frontline: murder on abortion row: Salvi's hearing transcripts

Volume: 1
Pages: 1-302
Exhibits: 9-14

COMMONWEALTH OF MASSACHUSETTS

NORFOLK, SS SUPERIOR COURT DEPARTMENT

* * * * * * * * * * * * * * * * *
*
COMMONWEALTH OF MASSACHUSETTS, *
Plaintiff, *
*
VS * Criminal Business
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JOHN W. SALVI, III * No. 99518 to
Defendant * 99523
*
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BEFORE: The Honorable Barbara A. Dortch-Okara, J.

PLACE: Norfolk Superior Courthouse
Room 25, Criminal Session
650 High Street
Dedham, Massachusetts 02026

DATE: Tuesday, July 25, 1995

TIME: 9:35 a.m.

__________________________

DANIEL J. JACQUES REPORTING SERVICES
Professional Court Reporter
14 Adin Street
Hopedale, Massachusetts 01747
(508) 473-3041

A P P E A R A N C E S

JOHN P. KIVLAN, Esquire
ASSISTANT DISTRICT ATTORNEY
360 Washington Street
Dedham, Massachusetts 02027
FOR: The Commonwealth

MARIANNE C. HINKLE, Esquire
ASSISTANT DISTRICT ATTORNEY
360 Washington Street
Dedham, Massachusetts 02027
FOR: The Commonwealth

JOHN H. LaCHANCE, Esquire
14 Vernon Street
Framingham, Massachusetts 01701
FOR: Mr. Salvi

J. W. CARNEY, Esquire
CARNEY & BASSIL
20 Park Plaza
Boston, Massachusetts 02116
FOR: Mr. Salvi

JANICE BASSIL, Esquire
CARNEY & BASSIL
20 Park Plaza
Boston, Massachusetts 02116
FOR: Mr. Salvi

I N D E X

EVENT PAGE

Competency Hearing Day 2 . . . . . . . . . . . . 4

________________

WITNESS DIRECT CROSS REDIRECT RECROSS

Dr. Phillip J. Resnick (Second Day)
By Mr. LaChance . . . . . . . . . . 62-87
By Mr. Kivlan . . . . . . . . 5 . . . . . . 79-88

Dr. Robert Kinscherff
By Mr. LaChance . . . 89 . . . . . 223
By Ms. Hinkle . . . . . . . . 144 . . . . . . 242

Dr. Ronald Schouten
By Mr. LaChance . . . 250
By Ms. Hinkle . . . . . . . . 292

________________

E X H I B I T S

NO. DESCRIPTION PAGE

9 Magazine . . . . . . . . . . . . . . . . . 10
10 Pamphlet . . . . . . . . . . . . . . . . . 11
11 Letter . . . . . . . . . . . . . . . . . . 143
12 Curriculum Vitae . . . . . . . . . . . . . 143
13 Curriculum Vitae . . . . . . . . . . . . . 253
14 Mr. Salvi Note . . . . . . . . . . . . . . 266

A Article . . . . . . . . . . . . . . . . . 44
B Dr. Resnick's Notes . . . . . . . . . . . O/R
C Notes and Test Results . . . . . . . . . . 157

P R O C E E D I N G S

THE CLERK: You may be seated.
MR. KIVLAN: Good morning Your Honor.
THE COURT: Good morning.
MR. LaCHANCE: Good morning Your Honor, before we start, may I say something?
THE COURT: Yes, be brief.
MR. LaCHANCE: I want to bring something to the attention of the Court. I was requested to go to see Mr. Salvi this morning and Mr. Salvi has requested that a statement that he has prepared be read on his behalf in court and on his behalf. I would request permission to do so?
THE COURT: No sir. Thank you, let's --
MR. LaCHANCE: Actually he would request permission to read it himself to the Court. Will you allow him to do that?
THE COURT: No sir, I will not. Yes Mr. Kivlan?
MR. KIVLAN: May we proceed Your Honor?
THE COURT: Yes. Doctor?
THE CLERK: Doctor, I remind you, you are still under oath.
THE WITNESS: Yes.

CONTINUED CROSS-EXAMINATION
By Mr. Kivlan
Q Now Doctor, before we resume at the point where we were at yesterday, I want to ask you a couple of preliminary questions.
Do you have a report in this case?
A I do not.
Q Do you have any notes?
A Yes.
Q Do you have any transcript of this second interview you did with Mr. Salvi on June 18th of this year?
A I do not.
Q Do you have notes of that interview?
A Yes.
Q Do you have the notes with you now?
A Yes.
Q May I see the notes please?
A Yes.
(Brief Pause)
Q These are the notes of your second interview with Mr. Salvi?
A Yes.
Q Now, with respect to the report, or the absence of a report, you usually write a report when you are called upon to do an evaluation in a case, don't you Dr. Resnick?
A If I am requested to, yes.
Q Well, if you're requested to, is that right?
A Yes.
Q And when you or when you were acting as a forensics psychiatrist at the request of the State of Ohio and you were asked to do an evaluation, you wrote a report, just like Dr. Haycock, right?
A You're referring to the Malcolm Case?
Q Not just the Malcolm Case, any case which you did for the State of Ohio, that was a formal case, that you were asked to evaluate a defendant for competency or responsibility, you wrote a report, right?
A If requested by the prosecutor, routinely reports were written in that case, yes.
Q And you've been interviewed or attempted to be interviewed by the State Police of Massachusetts in this case, right?
A Yes.
Q And you declined to answer any questions, is that right?
A I said that I would need instruction from the attorneys who employed me before I answered and they didn't call back.
Q Because you consider yourself to be employed by defense counsel in this case, right?
A I am employed by defense counsel, yes.
Q As a matter of fact, you used the term with the State Police Officer, I can't talk to you without their permission, words to that effect?
A That's right.
Q Is that right?
A Yes.
Q Now, ordinarily in a case, even if you were asked to do an evaluation by a defense attorney, you write a report for the attorney in the case, don't you?
A It depends on the request of the attorney.
Q Did the attorneys in this case request a report from you?
A They did not.
Q By the way, you've given discourses on writing reports to psychiatrists in the past, correct?
A Yes I have.
Q And you have given them advise about writing reports, is that right?
A Yes.
Q And you have told them, among other things, that reports can be, "picked apart," to use your words, on cross-examination, haven't you?
A Yes.
Q And that it is very important not to write preclusionary reports, is that right?
A Yes.
Q Now, with respect to some questions that I asked you yesterday that you said that you didn't have any materials, or hadn't had an opportunity to read them, have you since had an opportunity to read some of this materials that were in Mr. Salvi's possession at the time he was arrested or sometime thereabouts?
A Yes.
Q And do these materials include this magazine called the New American?
A Yes.
Q You've seen this now, and you've had an opportunity to read it, is that right?
A Yeah, I'm not sure what -- I've seen that cover but I'm not sure if --
Q Right, take a look at it?
(Brief Pause)
A It looks to me like I have read some of these and not others.
Q But that's the magazine, in any case?
A Yes.
MR. KIVLAN: Mr. LaChance has seen this Your Honor, and it is my understanding that he has no objection to this being the next exhibit.
MR. LaCHANCE: Your Honor, I just would request, we do stipulate that that was the magazine that was found during the search. I would indicate for the record that we have received a portion of that before, and this morning is the first time we received the full book. But this is the --
THE COURT: Exhibit 9.
(Exhibit Number 9, Magazine, Marked and Received into Evidence)
THE CLERK: Exhibit 9 has been marked, Your Honor.
THE COURT: Thank you.
Q And with respect to Exhibit 9 --
THE COURT: What is the name os this, the New?
MR. KIVLAN: The New American Magazine.
THE COURT: Thank you.
Q Some of the references on the cover to articles that may be found inside, are for example, Firearms and Freedom, Why Crime Pays, The Curse of Compromise, am I reading accurately?
A I can't see from here.
(Brief Pause)
A Yes, that's correct.
Q Can you agree with me sir that within, unfortunately there isn't a page number, but would you agree with me that's there an ad in here that states at the top, "Abortion, America's Greatest Crime?"
A Yes.
Q And also within Mr. Salvi's possessions was there a communication from something entitled, The Fatima Center, from Constable, New York, do you remember seeing this document?
A I saw the second article, but no the first article.
Q But you've seen the pamphlet, and you have at least seen some of the articles in it?
A Right, some were made available to me, some were not.
MR. KIVLAN: And again Your Honor, I understand that Mr. LaChance has no objection to this being the next exhibit.
THE COURT: Exhibit 10.
THE CLERK: Exhibit 9 and 10 have been marked Your Honor.

(Exhibit Number 10, Pamphlet, Marked and Received into Evidence)

THE CLERK: Exhibit 10 has been marked, Your Honor.
Q And with respect to Exhibit 10, among other things, you will agree with me sir, that there is contained articles which include, Russia, The United Nations and the Anti-Christian One World Government?
A Yes, I did see that one.
Q And another article, The New Age Movement, The Kingdom of Satan on Earth?
A Yes, and I saw that one.
Q Now, you testified at some length yesterday, and you supported your testimony with excerpts of a video of your interview with Mr. Salvi on January 15th, which is marked Exhibit 4 A, is that right?
A Yes.
Q And you used samples of conversations that you had with Mr. Salvi involving religious beliefs and political beliefs in support of your opinion that Mr. Salvi was delusional, is that right?
A Yes.
Q And you also offered an opinion to this Court, that those delusions constituted a mental disorder, in your opinion, is that right?
A I didn't say they constituted, but along with the other symptoms, they lead to a diagnosis of schizophrenia, yes.
Q And yesterday at one point, or at least in the past at one point, you've testified under oath that you don't read other psychiatric authorities, yesterday you told us here under oath that you do, is that right?
A I read other psychiatric articles and books, whether they are labeled authorities, I think was the confusion.
Q Well, we'll let the record show what it shows and the Judge will determine whether there was any confusion, but your testimony is today, that you do read other psychiatric authorities, or you do read other psychiatric materials?
A I do read other psychiatric materials.
Q By the way, would you acknowledge that schizophrenia, if it exists, whether it is in this defendant or any other defendant, is allegedly a mental disorder, by your definition?
A Yes.
Q Are you familiar with the Diagnostic and Statistical Manual of Mental Disorders, sometimes referred as D.S.M.?
A Yes.
Q Do you read that?
A Yes.
Q Do you consider that authoritative?
A I do.
Q Have you read the introduction to that, sir?
A Yes.
Q And with respect to the underlined portions I show you from the introduction on Page 21, I read to you, "A clinically significant --"
A Excuse me, you are beginning --
THE COURT: What are you referring to?
MR. KIVLAN: I'm referring to the Page 21 of the Diagnostic Manual that I just made reference to.
THE COURT: What version of that manual?
MR. KIVLAN: I'm sorry Your Honor, I will get it for you.
THE COURT: I like to read along with you, I do have a copy myself.
MR. KIVLAN: All right. It's D.S.M. IV, fourth addition Your Honor, and it's Page 21 of the introduction.
THE COURT: All right.
Q I'm reading now Doctor, from the bottom paragraph.
"Despite these caveats, the definition of mental disorder that was included in D.S.M. III and D.S.M. III R, is presented here because it is useful as any other available definition that has helped to guard decisions regarding which conditions on the boundary between normal, normality, and pathology should be included in D.S.M. IV," in D.S.M. IV, period.
"In D.S.M. IV, each of the mental syndrome or pattern that occurs in an individual and --"
A I'm sorry, you skipped a line.
Q I did?
A Yes.
Q Oh, you're correct sir, I did, I'm sorry. Where did I end according to you?
A Here.
Q All right.
"In D.S.M. IV, each of the mental disorders is conceptualized as a clinically significant behavioral or physiological syndrome or pattern that occurs in an individual and is associated with present distress, e.g. painful symptom or disability, i.e., impairment in one or more important areas of functioning or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom."
"In addition, this syndrome or pattern must not be merely an expectable and culturally sanction response to a particular event, for example, the death of a loved one."
"Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological disfunction in the individual."
"Neither defiant behavior, e.g., political, religious, or sexual, nor conflicts that are primarily between the individual and society, are mental disorders unless the deviants or conflicts is a symptom of a disfunction in the individual as described above."
Did I read that accurately?
A Yes.
Q Now, apart from what I just covered with you, Dr. Resnick, Mr. Salvi told you during that interview on January 15th, with respect to some of the views that he has espoused to you that most people take me with grains of salt, didn't he tell you that?
A Yes.
Q And that was when you were pressing him about some of the statements which you characterized as unusual, isn't that right?
A Yes.
Q Now, yesterday you did acknowledge that some of the facts in this case indicate that the individual, which the evidence shows to be Mr. Salvi, who entered these women's clinics and murdered employees there, and shot and wounded other people, that one could consider that having been done consistent with a political cause, is that right?
MR. LaCHANCE: Your Honor, I object because it assumes facts not in evidence in a sense that --
MR. KIVLAN: I believe those facts are in evidence.
THE COURT: Repeat the question.
Q Yesterday, did you acknowledge that you had examined Grand Jury notes and police reports and you are familiar with the fact that there was evidence in this case that show that Mr. Salvi had had some contacts with antiabortion groups, had attempted to distribute antiabortion material, had made statements that the antiabortion movement wasn't doing enough.
That he had numerous materials in his possession, including the one that is Exhibit 9, that we just introduced this morning, "Abortion is a Crime," and that Mr. Salvi armed, and prepared himself to enter two women's clinics and murdered employees there, and shot other people who were present.
Did you testify yesterday that those facts are consistent with a crime committed in the name of a political cause so to speak?
MR. LaCHANCE: Objection, they are not facts.
THE COURT: Sustained.
MR. KIVLAN: Excuse me, what was the objection again, sir?
MR. LaCHANCE: That they are not facts, Mr. Salvi has not been convicted. There is information that --
THE COURT: Sir your objection is sustained. Move on.
Q Did you acknowledge yesterday sir, that there were facts within the materials that you possess that inferences could be drawn that I just related to you?
A That is one possible explanation, yes.
Q And you acknowledged yesterday that, without being repetitious, that people who are engaged in that kind of criminal activity, for those reasons, among others, are usually competent, is that right?
A Yes, if they are not psychotic.
Q But the question was, did you state that they were usually competent?
A The way you phrased your question, those reasons, among others.
Q And did you also state in your article that these people frequently are uncooperative, don't cooperate with their attorneys, and attempt to disrupt the course of their court proceedings, did you state that?
A Yes.
Q And is it also a characteristic of this defendant, which you now acknowledge, these facts possible show him to be, that they also are very interested in media coverage, is that true, according to your article?
A Yes, if someone has a primary political goal, yes.
Q Now, in connection with writing that article, you obviously had done some research, correct?
A Yes.
Q And you were aware that there are cases in which people commit crimes for reasons related to political or religious reasons, or a combination of that in attempting to get media attention to themselves or their cause, is that right?
A (No Verbal Response)
Q There are people who do that?
A Yes, I focused really on people who do it for political cause rather than just media attention, separate from media attention.
Q But you did state in your article that usually those people seek media attention?
A Yes.
Q Now, with respect to doing that research, you cited some cases in your article, is that right, that you were familiar with, one of them being the Robertson Case, United States verses Robertson, is that right?
A I don't recall it now, but I will accept your statement.
Q Now, you obviously, you asked Mr. Salvi in your interview on January 15th, if he knew anything about these shootings in Florida, didn't you?
A Yes.
Q And that's because you determined that that might be relevant to your evaluation of Mr. Salvi, is that right?
A Yes.
Q And that's why you asked him more than once, correct?
A Yes.
Q And you are familiar, generally, that there have been some murders at women's clinics in Florida, right?
A I recall the one more distinctively than the other, yes.
Q Well, did you do any research into these cases?
A No, I did not.
Q But you did consider the facts pertaining to these cases to be relevant to your evaluation, is that right?
A The one case, yes.
Q Well, did you know that there were two cases?
A I do now.
Q And the first case was on March, occurred on or about March 10, 1993, correct?
A I don't know.
Q Well, do you know when it occurred?
A I don't.
Q Do you have any idea?
A I don't.
Q Well if I suggested to you that it was on or about March 10, 1993, would that be consistent with your memory?
A I just told you I don't have a memory.
Q You have no memory at all?
A I don't recall when it occurred, no.
Q Have you ever heard of the name Griffin?
A Vaguely yes.
Q Well you said you now know about both cases?
A You mentioned them yesterday, yes.
Q You didn't ask anybody about it, you didn't discuss it with anybody?
A No.
Q Well, Mr. Griffin, Doctor, if you knew the following facts would this have been relevant to your evaluation, if you knew that Mr. Griffin was a person known to carry a bible and make biblical references, would that be relevant to your evaluation?
A I don't know, I think it would depend on, I might inquire of the defendant whether he had knowledge of it, but the exact nature of it wouldn't be relevant to my evaluation.
Q Would it be relevant to your evaluation to know that Mr. Griffin refused to cooperate with psychiatrists and attorneys in his case in Pensacola, Florida, four hundred miles from where Mr. Salvi grew up?
A Yes, that could be relevant.
Q And would it be relevant to your evaluation to know whether or not that trial had been televised by T.V. or any other broadcasting?
A It would be particularly relevant to know if Mr. Salvi watched it.
Q You did tell us yesterday that you were aware from reading Mr. Robert's interviews that Mr. Salvi was described by Mr. -- well, you didn't, I didn't ask you this question, but you did read the reports and the interviews of Mr. Roberts, right?
A Yes.
Q A former employer of Mr. Salvi's?
A Yes.
Q And he describes Mr. Salvi as being a news addict, right, somebody that always wanted to listen to the news, right?
A Yes.
Q And in his words, in substance, somebody he thought that wanted to be in the news someday, or words to that effect, right?
A Yes.
Q And with respect to, again, to your evaluation of Mr. Salvi, would it have been relevant to know what defense if any, Mr. Griffin asserted at his trial in Pensacola, Florida?
A Potentially, yes.
Q And would it be relevant if you knew that Mr. Griffin attempted to introduce a defense of necessity, that is, the defense of another which was rejected by the Florida Courts, would that be relevant?
A Possible, but since Mr. Salvi didn't raise that, it would be less relevant.
Q Well, would it be relevant to your evaluation to know that Mr. Griffin did not attempt to introduce a so-called insanity, or a lack of responsibility defense, would that be relevant?
A Possible.
Q And would it be relevant that after Mr. Griffin's conviction, that he's been calling upon the State of Florida to put him to death, would that be relevant to your evaluation of Mr. Salvi?
A Potentially, yes.
Q And with respect to the death issue, you made reference to, as part of the basis in your opinion, Mr. Salvi's statements about seeking the death penalty, do you remember saying that yesterday?
A Yes I do.
Q And this was taken up with Dr. Haycock to, you have read Dr. Haycock's report, right?
A Yes.
Q And you understand from Dr. Haycock's report, that in his experience, frequently defendants who are charged with first degree murder, state that they would rather be put to death then spend their life in prison, isn't that true, that's been stated numerous times?
A Yes.
Q And with respect now to the other case in Florida, the so-called Hill Case, are you familiar with the name Paul Hill?
A Yes.
Q And did you know that Paul Hill attended Mr. Griffin's trial?
A No I didn't.
Q Would that have been relevant to your evaluation?
A Of Mr. Salvi?
Q Yes.
A No.
Q Did you know that Mr. Hill committed the murders of a doctor at a women's clinic in Pensacola, Florida on July 29, 1994?
MR. LaCHANCE: Your Honor, I am going to object. These all assume facts that are not in evidence and are not within the personal knowledge of Dr. Resnick
THE COURT: Overruled, you may answer.
Q Did you, Doctor, with respect to Mr. Hill, I will ask you again first, if you are familiar with the name Paul Hill?
A Yes.
Q And incidently did you know that Dr. Haycock asked Mr. Salvi whether or not he knew Mr. Hill, did you know that?
A I don't recall if that was included in his report or not.
Q Well, it wasn't included in his report.
Did you ever talk to Dr. Haycock?
A Very briefly yesterday, not about that.
Q Did you ever talked to him before you formed your opinion in this case?
A No, I did not.
Q And Salvi was at Bridgewater State Hospital for almost sixty days, is that right?
A I'm not sure of the exact length, I know there were two stays.
Q And you have received, since these proceedings commenced, copies of notes that Dr. Haycock took with respect to his evaluation of Mr. Salvi, right?
A Yes.
Q And did you ever make an attempt to talk to Dr. Haycock at any point?
A Yes.
Q Yesterday, you say?
A Yes.
Q But not until yesterday?
A That's correct.
Q And you don't know that Dr. Haycock asked Mr. Salvi if he knew who Paul Hill was, you don't know that?
A Right.
Q Did you know that Mr. Salvi asked Dr. Haycock where he could write to Mr. Hill, if you knew what -- strike that -- if Dr. Haycock knew what institution Mr. Hill was in?
A No.
Q Would it have been relevant to your evaluation to -- strike that.
From the facts that you have in the Grand Jury materials that you reviewed and the police reports, did you glean from those that there was evidence that suggested that Mr. Salvi had purchased a 22 caliber Ruger rifle, converted it into an assault weapon, and then two days before these murders in Brookline, went -- strike that -- the day before these murders in Brookline on December 30th, went target practicing, practiced with that rifle, did you know that?
A Yes.
Q You did know that?
A Yes.
Q Would it have been relevant to your evaluation of Mr. Salvi to know that Mr. Hill within days of the murder at the women's clinic on July 29, 1994, had also purchased a shotgun and converted it into an assault mode, and that he had target practiced for two days before going to the women's clinic and murdering the doctor and another person, would that have been relevant?
MR. LaCHANCE: Objection.
THE COURT: Rephrase the question sir.
Q Would those facts have been relevant to your evaluation of Mr. Salvi?
MR. LaCHANCE: Objection.
THE COURT: Sustained.
Q Are you aware that there are -- Well, let me withdraw that question.
With respect to Mr. Hill's trial, do you know that Mr. Hill's trial was televised in part?
A I knew there was a media coverage of it, I don't know if it was on Court T.V. or not.
Q And do you know when the trial was actually played on Court T.V. and other networks?
A No.
Q So you don't know, if I suggested to you that they, that those tapes of that trial were played at the end of November and the beginning of December of this year, approximately or not less than thirty days before these murders in Brookline, if I suggested those facts to you and I ask you this question, whether or not that would have been relevant to your evaluation of Mr. Salvi?
MR. LaCHANCE: Objection.
THE COURT: Overruled.
A Yes, that would be relevant.
Q And if the evidence at this hearing showed, or anywhere, showed that Mr. Hill had refused to assert an insanity defense at his trial, would that have been relevant to your evaluation of Mr. Salvi?
A Yes.
Q And you do know that Mr. Hill was convicted on or about December 5, 1994, and received the death penalty, you do know that?
A I knew he was convicted, I did not know the date.
Q And did you know that Mr. Hill made statements to the jury at his trial with reference to the bible and the like?
A No.
Q Would that have been relevant to your evaluation of Mr. Salvi if you had known those facts?
A Potentially.
Q Right after Mr. Salvi was arrested, numerous law enforcement officers tried to interview him?
A Yes.
Q And you have read the reports of those attempts to interview him?
A Sometime ago, yes.
Q And throughout those reports, is it fair to say that Mr. Salvi would discuss certain things with the officers, some things, and they wrote reports, right?
A Yes.
Q But every time they attempted to ask him about the events of December 30th, as early as that date, he refused to make any statements about it, right?
A Yes.
Q Did you read the report of a Trooper Joseph Flaherty with respect to his attempt to interview Mr. Salvi?
A I don't recall, no.
Q All right, well whether you recall his name or not, do you recall at some point that a Trooper, when asking Mr. Salvi of the events of December 30th, had a newspaper in his hand from Boston relating the events in the front page stories, do you remember that report?
A I don't.
Q Well, do you remember Mr. Salvi indicating that he wanted to read those newspapers and reading those newspaper in the presence of the officers?
A I don't recall it, but it certainly not uncommon for criminals to be very interested in news media attention.
Q Did you read the characterization of one of the officers from Virginia, who attempted to interview Mr. Salvi, that in his view, he was playing the P.O.W. game, did you read that report?
A I don't recall.
Q You don't recall.
Now, getting back to this political or religious type of defendant, are you familiar with an organization that refers to themselves as the Lambs of Christ, do you know who they are?
A No.
Q Would it have assisted you in your evaluation of Mr. Salvi to know that there is such an organization and that characteristically when they are involved in abortion, or antiabortion protest, and they are arrested that they refuse to cooperate with the authorities, and sometimes remain silent at their trials, would that have been relevant to you?
MR. LaCHANCE: Objection.
THE COURT: Would you come to the side bar please?

SIDE BAR CONFERENCE

THE COURT: What are the basis of your objection, sir?
MR. LaCHANCE: My objection is that basically Mr. Kivlan is testifying, there is no foundation.
THE COURT: I need to know whether any of this is in the materials, I am not privy to all of them. I haven't read through everything.
MR. KIVLAN: Right, some of it is in the materials, and the stuff that isn't on the materials, we will introduce by the close of the hearing.
THE COURT: If that's not so, sir, you may move to strike.
MR. LaCHANCE: I'm sorry I didn't hear what you were going to say.
THE COURT: If there is no foundation, at the appropriate time, you can move to strike.

END SIDE BAR CONFERENCE

THE COURT: Counsel, would you just come again to the side bar.

SIDE BAR CONFERENCE

THE COURT: Sir, would it help you if we turned the air conditioners on?
MR. LaCHANCE: Yes it would.
THE COURT: I don't know how we will be able to hear.
MR. LaCHANCE: I'm very sensitive to the heat.
THE COURT: It appears you are suffering. We will try it, but it really may interfere with my being able to hear, the hearing the witnesses, but we can try.
MR. LaCHANCE: Okay, thank you, Your Honor.
THE COURT: Turn the air conditioners on.

