Opinion ID: 577004
Heading Depth: 1
Heading Rank: 2

Heading: Nancy Kevorkian's Psychiatric History

Text: 8 Defendants argue that the district court committed reversible error in a series of rulings regarding Nancy Kevorkian's psychiatric history.
9 On May 8, 1990, Magistrate Judge Collings ordered the government to make available the psychiatric records of its witnesses to the extent that ... the records tend to call into question th[e] ability of the witness to perceive events accurately and/or to recount those events truthfully and accurately at a later time. At a subsequent motion hearing, the government learned from Butt that its key witness, Kevorkian, had attempted suicide in 1987 and that she had been hospitalized and examined by a psychologist as a result. 10 The government discussed the incident with Kevorkian and concluded that the contents of the psychological report were not within the scope of the magistrate judge's order, since her suicide attempt was the result of depression, rather than any disorder that might alter her ability to perceive events or to recount those perceptions at a later time. Kevorkian's attorney, David Kelston, obtained a copy of the psychologist's report and was of the opinion that it was not exculpatory. The government declined to review the report, considering it to be private and potentially privileged. 3 It requested, instead, that the district court determine in camera whether the report fell within the terms of the disclosure order. 11 On November 26, 1990, the first day of trial, the district court announced that it had reviewed Kevorkian's hospitalization records in camera and that it was disposed not to release them, finding nothing ... exculpatory or potentially exculpatory. However, the court directed defense counsels' attention to two terms appearing in Kevorkian's medical report, splitting and hysteroid dysphoric, and invited briefing from defendants on whether the terms indicated a disorder affect[ing] the ability of someone to comprehend and properly testify or a person's ability properly to respond to questions. 12 Semon submitted two affidavits from a psychiatrist, Dr. Alan Green, commenting upon the meaning of the terms splitting and hysteroid dysphoria and suggesting that access to the report could be helpful to defendants. The court agreed to provide defense counsel with the portions of the report containing those terms and another, borderline personality disorder, but denied Semon's motion for additional disclosure of the document on grounds that the information requested was not relevant and would not be admissible at trial. 13 The defense renewed its request for further disclosure at the conclusion of the government's case. Defendants also sought to call a psychiatrist, Dr. Martin Kelly, to testify to the meaning of the psychological terms appearing in the redacted version of the report. The court again denied defendants' disclosure request. As well, it ruled the redacted copy of the report inadmissible and barred the expert testimony. 14 Defendants claim the court erred in three ways with respect to Kevorkian's psychological evaluation: (1) in denying defendants further access to the hospitalization report and in refusing to admit into evidence the redacted version; (2) in barring expert testimony on the significance of the psychological terms contained in the redacted copy of the report; and (3) in failing to provide an adequate opportunity for cross-examination of Kevorkian. We shall discuss each in turn.
15 Defendants claim that the district court erred in disclosing only a small part of Kevorkian's hospitalization report and in excluding the disclosed portions from evidence. They claim that this evidence was relevant and admissible because it would have demonstrated that Kevorkian was both biased and unable to perceive or tell the truth. We address these arguments separately.
