Patterico's Pontifications

8/29/2007

Ex-Astronaut Lisa Nowak has News for NASA

Filed under: Miscellaneous — DRJ @ 12:17 am



[Guest post by DRJ]

The Houston Chronicle reports that Lisa Nowak has been diagnosed with Asperger’s Syndrome, a disorder sometimes referred to as high-functioning autism:

“In July, NASA reported that a review of her physical and behavioral record showed no indication of psychological problems from the time she reported to the Johnson Space Center in Houston for astronaut training in August 1996.

But according to the notice filed in court Tuesday, Nowak suffers from obsessive compulsive personality disorder and Asperger’s disorder — a neurobiological condition on the mild side of a personality disorder spectrum that includes autism — in addition to depression, insomnia and related significant weight loss.

Asperger’s disorder, usually diagnosed in early childhood, impairs a patient’s ability to socialize and communicate with others, according to the Mayo Foundation for Medical Education and Research. Children with the disorder typically exhibit social awkwardness and an all-absorbing interest in specific topics.”

NASA must be reeling.

32 Responses to “Ex-Astronaut Lisa Nowak has News for NASA”

  1. As the dad of an autistic child, I take exception over the idea NASA has to reel over the idea an astronaut may have Asperger’s syndrome.

    Getting over my personal views, Asperger’s does not lend itself to planned, long distance violence. An Asperger’s person may react badly to being crowded in line (and that may or may not involve violence), say, but they’re not gonna travel a few states over to lash out at someone due to Asperger.

    Brian (56a0a8)

  2. Point taken, Brian, but I think the reason that NASA might be reeling would have to do with the fact that a person with Asperger’s or other similar disorder shouldn’t be in close confined contact with others for extended periods of time. If you think about it, being in a space station with someone like this for six months could be the subject of a scary movie.

    driver (faae10)

  3. NASA must be reeling.

    Or they are pulling out every psyc eval she ever underwent, and getting ready to slam the crap out of her.

    Certainly they would KNOW if she’s got Asperger’s syndrome or OCD.

    Though by “no indication of psychological problems” might mean “She wasn’t insane enough to wear diapers, drive across multiple states, and try and kill/kidnap/assault someone”.

    Scott Jacobs (e3904e)

  4. I think the defense is grasping at straws. Below is Florida’s insanity defense statute from online. I don’t think the defense will even be allowed a jury instruction:

    775.027 Insanity defense.–

    (1) AFFIRMATIVE DEFENSE.–All persons are presumed to be sane. It is an affirmative defense to a criminal prosecution that, at the time of the commission of the acts constituting the offense, the defendant was insane. Insanity is established when:

    (a) The defendant had a mental infirmity, disease, or defect; and

    (b) Because of this condition, the defendant:

    1. Did not know what he or she was doing or its consequences; or

    2. Although the defendant knew what he or she was doing and its consequences, the defendant did not know that what he or she was doing was wrong.

    Mental infirmity, disease, or defect does not constitute a defense of insanity except as provided in this subsection.

    (2) BURDEN OF PROOF.–The defendant has the burden of proving the defense of insanity by clear and convincing evidence.

    nk (a6ecc6)

  5. Aspergers: now the most commonly self-diagnosed condition on the Internet.

    “Mom, I can’t get off of WoW. I have Asperger’s. See, it says so right here on the Wikipedia page.”

    Techie (c003f1)

  6. I have 2 cousins that are high functioning autistics, so I have a bit of experience in being around these people.

    The recent studies that show an incredible increase in autism, and its various permutations, seem to be ridiculous, and I wondered if there was any real science behind them. My armchair view was that just because it is being more readily and commonly diagnosed does not necessarily mean that it is occurring more.

    JD (e2fc98)

  7. The Chronicle reported that her lawyer says she’s got Asperger’s. She needed an insanity defense, and now gets diagnosed with this.

    Color me skeptical. Extremely skeptical.

