Guns and suicide

Got a link to this information through the NAME listserv and I thought I’d post it here:

A study by the Harvard School of Public Health of all 50 U.S. states reveals a powerful link between rates of firearm ownership and suicides.
… states where guns were prevalent—as in Wyoming, where 63 percent of households reported owning guns—rates of suicide were higher. The inverse was also true: where gun ownership was less common, suicide rates were also lower.
… Says HSPH Professor of Health Policy David Hemenway, the ICRC’s director: “Studies show that most attempters act on impulse, in moments of panic or despair. Once the acute feelings ease, 90 percent do not go on to die by suicide.”

Just as I mentioned before these impulse suicides need to be a real target of prevention measures, including telling folks that if they own guns keep them locked up or out of the house at the very least.

Sailor Heroin Deaths

Headline from the Great Lakes Bulletin:

“These shipmates made a life-changing decision…R.I.P.”
“Bad decisions lead to deadly consequences”

It then lists the names of three Sailors who have died this year, actually within the last 5 months, of heroin intoxication (some with other drugs in the mix). These were young men who made “bad” choices that cost them their lives, their potential lost.

The article concentrates on one the young men enough that you really get to know him. He really is just a kid wanting to enjoy life and with plans for the future. All that snuffed out with these decisions.

Did any of these young men know or consider the real risks of these actions? Drugs they can make you high and they can make you die.

Another drug-related death

Another drug-related death of a young man (in his 20s) this week (not to mention the gentleman in his 50s or the woman in her 30s, they are no less tragic and they also died drug-related deaths this week)

He died of heroin intoxication, abuse, over-use. What also stood out with this young man is that when we tested several items from his room for drug residue we came up with results that beg action or reaction. We found a dollar bill with heroin residue, cocaine residue on his dresser, cocaine and THC residue on a small scale in his room, and a part of a jeweler’s screwdriver with THC residue.

Youthful experimenting? To me it screams the need to get honest information repetitively out to the public (how do you get it to the youth of our community?). Among other important bits of information, that the heroin on our streets right now is potent and particularly deadly. We must develop and push prevention; we must develop and push treatment.

It will be work, hard work, but aren’t these folks worth it?

This ain’t CSI

Another in my “this ain’t CSI” posts:

About 5:20 pm yesterday I got an email that said: “I hope this doesn’t make it on your blog!” If you wrote that I’d advise you to stop reading now. I couldn’t resist.

Over several hours and multiple emails yesterday I and a very patient staff member of Finance tried to set up a meeting to go over my FY2009 budget with County Administration.

In one of my emails I described the interaction “like a game of Twister or Checkers on crack”. Over 20 emails rocketed over the wires and airwaves back and forth to get all of the folks scheduled together for the meeting. Last I heard it was still pending responses from 2 folks, so I am watching for more emails.

Our budget setting process might be “fun”, but I don’t think it will ever make an episode of CSI. I begin with my proposal shoe-horned into their forms and format. At times their forms seem arcane and not a good fit for what or how I want to submit stuff. That stuff is reviewed by Finance staff and some changes are made based on that back and forth give and take.

The next stage is the face-to-face review with a group of County administrators with my justifying changes from last year (e.g. a latex shortage in Asia threatening to drive up the cost of gloves in a few months). Heady stuff, but not the stuff of TV drama.

After that they review my budget without me present, figure how it fits with the County’s overall budget, and decide what they will recommend to the County Board. Then it’s through the Board committees and the full Board for approval in a few months.

On second thought, I think I’ll begin work on the script proposal, I think it has potential.

Preventing Death by Train

I just got a “save the date” card for an upcoming conference that sounds interesting. I was talking recently about the need to better secured train tracks (fencing and the like), both in reference to my impulse suicide post of a few days ago and with the incident of a recent suicide by train. Low and behold, I got a card in the mail about a conference entitled “Sealed Corridors”, put on by the DuPage Railroad Safety Council in September.

Looking at the DuPage Railroad Safety Council website, I was impressed with their various initiatives and projects. They undertake education to kids, educational materials at train stations, promoting legislation and enforcement, etc.

I think more “secure” tracks could prevent some impulse death by suicide, as well as some of the accidents we see involving trains. We have had cases (pedestrians and in vehicles) who ignore warnings, or who misjudge time to impact, or who are distracted to the point of fatal error.

The DuPage Railroad Safety Council efforts and their conference sound interesting. I look forward to learning more and supporting what I can.

