The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Major Banks Aid in Payday Loans Banned by States

Major banks have quickly become behind-the-scenes allies of Internet-based payday lenders that offer short-term loans with interest rates sometimes exceeding 500 percent.

With 15 states banning payday loans, a growing number of the lenders have set up online operations in more hospitable states or far-flung locales like Belize, Malta and the West Indies to more easily evade statewide caps on interest rates.

While the banks, which include giants like JPMorgan Chase, Bank of America and Wells Fargo, do not make the loans, they are a critical link for the lenders, enabling the lenders to withdraw payments automatically from borrowers’ bank accounts, even in states where the loans are banned entirely. In some cases, the banks allow lenders to tap checking accounts even after the customers have begged them to stop the withdrawals.

“Without the assistance of the banks in processing and sending electronic funds, these lenders simply couldn’t operate,” said Josh Zinner, co-director of the Neighborhood Economic Development Advocacy Project, which works with community groups in New York.

The banking industry says it is simply serving customers who have authorized the lenders to withdraw money from their accounts. “The industry is not in a position to monitor customer accounts to see where their payments are going,” said Virginia O’Neill, senior counsel with the American Bankers Association.

But state and federal officials are taking aim at the banks’ role at a time when authorities are increasing their efforts to clamp down on payday lending and its practice of providing quick money to borrowers who need cash.

The Federal Deposit Insurance Corporation and the Consumer Financial Protection Bureau are examining banks’ roles in the online loans, according to several people with direct knowledge of the matter. Benjamin M. Lawsky, who heads New York State’s Department of Financial Services, is investigating how banks enable the online lenders to skirt New York law and make loans to residents of the state, where interest rates are capped at 25 percent.

For the banks, it can be a lucrative partnership. At first blush, processing automatic withdrawals hardly seems like a source of profit. But many customers are already on shaky financial footing. The withdrawals often set off a cascade of fees from problems like overdrafts. Roughly 27 percent of payday loan borrowers say that the loans caused them to overdraw their accounts, according to a report released this month by the Pew Charitable Trusts. That fee income is coveted, given that financial regulations limiting fees on debit and credit cards have cost banks billions of dollars.

Some state and federal authorities say the banks’ role in enabling the lenders has frustrated government efforts to shield people from predatory loans — an issue that gained urgency after reckless mortgage lending helped precipitate the 2008 financial crisis.

Lawmakers, led by Senator Jeff Merkley, Democrat of Oregon, introduced a bill in July aimed at reining in the lenders, in part, by forcing them to abide by the laws of the state where the borrower lives, rather than where the lender is. The legislation, pending in Congress, would also allow borrowers to cancel automatic withdrawals more easily. “Technology has taken a lot of these scams online, and it’s time to crack down,” Mr. Merkley said in a statement when the bill was introduced.

While the loans are simple to obtain — some online lenders promise approval in minutes with no credit check — they are tough to get rid of. Customers who want to repay their loan in full typically must contact the online lender at least three days before the next withdrawal. Otherwise, the lender automatically renews the loans at least monthly and withdraws only the interest owed. Under federal law, customers are allowed to stop authorized withdrawals from their account. Still, some borrowers say their banks do not heed requests to stop the loans.

Ivy Brodsky, 37, thought she had figured out a way to stop six payday lenders from taking money from her account when she visited her Chase branch in Brighton Beach in Brooklyn in March to close it. But Chase kept the account open and between April and May, the six Internet lenders tried to withdraw money from Ms. Brodsky’s account 55 times, according to bank records reviewed by The New York Times. Chase charged her $1,523 in fees — a combination of 44 insufficient fund fees, extended overdraft fees and service fees.

For Subrina Baptiste, 33, an educational assistant in Brooklyn, the overdraft fees levied by Chase cannibalized her child support income. She said she applied for a $400 loan from Loanshoponline.com and a $700 loan from Advancemetoday.com in 2011. The loans, with annual interest rates of 730 percent and 584 percent respectively, skirt New York law.

