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FIRST ASSESSMENT DET. DAVID MICHAEL STARSKY, June 11, 1979

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The most used disclaimer:
The TV show "Starsky and Hutch", and the characters from it
are the property of the persons who hold the copyrights
and other legal rights to them.
This story is a work of fiction, written for pleasure only
and not for profit. It is not intended, in any way,
to infringe on these preexisting copyrights.

THE POST GUNTHER SESSIONS

Notes from the department psychiatrist and hospital psychologist on the
therapeutic sessions they had with Starsky and Hutch in the aftermath of the shooting.

FIRST ASSESSMENT DET. DAVID MICHAEL STARSKY,
June 11, 1979 – 11:15 AM, Memorial ICU

Jacqueline©2019-11-16

 

HISTORY:
Patient:
David Michael Starsky, white male, age 32
Date of admission: May 15, 1979 - 1:50 PM; time of incident: approx. 1:08 PM
Category: Multi-trauma and Injury; Penetrating injuries to trunk: 3 gunshot wounds (GSW); suspected trauma to spinal cord; severe (internal)
                bleeding/suspected arterial haemorrhage; weak / irregular pulse; respiratory distress; unconscious.
ER:           trauma staff worked to stabilize the patient until finally at 2:45 PM he could be transferred to the OR for surgery.
OR:          Trauma surgery team (OTT 4) – 9 hrs, 17 minutes; 3 bullets removed; 10 pints of blood; cardiac arrest after 4 hrs and 12 minutes;
                thoracotomy; resuscitation 7 minutes; cont. surgery.

Post-op status:

critical; comatose;
May 16, 1979 03:21 PM: cardiac arrest  resuscitation 14 minutes.
May 17, 1979 08.30 PM: Downgraded to serious/guarded
May 18, 1979 09:20 AM: off ventilator; nasal canula – status coma unchanged until
                                       08:05 AM: patient conscious
May 19, 1979 07:56 AM: patient awake – cognitive ability could not be tested yet
May 20, 1979 11:05 AM: level 1 cognitive ability test; failed
May 21, 1979 08:45 AM: level 1 cognitive ability test: successful
May 22, 1979 10:15 AM: cognitive skills: adequate (non verbal);  short term memory:
                                       unsatisfactory
May 23, 1979 09:45 AM: level 2 cognitive ability test: failed; respiratory infection
May 24, 1979 08:15 AM: respiratory infection; intravenous antibiotics; decision
                                       pending on putting patient on ventilator again.
May 25, 1979 08.15 AM: restless night; fever spiking at 104 degrees; upgrade
                                       intravenous antibiotics; patient sedated
May 26, 1979 08.15 AM: situation unchanged
May 27, 1979 08.15 AM: slight improvement; fever down to 100 degrees
May 28, 1979 08.15 AM: patient’s temperature down to normal level; sedation level
                                       reduced
May 29, 1979 09:15 AM: patient off sedation, temperature normal, first psychological
                                       assessment cancelled
May 30, 1979 10:05 AM: situation unchanged; introduction gelatin; special attention
                                       swallowing
May 31, 1979 09:30 AM: note nursing staff regarding development of bedsores;
                                       special attention/treatment plan
June 01, 1979 10:30 AM  wound care pressure ulcer started
June 02, 1979 08:15 AM  patient transferred to high care unit; special matress, wound
                                        care cont’d.
June 03, 1979 05:30 PM  introduction applesauce; nausea (admin. Prochlorperazine)
June 04, 1979 08:30 AM  breakfast gelatin first success after swallowing training;
                                       spontaneous breathing trial (STB) started to wean patient off                                  
                                       cannula – 20% reduction oxygen level after 30 minute trial; SB                                           
                                       moments will be increased by 10 minutes each day with 2 hour                                         
                                       breaks; monitoring (Sarge/Kramer alternating)
June 05, 1979 12:30 PM  pressure ulcer responding well to treatment; patient cognitive test
                                       level 3 successful; oatmeal/gelatin lunch, soft fruit: tolerated.
June 06, 1979 09:30 AM patient’s bed raised 15 degrees; monitoring Colley/Aaronson
                                       subsequent consultation Jamison (head of trauma 1, critical care,                                          
                                       physiatrist)/Aaronson (physical therapist) re therapy plan;
June 07, 1979 10:15 AM Pulmonary testing postponed in light of after effects of injury and
                                       surgery; STB continued: additional 15% reduction oxygen level
                                       (time intervals unchanged, Colley/Frantz alternating) pressure ulcer
                                       80% healed; yoghurt: tolerated
June 08, 1979 10:05 AM  Muscle strength/ROM testing (Aaronson, passive – assisted -
                                        mobilization protocol / muscle stretching protocol started); soft food
                                        / mash food diet started 3x/day; patient ready for first psychological
                                        assesment (Jamison / Johanson)
June 09,1979 08:30 AM   patient’s bed raised additional 15 degrees; monitoring Colley/
                                        Aaronson subsequent consultation P(a)MP;
June 10, 1979 10:05 AM  Pulmonary testing successful (level 2), STB longer interfalls,
                                        oxygen reduction unchanged; P(a)MP



