people, were destroying a lot stuff and of people were getting killed and they hate us. And his belief in god went to zero. This is the chaplain, you know. He got it back after a couple years. Moral injury. Moral so the reason why i came here tonight, because i was invited, thank you very much, but also heres the important thing. What is our part in moral injury of our troops . Its kind of a difficult question. Dont say you didnt mean to or it was war, its not your fault, okay, dont worry about it. It was his fault and he cant so listening in a validating way means yeah, as marines on said that was fucked up, lets just put it out doesnt have to define you for the rest of your life. Im sorry. Tothat sound like a segue kims story. Okay. For those of you who arent familiar with my story, i was a news correspondent for a number of years based in jerusalem. From 01 to 2003, then i moved to iraq from 03 to 06. Bomb. Ot hit by a car i was told by the doctors and the psychologist who was treating me at the time that much to my surprise no i had that youhe symptoms all associate with ptsd, the phrase weve been throwing i never actually i never actually had ptsd. I had posttraumatic stress. Which the practitioners who were treating me at the time defined as everything from hyper vigilance, flashbacks, anxiety, a grab bag of nightmares. That that, because that only lasted four to six weeks, it, and it didnt interfere with my daily life after that time, that therefore it was not the disorder. Is that still the way its defined . Okay. So i had pts. And pts became what the phrase they use to define what happens when you processed your pain and moved beyond it, posttraumatic growth. So that is a phrase i would love to see out there more. Every time i speak, i try to use that phrase. I lived in israel, after the israelis had encircled ramallah, get into who started what. But what it amounted to for me to the westiving bank to report on demonstrations or i was driving furiously around jerusalem on the highways at top speed to get to a suicide just gone off. I got very good at identifying which one the bomber was amongst the dead bodies. It was usually the one with the bare rib cage and the head was popped off, because thats what bombing does to a body. After a couple years of this, and i think i must have gone to, of 60nted once, out suicide bombings, we had gotten to more than 30 of them, my cameraman and i had. Skill ofed a survival hyper vigilance. Anywhere in israel without thinking like if youre alwayso a cafe, theres the choke point at the door where they checked your bags, where theats often suicide bombers would try to upe in and blow themselves amongst the line of people waiting for their bags to get checked. You got past that choke point and into the safety of the restaurant, then id bomb replaying all the scenes in my head, okay, if the bomb goes off outside of the building, the plate glass windows will come flying this way, all right. To choose that table there because its behind a large supporting column. To hideeres no column behind, im at least going to sit with my back facing the door glass would be hit my face, it will just hit the back of my neck. My reality, way before i got into iraq. In iraq, the First Six Months was a rebuilding mission, was pretty safe. The Insurgency Campaign began. It started with an attack on a compounded and then they hit the jordannian embassy, the red cross, and then they started hitting small hotels with foreigners in them that were not protected. And after youve covered a few of those and you know what a car do to a small poorly built hotel, it basically sheers hotel, youre looking 50 feet in to the back place. The id go back to my own small defended, wed watch the guards outside brothery let in their without looking in the back of beneathand park right our window, and then id try to go to sleep. Wasnt imagine sleep easy after a bit. Some nights i ended up sleeping bathtub, i later found out Richard Engel was doing the few other and a people. You have all these crazy bargains with yourselves because few hours sleep. And i learned that basically i could handle it for about three to four weeks until all my symptoms of hyper vigilance so intensely interfered with my ability to work that i wasnt functional any more, i could barely do a live shot because i couldnt string my thoughts together. I hadnt had had enough sleep, i was freaked out all the time. Overats how i developed that threeyear period that i was there before i left rather unwillingly. I would be in for 46 weeks symptoms would get so bad that i was not functioning. I would also start snapping at i noticed all of our staff would do the same thing. So then id go out and about two weeks to downregulate is the phrase that ive heard used in clinical settings. It basically means to me that i order. Adrenaline back in so 2006, my team was out with Fourth Infantry Division patrol and we got hit by a car ambushed and it killed the captain, the translator, killed my camera crew. Up in a Medical Center in pain withrible shattered femurs, ear drums had already done out of myhrapnel brain. And i had burns. So they kept taking me in and surgery to debride the debt flesh. They do that with a fire hose, glad i was under for that. Was a horrible painful experience and i really wanted back to the states because i thought once i got to statesrmany to the things would get better, and thats when i started getting hit by the posttraumatic stress. I took the ambulance ride with all the other wounded from land steul hospital to ramstein air base, i was ridinged that every car around us on this beautiful road german forest was an al qaeda suicide bomber bent on blowing us up. Was like shrinking away from we window terrified until got to the plane. Then of course i was convinced crash. Ne was going to you name it. Once i got to bethesda naval had nightmares. I started having flashback where the would feel the force of bomb throwing me forward in the bed. And then id come to and id be, this hospital bed unable to move. Injuries. The and i wanted to talk about the bombing. Now, because i had a brain my doctors basically had an internal fight. The major opinion was i should bombing. About the and i didnt care. Everybody who walked through the telling what i could remember. I had this desperate need to try to remember everything from the scene. Finally about two weeks in, a his reservepist on duty came in, hes like, so, i hear youre the patient who up. T shut ill work with you if you really want, but warning, i normally work with marines, so im going to swear a lot. Are you good with that . Im like yeah. Hes like and one more thing, you can already tell youre a im goingoccasionally to tell you to shut up and move along, are you good with that. So that is how i ended up talking with him every day about, hed come and stay for an hour and just what you were talking about in that very first experiment or series of patients back in doctor treated them war i, treating immediately and the prospect of getting well, those were the wents that i instinctively for and needed. I had a doctor who came in and said, you know, a psychologist trust your instincts, want to talk about it, talk about it. Trust youru instincts, youll be fine. But keep talking until you don any more. Lk so what i found was, and apparently