Wednesday, May 9, 2012

ayres' Unraveling Dementia Gambit

Right from the get-go, we've been reporting that ayres' claims of incompetency have been highly suspect.

In April of 2007, william hamilton ayres was arrested on charges of molesting multiple young boys. He claimed that he was giving medical exams while providing psychiatric services for the boys. In addition to the victims who were young enough to file criminal charges, there were more than 30 men who independently claimed and corroborated that they too were out of statute victims of ayres’ child molestations.

Ayres stood trial in June of 2009. The trial ended in a hung jury, with most, but not all of the jurors voting that he was guilty of child molestation. On several of the counts the vote was 11-1 in favor of a guilty finding.

After the mistrial, the DA decided to proceed with re-trial. At this point ayres fired his attorney Doron Weinberg, and hired attorney Jonathan McDougall to handle his case. McDougall’s immediate gambit was to have ayres claim that he was not competent to defend himself, and therefore the criminal trial should not proceed.  Dubious claims were made that ayres was suffering from dementia or Alzheimer’s disease, and was having trouble with recall.

Doron Weinberg had actually laid some of the groundwork for this claim: at the beginning of the criminal trial, he provided ayres with a cheat sheet of  “nouns” that ayres sometimes had trouble with and claimed that ayres was having trouble with some recall. During the trial ayres himself took the stand, and performed nearly flawlessly, at least from a “failing memory” perspective. There were perhaps two or three occasions when he actually seemed to stumble on a word – overall, stellar, for the amount of stress he must have been under. Conversely, he demonstrated that he was singularly focused on the topics of interest to him: in particular, his claims that he was better and more qualified to give “physical exams” than even pediatricians are, AND his clear fascination with the genitalia of pre-pubescent boys.

The normal procedure in a “not-competent to defend oneself” situation appears to be that the court appoints a couple of non-biased doctors to assess the defendant. If both doctors are in agreement, then the judge can make a call, and if they determine that the defendant is competent, they can decide to proceed directly to criminal trial, if everyone agrees. The defendant however, has a right to a competency trial even if all medical experts agree that the defendant is competent.

In this case, there were delays just appointing two doctors, as ayres is well known in the area, and was a former president of the American Academy of Child and Adolescent Psychiatry. Eventually, the court found two non-biased doctors to evaluate ayres. Both reported that ayres was competent to assist in his own defense at trial. Rather than accept this determination, McDougall demanded a competency trial for his client, to allow a jury to decide if they believed the non-biased court appointed doctors, or any doctors that the defense could hire to find a determination of incompetence.

On the morning that the competency trial was to start, one of the two court appointed doctors changed her report to indicate that ayres was not competent to defend himself. It was not publicly stated why this change occurred, but we do know that the doctor re-evaluated ayres prior to filing the changed report. The court then hired a third doctor to evaluate ayres; That doctor also determined that ayres was indeed competent to stand trial on criminal child molestation charges against him.

The competency trial proceeded, with ayres’ biased, paid doctors claiming that he was incompetent.

THAT trial also ended in a hung jury, and rather than retry the case, the DA agreed to the stipulation that ayres was indeed not competent to defend himself, and he was shipped off to Napa State Hospital to be "treated," with the intent to restore him to mental fitness so that he could then be brought back to face criminal trial.

Aside from all of the courtroom theatrics, there should never have been any question about ayres’ competency; ayres’ own actions as well as his medical reports have always indicated that he was deliberately putting on a show of being incompetent.

Before the competency trial:

Before the competency trial, ayres had several evaluations by court appointed doctors, and by his own personal physicians:   

➲ Dr. Robert Telfer, ayres’ neurologist, indicates that he evaluated ayres a few months after the criminal molestation trial. Telfer put ayres on Aricept for treatment of the dementia related to Alzheimer’s. He states that ayres “did not take to it” and therefore wasn't taking the medication.

➲ In July, 2010, ayres had an MRI that showed minimal shrinkage of the brain, within normal parameters for ayres’ age.

➲ ayres took two Mini-mental state examination (MMSE) tests. A score of 25-30 is normal, a score of 21-24 is considered to indicate minimal impairment. Scores below 21 can be considered to indicate dementia, (10 – 20 is “Moderate”) These scores generally don’t increase over time in a person suffering deteriorating mental status.  On ayres’ first test, he scored a 25 (NORMAL - no dementia) and on his second test just before the competency trial, he scored a 29 (NORMAL, no dementia). 

➲ An MRI indicated that there was no presence of “white matter” amyloid plaques that are associated with Alzheimer’s disease. 

During the Competency Trial:

During the competency trial, Amanda Gregory, Ph.D. a UCSF neuropsychologist, testified for the defense. Gregory claimed that ayres is without doubt, incompetent. Under cross examination by the prosecution, she admitted that most of her tests were subjective and that she did not use available objective tests with stringent criteria,  from which other evaluators would be able to draw the same conclusions. 