END SIDE BAR CONFERENCE

THE COURT: The air conditioner is on on the other side, so kindly speak louder if you would.
THE WITNESS: Yes.
Q With respect to Dr. Haycock's and the staff's at Bridgewater evaluations of Mr. Salvi, you did read their report, is that right?
A Yes.
Q And it was at least, the combination of the report was at least fifty pages, was it not?
A Longer I believe, yes.
Q And Dr. Haycock and his staff, and incidently you see references in that report that there was a, shall we say, a team approach to this.
There were other forensic experts who participated in the evaluation of Mr. Salvi, right?
A I just noticed the psychological testing of Dr. Cataldi, I didn't know other people participated.
Q Well, do you remember the name of a Dr. Birkmire, a forensic psychiatrist who also participated in the evaluation?
A My understanding --
MR. LaCHANCE: I object Your Honor.
THE COURT: Overruled.
A My understanding was that he saw the patient on admission, but did reach no forensic conclusions.
Q But there were numerous staff at Bridgewater who had contact with Salvi during the evaluation process, right?
A That observed him, yes.
Q And are those reports were made available to Dr. Haycock, correct?
A Yes.
Q And they had him down there twenty-four hours a day, for nearly sixty days, right?
A Yes.
Q And Dr. Haycock himself talked to Mr. Salvi for approximately eleven hours, right?
A Yes.
Q And Dr. Haycock focused, just as you did, on what you described as the central or critical issue on January 15th, of being Salvi's refusal to state a narrative of the events of December 30th, right?
A Yes.
Q And Dr. Haycock not only arrived at a conclusion that Mr. Salvi was doing that deliberately and intentionally, and that he was competent, but he wrote reasons, didn't he, why he believed that, correct?
A Yes.
Q He had facts, correct?
A (No Verbal Response)
Q He had facts that supported his opinion, correct that he cited in his report?
A Yes.
Q And among other things, he cited the fact that Mr. Salvi had been involved in three assaults down at Bridgewater, correct?
A Yes.
Q Fights with other inmates or guards, right?
A Yes.
Q And Mr. Salvi gave an account to Dr. Haycock in detail of those events, and what witnesses were present, and what his position was in those matters, right?
A Yes.
Q And Dr. Haycock even noted, either in his notes, or his report, that he had given such an account to one of his defense attorneys, Ms. Bassil, do you remember that?
A Not exactly.
Q Now, with respect to Dr. Haycock's notes, have you read the notes?
A I did, but they were not fully legible.
Q You told this Judge yesterday that one of the reasons that you arrived at your opinion was that Mr. Salvi, in your view, didn't have an understanding of the case against him, is that right, did you say that in substance?
A A full and rational understanding, yes.
Q And you offered as a reason that, did you not, in substance, that he wasn't able to evaluate his possible defenses in your view?
A Yes.
Q And by the way Doctor, you're familiar and you've written about the fact that there are a number of cases in this area, and you're quite conversant, aren't you, legal cases?
A I'm not sure what area you are talking about.
Q The area of competency?
A Yes.
Q And you have a particular view when it comes to this type of case with respect to competency, and this type of defendant and this type of case, don't you Doctor?
A If you are referring to the imposition of an insanity defense, over a person's will, yes I have written on that topic, and I have expressed a view.
Q And do you remember in -- and that's, shall we, can we agree that that's your view, something that you propose, as matter of fact, in this article, that I made reference to relating to political defendants, is that right?
A Yes.
Q And that's your prospective on it, knowing that some Courts don't agree with that?
A Absolutely.
Q And remember I asked you at the outset yesterday, if you were contacted in Cleveland because you brought to this case some unique theory or application of psychiatric practices that related to competency, do you remember those questions?
A Yes.
Q And you do have a unique theory with the application of competency cases such as this, don't you?
A I would not call it unique.
Q Well Doctor, did you state, we will let the article speak for itself.
Did you state in this article, and I direct your attention to Page 389 of the article, and again this is the Political Offender, Forensic Psychiatric Considerations, Philip J. Resnick, M.D., directing your attention to the top of Page 389.
"This paper will examine one such case in detail. The relationship between refusing an N.G.R.I. plea and competency to stand trial will be explored. It will proposed that an N.G.R.I.," and can we agree that's an insanity defense, so-called?
A Yes.
Q "An N.G.R.I. defense should not be imposed against the defendant's wishes."
Did you state that?
A Yes.
Q And then you went on to discuss some cases, where courts have considered imposing such a defense, when there was significant substantial evidence of insanity, is that right?
A Yes.
Q And the courts, in substance, were applying a balancing test as to whether or not, not withstanding that evidence, a defendant had a particular religious or political views, that he had a right to make his decision whether it was to his alleged determent or not, is that right?
A That's right.
Q And as you stated in this article, you proposed in this article, that this defense, no matter what the courts say, should not be imposed on an unwilling defendant, is that right?
A That's correct.
Q You propose instead that these defendants just be found incompetent, and if it abused the competency process, well, it really isn't as important as not allowing the insanity defense impose against their wishes, is that the substance?
A No, that's not.
Q All right, well, let me read to you what you said. I read to you from the concluding paragraph of that same article I made reference to, and did you state this?
"The need to safeguard the rights of all defendants to participate rationally in their trial is more important then the occasional abuse of the competency issue."
Did you state that?
A Yes.
MR. LaCHANCE: Can we have that article marked for identification?
MR. KIVLAN: We could mark it as an exhibit if you would like.
MR. LaCHANCE: I would like to get a copy. I would like it marked for identification.
THE COURT: For identification.
THE CLERK: It has been marked, A for Identification.

(Identification A, Article, Marked)

Q Since that Robertson case that you discussed in your article which is now marked for identification, are you aware that there have been some cases since that, one being Frednak, and another being, Godinez, Untied States Supreme Court cases?
A Yes, I am. Frendak.
Q Frendak?
A Yes.
Q And with respect to Godinez, was that the last in the series of cases?
A Yes, that's the U.S. Supreme Court Case.
Q And you are aware, are you not sir, that Godinez, the court in the Godinez case states, in substance, that once a defendant is competent, he is competent, and the question of whether or not he can waive counsel or make other decisions is a separate decision of whether he makes knowing, willing choices, is that the substance of that case?
A No, that's not how I would characterize it.
Q Well, the Court has available to it, the case.
Does the case discuss the fact that there aren't levels of competence, does the Court state that?
A Right, and in fact, I think it supports my view.
Q I can't hear you.
A I think it supports my view.
Q Right, okay, but they say that, that there aren't levels of competence, right?
THE COURT: Are not levels, is that what you are saying?
Q There are not levels of competence, that's what they state in the opinion?
A That's right, a single standard.
Q And the opinion, their opinion, is the law of the land, right?
A Yes.
Q Now, the defendants and other people make these kinds of choices everyday, don't they, Dr. Resnick?
A I'm sorry, the question is vague.
Q All right, well, people have to make choice everyday, is that fair to say, I know it is a broad statement, but is that fair to say?
A People make choices everyday, I agree with you.
Q And for example, you stated that you consider psychiatry to be, in your view, a branch of medicine, is that right?
A Yes.
Q And there are more precise, shall we say, branches of medicine, these kinds of issues, of patients making choices come up everyday, don't they?
A I can't answer that yes or no.
Q Well Doctor, just as an example, don't doctors have to deal on a daily basis with people who have religious beliefs, who refuse various kinds of treatments because of their religious views don't permit them to do it?
A Yes.
Q For example, if you know, the Seventh Day Adventists refuse blood transfusions even though they may save their lives?
A That's correct.
Q And the Christian Scientists sometimes refuse medical treatment that may save their lives?
A Yes.
Q And just ordinary people, refuse to undergo chemotherapy for any number of reasons, is that true?
A Yes.
Q And do you know whether in the medical community, there have been articles published about these issues, are you familiar with any articles in the New England Medical Journal relating to those kinds of issues?
A Not particularly in the New England Medical Journal, but I have read about the topic.
Q And, well, is there a consensus, if you know, in the medical community, that when a competent patient makes a decision, whether it is in their best interest or not, the physician honors the decision, is that correct?
A Absolutely, if it is a competent decision.
Q Now to get more directly on point with this case, defendants in criminal cases make choices as well, is that right?
A Yes.
Q And sometimes against the advise of their attorneys, and other, they decide to plead guilty sometimes, is that right?
A Yes.
Q And sometimes they decide to reject defenses that might be available to them, arguably, right?
A Yes.
Q Are you familiar with any Massachusetts cases in this area?
A No, I am not.
Q Are you familiar, you know of none, you don't any?
A Not in the criminal area.
Q Now, Mr. Salvi and you have discussed his choice to proceed to trial with a defense of silence, do you remember that?
A Yes.
Q And do you remember telling Mr. Salvi words to the effect, I can tell you that isn't going to happen, you can't do that, or words to that effect?
A Yes.
Q That's not true is it?
A (No Verbal Response)
Q That's not true, is it?
A I told him that if the defense of silence was due to mental illness, then there was a risk of him being found not competent to stand trial.
Q Well let's exactly what you said.
MR. KIVLAN: Your Honor, from the transcript, which is Exhibit --
THE COURT: Eight?
MR. KIVLAN: Eight. I'm reading from the bottom of Page 63.
MR. KIVLAN: Just a second, Your Honor.
Q Would you agree with me sir, that this bottom statement is a quote by you directed to Salvi?
A Yes.
THE COURT: What is the statement sir, I don't have it. What page is it on, sir?
MR. KIVLAN: I'm going to read it, Your Honor, but I just wanted, I thought you wanted to know exactly where we were.
THE COURT: Yes.
MR. KIVLAN: I'm sorry it's not numbered, Your Honor.
Q You to Salvi, "Okay, that's fair, that's fair, but the reason I am letting all of this out to you, is because when you have talked about your defense of silence, I had the impression that you might just go through the trial and just decline to discuss the crime, and I am telling you that won't happen. That you can do that, but you are likely to be found not competent to stand trial and sent to a psychiatric hospital."
Did you say that?
A Yes.
Q Salvi corrected you, didn't he?
A I don't recall.
Q Well, did he state to you in substance, that he had a Fifth Amendment privilege, and he could sit through a trial and not say a word at the trial?
A Yes, and I told him that that was true.
Q He can chose to testify or not testify, that's his choice?
A Yes, and I told him that was true.
Q And you know that he told Dr. Haycock that the Commonwealth, that the State, the prosecution has the burden of proof and has to prove his quilt, he doesn't have to do anything, right?
A Yes.
Q And that's absolutely true?
A Yes.
Q And as far as your opinion to this Court about Mr. Salvi making, in your view, a rational decision, you're aware of what facts are available to Mr. Salvi to base that decision on, aren't you?
A I'm not clear on your question, sir.
Q Well, you understand what facts are available to Mr. Salvi to make that decision, he has facts to make a decision, doesn't he, as to whether he wants to remain silent or not?
A Well, at the time I saw him on January 15th, he said, I don't know the strength of the prosecution case.
Q And since that time, he's acquired so-called discovery, the evidence in the case, Grand Jury minutes, police reports, he's talked to you, he's talked to Dr. Haycock, he's talked to his lawyers, he knows all that, right?
A I don't know if he's read all those documents. He's been told the equivalent of the fact that there is very strong evidence against him, yes.
Q And as a matter of fact, Dr. Resnick, he told Dr. Haycock, in substance, that his case, meaning what defense if any that he would have, was weak, and that he had no alibi, he told Dr. Haycock that, did you know that?
A I don't recall it being said that way, no.
Q Well, have you read Dr. Haycock's notes?
A I told you that they were not all legible.
Q They're not all legible?
A Right.
Q The notes, is it fair to say contain some things that Mr. Salvi told Dr. Haycock that weren't in his report?
A Correct.
Q And one of the reasons being that if a defendant makes a statement like this, sometimes the forensic psychiatrist won't include it in the report, because they may fell it is not appropriate to do that, is that fair to say to say?
A I can't speak for Dr. Haycock, but in general that's true.
Q I'm going to show you Page 2.
MR. LaCHANCE: Your Honor, may we approach?
THE COURT: Yes.
MR. KIVLAN: I'll move on, Your Honor, just to save some time.
Q Look Doctor, you say you have read these notes, and you don't know that, or you can't read the notes?
A I told you --
Q They are not legible?
A I told you I attempted to read the notes and they were not fully legible.
Q You interviewed Mr. Salvi on June 18th, did you Doctor?
A Yes.
Q He told you on June 18th that he didn't have an alibi, didn't he?
A I don't recall the exact way that was phrased, we did discuss that. I asked him if he had an alibi.
Q What did he tell you?
A If you would give me my notes, I could refresh my mind.
(Brief Pause)
A What I have written here, is no alibi, that's not clear to me whether he said that categorically.
Q What did he say?
A I don't recall the exact words.
Q Don't you think that's kind of important?
A (No Verbal Response)
Q Do you think that's important in terms of forming an opinion in this case?
A I think it's one of many factors, yes.
Q You're telling this Judge, you don't know what he said about the alibi?
A Well, the gist of it was, that he said that he did not have an alibi.
Q You described the evidence in this case, as you know, as being overwhelming, is that what you said yesterday on direct?
A Yes.
Q And Mr. Salvi has told you that he has no alibi, right?
A Yes.
Q And you're -- by the way, with respect to an insanity defenses, or a lack of responsibility defenses, you have some knowledge in that area, right?
A Yes.
Q And can you tell us approximately in the some thirteen million cases that are filed every year, criminal cases, roughly, the percentage that an insanity defense is asserted, much less successful?
A It is asserted one percent of the time.
Q And the amount that it is successful is a fraction, is that correct?
A Twenty-five percent.
Q And in this case, you are aware that after a sixty day evaluation, at Bridgewater State Hospital, which Mr. Salvi is fully aware about, they made no explicit finding, well, -- strike that -- they made a finding that Mr. Salvi was competent, is that correct?
A They offered that opinion.
Q And that he had no thought disorder or mental disorder that interfered with his ability to rationally consult with his attorneys and make choices in this case, including whether or not to speak with him about the events of December 30, 1994, is that right?
A No.
Q Excuse me?
A No.
Q Well, the Bridgewater report is an exhibit.
Do you agree with me that the Bridgewater report states, in substance, that Mr. Salvi willfully and intentionally refuses to give an narrative to his attorneys, is that what it states, in substance?
A That's what the second opinion states, yes.
Q All right, in conclusion Doctor, I just want to get one other thing cleared.
Yesterday I asked you about a case, the State of Ohio verses Malcolm, do you remember that?
A Yes.
Q And you remembered some things about the case yesterday, but you didn't recall some others, is that right?
A Yes.
Q But you did agree that you did remember that this was a defendant about whom there was no question that he had organic brain damage, is that right?
A Yes.
Q And who went into a public library and just randomly -- strike the word randomly, just shot three women in this library, is that correct?
A Yes.
Q And you also recalled that this individual, there was overwhelming evidence, had been in and out of state hospitals all of his life, state mental hospitals, is that right?
A Yes.
Q And clearly was delusional and hallucinating to the point where he claimed that he heard voices, voices of God, voices of other things, and they came to him through birds and rocks, you acknowledged that yesterday too?
A Yes.
Q And you diagnosed this individual yourself, as having schizophrenia, correct?
A Yes.
Q And you offered an opinion to that court that Mr. Malcolm was competent, not withstanding the fact that he was refusing to cooperate with his attorneys, that he was acting up in the courtroom, and otherwise acting out in court, is that right?
A No.
Q You don't recall that at anytime that, well, you testified in the case, didn't you?
A Yes.
Q As a matter of fact, you testified that Mr. Malcolm was responsible, that he was not insane, is that right?
A That's correct.
Q And during that trial did Mr. Malcolm act up during the trial, speak out and try to speak to the judge?
A I don't recall.
Q I'm not going to take up the Court's time with the entire transcript, Doctor, but are you, I have them if the Court wishes to see them.
So you told the court, that that defendant was competent to stand trial, is that right?
A Yes.
Q And if I understand your testimony, you are telling this Court, that this defendant, you're telling this Court and families of the victims of these murders that this defendant --
MR. LaCHANCE: Objection.
THE COURT: Rephrase the question.
Q You are telling this Court, this defendant, about whom there is no evidence of any psychiatric treatment, about whom the evidence, as you've indicated, showed that he planned, and prepared, executed and almost got away with these murders in Brookline, that this is not competent, is that what you are telling this Judge?
A Absolutely.
Q You said yesterday that a delusion is a fixed belief, is that right?
A Yes.
Q A fixed false belief, that no one can change with logic?
A Yes.
Q Is that right?
A Yes.
Q No matter how much logic, it won't change, is that right?
A Yes.
Q Doctor, isn't it exactly this kind of testimony and the testimony that you gave in the Malcolm case that caused the type of article that you were quoted in the other day about banning psychiatric forensic testimony, isn't that exactly that kind of testimony --
MR. LaCHANCE: Objection.
THE COURT: The objection is sustained.
MR. KIVLAN: All right, that's all I have.
THE COURT: Yes sir, anything else?
MR. LaCHANCE: Yes, Your Honor, I do have a redirect. I would like a brief recess if possible. I would like to review the article that was marked A before I proceed with the redirect.
THE COURT: Doctor, let me ask you a couple of questions if I could. You say you accept as authoritative this D.M.S. IV?
THE WITNESS: Yes.
THE COURT: Do you accept the outlines, or definitions, or whatever they are correctly called for the mental illness that you described, that the defendant suffers?
THE WITNESS: Yes I do.
THE COURT: Do you also accept it for the schizotypal personality disorder as it is stated here?
THE WITNESS: Yes I do.
THE COURT: So I can consult this and you would agree with the definitions that are here, if I were looking for a definition for schizophrenia?
THE WITNESS: Yes, absolutely, Your Honor.
THE COURT: How much time do you want?
MR. LaCHANCE: Probably about ten minutes, Your Honor.
THE COURT: We will take our normal morning recess, about twenty minutes or so.
THE COURT OFFICER: All rise please.

(RECESS)

THE COURT: Yes sir?
MR. LaCHANCE: May I proceed?
THE COURT: Yes.

REDIRECT EXAMINATION
By Mr. LaChance
Q Dr. Resnick, during his cross-examination, Mr. Kivlan kept referring to a single main issue with regard to competency.
Do you consider that there is one main issue or more than one main issue?
A There clearly is more than one main issue in my opinion that Mr. Salvi is not competent.
MR. KIVLAN: Objection Your Honor. This was all taken up on direct. I hope we are not going to be repetitive.
THE COURT: Overruled. Finish your answer.
THE WITNESS: I finished my answer to the question, yes.
Q How many issues do you see with respect to Mr. Salvi's competence?
A Yes, there are four separate main issues in my opinion.
Q And would you identify them for us?
A Yes, the four issues have to do with the fact that Mr. Salvi, first of all, and the one I consider most important --
THE COURT: Quickly sir, you did go through that on direct.
THE WITNESS: I did identify those issues before, yes.
THE COURT: You can state them, but quickly sir, without explanation.
THE WITNESS: Oh, I see. Okay, yes.
A The four issues are the importance of Mr. Salvi getting out his psychotic message, the fact that he can not testify relevantly, the fact that his irrationally refusing an insanity defense as well as his inability to give an account of his whereabouts at the time of the crime.
MR. KIVLAN: In his opinion.
THE COURT: Proceed.
Q Dr. Resnick, during the course of Mr. Kivlan's cross-examination, he talked to you about an article you had written, The Political Offender, Forensic Psychiatric Considerations, is that right?
A Yes.
Q And during the course of that, he showed you and read to you three excerpts from that article, is that correct?
A Yes.
Q One of the excerpts he read was that the need to safeguard the rights of all defendants to participate rationally in their trial is more important than the occasional abuse of the competency issue.
Can you explain to us what the rest of your article refers to by the use of the word, abuse of the competency issue?
MR. KIVLAN: Objection Your Honor. I offered to introduce the article as an exhibit so you can read the thing in its entirety.
THE COURT: This is proper redirect.
MR. KIVLAN: Okay.
THE COURT: You may answer.
A Yes, the article which talked about political offenders talked about the fact that it is possible for the government, particularly in Russia, to take someone who is a political offender and cause them to abuse the competency process by precluding taking someone to trial.
And the fact that that could occur in the United States, on rare occasions, that is an abuse of the competency issue for political suppression, in my opinion, does not outweigh the fact that someone should not have imposed upon them an insanity defense, so that was the context of how the word abuse was used.
Q And in the course of the article, he also quoted to you a line with the words in which you indicate that most political offenders are competent, is that true?
A Yes.
Q Did you also consider in the article, and consider now, about a political offender who may also happen to be psychotic?
A Yes I did.
Q And would you explain to us the issue of the psychotic, political offender?
A Yes, if someone is simply a political offender, it is rather straight forward that they would be competent to stand trial, even if they chose not to cooperate, even if they chose to disrupt the trial.
However, if someone is both psychotic and a political offender, as is possible in Mr. Salvi's case, then it requires a very careful dissecting of issues, as to whether the noncooperation is due to the political goal, or it is due to a psychotic interference.
And in Mr. Salvi's case, it is my opinion that it is the psychotic interference and the importance of getting out his message about Catholic persecution which is separate from a political motive regarding abortion.
In his case, all the statements he sought to release don't have to do with abortion, they have to due with the persecution of Catholics, and that supervening, overwhelming, primary factor is what is interfering, in my opinion, with his cooperation in this case rather than a political statement.
Q Are you able to determine whether Mr. Salvi is, or meets a criteria for being a political offender over the issue of abortion?
A Because he has chosen to remain silent, I can not say categorically whether he is or is not. He may be.
Q In the first interview that you conducted, he did discuss with you some things about abortion, is that correct?
A Yes, briefly, but he again, he set limits on what he would say about it.
Q And none of those statements that he made to you during that first interview, indicated any call to violence, did they?
A No, not at all.
Q As a matter of fact, isn't it fair to say, statements that he made were equivocal on the nature of abortion and his feelings about abortion?
A Yes, he was not that forth coming, really, and I think the point here is that if his goal was to make a political statement about abortion, I would expect him to do it, but instead each written statement, each outburst in court, has focused instead on Catholic persecution rather than on abortion.
Q Sir, during the course of your testimony, you were asked about the Malcolm case, do you recall that?
A Yes I do.
Q And in that case, Mr. Kivlan brought out that an individual who was both hallucinating and psychotic, you opined was competent, is that right?
A Yes.
Q Can you tell us what the distinction was between that case and the Salvi case?
A Yes. I think the principle point here is, is that simply a diagnosis of schizophrenia, or active hallucinations, or delusions, do not categorically make someone incompetent. It's only when those delusions interfere with the functional capacity to assist counsel, that someone would rise to the level of incompetence.
So in Mr. Malcolm's case, yes he was psychotic, yes he had the same diagnosis, but it did not keep him from cooperating with counsel.
Whereas in Mr. Salvi's case, it is my opinion that the nature of his psychotic thinking, his idiosyncratic, peculiar, delusional thinking does not allow him to rationally weigh the options and rationally participate in the decision making regarding his trial, and that's quite separate from any political goal he may have.
Q Now, you were asked if you knew certain information or evidence relevant to Mr. Salvi's alleged offense, is that right?
A Yes.
Q And the thrust of those questions dealt with planning and purposefullness that could be inferred from the facts that Mr. Kivlan presented to you, is that correct?
A Yes.
Q Now, can you tell us sir, whether in your opinion an individual who can plan and even perhaps almost get away with it, if that person is also psychotic, can that person be incompetent?
A Yes, and I think the best way I could explain that is to take an actual case which is the case of Mr. Hatfield in 1800 who fired over the head of King George the third. The reason he took a shot at the king was because he believed that the state would then kill him and he would then save mankind as Jesus did.
So here we have someone who planned, and in fact, he practiced just like Mr. Salvi the day before the shooting with pistols. He planned the crime, his goal was a psychotic one, and his goal was then to be executed by the state, and in the sense that he had self defeating behavior, he would not be competent to stand trial.
So here is an example of a man capable of planning, diagnosis of psychosis, but because the nature of his illness would cause him to commit an act for psychotic reasons and then not be able to cooperate rationally, because he thought the state killing him would actually bring about the salvation of mankind.
Q Now sir, you were also asked on cross-examination, a number of questions about whether you had read certain materials, certain Catholic materials, certain Fatima materials, and certain other materials that were found either in John Salvi's apartment or in John Salvi's vehicle, after the alleged offense.
Have you read those that have been provided to you, sir?
A Yes, I read them all, last night in detail.
Q And those questions, I take it, dealt with the issue of whether or not certain aspects of what you called Mr. Salvi's delusions were common to other individuals, is that right?
A Yes.
Q And what is the significance of whether or not delusions are common to other individuals?
A If a small group of people have a very unusual belief, that would not be technically defined as a delusion because if a large number of people share a belief within a given culture that is not consider a delusion.
Q Now sir, did any of the materials that you read, the materials that were provided to us, change your mind about whether John Salvi was suffering and is suffering from a delusion or delusions?
A No, the material, the only references that I considered significant were references to Free Masons. However, they did not replicate Mr. Salvi's delusional system. For example, none talked about the sterilization of Catholic males by injection of spermicide at birth. None talked about printing United States currency, letting people out of prison to do that, by the Vatican. Those ideas were not at all replicated in the written material.
And it is quite normal for people to take a kernel of truth or a kernel of concern and incorporate it in delusions.
So even though, for example, a substantial number of people may believe that there may be life on Mars, if someone believes that they were raped by martians last night, that would still be considered a delusion, even though others might share the believe that there may by life of Mars.
Q Yesterday afternoon, there was an outburst by Mr. Salvi in the courtroom, did you observe that sir?
A I did.
MR. LaCHANCE: Can I have Exhibit Number 8? Not 8, the last one. Thank you.
Q I show you Exhibit 7, which is what Mr. Salvi was attempting to read to the Court, and ask you to read through that paper, if you will.
A Thank you.
MR. KIVLAN: Objection. It's an exhibit.
THE COURT: Overruled.
(Brief Pause)
Q Have you done so?
A Yes.
Q Does the fact of the outburst yesterday and the content of the information which Mr. Salvi wished to impart to the Court, to the public yesterday, does that have any effect on your opinion with respect to competency?
A Yes it does.
Q And can you tell us what that is?
A Yes, the fact that Mr. Salvi sought to introduce material in Court, which had to do with his themes of Catholic persecution, and credit, and debt enslavement, suggest again, that rather than focusing on the central issues, which if this hearing is competence to stand trial, or the shooting of abortion workers, the themes which are in his mind, which he is preoccupied with, are the delusional message that is so important for him to get out.
And that supports my earlier contention that that dominant psychotic belief and getting the message out is shifting his focus away from the issues and not allowing him to fully appreciate the jeopardy that he is in because of this psychotic emphasis.
Q What about the first part of the statement Doctor?
A The first part of the statement addresses the issues as to whether there might be bias from the bench and I would not describe that as irrational or unrelated to his appropriate concerns.
Q Sir, in observing the outburst and based on the other information we have with respect Mr. Salvi, do you have an opinion as to whether that outburst constituted part of a malingering plan to appear incompetent?
A I do have an opinion.
Q What's that?
A It is my opinion with reasonable medical certainty that Mr. Salvi is not malingering. That was supported by Dr. Haycock's opinion, and as I observed the outburst yesterday, again, he did not try and look crazy, he tried to get across this important theme to him, and in my opinion, it was not faked, but was in support of his psychotic message.
Q You mentioned Dr. Haycock, you were asked on cross-examination whether you ever contacted Dr. Haycock, let me ask you this sir.
You saw Mr. Salvi first, is that right?
A Yes I did.
Q Did Dr. Haycock ever call you to attempt to talk to you about your observations of Mr. Salvi or your opinions?
A He did not.
Q Now sir, yesterday afternoon, a large portion of a video tape of your interview with Mr. Salvi was played.
On direct examination, you had an opportunity to comment on the significance of what you saw in that portion of the video tape of Mr. Salvi's competency, didn't you?
A Actually I had an opportunity on direct to comment only on the prearranged excerpt. I have not yet had an opportunity to comment on the part shown by Mr. Kivlan.
Q And with respect the part shown by Mr. Kivlan, yesterday are there aspects of that that are significant with respect to your evaluation of Mr. Salvi and your determination of whether or not he is competent?
A Yes there are.
Q And would you tell us what those portions are?
A Yes, the potion shown later in the day showed some good examples of concrete thinking, that is, when he was asked to interpret a proverb such as don't cry over spilt milk, his answer had to do with it will smell after three days, rather than seeing the meaning of the proverb, he took it in a very literal way. That's characteristic of schizophrenic thinking.
Secondly, it showed examples of the Catholic persecution themes insinuating themselves into irrelevant areas.
When I asked about the proverb, people in glass houses shouldn't throw stones, his answer was not only concrete, talking about breaking glass, it also again raised the Catholic persecution issue, and that is further evidence that if he were given the opportunity to testify, he would very likely not testify relevantly but continue to insinuate the Catholic persecution themes.
The other example I think that was shown in the latter portion of the tape was that he is very hard to interrupt and redirect. I felt the best example of that was when he was talking about adding the deck to the house and I, as an example, and I kept saying let's go onto another area, and he kept persisting.
So that further shows that, in my opinion, he would both be hard for his attorneys to gather information from, and also it would be very hard to direct on either direct or cross-examination.
Q That was the view of John Salvi on January 15th, is that correct?
A Yes.
Q You saw him again on June 18th, is that correct?
A Yes.
Q Did you notice a significant change between those two dates?
A There were some changes.
Q Can you describe those for us?
A Yes, in the June interview, Mr. Salvi was less forthcoming about the delusional persecution themes, but he was just as persistent in not answering questions which would be helpful, continued to say, that's personal, I won't discuss that, ready to interrupt the interview rather than if I pressed him on an issue.
So the themes which interfered with his competence were unabated, but he was less revealing of some of the psychotic themes, and I think that is relevant in the sense that Dr. Haycock may or may not have had a chance to see the delusions in their most blatant form because by the time I saw him in June, he was less willing to share those.
Q Is that characteristic in schizophrenics?
A Actually schizophrenia, it may get better, it may get worse, it may vary, so I wouldn't say it was particularly characteristic, but it is certainly consistent with schizophrenia.
Q Let me ask you this, in that second interview with Mr. Salvi, was he still adamant that he is competent, does not have mental illness?
A Yes, he was very strong in his desire to go forward with the trial, to refuse the insanity defense, and to deny that he was mentally ill.
MR. LaCHANCE: Thank you, I have no further questions.
MR. KIVLAN: Just very quickly, a couple of things.