Drug combinations multiply lethality

I came across this reminder that drug combinations are almost always more lethal than single drugs alone. (Actually I had been corresponding with the author of this article before he published this in the paper/on the Internet. He had picked up on my blog as a source of information after a recent death involving a sorority “sister”)

The combination ingestion (by different routes but at the same time) of alcohol and cocaine is more lethal that either alone, at least in part because of the metabolite formed in the body (there may also be an effect on metabolic pathways seperate from the formation of this metabolite).

Research into the lethality of cocaethylene use compared to cocaine use alone is young, but anecdotal experiments have pointed towards an increase in mortality rates from a combination of cocaine and alcohol consumption. One of these, a 1999 study of drugged rats by the Kyoto University Graduate School of Medicine, found cocaethylene 46 percent more lethal than the control group of cocaine use alone.
Additionally, a study appearing in the July 1997 issue of the Journal of Addictive Diseases stated that cocaethylene has been associated with seizures, liver damage and compromised functioning of the immune system and found an 18 to 25 fold increase in risk for immediate death over cocaine use alone

Don’t take chances, make good choices, think

Health Promotion to Forestall Death

I agree with the author of an article I just got around to reading: Improving Public Health Through Prevention.

Not only do we need access to healthcare and healthcare coverage for all, we need what the author calls “Universal Coverage PLUS”:

A high-performing national health-care system must also focus on the prevention of disease and promotion of optimal health for all its citizens…
The existing system focuses primarily on diseases -- once symptoms are well established and treatments are costly. The system needs to include a logic of targeting investments and interventions earlier in the evolution and development of diseases. Improvements in the natural, social, and built environments in which individuals live, as well as enhancements in diet, exercise, and lifestyle, can have a profound effect on health trajectories, adult medical needs, and the overall costs of care. Recalibrating our health system to address this undeniable reality will require more than universal coverage.

As I heard someone say recently we need to “make sure you are around for all the birthdays you possibly can”. To do that we must make certain everyone has access to medical care, not just episodic acute care in an ER but a long-term healthcare provider relationship with chronic disease diagnosis and management as needed. Along with that, we need to push folks to get healthy and stay healthy. We need to work on healthy communities and healthy environments so folks can get out and get healthy without the potential of others affecting their health and their new healthy lifestyle (i.e. with violence,etc.).

If the working for the common good isn’t enough of a reason for you, think of it as an investment in “human capital” (to borrow once again from the author).

“The City of Broken Men”

I read an article from the July GQ magazine yesterday (not my usual reading material, my wife saw the article at the spa at which she works). The article was about the military hospital, Landstuhl Regional Medical Center, and the work they do there. The article should be required reading for every American.

Every soldier injured severely enough to leave their units in Iraq or Afghanistan go through that hospital in Germany. They do incredible work there. The article centers on one injured soldier who had his leg blown off, in telling the story of the medical center, its staff, and its work.

Two things in the article really grabbed me. They drove home to me the enormity of this side of the war. The enormity of which we regular citizens don’t see, don’t hear about, don’t know enough about. As the author points out it is and enormity that will affect us as a nation and as people for a long time to come.

The soldier the article focuses on is “more or less the 44,360th person hurt badly enough to be evacuated out of Iraq or Afghanistan”. 44,360th and that was months ago.

And then the article’s thought provoking closing:

“We can send you to a broiling desert across the world to fight precision battles in a country you know nothing about; and we can beam you up when you’re hurt and put you down in the middle of Germany, rebuild your leg, get you free cheese and $50,000. But there are some things we just can’t do. And what it is we couldn’t save Mike Brown from what he’ll find out next [back home].”

What we do for all the Mike Brown’s into the future is our challenge as well.

[“The City of Broken Men” by Devin Friedman, GQ, July, 2008]

Suicide: premeditated v. "crime" of passion

I came across an interesting article this week (via the NAME listserv) about suicide. Early on it brings up an interesting statistic that “the nation’s suicide rate (11 per 100,000 inhabitants) is almost precisely what it was in 1965”. Despite all the research, all the programs, all the new medications, the rate has not changed in over 40 years. That really is startling.

The author, as well as some researchers, feels that that is due to a dichotomy in suicidal behavior, much as there is in homicide. He discusses a premeditation vs. passion division amongst deaths by suicide. The premeditated suicides are most easily impacted by programs, medications, and therapy. The passion or impulsive suicides not so much. His discussion resonates with my experience.