Ms. Baptiste said she asked Chase to revoke the automatic withdrawals in October 2011, but was told that she had to ask the lenders instead. In one month, her bank records show, the lenders tried to take money from her account at least six times. Chase charged her $812 in fees and deducted over $600 from her child-support payments to cover them.

“I don’t understand why my own bank just wouldn’t listen to me,” Ms. Baptiste said, adding that Chase ultimately closed her account last January, three months after she asked.

A spokeswoman for Bank of America said the bank always honored requests to stop automatic withdrawals. Wells Fargo declined to comment. Kristin Lemkau, a spokeswoman for Chase, said: “We are working with the customers to resolve these cases.” Online lenders say they work to abide by state laws.

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Athletes cash in on California's workers' comp

SACRAMENTO — In his seven-year career with the Denver Broncos, running back Terrell Davis, a former Super Bowl Most Valuable Player, dazzled fans with his speed and elusiveness.

At the end of his rookie year in 1995, he signed a $6.8-million, five-year contract. Off the field he endorsed Campbell's soup. And when he hung up his cleats, he reported for the National Football League Network and appeared in movies and TV shows.

So it may surprise Californians to find out that in 2011, Davis got a $199,000 injury settlement from a California workers' compensation court for injuries related to football. This came despite the fact Davis was employed by a Colorado team and played just nine times in California during an 88-game career, according to the NFL.

Davis was compensated for the lifelong effects of multiple injuries to the head, arms, trunk, legs and general body, according to California workers' compensation records.

He is not alone.

Over the last three decades, California's workers' compensation system has awarded millions of dollars in benefits for job-related injuries to thousands of professional athletes. The vast majority worked for out-of-state teams; some played as little as one game in the Golden State.

All states allow professional athletes to claim workers' compensation payments for specific job-related injuries — such as a busted knee, torn tendon or ruptured spinal disc — that happened within their borders. But California is one of the few that provides additional payments for the cumulative effect of injuries that occur over years of playing.

A growing roster of athletes are using this provision in California law to claim benefits. Since the early 1980s, an estimated $747 million has been paid out to about 4,500 players, according to an August study commissioned by major professional sports leagues. California taxpayers are not on the hook for these payments. Workers' compensation is an employer-funded program.

Now a major battle is brewing in Sacramento to make out-of-state players ineligible for these benefits, which are paid by the leagues and their insurers. They have hired consultants and lobbyists and expect to unveil legislation next week that would halt the practice.

"The system is completely out of whack right now," said Jeff Gewirtz, vice president of the Brooklyn Nets — formerly the New Jersey Nets — of the National Basketball Assn.

Major retired stars who scored six-figure California workers' compensation benefits include Moses Malone, a three-time NBA most valuable player with the Houston Rockets, Philadelphia 76ers and other teams. He was awarded $155,000. Pro Football Hall of Fame wide receiver Michael Irvin, formerly with the Dallas Cowboys, received $249,000. The benefits usually are calculated as lump-sum payments but sometimes are accompanied by open-ended agreements to provide lifetime medical services.

Players, their lawyers and their unions plan to mount a political offensive to protect these payouts.

Although the monster salaries of players such as Los Angeles Lakers guard Kobe Bryant and Denver Broncos quarterback Peyton Manning make headlines, few players bring in that kind of money. Most have very short careers. And some, particularly football players, end up with costly, debilitating injuries that haunt them for a lifetime but aren't sufficiently covered by league disability benefits.

Retired pros increasingly are turning to California, not only because of its cumulative benefits but also because there's a longer window to file a claim. The statute of limitations in some states expires in as little as a year or two.

"California is a last resort for a lot of these guys because they've already been cut off in the other states," said Mel Owens, a former Los Angeles Rams linebacker-turned-workers' compensation lawyer who has represented a number of ex-players.

To understand how it works, consider the career of Ernie Conwell. A former tight end for the St. Louis Rams and New Orleans Saints, he was paid $1.6 million for his last season in 2006.

Conwell said that during his 11-year career, he underwent about 18 surgeries, including 11 knee operations. Now 40, he works for the NFL players union and lives in Nashville.