FIRST ASSESSMENT DET. DAVID MICHAEL STARSKY,
June 11, 1979 – 11:15 AM, Memorial ICU

Memorial (transcript from recording)

 

 

FIRST ASSESSMENT
First psychological assessment (originally scheduled May 22, May 29 – both postponed)

Consultation (Dr Johanson):
Note (June 11, 1979 9:30 PM): Consultation with patient after his morning routine and breakfast. Drs Jamison, Foretti and Aaronson were present for the consultation. Calahan was there for recording and incidental notes.

Jamison:
Good morning, Mr. Starsky. How was your night, did you sleep well?

S:
Yes, sir, thanks.

Jamison:
Did you have breakfast yet?

(note: patient nods affirmation)

Jamison:
How did that go?

S:
Not a fan of ---- milk – no, --- yoghurt.

Jamison:
Well, it’s a first step towards more solid food. Just hang in there a while longer and you’ll be having a breakfast more to your liking. What would that be?

S:
Oh, I don’t know --- pancakes or ---- salami bagel ---

(laughter)

Jamison:
Well, we’ll just work toward toast and jelly first, don’t you think? Now, you do remember us from stopping by before, don’t you? Do you remember our names?

S:
You’re Dr Jamison ---- uh, dr ----- Atkinson?

Jamison:
Dr Aaronson.

S:
Aaronson, sorry --- Moses!

(laughter)

Aaronson:
That’s right! You remembered.

S:
Uh, the other gentleman is a uh ---- neu---- neurologist, right?

Jamison:
That’s right, dr Foretti.

S:
Foretti, yeah --- uhm --- Then there’s Joan  ---- excuse me, nurse Calahan and ----- I’m sorry ma’am, I don’t remember your name ---

Jamison:
This is dr Johanson, the team psychologist. I’ve explained to you earlier that in traumatic cases such as yours, it is usual practice for the BCPD and Memorial to have a patient assessed by a psychologist, to evaluate the impact of a traumatic incident such as what happened to you, on the patient. So, to that effect, Dr Johanson will have her first intake with you now, as we’ve talked about before. Dr Johanson?

Johanson:
Mr. Starsky, I’m going to ask you some questions about the shooting incident in which you were injured and how you have been feeling and doing lately or since the time of the incident. It might be difficult for you to revisit the incident, so if there is anything I can do to make our conversation easier for you, please let me know. Do you have any questions before we begin? 

S:
I’m just ---- I’m not sure if there’s a lot I can tell that will help you ----

Johanson:
Mr Starsky, I --- we --- are here to help you. So, don’t you worry about being able to, as you say, tell us a lot --- just tell me what comes up when you think about the incident and let us help you.

S:
Okay.

Johanson:
Mr Starsky, from the intake form from the day of the incident, May 15 until the latest status reports on your condition, I can see that you were shot in your upper body three times, were transferred to this hospital in critical condition, had hours of trauma surgery to repair the damage done by the bullets that were successfully removed from your body and that you woke up from your coma 56 hours after surgery. Is that about right? You were aware of these facts?

S:
Yes --- well, not until Dr Jamison told me ----- told me what put me here ---

Johanson:
What were your initial thoughts when you found yourself in hospital? Were you aware that you were in hospital and for what reason?

S:
I --- to tell you the truth --- I don’t really remember when I was told what happened --- and --
I don’t really know how I felt ---- I was kind of groggy for a while there --- I know several people --- there were a lot of people coming and going --- in my room I mean --- uh --- I know several people told me I was in hospital, so I guess I must’ve asked them more than once ---

Johanson:
What was your initial reaction once you were aware enough to understand why you were in hospital? What had happened to you?