The impulsive suicides are best impacted by creating “barriers to suicide or means restriction”. This was well documented (and then ignored) in the 60s and 70s in Great Britain. Death by suicide dropped by a third with the change from coal-gas to natural gas stoves during those decades. In the 50s “sticking one’s head in the oven” accounted for half of all British suicides. "Many of those were impulsive acts using a means with little time for second thoughts". “Remove it, and the process slowed down; it allowed time for the dark passion to pass".

We need to modify how we address death by suicide, how we think about death by suicide. They are not homogenous (neither the individuals nor the methods) and likely require multiple, varied interventions. Youth particularly fall into the more impulsive category, making brief, timely interventions critical. This recognition of differences can lead to more successful intervention.

But never lose sight of the underlying condition:

"They had wanted their inner pain to stop; they wanted some measure of relief; and this was the only answer they could find. They were in spiritual agony, and they sought a physical solution."

Coroner speaks to alcohol pushers

Last night I practiced what I preach. I have been preaching that we need to change the social norm surrounding alcohol consumption. We don’t need alcohol served at every celebration or get-together. We don’t need alcohol to have fun or as a social lubricant. We need to step up and speak out against this “social norm”. That is one way we can change teen/youth conviction that we need to consume alcohol.

I was at an event where several upcoming events/parties were announced. Every one had alcohol as the first word in what would be happening at each of them. After listening, I stood and spoke out. I told them that what I was going to say might be uncomfortable, but that it is not right for alcohol to be “the guest of honor”. I am not against responsible drinking by adults, but it should only be a side, not a main course. I cautioned them that if they were serving, they would share responsibility if any over-drinking occurred. Just as I tell teens: Think, make good choices, don’t take chances.

Now it is your turn to speak out. Only with speaking out can we alter that social norm.


On another related topic: I am appalled by a commercial that I have heard several times on the radio. To quote (or come close anyway): “…two things you should know about morning hangover…” Both those things pertain to their product. No. The 2 things you should know have nothing to do with their product (yes, something I learned a long time ago): You drank too much and don’t do it again.

“21” saves lives, enough said

The Substance Abuse Policy Research Program put out a press release a while back that I just got through my ASAM listserv:

… the study published in the July 2008 issue of the journal Accident Analysis and Prevention found that laws making it illegal to possess or purchase alcohol by anyone under the age of 21 had led to an 11 percent drop in alcohol-related traffic deaths among youth; secondly, they found that states with strong laws against fake IDs reported 7 percent fewer alcohol-related fatalities among drivers under the age of 21.

Controlling for possibly confounding variables, this study presents convincing research results that should quiet discussions about lowering the legal age limit. No longer should “21” opponents be able to confuse the issue with issues of improved car safety, for example.

The other finding of the study was:

…the authors … found that tougher sanctions against fake identification cards may represent the second-best legislative tool that states have in combating drunk driving deaths among young people.
“We found a 7 percent drop in youth alcohol-related fatalities in states that are willing to take strong actions, such as automatically suspending the driver’s license of a young person caught with a fake ID.“

Still more needs to be done pushing for consistency in the various laws encompassed in “the legal drinking age of 21” (across states and other jurisdictions)and a push is needed for consistent enforcement as well, but there is proof that this is the way to go to prevent deaths of teens.

Enough of the talk, featured recently on one of the news channels (I forget which), of the talk of a return to 18 as the legal age for drinking. “21” saves lives, enough said.

Coroner Business as a Profession

I was interviewed for an article that will be used by “Bridges…the Student Success Company” to acquaint teens with the Coroner business as a profession. I liked it when they sent it to me for checking, so I thought I’d put it up here:

"As a coroner you also have to deal with the politics, administrative, and personnel issues that don't show up on CSI," says Dr. Richard
Keller. He is a coroner in Illinois.

"It is great work, but it is not for everyone. It is difficult work mentally and physically. The deaths of kids, dealing with a decomposed body or a gruesome death are all tough. Equally tough are working in the cold, rain, mud, and all the locations and conditions that can surround a death," says Keller.

One of the main responsibilities of a coroner is to determine the cause of death.

In one of Keller's cases, deduction and reasoning among all the staff in the coroner's office was necessary. They suspected that the man had died of cocaine intoxication based on circumstances and his history. But there was no blood or other body fluid available for testing to prove their suspicion. They found a solution.

