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FRONTLINE
A CASE OF INSANITY

lawrence siegel, m.d.


Dr. Lawrence Siegel, a psychiatrist, was hired by the prosecution to determine whether Tortorici was legally responsible for his actions when he took the students hostage at SUNY-Albany. After an examination, however, Siegel concluded that Tortorici was too delusional and mentally ill to be deemed fit for trial. He couldn't address the issue of whether Tortorici was legally insane at the time of the hostage-taking incident, he said, until he was in a more stable mental state. Siegel delivered a nine-page letter to the district attorney's office, elaborating on his findings. Here, Siegel talks about his reaction to the court's decision to proceed despite his letter and why he thinks the insanity defense is indispensable. This interview was conducted in October 2001.

[Describe how you got involved in the Tortorici case.]

I got a call from the Albany County district attorney's office. Cheryl Coleman told me that there was a case that was going to trial. ... I think she called me about a week before the trial. She had wanted me to evaluate [Ralph Tortorici] for criminal responsibility, and that's usually short notice. From what I understood, there were some experts who had said that he was not responsible for the offense, and she wanted an evaluation from me to see what I thought, whether there was good evidence to go against that.

The first thing that struck me was the short amount of time before the trial was starting. I told her that she should ask to get it adjourned. What I was told was -- I don't know if it was these exact words -- but that when a trial is on the calendar in Albany, it's like a freight train; it's moving, and no one is stopping it. ...

Give me a sense of how unusual is it. They actually were in, I believe, the second day of jury [selection].

... To examine someone on the eve of trial for the prosecution or after it's started, it's quite unusual. It doesn't give one time to do a really thorough evaluation. ...

Did she actually tell you ... how many doctors [they had already] contacted?

I think she had mentioned that there may have been one doctor who had done a competency [exam]. Really, what other doctors find are not important. The question is what's my opinion, which I need to come to on my own. ...

Psychiatrists, I think until more recently, often equated being mentally ill or psychotic, having a severe mental illness, with being incompetent to stand trial or with being insane. But it's really not what the standard is. People can be quite ill, can be out of touch with reality, and yet still have more than a surface knowledge that what they're doing is either against the law or against common morality.

I was hoping that this case would go up to the highest court, because I know in my heart an incompetent man was tried.

And that's the issue. It's a different issue than whether they're sick. Some people are less stringent on that than others. That was my task -- to see whether he knew what he was doing ... was wrong. ...

You're being called in on the second day of jury selection. What is everyone expecting to happen in the case?

From what I understood, they expected the most likely thing was that a jury was going to find him not responsible, because there was no expert to testify on the other side. It's a common perception by attorneys that if they don't have an expert to rebut what the defense expert says, that it's a foregone conclusion that the jury is going to agree with that expert. But I can tell you from my experience, that's an inaccurate perception. ...

Give me a sense of what you're thinking [as you examine Tortorici]. ...

Well, I'm thinking that at this point I haven't been able to confront him enough to determine if he is criminally responsible or not. There's very strong indication that he's mentally ill. I know he's mentally ill now; from the crime, I can tell that he was mentally ill at the time. But to try and determine if he knew it was wrong at the time, I'd like to get a better sense of what did he think about the police, what did he think that the students would want? How did he think the professors would take this? ... Was it accidental that the gun went off?

I couldn't confront him, because when I confronted him, I couldn't tell what was psychosis in front of me and what was psychotic at the time of the alleged offense. So I really couldn't understand what was going on in his mind. ...

[Who stopped the interview?]

I think I stopped the interview. We kind of had gotten as far as we were going to get. I couldn't determine ... what was ill now, what was his thinking at the time. And we stopped. I believe I may have spoken to [the prosecutors]. ... I believe it was during that meeting, I may have said, "I don't think he's fit to stand trial, because he really didn't understand what was going on in court." ...

Did you think Cheryl Coleman was surprised at this?

No, I didn't think that she was that surprised. ... They had sat and saw the exam. I think that they were a little bit surprised at his presentation. ... Unless you spend time with people who are severely mentally ill, it can be shocking to see the way people can behave.

It didn't shock me. I mean, I've seen people who have behaved like that during my career. But I think the severity of the illness shocked her. As to the unfitness, I don't know if that shocked her. ...