According to reports, Gregory was paid $20,000 for her testimony. 

On the other hand, Dr. Paul Good stated that ayres’ was definitely competent, and left no room for argument otherwise. 

Defense attorney McDougal poked, cajoled and harangued Good, questioning Good on segments of the testing, and was trying to get Good to say that some level of incompetence was shown, and that ayres couldn't answer simple story questions. 

➲ Good told the jury that that the story he used in the test was very complex and abstract, and that it is THE most challenging test sample. He said that initially ayres refused to answer questions, and that if those non-answers were scored, he wouldn’t have passed, but Good says that because he knew that ayres is intelligent, he needed to have a challenging enough test to get him to cooperate, and when he actually got ayres to participate, ayres scored absolutely fine on the test. There seems to have been an implication here that the defense doctors may not have been persistent and patient enough to overcome ayres' stubborn refusals, and simply accepted non-response as a failure. 

➲ McDougall kept hammering at Good about ayres’ off-topic rambling during the criminal trial.  Good was adamant that these instances were NOT off-topic rambling. He says that ayres clearly wants for his attorneys to understand his points, and ayres is trying to keep these points central to the discussion. Good says that ayres wants everyone to know that he was trained to “examine” young boys and that he does not want to plead guilty because he does not think he is guilty.  When his attorneys stray from that topic, ayres is bringing the point to the center of attention again.
In spite of the hard evidence showing that ayres is competent, much of the jury was swayed by the subjective (and in one case, recanted, based on questioning by the prosecution) testimony of ayres’ highly paid witnesses, and the jury was hung, and it ended in mistrial.

After the Competency Trial:

After the competency trial, the prosecution was deciding what to do next. Options were either to re-try the competency phase, or concede that ayres was incompetent. Before the DA was slated to announce their decision, some families and friends of the victims hired a private investigator to follow the child molester.  

According to the video and report from the investigator, ayres was clearly behaving in a very competent fashion. In fact, he was seen dining in San Francisco for lunch with his wife Solveig, and doctors Larry Lurie, MD and Robert Kimmich, MD, both of whom are San Francisco shrinks. 

According to Solveig, these are “very, very, good friends” of ayres'. 

➲ Among other things,  Larry Lurie writes professional papers on the symptoms and treatment of Alzheimer’s disease. According to the private investigator, the foursome had a good laugh over comments that it’s advantageous to talk about Alzheimer’s disease in front of lawyers. 

The DA and court ignored the private investigator reports, and conceded that ayres was not competent, and sent him off to Napa State Hospital to be “treated” in hope that competency could be restored so that criminal retrial might proceed. 

After ayres was locked up in Napa State Hospital for six months (the MINIMUM required), McDougall demanded that his client be set free. 

McDougall’s motion was declined. 

During the hearing, the results of the 90 day medical report were discussed. According to the prosecution, the report does not indicate any diagnosis, as ayres has not been cooperative with the medical staff and he indicates that he’s not cooperating at the instruction of his attorney, Jonathan McDougall.

The report says that ayres 
➲ was not being cooperative
➲ he was not taking medication
➲ he was not sleeping because he refuses to use his CPAP machine (usually used for sleep apnea patients), 
➲ he was refusing to participate in group sessions
➲ he was not participating in restoration planning.  

The report DOESN'T say anything about whether or not he can be restored to competency, because the doctors need to be able to evaluate him, but he’s not cooperating. 

The prosecutor says that there seems to be some indication that ayres could be "returned" to competency.

Prosecutor McKowan  stating the following about what the report indicates: 
The doctors report that ayres was INTENTIONALLY not cooperating:
1) Because his lawyer told him not to.
2) The doctors specifically stated in the report that at one point Solveig tells her husband, to “Just go ahead and give it a try” to do what the doctors request and see if it works. ayres’ reply was “Why, so I can go to prison?” 

The prosecutor states that ayres has a “pointed intention NOT to be restored to competency.”

It should have been painfully obvious to the DA and to the court that ayres has all along been actively deceiving the court, and that competency has never been an issue. 

In an article titled "DA: Committed doctor trying to avoid molestation trial" [pdf] by Michelle Durand of the San Mateo Daily Journal, Durand says that McKowan told the paper:

The former child psychiatrist who escaped a retrial on multiple molestation charges by being hospitalized as mentally incompetent is purposely not taking his medication because he knows it could help bring him back to a level of awareness necessary to face a jury.


  1. Of COURSE the DA knows Ayres is competent. Why do you think Wagstaffe panicked after the families took matters into their own hands and hired a private investigator in August 2011 ? Wagstaffe was so freaked out that he wouldn't return reporters' calls for three days. Experts from around the country are baffled at the DA's timidness and lack of conviction and incompetency in the Ayres case.