"We used a blender on the colony of maggots that was where his brain should have been -- long before the somewhat similar CSI episode. On testing the resultant mass ... in our toxicology laboratory, we found that he had indeed died from the use of cocaine. The maggots were positive for cocaine that they had acquired by consuming him," explains
Keller.

Keller is a physician who became a coroner to target the public health aspects of the job. He is interested in educating the public to help prolong life by avoiding similar untimely deaths.

"Certainly, learning and investigating all the different ways people die is interesting and exciting, but by the same token, getting out and talking to folks, particularly youth, about our work and how they can forestall their own death is really great as well," says Keller.

Keller says that most science and medicine educational backgrounds are useful for future coroners [and their investigative staff].

"There are some good forensic science programs in various places, but there is also some coursework that has been thrown together to catch the wave of interest. Look for older, established programs," says Keller.

In Illinois, coroners are elected and only required to be 18 years old and registered as a voter. Keller is the first physician the office has seen since the 1940s. His deputies have two-year associate degrees in criminal justice or healthcare.

"As populations grow, the numbers of deaths also grow, necessitating increasing numbers of medico-legal death investigations and the personnel to do them. I am sure that there will be an ongoing increase in demand for more sophistication, training and education among this personnel," says Keller.

"Verbal and written communication is incredibly important and is one of the most important skills high school students can work to develop when thinking of this field," says Keller.

Dr. Richard Keller is a coroner in Illinois. "There will always be deaths and the need for investigating them. There is some trending nationwide to changing from coroner to medical examiner systems, as well as increased credential requirements," he says.

"There are other options for jobs in this field beyond coroner and/or medical examiner," says Keller. He adds that the Bureau of Justice reports 1,998 coroner and medical examiner offices nationwide.

"When I ran for office, I pledged to also investigate 'medical misadventures'. Just as our office obviously is there to serve [the deceased] who can no longer serve themselves, just as much, we are here to protect the living residents of Lake County and to forestall death when we can," says Dr. Richard Keller. He is a coroner in Illinois and was faced with this exact circumstance and decision in real life.

There was a coroner's jury (a body convened to assist a coroner in determining the cause of death) in the case, and Keller told them that,
"The definition of homicide that I give to the jury is either a willful and wanton act, or recklessness on the part of someone, whether that's by their actions or by their inactions. Certainly, by that definition, this is a homicide."

The coroner's jury agreed with Keller, and ruled the woman's death a homicide. This meant that her death would be investigated further, including the hospital's practices.

"This is a social justice, a greater good issue," says Keller. He used the media attention that the case received to call for better care. "The quality of medical care must be improved. No more excuses about an overburdened system. Develop systems (quality) to ensure this never happens again."

Young people die using/abusing drugs

Young people use/abuse drugs. Young people die from using/abusing drugs. We need to stop young people from dying from drug use/abuse. (The same goes for older people, but it always seems more shocking when it is young people who die. Is more potential lost?)

I was reading an interview with Dr Drew Pinsky (currently rehab doctor to the stars) recently and he sure makes it sound tough. Although he wasn’t talking about young people in particular, he laid out the 3 events that motivate change in his experience, i.e. motivate folks to quit abusing drugs:

Near death experience (i.e. the drug abuser nearly dying)
Looking in the mirror and feeling genuine disgust
Loss of your children, having them taken away (particularly true of women)

I feel there must be other ways to motivate the desire to make the life change involved in quitting the abuse of the drugs, particularly in young people. Or do we work at instilling self-disgust, if his motivating events are all-inclusive. The younger the person is when we begin to intervene the less entrenched the drug abuse behavior is. That should make available more intervention options. Of course, prevention is an even better goal to drug abuse prevention.

“Just say no” isn’t working, as evidenced by multiple studies. We need real, evidence-based intervention strategies. Scaring them straight doesn’t work. Their minds are still developing, but their intellect is there. Interventions need to use that fact.

There has to be something that we can do. The 24 year-old young lady didn’t need to die today.

Suicide is not chosen

Truism/quote from the final page of the 2007 Illinois Suicide Prevention Strategic Plan

“Suicide is not chosen; it occurs when pain exceeds resources for dealing with pain” Dr. David Conroy

“Good” Heroin v. Tainted Heroin Causing Deaths

As I mentioned in my talk the other day, the movie “American Gangster” among other things, shows what happens in an area (Harlem in the 70s) when the quality/purity of heroin improves. It is somewhat easy to miss, but before the consumer base stabilizes there are a number of addicts that die because they aren’t used to the less cut heroin suddenly available on the streets. They continue to use the amount of drug that they were using and it becomes an overdose before they realize it.

