Chapter 27: An Injured Brain

JJ Muggivan

The state pathologist’s post-mortem report noted ‘considerable venous pressure’ and ‘tiny areas of bleeding’ in Brendan’s brain. The brain was retained for possible further examination later. Dr Harbison suggested that Brendan’s brain was at the lower limit of normal for size and weight, weighing 1,195g. However, according to Henry Gray, author of Gray’s Anatomy, it

would seem that the size of the brain is not a very important issue.

What is more important, however, is evidence, or lack of evidence, of shrinkage. If there was shrinkage, it could have come from early use of Valium and later use of anti-psychotic medication. Signs of damage or injury in the frontal lobe area would also be significant.

Dr Harbison’s report found physical evidence that Brendan had extensive brain injury.

The upper surface appeared slightly flattened, due to fixation without sufficient buoyancy or suspension. Two small areas of prominent veins with possible small leakage of blood were

present on the convex surface of the left frontal lobe and a third on the left occipital lobe, none of these more than 5mm wide or 10mm long. (RECORD OF VERDICT, 26 November 1997)

Dr Graham Turrall, a clinical psychologist practising in Toronto, Canada, gave evidence that Brendan had had ‘considerable difficulties’ with psychological tests, which had judged him to have a mental age well below his actual age. According to Dr Turrall, ‘Other tests were suggestive of brain dysfunction in the frontal lobe area.’

Researchers into brain function have written about cases where patients laugh or giggle for no apparent reason. For example, in their book, Phantoms in the Brain, V.S. Ramachandran and Sandra Blakeslee cite an account of a fifteen-year-old girl who was being treated surgically for epilepsy. The girl was awake for the procedure, and laughed uncontrollably when certain parts of her brain were stimulated in the course of the operation.

They also write of a neurological disorder in which patients do not register pain:

Patients with this condition do not register pain when they are deliberately jabbed in the finger with a sharp needle. Instead of saying, ‘ouch!’ they say, ‘Doctor, I can feel the pain but it doesn’t

hurt’... many of them actually start giggling, as if they were being tickled and not stabbed....

The authors explain that this syndrome is often seen in cases of damage to a specific part of the brain that normally registers pain and sends messages regarding the agony of pain. They describe

the result:

One part of the person’s brain (the insular cortex) tells him, ‘Here is something painful, a potential threat, while another part (the cingulate gyrus of the limbic system) says a fraction of a

second later, ‘Oh, don’t worry; this is no threat at all.’

From early childhood, Brendan had episodes of unusual laughter, silliness, and giggling. It was seen by his parents who reported it to Dr Ledwith. It was also seen by his sister, by my brother, Tony, and his family, by Kevin Brennan at Trinity House, by the Monaghans, by his grandmother, and by doctors who treated him.

More than one psychiatrist referred during their testimony at his trial to Brendan’s unusual laughing. However, they appeared to treat it as something to be expected with a disorder such as schizophrenia. Dr Peter Breggin, however, identifies unusual laughing as a clear sign of brain injury. With Brendan, it was a lifelong behaviour, suggesting that the brain injury giving rise to it occurred early.

Post Traumatic Stress Disorder (PTSD) can be caused by ‘witnessing an event that involves death, injury, or a threat to the physical integrity of another person.’ The person witnessing the event will experience ‘intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behaviour. . . .)’ (DSM-IV-TR, p. 463)

When Brendan was brought to see Dr Ledwith initially, Margaret O’Donnell told the doctor that her son’s usual reaction to stress or tension was to freeze and turn pale. As far as we know, this behaviour was reported after Brendan had witnessed his mother’s suicide attempt. He experienced at least two events which might have caused Post-Traumatic Stress Disorder, namely his mother’s attempted suicide and her death and burial.

Research in the US has found that Vietnam veterans with very severe PTSD suffered brain shrinkage of about 25 per cent. Their performance in verbal memory tests was about 40 per cent

below that of others of comparable age and education. The researchers discovered that:

PTSD patients’ difficulties with putting feelings into words are mirrored in actual changes in brain activity. (Bessel A. Van der Kolk, Alexander C. McFarlane, and Lars Weisaeth, eds, Traumatic

Stress, p. 233)

Those suffering from severe PTSD can also experience ‘auditory hallucinations and paranoid ideation’ (DSM-IV-TR, p. 465).