it common for a lot folks, i needed to have this illusion of control over the out exactlyiguring what happened. Halfnt the next year and a actually frying to track down been there. Had a power point of the bomb scene with where everyone was laying, that myfirmed to me memories of where i was laying and who was talking to me that i had it all right. So after about five weeks in, my my hypers stopped, vigilance stopped, i stopped being afraid that the meal cart up. Going to blow still didnt like the food. And that faded. Didnt fade was survivors guilt and grief. Id lost my guys. Had never expected to lose somebody in the field. When i found out that the furious with all me, the families of the dead families of the cameraman and the sound man, i blamed myself too. The other thing i found is that things in the stages of grief is you find someone to blame. My case it was me. Finally what released me from that was bob woodruff had been hit four months to the day had. E i so abc news correspondent, so he came in to see me. No, no, we talked on the phone because he was still in his recovery because it hit him in head. And he said look, paul and i understand that you feel bad that that youve lost them, paul douglas and james brolin, our cbs team. Those guys chose where they went, when they went, why they went. If you tried to take responsibility for them being day, youre dishonoring their memory. You didnt order them to be there. And i found that was like, that became one of these life lines realized he was right. So, but i still, every memorial day, i basically go into a fog, because thats when we were hit, day. Ial and now i just know, im like okay, just going to have to the next three days, im going to be miserable, askedsed, im going to be myself why am i still here and whoamazing professionals survived so many wars and had families and children, why are gone. And then ill try to keep paying it forward when this holiday is past. So i got past all that. Part was coming out howt to find that no matter far along i thought i was, that that i hadn public met on the street when i got out let mehospital would not out of the injured box. Walking thought i was a ptsd time bomb, because of what they had seen in hollywood, the storiesome of that we in the media have put out. Did this yeomans efforts teach the public that there were people within the military who needed help and yetir war injuries, we somehow tarred the whole with that brush. So i shared this a few times folks who have come seas and theres always like knowing nods around the room. Including in the special operations community. One Sergeant Major who had been mogadishu to all the worst place as cross afghanistan and iraq, like yeah, no matter how many times i tell my mom i dont have ptsd, she so the hardeve me. Part is that becomes a self full fulfilling prophecy. If you are experiencing bad symptoms of posttraumatic youre not an obnoxious overtalkative like 40scorrespondent in her from the oprah generation, are you going to seek help like i did . Are you going to fight through that wall . So thats what im worried were putting this message out there that, that poster foric tonights event, thats not an image of someone you want to be. Its a guy like this. See theeople to posttraumatic growth part so that they know theres an end for. To shoot and i dont know how, weve got to start shifting the balance wow, everyone is broken to, people, 10 , 8s have something that may always be with them. And then theres a larger part whohe bell curve of people will take this experience, make it part of their wisdom, their resilience, their life story, and they will be able to share peoplesons to help through every other hard thing in life. You think we want some time for your questions. And that seems like appear opening. You have a question, please raise your hand and wait for jason the bring you the microphone. Yes . What are any thoughts on like the higher rates of posttraumatic stress disorder from urban combat and like combat versus say the traditional open field, like you jonathan sheas book, what he talked about the constant journal and not just the cycle, but the constant adrenaline that comes from in ag to be vigilant jungle environment where you cant ever see, and i suspect fighting. Ar in city greatert creates a reaction what are your thoughts on that . I think dave was going to this. Bout yeah, i just wanted to val i date what you were saying. And afghanistan, i of firee majority were oneich i went way. Which was a sniper would open up, there would be an ambush or i. E. Didnt that would go off therear bomb, and then would be nobody to shoot back at. And it just makes guys, and when guys by the way i mean men and women, it makes guys go berserk. I was in a Marine Battalion and in thishunkered down farm compound. And somebody shot an r. P. Tbvment and it exploded amongst us, nobody was hurt, but you have seen them, finally we get to fight back. And it wasout there absolutely quiet, nobody out there. And there was such a huge amount that happensn and day after day after day after day. Fter and you know, which explains some of the incredible violence where they doghts find an enemy and they just go after them tooth and nail. Think that that adds up to a significant psychological burr after a while. Has talkedthan shea about this quite a bit in relation to vietnam. This, that goes way, way back, this is not new stuff. But these wars in particular because the enemy has been so have been particularly psychologically. Hi. Sayingd on what you were about pts versus ptsd, do you from the difference comes the treatment, like what you received or is it more kind of from the actual incidents that cause it . Well, as it was explained to me, its all posttraumatic stress, but it on gets diagnosed the disorder if it interferes with your daily life. Fourhats generally after to six weeks if it still keeps going. Right. The post part of it, when youre talking about with theder, has to do arrival of symptoms. So it may not be immediate. Or years downnths the road before you actually symptoms. Ave the what you probably was more, would be more accurately called stress. Because it was immediate. And thats actually what i was thinking, is so much of the of this are almost irrelevant to the person who is it and really for a lot of the treatment as well. We have Clinical Practice Guidelines that tell us what are the best treatments, the evidence tells us what are the ptsd. Reatments for we dont have that for acute iness or pts or what we call the army combat and operational stress reaction. We dont have that necessarily. But it does not mean that you from those other aspects. Wait a minute. You dont have a way to treat stress . I didnt say that. I misunderstood then. So we have begin cal practice guy lines that the v. A. And the d. O. D. Publish that tell us evidence and research, what are the three ptsd. Ays to treat and what are the three . Exposure. Prolonged i guess thats what i naturally did, prolonged exposure. Did it to yourself. By going over and over the incidents. Theres processing therapy. Theres another therapy it . You familiar with eye movement and desensitization. I had it written down. Whats strange about this is that two of those three are simon did. And i think people ask about were, even inds the absence of these particular