Journey to the Edge of Texas Chapter 9

Expert Testimony

"WE HAVE A WITNESS," Steve Petrou announced, "that is being called out of order this morning."
"Call the witness," Judge Gibson said.
"We call Kuyk Logan."
Petrou turns to his witness.
"Did you at one time work for The Houston Post?"
"Yes."
"And when did you start at The Post?"
"In July of 1969 and was there until the day it was sold on December 1, 1983."
"And who hired you, Mr. Logan, to work at The Post?"
"The Hobby family."
"What position did you last hold at the paper?"
"In May of 1976,1 was promoted to managing editor, and I stayed as managing editor until I left the paper in December of '83."

Now,   I'D   LIKE  TO  TURN  your attention to the plaintiff in this case, Mr. Carl Leatherwood. Have you come to know Mr. Leatherwood?" "Yes."
"Did you ever supervise Mr. Leatherwood's work?" "Yes. I was in charge of the whole shooting match. Everything. All reporters, all the editors."
"Were you all working pretty closely together in that newsroom?" "Very close."
"If somebody made a big disturbance, would you be able to notice it?" "Yes."
"Can you tell us—describe the performance of Carl Leatherwood as an editor?"
Raymond Kalmans, attorney for the defense, objects to the line of questioning, saying, "The witness testified he left in December of 1983. Mr. Leatherwood was terminated six years later in 1988."
The court: "I understand. The jury can keep that in mind. Proceed with your question."
Petrou continues: "Tell me about the Carl Leatherwood that you knew while you were the supervisor. What kind of a job did he do?"
"Carl was an extremely accurate, thorough, and dependable editor."
"Did he always do his job?"
"Yes."
"From your experience as a newspaper man, which job is under greater deadline pressure, a feature writer or a wire editor?"
"A wire editor. Because a wire editor is responsible for making decisions on the international and world news that goes into the paper, and this is a decision that sometimes is made just right up to deadline time. There's a tremendous amount of tension and pressure."
"While you were managing editor, did you ever switch employees from one position to another position?"
"Oh, yes, yes."
"As a person in the management of The Houston Post under the Hobby family, what was your approach to working with staff members who had health problems?"
"The Hobbys were a benevolent family and if somebody was sick, their main concern was that they get well and get back to work. We had a loose policy of a sick policy. If somebody was sick, they could be off until they got well."
"Did Mrs. Hobby personally approve some of the raises?"
"Every raise."
"Thank you, Mr. Logan," Gibson said. "The witness is excused. You will resume now with Mr. Leatherwood's testimony."

BOUNDS   ADDRESSED   THE   WITNESS. "Didn't you show up at The Post one day with your dog to report to work?"
  "Yes, I did."
"Is spending money a problem?"
"Spending sprees, yes. It is with me and with a lot of manic depressives."
"In fact, each time you have an episode of this manic nature, you spend most, if not all, of your money, don't you?"
"No, ma'am. Not each time."
"How much money did you spend during your manic episode in the fall of 1988?"
"I don't know because I was using credit cards and I had redecorated my living quarters on those credit cards. Several thousand dollars."
"Could you be a little more specific about what exactly you did?"
"Paint, carpet, flooring."
"For your whole apartment?"
"Yeah."
"And you put that all on credit cards?"
"Yes."
"Mr. Leatherwood, I've handed you what's been marked as Exhibit No. 3. Would you read the cover of that and tell the jury what it is that we're going to be looking at?"
"Medical records on Carlton E. Leatherwood, Jr."
"From whom?"
"From Adriana Nuncio, custodian of medical records for Dr. Archie Blackburn."
"Did you resist the constables when they tried to take you to the hospital in 1988?"
"In my home, I resisted. I did not perpetrate violence. I resisted the constables because I didn't think they could come into my private home and get me. My watch has a little piece on it that they can't fix and my hand came up and cut my lip. It's not a head injury. It is a cut lip."
"Okay. I apologize for the confusion. So we're in agreement then that you did offer resistance to the constables."
