ayres Competency Trial - Day 3

In Court: Tuesday October 30, 2012:

Interesting Development: ayres attempted to groom a developmentally disabled man while in Napa State on multiple occasions ...   Read Merc News (pdf)...

10/31/2012 6am PST Update: 
Decision Expected Today:
The San Mateo Daily Journal is reporting (pdf) that Deputy DA Karen Guidotti says that Judge Grandsaert will ask any follow up questions this morning, and then issue a ruling today. 

Also, see the extensive update immediately below, if you haven't already:

10/31/2012 1:30am PST: Afternoon Update:


In the afternoon,  Dr. George Wilkenson, who testified in ayres’ first competency trial, took the stand.

Previously, Wilkenson had testified that ayres was competent, but that he probably needs some minor accommodations if he's going to testify, like the use of notes as was the case in the criminal trial, or more frequent breaks.

Wilkenson met with ayres four times recently over about eight hours while he was in San Mateo County Jail, the most recent interview was on 10/25/2012. Wilkenson reviewed other reports in the case as well, including Amanda Gregory’s reports, and records from Napa State and from the Jail.

Wilkenson concludes that ayres is competent to defend himself at trial. He finds that ayres did VERY well on the Verbal IQ test, and an “abstract” test, and passed the apraxia test (100% score).

Wilkenson talked about the possibility that ayres has some minor defects with verbal memory areas, but he states, much like Dr. McIlnay, that it’s difficult to tell, as ayres clearly exaggerates his deficits so much.

Wilkenson noted a drastic difference in ayres behavior over a short period of time: On one occasion, ayres seemed profoundly disoriented, but the team monitoring ayres at the county jail reported that only a few weeks prior, he was functioning perfectly normally. When Wilkenson first went to interview ayres at the jail (close to a year after Wilkenson last met with ayres) ayres said “Oh, Hello Dr Wilkenson!” but then acted totally confused.


Dr Wilkenson also recounted several occasions that indicate that ayres is clearly competent:

- He said that ayres like to control the interview, moving to topics that he wants to discuss, but then is cooperative when asked to return to the tasks at hand. Wilkenson concludes that this demonstrates the skills necessary to understand and assist his attorney in a cooperative fashion as would be necessary in court.

- He reported that ayres complained to him about a medical problem while in San Mateo County Jail. He  suggested that ayres write a request to deal with the issue. Later he found out that ayres did write a request and the problem was successfully resolved.

- He talked about a time that ayres recounted overhearing McKowan talking loudly to a witness during the criminal trial, and he extensively reported the detail that they were discussing, even to the point that he drew the conclusion that she was coaching the witness against him.

Wilkenson discussed a “Rey Test” which is a complex neuropsychological assessment that relies on a complex of different cognitive abilities. Ayres made a series of errors in taking the test that could be indicative of malingering. 

He also talked about Dr. McIlnay’s report: He was very impressed with the report, and called it an “elegant” report, “very balanced.” He noted that it wasn’t just a neuropsychological evaluation, but that it included a “quite powerful analysis” of all of the pertinent case details, and with “everything thought through.” 

This assessment of the McIlnay report enraged defense weasel Bentley. Bentley asked if Wilenson talked to McIlnay or Sutherland. – “No”, he didn’t. 

Bentley pointed out that previously Wilkenson testified that ayres ability to assist in his defense was only marginally adequate, and asked him to confirm that that’s still his assessment. Wilkenson responded that no, he no longer thinks that, and that he thinks that ayres may be malingering, 

Clearly pissed off, Bentley told Wilkenson “You didn’t say that before…” to which Wilkenson replied "No, I think that now though."

Staff Testimony:

The defense attorney clearly objected to the staff being present as witnesses, he didn’t like that they were allowed to testify, and he gave the impression that he had no respect for them at all. He didn’t even bother to cross examine one of the afternoon witnesses. This is probably because their testimony was quite damaging.

Staff first to testify in the afternoon was the Supervising Nurse Sybil James. 

James primary concern is the safety of the patients in her unit. She made several observations about ayres’ behavior while in the unit:

- She noted that ayres behaved differently when doctors were around: when they were present, he would make statements like “I don’t know what I’m supposed to do.” But he did not behave in this manner when doctors were not present. 

- She recounted an occasion when the patients were having a heated argument about what channels to watch on the television, some wanted Spanish, some English, etc… James reports that ayres proposed a sharing method that would help resolve the matter, and it was implemented by the staff.

- James noted that on several occasions, ayres was counseling patients, telling them what medications they should be taking and recommending treatment. James had to remind the staff about the safety of this kind of interaction, and about the “special treatment” that ayres seemed to be getting.

- Most troubling, James noted that ayres was being treated “specially” by all of the doctors on the unit, and she was clearly troubled by this inappropriate behavior, as it threatened the safety of her unit. She noted that one day, defense attorney McDougall just appeared on the unit, something that is NOT allowed and is never done. 

Grooming Behaviors:
Finally, over strong defense objections, the prosecutor asked James to describe what she saw happen with an incident that all of the witnesses and lawyers in the courtroom seemed to know about, but the full details of which were not disclosed during testimony: There was an incident that took place between a developmentally disabled man, ayres and a third man. James noticed the developmentally disabled man and the third man behaving suspiciously, and then at a later time, ayres and the third man had the developmentally disabled man positioned between them and there was some suspicious behavior or activity. James described “physical closeness” and “grooming behaviors.” The three men were physically separated by staff, and a police report was filed, and the disabled man was then moved to another unit to protect him. There was not more clarification, and the testimony was allowed only so that it could be considered when it comes time to decide what to do after the judge rules on the competency issue. (In relation to release/incarceration/bail is my guess here...)

A unit social worker (Jacquelyne Green-Gorbey) also took the stand in the afternoon. 

