A QUESTION OF SANITY
Dr. Kathy's world was filled with violent people who may or may not be sane enough to stand trial.
As a forensic psychiatrist who served as a consultant to the courts, determining that sanity is Dr. Kathy's job. Her work placed her competence under even stronger scrutiny by the legal community than that placed on defendants who are under examination. But this competent, compassionate woman survived the scrutiny.
According to the District Attorney, Dr. Kathy "is tough-minded and rugged in her approach to adversarial situations. She stands her ground well."
Forensic psychiatry is that branch of the profession that provides expert courtroom testimony based on psychiatric evaluations to determine issues of sanity, competency, emotional damages, etc. She says that most forensic psychiatrists can tell whether a person is insane or not within five minutes of contact. "There is a sense, a feel, a combination of information available from a person."
She is aware of the criticism sometimes leveled at forensic psychiatrists -that they are "hired guns" whose expert opinions could, with equal validity, support either the defense or the prosecution. That complaint has not been leveled at her, however. The DA said that “she is viewed as a mental health professional whose opinion can be relied on both by the defense and the prosecution. "
Dr. Kathy is no stranger to demanding situations. An only child until the age of 17, she grew up in an environment that fostered achievement. She seems to have been unhindered by restrictions some placed upon blacks and women. She and the boy next door pledged in blood at age 6 that they would become doctors, and both did so. Dr. Kathy says she briefly thought about teaching or nursing as "alternative" career choices, but she never really considered anything but medicine.
She had initially considered a career in pediatrics, however, while a student at Howard University in Washington, D.C., she met a prominent psychiatrist with special interests in law and battered children. Dr. Kathy credits her professor with strongly influencing her career: "This dynamic, powerful woman really taught me a lot.”
Dr. Kathy reached one of life’s goals when she was accepted into the Harvard University Psychiatric Residency Program, however, she would later transfer her training to a program that focused on Battered Children.
Now, with additional training at law school, Dr. Kathy takes everything in stride. She has qualified as an expert witness in more than 500 criminal and civil trials, and was involved in the nationally known Phil Donahue lawsuit in which she was asked to determine the extent of the plaintiff's emotional damages.
Actual legal training is not a requirement for forensic psychiatrists. What is required, however, is the development of a professional style that is different from the one taught in medical school.
"A general psychiatrist," Dr. Kathy says, "is expected to be neutral, understanding and reflective. A forensic psychiatrist, on the other hand, charged with evaluating the personality and mental state of a person accused of a criminal act, must be more confrontive.” One of the most important. techniques of forensic psychiatry, according to Dr. Kathy, is "to be patient and to pay attention to details.”
While she works with precise legal definitions and medical criteria, Dr. Kathy says some of her assessment skills are intuitive. Some people will try very hard to present themselves as eminently sane when they are not, because, as Dr. Kathy says, "There's still some respect in the penitentiary - but in the state hospital, there's none. "
Others pretend to be insane when they are not, presumably believing they will avoid severe. punishment. Some claim to hear voices. Others suddenly come up with identical twin siblings. Dr. Kathy says she finds these maneuvers easy to see through and that anyone's ability to plan and carry out such ruses is evidence itself of clarity of thought.
When testifying, Dr. Kathy says, "The question is whether I can respond with a degree of medical certainty about particular aspects of a case. The definition of insanity is legal and not medical, so there is room for interpretation on the part of the forensic psychiatrist. It is crucial to be very clear about the contribution of psychotic behavior to the criminal act (crime) because there are people who are psychotic, but their psychosis had nothing to do with what they did. Expert Witnesses must be very clear about the way in which that psychotic behavior contributed to the act.”
Actually, there is only a small number of people who plead insanity and a smaller number that is declared to be insane at the time of the crime.
Dr. Kathy does not find it difficult to maintain her professional objectivity. Still, she admits, "it's a question I have to ask myself all the time." She says she often spends many hours just thinking about a case. To further minimize the possibility that her opinion will be subsconsciously swayed. Dr. Kathy always clearly tells attorneys at the outset: "I will work on the case if you accept that I have no idea what my opinion will be until I've completed a thorough evaluation."
She says her testimony never totally benefits one side or the other. "When I've given it everything I've got," she says, "and I've called it the way it is, I know some things will be supportive of the defense and some will be supportive to the prosecution. The greatest compliment I can get is when I can walk out of the courtroom knowing that both attorneys have respected what I've said. They don't feel there has been any particular bias." She is confident that her abilities allow her to provide reasonable and accurate assessments.
Asked if there are gray areas between sanity and insanity, Dr. Kathy says “yes.” But forensic psychiatry demands clearcut distinctions and she showed little hesitation in doing so. To the lay observer, questions about sanity may seem hopelessly abstract and muddled. But to Dr. Kathy, they constitute a challenge that she enjoys and that she is more than prepared to meet.
Isn't forensic psychiatry a dangerous field? Dr. Kathy admits that when she first entered the field, "the idea of talking to someone who had just murdered someone scared me to death.” Now, she says, she always felt safe. For one thing, she believes that a woman is in less physical danger than a male counterparts because, among the population she works with, "there's no honor in hitting a woman."
M.Tem, Freelance Writer