RECROSS-EXAMINATION
By Mr. Kivlan
Q You have already testified yesterday and acknowledge, that most psychotic people are sane, right?
A Yes.
Q Didn't you say that?
And with respect to this Malcolm case, are you trying to fool this Court about that case?
A No.
MR. LaCHANCE: Objection.
THE COURT: Rephrase the question.
Q The Malcolm case, you tried to interview Mr. Malcolm, didn't you, in connection with the competency evaluation, right?
A I did interview him.
Q Well, the first time you tried to interview him, do you remember trying to interview him through a jail door, because he was kicking and yelling and screaming, do you remember that?
A I don't remember that.
Q Do you remember he was insulting you in the process?
A I'm sorry, it's been many years ago.
Q Well, let me show you the transcript.
You'll agree, this is direct examination of Philip Resnick by a Mr. Howsell, is that an Assistant District Attorney in Cleveland?
A Yes. Could you give some context --
THE COURT: Louder Doctor, I can't hear you.
THE WITNESS: Are you referring now to hearing on competency or insanity? Hearing on competency?
Q Right.
Question, "Tell us what happened on the first occasion?"
Answer, "On the first occasion, Mr. Malcolm was detained in a small holding cell in our area. And by the time we were ready to see him, he was very angry and frustrated, and kicking against the door and swearing. I went to see if I could calm him down and talk to him through the door. He was extremely angry, insulting, and cursing, and declined to be interviewed on that occasion. So that was a very brief interview through the door."
A Yes.
Q Is that right?
A Yes.
Q And then you interviewed him again after that, right?
A Yes.
Q And by the way, contrary to what you suggested on redirect, Mr. Malcolm was also uncooperative with his attorneys, wasn't he?
A Not to the point it interfere in getting a fair trial.
Q Well, let me direct your attention to a further portion of your testimony.
Question, "What significance --"
I will read the whole thing so you don't have any question about it.
Question, "On Page 5 of the of the report, there has been some testimony by the prior witness, Dr. Alcorn, relative to certain delusional ideas, I direct you to Page 5, first full sentence on Page 5, actually the full sentence, able to interpret some proverbs appropriately, he expressed numerous delusional ideas. I think that's in the area we want to get."
"It goes on to say, `These had to do with notion that he hears the voice of God, which he calls the Christ within.'"
"It goes on to say, `He stated he began studying religion in 1975 at his Mother's instigation, this also related to being involved in alcoholics anonymous. He stated he got to far into religion and then he began to actually hear God. He said that God is actually a piece of expletive, in an agitating,'" looks like a spelling error, "worm. He angrily blames God for creating all the evil in the world."
"He stated that God speaks to him in a small nasal mocking voice. He also claims that God talks to him through other people, through birds and through dirt. He describes having to be certain when he actually hears God voice and when he hears other voices."
"In order to be certain about this, he uses the I-Ching, he claims he has memorized this oriental book of wisdom. What's the significance of those things that Mr. Malcolm would tell you, Doctor, relative to his competency to stand trial because they appear in your report?"
Answer, "Well, in ascertaining whether a defendant is competent to stand trial, one looks at current mental functioning. This defendant showed some degree of active psychosis, which you described in detail from the mental stasis examination."
"The question then becomes as to what extent this psychotic material would interfere with his ability to pay attention at the trial and be able to understand what is going on because the defendant did not have his delusions involved in the justice system or the judge in the case, and understood the roles and the proceedings at the trial."
Did you, -- oh I'm sorry.
"I felt that the delusional belief would not directly interfere with his capacity to understand and participate in the proceedings."
Did you say that?
A Yes.
Q Then they go on to ask you.
"And in spite the fact that he exhibited an explosive personality at times?"
Answer, "That's correct."
Question, "How about being uncooperative at times, does that still indicate to you that at other times he's not explosive or is cooperative, and therefore his ability to stand trial would continue?"
Your answer, "I believe his noncooperation was elective rather than involuntary or a part of the psychosis."
Did you also state that?
A Yes.
Q Now, during this trial, this defendant spoke out as well, did he not?
A Yes.
Q And he asked the judge for a lighter at some point for a cigarette, in open Court, didn't he?
A I didn't know that.
Q Well, you were at the trial, weren't you, you testified, do you know it occurred during your testimony?
A Oh, I'm sorry, I didn't know which you were talking about.
Q Page 1967 of the trial transcript.
"Defendant: Yes, can I have your lighter, I don't have any matches."
On Page -- during your testimony, your testimony, in open Court, this defendant also stated, among other things, "I told you that loss --
A Where are you?
Q I'm reading right here, Line 19.
"I told you that loss --
A This is the defendant?
Q This is the defendant. During your testimony in open Court.
"I told you that loss and failure would result. The loss experience of the loss, that's when the voices mock me after I failed. I don't care. I just can't stand to listen to somebody lie. I can't take it. I can't have somebody f-ing lying and just --"
"The Court: Take him out."
Now did that happen during that trial?
A During the competency hearing.
Q Did it happen at any time, during the trial or the competency hearing, did that happen?
Obviously it happened, right?
A I'm sorry, were you reading from the trial or the competency hearing?
Q This I read from the trial.
A Oh, you confused me, I'm sorry.
Q Well, he was on trial, right?
A After the competency hearing he went to trail, yes.
Q And you testified he was responsible, not insane, right?
A Yes.
MR. KIVLAN: That's all,Your Honor.
THE COURT: Briefly sir, we have to end this. Anything further?
MR. LaCHANCE: Yes Your Honor, sorry I didn't hear you.
THE COURT: Sir, on what areas, because this is your witness, I have to stop this at some point.
MR. LaCHANCE: Okay, just one question.

REDIRECT EXAMINATION
Mr. LaChance
Q Is what Mr. Kivlan just read to you from the transcript change your mind about whether or not somebody who is psychotic can also be incompetent?
A No. In fact, I think it was a very clear example of how the words he quoted said that in that case the psychotic symptoms did not interfere with the critical capacities to participate in his trial.
And in my opinion, Mr. Salvi, his psychosis does interfere with the critical issues necessary to get a fair trial.
THE COURT: Thank you. Anything else. On this issue only sir?
MR. KIVLAN: Yes.

RECROSS-EXAMINATION
Mr. Kivlan
Q Your opinion about psychosis is based on your belief that these statements are a delusion that he makes, right?
A Yes.
Q That delusion being a fixed belief --
THE COURT: I understand that, sir.
MR. KIVLAN: Okay, all right, I withdraw.
THE COURT: Thank you, you can step down, sir.
THE WITNESS: Thank you.
THE COURT: Yes?
MR. LaCHANCE: Dr. Kinscherff please.
THE CLERK: Raise your right hand please.
(Witness Complies)
THE CLERK: Do you solemnly swear the testimony you are about to give to the Court in the case now in hearing shall be the truth, the whole truth, and nothing but the truth, so help you God?
THE WITNESS: I do.
THE CLERK: Thank you, you can have a seat.
THE COURT: Speak louder than normal because of the air conditioner.
THE WITNESS: Yes Your Honor.
THE COURT: Thank you. You may proceed.