individuallyked with people. He was patient with them and stayed up all night talking to thats how long it needed to be. Talkingned to people about their fears and their experience. Washe didnt think it magic. But it was very humane. And i think one of the things is frustrating to us now is that medical systems are delivered in 50 minute or that we dont have enough time to follow through with somebody. And this is as true in civil kran life as military life, that take as much as it takes to do this. Of thehink just in terms social compact, we have to be willing to pay for what it costs we do. He wars that and that was really what simon thisbout, was anticipating huge Mental Health crisis that he saw in the wake of the first insisting that it paid for. Ng that was can you tell us what the rap is . E movement thing process that be aable to explain it better than i can. People have to be trained how to do i. On top of, for example, having a phd in clinical psychology, it training. Focusu get a person to on, for example, my hand, how its going back and forth like this, and theres something that happens while theyre doing that and talking about the event that to, remember i mentioned the hard wiring earlier, theres something about that that seems break that, so that theyre able to process the event better. Having the eye follow something going back and be activating the right ask left side of the brain . That there ise anybody who knows exactly what the mechanism is. The Research Tells Us is that there is evidence that works. We have a question from sun who is watching the live stream. Are there any differences ptsd soldiersale and female and do they cope with it differently . The diagnostic criteria are for men and women. So an individual might have a different constellation of the but really the criteria are the same for men and women. Think that women are more likely to have a depression with than men are, but thats only speaking very generally. So between individual i dont can specifically say that there are differences between the genders. Of individuals that are ptsd, ever ebbs press to involves themselves in violence or war, because you talked about that vigilance, anxiety and fear. You cant act that way in a walmart, so do they want to go war so that they feel that theyre acting normally or being comfortable . More accurate to say that they feel more comfortable back in a combat environment. Its not necessarily that they want to be engaged in feel more athey home in that environment. Heard. Mes is what ive my experience, i mean, i know who only feel comfortable combat. Some of the reasons you like go back to a combat zone, its not particularly the people youre with and the shared mission. Stateis very hard to find side. Whether you under a news crew or soldiers, that theres this shared mission that for youreach other survival. And theres almost nothing like that back in the states that i of. So a lot of people really miss that and then they get here most people go from their jobs to the grocery store, home to the dvr and they don have much interaction, and they miss you were living in, you know, with eleven other people andyou knew their business they knew yours, and you always company. Its even more than that. That iswe all know, and unitpeople in combat develop love for each other, i think thats not too strong a although they dont quite. This idea that youre responsible for your buddy no what. What. Earn from the they learn from the first day in boot camp or basic training, and then that becomes a shared moral value and they are bound to each other and closer to each other in many ways than they are to their wives or parents or children. I have a strong passion for Mental Wellness and there is an International Program that is called Mental Health first aid. It . You heard of well, i left you some papers here, because im so excited about it. One of the first 100 trained the the country. In 2008. Was because i couldnt get my daughter help. She had a brand new baby, a war hero, and nobody gave her help. She was probably one of the first ones that used telemedicine with the car college psychiatrist. All right, my question is, you dont know about Mental Health first aid. Listening isu say very important. Support when you get home is important. Mental Health First Aid is international and theres now a military members veterans and their families Mental Health aid module. And the whole aspect of mental aid is listen nonhave mentally him do you feel if the people here at home could know how to help someone because you came out and there were, who helped you, you have the professionals i think you misunderstand me. Help within the hospital when i asked for it. And i continued to ask for it. And now what you have is the resource of some of these andrans who have come back have 80 have incorporated their or theirmatic stress combat experience and they have wisdom to offer all of us. Right. Thats the message that needs to get out. But id love to hear what your is. Tion i know youre talking about them having wisdom because theyre going through the strain. Well you knee to have people that are support systems for you and if we dont have and theireople families, if the husband doesnt know how to help the wife who with have come home posttraumatic stress disorder, im asking you, do you think in our country could do a better job of helping our military veterans or active get wellservice people from their issues that they have went on and suffered for us for our freedom. There more that we can do to help them get well or do we have professionals do their job . More. , we can do subject. Thats a huge thats a huge subject, and i dont think we really have time it tonight. Id be happy to talk afterwards. But i feel strongly that its everybodys responsibility to be part of the solution. Sayingnder what you were about you got great professional help. The medical care and mental our governmentt provides to the departments of affairs is veterans absolutely superb. Its the best that there is. But it cant possibly be enough. At some point veterans come home and back into our communities, themed to be in touch with and im reluctant to say we can them, because you know, thats, i dont know that were smart enough to do that. We can certainly welcome them back. Dontust, im so worry, i want people leaving this forum pooring oh, oh, those veterans. They have things to share with us. Experienceisdom and and this sense of billion a team really so resonant in here. Pulation back so, yes, its great to be willing to help them. People to looke at them with the preset notion the 80 who one of is more resilient tonight rest be leaders,hey can as opposed to people we need to ground. Off the because also those who are out struggling,re still if they know that that is the vision of what they can be ask what their country thinks they are, theyre going to reach out the hard work to become that. We have time for two more questions. You. Ank i think ptsd by its nature is physical Mental Illness. I was just curious what you might be an effective treatment approach for sort of symptoms. Ore physical there was some discussion about kicksrenaline rush that in automatically. Im not a psychiatrist, so i dont have an much d. , i i do know thatut use benzories not to diasipines, we try not to use potentsause