"To a degree because I had called 911 to ask if they could come into my home and get me, and I was waiting on the results of that call."
"Would you look down on page 77 where it's underlined 'physical examination.' Would you read that paragraph, please?"
"Patient had resisted the constables who brought him to the hospital. He was initially angry and puzzled. He accepted continued use of lithium carbonate, 1200 milligrams per day, as had been his custom over recent months. Court commitment initially recommended on grounds of likelihood of deterioration to dangerousness if not treated."
"Would you now flip to page 57 in that same record?"
"The date of admission is November 16, 1989."
"This was less than a year after the other report. Down under physical exam, would you read those sentences, please?"
"The initial assessment was remarkable only for superficial abrasion on the forehead. Persisting combativeness requiring restraints and limited the extent of the initial assessment."
"Thank you, Mr. Leatherwood.
"These reports from the doctor regarding your admissions in 1988 specifically, then again in 1989, do tend to indicate a tendency towards violence, don't they?"
"I don't read it as perpetration of violence."
Petrou had a final two questions.
"Is allowing you to be a full-time writer part of the accommodations that you are seeking from The Post for your disability?"
"Yes."
"And how would allowing you to be a full-time writer have accommodated your mental condition?"
"It would have been a less stressful position than wire editor, one, because there are not as many deadlines and, two, a change of pace, change from a burnout situation, can be less stressful."
Petrou: "The plaintiff calls Rebecca Bibens. Ms. Bibens, what was your job when you started out at The Post?"
"I was a copy editor, but I have worked in several positions during my eight and a half years at The Post. A lot of the time I was a rim editor, which means you just read the stories and write the headlines. Occasionally I would do a little bit of layout. Sometimes I would be a slot person. That's the person who reads the stories after the rimmers edit the stories. You're checking other people's stuff. Sometimes I would work a little bit in the back shop where they put the pages together and just try to make sure everything fits and looks right.
"Did copy editors sometimes make mistakes?"
"Yes."
"What kind of mistakes would they make?"
"Well, grammar mistakes, spelling mistakes. It's not always that they made mistakes, it's that sometimes they didn't catch the mistakes. That was, you know, our job, but when you read so much, you can always, you know, read over something and miss something."
"Did you sometimes edit business copy?"
"Sometimes, yes."
"And when you edited business copy, did you come to know the plaintiff in this case, Mr. Carl Leatherwood, here?"
"Yes."
"When you edited business copy, about how close were you to Mr. Leatherwood?"
"Well, it varied. Sometimes I would be right next to him, and then sometimes I would be a few people away."
"When you were sitting near Carl, were you able to observe him working?"
"Yes."
"How was his conduct on the job?"
"He was always fine I thought."
"From your observation, was Mr. Leatherwood serious about his work?"
"Yes."
"From your observation, did Mr. Leatherwood meet his deadlines?"
"As far as I know, yes."
"Did Carl Leatherwood seem to care about the quality of his work?"
"Yes."
"Were there occasions when as slot editor you had to review Carl's work?"
"Yes."
"When you reviewed his work, did he make a lot more mistakes than other editors?"
"No, I would not say he made more mistakes than other people."
"Did Carl ever disrupt you from doing your work?"
"No."
"Did he ever cause chaos in the newsroom?"
"Not when I was there, no."
Kalmans came forward for the defense.
"Ms. Bibens, were you working at The Post on the day that Mr. Leatherwood brought his dog up into the newsroom?"
"No."
"And isn't it true that Mr. Leatherwood frequently had—didn't— forgot how to work the computer?"
"I don't know."
"Now, didn't he move around a lot? He wasn't just seated at his desk, was he?"
"You mean like did he get out of his seat a lot?"
"Yes."
"Not that I know of."

THE NEXT WITNESS , who had just rushed into the courtroom wearing a white medical coat, was called. Petrou went to work.
"Good afternoon, Dr. [Robert] Hirschfeld. And what do you do for a living?"