Green-Gorbey reported that during social group meetings, they would show videos with questions afterwards, and ayres always did fine, and never displayed any signs of confusion. She also stated that while he never demonstrated any problems with memory, whenever there were doctors around, he would complain of memory trouble. 

After the July 25th 2012 hearing in which it was revealed that ayres was found to be competent, and that he would be booted out of Napa and transferred to jail within 10 days, ayres was enraged. He had a tantrum when the driver parked the car when they got back to Napa State. He held on to a post and wouldn't let go, then he fell and insisted that he broke his hip. He complained about his injury whenever anyone would listen, but then he engaged in group physical activities without complaint in the mean time.

ayres told Green-Gorbey that Dr. Sutherland told him that it was a foregone conclusion that ayres would be found incompetent, and that it would just be a matter of finding some retirement home for him. Ayres told her that he didn’t understand the report’s conclusion that he was competent, and that he didn't know how he was going to pay bail.

Last on the stand was the intake RN (Karen Doyle) who was there when ayres was initially admitted. 

On intake, ayres supplied all of the correct information about what medicines he was taking, what the correct doses were, along with the problems he was having and related surgeries and procedures. ALL FROM MEMORY. Doyle even asked him how to spell “Alzheimer’s” and he told her how it’s spelled. Doyle commented that she didn’t think she’d be able to do that for her own medical history; that she’d need her medical history card. 

Doyle described ayres as arrogant, and said that he asked her “Do you know who I am??” and told her about his sex-ed series, and said that some  republicans didn’t like him because of it. She thought he was making it up, but then learned that he was telling the truth. 

Ayres told her that he was afraid that he’d be harmed because of the nature of the charges against him, and he requested a private room. 

In all, a pretty good afternoon for the Prosecution. 

The judge is reviewing the reports tonight, and the attorneys will do their closing statements tomorrow at 10am. Bentley says he needs about five minutes, and McKowan said she’d need about three hours. Everyone laughed at this.

 I hope Bentey actually only takes five minutes. 

Brief afternoon update: 
In the morning, Dr. Good took the stand first, due to his availability. Dr. Good has met with ayres again to test for malingering. Good has extensive experience in testing for competence and in testifying about such cases. Good stated that of all the cases he's handled this particular case has weighed most heavily on him.

Good states in no uncertain terms that ayres is competent but with some borderline deficit. Good also states in no uncertain terms that ayres is NOT malingering. Prosecutor McKowan asked if this means that if ayres  were to be re-tried, that it must happen expeditiously so that further deficit does not become an issue. . Defense attorney Bentley objected strenuously to this question, but was overruled. Good agreed with McKowan's assessment.

Later in the morning McIlnay took the stand again, and was questioned by Bentley:

Bentley walked McIlnay through each of the reports that he reviewed, (16+ reports) and questioned him about whether he agreed with the conclusions of the reports or not, McIlnay explained why and to what degree he disagreed with most every one of the reports. His testimony seemed firm and authoritative to our observers.

Bentley asked if McIlnay's report was based on lots of assumptions. (Uh... and interviewing the wife and child of the child molester isn't fraught with all kinds of assumptive problems?)  Bentley said that yes, his report was based on assumptions, and as an example, he talked about the fact that none of the others considered ayres' intelligence and education, and that it is important to take that into account in findings of malingering. (Of note: Dr. Good called ayres a "high powered intelligence" and stated that his intelligence was an important factor that he took into account when finding that ayres is competent.)

McIlnay said that it is impossible to discern if ayres is experiencing any cognitive deficits, because of the extent to which he is clearly exaggerating symptoms. 

McIlnay stated that he doesn't take his responsibility lightly, that the reports that he writes will have profound impact on people, and he feels that he has a duty to be accurate and clear. McIlnay took Sutherland to task a bit in this area: he reported that although Sutherland had had a good deal of contact with ayres, there was hardly any written report material from Sutherland about ayres, and he felt that this was problematic. When he went to discuss ayres with Sutherland, McIlnay found that Sutherland had NO CLUE that ayres had been refusing his medication and refusing to use his CPAP machine. (Both of these things may very well be able to reverse any actual minor deficit that ayres be suffering, especially if the deficit is not actually related to dementia.)  

More on the testimony will be added tonight.

During a break, Bentley and McKowan were overheard in discussion: McKowan wanted to discuss "Dangerousness" and Bentley wanted to wait until after the trial. They went back and forth into judge's chambers and then went to talk to Solveig and Barbara. Not entirely clear what this was about, but likely either discussions about incarceration or outpatient release or bail, depending on the outcome of this trial.

Witnesses may wrap up this evening. There are four more prosecution witnesses, sounds like they are Napa staff. This may be rapidly drawing to a conclusion. 

william hamilton ayres was arrested on April 5, 2007 on charges relating to his molestation of many young boys while he was alleging to provide psychiatric care to private patients as well as referrals for evaluation from the juvenile court system in San Mateo County. ayres has been delaying his way through the system free from custody until this latest gambit to skirt prosecution by playing demented for the courts. ayres is currently under the conservatorship of his daughter Barbara Ayres of Sacramento, CA. 

ayres has had significant interaction over the years with local politicians on boards like the "Children and Families First Commission,"  including the DA who was serving when prosecution began Jim Fox and Assemblyman Rich Gordon. In fact, Gordon nominated ayres for a lifetime achievement award for his "Tireless effort to improve the lives of children." ayres has also been vocally supported during his criminal trial by local head-shrinkers like Bart Blinder, Etta Bryant, Mel Blaustein, Harry Coren, Tom Ciesla, Robert Kimmich, Larry Lurie, Maria Lymberis, Richard Shadoan, Captane Thomson, and Harold Wallach.