theres the to become addicted to it. What we typically do in addition i the therapies that mentioned earlier, would be to to dosomeone how relaxation, deep breathing, to regulate their physiological it without we can do medication. The mindfulness app is pretty cool. The u. S. N download armys mindfulness app on their smart phone and it walks you meditation, so you can listen to it as youre Walking Around campus. Driving. T not driving. My wife there who was a come ba nurse and we both have ptsd, innosed with fact my wife was one of the first once. Earlier they told her that nurses were not exposed to cam bat. And my wife is one of the most decorated nurses that served in vietnam, including the bronze star. The question i have is, ive lot of peopleh a in the medical area who did not symptoms foror the 10, 15 years. That . U explain we had each other. She wanted to go back to vietnam. I didnt want to go back. Didnt. Nteered and i the v. After used to send different facilities throughout the united states, to tested for ptsd and nothing was ever successful in treating her ptsd. The reason its different now in afghanistan, they usually go over there as union and it come back as unit. Can interact with each other. In vietnam, like one day you know whos on your right and your left. Saying, saying, dr. Porter, that 80 of the people with ptsd get better, is that correct . 80 of the people who go through a complete course of treatment. What about people from afghanistan and iraq or people who theres been lots of literature coming out, there was one study of 200,000 veterans with ptsd shows that there a twofold chance of developing dementia later in life. A like you to address that. Is there anything being done for that right now . So you want to know if being done forg veterans who may develop dementia . A few months ago, that was on ptsd of their agenda, so im hearing two questions from you. For the cases of people who werent diagnosed early on decades later exhibiting posttraumatic stress disorder symptoms, a cues that are interfering i assume with their daily life, is alle something new that you are trying or recommending, or three courses of treatment . In the army we wouldnt be necessarily treating the first of all. That ithe three mentioned are what is shown by the evidence to be the most effective. But obviously theyre not going to be effective for everyone and be Something Else that is more effective for your wife. Be that shes always going to carry this with her. Many people still in the army who have ptsd, but withre able to function it. And theyre able to get through, whether its with their or because they know how to manage it, they continue with it. They still have some of the symptoms. So thats another thing i think what ups along with were saying, is that just because you have ptsd doesnt youred aeled with all kind disabilities. But it could be that it affects your sleep or nightmares are one incident that come up every month or Something Like that. Right. And where ptsd and traumatic injury overlp a lot of times has to do with the way that somebody gets a traumatic brain injury could be through a traumatic event, so they might the ptsd associated with traumatic brain injury. If traumatic brain injury then later on dementia, which were seeing more and more evidence that thats a possibility, i am optimistic and would be surprised if it werent that the v. A. Is going to look at that and take that consideration. inaudible question. Sir, i think thats another panel. This concludes our panel evening. N for this please join me in thanking our panelists. [applause] thank you all for coming. Well hear from the st. Louis prosecuting attorney and then president obama on the grand jurys decision. Later, well bring you interviews from a couple of retiring members of congress. Well hear from representative wisconsin and new york congresswoman carolyn mccarthy. Late monday night, the county announced a grand jurys decision not to indict Ferguson Police officer darren in the shooting death of 1yearold Michael Brown. Inaking from a courthouse clayton, missouri, he talked evidence that was presented to jurors and took questions from reporters at this news conference. Good evening. I have a statement at the beginning and then well be happy to answer questions when with that. Hed first and foremost id like to deepesttend my sympathies to the family of Michael Brown. As ive said in the past, i know the regardless of circumstances here, they lost a loved one to violence and i know accompaniesn that such a loss knows no bounds. The accounts were filled with speculation and little solid information. Almost immediately neighbors tbn gathering and anger began growing because of the various what hadons of happened and because of the underlying tension between the Police Department and the significant part of the neighbor. The st. Louis county Police Conducted an extensive the crimeion at scene, at times under very trying circumstances, by randomd at least fun fire. Beginning that day and for the along with,onths, they along with the agents of the federal bureau of investigation at the direction of attorney general eric holder located numerous individuals and gathered additional evidence and information. Buty aware of the unfounded growing concern in some parts of our community, that the thistigation and review of tragic death might not be full and fair. I decided immediately that all physical evidence gathered, awe people claiming to have witnessed any part or all shooting, and any and all other related matter would be presented to the grand jury. The grand jury of 12 members of this community selected by may of thissier long before this shooting occurred, i would like to briefly expand upon the unprecedent cooperation 2010 the local and federal authorities. Holdertorney general first announced the federal investigation just days after he pledged that federal investigators would be working with local authorities as possible at every step of the way, and would wherever theyts may take us. As general holder and i both out separate investigations followed that trail of facts with no whereceived notion of that would take us. Our only goal is that the investigation would be thorough give the grand jury, the department of justice and ultimately the public all evidence to make an informed decision. All evidence obtained by federal was immediately shared with st. Louis county investigators. Like wise all evidence gathered by st. Louis county police was immediately shared with the federal investigators. The department of justice conducted its own examination of all the physical performed its own autopsy. Another autopsy was performed at the request of the brown family, and all of this information was also shared. Importantly, all testimony before the st. Louis county grand jury was immediately provided to the justice. T of so although the investigations local andte, both the federal government have all of the same information and evidence. Our investigation and presentation of the evidence to the grand jury at st. Louis county has been completed. The most significant challenge encountered in this been thetion has 24hour news cycle and its insatiable appetite for something, for anything to talk about. Following closely mine with the media. Rumors on social i recognize of course