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Vestal: Trooper’s tangle stems from brain injury maze

First of two parts.

One August midnight four years ago, Washington State Patrol Trooper Allen Larned was sitting in his patrol car on the side of Interstate 90.

In the back seat sat a drunken driver in handcuffs. Another impaired driver – without even touching his brakes – plowed into the lit-up cruiser and wreaked havoc with Al Larned’s life.

The exact nature and extent of that havoc, however, is in dispute. Larned says his brain injuries from that night – eight “brain bleeds” – have left him struggling with a wide range of symptoms, which worsened after an aborted attempt to return to work. He says he doubts his ability to work as a state patrolman. He says his brain is not right – from vertigo to forgetfulness to extreme sensitivity to light and noise, to the loss of his senses of taste and smell – and he offers medical evaluations to back that up.

“I can’t trust my mind anymore,” he says.

The State Patrol, meanwhile, has ordered him back to work. It relies on medical evaluations as well, which conclude Larned is fine to return to work full time as a trooper, because his problems are psychological and not physical.

Larned, 51, grew up in Spokane, graduating from Central Valley High School in 1979. His father, Harry Larned, served on the county commission for eight years and was a prominent Spokane Valley business owner and community leader. Al Larned went to Washington State University and Eastern Washington University, graduating from EWU with an economics degree in 1986, and went to work for the State Patrol in 1987.

Larned doesn’t remember the events of that early morning, Aug. 17, 2008. But news reports and his medical files detail what happened. He pulled over a Subaru Outback around midnight in the westbound lanes of I-90 near Argonne. The Outback’s driver was cuffed and placed in the back seat, awaiting arrest on charges of drunken driving. Larned was sitting in the front, likely completing the paperwork.

A Dodge pickup driven by William Zink crashed into the patrol car from the rear, sending it into the Outback and then a concrete barrier. Then a fourth car struck the patrol car. The crash mangled the cruiser so badly it’s amazing that anyone inside survived, but both Larned and the suspect inside did. Zink was charged with vehicular assault; he was later convicted and sentenced to 15 months in prison.

Larned was hospitalized for a week at Sacred Heart and proceeded to rehab at St. Luke’s. Photographs from the time show him grinning from his hospital bed, raccoon-eyed with bruises. His extensive physical injuries included damage to his lower back and left leg, among others. He said he experienced “full-body pain.” But he also began to suffer various other problems stemming from a concussion and brain contusions. He developed light sensitivity, had trouble sleeping and eating, began hearing a ringing in his ears, and showed a variety of other symptoms affecting his memory and cognitive function, according to medical evaluations.

Larned worked hard at rehabilitation, trying to get back on the job as quickly as he could, he said. He now believes that was a “horrible mistake” – in part because it began to lay a pattern that the WSP could interpret to doubt his claims.

He returned to work in March 2009. For two years he continued full time as a state trooper, though he struggled with physical pain as well as the vague, hard-to-pin-down symptoms that often accompany head injuries. He struggled to get enough sleep, and when he didn’t, his other symptoms worsened; he sought permission to go to strictly day shifts to help him sort through the problem, and he was denied.

During this time, according to Larned and other records, he developed a conflict with a supervisor at work. Larned said he was being treated unfairly by a sergeant, and he eventually filed a complaint about a “hostile work environment.” In December 2010, he stopped working, just as his complaints over his supervisor and his failure to be moved permanently to day shift were coming to a head.

The State Patrol would not comment specifically about details of Larned’s case. But Bob Calkins, spokesman for the agency, said it had been working hard to look out for the welfare of various parties: the patrol, the public and Larned. He said the long process of assessing Larned’s health and trying to accommodate him has included a lot of effort on the patrol’s part and that the patrol would help him deal with his health problems if he returned.

“The law does require reasonable accommodations, and if, generally speaking, an employee can come back and show us a reasonable accommodation is needed, the law requires us to do that and we happily follow the law,” he said.

Larned said that various symptoms related to his brain injuries were becoming worse and worse in the months leading to his decision not to return to work. His concentration and memory suffered. He experienced frequent vertigo and ringing in the ears. When he was stressed or tired, everything was worse. Both he and a clinical psychologist call this a relapse; Larned casually describes this as his brain “blowing up.”

And so Larned, the State Patrol and the state Department of Labor and Industries entered a complicated and drawn-out process to discover whether he should be back behind the wheel of a patrol car again.

The human brain remains an intricate mystery. The nature of brain injuries – how they affect people, how long they last, how predictable and diagnosable they are, what may exacerbate or calm them – makes them liable to uncertain diagnoses.

Traumatic brain injury – now often called TBI – is sometimes referred to as the “invisible injury,” and our understanding of its long-term ramifications is evolving. Coaches and others who work with young athletes are becoming more aware of the dangers arising from concussions. Veterans returning from combat are realizing more and more that they suffered some level of TBI.

Experts say TBI manifests itself differently from person to person. Among the effects are headaches, hearing loss, dizziness, a change in taste and smell, forgetfulness, problems with concentration and focus, and being quick to anger and frustration. Larned describes undergoing most of those symptoms to one degree or another.

But the murky nature of TBI raises another possibility. Unlike, say, a broken leg, brain injury does not present obvious, clear-cut diagnoses. Symptoms may stem from psychological factors, not physical ones. Patients may be depressed or neurotic; they may become so convinced of their disability status that it influences their effort in trying to overcome it.

That’s why it’s not uncommon to see divergent opinions when doctors evaluate a patient, said Craig Beaver, a neuropsychologist practicing in Boise.

“It’s never a black and white kind of deal,” he said.

The fuzzy nature of the injury also makes allegations of fraud or malingering common. Various studies have undertaken how to separate malingerers from the legitimately brain-injured; some have shown a high rate of apparent malingering among people seeking injury benefits.

So far as I can determine, no one has accused Larned of faking it. But there is clearly skepticism in some quarters about whether he’s indeed unfit for work and whether his problems are psychological. The WSP has ordered him to return; he has refused. It seems destined for court.

What do the doctors say? Depends on which ones you ask.

Saturday: Evaluating Allen Larned.

Shawn Vestal can be reached at (509) 459-5431 or shawnv@spokesman. com. Follow him on Twitter at @vestal13.