DIRECT EXAMINATION
Mr. LaChance
Q Would you tell us your name and spell your last name?
A Dr. Robert Kinscherff, K-I-N-S-C-H-E-R-F-F.
Q What is your profession, sir?
A I am a clinical psychologist.
Q What current position do you hold?
A I am currently a Senior Forensic Psychologist for an organization called the Center For Health and Development. I'm also Associate Director for Forensic Services at the Law and Psychiatrist Service at Mass General Hospital.
Q Would you describe your education and training for us, sir, in the field of psychology and any other related illness?
A I received my Bachelor's in 1977 from University of California at Berkeley, a Master's from the University of Chicago in 1980. Those were not in the fields of psychology. I received my Doctorate in Clinical Psychology from the City University of New York in 1988. And in 1992, I received my J.D. Degree from Harvard Law School.
Q Do you hold any licensures in this state?
A Yes I do.
Q What are they?
A I have a full licensure for the practice of psychology in Massachusetts. I have the similar license in Texas. I've also completed a course of training and examination to be permitted, the designated forensic psychologist which is required for persons to conduct statutory evaluations in Massachusetts, such as competency to stand trial evaluations, or not guilty by reason of insanity, criminal responsibility evaluations on order of the court.
Q Do you hold any academic positions?
A Yes I do.
Q Describe them for us, please?
A I'm an instructor in the Department of Psychiatry, the Division of Psychology at the Harvard Medical School. I am also a lecturer at the Boston University School of Law where I co-teach the Law and Psychiatry Course.
Q Do you have experience, sir, in conducting psychological services related to competency examinations?
A Yes I do.
Q And would you describe that experience for us sir?
A Prior to 1993, I conducted a number of supervised evaluations and completed an examination in the relevant law in order to be designated in D.F.P., designated forensic psychologist.
Since then I have conducted specifically competency and criminal responsibility questions probably one to four times, annually. Primarily in inpatient settings.
And I have also supervised the work of other persons conducting these evaluations as they try to complete the D.F.P. process since 1994 when I was designated a forensic mental health supervisor.
Q Do you know an individual named John Salvi, sir?
A Yes I do..
Q And is he present in the courtroom?
A Yes he is.
Q Would you point him out for us, please?
A He's the gentlemen here in the blue blazer.
MR. KIVLAN: May the record reflect that he has identified Mr. Salvi?
THE COURT: Yes.
MR. KIVLAN: Thank you Your Honor.
Q How did you come to be involved in Mr. Salvi's case?
A I came to be involved in Mr. Salvi's case when I was approached by Dr. Schouten of the Law and Psychiatry service who indicated to me in early February that he had been contacted by defense counsel, and he thought that a psychological testing battery should be conducted on Mr. Salvi's as part of the evaluation of the case.
Q And did you agree to perform services for Mr. Salvi under the -- at the request of Dr. Schouten?
A Yes I did.
Q And having performed that battery of test, did you also do some additional things other than testing?
A Yes I did. I participated in two interviews of Mr. Salvi, both of them for approximately two hours each. Once on the 23rd of February and most recently on the 23rd of July.
Q That was last Sunday?
A That was last Sunday, yes sir.
Q Did you interview him alone or with somebody else?
A I was with Dr. Schouten at the two interviews.
Q On both occasions?
A On both occasions, yes.
Q Did you see Mr. Salvi separately on another occasion?
A For the psychological testing on the 13th of February.
Q Would you describe for us, what psychological testing is and how it fits into the picture of competency?
A Yes. Psychological testing is a method of gathering information that is independent from clinical interview. There are a variety of different kinds of psychological tests depending upon the function or capacity that you are attempting to evaluate or gather information on.
The best tests are ones that have a methodological construction and statistical understanding of how they operate and how they may look across the population.
In this particular case, I selected measures of his thinking, his cognition, specifically an intelligence test, also measures intended to get at personality functioning and psychological processing.
Those test do not in and of themselves give a definitive answer to the specific question of competency to stand trial, but they are one source of information about how an individual experiences the world, thinks about the world, the quality and nature of those processes.
Q Is testing also related to diagnosing mental illnesses in an individual?
A Yes, it is often helpful in gathering data that can be put together in the puzzle of pieces that you use in making a diagnostic determination.
Q When did you administer the test to Mr. Salvi?
A On the 13th of February, of the this year, 1995.
Q Are you aware of other psychological tests being administered to Mr. Salvi at Bridgewater State Hospital?
A Yes I am. I have been provided the report of the psychological testing conducted by Dr. Frank DiCataldo.
Q Did he administer psychological tests before or after you did?
A After I did.
Q What tests did you administer to Mr. Salvi?
A I administered the Wechsler Adult Intelligence Scale, the revised version. I administered the, what's known as the M.M.P.I. 2, the Minnesota Multiphasic Personality Inventory, and I administered the Rorschach Psychodiagnostic Battery.
Q With respect to the Wechsler, would you describe for us, what kind of test that is?
A It would go into the general category of an intelligence test, but there are actually several different subtests that make up the instrument. They are intended to tap such things as attention, concentration, fund of general knowledge, the way in which a person will interpret social information both visual and verbal, and a variety of similar cognitive tasks.
These are then scored in a way that profile the individual compared to the general population and there is a scoring system that gives you what's called an I.Q., the intelligence quotient.
Q And you performed that test with respect to Mr. Salvi?
A Yes I did.
Q Could you describe how that test was administered to Mr. Salvi?
A The test itself, comes in a briefcase, and it's done in the same way at each administration. The subtests are administered one at a time and it usually takes somewhere on the order of one to two hours to complete the full administration.
Q Would you describe the administration of the test to Mr. Salvi?
A On Mr. Salvi, particularly, my experience of that, sir?
Q Yes.
A During the testing with Mr. Salvi he showed a number of unusual responses. He had difficulty with this test in remaining within the instructions of the test. There were points at which he seemed to lose touch. He seemed to be distracted and I had to bring him back to the test at hand. Sometimes this required that I call his name or mention his name several times in order to refocus him.
Q What was he doing, when you say he appeared distracted?
A He was sitting and starring. At other times he was quite involved in the testing process, did not require refocusing or re-administration of the instructions to the subtest.
There were times at which he, without any provocation that I could detect, seemed to oddly grimace or to give a sort of short laugh and a smile in which he looked sort of very tense and would laugh, give this odd grimace and sort of look back at me again and return to the task at hand.
Q Did that have some significance to you, those observations in accessing Mr. Salvi?
A Yes they did. They were one of the features that I would look at when assessing his test results in order to see whether or not the test itself actually was reliable and valid in assessing his actual intelligent processes, and also to look and see whether the external behaviors were consistent with the kinds of thought processes that were reflected in the testing.
Q You referred to three subtests, directing your attention to the first subtest, directing your attention to the first, can you describe what that is and how it is administered?
A There is actually a number of subtest. There is one, two, three, four, five, six, seven, eight, nine, ten, eleven of them.
Q Eleven of them, I'm sorry.
A The first subtest is the information subtest, this is essentially a fund of general information test that is sensitive to such things as cultural exposure and formal education.
Q And could you describe how that is administered?
A I simple ask him a series of standardized questions. I note down his response, and then a score is assigned to his responses to whether or not it was correct or incorrect.
Q Any significance to the --
A He's fund of --
Q -- the nature of the responses he made to those questions?
A The fund of information that he offered himself was actually, technically, in the average range for a person of his age and demographics.
There were unusual features to it, for example, on Question 5, he showed some concreteness of thought when asked the question, in what direction does the sun rise, he inquired, he indicated that it depends on where you are living.
When I suggested to him that we should perhaps, just give me the answer where the sun rises and what direction does the sun rises if you happen to be living in Boston, he had what appeared to be a lapse of attention for roughly twenty seconds and then began under his breath saying the sun rises in the sun rises in the, then I suggested that he just go ahead and take a guess, and he declined to take a guess.
He then went on to answer a whole series of questions correctly. When he got to the twenty-seventh question, he showed -- I'm sorry, the twenty-sixth question, he showed what appeared to be a looseness of association. That is, he heard a word and instead of responding to the meaning of the word, he first imposed his own idiosyncratic meaning and then sort of went of on his own tangent.
The particular question asked the
respondent if they can identify what Madame Curie
was famous for, or noted for, and he responded that Madame Curie, this is a quote, "Developed a sauce called a puree sauce. She taught pygmy cannibals in Africa how to puree tomatoes using the technologies of 1812."
Q You mentioned the term looseness of association, what does that specifically mean?
A Looseness of association is a process by which the meaning of information to a person is disorganized because instead of staying within the frame of the meaning, or the frame of the information, they begin to go first from Curie, to puree, to tomatoes and on like that.
Q What's significance does looseness of association have in diagnosing mental illness or in determining psychological status?
A Looseness of association is a disturbance of thought that is characteristic of psychotic processes.
Q Have you finished describing the first subtest, sir?
A Yes I have.
Q Could you go on and describe the rest of the subtests that Mr. Salvi took in any significant responses he gave?
A Yes.
Q If you would, please?
A The second subtest is one called picture completion, this is essentially a test of the ability of an individual to locate relevant visual information.
On this particular subtest, he did quite poorly. In fact, he would have been in less than five percentile for what would be expected of a person of his age and demographics.
During this particular test which involves the showing of cards and asking a person to identify what might be missing in the picture, he did very poorly, getting only the first one.
What was notable on this was his tendency to grimace, his long latencies, that is, periods of silence before responding, and what was also my need to redirect him back to the fact that we at a task together.
Q What is the significance of that?
A The significance of this, as I ultimately came to understand it, was that when Mr. Salvi is given less structured tasks, he has more difficulty keeping himself focused, more difficulty keeping himself on task, and is more likely to be intruded upon by his own idiosyncratic thought processes.
The third one was digit span. This is essentially --
THE COURT: I couldn't hear you, sir.
A I'm sorry Your Honor.
The third test is known as digit span.
THE COURT: Digit span?
A Digit span, D-I-G-I-T span.
This is essentially a test of auditory memory and short term attention in which a person is asked to repeat sequences of numbers, forward and then backwards, and you have a chance to see how focused a person can keep their attention when in this structured test. His performance on that was in the average to low average range.
Q The next subtest, sir?
A Yes sir, the next subtest is the picture arrangement subtest.
This is a subtest in which an individual is asked to take a series of cards and then to organize them into a sequence. It's a test of a person's ability to locate relevant visual information and to use common social events or sequences such as building a house, or somebody going by a house and playing a guitar, to construct the sequence.
Mr. Salvi did extremely poorly on picture arrangement. And he also began at this point to be more guarded, uncooperative, and terse in his language. He also manifested what is sometimes interpreted as possible indications of suspensions or paranoia.
For example, the test instruction tells the recipient of the test that each of the card sets have been mixed up and it is his job to put them into a correct order. Persons who are suspicious or paranoid, as did Mr. Salvi in this case, sometimes begin to believe that the examiner is attempting to trick them and that some of the card sequences are actually in the correct order, and the examiners are simply trying to trick them in some kind of way.
It also, in the content of his responses, one of the things that one does in a good administration with this test is when they line up the cards you ask them to tell you what the sequence is. In his particular case, he became more guarded or he began to offer responses that seemed idiosyncratic to say the least.
For example on the second sequence which is when he began to think that perhaps I was fooling him, this is a sequence of a man and a woman. His response -- he refused to resequence it, being satisfied the way that it was. When I asked him what was going on in the sequence, he simple offered non accomplishment, nothing is getting done, house of fools, and declined to say more.
On another sequence, number four, which is a sequence in which there is two young boys arguing over a comic book, an adult intervenes and then the boys leave and the adult keeps the comic book, that's what the correct sequence would be, he declined to resequence it and began sort of laughing and grimacing at the cards, again, sort of becoming preoccupied with what was happening in front of him, and I had to redirect back to that.
When I asked him to please construct a narrative to the sequence as he saw it, he did something that he frequently does in interviews as well, which is to ask me what I think the sequence is or what I thought about the sequence. When I pressed him on this particular one, and insisted that he give me a response, his responses was greed, selfishness, lack of Christian values.
I asked him could he please give me a narrative with a beginning, middle and an end to the card sequence, and he simple responded greed, selfishness, lack of Christian values.
On the card sequence number six, which is one in which properly sequenced it is of a prisoner escaping, police pursuit, he preferred not to sequence that one either, when I asked him what was happening in the sequence, he said trickery. I said what's happening in this sequence, it's not a pleasant scene, what's happening in the scene I inquired again, trickery.
This sort of intrusion of idiosyncratic thought processes and again the suspicions that the examiner himself was trying to trick him despite the clear instructions to the contrary.
The next subtest is one of vocabulary. This essentially asks for the person to generate definitions to words that start off being fairly common and then get more difficult.
Q Is there anything of significance that you noted with respect to that subtest?
A Yes, the first was that he began -- he also demonstrated looseness of associations, difficulty in maintaining the thought or the test task. He showed internal distraction, and ultimately turned the test from one of defining words to essentially a freedom of association exercise.
For example when asked to define the word terminate, he simple responded, Orkin men, referring to the company that does pest control, and he then returned back to a phrase that he uses at other times when asked to define the word commence, he simple responded, sage, bring me my fool. He had complete --
THE COURT: I didn't hear you.
THE WITNESS: Sage, bring me my fool, was his response to the request to define that.
It was notable that during this particular test or by this time in the testing sequence, his affect, his emotional state was quite flat. I was having to redirect back to the test task, and he seemed to do increasingly poorly at particular on those that are not actively structured by the examiner throughout the entire process.
Q Can you tell the Court what flat affect means for us lay people?
A A flat affect for an individual that you are observing is when they are simply responding in monotone without variation in their particular presentation. Without showing, for example, excitement. In testing, for example, when people are doing better and they no it, or they might start enjoying the task, you seem them brighten and that sort of thing.
His particular presentation of the flatness of this affect, the monotonal quality to him was particularly unusual because of the internal lapses and the occasional odd grimacing with a little short bark of a laugh, and then sort of returning back to the task.
He then performed the block design. This is one in which a person's capacity for visual motor construction. Simply put, the person is asked to take blocks and to match configuration that are cards, on cards. That's often done as a screen for particular kinds of brain damage. His performance there was average and unremarkable.
Arithmetic, his performance was in the low average, to borderline range.
During object assembly, which is another visual motor tasks where a person is essentially asked to put together puzzles, identify what they are, and put them together, he did relatively well. He worked more efficiently.
Although there were times when particularly on the last subtest, the fourth figure rather, of the this subtest, which is a puzzle of an elephant, excuse me, he took a bit longer than he might have and then ultimately made an error in the assemble of this puzzle, seemed sort of distracted.
It was also unusual that he used the piece that people use as the trunk for the elephant and instead placed a penis on the elephant.
The next subtest is the comprehension subtest. This is one of sort of common social reasoning. It asks you things like if you found an envelop that was addressed and had a new on it, what would you do with it, and the like. Notable on this was again he was back into the point where he would only give very brief responses for some things. As we began to get into areas that seemed possible connected to his beliefs, he would say no comment.
Ultimately, and we will get into this in the M.M.P.I., ultimately he and I defined what he was doing when he said no comment, but for example, when asked a question, why might some people prefer to borrow money from a bank then a friend, there was about a fifteen second lapse and he simple said no comment.
Why might the state want people to get a marriage license before getting married, no comment. Why should people pay taxes. Here he became more irritable, it depends on the situation, can you give some examples, who, what, when, where, why, how, it depends on the situation, can you give me an example of when a person should pay taxes, it's a personal preference, and declined to go further.
On the proverbs, well, I'm sorry. Asked the proverb, what might strike while the iron is hot mean? He responded that it meant the pot's calling the kettle black. The next question is why might land in the city be more expensive then land in the country. And here we begin another example of lapse in his thinking style.
Because people are stupid and some people are bright. I asked him how that response was connected to land prices, and he went on to do something that is called alliteration. Some people want cabbage, and others want sprite. If you see your neighbor in the right light, you will begin to pronounce in a joyous delight. If you see abuse and don't see Christian values, then you do not see the difference between a sage and a fool. Again, the intrusion of idiosyncratic content into a relatively neutral question.
Asked the meaning of the proverb, shallow brooks are noisy. He responded, it means it is a good place to get a drink of water. The next question, what might the proverb, one swallow doesn't doesn't make a summer. He interpreted the word swallow in a preservative way, that is to say, he didn't shift from the question about water, and interpret it as birds, one swallow doesn't make a summer, he held it as water, and said, "Don't drink too much water especially if you are in Mexico.
THE COURT: What?
THE WITNESS: Do not drink too much water especially if you are in Mexico.
A This is an example of rigidity of thought, and also being extremely concrete, not seeing this anymore, even as a proverb question.
This subtest ends with a question about why people might believe a free press is important in a democracy, and he became somewhat irritable and said no comment.
The next test is called the digit symbol test. This is one of capacity to sustain concentration, on a more -- when the material is relatively neutral. Essentially you are asked to copy, as rapidly as you can and as accurately as you can, a sequence of geometric figures. His test on this was in the low average to borderline range.
Q And what is the significance of that?
A It was my impression that his thought processes were both concrete and slowed.
Q And when you talk about concrete thought processes, could you explain what you mean by concrete?
A Yes, someone who, for example, has difficulty in interpreting things that may be metaphorical or maybe suggestive of other areas of information. A good example of that is someone, as he did, who can't respond to a proverb question as a proverb. He doesn't see that the proverb is a metaphor for something else.
There was also a clinical example of that, that I thought was a good one. When Dr. Schouten and I saw Mr. Salvi this past Sunday, he found it extremely difficult to respond to our question of what you might do if you thought a witness on the stand was lying, and Dr. Schouten's testimony may go into the significance of that more in detail.
It took us about thirty minutes to try -- Mr. Salvi's response was well, that isn't happening yet, so I can't possible know what I would do. We asked, would you tell your attorney if you thought, well it hasn't happened yet. This is a characteristic of his thought, that he has difficulty anticipating alternative scenarios.
Finally, Dr. Schouten happened on the idea, he asked Mr. Salvi if he ever brushed his teeth, Mr. Salvi said that he did. How often do you brush your teeth? Once. When do you brush your teeth? In the evening. Well, do you think you are going to brush your teeth tonight? I don't know it is not night yet. Do you think you will probably brush your teeth? Yes, I will probably brush my teeth.
Do you think you will probably be able to tell your attorney if somebody was lying on the stand? He gave that some thought, and said, he probably might be able to do that. This is an example of somebody being so concrete that you may be able eventually to get to the information that you want, but it requires trying to think as literally as they do, and finding an avenue of inquiry.
So, in that particular case, would you tell your attorney if you thought somebody was lying on the stand, it took us almost a half a hour to get a meaningful response, he probably would.
The next subtest, and the last one on the Wais's, is the similarity subtest.
This is one that looks more explicitly at abstract thought, and essentially what happens is people are asked to give a similarity between two things. For example the first one, the first and easiest question is, what's similarity might there be between orange and banana? He chose no comment on that question. What it showed here was as the abstractions became more difficult, he became more idiosyncratic.
For example, he was able to identify that eyes and ears are both senses, when asked how button and zipper might be alike, he responded they keep it together, which is true, but not necessarily the most precise or highest quality response.
How are north and west alike? Rather than responding that they are directions, he responded that they are positive and negative. How are an egg and a seed alike? And here begins, they become more intruded upon by his thought processes, which came first, the chicken or the egg? What's the similarity? I have no comment.
By the time we began asking him more complicated ones, he is either saying no comment, giving one word responses, and refusing to elaborate them, or giving responses that are simple, I didn't understand at all. For example, what similarity might exist between fly and tree? And the response was Country Time lemonade.
The general pattern of the testing, when scored, yielded a full scale I.Q. score of 75, which, in my impression, under estimates his actual intellectual capacities, but the general pattern of testing did reflect that his ability to do higher order thinking or abstract thinking was, at least at times, intruded upon by his own disturbances of thought. Particularly the closer the questions or material came to themes that seem to be of great concern to him, like banking, and money, and the like.
Q You indicate that this -- you indicated that this concreteness in thinking, has some effect on individual's whole psychological makeup, is that right?
A Yes sir.
Q Does it limit there abilities in certain areas?
A Yes sir.
Q And what kind of functional limits does it cause with respect to their abilities?
A It impairs their ability to assess their situation in the ways that other people might assess the situation.
It also impairs their ability to communicate effectively with people who not similarly impaired by concrete thinking. And it also impairs their ability to adequately consider hypotheses or alternative consequences to events.
Q You also indicated that this 75 I.Q., if you will, under estimated his intellectual capacities, is that correct?
A Yes sir.
Q Can you tell me sir whether or not you had any impression that Mr. Salvi was attempting to manipulate the test so as to get a low result, in other words, whether there was any malingering?
A I had the opportunity to form that impression. My impression was that he was not malingering in order to get a low result for two reasons. The first is that his pattern of malingering is, if that's what he was trying to do, is not of the sorts that you commonly see on this particular test.
The second was that I was aware that Mr. Salvi believes himself to be competent and wishes to proceed to a trial, and that in order -- that to malinger, being thought disordered and cognitively limited was likely to fly in the face of his stated intention to proceed to trial.
Q Does that conclude the Wechsler?
A Yes.
Q What was the next test that you gave Mr. Salvi that day?
A The next test that I administered to Mr. Salvi was the Rorschach Examination.
Q Can you tell us what that is?
A I'm sorry, let me correct myself, was the M.M.P.I.
Q And what is M.M.P.I. stand for?
A That's the Minnesota Multiphasic Personality Inventory.
Q What kind of a test is that?
A That is a self report test. There are over 500 questions, a person reads the statement, for example, the first one I enjoy reading mechanics magazines, if it's true or mostly true about themselves, they acknowledge it as being true, and if false, they acknowledge it as being false. There are over 500 questions, and they cover a variety of different kinds of experiences, interests, symptoms, and the like.
Q And what is this test used to do?
A It is usually used as a way of generating clinical hypothesis about a person, their diagnosis, the way in which they experience the world and are likely to respond to events in the world.
Q Is this an objective test in a sense?
A Yes it is. It's a well validated statistical test in which the individual's responses are statistically compared to the research and control samples taken from the general population, clinical populations and so forth. There is actually computer programs that can do the scoring and so forth on this statistical basis.
Q Would you describe to us your experience in giving that test to Mr. Salvi?
A Yes, I was actually hoping to get from Mr. Salvi a valid M.M.P.I. profile because they are --
THE COURT: I didn't hear you sir.
A I'm sorry, I was hoping to get from Mr. Salvi a valid M.M.P.I. profile because there are indicators in the instrument by which the computer can detect the likelihood that somebody is either attempting to what's call fake bad, that is make themselves look more disturb than they might actually be, or fake good, which is to look less disturb than they might actually be.
Unfortunately Mr. Salvi did not give a valid profile, so it could not be scored in that way, but he did something that was extremely interesting that I just hadn't seen before.
First of all, and this is actually fairly common, he worked relatively quickly at first and then sort of slowed down. And then he began to slow down to the point where I began to feel that this was going to take a very, very long time, and then I noticed that he was responding to some, not to others.