Something similar is apparently happening locally, as well as elsewhere in the country. We are seeing what looks like an increase in deaths due to heroin overdose (it is a bit early in the course to call it a trend, but it looks like it). Local law enforcement initially felt the deaths were due to “tainted” heroin, i.e. heroin cut/mixed with something that was causing the deaths in these folks. We have in the past seen fentanyl, a much more lethal drug, mixed in or replacing the heroin, causing similar deaths.

It was the opinion of my office that the deaths were more likely due to purer (“stronger”) heroin. Our toxicology testing has bourn that out. There is really good heroin on our streets.

I also warned the teens the other day that that purity also makes it more tempting to try this very addicting drug. You can snort it instead of using a needle. The numbers of those addicted will take longer to surface, but I suspect that that will grow as well with the increased purity. Teens, in particular, must be educated to not try the drug, their developing brains are even more susceptible to its addictive properties.

“Good” heroin is not a good thing. It contributes to all the problems inherent in the addicted population; physical problems, social problems, problems with the law. It contributes to death. Our tools consist of law enforcement, education and awareness, and treatment. All must be brought to bear on this problem.

Informative and Cautionary Coroner Talk

As I alluded to in my post yesterday, I spoke with a group of 40 students at Stevenson High School yesterday. I told them about what the Coroner and his “Office” does (in some detail, I had an hour and 15 minutes). Who we are in our office and what we do (often a bit more than is done in other coroner offices). I answered a number of questions. We discussed causes of death, manners of death (natural, accident, suicide, homicide and undetermined), ways of identification, post-mortem entomology, all manners of stuff “coroner”.

It was a bit tricky because the instructors had already written the test questions based on my talks the last 2 years and I don’t talk from notes, so I can’t necessarily guaranty repetition of all the material from one year to the next. I was prompted to cover an entomology point by a question from one of the instructors, so I must have got the other material, thankfully for the test-takers.

Most importantly, at times hopefully cleverly and at times blatantly, I peppered my talk (as I always do) with tips and reminders useful in their forestalling death. Honest warnings about drugs, recommendations about making good choices and not taking chances.

Interesting, informative, cautionary, I do my best. Besides, as I told them, giving those types talks are my favorite part of the job.

Are the dead too heavy?

What are we to do, our bariatric equipment is failing/breaking?

“Bariatric equipment”, in this case, is the fancy way to designate the heavier duty equipment we purchased to handle the heavier decedents we are tending to encounter. First our body lift, rated to handle 700 pounds, bent and the weld broke part way through lifting a female a few weeks ago (under warranty, so the company has replaced the damaged parts). Next our hydraulic morgue cart gave out under the strain of holding a large decedent (it was old anyway, so it was “retired”). Then last night our new transport cart (rated also at 700 pounds) broke while transporting another decedent to our van to bring him back to the office for autopsy. (It took 5 people to lift the decedent and the cart into the vehicle.)

Obesity is reaching (has reached) epidemic proportions. It is increasing the risk to my staff in lifting and moving folks. It is requiring heavy-duty equipment (that may not hold anyway). As I told a group of teenagers I gave a talk to today, do all you can to not get, or die, obese.

Death by Suicide or Lacking Access to Healthcaring?

(It is by intention that I wrote “healthcaring”. How caring is it that we allow so many people in our country to not have access to healthcare?)

How many more of these will we see? These words are from a suicide note left by an individual recently:

I didn’t call an ambulance because I’m not working any more and my insurance has run out.

My health has been getting worse and worse so this is not unexpected.

Please forgive any mess I leave behind.

It leaves me speechless.

Co-sleeping can be deadly

A reminder that co-sleeping with an infant can be deadly:

…the cluster of deaths is reason enough for doctors and public-health officials to repeat their warnings about sharing a bed with young children.
"The best way to keep something from happening is not to do it in the first place," said Dr. William Cotton, president of the Ohio chapter of the American Academy of Pediatrics.
"The bottom line is, we suggest that you don't co-sleep."

