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There are many drugs and drug combinations which will induce a drug psychosis. Hundreds of adverse reactions to hundreds of drugs. I cannot even speculate without knowing more specifics. However even drugs which are not considered psychotropic drugs can do this. However if I were to bet, this is an illicit drug/alcohol abuser who went over the top. The thing that seems to have changed so radically is the vicious nature of hurting little kids. It is so far beyond getting a whipping for doing something when I was a kid. A decision to cut of a childs arms is so definitive and barbaric. It isn't a random thought like, "today I'll cut off my 11 month old child's arms." There is clarity of purpose. It wasn't her finger or fingers or toes or other appendage. The arms were taken off and that conscious decision is a perplexing one. Even to kill the child seems to be a less dreadful act that cutting off the baby's arms. Think of what this woman must have been thinking. Even shooters, like these 2 Mohammud and the 17 year old, were random in their kiling. Ruthless and without remorse, but not a design "I will kill this person, or I will torture in such-and-such a manner" I remember once receiving a child in the emergency room. The 15 month old baby had been immersed in scalding hot water up to its armpits. That is where the stepfathers hands were holding the baby and he could not tolerate the pain. There was a circumlinear ring around the childs torso and burned with partial thickness burns (2nd degree) the entire lower portion of the body. This is a common type of torture well documented in trauma literature. Cruelty and mutilations have always occurred to the innocent, but there seems to be so much more these days. It may be an expression of population density induced anxiety, or envy, or a desire to get out of one's personal situation, mostly drug induced altered states of consciousness releasing inhibitions that are normally present, and then there are some who are just plain mean. In our society it seems there is more anger and more expressed anger. We drive down the road and someone cuts in front of you and you get angry but keep it in check. Some do not keep it in check and pull out a gun and start shooting. I remember on Valentines Day about 1991 I received a middle aged man in the ER with a gunshot would to the abdomen (self inflicted).I also received a 24 year old female who was DOA. I took the man to the OR and repaired the stomach, pancreas, several perforations in the small bowel and transverse colon, and did a diversionary colostomy on him. He progressed well. The story is that he caught his girl friend in bed with another man. He left the house and ruminated on it and began seething. He had been in a dispute with his sisters over inheriting a chicken house (that is where farmers raise thousands of chickens in one large chicken house. I don't know why I felt I had to explain what a chickenhouse is). He decided to settle all scores and took a 30-30 rifle and went to his sisters house and got in an arguement and shot her. Then he went into the house and killed his brother-in-law. He tried, 3 am , to find the man his girlfriend was shacking with and could not. By that time he knew his girfrient was at work so he went to the warehouse where she worked and shot her in the back twice. He then turned the rifle on him and shot himself. He is the only one who lived. Now I tell you this story to say this. About 4-5 days after his surgery I asked him what provoked him to this. He was a quiet,somewhat shy fellow who told me "I was having a bad day and decided to settle all scores". He had been drinking and smoking marijuana. I believe these chemicals removed normal inhibitions built into all of us, and allowed him to act on these impulses. These kinds of conscious decisions seem to be occurring at an ever increasing rate of occurrance. It used to be pleasant to see patients in the office. Now everyone is pissed off. There seems to have come a bitter resentment of many peoples station in life or opportunities to have settled over the country. President Bush (41) referred to it when lamented he wanted a kinder, gentler, America. My country has lost an innocents and a goodness. Not all people, but many. De Toqueville was right about the goodness of a nation. It worries me for posterity. I am what I am and that is settled. But what kind of world will we leave to our children. We have this repreave with W. But who comes after him. Heaven help us if Hillary Clinton and her moral compass guides this nation.