    –JRM

    JRM (de6363)

  8. To Brian and others – I completely understand your taking “exception” to the comment about Asperger’s being linked in the same sentence to this insanity plea or even the bizarre behavior exhibited by Lisa Nowak. That is unfortunate – however – I DO believe Asperger’s has played a role over-all in her behavior in general – I have been informed just one month ago that my husband has Asperger’s Syndrome. I can tell you that as far as I am concerned it just explained the “insanity” of the last 3 years of my life. I can tell you that it may be deemed a high-functioning” or “mild” from of Autism – but if you are the partner of someone NOTHING seems mild about it. Perhaps we can all become more aware of this syndrome as a result
    Linda

    Linda (ac061a)

  9. Brian,

    I am also the parent of an autistic child and I stand by my statement. We don’t know if Lisa Nowak has Aspergers but if she does, people with autism, Aspergers, and OCD present novel issues. High-functioning people can have these conditions and live full and valuable lives, but I still think this will give NASA administrators a big headache by heightening the controversy over NASA’s screening process.

    DRJ (8b9d41)

  10. A few thoughts-

    When I was in med school in the early 80’s, what we learned was that:
    – “if a person can read a book, they don’t have ADD/ADHD”
    – autism was a global inability to interact with “the outside world”
    – never heard of Asperger’s
    – a safe cholesterol total was 240
    – a safe blood pressure was 140/90; in an older person as long as the diastolic was 90 the systolic could be much higher
    – some people thought a bacterial infection in the stomach had something to do with ulcers (“what a bunch of crackpots”).

    I have known more families with children who have some degree of autism than children with diabetes or severe asthma together.
    I know from personal experience that children and adults can have ADD/ADHD characteristics that limit them unless understood as such and consciously compensated for.
    In the past more people who were “odd” found their niches in a society with larger extended families that looked out for each other, more diverse opportunities in manufacturing and on the farm, and people just died from accidents and other maladies and it was “just part of life”

    Questions:
    -We are diagnosing milder versions of some things now, how much does that contribute to the increased numbers?
    -Are there actually more people with Asperger’s, autism, ADD/ADHD and other things now than in the past, and if so, why?

    To be an astronaut one has to be a bit on the compulsive and obsessive side- attention to detail, checking and rechecking; studious, hence often not socializing as much as others.
    Where is the line between someone who is “nerdy” and socially awkward, more at home with equations than a party, and someone who is pathologically obsessive-compulsive and neurologically handicapped in social functioning?

    I agree with Brian that saying, “oops, she has Asperger’s, that explains everything”, it doesn’t
    really. But I also agree with Linda, it does explain a lot and puts perspective on other things as well.

    MD in Philly (3d3f72)

  11. My 10-year-old was diagnosed at the beginning of this year; I’ve always known he had some personality quirks, but resisted a definitive diagnosis. Now, ironically, having the diagnoses makes communicating with teachers and coaches a lot easier. If they don’t know what Asperger’s Syndrome (AS) is, they can learn very quickly.

    Asperger’s is on the autism spectrum, but there is a huge range in behaviors along the scale. My son, for example, has a great sense of humor and no problems at all discerning other people’s moods from their facial expressions; many people with AS, which is primarily a socialization disorder, have trouble in these particular areas.

    I agree with Brian: you wouldn’t want to be on an extended space mission with an AS sufferer, and I can not believe that NASA would let Nowak into the astronaut program if she really does have AS. However, I can see no connection between AS and and her long-distance drive.

    Joan (ce4c48)

  12. MD – As I am no doc, I speak only from my observations. To me, it is much like cancer, insofar as people have likely been dying from cancer since the beginning of time, they just did not diagnose it back then, have a name for it, or called it something else. As medicine evolves, we continually advance in terminology, technology, and our ability to pinpoint diagnoses. As such, what may have simply been viewed as a personality quirk in the 50’s is now properly diagnosed as Autism. Just my 2 cents … I could be way wrong.