Hobbled by injuries, he filed for workers' compensation in Louisiana and got $181,000 in benefits to cover his last, career-ending knee surgery in 2006, according to the Saints. The team said it also provided $195,000 in injury-related benefits as part of a collective-bargaining agreement with the players union.

But such workers' compensation benefits paid by Louisiana cover only specific injuries. So, to deal with what he expects to be the costs of ongoing health problems that he said affect his arms, legs, muscles, bones and head, Conwell filed for compensation in California and won.

Even though he played only about 20 times in the state over his professional career, he received a $160,000 award from a California workers' compensation judge plus future medical benefits, according to his lawyer. The Saints are appealing the judgment.

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That Syncing Feeling

“Smart, or stylish?” That’s the question facing casual watch aficionados looking for a new, high-tech addition to their collection.

On one hand (er, wrist), you’ve got the Pebble and other smartwatch upstarts, which come with built-in smartphone connectivity, customizable screens, and burgeoning developer communities eager to feed their app ecosystems. They also, by and large, look like uninspired pieces of mass-produced Chinese plastic, and that’s because they are.

On the “stylish” end of the spectrum is … not much. Except this: Citizen’s Eco-Drive Proximity.

The Citizen learns the current time from your phone, and the watch’s hands spin around to the correct positions.

By all outward appearances, the Proximity looks like any another chronograph in a sea of handsome mechanical watches. It has all the features you’d expect, including a 24-hour dial, day and date, perpetual calendar and second time zone. But housed within its slightly oversized 46mm case is a Bluetooth 4.0 radio, so it’s capable of passing data over the new low-energy connectivity standard appearing in newer smartphones, including the iPhone 5 and 4S. And for now, the Promixity is only compatible with those Apple devices.

Initial pairing is relatively easy. After downloading Citizen’s notably low-rent iOS app, you can link the watch to your phone with a few turns and clicks on the crown.

The gee-whiz feature is the automatic time sync that takes place whenever you land in a different time zone. Once connected, the Citizen learns the current time from your phone, and the watch’s hands spin around to the correct positions — a welcome bit of easy magic, considering the initial setup is a tedious finger dance.

The watch can also notify you of incoming communications. Once you’ve configured the mail client (it only supports IMAP accounts), you’ll get notified whenever you get a new e-mail — there’s a slight vibration and the second hand sweeps over to the “mail” tab at the 10-o’clock position. If a phone call comes in, the second hand moves to the 11-o’clock marker. If the Bluetooth connection gets lost because the watch or phone is outside the 30-foot range, you get another vibration and the second hand moves to the “LL” indicator. And really, that’s the extent of the functionality around notifications.

But notable in its absence is the notification I’d like the most: text message alerts. And it’s not something Citizen will soon be rectifying because the dials and hardware aren’t upgradable.

I also experienced frequent connection losses, particularly when attending a press conference with scads of Mi-Fis and tethered smartphones around me. This caused dozens of jarring vibrations both on my wrist and in my pocket, followed by a raft of push notifications on my phone informing me of the issue. Reconnecting is easy (and generally happens automatically), but the lack of stability in certain environments matched with the limited capabilities of the notifications had me forgetting to reconnect and not even worrying about it later on.

But actually, I’m OK with that. I still like the fact that it never needs charging. Even though there aren’t any solar cells visible on the dial, the watch does have them. They’re hidden away beneath the dial, and yet they still work perfectly. And even when its flagship connectivity features aren’t behaving, it’s still a damn handsome watch. It feels solid, and it looks good at the office, out to dinner, or on the weekend — something very few other “smart” watches on the market can claim.

However, those things can be said of almost all of Citizen’s EcoDrive watches. The big distinguishing feature here is the Bluetooth syncing and notifications, and they just don’t work that well.

WIRED A smart watch you won’t be embarrassed to wear. Charges using light. Combines classic styling with cutting-edge connectivity. Subtle notifications keep you informed without dominating your attention.

TIRED Loses Bluetooth connection with disturbing frequency. Limited notification abilities. No text message alerts. Janky iPhone app.