Valium consumed by a mother has a direct effect on the foetus. It is capable of causing physical addiction in the foetus and withdrawal symptoms at birth. Children born with an addiction to alcohol often have damage to the frontal lobes of their brain, and the effects of Valium addiction are similar to those of addiction to alcohol. The frontal lobes of the brain ‘control judgement, inhibition, concentration, self-control, conscience, personality and emotional traits as well as cognition and memory, motor speech and movement skills’ (Fetal Alcohol Syndrome Link).

Brendan first reported fear of his food when he told his mother that he saw animals in it. He was about five years old at the time. The record reports that he was given medicine to improve his appetite.

He seems to have had a lifelong paranoia about being in danger from food, and his first dangerous assault resulted from his belief that his sister was trying to poison him.

This kind of fear can be debilitating and may have been at the root of his attempted suicide by starvation prior to his trial. It seems that he was given medication again for his appetite.

Credible new research suggests that fear of food or disgust with food involves precise nerve cells in very specific subregions of the brain. Brendan’s fear of food may have started from hallucinations caused by addiction to Valium.

The following is a list of symptoms reported during Brendan O’Donnell’s childhood:

. Higher than normal to dangerously high pain tolerance (See above discussion on laughing)

. Severe loss of intellectual functioning

. Behavioural problems

7 Attention deficit disorder

. Extreme impulsiveness

. Poor judgement

. Little or no capacity for moral judgement . Little or no capacity for interpersonal empathy . Sociopathic behaviour

. Developmental delay

. Sleep disorder

. Night terrors

. Social problems

. Depression

7 Reactive outbursts

7 Suicide

7 Death.

The above can all be associated with neurological damage in children. All have been identified as problems experienced by children who have been exposed to high levels of alcohol while still in the womb. The effects of a drug such as Valium would be similar.

From early on, Brendan was reported as having symptoms such as clinging, shadowing, not sleeping in his own bed, and wanting to sleep with his mother. Such symptoms are typical of Separation Anxiety Disorder, and in Brendan’s case seem to have been precipitated by a combination of medicine reactions and an over-protective mother. It has been found that this disorder ‘is relatively more frequent in children of mothers with Panic Disorder’ (DSM-IV-TR).

Those suffering from Separation Anxiety Disorder will become excessively anxious on being separated from the home or from those to whom they have become attached, and will tend to ‘cling to’ or ‘shadow’ a parent. They may also be reluctant to attend school.

Achild such as Brendan O’Donnell can put enormous stress on a parent and can evoke harsh treatment. When parents of such children engage in excessive discipline, it needs to be understood that they are attempting to have their child become a child who performs like other children.

Of all of the possible causes for Brendan O’Donnell’s difficulties, parental discipline seems to be the least likely cause of his major problems. His ability to I earn the normal rules for living and

his ability to cooperate with authority were severely impaired from infancy.

However, research has shown that the response of parents is important to such a child. Aggression on the part of a parent will lead to counter-aggression in a child.

Brendan’s parents were in conflict, and so were incapable of providing consistent limits for him. He learned complex manipulative skills by exploiting parental disagreement over how to handle him. Margaret became more protective and Michael Pat may have become more critical.

Traumatised children in particular put enormous stress on family members and on those who have to live with them and teach them. It is also true that parents in serious personal emotional distress put enormous stress on their spouses and children.

Margaret O’Donnell, because of her illnesses, was a source of distress for her mother, her siblings, her husband, and her children. She traumatised Brendan by attempting suicide in his presence. She very likely injured him with her consumption of medication while she was pregnant.

As Brendan’s symptoms worsened, he, in turn, increased the stress on all members of his family.

A suicidal mother can traumatise an entire family just as much as an abusive husband can with physical violence. Serious illness necessitating constant attention and medication can sustain a high state of distress for partner and children alike.

Not being able to give relief to such an individual can cause guilt, shame, hopelessness, depression, and, ultimately, anger in all family members.

As the youngest child for nine years, Brendan seems to have borne the brunt of his mother’s distress. He seems to have taken on the responsibility for taking care of her. He experienced the

ultimate failure when she died when he was nine years old. He was never able to let go of the memory of his mother and her unhappy life.