    JD (e2fc98)

  13. JD, I completely agree with you, but what I don’t know, and I’m not sure if anyone does yet, is whether that is all of the story.
    I bet there is more to it, even if only things are skewed to more problematic because during development kids are watching fast-paced TV and computer, etc., instead of activities that allow more “thoughtfulness”.

    MD in Philly (3d3f72)

  14. So she’s obsessive-compulsive. Probably a neatness freak too, since she brought plastic bags for the dismembered limbs of the woman she certainly intended to murder.

    No help for the defense there.

    Glen Wishard (b1987d)

  15. MD – I agree that it is certainly not all of the story, as the disease processes tend to change and even evolve over time. There are also likely environmental factors, though to what degree would certainly be debatable.

    I guess my overall point is that we see these breathless reports in the papers and on the news about “Autism up 75% in last 20 years!”. They neglect to mention that it was rarely diagnosed then, and that the continued advancement of diagnostic procedures, technology, and education as to the process made the diagnoses more common simply because there is an accurate set of criteria by which patients can be assessed, and in the past, it was viewed as less of a medical condition, and more of a social condition.

    But, I am no doctor, to be clear.

    JD (e2fc98)

  16. MD,

    I agree with Sudhir Gupta, MD, UC-Irvine Medical School, who postulated in the 1990’s that some forms of autism can more correctly be termed neuroimmunological autism. They are basically autoimmune disorders that affect the neurological system in varying ways depending on the age of onset. The age of onset is probably determined by a genetic trigger, and there is NIH research focusing on identifying these triggers as we speak.

    I also think there are more cases of autism, ADD, ADHD, etc., than in the past – just as there are probably more people with autoimmune disorders than in the past. Part of that is the ever-expanding population so that the raw numbers have increased, another part is that we are living longer and healthier so we have the “luxury” of developing immune disorders secondary to other more serious diseases, and part may also be the increasing stress we put on our immune systems and the fact that these tendencies are being genetically selected and transferred.

    DRJ (8b9d41)

  17. I take her sudden diagnosis with a grain of salt, in that it is intended to keep her butt out of jail.

    sam (62e9df)

  18. Having cared for autistic adults, Nowak is the first one I know reported to have driven across several states to confront a romantic rival. The tape, gloves, rope, navigation, and determination suggests something far different from autism.

    No one will believe that a highly trained and medically examined Navy pilot and astronaut concealed autism for two decades.

    She should’a called Jessie Jackson for insta-redemption and entered a rehab clinic.

    Puleeeeeeeeeze!

    Clark Baker (fc36d5)

  19. Assuming she has Asperger’s, ect… I tend agree that would not work as an affirmative defense.

    Knowing myself (I have the later) I likely wouldn’t make a very qualified candidate for NASA.

    Qualifying that she is claiming to suffer from “mild” personality disorders I agree that we should take this with “a grain of salt.”

    Jim (4f214c)

  20. Asbergers is a long way from autism although it is a socialization situation. The common example of Asbergers is a geeky math major who’s never had a date. Bill Gates comes to mind. I can’t imagine that this is a useful defense as there are plenty of experts around who will not support this as a reason why she might try to kill a rival. I would not be surprised to see an Asberger’s syndrome person in the astronaut program although socialization issues would probably rule most of them out. The Asberger’s folks would be building the rocket booster or programming the computer.

    My lab partner in medical school might have qualified. He was one of two guys designing the solid rocket propellant for the Minuteman missile (1962). He flunked his first biochem quiz because he spent too much time trying to figure out what the prof was asking about co-valent bonds. He happened to have a PhD in P-Chem and knew more about co-valent bonds than anybody else in Los Angeles. When they figured out what happened, they quickly gave him an “A” and sent him off to work on something else. If he hadn’t had Asbergers (semi-facetious here), he would have told them he was over qualified before taking that quiz. It just never occurred to him that he knew more about organic chemistry than the guy teaching the class. He thought everybody knew that stuff.