I stand by my opinion, but will air others

I got a couple of these emails and while I stand by my opinion (as does a kayaker friend of mine) I thought I’d share these very good points with my readers. My job is to forestall death and my opinion and comment are to that goal:

Dr. Keller,

I am writing to you regarding the recent drowning of Ms. Connie Alton, the kayaker recently found on Lake Michigan, and specifically in regard to the statement attributed to you in the Daily Herald article, in which you are reported to have stated: "We've seen certainly more than one kayaker from Lake Michigan," Keller said. "With the conditions in that lake, it is certainly not a good place for kayaking." I am a paddlesports instructor, certified by the American Canoe Association, and serve on the Board of Directors of the Illinois Paddling Council, which is an umbrella organization of paddlesports clubs, retailers, providers, and individuals in the State of Illinois. At the IPC home page, you can find in the left margin, “Safety”, and under that “Lake Michigan,” where we describe many of the hazards & safety precautions necessary for safely paddling Lake Michigan.

Much has been made of Ms. Alton being an avid kayaker, who paddled Lake Michigan often. I won’t dispute that she may have been an avid paddler, but as a certified paddlesports instructor, I can tell you that “avid” does not necessarily translate into “skilled” or “knowledgeable.” I myself was an avid paddler for decades, before I learned how few skills I actually had.

(This) photo was taken from the Chicago Sun-Times web site.

There are many different kinds of kayak available for sale these days; each is designed for a different purpose. In the photo, it’s easy to see that this particular kayak is what we in paddlesports refer to as a “Recreational” kayak. It is designed for use on small, protected lakes, such as the lake at Independence Grove Forest Preserve, where the Lake County Forest Preserve District rents these kayaks to the general public. The LCFPD rental at that site is an appropriate use of this type of kayak, but this kayak was not designed for use in large bodies of water, like Lake Michigan. Experienced, knowledgeable paddlers know this. I would p osit that anyone who takes this type of kayak onto Lake Michigan is very unaware of the hazards to which they expose themselves (i.e., is both unknowledgeable and unskilled).

Another detail that illuminates this discrepancy is that she reportedly was not wearing her Personal Floatation Device (PFD, aka life vest). Experienced, knowledgeable paddlers always wear their PFDs, with the possible exception of what we call “pool sessions,” which are instructional events in very controlled, indoor pools, where multiple “safety boaters” and rescue-trained instructors are readily available.

There are other issues with this incident, which do not appear consistent with Ms. Alton being a knowledgeable or skilled paddler:

--I have seen no indication in the news articles that she had a companion along. Was she paddling alone? That’s never a good idea, especially on big water. A knowledgeable kayaker would typically paddle with a group of not less than three people, as a “safety net.”

--She was paddling on a foggy evening? This is never a good idea, as no other boat on the water will be able to see a kayak in fog. Knowledgeable paddlers are aware of this.

--The water temperature was around 50 degrees, which is cold enough to make somebody hypothermic in a very short time. A knowledgeable paddler would be wearing a dry suit, with multiple (not cotton) insulation layers inside it: He/she would be dressed for immersion in the water, not the air temperature. I don’t know what she was wearing at the time, but the answer to that question may shed additional light on Ms. Alton’s level of kayaking expertise.

I’m aware that Ms. Alton isn’t the first kayaker who has drowned in Lake Michigan; just last fall, one Mr. Doroba of Waukegan suffered a similar fate. A review of Coroner’s Office files should reveal if there have been others. As I recall, however, Mr. Doroba had just purchased his kayak, wasn’t wearing his PFD, and obviously had few, if any, of the appropriate skills for paddling Lake Michigan. I think it is also significant that neither of these victims were members of, or had any apparent contact with, any of the responsible paddlesports clubs that are organized in this area. Members of these clubs learn very quickly the limitations of their skills and equipment.

I will suggest that Lake Michigan is an excellent place for kayaking, provided the kayakers’ knowledge, skills, equipment, and experience are appropriate. In these two cases, the individuals’ knowledge, skills, equipment, and experience were clearly not adequate.

The point of this letter is not to highlight the probable shortcomings in these victims’ kayaking abilities. I do not, however, think it’s appropriate for a public official to be making uninformed and blanket statements to the media about the safety of kayaking on Lake Michigan. I’ll also note that many local jurisdictions, including the Lake County Forest Preserve District and many villages along the lakefront, support kayaking as a safe and ecologically friendly activity. That list of local jurisdictions also includes the US Navy, which provided the access for Ms. Alton to enjoy the lake.