that the lack of accurate detail shootingng the frustrates the media and the general public, and helps breed among those already distrustful of the system. Closely guarded details, best the physical evidence, give forenforcement a yard stick measuring the truthfulness of witnesses. Eyewitness accounts moss always be compared against the physical evidence. Many witness toes the shooting brown made statements inconsistent with other statements they made and also conflicting with the physical evidence. Some were completely refuted by the physical evidence. Rulesexample, before the of the private autopsy were released, witnesses on social media during interviews with the media and even during enforcement,y law claimed they saw officer wilson stand over Michael Brown and round boo his back. Into however, once the autopsy were released showing that Michael Brown had not sustained any wound to the back body, no additional witnesses made such a claim. Adjustedal witnesses their stories in subsequent statements. They did not witness the event at all but merely repeated what they heard neighborhood or had assumed had happened. For nationally for the integrity of our investigation, almost all initial witness interviews including those of officer were recorded. The statements of the testimony the witnesses were presented to the grand jury weree the autopsy results released by the media and before publisheddia outlets information and reports that they received from the d. C. Official. The juries were therefore, prior to the information going public and what followed in the news were able tories already assess the credibility those witnesses including witnesses whose statements and testimony remain consistent throughout every interview and were squint with the physical evidence in this case. My two assistants began the grand jury on august 20. The evidence was presented in an orderly manner. The jurors gave us a schedule of all 12ey could meet, were present for every session and all 12 jurors her every word of testimony and examined every item of evidence. Beginning august 20 and continuing until today, the dprpbl worked tirelessly to and reexamine all the testimony of the witnesses and physical evidence. They were extremely engaged in of process, asking questions every witness, requesting specific witnesses, requesting specific information, and asking for a certain physical evidence. They met on 25 separate days in months, heard more than 70 hours of testimony from about 60 witnesses, and reviewed hours and hours of recordings of media and law by manyent interviews of the witnesses who testified. They heard from three medical examiners, and experts on blood, firearms andcold, drug analysis. They examined hundred of photographs, they examined physical evidence. They were instructed on the law presented with five indictments ranging from murder tothe first bring involuntary manslaughter. Their burr was to determine the evidence the probable, there is no question that was involved. So the grand jury considered whether wilson was the initial aggressor in this case or whether he was or whether there was probable cause to believe that Darren Wilson was authorized as a Law Enforcement officer to use deadly force in this situation, or if he acted in selfdefense. I detail this for two reasons. First, so that everyone will know that as promised by me and attorney general holder there was a full investigation and presentation of all evidence and appropriate instruction of law to the grand jury. Second, as a caution to those in and out of the media who will pounce on a single sentence or a single witness and decide what should have happened in this case based on that tiny bit of information. The duty of the grand jury is to separate fact from fiction. After a full and impartial and critical examination of all the evidence in the law and decide if that ev supported the filing of any criminal charges against darrell wilson. They accepted and completed this monumental responsibility in a conscientious and eek pe dishes manner. It is important to say again that they are the only people who have heard and examined every witness and every piece of evidence. They discussed and debated the evidence among themselves before ooshriving at their collective decision. After their exhaustive review of the evidence the grand jury deliberated over two days making their final decision. They determined that no probable cause exists to file any charge against officer wilson and returned a no true bill on each of the five indictments. The physical and Scientific Evidence examined by the grand jury combined by the witness statements supported and substantiated tells the accurate and tragic story of what happened. A very general synopsis prenchted to the grand jury follows. Please note that as i have promised the evidence presented to the grand jury with some exceptions and the testimony of the witnesses called to the grand jury will be released at the conclusion of this statement. At approximately 11 45 a. M. On saturday the 9th of august Ferguson Police officer Darren Wilson was dispatched to the north winds apartment complex for an emergency involving a two month old infant having trouble breathing. At approximately 11 53 while still at the north winds call. Wilson heard a radio broadcast for a stealing in progress. The broadcast also included a brief description of the suspect, a black male, wearing a white tshirt who took a box of cigars. Other officers were dispatched to that store. Officer wilson remained with the mother and infant until ems arrived to transport them to the hospital. Officer wilson then left in his vehicle, a suv, and drove west on cantfield toward west flowersen. An additional description of the stealing suspect was broadcast about that time. Wearing a red hat, yellow sox, cackie shorts, with another male. As officer wilson was attending Michael Brown and companion were in a local convenes store. Michael browns activity was recorded by the cameras. The video often played ollowing its release in office shows Michael Bround grabbing a handful of signature rillos. As Michael Brown and his companion left the store someone inside the store called the police. After crossdzing, the two walked east in the middle of the street mr. Brown directly behind his companion. As officer wilson continued west on cantfield he encountereded Michael Brown and his companion still walking in the middle of the street. As wilson slowed or stopped as he reached mr. Brown, he told them to move to the sidewalk. Words were exchanged and they continued walking down the middle of the street. As they passed wilson observed that Michael Brown had signature rillos in his hand and was wearing a red hat and yellow sox. At approximately 12 02 p. M. , wilson radioed that that he had two individuals on cab canfield and need assistance. Officer wilson blocked their path and the flow of traffic in both directions. Several cars approached from east and west but were unable to pass. An altercation took place at the car with officer wilson seated inside the vehicle and mr. Brown standing at the drivers window. During the altercation two shots were fired by officer wilson while still inside. Mr. Brown ran east and officer wilson gave chase. Near the corner of canfield and copper creek mr. Brown stopped and turned back towards