If you have fewer than a certain number of responses, then the entire test is invalid, when I asked him what this might -- what was he declining to respond and the like, he made an interesting distinction for me. There were some questions that he was not able to respond to because he felt fifty percent of the way sometimes and fifty percent of the way the other times, and so therefore was unable to make a decision as to whether or not the statement be true or false about him.
He distinguished those from what he called his no comment responses. The no comment responses were ones which were deemed by him to be so incredible private or legally sensitive that he was unwilling to make any kind of indication one way or another on the testing. Although he might be willing to discuss them with defense counsel.
When I asked him how he would decide whether or not to discuss them with defense counsel, he was unable to articulate for me a rationale as to what he would choose and or not choose to share with defense counsel.
What was unusual was not just that he made this fine grain distinction which I never seen somebody do before, and we actually worked out a system where I could subsequently see which ones were the answered one, the unable to answer one, and the no comment ones. But what was interesting were, was the content of some of those that he deemed to sensitive to respond to.
Q Before we get into that Doctor, approximately what percentage of the test, or how many questions did he decline to answer for one of those two reasons?
A I'm not sure I know the answer to that question. I could probably look at it and take a guess, but once he went past the technical line for invalidating, I didn't access it any further.
Q Was it a significant number of them?
A Yes it was, a large number of them.
Q What of significance did you see in the questions that he made the no comment response too?
A Well, let me give you some example perhaps. Amongst the ones that were deemed too sensitive to response to on the test were things like, I would like to be a florist. I am almost never bothered by pains over my heart or in my chest. I am an important person. I think I would like the kind of work a forest ranger does. I know who is responsible for most of my troubles.
My conduct is largely controlled by the behavior of those around me. I believe I am being plotted against. The top of my head sometimes feel tender. I believe I am being followed. Sometimes -- I'm sorry. I have had blank spells in which my activities were interrupted and I did not know what was going on around me. Peculiar odors come to me at times.
Now, in looking at the pattern of these responses, some of them appear to be related to areas which he has over time shown a reluctance to discuss, even with his attorneys. These include things like his religious or political beliefs, his family, and the like. Areas about which he is more sensitive.
Some of them were deferrals of potentially significant clinical questions, for example, some of those having to do with possible paranoid experiences like believes is being plotted against, believes he is followed, believes there conspiracies, believes that his behavior is being controlled by others.
Q Now those questions he declined to answer, is that correct?
A Yes.
Q Are you familiar with individuals who attempt to fain mental illness on such a test?
A People who fain mental illness, yes.
Q Are those the kind of questions that they would not answer?
A If you were attempting to fain mental illness, those are the kinds of questions that you would fill in because some of them are more likely, even to a lay person, to represent unusual experiences.
In fact, the pattern of responding to particular kinds of questions, is one of the things that tips the statistical analysis off as to whether or not you have somebody who is faking bad, trying to look bad. And some of those are questions on it.
Q Were there some additional examples that you noticed?
A I like collecting flowers or growing house plants is one that I couldn't understand what the potential sensitivity to that would be. Ones about smelling unusual odors, that's a potentially a symptom of neurologic illness, particularly temple lobe epilepsy. Blank spells, temple lope epilepsy or other kinds of disturbances.
I was also, I mean, there are many, many, of these. But I also found some to which he offered responses that I found interesting, and was later able to follow up on. For example, on Question 198, I often hear voices without knowing where they come from, to which he responded true. I found that interesting because of his frequent denials of auditory hallucinations.
When I saw Mr. Salvi this past Sunday, I brought this one to his attention, and he did something that he frequently does, I've talked with him enough that I am beginning to understand a little bit about how he thinks.
When we inquired as to why he answered true to that statement, he indicated that he didn't have a complete -- I don't have a complete recollection of ever hearing voices, was his response. I then, do you have any incomplete recollections of hearing voices where you don't know where they come from and he was more equivocal on that. Well, if perhaps I have, but if I have they are very rare occasions, but they have happened.
And then he did what he often does, well, I am not going to acknowledge that I have. I then directly asked him are you going to deny that you have, and he sort of backed off and said well, I won't deny it either, I will neither confer or deny. But I think that is a good example where it takes a while to understand the total logic of Mr. Salvi. When he says he doesn't have a complete recollection, it doesn't necessarily mean no, it means you have to inquire further about the experiences.
Q Is there anything further that you wish to add specifically about the test answers?
A Not at this juncture.
Q You indicated that you were not able to score the test in a conventional way, is that correct, that is, it was an invalid test?
A It was an invalid test because of the large number of answers that he left unanswered in terms of true, false.
Q Were you able to draw any conclusions about Mr. Salvi's psychological makeup from the way he took that test?
A There were two dimensions to that, one of them way, again, the behavior, this is a test that takes a rather long time to administer, and once you give the person their answer sheet and the pencil, they are pretty much left to their own devices.
I had noticed Mr. Salvi with lapses of attention during the more structured test, so I positioned myself as he took the examination, so that I could observe him but not directly. I put myself at a 45 degree angle to him so that I could watch his reflection in the detain area door which is a glass door.
I noticed that Mr. Salvi had periods during the testing, sometimes, I wasn't even sure that they were lapses, very brief, five or ten seconds, some of them for periods that extended over thirty seconds, in which when he returned his attention to the testing, sort of gave a little grimace, or gave a sort of a start, and then sort of return himself back to the task.
This made me wondered whether or not he was being distracted by internal stimuli. Internal experiences to which I could not observe externally. This was a potential significance because this sometimes occurs with psychotic individuals where their attention to the outside world is impaired by internal stimuli. So I noted that as part of my observations.
The other was that in terms of the idiosyncracies of thought processes and the like, and given that he had made it very, very clear that the no comment responses were ones that he simple deemed too private or too sensitive, and that he might be able to articulate these to his attorney, might be able to discuss these with his attorneys, although he couldn't articulate how he would decide whether or not to, I found it extremely difficult to understand whether, how experiences like I would like to be a florist, or the top of my head is sometimes sensitive could be central to this case.
Q After you completed the M.M.P.I., what was the next test you administered?
A I administered the Rorschach Psycho Diagnostic Cards.
Q What kind of a test is that?
A This is in a layman's parlance, this is the ink blots. The ink blots is a -- it's a deck of ten cards which have ink blots on them, some of them black and white only, some of them with colors.
In recent years, it has gone from being primarily a test where the clinician would look at the pattern of responses, quality of responses, and make a clinical, individual clinical judgment about the meeting to one in which there is now also a statistical analysis of patterns, responses.
Unfortunately on this one, Mr. Salvi also did not give me a valid response that could be scored.
Q Is this the kind of test that is termed to be a projective test?
A Yes it is.
Q And what does that mean?
A Projective test is one in which you give the test taker an ambiguous stimulus and then you note how they respond back to it. And its the content of that response, the quality of how they form it, whether or not they go on to associate to other things, and the like, that is subject to the scoring system.
One of the things it does, it tells, for example, whether, cognitive processing, do people tend to focus on a detail and then expand to there? Do they tend to see the big picture? Do they tend to over focus? Do they tend to have their cognitive processes interfered with by emotional states and processes? That kind of information.
Q Were you able to get a valid test from Mr. Salvi?
A No.
Q Would you describe the testing process of why you weren't able to get a result that you could score?
A The administration is pretty straight forward. You simple take the cards, there are ten of them, one at a time, and present them before the test subject and then you have given them instructions to please indicate what the cards might remind them of or indicate to them, and then you score those, you write those down and later score those responses.
There is also a time in the testing called inquiry where you try and make certain that you understand how the person developed their response.
In Mr. Salvi's particular case, he did something that has been observed before, there is some discussion of it amongst people who give Rorschach, he simple gave a single response to card number one, he said art. And when asked to say more, no comment. Art, no comment. I gave him the instruction that persons often see more than one thing in a card, no comment.
He then gave the same comment, art, art, art, art, art refusing to comment on each of the remaining cards.
Q You've seen that before, sir?
A Yes, I have seen that before.
Q And is that of some significance in your evaluation of Mr. Salvi?
A Yes it is.
Q Could you tell us what the significance is and why?
A You most commonly see this in individuals who are either flatly attempting not to take the test, and they are attempting to avoid it by being uncooperative. You see it in people who are guarded, and who are trying to reveal as little information as possible, but without being obviously cooperative -- uncooperative.
You also see it sometimes in people who have concrete thought processes. It's called perseveration, they see the same thing on every card, and aren't able to shift set from card to card to card to card.
There is also some discussion that you see this in individuals who understanding or experiencing the ambiguity of the card and feeling threaten by the disclosure of their association to this ambiguous material, actually respond in a pattern that is defensive but unconscious as opposed to somebody who is deliberately trying to be uncooperative. It's a way of defending themselves from their own experience of being disorganized by being subjected to this test. You do sometimes see that in persons with psychosis.
In fact, there are times when you administer this test to people who have active psychosis and they become visible disorganized during the course of the procedure itself.
Q Those were the three test you administered to Mr. Salvi?
A Yes sir.
Q Now, you indicated that you were aware that subsequently Dr. DiCataldo down at Bridgewater State Hospital administered psychological test to Mr. Salvi, is that correct?
A Yes sir.
Q You've been provided with the results and a narrative description of those tests?
A Yes sir.
Q Can you tell us sir, how his testing compares to your's of Mr. Salvi?
A He didn't give the Wechsler, that's probably because the Wechsler instructions indicate that it shouldn't be repeated with some months or a year in order to avoid getting things like a practice effect. But he did readminister the M.M.P.I. and the Rorschach.
The finding of Dr. DiCataldo's testing in which he characterized the defendant as having rigid and concrete thinking and also some looseness of associations but without evidence on the testing itself of a severe psychosis. That was his term I believe, severe psychosis. It's essentially the same as my findings. I substantially concur with his testing results. He saw what I saw in other words.
Q Having in mind Dr. DiCataldo's testing results, your testing results, and your observation of Mr. Salvi. during the administration of those tests, can you tell us what in combination, the psychological tests tell us about Mr. Salvi's thinking process and his level of mental functioning?
A His thinking processes are rigid, that is to say he has difficulty both shifting set and perceiving information the way that other persons may perceive it. They are concrete, at least at times, that limit his ability to consider hypothetical or alternative courses of action.
They are, the thought processes are intruded upon at least at times by idiosyncratic material. There are indications on the testing of looseness of associations and these kinds of intrusions such that his, what I would presume to be his pre-morbid or his base line level of thinking, capacity for thought, is impaired by his psychological functioning at this time.
Q How is that of significance to a determination of competency, sir?
A It means that Mr. Salvi has important impairments in his ability to consider information and make judgments.
This is complicated also by what appears to be experiences which limit his ability to consider himself in -- I'm sorry, would you reask the question. I'm sorry I lost my train of thought.
Q Sure. How do the testing results that you observed and taking into consideration Dr. DiCataldo's also, assist us in coming to some conclusion about competence?
In other words, what part did they play in the overall assessment of competency?
A They help to understand what the thought processes would be and help us understand where their might be impairments in his ability to cooperate with counsel or understand the proceedings against him, as a result of his impaired emotional and cognitive functioning.
These would include such things as his concreteness of thought. For example, insisting to interviewers that has already answered their questions when in fact, he has not. Insisting that he has already provided information to his defense counsel that is meaningful to them when in fact, he has not.
He also is intruded upon by idiosyncratic thought processes that brings his own individual material even into more neutral kinds of questions.
It also indicates that he is more likely to be impaired in his capacity for reasoning and judgment in what we would call relatively unstructured settings, that is times when people are not actively working to structure his thinking limit, his thinking.
This may be a problem because if you are asking someone to make rational decisions, but you have to structure the thought process for them, it is often difficult to tell whether you are doing the thinking for them, or they are doing the thinking for themselves.
Q Are these psychological tests also used in considerations of possible diagnosis?
A Yes they are.
Q And given the tests that you administered and your observations of Mr. Salvi during the test, did you come to some preliminary conclusions about what diagnosis are suggested by the test results?
A Yes I did.
Q Can you tell us what those were please?
A The diagnosis, the testing results would be primarily consistent with a range of diagnosis, having to do with odd idiosyncratic and potentially psychotic emotional and cognitive functioning that in its attenuated form, or its lesser form, might look like schizotypal personality of the sort diagnosed by Bridgewater State Hospital, but would also be consistent with a schizophrenia, particularly if it was schizophrenia that has not yet become chronic.
That is to say, somebody who has not been impaired over a long period of time by their mental illness.
Q Now sir, you were acting principle to perform these tests, is that correct, and to provide these results to Dr. Schouten?
A Yes, I was engaged to do the testing, and I also attended the interviews in order to have first hand observations in order to try and confer with Dr. Schouten, but also to make observations that might be relevant to how the testing results applied in his presentation during clinical interviews.
Q By the way sir, were the results that you got from the testing, consistent with or inconsistent with what you observed on the two occasions that you visited Mr. Salvi?
A They were consistent with what I observed in interacting with Mr. Salvi. They were also consistent with reports that I had received from defense counsel about the nature and quality of interactions with them.
Q Now sir, were you provided, as others were, with the complete history with respect to this case and the background information and interviews pertaining to Mr. Salvi?
A No, I was not.
Q And were you able, without those, to render a final opinion with respect to competence?
A A final opinion with respect to competency, I would defer until I have the full record in order to do that. I would not be able to render a final and competent opinion in the absence of that information, although I, in giving as fair a reading as I can to the information that I have heard, my inclination at this point would be it indicates there are important, significant questions, regarding his competence.
Q And did you prepare a written report with respect to your findings in connection with this case?
A Yes I did.
Q I will show this document and ask you if you recognize it?
A Yes sir, I do.
Q What is it?
A This is the report, actually a letter, more technically a letter submitted to attorneys Carney and Bassil on April 15, 1995, from myself to them.
MR. LaCHANCE: Your Honor, I would offer that report.
MR. KIVLAN: We have seen that report Your Honor, but I would just like an opportunity to read it again if I could?
THE COURT: Yes. Read it now sir?
MR. KIVLAN: I would like to, Your Honor.
THE COURT: Before it's offered, before I label it, is that the --
MR. LaCHANCE: Yes, could I Your Honor?
THE COURT: Yes. Do you need to use it further in your examination, sir?
MR. LaCHANCE: No. I am almost through Judge. I was just going to mark his C.V.
Q I show you this document and ask you if you recognize that, sir?
A Yes I do.
Q And what is that?
A It's a copy of my curriculum vitae --
THE COURT: One minute.
A It's a copy of my curriculum vitae.
MR. LaCHANCE: I'd offer that as well, Your Honor.
MR. KIVLAN: We have no objection to either one, Your Honor.
MR. LaCHANCE: I have no further questions.
THE COURT: That would be 9 and 10, I think.
THE CLERK: I think it would be 11 and 12, Your Honor.
THE COURT: Yes.

(Exhibit Number 11, Letter, Marked and Received into Evidence)

(Exhibit Number 12, Curriculum Vitae, Marked and Received into Evidence)

THE CLERK: The letter dated April 15, 1995 is Exhibit 11, and the curriculum vitae is Exhibit 12.
THE COURT: Thank you.
THE CLERK: So marked.
MS. HINKLE: Should I proceed, Your Honor?
THE COURT: Yes. We will only have a few minutes, but I guess we can get started.

CROSS-EXAMINATION
Ms. Hinkle
Q The first question I have for you Doctor is, do you have notes of your interviews with Mr. Salvi, when you saw him with Dr. Schouten?
A Yes I do.
Q And did you prepare a report based on those interviews?
A Primarily on the testing. The last interview was on Sunday, so I did not prepare a report on that, based on that.
Q You were present during an interview, I think you said on February 23rd with Dr. Schouten?
A Yes.
Q And also an interview on July 23rd?
A Yes.
Q And you also have the raw test results that you were just reading from regarding the battery of psychological testing you gave to Mr. Salvi?
A Yes I do.
Q And do you have that raw data with you currently?
A Yes I do.
MS. HINKLE: Your Honor, I'd ask that a copy of the both sets of Dr. Kinschereff's notes and the raw psychological data, that copies are made available so we can examine them?
THE COURT: Yes, during our lunch break. Sir, you have them close to you at this point, please provide them.
Q Are those all your notes from both of the interviews you participated in, Doctor?
A Yes it does.
Q Now, you've indicated Doctor, that you were a designated forensic evaluator?
A Yes.
Q And you have been so designated since 1994?
A 1993.
Q 1993, and before 1993, any evaluation you did, therefore, would have been supervised?
A No.
Q Well, did you indicate in your direct testimony that before 1993, you had conducted supervised evaluations only?
A Supervised -- I'm sorry let me be clear. Designated forensic psychologist is a designation that allows persons to specifically conduct court ordered evaluation under Chapter 123 and specifically Section 15, the preliminary competency and criminal responsibility 15 B, the full evaluation under forensic commitment, and 15 E, aid and deposition evaluations.
At that time, there was a policy change. I had been conducting forensic evaluations, primarily under court orders, since 1984, not -- the vast majority which were not supervised.
THE COURT: Sir, I didn't hear your last statement.
THE WITNESS: Since 1984, the vast majority which were not supervised.
Q Well, you were designated to be an examiner in 1993?
A Correct.
Q Is that correct?
So it is from 1993 forward that with the designated forensic examiner, you could conduct a competency examination?
A I had conducted some competency evaluations prior to that time, there was not yet the policy inside of the Department of Mental Health or the funding to create the designated forensic psychologist program that was anticipated by the legislature and Department of Mental Health.
Q If you could try just to answer the questions I ask you, Doctor.
From 1993 forward is the only time you conducted competency examinations as a designated forensic examiner?
A As a designated forensic examiner, yes.
Q And you indicated that in fact, you've completed one to four competency examinations in the year 1994?
A Each year.
Q Right, so in the year 1994, you did somewhere between one and four?
A Yes.
Q What was it, was it one or was it four?
A My recollection is, it was four.
Q In 1994?
A Right, but I do have a lot of cases, and I am sometimes not sure --
THE COURT: Sir, you are dropping your voice at times, and I can't hear you.
THE WITNESS: I apologize Your Honor. I won't let it happen again.
Q You testified under direct examination that in 1994, that you conducted somewhere between one and four competency examinations, no more than four?
A No more than four.
Q And you said therefore, in 1995, you also conducted somewhere between one and four competency examinations?
A Yes.
Q Have many have you done in 1995, until today?
A My recollection is that it is two.
Q Two, so in 1994, you conducted four, and you believe in 1995, so far this year, you've done two competency examinations?
A Correct.
Q Now, you also indicated that you are a Designated Forensic Supervisor, is that right?
A That's correct.
Q And when -- and you received that designation in 1994?
A Yes.
Q That is last year?
A Yes.
Q When during the year, do you recall?
A I believe it was in the spring.
Q And as a result of that designation, you are then able to supervise the work of other examiners, is that right?
A Correct.
Q So for approximately a year, you had that ability?
A Correct.
Q And how many people have you supervised who themselves, now become supervisors?
A Who have now themselves become supervisors?
Q Yes.
A None that have become supervisors.
Q How many people have you supervised who have now become Designated Forensic Examiners?
A Two.
Q Two individuals?
A Yes.
Q Now, you indicated when you set out your experience that you are involved with the Law and Psychiatry Program at Mass General Hospital?
A Yes.
Q And you were contacted by Dr. Schouten, I believe you indicated, to become involved in this case?
A Yes.
Q And it is your understanding that Dr. Schouten had been contacted by Mr. Carney and Ms.Bassil?
A Yes.
Q And when contacted, your services were asked for by Dr. Schouten and then inferentially by Mr. Carney and Ms. Bassil?
A Yes.
Q And that separate from your work at Mass. General Hospital?
A No.
Q Well, Mass. General Hospital wasn't contracted?
A The Law and Psychiatry Service of Mass. General Hospital was contracted.
Q Now, when you conduct these interviews, you conducted them with Dr. Schouten?
A Yes I did.
Q And when you became a Designated Forensic Supervisor, did you have a supervisor?
A No.
Q You didn't have one?
A No, at the time, I didn't.
Q You didn't need one at the time?
A That's the feeling, once you begin to get that degree of familiarity with the process, that your own work does not need to be routinely supervised.
Q Well, in order to become a Designated Forensic Examiner, do you need a supervisor?
A Yes.
Q And who was that supervisor?
A Dr. Richard Barnum.
Q Now when you conducted the psychological testing, you indicated you did that on February 13th, of 1995?
A Yes.
Q And you conducted, which examination first?
A The psychological testing.
Q But which of the psychological test did you do first?
A The Wechsler.
Q And then you did the M.M.P.I.?
A Yes, I believe so.
Q And you did the Rorschach?
A I believe so.
Q And how long did it take for Mr. Salvi to finish the Wechsler I.Q. Test?
A I believe it was about 90 minutes.
Q So about a hour and a half, is that right?
A Yes.
Q And how long did it take for Mr. Salvi to finish the M.M.P.I.?
A About another two hours.
Q And how long did it take Mr. Salvi to do the Rorschach?
A Ten minutes.
Q And is the Rorschach include the T.A.T. Ap Perception Test?
A No, that's a separate instrument.
Q Did you do that for Mr. Salvi also?
A No, I did not.
Q You did not. And did you do all of those tests on the same day?
A Yes I did.
Q Doctor, within the profession of psychology, testing is a useful addition or useful part of an examination, is that right?
A Yes it is.
Q But one would not render a diagnosis based solely on psychological tests?
A That would be the best practice.
Q To not render a diagnosis based solely on psychological test?
A Correct.
Q Now, you indicated that during your examinations, the statements that you made were that Mr. Salvi in your opinion seemed to lose touch, you had to bring him back to the task?
A Yes.
Q The observations that you made, Doctor, were that Mr. Salvi stared for some thirty seconds or so sometimes?
A Sometimes, sometimes more briefly, sometimes longer.
Q Sometimes it was five or ten seconds?
A Yes.
Q Sometimes it was a little longer than thirty seconds?
A Yes.
Q And other times he concentrated on those test and moved along and answered them?
A Yes.
Q And when you brought his attention back, he refocused, and he continued on with the task?
A Yes.
Q And did this happen on a number of occasions?
A It happened throughout the testing process, yes.
Q Occasionally throughout the testing process?
A Yes.
Q And you said Mr. Salvi, can you go back to the task or whatever and he would?
A Yes.
Q And this test, you finished one and go onto the other and then go on to the other one?
A Yes.
Q And altogether those test, therefore, you were having Mr. Salvi do tests for a little over three and a half hours?
A Yes.
Q Now, have you had an opportunity to review the Bridgewater records?
A Not the records themselves, no.
Q Did you read the report that Dr. Haycock issued?
A Yes I did.
Q Both the May 8th and the May 26th reports?
A Yes I did.
Q But you didn't have an opportunity to look at the Bridgewater Records of Mr. Salvi's observation while he was there for sixty days?
A No.
Q Well, if you were going to make a diagnosis of someone and you knew that they had spent sixty days right around the time that you first -- in between the times that you saw him, do you think it would be relevant to have looked at the Bridgewater records for the time they were there?
A It certainly could be.
Q Well, in fact, in order for you to render a diagnosis, if you were doing a full evaluation, you would to see those records, wouldn't you?
A Not necessarily. I can imagine circumstances under which I would have enough information to render a diagnosis without seeing that particular piece of information.
Q Doctor, if you knew that a person you were trying to examine had been observed by clinical staff over almost sixty days on a daily basis, in fact, hourly basis, are you testifying that you don't think that would be relevant for you to look at to make a diagnosis of the person?
MR. LaCHANCE: Objection.
THE COURT: Overruled.
A It would be relevant, potentially, but not necessarily critical.
Q So that the information that was contained in that, you would not feel was -- I will use your word, critical to know what evaluations and observations were made over sixty days, twenty-four hours a day of a person you were going to evaluate during the time period in which you were evaluating them?
A It would be potentially relevant, yes.
Q In fact, it could be highly relevant?
A Absolutely yes.
Q You might see observations that other clinicians made that could be very important to you in making your evaluation?
A Yes.
Q In fact, you might suggest that Bridgewater look for certain things in fact, and then wonder to see if in fact they found them in their report?
A Yes.
THE COURT: Attorney Hinkle, we'll have to stop here for lunch.
THE CLERK: The notes and test results have been marked C for Identification.
THE COURT: Thank you.
(Identification C, Notes and test results, marked)