16 The thrust of the defense at trial was that no payoff scheme existed between defendants and Kevorkian or any other prostitute, and that Kevorkian, and those witnesses purporting to corroborate her testimony, were lying. According to defendants, Kevorkian's medical records were relevant evidence of her motive to lie about defendants' role in the payoff scheme. Defendants contend that her hysteroid dysphoria and potential for splitting caused her to harbor an irrational hatred of Butt and Semon, which drove her to testify falsely about them. 17 In so arguing, defendants relied upon the affidavits of their expert, Dr. Alan Green. Green informed the district court that hysteroid dysphoric individuals who employ splitting may idealize others and then quickly devalue them when they feel any hint of rejection. 4 Defendants argued that Kevorkian experienced an emotional backlash consistent with this profile, and that her testimony was concocted to punish them for dashing her magical expectations. The district court was not persuaded. Finding no support for defendants' bias theory, and, in particular, no evidence of any triggering rejection of Kevorkian by defendants, the court ruled Kevorkian's psychiatric history not relevant to her motivation to testify. 5 18 District courts have considerable discretion in determining the relevancy of evidence, and this discretion must be respected absent abuse. Conway v. Electro Switch Corp., 825 F.2d 593, 597 (1st Cir.1987); see also United States v. St. Michael's Credit Union, 880 F.2d 579, 601 (1st Cir.1989). We find no abuse here. 19 Defendants produced no convincing evidence that Kevorkian's testimony was fabricated to avenge imaginary insults, or, indeed, that it was fabricated at all. Kevorkian took the stand pursuant to an immunity and compulsion order. She stated that she was testifying against Butt and Semon because she had been subpoenaed to do so, and that she felt no animosity toward them. Undisputed evidence demonstrated that a close, personal relationship existed between Kevorkian and defendants. Kevorkian testified that she viewed their friendship as unwavering, from late 1983 on, and defendants produced no persuasive evidence to the contrary. 20 Defendants sought to convince the district court that certain discrepancies in Kevorkian's testimony demonstrated a growing vindictiveness toward them. They relied upon three examples. The first was that Kevorkian apparently told an FBI agent, at the outset of the government's investigation, that she and Semon had sex once, and then testified at trial that they had sex twice. It is not at all clear, though, that Kevorkian's testimony shifted on this point. It appears that when questioned by the FBI, Kevorkian stated that she and Semon had sex, without specifying the number of times, and that the agent, paraphrasing her remark, reported it as once. Her trial testimony, therefore, as readily corroborates as it does contradict her earlier statement. 21 The second example cited by defendants was that Kevorkian told the FBI that both defendants threatened her with violence lest she publicize the payoff arrangement, but testified at trial, months later, that only Semon threatened her. This inconsistency is less stark than defendants suggest. At trial, Kevorkian stated that while Semon uttered the threats, Butt was present whenever they were made. Her earlier assertion that both defendants threatened her--again, as paraphrased by the FBI agent--arguably reflects nothing more than this. 22 Finally, defendants maintained that the absence of any evidence of threats from certain audio tapes made by Kevorkian of conversations between her and defendants proves that the threats did not occur, but were, instead, recently contrived consistent with defendants' theory of her growing bitterness. Yet these tapes were made during the later phase of the payoff scheme, when, quite plausibly, Kevorkian had proved herself capable of keeping defendants' secret and the need for threats had dissipated. 23 At best, these examples are of minor significance. Without doubt, they are an insufficient basis for our finding abuse.
24 The district court found Kevorkian's hospitalization report of 1987 not relevant to her credibility, despite the suggestion contained therein that she was mentally unstable at a time covering events about which she later testified. Defendants, relying on longstanding precedent that evidence of mental instability is relevant for purposes of impeaching a government witness, argue that the court abused its discretion in deeming Kevorkian's medical history irrelevant. 25 For over forty years, federal courts have permitted the impeachment of government witnesses based on their mental condition at the time of the events testified to. See United States v. Hiss, 88 F.Supp. 559, 559-60 (S.D.N.Y.1950). Evidence about a prior condition of mental instability that provide[s] some significant help to the jury in its efforts to evaluate the witness's ability to perceive or to recall events or to testify accurately is relevant. United States v. Moore, 923 F.2d 910, 913 (1st Cir.1991). The readily apparent principle is that the jury should, within reason, be informed of all matters affecting a witness's credibility.... United States v. Partin, 493 F.2d 750, 762 (5th Cir.1974). See also United States v. Lindstrom, 698 F.2d 1154, 1165-66 (11th Cir.1983). 26 Despite this precedent, we are aware of no court to have found relevant an informally diagnosed depression or personality defect. Rather, federal courts appear to have found mental instability relevant to credibility only where, during the time-frame of the events testified to, the witness exhibited a pronounced disposition to lie or hallucinate, or suffered from a severe illness, such as schizophrenia, that dramatically impaired her ability to perceive and tell the truth. 