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It’s Indie Vets Vs. Upstarts at a Varied Independent Spirit Awards

LOS ANGELES (TheWrap.com) – After finding the Oscars encroaching on their territory for a number of years, have the Film Independent Spirit Awards finally gotten a little space from their bigger, flashier weekend neighbor?

You’d think so, given that six of the Oscars’ nine Best Picture nominees have grossed more than $ 100 million, and the roster of represented companies includes Warner Bros., Universal, 20th Century Fox, DreamWorks, Disney and Sony.

But one of those $ 100 million films, David O. Russell‘s “Silver Linings Playbook,” will be competing for five Indie Spirit Awards on Saturday, the day before it takes its eight nominations to the Oscars.

Another Oscar Best Picture nominee, Benh Zeitlin’s “Beasts of the Southern Wild,” will also be in the running for the top Spirit Award at the ceremony, which as usual takes place in a tent on Santa Monica beach.

Oscar best-pic nominee “Amour,” meanwhile, is nominated in the foreign-film category at the Spirits, while Wes Anderson‘s best-film Spirit Awards contender “Moonrise Kingdom” is up for an Oscar for its screenplay.

The Oscars are still honoring independent film, even in a year of unexpectedly big box office and surprising participation by the major studios. And the Spirit Awards’ definition of indie is still broad enough to encompass a wide range of movies, from the small-budgeted “Keep the Lights On” to the Weinstein Company release “Silver Linings Playbook,” which skirted the $ 20 million budget limit to qualify for the Spirit Awards but was let in on a judgment call by the jury assembled by Film Independent.

“The Spirit Awards are a celebration of independent film, and one of the things I love is that there’s a lot of diversity in there this year,” said Josh Welsh, co-president of Film Independent with Sean McManus.

“We have first-time directors and new filmmaking talent like Benh Zeitlin, but we also have directors that we go way back with, like Wes Anderson and David O. Russell. This year is a combination of discovery and bringing back people who are a part of what we’ve been doing for years.”

Russell first came to the Spirit Awards in 1995 with “Spanking the Monkey,” for which he won the Best First Feature award; he returned two years later as a Best Director nominee for “Flirting With Disaster.” Anderson won the Spirit Award as Best Director for “Rushmore” in 2000.

Their two films, “Silver Linings Playbook” and “Moonrise Kingdom,” lead the pack with five nominations each. “Beasts of the Southern Wild” has four – and, crucially, the Spirit Awards jury opted to nominate it and its director in the Best Feature and Best Director categories rather than putting them in the Best First Feature category, where they would almost unquestionably have won.

“Keep the Lights On” and “Middle of Nowhere” also received four nominations each, though the latter film did not crack the Best Feature category.

Despite the presence of “Bernie” and “Keep the Lights On” in the top category, this year’s awards do seem to be a shootout between “Silver Linings,” “Beasts” and “Moonrise,” perhaps with a slight edge to the first two – the first a crowd-pleasing film with real awards momentum, the second the clear indie breakout of the year.

Last year’s winner, “The Artist,” was the first film to win both the Spirit Award and the Best Picture Oscar.

Of the 21 Spirit acting nominees, the only ones to also be in the running at the Oscars are Bradley Cooper and Jennifer Lawrence from “Silver Linings,” Quvenzhane Wallis from “Beasts” and Helen Hunt from “The Sessions.” Chances are that Cooper and Lawrence have the edge, with more than 80 percent of Spirit Awards winners since 2000 coming from the ranks of Oscar nominees.

The awards are voted on by the 4,000 members of Film Independent, which is made up of professionals in the indie world but also of film fans who pay the yearly dues. Voting is done online, and Film Independent holds free member screenings in Los Angeles and New York to allow voters to see the films.

MacManus told TheWrap that Film Independent also made a deal with iTunes this year to make some of the nominated films available online, while members also received a 14-film DVD collection containing all the nominees that had chosen to participate. (Members had to sign restrictive use agreements to receive the package, added Welsh.)