officer wilson, officer wilson also stopped. As Michael Brown moved towards officer wilson several more shots were fired by the officer and Michael Brown was fatally wounded. Within seconds of the final shot, the assist car arrived. Less than 90 seconds passed between officer wilsons First Contact with Michael Brown and his companion and the arrival of that assist car. During the investigation many eye witnesses were interviewed by various media outlets. Several others chose not to talk to the media but contacted Law Enforcement directly. Witnesses were interviewed by local and federal Law Enforcement. Sometimes together, sometimes separately. But all statements were provided to the other party. All previous statements of witnesses who testified before the grand jury were also presented to the grand jury whether they were media interviews or whether they were interviews by the f. B. I. Or by the county Police Department. The statements of all witnesses civilian Law Enforcement and experts were challenged of course by other Law Enforcement by the prosecutors and by the grand jurors themselves. The common and highly effective method for challenging a statement is to compare it to the previous statements of the witness for consistency and to compare it with the physical evidence. Physical evidence does not change because of public pressure or personal agenda. Physical evidence does not look away as events unfold nor does it block out or add to memory. Physical evidence remains constant and as such is a Solid Foundation upon which cases are built. When statements change witnesses were confronted with the inconsistencies and conflicts between their statements and the physical evidence. Some witnesses admitted they didnt actually see the shooting or only saw a part of the shooting. Or only repeating what they had heard on the street. Some others adjusted parlts of their statements to fit the facts. Others stood by original statements even though their statements were completely discredit bid the physical evidence. Several witnesses described seeing an altercation in the car between mr. Brown and officer wilson. It was described as tussling, wrestling, a tug of war, or just some movement. Several other witnesses described mr. Brown as punching officer wilson while mr. Brown was partially inside the vehicle. Many of the witnesses said they heard a gunshot while mr. Brown was still partially inside the vehicle. At least one witness said that no part of mr. Brown was ever inside of the vehicle and that the shot was fired through an open window while mr. Brown was standing outside. The vehicle and officer wilsons clothing and equipment were examined by various technicians and scientists. Mr. Browns blood and or dna were located on the outside of the drivers door. His blood and drn na were also found on the outside of the left rear passenger door of the police vehicle. Mr. Browns blood or dna was found on the inside of the drivers door. The upper left thigh of officer wilsons pant leg, the front collar of officer wilsons shirt and on officer wilsons weapon. Additionally arks bullet fired from officer wilsons weapon was located inside the drivers door. The shot was fired from inside the vehicle, striking the door in a downward angle at the arm rest. The second bullet was not recovered. Regarding the gun shot wound to mr. Brown, it should be noted that the three separate autopsies were conducted. One by st. Louis county medical Examiners Office one by a private pathologist and one by the department of Defense Armed Forces medical examiner. The results of all three are consistent with one another in all significant respects. Mr. Brown has a gunshot graze wound to the right thumb. The path of that bullet is away from the tip of the hand. Soot consistent with a close range gunshot is present inside that wound. Officer wilson also had a medical examination which indicated some swelling and redness to his face. Almost all witnesses stated that after they heard the shot fired while mr. Brown was at the car he hesitated and then ran east on canfield. Most stated that almost immediately officer wilson got out of his vehicle and chased after him. Some witnesses stated wilson fired at mr. Brown as he chased after him striking him at least one witness saying he struck or one of those shots struck mr. Brown. Others stated that he did not fire until mr. Brown turned and came back toward officer wilson. At least one witness stated that as officer wilson got out of his vehicle he shot mr. Brown multiple times as mr. Brown stood next to the vehicle. Yet another witness stated that officer wilson stuck his gun out the window and fired at mr. Brown as mr. Brown was running. One witness stated there were actually two Police Vehicles and four officers present but only one officer fired a weapon. Most witnesses agreed that near the corner of canfield and copper creek mr. Brown stopped and turned around facing officer wilson. Some said mr. Brown did not move toward officer wilson at all but was shot multiple times as he stood near the corner with his hands raised. In subsequent interviews with Law Enforcement or their testimony before the grand jury many of the same witnesses acknowledged that they didnt actually see the shooting. Some were running for cover, some were relating what they heard from others or as i said what they assumed happened in that case. Several other witnesses maintain their original statement that mr. Brown had his hands in the air and was not moving toward the officer when he was shot. Others said that he was shot several witnesses stated that mr. Brown did not raise his hands at all or that he raised them briefly and then dropped them and turned officer wilson who then fired several rounds. Other witnesses stated that mr. Brown stopped for a very brief period then moved toward officer wilson again. One described his Movement Toward officer wilson as a full charge. According to some witnesses officer wilson stopped firing when mr. Brown stopped moving toward him and resumed firing when mr. Brown started moving toward him again. These witnesses did not make any statements to the media. The description of how mr. Brown raised his hands or the position of his hands is not consistent among the witnesses. Some described his hands as being out to his side some said in front of him with his palms up. Others said his hands were raised near his head or were by his shoulders. Still others said they were down by chest or stomach. Others described being in a running position or fists. There are also various witness statements regard plg browns movement after he stopped and turned back to toward officer wilson. Several said mr. Brown never moved toward officer wilson and was shot where he stood at the corner. Most said that the shots were fired as me moved toward wilson. Mr. Browns movements were described as walking, moving fast, stumbling, or full charge. Like other aspects of this case the varying descriptions were sometimes provided by the same witnesses in subsequent statements or testimony. The entire area was processed by the st. Louis county crime scene unit. The total of 12 rounds were fired by officer wilson, two shots at the car, ten more shots farther east on canfield. Mr. Brown sustained a graze wound to his thumb while standing next to the vehicle. He sustained six