"I am the professor and chairman of the Department of Psychiatry at the University of Texas here in Galveston. It's about a thousand-bed university hospital. In effect, it's the oldest university medical center west of the Mississippi." "And you also teach psychiatry?"
"I teach psychiatry there. I provide psychiatric practice to patients, provide service, and also we train people to become psychiatrists and medical students."
"And how long have you been teaching psychiatry?"
"I would guess twenty years, something like that."
"Do you have an area of specialty in the field of psychiatry?"
"Depression, depressive illnesses, bipolar illness, anxiety disorders."
"Is part of that area manic depressive illness?"
"Well, that's really an old term, manic depressive illness. The more modern term is bipolar illness in which patients have episodes both of highs, which we call mania, and lows, which are episodes of depression."
"Are you on a national committee regarding bipolar disorders?"
"Yes. I've been very concerned about the rights of patients with psychiatric illnesses and have served as a consultant to several organizations that advocate for the rights of patients and destigmatization. One of them is a group called the National Depressive and Manic Depressive Association. It's a group of about 35,000 members in the United States, patients and family members of patients, and I'm privileged to serve as the chair of their scientific advisory board."
"Dr. Hirschfeld, can you tell us what is bipolar disorder or what used to be called manic depressive illness?"
"Certainly. It is a medical illness in which people have episodes of highs, that is, where they often feel on top of the world. They feel that there's nothing that they can't do. Sometimes they think of themselves as being very important. They tend to have a real lot of energy. They have much less need for sleep. A lot of times we sleep less than we would like to, but when people are actually manic, they have less need for sleep. They can sleep only three hours a night. They just have a real lot of energy.
"And they often do things that later turn out to be very embarrassing or devastating to themselves and their family. They spend a lot of money. They may go out and be very promiscuous when they're not at all promiscuous kind of people. They may do things that are very risky. They certainly may go out and abuse substances, drink too much, and things like that. So that's what happens when they get high.
"Then they're completely opposite with the lows or the depressions in which they feel like they're at the bottom of the barrel. They feel that they're just as low as they can be. They feel terrible. Their self-esteem is poor. They have no energy instead of having all this energy. They can't concentrate. They lose their appetite. They lose their interest in things. And it's really striking to see the difference.
"And that's very different from the kind of experience that most of us have when we're disappointed. And we've all had times when something hasn't worked out for us or we've lost our job or a love relationship hasn't worked out, when we feel pretty badly for a few days. But this is unremitting and you just can't move and some people who are very severely depressed don't even get out of bed. They just don't have the energy to do that.
"Are there some patients who are more manic than they are depressed?"
"Almost all combinations that you can imagine."
"And when these people act in this embarrassing manner that you describe, do they know at the time what they're doing?"
"They usually don't and one of the problems that we have as clinicians is to try to catch the episode early to get the patient's cooperation. Because usually when they get it full blown, the patient has no realization that they're doing something wrong or wild or reckless and are not cooperative."
"Can employers be involved?"
"One of the things I try to do when I work with a patient with bipolar illness is to get as many people involved as possible."
"You mentioned spending sprees. Tell us a little more about that. Why do some people who are in mania go into these spending sprees?"
"It's part of the illness. They just think that there's nothing they can't do and nothing that they can't have and so they will buy expensive cars, they will buy jewelry, they will take airplane trips around the world. I mean, it can sound very entertaining and sometimes even can be funny until it all comes—you end up having to pay the piper, and people's life savings have been squandered in a week.
"It can happen that quick?"
"Oh, yes. Oh, yes."
"When people are in mania, they sometimes do lose touch with reality; isn't that true?"
Kalmans: "Objection, Your Honor. He's leading."
Petrou: "Your Honor, what's your ruling?"
The court: "What's your question?"
Petrou: "Do some people lose touch with reality?"
The court: "Overrule the objection. This is an expert."
Petrou: "Yes, go ahead, Dr. Hirschfeld."
"In the more severe forms of bipolar illness, people can become what we call psychotic, which means they do lose touch with reality and they may hallucinate or see things that aren't there, hear voices, believe things that are clearly not true. Not everybody who has bipolar will do that."