Cheryl's memory of this is ... that you said to her, either as you are walking out or in the interview, "Look, Cheryl, this is the best I can do for you." ... What does that mean?

Her goal is to have him found responsible. The premise she is working under is that, unless I can find him criminally responsible, he's going to be found not responsible, and then he'll go to a mental hospital. I can't say he's not responsible; I can't say he's responsible. But in looking at it objectively, he's not fit to stand trial.

Now, how my evaluation helped Cheryl if I can't form an opinion [is that] ... if the trial is stopped and he gets treatment and he comes back fit, I would be able to do a better evaluation and be able to help her understand or decide how she wants to handle it, based upon whether I think he is criminally responsible or not. So actually, if it was her goal to have him found responsible, the best I could do is say he's not fit and delay things. ...

Can you describe what happens then?

... My understanding is that the prosecution has an obligation if they think someone is unfit to let the court know. I told her that was my understanding. ... I think I had suggested that she could inform the court and she did so, verbally inform the court. And she said the court said, "Trial's going ahead. Next witness."

It blew me away, because the issue of whether someone is competent, you need to have that before you can have a trial. She told me that Mr. Lynch [Tortorici's defense attorney] said he had no problem. That also surprised me, because the question was, how could someone argue that the fellow was not responsible because he was so mentally ill; but yet, when he presents during exam in a psychotic manner, say, "Well, he's not so psychotic that he's not competent?" It was internally inconsistent.

I think it was a strategic decision on his part to let the case go forward for what everyone seemed to think was the decision that he'd be found not responsible. I think that the thing that didn't turn out as expected was the jury verdict, when they found him guilty. ...

When Cheryl told me [the trial was moving forward], I was flabbergasted. I said, "Well, listen, if the judge wants to have a trial and doesn't want to have [another competency] hearing, I'm going to write him a report. I'm going to let him know what I saw, and then he'll do whatever he wants to do."

Judges always do what they want; that's part of being a judge. ... And it was his decision. My job is to try and explain as best I can what I saw, what my opinion is and why. So that's what I set out to do -- to describe the examination of Mr. Tortorici, so that the judge would know why I thought he was incompetent.

What did you say in your report?

What I tried to do was to describe the exam much as I described it to you. I tried to give a sense of what it was like to be in the room with Mr. Tortorici. ...

What does Judge Rosen do?

From what I heard from Cheryl, he read my report. ... He asked Mr. Lynch if he had a problem speaking with his client, and he said no. He may have asked a few more questions about whether he thought his client was incompetent or something like that, and he said, "OK, next witness."

... [In your report, you point out that Ralph knows who the defense attorney is; he knows the judge is arbitrator between facts. He knows all the roles, which is a competency standard, and that's what Judge Rosen points to.] ...

If you were trying to describe whether someone was disabled or had a deformity, and you said, "Well, they have two arms and five digits and they have a chest and it moves up and down and nose, eyes. But they're missing their legs." Well, those who say there's no deformity can point out to the description of the upper torso. That doesn't mean that something very important isn't missing.

In the case of Mr. Tortorici, something very important was missing, which was a rational understanding of what was going on in the courtroom. They could point all they wanted [at] him knowing the charges and knowing how a courtroom works in the abstract. But he didn't understand what was going on in the courtroom at that time. ...

If competency is such a cornerstone of our legal system, why is the threshold so low?

The threshold is low because you really don't need to do all that much to go to court. Maybe in the days before people had assigned counsel, one had to defend oneself, one had to be able to talk, call witnesses. Everybody has a lawyer now. The lawyer does everything. The lawyer cross-examines. The lawyer puts on witnesses. What the defendant needs to do is converse with the lawyer, give enough information to assist the lawyer in presenting the defense. But he also has to do that with a reasonable degree of rational understanding. ... I didn't see that there was really very much reality to Mr. Tortorici. ...

Judge Rosen is a little miffed that you're coming in there, hired to do an insanity evaluation, and then saying [Tortorici's] not competent. ...

He's right that I wasn't asked to evaluate him for competency. I was asked to evaluate him for responsibility but ... I couldn't do it. I could not pay attention to the things that I needed to because of the way that Ralph was when I saw him. The only way that I saw that might be helpful to the prosecution was to stop what seemed like a foregone conclusion [of him being] found not responsible. ...

