Competency Trial Day Five

[Original Post by DS: 06/13/2011 8:30PM PST]

Notes from trial day five:



First to testify for the defense today was William Mcmullen, PHD, a specialist in Neuropsychology, head of neuropsychology at California Pacific Medical Center in San Francisco.

Mcmullen saw william hamilton ayres  (in August 2009?) on referral from Dr. Telfer who testified last Thursday. Mcmullen stated that the presenting complaint was forgetting names, etc, and further stated that Solveig came with ayres at the time of the appointment, and that she stated that ayres had noticed these problems for the last four or five years. Mcmullen reviewed ayres’ medical history and said that ayres’ history shows a strong possibility that vascular disease is the cause of the memory problems.

Defense attorney McDougall presented a chart with various tests and their scores. Most were normal except tests for verbal memory.  Visual memory tests showed good. The report back to Dr. Telfer show that ayres attention was average, language a bit weak, visual/spatial skills HIGH STRONG.  It stated that memory and language are the basic problem. The report shows that ayres SUFFERS DEPRESSION. (Cue violins…) The diagnosis was Cognitive Disorder (either vascular or Alzheimer’s)

On cross examination, the prosecutor, McKowan, asked if ayres might be “malingering.”  Mcmullen didn’t get that impression. She then asked Mcmullen if he had known about the trial, might he have made the assessment that there was some malingering, but the doctor didn’t go for that… he said that his assessment was clinical and not forensic, and that he didn’t do any tests that would help with that kind of assessment.

Another line of information that the prosecutor pursued related to the timing of the claims of memory loss.

Dr. Mcmullen reported that Solveig said that ayres had been having problems for four or five years, and that ayres himself stated one to two years. There was also some reference to testimony or other court record that shows that Solveig or ayres himself reported only having problems for about a month at the time reported. (The point, I think is that at the beginning of the first trial, memory had only been an “issue” for a short time, but that immediately after the trial, suddenly the problem appears to have been retroactively claimed to be “more persistent.”)

Second to testify today was Amanda Gregory, Ph.D. a UCSF neuropsychologist.

Gregory was contacted January 2010 by McDougall to do an evaluation of ayres. ( IMPORTANT NOTE: I’m not 100 positive about this date.) If this date is correct, then that means that McDougall was well aware of the competency results and had this defense tactic in mind THREE MONTHS before the scheduled start of the criminal retrial. And yet, he waited  until the pre-trial hearings to make his claim.  Also note that the Defense sealed ayres’ medical records way back in October, 2009 due to a “medical event.”  

Gregory wrote three reports after ayres assessment. She reviewed records from a 6/15/2009 report from Dr Firestone, the report from Dr. Mcmullen, an MRI, and information from Dr. Telfer.  She met with ayres 3 times in February and March - a total of 9 hours.

She also met with ayres  again LAST FRIDAY. Ayres was asked who testified, and he remembered that a doctor testified, but he couldn’t remember who, and that his wife testified, but he didn’t remember what she said, but that he thought she did a good job.

Solveig reported declined memory since 2003 (So now, the story has expanded to 7 or 8 years) Gregory used 15 neuropsychology tests and 3 symptom questionnaires.  She said that she gave three tests to make sure that there was no malingering.  Her tests indicate the same as Mcmullen’s poor scores on verbal memory, and visual/spatial are good.

Her recommendation was that he see a psychiatrist to get correct medications to treat the condition. She recommended the UCSF Aging Center. He went to Stanford Clinic instead and saw Telfer.  Gregory reviewed further information from Dr. Telfer and a Dr. Kirshner. Kirshner put less weight on a vascular diagnosis and more weight on an Alzheimer’s diagnosis.

Gregory flat out stated that ayres is NOT competent to assist in his defense. 

On cross examination, prosecutor McKowan pointed out his lucid testimony during the criminal trial.  She read many examples from the transcripts that demonstrated his quick and pertinent responses about his past, medical diagnoses that he had made in the past, and quick and even fiery responses on cross examination when pressed. McKowan kept asking Gregory if that demonstrated enough functionality to assist in his own defense, to which Gregory always responded yes, AT THAT TIME.  This probably occurred 7 or 8 times during the cross.  McKowan also pointed out that the first test showing verbal memory problems was only ONE MONTH after the testimony read, and that there has not been significant decline between then and last Friday.

McKowan asked about tests that apply stringent criteria to make a competency evaluation, and asked if Gregory had administered any. Gregory’s response was that she hadn’t and that she had relied on her own independent assessment. McKowan pointed out that no one else would be able to comment on Gregory’s assessment, since there was no test record to corroborate the conclusion.

Other significant notes:

At some point, Godinez v. Moran was mentioned. This is interesting because the Court found that if a person is found competent to stand trial, they are likewise competent to plead guilty or to waive an attorney. It also appears to say that a single standard of compentecy should apply to the whole of the criminal proceedings. This may be to wave off any future defense malingering each time the proceedings enter a new phase.

McKowan asked questions revolving around ayres desire to testify and his level of trust for his defense attorney. One of the two doctors (Gregory, I think) indicated that ayres had responded that he was not clear about what he wanted to do, but that he wanted to do whatever was best for his wife.

Jurors: a few appear very attentive and taking notes. Some appear to be goofing around (chuckling in the back row) and a few seem barely able to stay awake. 

My comments on the day:

1) Thank you to the family and friends present in the courtroom for being there, and for putting up with my testy grilling about what happened. If there are any corrections or additions, please post them. I'm tired and angry. 

2) On Mcmullen’s diagnosis that ayres is depressed:

When ayres is so depressed that he frequently thinks about suicide (at least conceptually), has nightmares most nights about his family coming to harm, and wakes up every morning wishing he had died peacefully during the night, and when he does that retroactively for most of his adult life, or, when he engages in angry, risky behaviors that eventually kill him, THEN I will be satisfied that he is depressed enough.

Until then, he can go fuck himself.