(RECESS)

CONTINUED CROSS-EXAMINATION
Ms. Hinkle
Q Now Doctor, you indicated that you did not have Grand Jury minutes regarding this case, is that right?
A That's correct.
Q And do I take it, that you also did not have police reports?
A That's correct.
Q Or any witness statements or summaries or anything like that?
A That's correct.
Q Now when you were evaluating -- when one evaluates the I.Q., the Wechsler, that's also called a Wais, is it also called a Wais?
A Yes.
Q When one evaluates that Wais Test, if a person doesn't answer your questions, they lose points for that?
A Correct.
Q And if they don't answer questions within a certain period of time, they lose points, is that right?
A It depends on the test, but there are some of the subtests, yes.
Q And so someone who doesn't cooperate with the test for example, loses points?
A They certainly could.
Q Well, because if you don't answer certain questions, you lose points?
A If you don't answer the questions at all, you would lose points, yes.
Q And on certain parts of test, if you don't answer them within certain pre-prescribed periods you loose points?
A Yes, that's true.
Q So a person not cooperating gets a lower score than they might get if they fully cooperate?
A Yes, that's true.
Q Now, when you were evaluating your reasons, for example, on the tennis racket, did you include as a possible reason that Mr. Salvi didn't want to cooperate?
A Yes I did.
Q And that he said hair color instead of the missing tennis racket because he was being flip for example?
A Yes I did.
Q And that's as option that's available to people on these test as well?
A Yes.
Q Along with sarcasm?
A Yes.
Q Along with humor?
A Yes.
Q Along with thinking that the test is silly and so giving intentional silly responses?
A Yes.
Q Those are all possible options that people can choose when they are doing this test?
A Yes.
Q Now, you said you found on some of the tests, I think you specifically noted on the digit span and a few other test, that Mr. Salvi cooperated?
A (No Verbal Response)
Q He answered all the questions?
A Yes.
Q And in fact, he did in the average range?
A On some of them, yes.
Q Well, particularly on the digit span test, you said he got average results, is that right?
A Yes.
Q And I believe you said that what that tests for, is memory and concentration?
A Short term auditory memory and short term attention, yes.
Q Memory and attention?
A Yes.
Q And the ability to concentrate on something?
A Usually concentration, it refers to a more extended task, but in a lay person's term, yes, concentration.
Q And he got an average result on that test?
A Yes he did.
Q And he did, it appeared to you anyway, to have some ability for auditory memory as you described it?
A Yes.
Q And for short term memory?
A Yes.
Q Now, you said that at some point as you went through these tests, that Mr. Salvi became more guarded, more uncooperative?
A Yes.
Q Less willing to respond to some of the questions you were asking?
A Yes.
Q Now, throughout this test process Doctor, Mr. Salvi chose to answer some questions?
A Yes.
Q And did answer some questions?
A Yes.
Q And he chose not to answer other questions?
A Yes.
Q And didn't answer them?
A Correct.
Q And sometimes you would ask him a number of times the same question, and he still if he chose not to, he didn't answer?
A Correct.
Q Now other kinds of questions, for example, the terminate -- you mentioned that when you asked Mr. Salvi how he would define the word terminate, he gave you an answer Orkin man, is that right?
A Yes.
Q Now, someone who is being flip or sarcastic might say terminate sounds like Terminex, Orkin man, is that fair to say?
A Yes.
Q So again, flippancy, sarcasm, being silly, intentionally giving silly answers because one might think the test was silly is an option available to people on these tests?
A Yes.
Q And in fact it is something you see at times when people take this test?
A Yes I do.
Q Now you also talk about some other tests, the block design test, the arithmetic test, and Mr. Salvi got average scores on those test?
A Yes.
Q And those are neutral sort of test, is that fair to say, as opposed to requiring someone to engage more abstractly?
A Or thinking of a different kind, visual motor thinking as opposed to verbal thinking, yes.
Q Well that test requires concentration, the block design test?
A Yes.
Q And attention?
A Yes.
Q And you have to actually replicate patterns that you see in one place to another place, is that right?
A Yes.
Q And Mr. Salvi did that and got an average result?
A Yes.
Q And the arithmetic, you said that in the arithmetic test he got a low average score to borderline test?
A Yes.
Q And for someone who actually said that math wasn't one of their strength, that wouldn't be a surprising result would it?
A No.
Q Now you testified on direct, I believe, or in one of my early questions, that you did not give a T.A.T. test, but in fact you did, didn't you to Mr. Salvi?
A No, I did not.
Q You did not?
A No.
Q Do you have your test results with you?
A I'm sorry, I do, I did administer that test.
Q You did do a T.A.T. test?
A Yes I did.
Q Now, the T.A.T. test and the Rorschach Test, you said basically you got answers that meant you couldn't score it?
A There is no scoring system for the T.A.T. but --
Q Well, not valid responses?
A Correct.
Q And on the Rorschach Test, you said that was because he said art to every single card?
A Yes.
Q Art, art, art, art, art, every time you would hold up a card, he responded the same way?
A Yes.
Q And again the sarcasm, flippancy, thinking the test is silly, not wanting to give more involved answers, because one is bored, tired, tired of talking to you, those are all valid options available to those taking this test?
A Those are valid hypothesis for this.
THE COURT: Louder sir.
A Those are valid hypothesis for the performance, yes.
Q And again answers that I am sure you have seen similar kinds of things that someone that doesn't want to answer questions, just gives you one answer over and over, I see frogs, or I see just ink blots?
A Yes.
Q Does the thing about some of those test, Doctor, is that they appear, to the person who is taking the test, that you are trying to get into their mind, isn't that right?
A Yes.
Q Trying sort of, trying to see what they are thinking about?
A Yes.
Q And if a person doesn't want to share that, then they may well observe that and therefore give some simple answers?
A Yes, you most often see that in paranoia, for example.
Q Well, you interpret it as paranoia Doctor, but if I were bored by a test that you were giving me, if I didn't want to talk to you anymore, and you were showing me cards that had different patterns on them, I could shorten that test by responding art to each one of those answers, couldn't I?
A You certainly could, yes.
Q And in fact, I could shorten all of those abstract tests by giving you short quick answers because I wanted to stop this and I was tired of it?
A You could, yes.
Q And if I didn't want to cooperate with the test, because I chose not to answer them, I could give those responses?
A Yes that's true.
Q Did you consider in evaluating these test results that some of these responses of Mr. Salvi's could have been humorous?
A Yes I did.
Q Country Time lemonade for example, Orkin man, the chicken or the egg, which come first?
A Yes.
Q And you have not been to review Dr. Resnick's tape, is that right?
A I'm sorry?
Q Did you have an opportunity to review Dr. Resnick's interview from January?
A Some portions of it, yes.
Q You never saw the whole tape?
A Not the whole tape.
Q Have you seen the entire transcript?
A No.
Q You never have?
A No.
Q Did you see those portions before you did the testing or after?
A Before.
Q Before. What portions of it did you see?
A I saw some portions in which the defendant was discussing some of his political beliefs. I saw a portion, which was played here also, where Mr. Salvi was resisting Dr. Resnick's attempt to return him back to a particular topic.
Q Did you see two excerpts, Doctor?
A It would be hard for me to say how many that I saw. I essentially had it on my home recorder, and went through. I had the tape the evening before.
Q Well, did you have the entire tape and you only saw certain parts or were you given a part that only had excerpts?
A I had the entire tape.
Q You had the entire tape, but you didn't view the entire tape?
A No.
Q And you haven't view it up until today?
A But for what was shown in court yesterday when I was here.
Q Well, did you see -- did you see the tape that went on at some length where Mr. Salvi at times gives, appears to be dueling with Dr. Resnick?
A Yes.
Q Did you see that part before you did your test?
A My recollection is that I did, yes.
Q That you did?
A Yes.
Q And one of things that someone could do with these test results is a similar kind of thing, just dueling or not answering things that one doesn't want to answer?
A Correct.
Q Now, you said you did not review the Bridgewater records?
A Correct.
Q Did you speak to anyone at Bridgewater about their observations of the defendant?
A No, I did not.
Q Did you know that the defendant for example, was observed at Bridgewater at times, on ten minute intervals?
MR. LaCHANCE: Objection Your Honor.
THE COURT: Overruled. You may answer sir.
A I was not aware of that. I assumed that to be the case because I am aware of the protocol at Bridgewater.
Q And so that's actually some member of the clinical staff at Bridgewater observing Mr. Salvi say, at ten minute intervals over several hours, that that occasionally occurs at Bridgewater, isn't that right?
A Yes.
Q And that's an opportunity to see an individual as closely monitor as one can in fact do, except for one on one constant observation, isn't that right?
A Yes it is.
Q You indicated Doctor, that Mr. Salvi and you worked out a system eventually, I believe you said it first occurred in the I.Q. test and then it was firmed up in the M.M.P.I., is that right?
A No, it began -- our discussion about that began in the M.M.P.I.
Q And the reason that came up was because there were some times that Mr. Salvi responded no comment to questions and other times that he said, I can't really answer this because I feel fifty fifty, fifty percent one way, fifty percent the other, is that right?
A Yes, he was leaving a number of responses blank, and I was inquiring as to why that was the case.
Q You asked him why?
A Yes.
Q And he was able, he told you that the reason was because some he wasn't going to answer because he considered them subjects he did not intend to respond to, is that right?
A Correct.
Q And other ones, he found he had, he couldn't answer the question yes or no, for example, or this or that, because he had feelings, sometimes they went one way, sometimes they went the other?
A Yes.
Q So that those, that was a distinction that he made, between kinds of questions, neither of which he intended to respond to?
A Or could not because it was fifty fifty, but yes.
Q Right, but he told you those were the ones he was going to chose not to answer, and he defined for you a distinction between the two kinds of responses, is that right?
A Yes he did.
Q And in fact, you worked out that agreement with him that he would say no comment for the questions he chose not to answer, is that right?
A Yes.
Q And what did you agree with him that he would say for the question that he fifty fifty views on?
A We used a marking procedure where he used a pen to mark one set of responses and a pencil to mark other sets of responses, so that when I looked at it later, I could tell the difference between the two.
Q You could tell which was one and which was the other?
A Yes.
Q And Mr. Salvi -- then did you do that through the M.M.P.I.?
A Yes.
Q So in a variety of places, he would either pick up the pen and respond, was it a different pen then the one he was using for most of the answers?
A It's usually administered in pencil because sometimes people change their minds.
Q Okay, so the questions he chose to answer, did he do those in pencil?
A Yes.
Q And then what did use for the no comment answers?
A I can tell you precisely. Right here. My recollection was that he would fill in both bubbles and if it was a no comment then he would put a pencil line across, and if it was a don't know, because it is fifty fifty, he would put a pen line across.
Q I'm sorry I can't hear you.?
A He would put a line with a pen across so that --
Q For no comment?
A Yes.
Q All right, so that the system that you worked out with Mr. Salvi was, if he chose to answer the question, he would it in pencil?
A Yes.
Q Is that right, if he chose -- if he said I can't really answer this because -- definitely one way or the other because I have fifty fifty feelings about the question, sometimes I think it would be a yes answer, half of me thinks it would be a no answer, then he would put a line with a pencil, wouldn't he?
A Yes.
Q And if the question that he chose not to answer, then he put a line with a pen?
A Yes, the no comment answers, yes.
Q And did Mr. Salvi in fact, do that?
A Yes he did.
Q So as he went through the test, there would be questions where he would answer, circle with pencil, or pick up the pen, or pick up a pencil, he followed that kind of a system?
A Yes.
Q Through the entire M.M.P.I., which I think you said took about two hours?
A Yes, a bit longer then it might ordinarily because of the extra effort required in doing that.
Q Because that's complicated, isn't it, Doctor?
A Yes.
Q So one has to keep track not only which answers are going to which questions, but what form one uses to answers those questions, that is a pencil, or the pen, or a line, or a circle?
A Yes.
Q Now, as a result of Mr. Salvi not responding to the questions on the I.Q. test for example, you found that that test was something that you don't think the scores to it are valid?
A I don't think the I.Q. score is valid.
Q Right, you came up a final score, but in your opinion those aren't valid?
A Correct.
Q They don't accurately reflect Mr. Salvi's intelligence quotient?
A They don't accurately reflect what his cognitive potential would be, yes.
Q I'm sorry, I couldn't hear you?
A They do not accurately reflect what his cognitive capacities are likely to be when unimpaired.
Q Well, if one were to respond to all of the questions, and one were to cooperate fully, one would expect that you would get an I.Q. test result you might take a position that was valid, is that right, that's the goal of the test?
A Yes.
Q So that because Mr. Salvi didn't cooperate with that test, you got scores that you say in your report, in your opinion, aren't valid?
A They do not accurately reflect his cognitive potentials, yes.
Q And then you said you gave him a Rorschach test that you didn't believe was valid?
A Correct.
Q And you gave him a T.A.T. that you didn't believe was valid?
A Correct.
Q And you gave him a M.M.P.I. that you didn't think was valid?
A They were not scoreable by the usual methods, correct.
Q Well that signified invalidity in your profession, doesn't it?
A Yes.
Q You spoke to Mr. Salvi, you had an interview with him that was in July, I think you said, with Dr. Schouten?
A Yes.
Q And at some point, you asked him about these voices that he had mentioned, it was a question from your test, is that right?
A Yes.
Q A question he didn't answer?
A It was a question he did answer.
Q Did answer, and then you asked some more question in July about that?
A Yes.
Q And his response to you was that if it even occurred it was very rare and he wasn't even sure that it had actually occurred, is that right?
A That's correct.
Q That's what he told you in July?
A Yes.
Q You testified on direct examination that you wondered, that what you observed, the observations you made during this testing that Mr. Salvi occasionally would grimace or would smile or something, is that right, during the testing, and then start answering questions again?
A Yes.
Q And that sometimes that sort of lapse was five or ten seconds, sometimes it was about thirty seconds?
A Sometimes as long as a couple of minutes, yes.
Q How many times was it a couple of minutes?
A I don't have a firm recollection of that, I didn't note a precise number of those longer ones in my notes.
Q Well, didn't you think -- if you know that Mr. Salvi had a lapse of two minutes, wouldn't you think that was significant?
A Yes.
Q And you took down how many times you saw that?
A I'm saying I did not.
Q You did not?
A Not each time, no.
Q So you have no idea whether it was once, you don't how many times that occurred?
A My recollection is that it was between five and ten times, but I did not note that in my protocol. If you include also, I'm sorry, if you include also the M.M.P.I. in the period as well.
Q But you didn't write that down anywhere in your notes about it?
A No.
Q And you didn't testify about that on direct?
A No.
Q Now, you saw some kind of, in the interview with Dr. Resnick, there were times when Mr. Salvi would smile or smirk, did you see that when you saw Dr. Resnick?
A Yes I did.
Q And then you see sometimes when Mr. Salvi would pause for five, ten, fifteen seconds?
A Yes.
Q Now, have you ever paused before answering a question because you are thinking about your answer?
A Yes I have.
Q Have you ever paused for a while, while you are deciding whether or not you are going to answer a question?
A Yes I have.
Q But you formed, you opined, and testified on direct, that this made you wonder if Mr. Salvi was distracted by internal stimuli?
A Yes, it is one of the hypothesis.
Q That's one of the hypothesis, is that right?
A Yes.
Q Another hypothesis is that he was thinking about the answer?
A Yes.
Q Another hypothesis is that he was thinking about whether to answer it or not answer it?
A Yes.
Q Another hypothesis is that he was thinking about whether to answer it or say no comment, or say I am not sure, fifty fifty?
A Yes.
Q Another hypothesis is that he didn't like the question and he wasn't going to answer?
A Correct.
Q And those are potential hypothesis to explain the object of observation you made which was just that Mr. Salvi had a lapse and starred for somewhere between 15 to 30 seconds?
A Yes.
Q Those are all alternative hypothesis?
A Those are all alternative hypothesis.
Q Again Doctor, if you, generally, or isn't it often the case that one gives these tests on a couple of different days?
A It can. The best practice unless the test subject is tiring or there are to many to complete without tiring the test subject is to administer them on a single occasion if possible. This is a relatively brief battery, so this would be the sort of battery where one would ordinarily anticipate a person who would be able to complete it in a day without tiring.
Q Doctor, that's one test that took an hour and a half, and then a test that took two hours, and then the T.A.T. which you now agree you gave him and --
A Yes.
Q And the Rorschach that might take, probably would take a half a hour, maybe longer or that?
A Yes.
Q You would ordinary do all five and a half hours of that testing in one day, at one sitting with someone?
A Not necessarily one sitting, but perhaps all in one day.
Q Well you did in one sitting with Mr. Salvi?
A Yes.
Q So he had to sit there for some three and half, a little over three and a half hours, and do one test after the other, and the other, and the other, after the other?
A Yes.
Q No lunch, no break, you just kept giving him tests?
A Yes.
Q You said doctor, I think on direct, you said that in the Rorschach test, that some people who are, have some sort of a mental illness, might become visible disorganized in the course of the test, is that right?
A Yes, some people --
Q You didn't see that with Mr. Salvi?
A No, I did not.
Q You said that you agreed with Dr. DiCataldo's testing results, didn't you?
A That my findings and his findings were essentially consistent, yes.
Q That they were essentially consistent?
A Yes.
Q And Dr. DiCataldo, did you read Dr. DiCataldo's findings in the Bridgewater report?
A Yes I did.
Q And Dr. DiCataldo found that the test, that Mr. Salvi did not produce test signs of gross disorder of thought, is that right?
THE COURT: Could you repeat your question please.
Q You had an opportunity, did you read Dr. DiCataldo's conclusions in the Bridgewater report?
A Yes I did.
Q And Dr. DiCataldo's opinion was that Mr. Salvi did not produce test signs of a gross disorder of thought, in the test Dr. DiCataldo gave him, is that right?
A Correct.
Q And Dr. DiCataldo also found that the test results may best be characterized by a personality style that is emotionally shallow and constricted, interpersonally remote and distant, and an preoccupation with autoereccentric ideas and behavior, is that right?
A Yes.
Q And Dr. DiCataldo also found that the test results did not contain signs indicating Mr. Salvi was grossly disconnected from the center of reality, is that right?
A That's correct.
Q And that there was no evidence of loose associational practices, or poor conceptual, perceptual boundaries, or bizarre ideational content often found in the test protocols of severely psychotic individuals, is that right?
A That's his statement, yes.
Q Well that's what Dr. DiCataldo said, isn't it?
A Yes.
Q And his psychological testing results do not contain the more serious disease of profound thought disorder?
A Yes.
Q And those are conclusions that -- those were testing results that you said you primarily agreed with?
A The characterization of the thought processes, yes. I think --
THE COURT: I didn't hear you.
A The characterization of the thought processes as rigid, and narrow, and the like, I think Dr. DiCataldo's protocol was limited in that he also did not have the opportunity to get the response pattern on the Wechsler.
Q So you think that the one thing that may have hampered Dr. DiCataldo was that he didn't have the results you had on the Wechsler test?
A I think that would have given Dr. DiCataldo more evidence of looseness of associations, for example.
Q So that would be important for you to know whether Dr. DiCataldo had that Wechsler result?
A It would be important to know if he had those results and considered them yes.
Q Because if he did, then he would have had as informed a basis as you had to make any conclusions?
A Yes, and if there were disagreements, then the areas of that disagreement would be sharpened, yes.
Q And would it surprise you Doctor, if I told you that your test results were provided to Bridgewater?
A No.
Q In fact, you would expect that they might well be, wouldn't you?
A Yes.
Q And that Dr. DiCataldo, as you said on direct, didn't do his own testing because in your profession there is a caution against doing that, that is giving I.Q. tests too quickly on the heels on another one because there is some learned behavior ability that can --
A People practice, they get a practice effect, yes.
Q Okay, that's right. But if Dr. DiCataldo had the I.Q. results and evaluate them along with the other test results and formed those conclusions, he would form his conclusions based on the same information you have?
A He may have, there is no reference in his report that he had reviewed the protocol that had been provided that if those were the case.
Q But if he had the I.Q. protocol Doctor, then he would have the same test responses that you had?
A Yes.
Q In fact, he would have some additional ones that you didn't have because he administered his own, M.M.P.I., T.A.T. and Rorschach, isn't that right?
A Yes.
Q So he would have actually more information than you had when you made your analysis and wrote your letter that has gone in as an exhibit?
A Yes, he would have had his own separate protocols.
Q In fact, Dr. DiCataldo would have of also have had the ability to confer with clinicians at Bridgewater and to find out what observations were being made, presumably, of Mr. Salvi while he was there, wouldn't he?
A Presumably he would have that opportunity, yes.
Q And more information in your field, Doctor, in attempting to make a diagnosis, isn't it better to have more information rather than less?
A In attempting to making a diagnosis, yes.
Q And in fact, the more information one has, the more reliable one's diagnosis generally can be?
A Hopefully, yes.
Q That's the whole point of gathering information, isn't it?
A Yes.
Q Because the more you know about someone the more reliable your analysis is going to be?
A Yes, generally.
Q Now, taking someone just a snapshot, that is a slice for example of a person's life, on a particular day for example, doesn't give you as much information as observing that person over days, or weeks, or months?
A That's true.
Q Doctor, schizotypal personality disorder includes odd and idiosyncratic functioning, doesn't it
A Yes it does.
Q And somewhat restricted affect?
A Yes it does.
Q And some odd ideas?
A Yes it does.
Q Those are all, in fact, the defining characteristics of a schizotypal personality disorder?
A Those are amongst the most important criteria, yes.
Q I'm sorry?
A Those are amongst the most important criteria, yes.
Q And I believe you testified Doctor, that after all of your -- well, your analysis, that is the analysis that you made in the letter that had been submitted as an exhibit here, that was based, as I understand it, you wrote that before your July interview?
A Yes I did.
Q So that was based on your testing from February of 1995?
A That's correct.
Q And so that included the Wechsler I.Q. test, the M.M.P.I., the Rorschach and the T.A.T. test?
A Yes.
Q And that's the sum total of what you had at that point because you hadn't interviewed him yet?
A I had interviewed him --
Q Oh with Dr. Schouten?
A With Dr. Schouten, yes.
Q So you had that interview with Dr. Schouten?
A Yes.
Q In February?
A (No Verbal Response)
Q And in that --
THE COURT: Is that correct?
THE WITNESS: Yes, that's correct.
Q Is it fair to say Doctor, that interview in February 23rd, that you didn't get much out of Mr. Salvi?
A I'm not sure I understand your question. There was --
Q Let me rephrase it.
Did you tell Trooper Lint last week sometime when he called you to discuss this, that you didn't much out of Mr. Salvi, that you just basically gave ballpark stuff things from your testing?
A No, that's not what I said to Trooper Lint.
Q You didn't say that?
A No.
Q Did you say to Trooper Lint that you didn't get much out of Mr. Salvi?
A No, I never said that to Trooper Lint.
Q You never said that?
A I said, he asked me -- you may be referring to, he asked me I had made a firm diagnosis and I indicated to him that there was a range of diagnoses and then he moved on to the next question.
MR. LaCHANCE: Could he finish his answer, please?
THE COURT: Did you finish your answer?
THE WITNESS: Yes Your Honor.
Q Didn't you use the term, in fact, ballpark stuff?
A I don't recall ever using that term.
Q Well the letter that you wrote was based you said on those four tests, and then sitting in an interview with Dr. Schouten in February of 1995?
A Yes.
Q And your letter was primarily based on your test results, is that right?
A Yes, that was my role.
Q That was your role in this case?
A Yes, primarily.
Q Was that you do psychological test?
A Primarily, yes.
Q And it was based on the psychological test that you wrote the letter that has gone in as an exhibit?
A Yes.
Q And that is, the Rorschach, the T.A.T., and the M.M.P.I, all of which you testified were invalid, is that right?
A Yes.
Q And the I.Q. test that you don't believe is a valid analysis or indication of Mr. Salvi's true I.Q.?
A Correct, or potential I.Q.
Q Doctor, one of the test questions that you asked, that you indicated Mr. Salvi gave what you believe to be a non-responsive, was one swallow doesn't make a summer, do I have that right?
A Yes, that's one of the proverbs.
Q One swallow doesn't make a summer?
A Yes.
Q Do you understand what that means, Doctor?
A Yes, I think I do.
Q What does it mean?
A One return of a bird, does not mean that summer is here. It is one of the more difficult proverbs because it is so unusual.
Q Now, that is a highly unusual proverb, isn't it?
A Yes, it is not one that remains in common usage anymore.
Q I would imagine that most people don't get that?
A Actually most people, if they have gotten firm scores up to that point --
THE COURT: I can't hear you, sir.
THE WITNESS: People who have gotten firm scores --
THE COURT: Firm scores?
THE WITNESS: Firm scores on that similarity subtest, up to that point, often puzzle it out, they reason it out. They, for example, rule out that the word swallow probably refers to the physical act of swallowing, they then think swallow, one swallow doesn't make a summer, and then are able to reason it if they are still within their intellectual capacities for abstract verbal analysis.
Q So in the universe of some -- of people answering that question, Doctor, that's a pretty hard one?
A That's amongst the more difficult ones, yes.
Q In fact, it requires several levels of abstract thinking in order to get there?
A Yes.
Q And one might think, a person might think that one swallow doesn't make a summer has something to do with drinking things in the summer time when it might be hot, is that right?
A Some people interpret that way, yes.
Q And you probably get that answer with some frequency?
A Yes I do. Primarily with retarded individuals or persons of low average I.Q., or persons who are concrete in their thinking, yes.
Q Do you have people who say when they hear that Doctor, say to you, what do you mean, swallow like swallow or swallow like the bird, or?
A On occasion, yes.
Q You had the opportunity Doctor, you indicated, to speak to Mr. Salvi in February of 1993, with Dr. Schouten, 1995, I'm sorry, with Dr. Schouten, is that right?
A Yes I did.
Q And that interview was, there's a transcript of that interview?
A Yes there is.
Q Now, in that interview, you discuss a variety of subjects with Mr. Salvi, didn't you?
A Together with Dr. Schouten, yes.
Q About a wide variety of subjects?
A Yes.
Q And through that interview, Mr. Salvi did not take a significant portion of that interview to explained his Catholic or religious views, did he?
A No.
Q In fact, the only objective religious responses when you or Dr. Schouten asked him a question having to do with religion?
A (No Verbal Response)
Q You asked him about the Holy Spirit and the Paracletes, is that right?
A Yes.
Q And he responded to that, in response to your question, about some religious value?
A Yes.
Q But he did not during that entire interview go on at any length about the Catholic welfare proposal, or persecution of Catholics, or any of those things, did he?
A He didn't do that. What he did on occasion, was when asked about specific events in the past, he would shift ground by asking religious questions.
Q Well, he asked you and Dr. Schouten at some point, what ethnic or religious nature you were, is that right?
A Yes.
Q And occasional he tried to turn questions back on you and Dr. Schouten?
A Yes.
Q He attempted to control the interview himself, for example?
A Yes, at times.
Q More than a few questions?
A Yes.
Q And he indicated that if he asked you every question he could think of, there would be some questions you wouldn't answer either?
A Yes he did.
Q He in fact, said that to you, didn't he?
A Yes he did.
Q But you saw on the tape with Dr. Resnick an extended period of time where Mr. Salvi expounded upon his political or religious views, did you see that in the Dr. Resnick tape?
A Yes I did.
Q And you saw nothing of that length or that duration in your interview on February 23rd?
A No, we didn't see that. We --
Q Just answer my questions.
The primary, you published a number of articles, in fact, Doctor, haven't you?
A Yes, I have co-authored a number.
Q And the bulk of those articles concern issues of children and juveniles in the law?
A Yes.
Q And that is in fact a specialty?
A Yes.
Q Children, children related to families?
A Yes.
Q Now, did you know any history about Mr. Salvi before you offered that opinion in the letter, which is entered as an exhibit, background about him?
A I had some discussions with Dr. Schouten and I was generally aware of the media presentation of the case, but I did not --
Q Did you know that Mr. Salvi -- did you know that Mr. Salvi graduated from high school?
A At that time, yes I did.
Q And did you know that he had no history of any head injury or loss of consciousness, or anything like that?
A Yes.
Q No history of any seizure disorder, no history of any learning disability, no history of being on any medication?
A I knew that he had reported that history, yes.
Q And did you know that Mr. Salvi had a driver's license?
A I believe so, yes.
Q That he'd gone to two fire academies, that he graduated from one, that he graduated from a beauty school, and had taken courses at a second?
A In less detail than that, but I knew that he been in some training programs and the like, yes.
Q And successfully, been in some training program?
A Yes.
Q And did you know that he had been employed at several jobs, he worked for a security company, he worked for hair salons, he had worked for other different businesses, both in Massachusetts and in Florida?
A Yes, not to that detail, but I knew he had an employment history.
Q And you indicated Doctor, that one of the things, this is in your report I believe, that one of the things that you observed in Mr. Salvi during the course of your testing was oppositional behavior, is that right?
A Yes.
Q In fact, he seemed at times oppositional, unwilling or unable to be cooperative?
A Yes.
Q And oppositional is, I don't want to do something that you want me to do?
A Sometimes, yes.
Q Now, you indicated before you did that testing, you had the opportunity to see parts of the interview that Dr. Resnick conducted on video tape?
A Yes.
Q And you knew therefore, from seeing that, there were times that Mr. Salvi didn't want to do what Dr. Resnick wanted him to do?
A Yes.
Q Didn't cooperate with questions that Dr. Resnick asked?
A Yes.
Q Appeared to give silly or smart sarcastic responses?
A Yes.
Q Sometimes tried to turn the interview around, and control it himself?
A Yes.
Q Asked Dr. Resnick a number of questions?
A Yes.
Q In fact, said at one point, you have to take things I say with a grain of salt?
A Yes.
Q Now, you didn't see any signs that you wrote about of hallucinations, did you Doctor?
A With the possibility of the long lapses and difficulty or need to sort of return him, I didn't.
THE COURT: Sir, repeat that.
THE WITNESS: With the exception of the lapses where he seemed to be preoccupied and I sometimes had to get his attention in fairly forceful ways, return him back to the task at hand. And in terms of gross indications of disorganization, no.
Q Well Doctor, what you observed was that Mr. Salvi was, during three and half hours, answering tests, he had circled, he had pencils and pens, he had all these things in front of him, and at sometimes, he would stop and he would sit there, for sometimes five seconds, sometimes thirty seconds, and then he would go back to the test, that's what you observed, isn't it Doctor?
A That's some of what I observed, that's not all of what I observed in terms of those long lag times.
Q Well, there would be times in which he wouldn't respond to questions, but it is your interpretation, your putting on to that, what was in Mr. Salvi's mind, that is, that you thought or you decided that he might be hallucinating?
A I didn't decide that. I wondered if that was a hypothesis for the lengthy lag times and my need to sort of fairly forcefully call his name or physically move in order to disrupt that.
Q You wondered?
A Yes.
Q You wondered if that could be, because you didn't know?
A I can't know what's going on inside of his head. I can only rely upon the observable information.
Q Right, and the observable information was time lapses?
A Yes.
Q Mr. Salvi didn't tell you during the course of that personality testing or the I.Q. testing, or the Rorschach or anything, he didn't tell you at any great length about his theory of providing welfare systems to Catholics, did he?
A No, he did not.
Q And during the interview that you had with Dr. Schouten, February 23rd of 1995, Mr. Salvi didn't tell you at any great length about his theory of welfare assistance to Catholics?
A That was not something he dwelled a long time on, no.
Q Or his economic theories about credit or a debit systems?
A No, that was not a prominent theme in the interview.
Q So that through three and half hours of psychological testing with Mr. Salvi and through approximately two hours of interview with Dr. Schouten, those themes were not repeated to any great degree at all?
A No, they did not become the sort of persistent discussion with which he interacted with Dr. Resnick.
Q With Dr. Resnick in January?
A Yes.
Q In fact, he didn't discuss those views basically with you at all, except when you asked him a question that related to religious themes in the February 23rd interview for example or when he was asking you what your religion connection was?
A Correct.
Q Now Doctor, you wrote in this report that you wrote, after setting out some of the test that you just talked about, you said you never were able to form a real conclusion about whether Mr. Salvi was competent, is that right?
A For this report.
Q Yes.
A The function of my report was to give an indication to defense counsel as to whether or not it would appear warranted to petition the Court for a 15 B. It was not my role to form an opinion as to his competency at that time, but merely to advise counsel as to whether there were enough indications that would warrant petitioning the Court for a 15 B evaluation.
Q And you didn't form a definitive opinion about competency in this report that you wrote in April?
A Correct.
Q And in fact, I think your testimony on direct was, you didn't form a definite opinion about competency, until today?
A I'm sorry?
Q You didn't form a definitive opinion as to competency even up until today?
A Correct.
Q But you go on in this report to talk about things that you believe that Mr. Salvi is unable to do, inability to discuss in meaningful detail areas with potentially legal relevance, inability to recognize and has failed to provide necessary information to defense counsel, inability to disclose pertinent facts of potential evidence, inability to trust and communicate with defense counsel.
Now Doctor, every single time that you put this in the report, it could also say, or unwilling?
A It could, but that wouldn't reflect my impressions or opinions regarding his capacity.
Q Well, as of the time that you wrote this report, you were basing it on three invalid tests, and I.Q. test that you say had nothing to do with a valid depiction of Mr. Salvi's intelligence quotient, isn't that right?
A That's a mischaracterization of what I am saying about the I.Q. test. It is still useful for understanding his thought processes although not necessarily for providing a reliable score.
Q Well, in your profession Doctor, that test is invalid because you can't score it by any standard scoring criteria?
A Correct, but invalid does not equate to not useful.
Q So you basically took three invalid tests, and a mostly invalid test to form a conclusion that are in this report?
A That's also mischaracterization.
Q Well, Doctor, the test you said you did, are the Rorschach, the T.A.T., the M.M.P.I. and the Wechsler I.Q. test, have I missed any test that you gave him?
A No, it's not the test that you are mischaracterizing but to equate invalid with not clinically useful is not correct.
Q Well, you formed the opinion that Mr. Salvi was unable, for example to discuss meaningful areas of potential legal relevance, all the inabilities that you talk about, did you ever attempt to determine Doctor, whether Mr. Salvi for example, had the capacity, the ability to discuss narratives about other events that had occurred in his life?
A Yes.
Q Did you attempt to determine whether while he was at Bridgewater, he gave the staff at Bridgewater very clear, very detailed descriptions of events, incidents in fact, that he had just been involved in in the last day or two, did you know that?
A It wouldn't be surprising. That ability would be consistent with a schizotypal to schizophrenic disorder, that they would be able to provide accounts of some events. It's not a all or nothing proposition.
Q Doctor, the question that this hearing is about, is Mr. Salvi's abilities, not his willingness, not his desires to, but what abilities he has that he can chose to exercise or not exercise, isn't that right?
A Correct.
Q And one of those abilities is the ability to give a narrative about events that have occurred to him?
A Correct.
Q So it would be important for you to know in trying to evaluate that question, whether Mr. Salvi had that ability about other subjects in his life?
A Yes.
Q And would it be important for you to know whether Mr. Salvi in evaluating his ability to cooperate with his counsel, whether he's demonstrated an ability to cooperate with these counsel on other subjects?
A Correct.
Q That would be highly relevant, in fact, wouldn't it?
A Yes.
Q Because that would demonstrate the likelihood of a choice, as opposed to an inability?
A It certainly raises that as a hypothesis, but it does not necessarily follow that because he can cooperate in some ways, he can cooperate in all ways.
Q Well, the ability to recognize important facts, in other events that occurred to one's life, is important to know in evaluating the ability to recognize pertinent facts about one particular incident?
A The general ability to do so, yes, that's important, that's relevant.
Q So in fact, Doctor, for example, if you were to be told that during a person's observation over a long period of time, it would be relevant for you to know, that they had the ability to give narratives, to trust people, to in fact take counsel's advice, to in fact, relate pertinent facts and identify witnesses, those would all be highly relevant to you in making a determination, wouldn't it?
A Yes that would be relevant.
Q About Mr. Salvi's current abilities regarding his trial?
A Correct.
Q Now Doctor, the final paragraph or couple of paragraphs that you have in your report, you indicate that based on all of your testing, it was your opinion that Mr. Salvi should be further examined, is that right?
A Yes.
Q And you recommended in fact, that there be a petition under 15 B for Mr. Salvi to be sent to Bridgewater?
A I recommended that his counsel consider that option, yes.
Q And you set out some possible options of things that Bridgewater should look at in your opinion for further clinical evaluation?
A Yes.
Q Is that right?
A Yes.
Q And the things that you suggested they should take a look at, were schizophrenia, delusional disorder, schizoaffect disorder or psychotic disorder and not otherwise specified?
A Those were some that I listed to be included, yes.
Q Of possible things that Bridgewater should take a look at?
A Yes.
Q So you didn't diagnosis Mr. Salvi as any of those things as of April of 1995?
A No.
Q And the reason Doctor, that you suggested the Bridgewater evaluation was because of what you said before, more information is better than less, isn't it?
A Generally yes.
Q And so a long term period of observation, such as Bridgewater, where one can be observed seven days a week, twenty-four hours a day for two months, is a good period of evaluation to look at someone's mental functioning?
A It's a better period than --
Q It's better than one day, isn't it Doctor?
A Yes.
Q And better than one set of psychological tests?
A Yes. It certainly can be.
Q Because more testing can be done?
A Yes.
Q Because more people can, clinicians can observe the individual?
A Yes.
Q Because more in depth interviews can be done?
A Not necessarily more in depth interviews, but yes.
Q Well more time can be spent with the individual, isn't that right?
A Yes, if they -- yes they can, whether or not --
Q Because Doctor, one of the issues in clinical interview is trust, isn't that right?
A Yes.
Q That it assists you in getting more information out of the individual to the extent that the individual opens up to you?
A Yes.
Q And contrary, you get less information to the extent that the individual doesn't open up?
A Not necessarily.
Q Well, but if someone opens up over time, that's one of the values of having someone in the same place for a period of time, that they can get more information out of the individual?
A Yes, you can generally get more information if you can establish that rapport. It's not always the case that you get more useful information merely on the basis of establishing a rapport.
Q And the reason you suggested that Mr. Salvi go to Bridgewater was because that would provide a better opportunity to take a look over a longer time, take a look over twenty, forty, or in this case, sixty days at Mr. Salvi's intellectual and mental functioning?
A Yes, the reason that I suggested that counsel consider that is because I thought there were very important questions to be resolved regarding diagnosis and the impact of mental illness on his functional capacities relevant to competency to stand trial.
Q And in fact, that was done in this case, wasn't it, Mr. Salvi was sent to Bridgewater?
A Yes he was.
Q And reports were issued?
A Yes.
Q And those reports found Mr. Salvi did not suffer from any of the four things that you just described, that Mr. Salvi did not, in the opinion of Bridgewater, that Mr. Salvi did not suffer from paranoid schizophrenia, isn't that Bridgewater's conclusion?
MR. LaCHANCE: I object to the opinion of Bridgewater, it's the opinion of one individual.
THE COURT: Overruled.
Q Bridgewater came to the conclusion Doctor, that Mr. Salvi did not suffer from paranoid schizophrenia?
A No, they diagnosis him as a schizotypal personality disorder, yes.
Q So they came to the opinion he did not suffer from schizophrenia?
A Yes.
Q And Bridgewater formed the opinion Mr. Salvi did not suffer from a delusional disorder, paranoid type?
A Assumable.
Q Well, they said he didn't suffer from any disorders, any schizophrenia type disorders, is that right?
A (No Verbal Response)
Q Didn't Bridgewater say that?
A I'm not clear that that's what Bridgewater said, since schizotypal personality, as it extends, as Dr. Resnick testified last time, used to be known as simple schizophrenia. There is continuum of impairment that can wax and wane over time. What they concluded was based on their information, their period of observation that he would not meet their criteria.
THE COURT: The criteria?
THE WITNESS: The criteria for schizophrenia.
I am assuming that in the absence of them saying this is a specific rule out, and instead, describing him as schizotypal personality, that that was their conclusion, yes.
Q Well, did you see in Bridgewater's report, that they said, in their opinion Mr. Salvi was not psychotic?
A I saw them say that they did not think that he was severely psychotic or grossly psychotic.
THE COURT: Sir, are you saying that schizotypal personality disorder is some kind of psychosis.
THE WITNESS: It's on a continuum, Your Honor, where at periods of time, the individual's functioning can wax and wan, and can exasperate, it can resolve.
During the period of time that they had him there, he presented to them, as being most consistent with schizotypal personality disorder, although a person's functional capacity with that personality disorder can wax and wane markedly over time and in response to stresses, and in response to structure and the like.
THE COURT: Is that necessarily so?
THE WITNESS: It is not necessarily so that it will wax and wane in a marked way, but it is not an uncommon occurrence, that a person's functional capacities might alter over time.
THE COURT: So a person who is describe as suffering from schizotypal personality disorder, is one who may also, from time to time, suffer from schizophrenia, necessarily, I mean does it necessarily imply?
THE WITNESS: The disturbances and distortions in their emotional functioning and their thinking, may wax and wane over time, there may times when --
THE COURT: But is that a part of it, sir, is that a requirement, is that necessarily so?
THE WITNESS: No, it's necessarily the case that their disturbances of thought would reach psychotic proportions.
Q Personality disorders, in fact, in the D.S.M. IV, Doctor, are defined as -- they are personality disorders, not psychosis, isn't that right?
A That's correct.
Q Personality disorders are a separate category, we are not talking about schizophrenics, we are talking about people with personality disorder, of which there are many?
A Yes there are.
Q Isn't that right, including antisocial personality disorder, which is commonly seen in people who have kind of a disregard for and violation of the rights of others?
A Correct,
Q Included is a narcissistic personality disorder, people who have grandiose feelings, a need for admiration, and a lack of empathy, is that right?
A Yes, that's another --
Q Obsessive, compulsive personality disorder, none of those things involve any psychosis, do they Doctor?
A No, not necessarily. Although you can have a person who has both the underlining personality disorder and what is called an axes one diagnosis of another concurrent mental illness.
Q Right, what you are saying, is that there is nothing about personalty disorder that precludes someone from also having schizophrenia?
A Correct.
Q But Bridgewater formed the opinion, and it's in their report, that Mr. Salvi does not suffer from schizophrenia, isn't that right Doctor?
A That's right.
Q So they didn't say he has a schizotypal personality disorder and maybe he is schizophrenic, that was not Bridgewater's conclusion?
A That was not Bridgewater's conclusion.
Q They believe Mr. Salvi does not suffer from any schizophrenia, right?
A Correct.
Q And in fact schizophrenia and personality disorder are two entirely different things?
A No --
Q They may sometimes overlap, in the same person, but they are two different disorders?
A They are two different disorders although the prominence of schizophrenic like symptoms is more frequently seen in persons who have schizotypal personality or schizotypal personality features.
Q There are lots of people Doctor, who have schizotypal personality disorder, who do not have schizophrenia?
A That is true.
Q And in fact, the fact that both of those words start with S-C-H-I-Z, is only a coincidence?
A No, it's not only a coincidence.
Q Well, they are not related, they are not the same disorder in any way?
A That's not entirely true. Persons with schizotypal personality disorder are more at risk over the course of life to develop a more clear schizophrenic picture and it is often difficult in the early stages of the development of schizophrenia to confidently draw the line where the schizotypal personality ends and a more clear schizophrenic picture begins to emerge.
Q But Bridgewater formed the conclusion that this man does not have schizophrenia, that he may well have a personality disorder?
A I think they went beyond, `may well'. I think they diagnosed him --
Q That he has a personality disorder?
A Yes.
Q But he does not have schizophrenia?
A That was their conclusion, yes.
Q Doctor, you said you had opportunity in July, the 23rd of July, apparently, of this year to see Mr. Salvi for a couple of hours with Dr. Schouten?
A Yes I did.
Q And in the course of that interview, Mr. Salvi related to you a memory of some events, didn't he?
A I'm sure he did.
Q Well, he related to you that he had been, for example, at the clinics in the past?
A Yes he did.
Q And that he had handed out literature at those clinics in the past?
A Yes he did.
Q And that he in fact, had at sometime been practically assaulted by people who were on the other side of that issue?
A Yes he did.
Q That he was handing out literature prolife type literature?
A Yes.
Q And that he knew a lot of the people who protested at the clinics, on one side or the other?
A Yes.
Q That his picture had been taken there?
A He believed that to be true, yes.
Q That in fact, he had participated in a number of different protests there, and he had even gotten a parking ticket I believe at some point?
A He made some reference to getting a parking ticket, yes.
Q And he told you that the people on the other side of the issue, that is, on the other side of what he defined or describe as a prolife side, which is how Mr. Salvi describe his won side to you, didn't he?
A Yes, he used that term.
Q That the people on the other side sometimes gave them a hard time, that is, the prolife, so to speak protestors, and sometimes they yelled at them?
A Yes.
Q And he related all of that to you?
A Yes he did.
Q And in fact, he related to you that the yelling at him, for example, was often done not by other protestors, that is, the protesters who might be described as the prochoice protestors, but rather by passers by?
A Yes he did.
Q He told you that?
A Yes he did.
Q And he related that those kinds of attacks occurred on a number of occasions?
A Yes he did.
Q At these clinics where he was?
A Yes.
Q And he told you about having been there?
A Yes.
Q You also, at some point, you and Dr. Schouten, I believe you actually asked Mr. Salvi about this interest in the potential of the death penalty, is that right?
A Yes.
Q And asked him why a death penalty would be better then life in prison and Mr. Salvi said to you that it can be difficult, that is being in prison?
A Yes.
Q As an explanation for a reason why someone might choose the death penalty as opposed to the rest of their natural in prison?
A Yes he did.
MS. HINKLE: May I have a moment?
THE COURT: Yes.
(Brief Pause)
MS. HINKLE: I have no further questions.
THE COURT: Yes, anything further, sir?