The trial goes ahead. The jury never sees Ralph. How is that mixed in with his competency or incompetency from what you saw?

Well, his stated reason to me was he wasn't going to court because it was his graduation to be the Antihrist and the Christ figure. ...

He is waiving his right to be in the trial [because of his delusions?] ...

He thought that the court was not just to decide whether he was guilty of a crime. He thought the government was behind what he did and had directed it. ... He told me he thought that there were airwaves in the court. He thought that everybody knew what was going on. ...

How can a delusional system like that affect your competency?

There are a lot of different things one needs to have to be competent. You need to know where you are. You need to have a rational understanding of the charges. It's usually not an all-or-nothing thing. There are some individuals who are so mentally ill that they can't even talk straight, and Ralph wasn't one of those. But he had severe delusions; he had hallucinations. I think it was very clear that, because of them, he really didn't understand what was going on in his case -- and that's the standard. ...

I don't know that anybody disputes what I found. ... No one said that I inaccurately described what he told me. No one said I shaded anything. I think any objective reader of the report that I wrote, anybody who hears how he was -- if you take that as true and as truly indicative of what he was thinking -- there's no way this man could have been competent. It's just impossible. ...

So why in all those people are you the only one that's finding this so important?

I don't know that I'm the only one who's finding it so important. ... The prosecution played it right. They turned over my report and they advised the judge of what they found. Based upon what I've read, that's the proper thing for them to do, and they did it. ...

Do you hear at all about the sentencing? ...

Well, I saw a copy of the transcript of the sentencing. You look at that, and he was talking about dolphins and monkeys and government experiments. ... He kept talking, and much of it was thought-disordered; it was delusional; and eventually the judge kicked him out of the courtroom.

Now, again, I don't know what the standard is. But I can tell you that I've been involved in cases -- again, in the city -- where, after someone is convicted, they act unusually or appear ill, and the judge will order a competency-to-be-sentenced evaluation. That could have been done, I would assume. But again, it seems like the freight train was going, and it kept going until Ralph went upstate. ...

What struck me in looking at [the sentencing transcript] was how similar what he was saying in court was to what he said to me. ... I would guess Mr. Lynch might have said, "I want a competency evaluation." Maybe he felt embarrassed, having said all along that he was fit, to bring it up at this late date.

I think that's why they appealed the issue, and that's what's tragic about this. I was hoping that this case would go up to the highest court, because I know in my heart an incompetent man was tried, and I think it was unfair. In reading the decisions of the majority in the New York Appellate Division and the Court of Appeals, I think that they were paying attention to legalistic issues of whether the judge abused his discretion. I don't think that's as important.

I think what's as important is that you cannot try someone who's incompetent, and that's the most important thing. ... It ought to have been corrected. Unfortunately, because Ralph killed himself, we'll never know what the Supreme Court would have decided, and I think it's very sad. ...

[Are attorneys now] using the Tortorici case to not argue for competency hearings?

No. They're using the Tortorici case to argue that even though the guy is sick and may say a lot of crazy things; if he knows the date and he knows what a judge does and a jury does, you could find him fit [to stand trial]. ... Those types of arguments are being made, I think in part based on this decision.

Why is that so dangerous?

Again, it's because the legal system requires a person to be competent so they can properly defend themselves. ... I was taught that that's how the system works. This is not an inquisitory system, where we're trying to figure it out. It's an adversary system, and the prosecution is going to use everything to their advantage. ... The defendant has to have that degree of minimal skills and minimal abilities to be able to assist in his defense in a reasonable and rational manner.

And Tortorici is being used to say, "Well, he doesn't have to have everything. If he knows what's going on, that may be enough." ... I don't know that that's what the court meant to say, but I think that's the way it may be used.

Do you think he belonged in prison?

You know, that's a difficult question. People who are very sick go to prison. The standard in New York for being not responsible is a very tough one to meet. You have to be unable to know or appreciate the major consequences of your conduct or that it was wrong. ...

I work in a prison, and we treat people with schizophrenia, people who are psychotic. That's part of our job, and a lot of the care in prison is very good. But all these people hopefully have been sent to prison after they had an opportunity either to plead guilty while they were competent, or they had a trial while they were competent. ...