This year’s show will be hosted by comic and actor Andy Samberg, whose film “Celeste and Jesse Forever” is in the running in the Best First Screenplay category.

“He brings a very new vibe and personality to the show,” MacManus said. “We wanted to look at this year’s show with fresh eyes. There’s a new look to the room, we’re doing something different with the food – everything is a new take.”

Last year’s host was Seth Rogen, who took the stage and immediately labeled the show “inconsequential.”

“Winning one will get you absolutely nothing,” he said, drawing a big laugh. “It won’t even raise your price, because it proves that you’ll work for nothing.”

If Samberg takes similar shots at the show, both MacManus and Welsh said they won’t mind.

“The awards are incredibly meaningful,” MacManus said. “We believe in independent film and we take it seriously, but we don’t take ourselves seriously. We are okay with poking fun at ourselves.”

Added Welsh, “We’re not all puffed up or self-important. But all joking aside, these awards are significant. It’s a genuine act of honoring the independent film of the last 12 months.”

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Gunfire and deadly crash rattle the Las Vegas Strip

LAS VEGAS — A spectacular predawn crash on the Strip — triggered when bullets fired from a black Range Rover peppered a Maserati — hit this resort city right between the eyes. In the end, three people were dead and a major intersection under lockdown during a three-state manhunt for the shooters, leaving even casino veterans used to the extraordinary scratching their heads.

The mayhem was sparked, witnesses told police, by a quarrel early Thursday at a hotel valet stand.

The two vehicles left the Aria resort hotel and were heading north on Las Vegas Boulevard at 4:20 a.m., an hour when the casino marquees shine brightly but the gambling thoroughfare is largely empty. At Harmon Avenue, occupants inside the Range Rover opened fire on the Maserati, police said.

The silver-gray sports car, which was struck several times, sped into the intersection at Flamingo Road, ramming a Yellow cab. The taxi exploded, killing the driver and a passenger. Four other vehicles in the intersection were also involved in the crash and explosion, but officers offered no details.

"Omg Omg Omg that car just blew up!" one witness tweeted shortly after the crash, posting a photo of the wreckage. "God Bless their Souls! Omg!"

The driver of the Maserati died later at a hospital, police said. A passenger in the vehicle received minor injuries and was being interviewed by investigators. At least three others were also injured.

Police in Nevada, California, Arizona and Utah were on alert for the distinctive black Range Rover SUV, described as having dark-tinted windows, black rims and out-of-state paper dealer plates.

"We are going to pursue these individuals and prosecute them," Clark County Sheriff Doug Gillespie said at an afternoon news conference. "This act was totally unacceptable. It's not just tragic but unnecessary — the level of violence we see here in Las Vegas and across America."

Authorities had not publicly identified the dead. But a Las Vegas television station late Thursday identified the taxi driver as Michael Boldon, 62, who the station said had recently moved here from Michigan to care for his 93-year-old mother.

The victim's son, who drives a limousine, told Fox News 5 that he last talked with his father after 3 a.m., and later called his cellphone shortly after the crash to warn him to avoid the Strip. But there was no answer.

The station also identified the driver of the Maserati as Ken Cherry, a rap artist from Oakland who also is known as "Kenny Clutch." The station quoted family members identifying Cherry as the driver. An Internet video of a Cherry song called "Stay Schemin" shows two men in a vehicle on the Strip.

Police had more questions than answers.

"It began with a dispute at a nearby hotel and spilled onto the streets," said Capt. Chris Jones of the Las Vegas Police Robbery and Homicide Division.

The morning's events threw the Strip into disarray all day. The gambling boulevard's busiest and best-known intersection was cordoned off by yellow police tape until nightfall, keeping traffic and curious pedestrians away from the carnage. Even skywalks were blocked off.

While slot machines beeped and card games continued inside casinos around the accident scene — including the Bellagio, Caesars Palace and Paris Las Vegas — hotel bell captains were fielding questions from tourists who had awakened to news of the crash and the Strip shutdown. The alleys and side streets between nearby hotels were clogged with pedestrians who inched along on narrow sidewalks, past delivery doors, many making their own paths between the landscaped bushes and palm trees.