    Why didn't the prosecutor return the calls of lawyer Kevin Taguchi, who worked for one of the fathers of the in-statute vicitms?, who called her in August 2011 to say he wanted to show her evidence that Ayres was competent to stand trial? Taguchi reports that the prosecutor was most displeased - even angry- by the news that there was evidence that Ayres was competent. He reports she stated "I don't believe he's competent" and then refused to take his calls or look at the investigator's video.

    Any other DA's office would have been thrilled to get the evidence. That they freaked shows that they are scared of a conviction. Remember; the County has paid at least half a million dollars to Ayres for the past 40 years to rape boys. Do you think they want lawsuits ?

    The DA's office has been conflicted about this case from the beginning. Signs point to corruption. Let the government agencies (FBI, etc) who are investigating Steve Wagstaffe and his crew continue to investigate.

    And watch for new lawsuits from juveniles who were molested by Ayres in court ordered sessions (including rape)..

    1. I was a patient of his for many years. I really was surprised that so many people had been molested. I remember he did physical exams but never did he touch me in any other way.

    2. Some questions and comments:

      Are you male or female, and how old were you when you were going there?

      More than 40 men have reported that they were molested by ayres (independently). Most experts will tell you that normally, the number who REPORT are just the tip of the iceberg -- the majority of victims never report.

      Also: if you were having medical exams at all, especially if ayres was touching your genitals, it is almost 100% certain that this was being done for his own sexual interest

      There were NO experts who testified that they were trained to do medical exams. There was ONE person who claimed that there was some literature that said that medical exams could be given, but none under the circumstances that ayres claimed. Also, that expert would not come back to testify for ayres a second time. Many of the people who trained WITH AYRES told reporter Victoria Balfour that they were NOT trained to do medical exams.

      One more question: how often did he ask you to describe how often you masturbate?

    3. Here is some information about statements that the doctors who trained with ayres have to say about psychiatrists giving medical exams, and about the training that was given at the place that ayres received his training, at the time that he was trained:

      Judge Baker Doctors on Psychiatric "physicals"

      And here's what Stanford Psychiatrist Anthony Atwell had to say about the same topic"

      Testimony of Anthony Atwell

      Don't kid yourself: psychiatrists don't perform physicals, except under dire medical circumstances (No physicians available in the area for example.) And when they do, they are generally encouraged to discontinue psychiatric relationship with the patient.

      william ayres was NOT performing medical examinations.

  2. A very nice and succinct peice. I think the prosecutor and defence are in collusion to make this take so long he dies without a conviction.

  3. "The DA and court ... conceded that anus was not competent, and sent him off to Napa State Hospital to be “treated” in hope that competency could be restored so that criminal retrial might proceed."

    Meh. This man was being generally cared for and housed, but he wasn't being treated - and I use that term lightly - for dementia or Alzheimer's Disease (AD). You can't treat dementia or AD. Dementia and AD are relentlessly progressive; the former always precedes the latter by a year or two and remission never occurs in either stage. Medications that are commonly prescribed to patients typically only DELAY the progression of dementia or AD by about six months to a year for about half of the patients who take them. No setting (clinical or otherwise) and no medication can treat or restore the mental health of someone who has dementia or AD. Nerve cells are irreplaceable and (notably, brain) nerve cell death is permanent. As I've said before, I do not understand why this man had lodged in Napa State Hospital when he should have been convicted and imprisoned.

    And --

    "[He] demonstrated that he was singularly focused on the topics of interest to him: in particular, his claims that he was better and more qualified to give “physical exams” than even pediatricians are, AND his clear fascination with the genitalia of pre-pubescent boys."

    This is weird. Don't people who have AD (especially those in the latter mid-stage and late stage) lose interest in, and awareness of, the people whom and the places and events that had interested them when they were mentally healthy? And are adults usually fascinated by the privates of pre-pubescent ANYthing?

    This is slightly off-topic, but I also don't understand why psychiatric (or psychological) counseling would include PHYSICAL exams. I think this sounds like a ruse - albeit perhaps a ruse made up by a powerful authority figure whom a troubled adolescent would not be able to challenge.

    Only a guilty person would go through the lengths to deceive others that this man has gone through in order to evade prosecution and punishment.

    That 30-plus people have independently complained about the same person for the same reason tells me that they are correct and telling the truth. As such, this self-entitled man has damaged countless lives. No surprise there - that's what psychopaths do. If and when this man ends his deceit and owns up, I think we should not lock him up and throw away the key. Instead, I think we should lock him up and study him. Psychologists who have no personal or professional connection with this man should consider interviewing him to find out what makes him tick. Psychopaths love to talk about themselves and they love to receive attention (especially from high-ranking people). As a society, we should study this man (and others of his ilk) so that we can learn how to better spot psychopaths before they harm others - especially young people - in the future.