REDIRECT EXAMINATION
Mr. LaChance
Q During the course of the July 23rd interview of Mr. Salvi, did you, after he had related this information to you in response to your questions about his being present at the abortion clinics, then attempt to ask him where he had been and what he been doing between December 28, 1994 and January 1, or 2, 1995?
THE WITNESS: Excuse me, just a moment.
THE COURT: I didn't hear you sir.
THE WITNESS: I'm just apologizing, this thing is going off, let me turn it off.
A Yes I did.
Q Were you able to get an answer from him as to where he had been and what he had been doing during that period of time?
A No sir.
Q What did he tell you?
A My recollection is that unless you have a specific section of the notes you would like me to turn to, my recollection is that he indicated that he would rely on his facts, his opinions and his defense of silence.
Q His facts, his opinions, and his defense of silence, is that right?
A Yes.
Q Did you hear that phrase from him more than one time during your July 23rd interview?
A Yes.
Q On how many occasions did you hear it?
A There were several times when he would sort of recite it. When we attempted to ask him about what he would consider to be facts that would be useful to his attorney and the like, he was unable to speak to us about that.
Q Now, sir, you talked a little bit about schizotypal personality disorder.
You are familiar with that?
A Yes I am.
Q Is schizotypal personality disorder classified as mental disease, or a mental illness?
A It's in the Diagnostic and Statistical Manuals, it's classified in what's called Axis II, which are the personality disorders. These are disorders in which the person's general pattern of functioning in the world is impairing in their ability to function optimally.
Q Does it effect their certain cognitive abilities, specifically schizotypal personality disorder?
A Yes, one of the definitional criteria for schizotypal personality is a pattern of cognitive, and perceptual, and emotional impairments, and distortions that make it difficult for individuals to function effectively.
Q Is schizotypal personality disorder affect an individual's ability to interrelate and communicate with other about matters of critical importance in their lives?
A Yes, one of the features of schizotypal personality disorder is a social anxiety that does not get better with familiarity.
One of the examples would be, for example, someone who goes to a dinner party where they are new there, and unlike most of us who might begin to feel more comfortable over the course for the evening, in fact, they are more likely to feel more anxious.
Q Is it possible for schizotypal personality disorder to create impairments of cognitive functioning which would inhibit disclosure of critical information?
A Yes, one would be by their misapprehension of social situations and picking up the kinds of cues where others of us might begin to develop a rapport or feel more trust. The other is in processing information in the sense that they often hold odd, or unusual beliefs, or ways of understanding information that make it difficult to communicate with them in the same line of reasoning.
Q Does schizotypal personality disorder often resolve into schizophrenia with respect to those individuals who have that disorder?
A There is a percentage where in looking back at the history, you see that at some point, they either were given the diagnosis or it would have warranted the diagnosis of schizotypal personality and then go on to evolve more explicit schizophrenia.
Q Sir, you were asked about the validity or the invalidity of the specific psychological tests that you gave to Mr. Salvi, is that correct?
A Yes.
Q Dr. DiCataldo gave him tests as well, is that correct?
A Yes.
Q Are you familiar with his report relating to his testing of Mr. Salvi?
A Yes.
Q Okay. The test that he administered, was he able to get valid results of the tests?
A No, he ran into the same difficulties I did.
Q And in spite of not being able to get valid test results, did he continue to use his experience in testing Mr. Salvi to render clinical opinions with respect to Mr. Salvi?
A Yes. He made the quite accurate point that the fact that the test are invalid, as a technical matter, scoring and interpretation, still allows for their clinical use in trying to understand Mr. Salvi's patterns and functioning and went on to rely upon that information in forming his own opinions regarding the testing and Mr. Salvi.
Q And he described certain conclusions that he came to as a result of his administering and observing Mr. Salvi and taking those test, is that right, sir?
A Yes he did.
Q And he observed certain limitations on Mr. Salvi's level of functioning, did he not sir?
A Yes he did.
Q Could you describe what his thoughts are on that particular subject?
A Yes.
Q Do you have the report in front of you?
A Yes. I have the report in front of me. He noted that, and these are his words.
"He often refused or was unable to provide elaboration of his responses beyond reporting what he perceived in the test stimuli. His test responses stayed concretely focused on the objective reality of the test stimuli. He remained rigidly and safely anchored on the Rorschach, to what he characterized as obvious observable features."
He then went on to describe his clinical interpretation of the psychological testing results, and he indicated that from the data that he had, Mr. Salvi, this is a quote, "Did not produce test signs of a gross disorder of thought. His thought processes are obsessive and rigidly concrete and devoid of fantasy activity and creative symbolism."
Those last two really refer to an internal world of some complexity or richness.
Q And were those observations that you had made during the testing as well?
A From the testing, I would have very readily agreed with the characterization of thought processes that are obsessive and rigidly concrete.
Persons who have obsessive and concrete thought processes often, with the quality of this thought is one which tends to focus on a particular detail and then rigidly hold on to it, not seeing the information in connect, not being able to connect that information is a meaningful way to other kinds of information.
Q Now Dr. DiCataldo administered his tests over a period of several days, is that correct?
A Yes. I am assuming that. I could to look to see. He, yes, on two separate occasions, the 2nd of May, and the 5th of May `95 is what he has designated.
Q And he administered the Rorschach also, is that correct?
A Yes.
Q And does he describe what Mr. Salvi did with him on the Rorschach despite the fact that it was not at the end of a long five, five and a half hour test protocol, such as it was with your situation?
A Yes, in his report, and this is a quote.
"On the Rorschach, he only gave one response per stimulus card, yielding an insufficient number of responses for the use of normative comparison data. While standard normative data can not be applied, the test results can still interpreted from a clinical prospective."
Q Now, it was suggested to you that some of Mr. Salvi's answers on the Wais, for example, might have been quote, "Sarcastic, humorous or silly."
You had an opportunity to observe him when he was making the answers to the questions that you found of significance.
Did you find him to be sarcastic, humorous, or silly in making those answers?
A No, my observation was essentially the same as Dr. DiCataldo's in that, like Dr. DiCataldo's description, I found the defendant humorless, muted, with a bland and flat affect.
Q So there were no outward signs that he was sarcastic, humorous, silly, or otherwise attempting to defeat the purposes of the questions?
A No. And given that Mr. Salvi has indicated his firm belief in his competence and his desire to go forward, I would find it odd that given that a good test performance would probably work in his favor to proceed with this matter, to trial, I would find it odd if he were to intentionally sabotage testing rather than, well, asking for a ten minute break for example.
Q Are you familiar with a concept of reverse malingering?
A Yes I am.
Q And what's that?
A That is what I was referring to when I was talking about the M.M.P.I. and it having measures for faking good and faking bad.
Malingering is usually a term where a person seeks to make themselves look physically or mentally ill in order to achieve objectives. For example, someone who might fake a medical illness in order to get social security disability payments fraudulently. That would be what is usually called a malingering or faking.
However, there are persons who under the right circumstances will, as the M.M.P.I. protocol calls it, fake good. That is to say, they will make every effort in order to minimize, under report, their actual experiences in order to reach a goal that they hope that they will reach by not looking impaired.
Q At the time you tested Mr. Salvi, he had already been seen by Dr. Resnick, is that correct?
A Yes.
Q And you saw the tape, as it was played in the courtroom today and had access to it previously, is that correct?
A That's correct.
Q And Dr. Resnick had some conversation with him about the possibility of his being found incompetent, is that correct?
A That's correct.
Q Did Mr. Salvi, over a period of time, express to you whether or not he wanted to be found competent to go to trial?
A He's been consistent in wanting to be found competent and to move on to trial.
Q Would you consider then that he had a psychological motivation for attempting to appear saner, for lack of a better word, than he is?
A That would be a motivation, yes sir. It would also be a motivation once he realized that in this particular context, people might find his expression of his internal world, including particular beliefs and so forth that he has, as being evidence of impairment that he, because he is not grossly disorganized by psychosis, he may very well at times, under report, minimize more kinds of reports that people might consider a frank symptom of a mental illness or delusion.
Q If an individual has been presenting information which other people might term delusional and is appraised of the fact that kind of information and that kind of lack of cooperation might render them incompetent, does that provide them with a motivation to minimize the expression of that information in a clinical context?
A It certainly could, it certainly could be a strong motivation.
Q We talked a little bit about short term memory, could you describe for us what short term memory is?
A Short term memory is the ability to take in some information and hold on to it for a relatively brief period of time.
Q Does that indicate anything with respect to a person's ability to recall events that are longer away, and -- Well, that was extremely badly phrased.
Does short term memory or the ability to have a good short term memory, is that linked to an ability to have a long term memory?
A To the extent to which if you can't hold information in short term memory, it doesn't have an opportunity to get processed into long term memory. If you have impairments there, you may have persons who have difficulties remembering things at all.
Q But in terms of an individual who has a good short term memory, does that inevitable mean that they would have a long term memory equally as good?
A No, there can be separate impairments of long term memories of different sorts.
Q By the way, you were asked about how long the session lasted and you were asked a series of questions about possibilities for someone wanting to get the session over with and answering questions, etcetera, in such a way as to be non-responsive in order to terminate the session, do you recall those questions?
A Yes.
Q At any time during the session that you had with Mr. Salvi, the testing session, did he indicate that he was tired?
A No, he did not.
Q Did he indicate that he wanted a break?
A No, he did not.
Q Did he indicate to you in any way that he wanted food or water, or something else?
A No.
Q Did he indicate to you that he wanted to terminate the interview because he didn't feel like continuing it?
A No, he didn't. And I also considered the fact that it was at the end of the interview process, or the testing process, where he actually engaged in behavior that substantially slowed down the process of the session.
I would have thought that if he wanted to abbreviate the session because he was bored or tired of it, that he would not have selected the M.M.P.I. to, and the pattern of responding which then substantially lengthened the session.
Q You were asked questions about whether he had express hallucinations to you, is that correct?
A Correct.
Q Did you talk to him about hallucinations during your July 23rd interview?
A Yes we did.
Q And what did you ask him about hallucinations at that interview?
A I asked him if he could tell me more about the response that he had given on the M.M.P.I. in which he indicated that -- let me see if I can get to that specific test question.
The test question in which he had entered true to the phrase, "I often hear voices without knowing where they come from."
And when I asked him more about that on the 23rd, he gave a long pause and then sort of said to himself, to hear voices, and then another long pause, and then he looked at Dr. Schouten and myself and said, "I imagine it is very, very rare. I don't recall many incidence where I was just sitting around and hearing voices, although I can't say. I seem to recall something like that but not often."
I asked him if he could recall on those occasions when he did hear voices, what they were saying to him, again a long pause, "No, I wouldn't have any complete recollection of something like that."
And that's when I asked him if he ever had an incomplete recollection of anything like that. And he said, "No, not for the most part, that I can state as fact."
And I asked if he could recall when he might have heard voices. "I don't wish to go into it anymore, other than to say, something could have happened like that although I am not saying it as a fact."
I pushed him on it again. He responded, "I don't completely acknowledge hearing voices." And I said, but you don't completely deny hearing voices? And his response was, "Basically."
THE COURT: Was the word, basically.
THE WITNESS: Basically.
THE COURT: Sir, let me ask you this. When you were administering the test, the M.M.P.I., were you following the answers as they were given?
THE WITNESS: No, this is a pencil and paper measure where the test subject reads the questions and then responds to them.
THE COURT: So you didn't know how he had answered the question relating to hallucinations until after the test was over?
THE WITNESS: Correct. And I would have not have known that specific question unless I had gone through every single test question.
THE COURT: So what led you to believe that the pauses in taking the test were relative to hallucinations?
THE WITNESS: I wasn't sure what they were relative to except for their oddity, their duration.
THE COURT: Their what?
THE WITNESS: Oddity. I -- I don't, if you had -- I don't know if you have ever observed someone with a petty mal seizure, for example. Well, a petty mal seizure is a seizure where people don't have seizures in the sense of their losing muscular control, but where they literally space out for a few --
THE COURT: Yes.
THE WITNESS: -- seconds or moments.
The quality of Mr. Salvi was that he would be working on a particular test item and then he would look up and without seeming either involved in the test material or interacting with me in any way, he would stare blankly and vacantly.
When I was doing the more structured testing, I would redirect him and interrupt him. I did not do that so much during the M.M.P.I. because I wanted to see how long these would last if left undisturbed.
THE COURT: But there was something odd about it. It wasn't that he was daydreaming?
THE WITNESS: He was motionless. He wasn't doing the sort of things that people often do for example, when they are thinking about a question. He didn't fool with the pencil. He didn't go like this.
THE COURT: I see.
THE WITNESS: He didn't reread the question, he didn't furrow his brow, he simply looked up for a period of time and stared and then when I did not interrupt that process, when he brought himself back, if you will, he did so with sort of a short start or a blink, and then sort of in a very mechanical kind of way, just would turn back to the task without any comment to me or anything of the sort.
THE COURT: But what leads you to believe that he was hearing voices, as opposed to something else that may be equally bad, or equally ill, why voices?
THE WITNESS: I'm not sure that is was voices. In my report, I wondered whether it was internal stimuli. That may be voices, that may be unusual feelings in his body, that may be believing that he is seeing something in front of him. For example, later, we inquired to him about ghosts and visions, and he gave a very equivocal response about whether or not he ever sees ghosts and visions. So it may not necessarily be voices, but some sort of distraction that others around him would be unlikely to perceive.
THE COURT: Yes sir.
MR. LaCHANCE: That was going to be my last question, Your Honor.
THE COURT: Okay. Anything further?
MS. HINKLE: I have a couple of questions.
THE COURT: Yes.

RECROSS-EXAMINATION
Ms. Hinkle
Q Doctor, is it your testimony that people who have social anxiety like at a dinner party or something like that, because of their social anxiety and reluctance would be incompetent to stand trial?
A Absolutely not.
Q No, because that has nothing to do with the standard, the legal standard we are talking about on competency to stand trial?
A Social anxiety at dinner party, no. Anxiety that impairs a person's ability to develop a rapport or trust could well be relevant if it got to the point where it impaired a person's ability to effectively communicate with for example, their attorneys.
Q Personality disorders have nothing about them, by themselves, that relate to an incompetency to stand trial?
A No mental illness or disorder all by itself is necessarily related, that's why one has to go through the process of establishing the links between any existing diagnosis and the functional impairments that that diagnosis may create in an individual's competency.
Q For example Doctor, many of the people who are prosecuted on a yearly basis in this court, one might imagine suffer from antisocial personality disorder?
A Correct.
Q In fact, that's sort of what it means. It's a people who commit crimes, often have an antisocial personality disorder?
A Yes, that's a common overlap.
Q There's nothing about that personality disorder, that has any relation to those people's ability to be competent?
A No necessarily.
For example, if somebody had such a severe personality disorder that they were unable to be contained in their behavior in a courtroom even when it might serve their own interest to sit quietly and allow the proceedings to go forward, if they were that oppositional, intractable because of their personality style, it would certainly be an area where a personality characteristic might have some bearing on their ability to go through the process of trial.
Not necessarily, not all persons with an antisocial personality, in fact, most persons with antisocial personality don't have difficulties with competence, at least in part, because they know they do better if they don't disrupt proceedings and if they can work cooperatively with their counsel to mount the best defense possible.
Q Well, for people who do that Doctor, there are others way that the court deals with that other than finding them incompetent, aren't there?
A For antisocial personality disorder?
Q Yes, for somebody who acts up in the courtroom for example?
A Yes, certainly there are other options available to --
Q They are restrained?
A -- the court.
Q There is a variety of options available to the court other than finding them incompetent?
A Yes.
Q And in fact, you say most people with antisocial personality disorders would be competent, most people with schizotypal personality disorders would be competent?
A That's likely to be the case. I don't know of any empirical study of that, but it's likely to be the case.
Q Well, you indicated that Mr. Salvi told you, kept repeating, and Mr. LaChance just asked you about it, his defense of silence?
A Yes.
Q Is that right? And you took note of that phrase, you wrote it down?
A Yes.
Q Would it be relevant to you in evaluating that to know that other people who have shot providers at clinics providing abortion services, have raised defense of silence?
A It would be potentially relevant to understanding his thinking, yes.
Q That in fact, other people have done it before Mr. Salvi?
A Yes.
Q You also indicated that one of the questions is Mr. Salvi's, what he said he would testify about, that is, what information he provided, he indicated to you he would rely on his defense of silence, and his beliefs and feelings, is that right?
A I believe it was opinion, facts, and my defense of silence.
Q Well in evaluating what evidence one might rely on in one's defense, it is relevant to know one whether has available to a person an alibi defense, for example, isn't it?
A Correct.
Q And you know from earlier today that Mr. Salvi told Dr. Resnick he didn't have any alibi?
A Yes.
Q And one of the other issues that might be relevant is what options a person has in terms of deciding what evidence they would present in their defense?
A Correct.
Q And those might be limited options?
A They might be limited options. The more limited they are, in offering more standard defenses, mistaken identity, alibi, and the like, the more important it would be for a defendant to be able to rationally consider other kinds of defenses, such as criminal responsibility defense.
Q A criminal responsibility defense is only valid to consider if one actually is mentally ill, isn't that right?
A Yes, that's one of the prongs of the test.
Q And in fact, the insanity defense has in historical experience, a very low percentage of success?
A Correct.
Q And one would factor that into it, whether that was worth it, to do that, to then find oneself labeled mentally ill, isn't that right?
A If Mr. Salvi had indicated to me that was one of the factors he was considering with his attorneys, I would consider that to be evidence of an ability to rationally consider this.
Q That certainly is one of the factors that one might enter into in making that determination?
A Correct.
Q And in fact, you indicated that you saw Mr. Salvi as a very humorless person, is that right?
A Humorless? In the interactions that I have had with him, his mood has been flat, his affect has been flat. He has not engaged in a lot of sort of give and take. Admittedly we were in a serious kind of --
THE COURT: I would like to hear the answer to that question, humorless.
THE WITNESS: At the times that I saw him, although acknowledging that I saw him under a very serious circumstances, I didn't see -- I saw him as humorless, yes.
Q Now, you had an opportunity to see Dr. Resnick's tape interview, is that right?
A Yes.
Q And there were several places in there where Mr. Salvi attempted to inject humor, didn't he?
A Yes, there were some.
Q In fact, he was able on five or six occasions to make Dr. Resnick laugh?
A Yes.
Q Now, Mr. LaChance asked you some questions about short term memory, Doctor, but Mr. Salvi told you about events where he was talking about his presence at abortion clinics and his experiences there that were prior to his arrest, isn't that right?
A Yes.
Q Because you knew he had been arrested early in January and was in custody from then until the day you saw him in July?
A Correct.
Q So when he was relating to you his experiences at those clinics, it was prior to the time of his arrest, that is prior to January?
A Yes.
Q So that is some eight or, seven or eight months earlier than the time he was relating those occurrences to you?
A Yes.
Q That's long term memory, Doctor, isn't it?
A Yes.
THE COURT: Is that all Ms. Hinkle?
MS. HINKLE: Yes.
THE COURT: Thank you sir.
THE WITNESS: Thank you.
THE COURT: Yes sir?
MR. LaCHANCE: Dr. Schouten.
THE COURT: Raise your right hand.
(Witness Complies)
THE COURT: Do you solemnly swear that the evidence you will give in the matter now in hearing will be the truth, the whole truth, and nothing but the truth so help you God?
THE WITNESS: I do.

DIRECT EXAMINATION
Mr. LaChance
Q Now Doctor, would you tell us your name and spell your last name please?
A My name is Ronald Schouten, S-C-H-O-U-T-E-N.
Q And what is your profession, sir?
A I'm a psychiatrist.
Q And what is your current position?
A I am Director of the Law and Psychiatry Service at the Massachusetts General Hospital. I am also Assistant Director of the Somatic Therapies Consultation Service at Massachusetts General Hospital.
Q How long have you held your current position?
A Since 1989.
Q Would you briefly tell us about your education, training that brought you to this position?
A Yes, I graduated from Haverford, H-A-V-E-R-F-O-R-D in Haverford, Pennsylvania in 1975 with a Bachelor of Arts Degree in Psychology. I then attended the Boston University School of Law and graduated with a Juris Doctorate Degree in 1978.
I began taking premedical courses I believe in, well, in 1979 and `80. I then entered the University of Illinois College of Medicine in 1981 and graduated with a Doctor of Medicine Degree in 1985. I did a one year internship in internal medicine including three months of neurology training at Lutheran General Hospital in Parkridge, Illinois.
I then began a residency in psychiatry at Massachusetts General Hospital in 1986. I did two years of my residency at Massachusetts General Hospital and did my last of residency as the Chief Resident in Legal Psychiatry at the Massachusetts Mental Health Center.
Q Do you hold any Massachusetts' licenses, sir?
A Yes I do.
Q What do you hold?
A I'm licensed as a physician.
Q Are you Board Certified sir?
A Yes I am.
Q In what specialties?
A I'm Board Certified in Psychiatry and I also have added qualifications in Forensic Psychiatry.
Q Have you published in the field of forensic psychiatry?
A Yes I have.
Q And do you hold any academic appointments?
A Yes. I am a instructor in psychiatry at Harvard Medical School.
MR. LaCHANCE: Your Honor, rather then go through the rest of the credentials in the C.V., I would simple ask that it be marked as an exhibit at this time.
THE COURT: Yes, Exhibit 13.
THE CLERK: Exhibit 13 has been marked.
(Exhibit Number 13, Curriculum Vitae, Marked and Received into Evidence)
Q Have you had occasion to perform forensic examinations for competency to stand trial prior to the one did with respect to Mr. Salvi?
A Yes I have.
Q On how many occasions?
A Oh, this would be a rough estimate. Somewhere between probably in the neighborhood of about thirty times.
Q Have you qualified to testified as an expert in the Courts of the Commonwealth of Massachusetts with respect to competency?
A Yes I have.
Q And how many times?
A On one occasion specifically, and that was in Suffolk Superior Court.
Q Now, with respect to Mr. Salvi, do you see him present in the courtroom?
A Yes I do.
Q Would you point him out please?
A He's the gentlemen in the blue blazer sitting at the table.
MR. LaCHANCE: Let the record reflect he is identifying the defendant?
THE COURT: Yes.
Q Now, sir, how did you come to be involved in Mr. Salvi's case?
A I received a telephone call from Ms. Bassil.
Q And what were you requested to do with respect to Mr. Salvi?
A I was asked to go see Mr. Salvi for the purpose of performing a general psychiatric evaluation because of difficulties that the defense team was having communicating with him and understanding his thinking and his approach to the situation.
Q What did you do in response to that request, Doctor?
A I asked for some materials, I reviewed some materials that were then available, and then I went to see him at the Dedham House of Correction on, I believe it was for the first time, February 8, 1995.
Q And how many times did you have occasion to visit Mr. Salvi during the course of your evaluation?
A Four times.
Q And when were those times?
A February 8th, February 23rd, June 13th, and again July 23rd.
Q And did you have anybody accompany you with resect to any one of those?
A Yes I did.
Q Who was that?
A Dr. Kinschereff accompanied me on July 23rd, I'm sorry, yes on July 23rd, and also on February 23rd, and Ms. Bassil accompanied me on June 13th.
Q Now with respect to the reasons that Dr. Kinschereff accompanied you, did you ask him to do something in connection with your evaluation?
A Yes I did.
Q What did you ask him to do?
A After my first evaluation session with Mr. Salvi, I had concerns about his cognitive performance and his overall mental status, and I asked Dr. Kinschereff to perform a psychological testing battery.
Q And did you bring Dr. Kinschereff to the February 23rd interview for any particular purpose?
A Yes I did.
Q And what was that?
A To try and clarify some of the responses and get a better understanding of what had gone on at the psychological testing session.
Q The psychological testing session was before your second visit?
A Correct.
Q Sir, you indicated that Ms. Bassil had told you that they were having some problems communicating with Mr. Salvi, is that correct?
A Yes.
Q Specifically what did she tell you their concerns were?
A The primarily concern seemed to be that he was not telling them anything about the events surrounding the time period of Christmas 1994, up through January.
Q Now in addition to seeing Mr. Salvi on four separate occasions, did you also obtain and review some information that you thought would be relevant to your determination of whether or not Mr. Salvi was competent to stand trial?
A Yes I did.
Q What did you obtain and review in connection with that investigation?
A I reviewed copies of various statements that Mr. Salvi had written on a number of dates including January 4th, December 31st, up to the most recent statements over the course of time. There was some stories that he had written as well.
I reviewed notes written by his Mother, Mrs. Salvi, I reviewed notes of interviews conducted with Mr. Salvi's parents. I reviewed an affidavit written by Special Agent, I believe it is Robert Small of the F.B.I. Various investigatory reports that were written of investigations conducted by I believe the State Police here in Massachusetts. Notes of an interview with a Ms. Cindy Lockshire.
I reviewed the Bridgewater State Hospital record. I also reviewed excerpts of Grand Jury Minutes, involving a number of witnesses. There was a memorandum I reviewed from Dr. Haycock to Assistant District Attorney McDermott. I reviewed Dr. Haycock's reports as well. And finally, I believe there was an investigatory report concerning an interview with a Mr. Marc Roberts that was done by the State of Florida.
Q Now sir, as a result of your review of that documentation, your four interviews with Mr. Salvi, review of Dr. Kinscherff's reports -- did you read Dr. Haycock's reports as well?
A Yes I did.
Q With the review of Dr. Haycock's report, based on your training and experience, were you able to form an opinion based on reasonable medical certainty as to whether Mr. Salvi was suffering from a mental disease, at the time, or is currently suffering from mental disease?
A Yes I was.
Q And what was that opinion?
A My opinion with a reasonable degree of medical certainty is that he is suffering from a psychotic disorder and as best characterized as schizophrenia.
Q Were you able to determine any particular type of schizophrenia?
A It is most likely undifferentiated type at this point.
Q And could you tell us in layman's terms, what schizophrenia is?
A Schizophrenia is an impairment of thought and behavior that is generally a chronic disease, believed to be biologically based. It is marked by several characteristics, including in Mr. Salvi's case, delusions, and most likely hallucinations as well as oddities of thought and behavior, and difficulties with interactions and functioning in the community.
Q Can you tell us what evidence you based your medical conclusion that Mr. Salvi is suffering from schizophrenia?
A Yes. Mr. Salvi harbors a number of beliefs that are characteristic and appear to be delusions. These include his belief that not only are there people who dislike Catholics as a group, as a matter of personal preference, but that indeed, there is a international conspiracy against Catholics.
That as part of this conspiracy, there are many Catholic men who are boys, infants, who at birth have spermicide injected into their scrotum for the purpose of making them sterile, and Mr. Salvi offers this as an explanation of why so many Catholic men are sterile.
He related to his father at Christmas time of this last year, that their car was bugged and feared that someone was listening to him and at that point passed his father a note in which he related concerns about the Ku Klux Klan and the Mafia.
He indicates that as apart of this conspiracy, international conspiracy against Catholics, that eighty percent of the population in the United States is getting some sort of financial payment every month and that the only people who are not getting this extra welfare payment are Catholics.
He believes that Catholics are being laid off from work and others are not and that there is an organized conspiracy to lay Catholics off from work.
He also has as what I would characterize as a grandiose scheme in which everyone would be paid a certain amount of money, I believe it is $700 a year no matter how much other money they made so that --
Q Is that $700 a year or a $700 a month?
A $700 a month, I'm sorry.
So that everyone would be supported and he believes that the way that this could be done is by organizing the release of all counterfeiters to be released from prisons so that they then could begin to work for the Vatican printing money.
He also believes, finally, that he was being poisoned while he was in jail, and I would characterize those as delusions.
With regard to hallucinations, well, actually I would continue a few more things in terms of his delusions.
He believes that credit cards contain a computer chip, that this credit card allows the government to control the lives of all of us who carry these credit cards, that the computer chip contained in the credit card is quote/unquote, "Mark of the Beast," referred to in the Book of Revelations in the Bible.
He believes that there will be two rising of the dead in the future. The first rising of the dead will be blessed and the second rising will not be blessed because those individuals will accept the mark of the beast.
He also believes that he is part, and again, this is of a grandiose nature, that he is part of a special group of individuals which he refers to as an apostleship that exists within the community and that will lead the Catholic people out of their current state.
With regard to hallucinations, we have a number of reports from individuals who have spent a lot of time with Mr. Salvi. He related to his father, in 1992, that he saw a large black evil bird in the house.
In the summer of 1993, he told his parents that he felt the presence of evil in his home. He spent the night praying as a result of that and moved out of the apartment.
He reportedly told Ms. Cindy Lockshire that he head people talking, that he heard spirits talking to him, that these voices were outside his head, and that spirits related messages to him.
He, in his interview with Dr. Kinschereff and myself on July 23rd, for the first time in my questioning him about hallucinations, did not adamantly deny ever having them, but in fact acknowledge that he may indeed of have them, but he would neither affirm or deny that.
He also related to us, interestingly, at this July 23rd meeting, in response to another question, that he does not know, he is unable to tell the difference between what is real and what is not real. And this came up in the context of our discussion whether or not he had ever seen visions.
He has a number of peculiarities, of his speech, and his writing, and his thought processes. These included a recent statement, some alliteration, or repeated word sounds that are sometimes referred to as clang associations, although these are not quite clang associations.
Q What are clang associations?
A Clang associations are loose associations in which the individual starts out with a certain thought, and then on the basis of rhyming, comes up with the next lines of thought.
A good example of this is from a recent statement in which he writes in part, "Math matters, blue is the topic, Catholic eyes are smiling about a tide in the Church without the ability to raise a blooming top." And then he says, "Surf, sayith, pious, pontiff, something parker on pastoral possidy in parochial parliament."
So that sort of association of words based not on any real context, but rather on the sound of them would be referred to as a clang.
Q What's the significance of clang?
A It's a characteristic symptom of schizophrenia.
Q Do you have before you the document that you were referring to, sir?
A Yes.
Q Is that a document that was given to you represented to you that it was written by Mr. Salvi?
A Yes it was.
MR. LaCHANCE: Your Honor, I would like this marked.
MS. HINKLE: Can I see what it is Your Honor?
(Brief Pause)
MS. HINKLE: Your Honor, I don't object to it being admitted. There is only one page of this that I recognize frankly. There are a lot of materials here, but I don't know them.
THE COURT: What is it?
MR. LaCHANCE: This was a statement that was written by John Salvi and he attempted to release it and did release some it the last time he was in court. I'm not referring to yesterday. I'm referring to the last time.
THE COURT: This is a much more statement that I saw in passing, on that occasion, sir.
MR. LaCHANCE: That's what it was represented to me to be.
MS. HINKLE: I would just like copies of it Your Honor?
THE COURT: It will be Exhibit 14.
THE CLERK: Exhibit Number 14 has been marked, Your Honor.