or seven more gunshot wounds depending upon whether one of the shots was an entry or a reentry wound. Mr. Brown sustained a second graze wound another graze wound to his right bicesep. He also sustained wounds to his right forearm upper front right arm lateral right chest upper right chest forehead and top of the head. The top of the head, forehelped, and perhaps the upper right chest were consistent with his body being bent forward at the waist. The medical examiners are unable to determine the order of the shots. The graze wound to the thumb sustained at the vehicle is likely the first wound. It was the only closerange shot. The shot to the top of the head was most likely the last. It would have rendered him immediately unconscious and incapacitated. Mr. Browns body was located approximately 153 feeths feet east of officer wilsons car. Mr. Browns blood was located approximately 25 feet farther east past his body. A nearby tenant during a video chat inadvertently captured the final ten shots on tape. There was a string of several shots followed by a brief pause followed by another string of several shots. As i stated earlier, the evidence and the testimony will be released following this statement. I am ever mindful that this decision will not be accepted by some and may cause disappointment for others. But all decisions in the criminal Justice System must be determined by the physical and Scientific Evidence and the credible testimony corroborated by that evidence rg, not in response to public outcry or for political expediency. Decisions on a matter as serious as charging an individual with a crime simply cannot be decided on anything less than a complete critical examination of all available evidence. Anything less is not justice. It is my sworn duty and that of the grand jury is to seek justice and not simply obtabe an indictment or conviction. I do want to say that during this extremely tense and painful time that we have, the citizens of this community should be and i know are very mindful of the fact that the whole world is watching, and watching how we respond and how we react. And i urge each and every one of them with the loss suffered by the brown family no young man should ever die. This is the loss of a life and its a tragic loss regardless of the circumstances. But it has opened old wounds and given us an opportunity to address those wounds as opposed to in the past they just fade awafmente how many years have we been talking about the issues that lead to incidents like this and yet after a period of time it sort of fades away. So i urge everybody engaged in the conversation, engaged in the demonstrations to keep that going and to stay with that, not to let that go, and to do it in a constructive way in a way that we can profit from this, in a way that we can benefit from this by changing the structure, by changing some of the issues, by solving some of the issues that lead to these sorts of things. I join with Michael Browns family and with the clergy and with anyone else and everyone urban he naacp and the league and er Government Official and every private citizens that youve heard to continue the demonstrations the continue discussion, address the problems, but do so in a constructive way and not in a destructive way. I have time for a few questions now. Es, sir. Whether the grand jury made this decision unanimously . And can you tell us us whether you presented any charges recommended any charges to be brought by this grand jury. To the first question as to whether the vote the grand jury by statute is not allowed nor am i or anyone else allowed to ask or to discuss the vote or the deliberations themselves. The grand jury is a very secret process. And it should be in order to protect that secrecy, to protect the witnesses so that people can come out and talk about and speak freely in there. Jury deliberations in the grand jury or trial jury theyre not reported in a trial of course theyre unanimous but by statute the grand jury is not allowed nor is anyone allowed to ask what the vote was nor are they allowed to or anyone allowed to ask what the discussion was, the opinions expressed by the other grand jurors. [inaudible] no. My two assistants did all the presentation in the grand jury. We prepared as their Legal Advisers of course as we do in every case potential charges for that and presented in this case five charges, five indictments to them. I heard you describe some very problematic witness statements. Do any rise to the level of you going after perjury charges . I think there are a number of witnesses in all honesty that truly believe what they said. And the ones who were consistent throughout, even in the face of their testimony being in conflict with the physical evidence that was there. I think they truly believe that that is what they saw. But they didnt. So no. Some of the others, yes, were making it up but pretty much acknowledged that they saw parts and then made up other things. There have been many that have been critical of this process, calling it a secret trial. Do you regret taking this to the grand jury . Do wish there had been a coroners jury . Not at all. I certainly dont regret taking this. I think it was a good decision to take this to the grand jury. We presented to this grand jury as i detailed in here all the evidence that there possibly could be all of which will be available as we finish this tonight. So everyone will be able to examine that same evidence and cox to their own conclusion. That is the only thing i would urge. I know people arent going to go home and Read Everything that was on there and make a decision based on that. But you need to keep in mind that these grand jurors poured their hearts and souls into this process. Their term was scheduled to end in Early September and they gave up their lives put their lives on hold, families on hold, they put everything on hold so that they could come in and do their civic duty. And it was a very emotion yam process for them. I met with them before any evidence started to tell them what the process was going to be and i met with them today after their decision. And i can tell you just how emotional and how draining it was for each and every one of them. So to suggest anywhere or anyone suggesting that somehow its just not a full and fair process is just unfair to these people. They poured their hearts and souls into this. Yes, maam can you tell us anything more about the grand jury . Weve heard just some very basic demographics mainly just race and sex. Can you tell us any more, the basic ages and maybe perhaps those folks voted . I really cant. That was the information that the judge released and allowed to be released on the demographic ors the makeup of the grand jury. What i can tell you and probably not speaking too far out of line is that when the judge, any judge, picks a grand jury theyre looking for a Cross Section of st. Louis county. And i will say that almost any demographic calingtgri you can come up with is going to be represented on that grand jury. Various ages, income, where they live, how they live, retired or not retired still working blue collar professional, almost anything you can think of is going to be on that grand jury. And they tend to be that way across the spectrum. Senior, were there any African American witnesses who testified