"Do some manic patients become irritable?"
"Irritability is very characteristic. And often if someone who is manic is frustrated, if you tell him or her they can't do this or that, they will become frustrated and very irritable and may become quite combative."
"Do some of the people who have mania become disabled from working for periods of time?"
"Bipolar illness tends to be episodic, and people can function at very normal—many people can function at very normal levels between episodes. There are some people who become chronically ill or
chronically depressed and can't work at all, but a significant portion of people do very well, especially if they're maintained on maintenance medication between episodes.
"I forgot to ask you at the very beginning when you were introducing this kind of mental illness about how many people in the United States suffer from this general illness that was called mania or depression?"
"One percent of the population has bipolar disorder, or in the range of 2 million people."
"How can this illness be controlled?"
"Well, the wonder drug is lithium carbonate. There have in the last ten years now been a number of other medications that are also very useful in the treatment of bipolar illness.
"When patients with bipolar illness get depressed, there are a number of antidepressive medications such as Prozac, which has received a lot of press. Also it's very important for patients with bipolar illness to get psychotherapy and psychological management, because as you can imagine, the kinds of things that occur when they're manic really need—can have devastating effects on families, relationships, and jobs. So dealing with that in psychotherapy is very important."
"Okay. Are there times when people with bipolar disease become disabled despite taking medication?"
"There are people who do not respond to one treatment and they may respond to another treatment and they may end up not responding to any treatment."
"Can workers who are disabled by bipolar illness or disorder be stabilized and return to their jobs?"
"Often they can. There are certainly people who are unable to work or are completely disabled. Between 80 and 90 percent of the people can do very well. It's that last 10 to 20 percent where the variability is—and this is quite rough, but I would expect that perhaps 5 percent of patients with bipolar illness would be completely disabled. But I would say the majority of the patients can lead productive and satisfying lives.
"I want to read to you a quote by Vincent van Gogh, the Dutch artist, and tell me what it means in today's terms."
Kalmans: "Objection, Your Honor. This doesn't have any bearing on this case."
The court: "Can you come up here? Can't you just ask him questions that go to his expertise? We don't have to worry about quoting van Gogh."
Petrou changed tack:
"How do you compare someone who has mental illness such as
bipolar disease with someone who has a physical illness such as heart disease?"
"I don't make the distinction. Both types of illnesses have genetic aspects, biological aspects, psychological aspects, and behavioral aspects."
Kalmans: "Your Honor, we would object to the narrative. There's no pending question at this time."
The court: "Overrule the objection. Proceed."
"Please go on with your explanation," Petrou said.
"For example, with hypertension, high blood pressure, you can reduce your blood pressure by behavioral ways, changing life-style. So no one would say that hypertension is not a physical illness and that you can do a lot to treat it in a psychological way."
"Can people who have bipolar disease be accommodated in similar ways that people who have these other physical diseases such as heart conditions?"
Kalmans: "Your Honor, we would object. There's no evidence that this doctor has any knowledge of this particular work place environment, and we would object to this question."
The court: "Overrule the objection."
"The question was: Can people who have bipolar disease be accommodated perhaps like people who have other physical diseases?"
"Well, my understanding is that this currently is something that would be covered in the Americans With Disabilities Act. Now, maybe that's not specifically answering the question that you asked, but certainly people with psychiatric illnesses including bipolar illness can be very productive and can perform responsible jobs."
"Dr. Hirschfeld, can the termination of employment cause the condition of a person with bipolar disorder to deteriorate?"
"Sure. Any very significant distressing event can have a negative affect on any health condition, certainly including a psychiatric one."
"Do you have an opinion as to what employees can do to help people with bipolar disorder lead a productive life?"
I think that it's important to treat people with any illness as normally as possible, but to be sensitive, with someone who has bipolar illness, to the early signs of an impending episode and to try to warn the person, the family, and perhaps the employer as things begin to deteriorate. I think that's how you would be most helpful.
Petrou: "I appreciate your answers, Doctor. I have no further questions."