Mills went into her pitch. 'The defendant claims PTSD, Your Honor, but the defense here is that he didn't do it. If he didn't do it, then his state of mind is irrelevant. All this is going to do is put his war record and injuries in front of the jury to excite sympathy.'
Washburn, leaning back with his legs crossed, ran a finger around in his ear. 'My client was blacked out during the period where it appears Mr. Nolan was killed, Your Honor. First, evidence of PTSD will support his claim that he can't remember anything about this period. Second, if he did kill someone and there is a doubt about his mental state because he might have been in a PTSD episode, then he is entitled to that doubt. The crime would certainly be less than premeditated murder, maybe voluntary or even involuntary manslaughter.'
This brought the first sign of Tollson's courtroom testiness. 'I believe I understand the issues, Counselor.' He spent a few more seconds looking over Mills's pages, then squared them and put them down with Washburn's questionnaire. 'I'm going to allow two weeks for motions. Until we know what the jury will hear, we can't tell them how long the case will be, so jury selection starts two weeks from today. Sound good?'
It sounded good to Mills. She'd gotten her hearing. A good omen.
Tollson continued. 'My staff will have the jury commissioner start to put panels together. Six court days for jury selection, including three days of hardship. Six weeks of trial or so if you get into PTSD, probably four at the outside if you don't. Let's get outside on the record and get to work.'
20
Everett Washburn stood in the center of the courtroom, addressing his first witness in the hearing on PTSD. Dr. Sandra Overton was a frizzy-haired, earnest psychiatrist in her mid-forties. She wore a dark blue business suit with low heels. She had already recited her credentials and experience as a psychiatrist-i.e., a medical doctor- specializing in veterans returning from active combat. 'In your experience with these veterans, Doctor,' Washburn asked her, 'have you run across a condition known as post-traumatic stress disorder, or PTSD?'
She almost laughed at the question. 'It's pretty much all I work with.'
'Can you tell the Court exactly what it is, then?'
'Certainly.' She looked across at the prosecution table, where Mills sat with her hands folded in front of her, then around and up to where the judge sat on the bench. 'It's pretty much what the name says. It's a psychiatric disorder that occurs after an episode of traumatic stress.'
'A psychiatric disorder? Do you mean it's a mental illness?'
She shook her head. 'That's not really a descriptive term. Legally it would qualify as a disease, defect, or disorder. Medically it is more a range of continuing symptoms and reactions experienced by someone who's endured a traumatic event. The key word being
'In what way?'
'Well, almost everyone who experiences a traumatic event has a reaction to it. Shock, or depression, or insomnia. But with PTSD, the reaction first tends to be more serious and second, it persists for a lengthy period of time, sometimes forever. It becomes a disorder, not a reaction.'
'And what is a traumatic event, Doctor?'
Again, Overton shook her head. 'There's no one definition. What's traumatic for one person might be relatively innocuous to another. But certainly traumatic events would tend to include military combat, serious accidents, crimes such as rape, natural disasters, terrorist incidents, and the like.'
'Military combat?'
'Yes. Very commonly. Although the disorder wasn't much studied until after the Vietnam War. Before then, when people talked about it at all, it was usually called Da Costa's syndrome. But since Vietnam, estimates of soldiers with combat experience suffering from PTSD have run as high as thirty percent.'
'And what are some symptoms commonly associated with PTSD?'
'One of the main symptoms is a reliving of the original traumatic experience through either flashbacks, or in nightmares. Beyond that, there's insomnia, of course, and a sense of disconnect with life. Then depression, memory and cognition issues, abusive and self-destructive behavior. A huge range of personal and societal problems, actually.'
'Doctor, you referred to abusive and self-destructive behavior. Could this include alcohol abuse?'
'Yes, of course.'
'And memory issues? Do you mean blackouts?'
'Yes. Blackouts are not uncommon, especially if coupled with excessive drinking or drug use or both.'
'I see.' Washburn acted as though he were hearing all of this for the very first time in his life. Now he moved a step closer to his witness. 'Doctor, is there a physical component to PTSD? Or is it simply what a layman might just call a mental problem?'
As Washburn intended, this question kept Overton from becoming lulled in her relatively straightforward recounting. This hearing hadn't been his idea, but since he was in it, he was dry-running her to play to the jury's sensibilities when and if she testified at trial. She sat up stiffly, her expression defiant. 'Absolutely not! In the first place, a mental problem is a real problem. It's as real as a broken leg. Secondly, with PTSD there is measurable altered brain-wave activity, decreased volume of the hippocampus and abnormal activation of the amygdala, both of the latter having have to do with memory. The thyroid's affected, as is production of epinephrine and cortisol. I could go on, but suffice it to say that there are many, many physical and neurological changes and reactions associated with PTSD.'
'I see, Doctor. Thank you,' Washburn said. 'Now, have you had an opportunity to interview and examine my client, Evan Scholler, with regard to PTSD?'
'I have.'
'What were your findings?'
'I found that Mr. Scholler clearly suffers from the disorder. His memory, particularly, seems to be compromised, and this symptom has been aggravated by a traumatic brain injury he suffered in Iraq in August of two thousand three. He suffers from frequent migraine headaches. Beyond that, he has reported the experience of blackouts and episodes of rage, shame, guilt, and depression. Sleeping has been a consistent problem. Finally, he has spoken to me about a tendency to abuse alcohol and other painkilling drugs, such as Vicodin. All of these symptoms are not only consistent with PTSD, they are diagnostic of it.'
'And what about the physical changes you've described-to the amygdala and hippocampus and so forth? Did you test Mr. Scholler for these?'
'Yes, I did.'
'What were your findings?'
'I found decreased cortisol with increased epinephrine and norepinephrine levels. Together, these hormone levels impact the body's fear response and the startle reflex, both of which I found to be in the abnormal range with Mr. Scholler.'
'And your conclusions as a medical professional? Does Mr. Scholler suffer from PTSD?'
Dr. Overton looked over at the defense table where Evan sat. 'Yes. Unremitting and severe PTSD. Without a doubt, in my professional opinion.'
'Without a doubt. Thank you, Doctor.' Washburn inclined his head in a courteous bow. Facing Mills, he turned his palm up. 'Your witness, Counsel.'
'Dr. Overton,' the assistant district attorney began, 'you've testified that blackouts were not uncommon among people with PTSD. Were you saying that PTSD causes blackouts?'
'Not exactly. I believe I said that blackouts were common, especially when drugs or alcohol were part of the picture.'
'Oh, so PTSD does not in itself cause these blackouts, is that true?'
'Well, in a sense you can say that-'
'Doctor, I'm sorry. It's a yes or no question. Does PTSD cause blackouts?'
Overton frowned, glanced over at Washburn. 'They are commonly associated with PTSD, yes.'