that Michael Brown was coming towards the officer when brown was shot . Yes. All the ones that i mentioned specifically about the ones i mentioned specifically were all African Americans. The one who indicated that he came at him at a full charge and that as officer wilson fired shots at him mr. Brown stopped and officer wilson stopped shooting. And as mr. Brown started charging at him again, those were his words, his testimony, mr. Wilson started shooting again. So the others who had very consistent stories not just with each other or, not just their stories or their testimony throughout but they were consistent with the others, several others, theyre all African American. I wonder if you can tell us a little bit about officer wilsons testimony and perhaps his status tonight. Well, i have no idea what his status is. But his testimony was again its in the packet that will be released. But his testimony and these are questions a lot that were asked by the grand jurors on challenging him why he didnt use lesser force, why he didnt run away. I will say he did testify of course that he was sitting in the car and was punched by mr. Brown. I think all that information from his version out there is out there. I specifically didnt do that because in any case the target has the pect is most interest in the case. So we dont put a whole lot of stock. We would love to hear from him but dont put a whole lot of stock solely in that testimony. Theres ntioned that video of the final ten shots. Would that be released with the rest of the evidence that youre releasing tonight . I assume that microphone is going somewhere. You mentioned that there was video of the final ten shots. Theres not video. Theres audio. He was on a video chalt in the background but yes that should be in the packet if its not we will get the audio out. I want to ask you a question and what the people who are protesting tonight might say that look this jury had nine whites and three blacks they would say you have a reputation right or wrong of being pro police. What do you say to somebody who might be out there who thinks it wasnt justice . How do you boil it down . Why is this justice . Its hard to boil down everything. It has to be based upon all the information thats available. You can certainly take out a witness here or there and come to a different conclusion. But i think everyone has to look theyll have the ability to look at every bit of evidence and information that was put on and all the testimony and can do that. And some i understand. I understand some people have made up their minds both ways. And are not going to change. So there isnt a whole lot i can do. What i would urge them to do is express those feelings, express them in a consthructive way and try to make those change soss that nothing like this ever happens again. Yes, maam. You just splabed that we need to work on shuds so this kind of thing will ever happen again. What are some of those fixs . And are any including whether or not police should shoot somebody whose hands may be at their side or up in the air and they are unarmed . Its difficult to answer in fact its impossible to answer questions like that because there are so many variables that play into every case. So theres just no real way to answer a question like that. And so you have to look at every bit of information and every case that comes in. The idea i hope is to avoid ever being in that situation. Yes, sir. As somebody who has had his record questioned, how do you file feel making this, announcing this decision . And what message do you think it sends to the community that says that they have had numerous members of their community, young predominantly black males killed by police with impunity. What kind of message do you think this decision says to them . Well, a much better message that youre saying young men being killed with impunity. Theyre not being killed with impunity. We look at every case that comes through whether young black men or white men. Weve had young white men who tragically have been killed by Police Officers in situations and we look at each and every one of those and hopefully learn how to avoid being in that situation in the future, whether its a justified shooting. So i think thats what has to go. And i think the people in the community they need to make their voices heard and they need to address those so that we get those issues so that we are never in this position again. Yes, sir. I think people looking at this from around the country are going to be struck by the fact that there is not a single law in the state of missouri that protects and values the life of this young man who unquestionably was shot and killed dead. Theres no dispute about that by the police officer. What do you say to people who wonder is there something wrong with the laws here that allows this to happen, that after this happens says we just move on essentially and that this is justice . Is this really justice or is there something wrong with the laws in the state that would say its ok . Well, you know thats another question that really i dont have an answer to that question that whats wrong with the law . There are no laws to protect this. Every law out there is to protect the safety of every individual regardless of their age and regardless of their race. And so if those laws are not working then we need to work to change them. Thats about all that we can thats not all but thats what we should be doing and thats where this needs to go from here. Youve been accused by some as passing the buck and putting this in front of the grand jury. Isnt that what you were elected to do is to take a stand in this case . You have to understand and fart of that system there isnt anyone in that system as part of the checks and balances is that no one office, no one individual has the ultimate or absolute authority. If charges were filed in this case as theyre filed in other cases, the case would still go to a preliminary hearing or to the grand jury. There still has to be a probable cause determination. No one can just file a charge and go directly to a jury trial. That just cannot happen. And we have an obligation to present the evidence. I dont know how anyone can say were passing the buck by gattering all this information and evidence and meeting with the grand jury. Its something we do on a weekly basis. We do it day in, day out, week in and week out. So its certainly not passing the buck. Can you give a specific vote breakdown and whats the possibility of federal charges . Are those still a possibility outstanding . I cant give you a vote breakdown and i dont know that nor can they reveal that. The federal investigation is still ongoing. They have all the information and evidence that we have. They had it as we got it. When we finished a days worth of grand jury testimony within a day or two that was in the hands of the department of justice. When they did an interview within hours that was in the hands of the department of justice. So they will conduct their interview or their investigation as we did. Theyre looking at different types of laws obviously and different violations. So but when they will complete that i have no insight into that. Did any witnesses refuse to testify . And if so how was that handled . I didnt hear the last part. If any witnesses refused to tey