Even casino industry workers were thrown into turmoil. Hotel maids and dealers who finished their midnight shifts after dawn were left without bus service home. "I'm stranded," said Tiruselam Kefyalew, 25, a maid. "What a day to leave my cellphone at home."

Limousine drivers who normally prowl the city's gambling core improvised detours. Some said the police blockade would cost them $500 or more in lost business and tips.

"Most people understand, but you have your complainers," said Jim DeSanto, a limo driver who waited for fares outside Bally's casino. "Those people will complain, even when everything is perfect."

Well after noon, guests peered out nearby hotel windows and others leaned into the street to glimpse the crime scene.

"Hey, honey, it must have happened right here," one man told his wife as they left Caesars around noon. The tourist, who would only say that he had arrived from Tampa, Fla., the previous evening, had looked out his hotel window at 4:30 to see a vehicle in flames.

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Good Lookin' Out

The other strap-it-on-and-get-rad cameras out there — the GoPros and the Contours and the Ions — are all pretty sick in their own right. But for ease of use, no camera is sicker than Drift Action’s HD Ghost cam.

It has enough capability and pure oomph to keep up with the competition — it captures 1080p at 30fps and 720p at 60fps, and it can talk to your other devices via Wi-Fi — but it also comes stock with features other cams make you pay extra for: an integrated 2-inch color LCD screen; big, meaty navigation buttons on top of the camera; and a wrist-mounted remote control that lets you start and stop recording from up to 30 feet away. The whole thing’s waterproof up to 9 feet, too, so mountain biking through a rainstorm or snowboarding during a whiteout doesn’t require a separate waterproof case.

Now, 1080p at 30fps isn’t the best in class. The best camera for slow-mo footage is the GoPro Hero3 (also $400), which offers double the frame rate at 1080p. And all those additional features — the remote, the LCD screen, the waterproof case — are available in some form or another with other cams, albeit usually at an extra cost. What makes the HD Ghost stand out is how easy to use it is. Thanks to the clearly labeled buttons and the intuitive menu on the LCD screen, I was able to ditch the user guide and still access the majority of the Ghost’s functions.

The wrist-mounted remote is great, too. The controls can be operated with heavy gloves on, and the buttons make changing settings, swapping functions, and checking out the footage you just captured remarkably easy. Colored LED lights on the watch-sized unit let you know what mode the Ghost is in, as well as the camera’s status.

My favorite feature on the Ghost is the on-the-fly video-tagging capability. When it’s in what Drift calls “Flashback mode,” the camera records video on a continuous loop ranging in length from 10 seconds to five minutes. If something sweet happens on your bike ride, you can press a button and save the last minute of footage (or however long), then immediately start a new loop. Not only does this save precious space on your memory card, but it also saves you from having to wade through hours of boring footage to find the good clips.

During my test trip to Squaw Valley in Northern California’s Lake Tahoe area, I never lost footage due to user error (leaving the camera off and thinking it was recording when it wasn’t, which I usually do all the time), and the rotating lens let me mount it just about anywhere without tweaking my angles. I was satisfied with the footage. It was clear and sharp, and I was able to snag the occasional still photo while I was recording video.

Here’s a highlight reel. This string of clips is made up of raw video straight from the camera.

The GoPro Hero and the new Sony Action Cam are still the wearables to beat for image quality and (especially with the GoPro) capturing slo-mo shots. But I can heartily recommend the HD Ghost, especially for those who’d rather get outside and start recording than spend hours digesting a manual to figure out how it works.

WIRED Simple out-of-box use. Battery lasts about three hours. Waterproof to 9 feet without a case. Intuitive smartphone app interface. Awesome remote you can strap to your wrist, or anywhere. Rotating lens lets you position it pretty much anywhere on your body or board and still find acceptable angles. Can capture 11-megapixel stills while shooting video.

TIRED Heavy. Multicolored LED lights aren’t great for us red/green colorblind folks. Pricey — Sony’s camera is less expensive.