Should it be that hard to get a not-responsible plea?

... Some states have abolished the insanity defense. Each state is free to make its own law as to where the cutoff is. I think the answer is, everybody is responsible for what they do except for those who are so mentally ill that they're not, and the exception proves the rule. So whether you're mentally ill or not, if you kill someone and you're found guilty, you're going to get a punishment, and generally there's a proscribed range.

Where you draw the cutoff line between those who are responsible versus those who are not is a societal and a moral issue. When Hinckley was found not responsible, the federal government had a volitional component. In other words, if you couldn't control your conduct or couldn't conform your conduct to the requirements of the law, you were not responsible, even if you knew it was wrong. They did away with that.

Is that wrong? Well, some psychiatrists would say yes. Each state is free to make their own rules and ... in New York State, it's pretty tough. Most of the people who were found not responsible, it's not by a jury trial. It's because the defense has him examined and the doctor says they're not responsible. Then the prosecution expert agrees, and there's no trial. There's just a plea arrangement, and the person then goes to the hospital on a plea.

Is it unfair to ask jurors to decide? ...

I don't know that it's unfair. Again, it's a societal issue of who you want to not punish and find not responsible. I think jurors are qualified to make society judgments. There's errors that they can make, as far as the degree of illness and what the person was actually thinking. Maybe one can say it's a terrible system, but it's the best one we have. I don't know that juries are always accurate. I disagreed with some juries' decisions, but that doesn't mean they were wrong. ...

[When people think of the insanity defense, they think people are getting away with serious crimes.]

... They did a study on the insanity defense in New York, and they looked into those individuals who entered insanity defenses. Actually, if you put in an insanity defense and you're unsuccessful, you're going to get sentenced to more time than those individuals who never raised their mental health as an issue. Also, if you put in an insanity defense, there's a very good likelihood you're going to spend more time in custody than if you were convicted. There are many cases like that. ...

It depends what you see as being good. If being good is getting treatment, getting better, and being well when you get out, then maybe it's better to have more insanity defenses, from the point of view of the individual. If what's good is having more freedom, then maybe you want to have less insanity defenses, because I don't know that it necessarily gets people out sooner.

If Ralph were found not responsible, he would have been sent for an evaluation to see if he was dangerous. The court would have had a hearing. He would have been in a secure hospital if he was dangerous. And he would have been found dangerous; I think there's very little question. It might have been three, four years before he was found well enough to go to a civil hospital. Once he was in a civil hospital, it might have been several years before he was allowed passes to go out -- first with staff, then with his family. And finally, if they thought he was well enough to leave, they might have sent him to a supervised residence. He would have been subject to a five-year [set] of conditions, which could have been renewed indefinitely.

So he might have been under governmental control for 10, 15 years, whereas with this sentence, whatever time he served, once it was up, time's up, he gets out. ...

What does it do to the dignity of the courtroom, of our legal system?

In this case, the dignity of the system didn't serve well. Personally, I was a little chagrined by the way that Mr. Tortorici was treated, whether he's responsible or not. ... If I thought he was responsible, I would have been happy to testify that he was, and see that he went to prison. But I think that it was disrespectful to him to have him be convicted when he really couldn't participate in what was so important to him. That wasn't fair to him. I think that diminishes the system a bit.

On the other hand, you want people to have a degree of fear of the court. As the queen said, I think, after someone had tried to shoot her, and I'm paraphrasing, "Even though a man may be mad and tormented, that doesn't mean that he's so far gone that sure punishment may not dissuade him from trying to do something that he otherwise might do."

So there are arguments on both sides. But I think that if there are rules, [they] ought to be followed. I pay a lot of attention to the ones on mental health. I think that Mr. Tortorici's case going forward as it did really didn't pay attention to what's written as to what should happen to someone who's questionably fit. ...

Why should anyone else care, and why was this different?

... Part of what defines us as a society is how we treat the people that we look at less highly. If we treat them poorly, then the next group goes. I think that everybody needs to be treated fairly and according to law. If we let things erode around the edges, then we are starting on a very slippery path. Who's the next group we're going to look at to limit their freedoms, or not let them be competent or plead insanity or whatever rights they're entitled to under the Constitution? ...

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