(Exhibit Number 14, Mr. Salvi's Note, marked and received into evidence)

THE COURT: Thank you. Yes sir.
Q Did you have further evidence with respect to your diagnosis of schizophrenia involving Mr. Salvi's speech or writing?
A Yes I do.
Q What was that, sir?
A In our interviews with Mr. Salvi, the -- and we've heard discussion of this by Dr. Kinschereff earlier, there was the question of these long pauses, of the delays when you would asked Mr. Salvi a question, you would get a very blank stare. At times, he would be distracted, and then ask you to repeat the question because he would have had another thought intrude.
At other times he would just stare blankly, and then when you would ask again, he would come back and give you the answer. Speculation is certainly possible that this is the result of him having internal stimuli, either hearing things, or feeling sensations as Dr. Kinschereff referred to.
There is a concept known as thought blocking which is characteristic of schizophrenia in which an individual's thought process will just suddenly stop and they will not be able to tell you that they have another idea, that they are having another thought, but just there is a delay in how their thinking is being processed, and then they can come back to what they were thinking about. So there's another possibility.
He is tangential at times, when you ask him a question, he will give bizarre answers. For example, in one statement that he wrote, he was asking the question, who is the anti-Christ, and his response to his rhetorical question that he posed to himself was, is it a man named Ilford Alsack, or would we throw pickles on him and call him Herman Munster.
Out of context, makes no sense, and is a bizarre, loosely associated comment.
In our discussions about possible defenses, and efforts to discuss with him the insanity defense and the possibility of a diminished capacity defense, he continues to shift. He is unable to hold on to those concepts.
In fact, in a very serious discussion, about those issues with Ms. Bassil present, in which I observed her trying to explain to him the elements of the insanity defense in diminished capacity, he paused briefly when she asked if he understood and began going off on a tangent about how he had asked Mr. Carney to take care of his vehicle.
We were unable to redirect him. He perseverates when he gets on a single topic and will not let go of it, and once he is on that topic, is unable to shift set very easily. In other words, we are unable to move him from that topic to another.
Q Doctor, let me interrupt you.
A Yes.
Q Just for a moment and ask you if you could define perseveration for us?
A Perseveration is a tendency to say the same thing or think about the same thing over and over and over again. And it is characteristic of certain types of mental disorders. Some people with frontal lobe head injuries will do this. Some people with dementia will do it. It's also seen in psychotic disorders like schizophrenia.
Q Did you notice that particular kind of activity by Mr. Salvi when you visited him on July 23?
A Yes.
Q A repartition of a particular series of words?
A Yes.
Q What were those?
A There were several. One was this notion about using his facts, his opinion, and his defensive of silence as an answer. In the past, he used the phrase, what is, is, what will be, will be. Similarly this last visit last Sunday, he focused on the notion of a sentence of natural life.
When we asked him about penalties, when asked about penalties, he talked about well natural life. And went on persistently about the notion that the sentence of natural life was handed down arbitrarily, that it is suppose to be reserve for people who are the most disordered.
And after trying to educate him about that and talking about the term natural life and what it more likely meant, he continued to refer to the same topic, he was not able to shift off of that notion and come up with a clear sense of what it meant. He was referring to in essence, as if it were an insanity defense. He thought it referred to a sentence given to people who are found not guilty by reason of insanity.
Again, unusual patterns of speech, when asked about this conspiracy and the credit card system and the mark of the beast, he gave credit to the people he believed who were in the conspiracy, and said these are not stupid people. The phrase was, there are a lot of brights involved, a lot of brights, referring to a lot of intelligent people, but there are a number of instances with those peculiarities of speech.888
Also find that he has a number of what we consider to be negative symptoms of schizophrenia, is his affect, while he attempts to joke periodically, and this is not unusual, his affect his general flat and very somber, and when he does attempt to joke, it's usually in an inappropriate circumstances, which I have characterized as inappropriate affect at times.
Further with regard to schizophrenia, I think there is evidence that he has not accomplished the things as well as he set out to do in terms of consistency of performance, for example, he went to fire training school on two occasions and he had failed to pass the examine by several points. He did graduate from beauty school and got a job, but had a number of difficulties in that job, getting along with both the customers and because of his rather strange --
THE COURT: I didn't hear you sir, being what?
THE WITNESS: I'm sorry?
THE COURT: Something concerning customers, I didn't hear that.
THE WITNESS: His difficulties with customers and also his strange behavior with coworkers.
Perhaps most perplexing from the stand point of competency is the rigidity of his thinking and the concreteness of his thought processes. He is --
Q How does that relate to the mental illness, schizophrenia, and also to competency?
A That that is -- that sort of concrete thinking and rigidity of thought is something that we see in people with psychotic disorders.
He is so focused on the specific of questions that he is really unable to understand it. He has a great deal of difficulty understanding the larger picture. And Dr. Kinschereff gave a very nice example of when we met with him last, last Sunday, July 23, in which we asked him, I asked him how would you respond if somebody lied on the stand.
And he said, well, I couldn't tell, I don't know, I can't answer that. And literally thirty minutes to walk him through the situation to get him to the point where he would understand that the question was asking him to look into the future to some extent and base a decision on his current situation and behavior.
And finally, he has no insight whatsoever.
Q What relevance does that have in the diagnosis?
A Insight, as the term is commonly used, refers to the capacity to examine one's behavior and understand that behavior and the consequences of that behavior. And it is quite characteristic of people with schizophrenia, in fact, there have been recent studies that suggest that insight is something that is a persistent deficit even when the more active psychotic symptoms have been treated.
MR. LaCHANCE: Your Honor, I am about to move to a whole different section, and it is probably going to take about a half a hour. It's after four o'clock, I don't know if you want to go forward.
THE COURT: Would you come to the side bar.

SIDE BAR CONFERENCE

THE COURT: Sir, I would like to complete this. If you say it is going to take until 4:30, to complete this direct, I would like to do that. If it's going to be five o'clock or later, than that's different.
MR. LaCHANCE: Well, I think they are going to have cross-examination.
THE COURT: Oh no, I said direct. To complete your direct.
MR. LaCHANCE: Okay, it may take a little more than a half hour, I'm not sure.
THE COURT: Sir, we are quite far behind, is this is your last witness?
MR. LaCHANCE: This is the last witness.
THE COURT: And the Commonwealth has how many witnesses?
MS. HINKLE: Possible one or two Your Honor.
THE COURT: When do you expect that you would finish, if we go another hour with this witness starting tomorrow, or is that unrealistic?
MS. HINKLE: Another hour with this witness after Mr. LaChance finishes?
THE COURT: Yes.
MS. HINKLE: I think that's realistic Your Honor.
THE COURT: Then how much more time would you need?
MS. HINKLE: I would think the Commonwealth could have all of its witnesses done tomorrow. I don't know how long cross-examination of those witnesses will go.
THE COURT: Tomorrow, using the whole day?
MS. HINKLE: I'm thinking both witnesses to testify on direct and cross, yes, I would think it might be.
THE COURT: Do you concur, sir?
MR. LaCHANCE: I think we will finish tomorrow, yes.
THE COURT: No, it's not a question of finishing before the end of the day tomorrow.
MR. LaCHANCE: I'm sorry.
THE COURT: I'm saying before the end of the day tomorrow is what my original thought had been, now you are talking about taking the whole day and then some, do you concur?
MR. LaCHANCE: It's going to depend on how many witnesses they put on and everything else.
THE COURT: You would have substantial cross-examination such that you cannot guarantee that the matter will be done tomorrow, is that what you are saying?
MR. LaCHANCE: No, I am not saying that. I think we can finish with everything tomorrow.
THE COURT: In any event I would like to go and at least finish the direct of this witness today.
MR. LaCHANCE: Okay.

END SIDE BAR CONFERENCE

Q Sir, having made the diagnosis of schizophrenia with respect to Mr. Salvi, I like to move on the area of incompetence if I could, or competence, and ask you sir, whether as a result of the information that you received about Mr. Salvi, your interviews with him, your review of the psychological testing, based on your education, training, and experience, you able to form an opinion as to whether or not Mr. Salvi is competent to stand trial?
THE COURT: Sir, you will have to speak a bit louder.
THE WITNESS: I will do my best.
A Yes I was.
Q And what is that opinion, sir?
A In my opinion, with a reasonable degree of medical certainty, he is not competent to stand trial.
Q Can you tell us what the basis for that opinion is, sir?
A Yes. There are several basis for the opinion. First I have considerable concern as to Mr. Salvi's capacity to testify relevantly should he be given the opportunity to testify or to assist his counsel in a relevant fashion.
Q Why is that, sir?
A He again, exhibits rigidity of thought patterns, making it very difficult for him to deal with complex concepts and make adjustments in his thinking in response to changes and events. He is concrete in his thinking. He had difficulty with regard to the idea of addressing witnesses.
For example, when we did finally, after our thirty minutes of effort, get him to talk about what he would do with regard to a witness he felt was lying, he conceded that he might tell his attorney, but he also conceded that he might say something in open court as well, so I worry some extent about his ability to comport himself appropriately.
There is an obsessive quality to his thought, as I mentioned,* makes it difficult for him to move on. He tends to perseverate about specific topics, more so, more so in our early meetings with him, although there is an element of that as recently as last Sunday.
For example, in my first meetings with him, he got on the subject of his grand scheme, for welfare for Catholics. He got onto the subject of the persecution of Catholics. Over time, he, that has decreased. When raised with him again however, he begins talking about it and it is very difficult to shift him off that particular subject, as it was when we fist met with him.
I do not believe that he has the ability to talk about or participate in the evaluation and certainly that's been evident with --
THE COURT: You talked* about in participate in what, sir?
THE WITNESS: In the evaluation of his over all mental state throughout the period of events so that if an insanity defense were to be pursue *, he is unable to participate in that because his response * is to relevant questions, are all along the lines that that's too private. I can't say. I don't want to talk about that right now.
Q Sir, do you have an opinion with respect to the cause of your description of his inability to testify relevantly?
A I do.
Q What is that?
A I believe it's a consequence of at least two things. One, the concreteness or rigidity of his thinking. It is also a consequence *if his difficulty in relationships, in establishing relationships with member*, with his defense counsel and also the experts retained by defense counsel.
Q Do you have an opinion as to whether his inability to testify relevantly is a product of a mental disease or defect?
A Yes I do.
Q And what is that opinion?
A That is a product of the mental disease and defect.
Q Would you please explain o us how his mental disease of schizophrenia interferes with his ability to testify relevantly with what you just described?
A Yes. The pattern of thinking, the difficulties with thinking, such as rigidity or perseveration, thought locking, concreteness are all characteristic of schizophrenia and other psychotic disorders and other mental illnesses as well.
But they are certainly present in Mr. Salvi and so they interfere with his ability to cooperate with his attorneys and to participate.
Q Do you have an opinion as to whether Mr. Salvi has the ability to defend himself?
A Yes I do.
Q What is that opinion?
A I believe that he does not have the ability to defend himself. In large part, because he is unable to rationally handle the decision making process and to appreciate the nature of the evidence that is against him and the severity of his current circumstances.
Q On what do you base that conclusion?
A Statements that Mr. Salvi made to me.
Q What kinds of statement, Doctor?
A Statements to the extent that this past Sunday when I was again reviewing with Mr. Salvi the options for his defense, I presented with him -- I asked him if he was aware of the evidence against him, knowing that defense had reviewed this evidence with him previously, and he told me that he was not aware of the evidence. I then went through with him what I believed to be the evidence against him, and his response to me, well, I wasn't aware of any of that.
So there's an element of -- there's a difficulty appreciating how significant his current situation is.
Q And is that difficulty related to a mental disease or defect?
A I believe it is.
Q How is it related?
A I believe it is part of his impairment in terms of being able to distinguish as he said, reality from -- the real from the unreal. It's part of his inability to develop a relationship with counsel, and it's part of an element of denial as well.
Q Did you have a conversation with him about his inability to distinguish the real from the unreal?
A Yes I did.
Q Could you describe that conversation for us?
A I believe the conversation went something as follows. We asked him if he had ever had visions, and his response was characteristically vague and confused. He wasn't sure if he ever had visions. And when I gave him an example, he asked us, well what is a vision. I said well, for example, we are sitting in a closed room, you, Dr. Kinschereff and myself, and the door is closed, and if suddenly you look over my shoulder and saw a figure appear, hover there and then disappear, most people would consider that a vision.
And his response to that was to say, well, he wouldn't be sure, he couldn't tell, he is not able to tell the difference between what is real and what is not real.
Q Did you have a further discussion with him about that?
A I believe we did, I don't recall the specifics right now.
Q Was there some kind of conversation about atoms?
A Yes. He suggested that what is the difference between a vision and something real, it is the difference between something with fifty percent spinning atoms and a hundred percent spinning atoms. He then went into some discussion about dream states.
Q About what?
A I believe it was about dream states.
Q Dream states?
A Yes.
Q Are there other reasons why you believe that he is not motivated or not able to defend himself?
A Yes, he has been unable, in spite of repeated attempts by defense counsel and myself, to understand what is involved in the insanity defense and a diminished capacity defense.
He continues to believe that the diminished capacity, that a diminished capacity defense means that one is stupid and not intelligent. He also continues to believe that an insanity defense is involved where someone is not competent and unable, and will not proceed to trial.
So he confuses the concepts of competency to stand trial and criminal responsibility.
Q Now with respect to his quote/unquote statements that he has been generating relative to what you termed were his delusions, does that interfere with his ability to understand the peril that he is in and the ability to cooperate with counsel in generating information about his case?
A Yes, I believe it does.
Q And is that related to his mental disease?
A Yes. His pattern of delusions of persecution and his grandiose delusions have become his main goal in life. He very much wants to be found competent, he believes he is competent. He wants to go to trial. He wants to have his statements released as he has demonstrated in court, and he wants to get his word out to the street.
Q How does that interfere with his cooperating with counsel in preparing a defense?
A He refuses to provide counsel with information related to the events of December 30th and 31st. He refused to provide information to any of us about events of Christmas Eve 1994.
Q And is that related to his mental illness?
A I believe it is, yes.
Q By the way, do you believe that his noncooperation with counsel has anything to do with the particular individuals that are representing him as opposed to counsel in general?
A No, I do not.
Q And why do you say that?
A Well in fact, on a number of occasions, I have asked him how he feels about Mr. Carney and Ms. Bassil, and he has consistently that he thinks they are supportive and helpful and decent.
However he has gotten angry with them at times when they have refused to release statements, and that became a point of contention, and he was prepared to fire them on that basis.
Q Are there other reasons why you believe that Mr. Salvi is not competent?
A Well, he has demonstrated further lack of cooperation with counsel by making independents attempts to contact the F.B.I., in an effort to plead, to enter a plea with the Federal Government, in order to get the death penalty.
Q Anything else?
A No, that's it.
Q I believe you said at some point earlier that he has an inability to cooperate with the evaluation, is that correct?
A Correct.
Q Would you describe what that inability is and where it comes from?
A I believe the inability relates to his unwillingness to discuss with us aspects of his mental life and his emotions, number one.
Number two, relates to his inability to describe accurately events that have occurred in the past in a way that is consistent with the reports of other individuals who are there at the time.
For example, his description of events in which he told his father about seeing a black evil bird. He is not able to talk about that. He's not able to describe his mental status at that time, and indeed, only grudgingly acknowledges that that may have happened.
Q Is the fact that he is able to give narratives about some things that have happened to him in the past indicative of an ability to give a narrative to his counsel of the events of December 30th, December 31st, January 1, 1994, `95?
A No.
Q Why is that?
A Individuals with psychosis can be psychotic around some issues but quite clear around other issues, and even while they are psychotic, they may have memories of events that have occurred to them.
Q Does it make a difference the importance of the events that they're attempting to relate, does that figure into the equation?
A In fact, the importance of the event, may work just the opposite then we might expect, and they may have more difficulty remember* more momentous occasions that are more troubling.
Q Now you've indicated that Mr. Salvi has talked less over a period of time to you as an evaluator of competency about his Catholic delusional system, is that correct?
A Correct.
Q Do you have an opinion as to why that is?
A I believe that Mr. Salvi in pursuit of his ultimate goal of standing trial and having his information released, his views released to the world, has realized after many of us have told him, that if he were to tell us certain things, we would think he was psychotic. That he had a mental illness, and that he would then be found not competent to stand trial and potentially not criminally responsible.
Q What has his response been with respect to inquiries about his state of competency and his desires in this case?
A He has indicated when we asked him those questions about his emotional state that this information is too personal, he doesn't wish to go into it, and he will -- that he has a defensive of silence.
And when we explain to him, when we ask him if that means the Fifth Amendment and he says yes, when we explain to him that the Fifth Amendment is applicable in court, but not applicable to his attorneys, he continues to maintain that he is defending himself in silence.
Q Have you told us the basis for your determination of incompetence, sir?
A Yes I have.
Q Let me ask you this Doctor, do you have an opinion as to whether since you have the opinion that Mr. Salvi is not presently competent, as to whether he is restorable to competency under any conditions?
A I believe there is some potential for him to be restore to competence.
Q Would you describe for us how that might occur?
A By continued placement in a structured setting would be helpful as it often is with people with psychotic disorders. I think a trial of antipsychotic medication would be helpful, in some cases, negative symptoms of schizophrenia are also helped by an addition of antidepressant medication to the antipsychotic medication.
Q Doctor, one more question, in coming to your diagnosis of schizophrenia, did you consider a possible diagnosis of schizotypal personality disorder?
A Yes.
Q And why did you reject that diagnosis?
A I rejected that diagnosis based on materials provided to me indicating that Mr. Salvi had frank hallucinations, that he had gross evidence of hallucinations and psychotic behavior in the past. He has denied hallucinations to us. We certainly did not see him responding to things in the room when we interviewed him. We didn't hear him responding to voices outside his head, or inside his head, that we could definitely tell.
However we have reports of hallucinations in the past, and we certainly -- he has his delusions that we've seen.
So that those in themselves, would take it the next step beyond schizotypal. I believe that schizotypal is not an unreasonable diagnosis as far as it goes. I also believe that schizotypal is significant with regard to the issue of competency.
MR. LaCHANCE: Thank you very much. I have no further questions.
THE COURT: I didn't hear you sir.
MR. LaCHANCE: I have no further questions, thank you very much Doctor.
THE COURT: Let's stop here, you can step down sir.
MS. HINKLE: Your Honor if I might, the first question I would be asking tomorrow is if he had access to Dr. Schouten notes of the four interviews he just testi --
If I could just ask a couple of questions, to establish that these exist, Your Honor?
THE COURT: Yes, you may ask your couple of questions.

CROSS-EXAMINATION
Ms. Hinkle
Q Doctor, you said you say Mr. Salvi on four occasions, is that right?
A Correct.
MR. LaCHANCE: Your Honor, in order to short circuit that. I will concede that notes exists that Dr. Schouten took during the four interviews.
THE COURT: Do you have them here?
THE WITNESS: I gave to Mr. LaChance.
MR. LaCHANCE: Yes we have them.
Q And I assume there are no reports that were written as a result as a result of those?
A No.
Q Just the notes?
A Correct.
MS. HINKLE: If I should also ask Your Honor, if Mr. LaChance is agreeing to give those to the Commonwealth. I don't know if he is.
In the absence of that, I ask for the Court to order that those be revealed.
THE COURT: You don't need the witness to concur --
MS. HINKLE: Well the only reason --
THE COURT: -- relative to this issue.
MS. HINKLE: I don't Your Honor, except that I note from the lunch break where I had to ask Dr. Kinschereff to really interpret some of his notes for me because I couldn't read them, the Doctor made the observation that his writing was worse then Dr. Kinschereff, so I may request that he assist me in trying to figure out what they say. Having them may not be enough.
THE COURT: Well, you may take a look to see whether you can read them. Do you have them there sir?
MR. LaCHANCE: Yes I do.
MS. HINKLE: I would need the Doctor just as to interrupting* what they say, based on just looking at them quickly.
THE COURT: Doctor, would you kindly assist counsel in reading.
THE WITNESS: Yes I will.
THE COURT: Thank you.
THE WITNESS: Glad to.
THE COURT: Pardon me sir?
THE WITNESS: Glad to.
THE COURT: Thank you.
We will resume tomorrow morning at 9:00 a.m.
(Brief Pause)
MR. LaCHANCE: Your Honor, may I be heard.
THE COURT: Come to the side bar, please.
SIDE BAR CONFERENCE

MR. LaCHANCE: May I just make a request that I know who the Commonwealth intends to call tomorrow.
THE COURT: So you can be prepared?
MR. LaCHANCE: Can we be provided with a witness list and a statement.
THE COURT: Well, let's see. Where you are going next.
MR. KIVLAN: Sure, tomorrow we are going to call, at this time at least, Dr. Kelley and Dr. Haycock.
THE COURT: In which order?
MR. KIVLAN: We haven't even made up our minds, honestly, whether we are going to call both of them or not.
MR. LaCHANCE: The reason I say that Your Honor is I need to know if they are going to call Dr. Haycock, otherwise I am going to move to strike the reports from the record. There has been no right to confrontation.
THE COURT: Well, let's say Dr. Haycock is going to be called, it's just a question of whether it's Dr. Kelley first or Dr. Haycock first.
MS. HINKLE: Exactly.
MR. LaCHANCE: I'm sorry. I thought he said they hadn't decided which one to call.
THE COURT: Which first.
MS. HINKLE: Which order.
MR. LaCHANCE: All right, okay.
MS. HINKLE: Your Honor, if I could ask just one more thing. I believe, though I am not sure, that there was a video tape of one of these interviews with Dr. Schouten.
MR. LaCHANCE: Yes, there is.
THE COURT: And which one was that?
MR. LaCHANCE: February 23rd.
MS. HINKLE: February 23rd I think was audio taped.
MR. LaCHANCE: I'm sorry, it's the one before that.
MS. HINKLE: So that would have been February 8th?
MR. LaCHANCE: Whichever, the one before. That is, I can't tell you the date because I am no sure.
MS. HINKLE: If I could ask if we could have assess to that video tape as well which apparently is the interview.
MR. LaCHANCE: I don't have it.
THE COURT: You haven't viewed it?
MR. LaCHANCE: I viewed it. I looked at it. I do not have a copy of it, and I do not have the original.
THE COURT: Assuming that it's accessible through Mr. Carney or Ms. Bassil, do you have an objection to providing this?
MR. LaCHANCE: I don't have an objection to providing it, but they may, either work product or some other privilege.
MR. KIVLAN: Do you know who has it?
MR. LaCHANCE: I don't know, I can ask.
We talked about this with them at side bar the other day and I think you might have requested that before and you may have ruled on it.
THE COURT: Well, I don't know whether this was a part of it because I don't know if you knew of the video tape at that time?
MS. HINKLE: Dr. Schouten hadn't testified yet, and no one knew exactly what he was going to say. We never had any reports from him or any notes.
THE COURT: Well, as I said yesterday, you did have the video tape of Dr. Resnick because Dr. Resnick was testifying concerning the interview.
MS. HINKLE: Exactly.
THE COURT: Here you don't have a situation in which the defendant has offered the interview as part of his presentation.
MS. HINKLE: That's certainly true, Your Honor, but Dr. Schouten testified that part of his conclusions are based on his four interviews, one of which we now know was video taped, and we were given a transcript of the interview of February 23rd with Dr. Schouten and Dr. Kinscherff, but there is --
THE COURT: You learned this through your early questioning of Dr. Schouten, you listed the various things that he has relied on and you mentioned his various reports including that interview.
MS. HINKLE: Four interviews, Your Honor.
THE COURT: Yes.
MR. LaCHANCE: Well, obviously he relied on the interviews. I think the distinction, Your Honor, may be, with respect to the tape and Dr. Resnick, is that since -- it was my opinion and I disclosed it before there was any order to do so, that if we were going to play a portion of the video tape, we therefore were obliged to give the whole tape to them. I would feel more comfortable, frankly, given my capacity with these tapes, if defense counsel responded to the request.
THE COURT: Well, they are present I assume in the courtroom and have not approached.
MR. LaCHANCE: Do you want me to get them?
THE COURT: Why don't you get them?
(Brief Pause)
MR. LaCHANCE: That would facilitate things because as I said I don't physically have possession of it or the facility to get it right now.
THE COURT: There has been a request for the tape of the first interview --
MS. HINKLE: I don't know which one it was, Your Honor.
THE COURT: February 8th, is that the date at least?
MS. HINKLE: I don't know that. I just, Mr. LaChance tells us that one of Dr. Schouten's interviews was taped.
THE COURT: The interview that was video taped.
MS. HINKLE: I don't know which one it was.
THE COURT: Mr. LaChance indicated that he would defer to counsel for Mr. Salvi on this issue. Do you have any response to that request?
MR. CARNEY: Yes. We would object to it at this time.
MS. BASSIL: My understanding is you have ruled on this twice before.
THE COURT: Yes, he has testified I didn't know -- counsel I know how many times I have ruled on it, the issue is that he has now testified. I guess, that is why the Commonwealth raised it at this point and indicated that he relied on it.
MS. BASSIL: We indicated at the time that you made those rulings that he would be one of the experts. That was in our affidavit when we made the request for a competency hearing and I don't think that his status has changed. He has always been, or it has always been assumed that he would be a witness.
THE COURT: The request is denied.
There is nothing further?
COUNSEL: No.
(RECESS)
WHEREUPON: This matter was continued to July 26, 9:00 a.m.
C E R T I F I C A T E

I, Daniel J. Jacques, a professional court reporter and notary public in and for the Commonwealth of Massachusetts do hereby certify that the foregoing transcript, Pages 4 through 301 , is a complete, true and accurate transcription of my audiographic recording taken in the above mentioned matter to the best of my knowledge, skill and ability.

_______________________________
Daniel J. Jacques, Notary Public

PLEASE NOTE:
THE FOREGOING CERTIFICATION OF THIS TRANSCRIPT DOES NOT APPLY TO ANY REPRODUCTION OF THE SAME BY ANY MEANS UNLESS UNDER THE DIRECT CONTROL AND/OR DIRECTION OF THE CERTIFYING REPORTER.

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