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The New Old Age Blog: For Traumatized Caregivers, Therapy Helps

I recently wrote about caregivers who experienced symptoms of traumatic-like stress, and readers responded with heart-rending stories. Many described being haunted by distress long after a relative died.

Especially painful, readers said, was witnessing a loved one’s suffering and feeling helpless to do anything about it.

The therapists I spoke with said they often encountered symptoms among caregivers similar to those shown by people with post-traumatic stress — intrusive thoughts, disabling anxiety, hyper-vigilance, avoidance behaviors and more — even though research documenting this reaction is scarce. Improvement with treatment is possible, they say, although a sense of loss may never disappear completely.

I asked these professionals for stories about patients to illustrate the therapeutic process. Read them below and you’ll notice common themes. Recovery depends on unearthing the source of psychological distress and facing it directly rather than pushing it away. Learning new ways of thinking can change the tenor of caregiving, in real time or in retrospect, and help someone recover a sense of emotional balance.

Barry Jacobs, a clinical psychologist and author of “The Emotional Survival Guide for Caregivers” (Guilford Press, 2006), was careful to distinguish normal grief associated with caregiving from a traumatic-style response.

“Nightmares, lingering bereavement or the mild re-experiencing of events that doesn’t send a person into a panic every time is normal” and often resolves with time, he said.

Contrast that with one of his patients, a Greek-American woman who assisted her elderly parents daily until her father, a retired firefighter, went to the hospital for what doctors thought would be a minor procedure and died there of a heart attack in the middle of the night.

Every night afterward, at exactly 3 a.m., this patient awoke in a panic from a dream in which a phone was ringing. Unable to go back to sleep for hours, she agonized about her father dying alone at that hour.

The guilt was so overwhelming, the woman couldn’t bear to see her mother, talk with her sisters or concentrate at work or at home. Sleep deprived and troubled by anxiety, she went to see her doctor, who works in the same clinic as Dr. Jacobs and referred her to therapy.

The first thing Dr. Jacobs did was to “identify what happened to this patient as traumatic, and tell her acute anxiety was an understandable response.” Then he asked her to “grieve her father’s death” by reaching out to her siblings and her mother and openly expressing her sadness.

Dr. Jacobs also suggested that this patient set aside a time every day to think about her father — not just the end of his life, but also all the things she had loved about him and the good times they’d had together as a family.

Don’t expect your night time awakenings to go away immediately, the psychologist told his patient. Instead, plan for how you’re going to respond when these occur.

Seven months later, the patient reported her panic at a “3 or 4” level instead of a “10” (the highest possible number), Dr. Jacobs said.

“She’ll say, ‘oh, there’s the nightmare again,’ and she can now go back to sleep fairly quickly,” he continued. “Research about anxiety tells us that the more we face what we fear, the quicker we are to extinguish our fear response and the better able we are to tolerate it.”

Sara Qualls, a professor of psychology at the University of Colorado in Colorado Springs, said it’s natural for caregivers to be disgusted by some of what they have to do — toileting a loved one, for instance — and to be profoundly conflicted when they try to reconcile this feeling with a feeling of devotion. In some circumstances, traumatic-like responses can result.

Her work entails naming the emotion the caregiver is experiencing, letting the person know it’s normal, and trying to identify the trigger.

For instance, an older man may come in saying he’s failed his wife with dementia by not doing enough for her. Addressing this man’s guilt, Dr. Qualls may find that he can’t stand being exposed to urine or feces but has to help his wife go to the bathroom. Instead of facing his true feelings, he’s beating up on himself psychologically — a diversion.

Once a conflict of this kind is identified, Dr. Qualls said she can help a person deal with the trigger by using relaxation exercises and problem-solving techniques, or by arranging for someone else to do a task that he or she simply can’t tolerate.

Asked for an example, Dr. Qualls described a woman who traveled to another state to see her mother, only to find her in a profound disheveled, chaotic state. Her mother said that she didn’t want help, and her brother responded with disbelief. Soon, the woman’s blood pressure rose, and she began having nightmares.