    He wound up a pathologist. Good spot for him.

    Mike K (6d4fc3)

  21. Also from the Houston Chronicle piece DRJ quoted:

    [Defense lawyer] Lykkebak said Houston psychiatrists Richard Pesikoff and George Leventon are expected to testify in her trial, set to begin Sept. 24. Neither doctor would comment on the case.

    A clinical professor of psychiatry at Baylor College of Medicine, Pesikoff was cited by Texas Monthly magazine as one of the state’s top psychiatrists. He served as an expert in the defense of Andrea Yates, the Houston mother who drowned her five children in 2001.

    I’m not acquainted with Dr. Leventon, but I am with Dr. Pesikoff. I would expect him to be a very, very formidable witness. That doesn’t necessarily mean, however, that his testimony will be as strongly supportive of the defense positions as Lykkebak would wish.

    Cross-examining psychologists and psychiatrists is just about the most fun thing a trial lawyer can do, but it’s a mistake to always be attacking or to have your ferocity dialed up to 11. I would bet that a very skilled prosecutor could rely on Dr. Pesikoff to give ground, honestly, on an awful lot of points that would be useful to the prosecution’s case.

    You pretty much had to expect the defense team to try to put the defendant’s mental status in play, but as nk notes, it’s far from certain that that will succeed. This should be a fun trial to follow. Does anyone know offhand if it will be on TV?

    Beldar (1b82e4)

  22. Beldar,

    If the Court permits the proceedings to be televised, I suspect CourtTV will cover it since they already have this case highlighted on their website.

    “Cross-examining psychologists and psychiatrists is just about the most fun thing a trial lawyer can do …”

    I know what you mean but only trial lawyers can say that with a straight face.

    DRJ (bfe07e)

  23. I have Asperger’s syndome, and belong to a support group, so I am aware of the mental issues associated. An AS person is NOT more likely to commit murder, or any crime, for that matter. Yes, we have socialization problems, which meand that we are awkward and have trouble communicating sometimes. It’s a mattter of unspoken subtleties. But we’re perfectly aware that murder (and many other acts) are WRONG and are not the way to handle a situation. Those are clear-cut matters.

    BAS (ac2ce3)

  24. I have a son with AS, and have some experience with service academies. I honestly don’t see how anyone with Asperger’s Syndrome, no matter HOW mild, could POSSIBLY get through the rigorous program at the Naval Academy – and then the space program.

    There are techi people at the academies for sure – but – I cannot see a person with Asperger’s making it through Plebe Summer, let alone the entire 4 years of unrelenting pressure – the combination of academic AND social. The social pressure (not how to be cool as much as not sticking out from the crowd with the military superiors in the student ranks).

    Having obsessive compulsive behavior does NOT put you on the autism spectrum; it’s a heck of a lot more than that. Females, granted, are a LOT more difficult to diagnose – but they’re issues are still apparent.

    bystander (eae5e7)

  25. I am yet another Aspie. I know the difference between right and wrong. My mother made sure I knew that. She couldn’t get me to talk to other people, however, or to exercise that mysterious quality called “common sense”. Which is a good indicator what AS/HFA is.

    It isn’t a disease–just a fundamentally different structure of the personality, with its own ways of communicating and functioning, and part of that means dealing with “normal” people and “normal” society is usually highly stressful. But it doesn’t mean I would go off and kill someone who was a romantic rival. (Not that I’ve ever been in a situation in which a romantic rivalry was even a remote possibility.) I can even act in “normal” ways when necessary, albeit not with pleasure and usually with some pain. And some of us are extroverts, which means we wouldn’t mind being in cramped quarters for long periods of time with a group of relative strangers, although whether the rest of the group would mind being with us is a different story. IOW, Asperger’s is not necessarily a red flag for NASA. (Not me, however. I would probably volunteer to be marooned on a desert island, as long as I had survival training first.)