S:
(note: patient is silent for a longer stretch --- seems to be trying to find the right words)
I ---- I wasn’t really surprised ----- I mean ---- I’ve been shot before ---- been in hospital before ----- I was more suprised by the fact that I’d already been in here a while and I couldn’t remember any of it ---- that was a first.

Johanson:
How did that make you feel? Did that scare you, or worry you ---- what were your feelings once you were made aware that you’d been in hospital for a while already?

S:
Nothing --- just ---- weird --- like I ---- like ---- I don’t know what I wanted to say anymore --- sorry.

Johanson:
When Dr Jamison and these other people told you why you were in hospital, did you remember anything about the incident itself?

S:
No.

Johanson:
How did that make you feel?

S:
I don’t know --- I didn’t think about it --- I mean --- I guess I believed the Dr and everybody --- I mean --- I, I was injured and in the hospital so --- I guess what they told me had happened was how ---- how it happened, you know?

Johanson:
When Dr Jamison informed you about the incident he also told you about the number and severity of injuries you sustained. How did that make you feel?

S:
----- That ----- I guess that ---- that this was probably the closest call yet ----

Johanson:
Did you feel helpless, horrified, or terrified?

S:
No ----- I just thought ----- that it’s probably the worst I’ve ever been injured ---- Why? Should I be terrified and ---- those other things you said?

Johanson:
I was just giving you some suggestions of feelings you may have had upon learning about your injuries. Did anyone other than the medical staff of this hospital speak to or with you about the shooting incident?

S:
Yes.

Johanson:
And who m----

S:
My partner ---- Detective Hutchinson ---- and my captain, Captain Dobey.

Johanson:
Did they speak with you in detail about the incident?

S:
No --- I don’t think so --- just --- that it happened at the station ---- the parking lot ---
broad daylight ---- and that it was a professional hit ---- fake cops ----

Johanson:
How did those details make you feel?

S:
----- I don’t know ------ probably ------ probably ---- what was your question again?

Johanson:
How did hearing the details of the shooting incident make you feel?

S:
----- That they fooled us ---- as fake cops ----- that’s a well organized hit ---

Johanson:
No other feelings? Or fears?

S:
---- That they tried ---- and lost ---- I’m still around, and they totally missed my partner --- so, they failed. That’s kind of a good feeling.

Johanson:
What are your feelings regarding your recuperation ---- your future?

S:
Well, Doc told me I was really bad for a while ---- so ---- he prepared me this will take a long time to ---- for me to ---- get back --- on my feet --- but I’m sure I’ll do better as soon as I can eat normal food again -----

Johanson:
How do you feel about your current condition --- how you are currently physically doing?

S:
(note: patient non verbal – non reactive)

Johanson:
What do you notice most about your injuries at the moment? What troubles you most or what causes you the most worry or discomfort?

S:
Well ---- I’m not sure I want to ---- let’s just say --- not --- that I can’t do --- you know --- every day things like ---- the ---- like ----- uhm ---- personal hygiene ---- That.

Johanson:
That is where Dr Aaronson comes in. He will soon start a physical therapy schedule with you that will help you get back on your feet again, literally. Well, I think we have had a good first conversation, Mr. Starsky. How do you think it went?

S:
Alright, I guess --- I don’t remember having a talk with a psychologist any other time I was shot ---- maybe I did --- maybe I just forgot ---

Jamison:
I think it’s a good idea if we leave you to rest, now, Det. Starsky. You did very well. Dr Aaronson and I will see you again tomorrow, alright? Have a good day. Doctors?

Psychological assessment:
Det. Starsky seems to be doing remarkably well, psychologically speaking, considering the massive physical trauma he suffered and the – for the time being – uncertain prognoses regarding his recuperation. Physically I could tell that this brief (under 15 minutes) assessment took a lot of strain and energy; towards the end of the consultation the patient was obviously suffering from loss of focus, concentration and energy. Further study of his coping mechanism as well as a personality or character assessment will yield a more reliable prognosis of his psychological state as his rehabilitation progresses and possible permanent effects of his injuries may reveal themselves. Perhaps a more organic process of evaluating Det. Starsky will deliver more, quicker/clearer, results. Suggestion: one on one during PT sessions.

Conclusion:
Request consultation with Drs Jamison and Aaronson regarding organic approach for further psychological assessment.


Myrna Johanson, Ph.D. (psychologist)