In therapy, Dr. Qualls reassured the patient that her fear for her mother’s safety was reasonable and guided her toward practical solutions. Gradually, she was able to enlist her brother’s help and change her mother’s living situation, and her sense of isolation and helplessness dissipated.

“I think that a piece of the trauma reaction that is so devastating is the intense privacy of it,” Dr. Qualls said. “Our work helps people moderate their emotional reactivity through human contact, sharing and learning strategies to manage their responsiveness.”

Dolores Gallagher-Thompson, a professor of psychiatry at Stanford University School of Medicine in California, noted that stress can accumulate during caregiving and reach a tipping point where someone’s ability to cope is overwhelmed.

She tells of a vibrant, active woman in her 60s caring for an older husband who declined rapidly from dementia. “She’d get used to one set of losses, and then a new loss would occur,” Dr. Gallagher-Thompson said.

The tipping point came when the husband began running away from home and was picked up by the police several times. The woman dropped everything else and became vigilant, feeling as if she had to watch her husband day and night. Still, he would sneak away and became more and more difficult.

Both husband and wife had come from Jewish families caught up in the Holocaust during World War II, and the feeling of “complete and utter helplessness and hopelessness” that descended on this older woman was intolerable, Dr. Gallagher-Thompson said.

Therapy was targeted toward helping the patient articulate thoughts and feelings that weren’t immediately at the surface of her consciousness, like, for example, her terror at the prospect of abandonment. “I’d ask her ‘what are you afraid of? If you visualize your husband in a nursing home or assisted living, what do you see?’” Dr. Gallagher-Thompson said.

Then the conversation would turn to the choices the older woman had. Go and look at some long-term care places and see what you think, her psychologist suggested. You can decide how often you want to visit. “This isn’t an either-or — either you’re miserable 24/7 or you don’t love him,” she advised.

The older man went to assisted living, where he died not long afterward of pneumonia that wasn’t diagnosed right away. The wife fell into a depression, preoccupied with the thought that it was all her fault.

Another six months of therapy convinced her that she had done what she could for her husband. Today she works closely with her local Alzheimer’s Association chapter, “helping other caregivers learn how to deal with these kinds of issues in support groups,” Dr. Gallagher-Thompson said.

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Wall Street Edges Ahead

Stocks rose on Wall Street Friday, bolstered by better-than-expected earnings from Hewlett-Packard.

The Standard & Poor’s 500-stock index climbed 0.4 percent, the Dow Jones industrial average rose 0.3 percent, and the Nasdaq composite index added 0.4 percent.

The S.&P. 500 has dropped 1.9 percent over the last two sessions, its worst two-day drop since early November, putting the benchmark index on pace for its first weekly decline of the year. The retreat was triggered by minutes from the Federal Reserve’s January meeting, released earlier in the week, that suggested stimulus measures may end earlier than thought.

Still, the index was up more than 5 percent for the year and has held above the 1,500-point level.

“When you get a move like that, you are bound to see a pause, and the Fed minutes is a good enough reason to at least reassess,” said Michael Marrale, head of research, sales and trading at ITG in New York.

But, he added, “ultimately, we are going to see rates go higher and, ultimately, that will take money out of bonds and into equities.”

Hewlett-Packard, the maker of personal computers and printers, climbed 5.1 percent after the company’s quarterly revenue and forecasts beat analysts’ expectations as it continued to cut costs.

Abercrombie & Fitch, the clothing retailer, dipped 1 percent after it reported a drop in fourth-quarter comparable sales, even as the latest quarterly earnings topped estimates.

The insurer American International Group posted fourth-quarter results that beat analysts’ expectations. Shares advanced 4.4 percent.

Marvell Technology Group, a chip maker, rose 5.8 percent after the company gained market share in the hard-disk drive and flash-storage businesses.

The European Commission forecast on Friday that growth in the 27-nation European Union would rise only 0.3 percent this year, while growth in the 17 members that use the euro would fall 0.1 percent for a second year of recession. Stock markets in Europe were mostly ahead in afternoon trading after a sharp pullback on Thursday.

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