    I view my autism as a blessing. It’s helped make me a person who finds his own pleasures where he wants to find them, without depending on the taste or talents of others, and to reject herd mentality, and a habit of thinking everything through. Not to mention a sense of humor as dry as the Gobi Desert, and, pace to my mother’s admonitions, a good deal of uncommon sense.

    Parenthetically, I think the “rise” in autism is simply increased rates of awareness and changing diagnostic methods. When I was a kid, it was simply accepted that I was heavily introverted, addicted to reading, socially clumsy, and without a grain of common sense, and no name was put on it. After all, everyone knew back then that kids with IQs like mine couldn’t possible be autistic.

    There are certain elements of the Nowak affair that can be explained by Asperger’s, but not all of them, and not enough by a long shot to be grounds for any legal defense. In as much as any autistic can be typical, she isn’t typical. Neither were Newton, Beethoven, and Godel, but we don’t mind being compared with them :)

    Final note: if I can ever be of assistance with advice or other to any of the parents of autistic children on this list, please feel free to contact me, under my nickname at either LiveJournal or Yahoo mail.

    kishnevi (da26af)

  26. I will take you up on your offer, Kishnevi, and thank you. In recent years, it’s been my experience that more and more medical professionals understand that autistics can have very high IQs.

    DRJ (bfe07e)

  27. Bystander–actually, the social pressures can be less for an aspie in a military situation than in a civilian situation. Military life (including the service academies) has explicit rules, and all you have to do is learn them. Civilian life has implicit rules, and figuring them out can be a serious challenge to an autistic person. And when we learn what the rules are, we apply them with deliberation. It’s hard for us to learn how to be one of the herd, but ironically once we’re part of the herd, it’s easy for us to stay part of it. We just make sure we imitate the rest of the herd.

    Of course, being autistic means each of us has different strengths and weaknesses, so I can’t really say anything about your son’s particular case. I myself am faceblind, and depend on clothing and haircut to help identify people. In the context of a service academy where every one else is wearing the same uniform with the same basic haircut, I’d certainly have a hard time.

    kishnevi (202292)

  28. …part may also be the increasing stress we put on our immune systems …

    As opposed to, say, the god old days before vaccines and antibacterials when adulterated foods were commonplace, London’s air was brown with smog, wallpaper leached arsenic, paint contained lead, fresh fruits and vegetables were a luxury in winter and tuberculosis was commonplace?

    Honestly.

    olivia (8fa0cc)

  29. “After all, everyone knew back then that kids with IQs like mine couldn’t possible be autistic.”

    Bingo. When I was five years old, my kindergarten teached and school psychiatrist diagnosed me with “high functing” autism based on my quirky behavior (inability to make eye contact, repetive bodily movements, clumsiness, tendancy to tune others out, etc.) However, my parents demanded a second opinion and was given an IQ test. Since I scored 167, it was concluded I couldn’t possibly be autistic.

    The sad thing is, probably a lot of AS kids who happened to be of only average or maybe a bit below average intelligence were probably misdiagnosed as full blown autistic and forced into special ed classes. Later (during the early 90s), a lot of AS kids were getting misdiagnosed as having ADD and pumped with ritallin. So even if more AS kids are getting diagnosed, a lot less are getting MISdiagnosed with some other fad disorder that doesn’t apply to them.

    Sean P (e57269)

  30. Olivia:

    …part may also be the increasing stress we put on our immune systems …

    As opposed to, say, the god old days before vaccines and antibacterials when adulterated foods were commonplace, London’s air was brown with smog, wallpaper leached arsenic, paint contained lead, fresh fruits and vegetables were a luxury in winter and tuberculosis was commonplace?

    Honestly.

    You make a good point, Olivia, although I think your uncalled-for sarcasm undermines the effectiveness of your point. My response would be to point out that there were much higher death rates among children during those days of smog, arsenic, lead, etc., which ties in with part of my post you omitted – that we now have the “luxury” of dying of new kinds of diseases.

    DRJ (bfe07e)

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