6 27 In United States v. Barrett, 766 F.2d 609, 615-16 (1st Cir.1985), for example, the jury heard evidence that the government's star witness had once been sufficiently agitated, psychotic, and delusional to have been prescribed a dose of medication typically recommended for those who confuse fact and fantasy, and that the witness had been taking this medication up until one or two weeks prior to trial. In Partin, where the exclusion of a government witness's psychiatric history produced reversible error, the witness had voluntarily committed himself to a psychiatric hospital a few months prior to the events about which he testified, experiencing auditory hallucinations and believing himself to be another person. 493 F.2d at 764. Similarly, in Hiss, the government's key witness was allegedly a psychopathic personality disposed to chronic, persistent and repetitive lying ... acts of deception and misrepresentation ... and a tendency to make false accusations. In re Hiss, 542 F.Supp. 973, 993 (S.D.N.Y.1982) (describing mental condition of government witness in Hiss, 88 F.Supp. 559), aff'd without opinion, 722 F.2d 727 (2d Cir.1983). And in Lindstrom, medical records showed that a government witness had manipulated the results of a medical test and woven an intricate fabrication to explain it, that the witness chronically misinterpret[ed] the words and actions of others, and that she exhibited pseudoneurotic schizophrenia with marked paranoid trends, 698 F.2d at 1164-65. 28 Defendants do not suggest, nor is there evidence to the effect, that Kevorkian was disposed to the sorts of hallucinations, false accusations, or distortions present in these cases. Her psychiatric history consists of a single report based on one interview following her suicide attempt in 1987. The disclosed sections of the report find no evidence of psychotic thinking. They describe Kevorkian as an angry and alert individual suffering from atypical depression and borderline personality disorder, namely, hysteroid dysphoria with a marked potential for splitting. As well, they report indications ... of considerable rejection sensitivity ... very poor personal judgment ... [and] impulsivity and despair.... 29 The district court was impressed, as are we, by the absence of a formal psychiatric diagnosis or of any diagnosis ... of a mental illness which [would] prevent[ ] [Kevorkian] from perceiving matters truthfully and testifying about them. After reviewing the report in its entirety, as well as observing Kevorkian on the witness stand for two days, the trial court was of the opinion that she was not mentally incapacitated in any way. It found no evidence of paranoid fantasies and concluded that her depression, as described by the examining psychologist in 1987 and as speculated upon by Dr. Green, was a condition ... within the norm. 7 30 We find nothing improper in the trial court's management of this delicate question. Having examined the 1987 report in full, ourselves, we find the court's assessment of it to have been fair. Admittedly, we cannot rule out the possibility of any relationship between Kevorkian's past mental health and her credibility at trial. Her depression may well have colored her perception of reality. The same may be said, though, of most of life's ordeals and of the painful and embarrassing ones, in particular. In ruling Kevorkian's psychological profile not relevant to her veracity, the trial court evidently concluded that a tighter logical nexus was necessary to justify the introduction of such personal and potentially stigmatizing material. While recognizing that another court might have ruled differently, we are unable to find that the district court in this case abused its broad discretion in holding as it did.
31 An additional aspect of defendants' relevancy argument needs to be addressed. According to defendants, the district court's relevancy ruling was predicated upon its judgment that Kevorkian's psychiatric history was per se inadmissible 'character evidence.'  Were we to concur in defendants' characterization, we might well be inclined to find reversible error. In our view, however, the district court based its exclusion of the contested evidence not upon a per se rule, but, rather, upon its carefully considered findings that Kevorkian's medical history was not relevant to any issue in the case. 32 To the extent that the court did rely upon Rule 404's proscription of character evidence, it explicitly considered the exception, contained within the rule, for evidence of a witness's character for truthfulness. 9 Thus, rather than making the sort of categorical judgment described by defendants, the district court simply determined that the proffered evidence did not bear upon Kevorkian's veracity. We therefore find no error.
33 Our affirmance of the trial court's relevancy determination disposes of defendants' claim that the trial court erred in barring full or additional disclosure of Kevorkian's 1987 hospitalization report. A district court's determination regarding compliance with a discovery order is committed to its sound discretion and is reversible only for abuse. United States v. Tejada, 886 F.2d 483, 486 (1st Cir.1989). The order of the magistrate judge required the government to make available to the defense the psychiatric records of government witnesses so far as they tend[ed] to call into question the ability of a witness to perceive events accurately and/or to recount those events truthfully and accurately at a later time. The trial court, having ruled Kevorkian's medical records not relevant to her truth-telling ability or any other issue, was free to limit their discovery. See United States v. Sterling, 742 F.2d 521, 527 (9th Cir.1984) (upholding district court's non-disclosure of government witness's psychiatric records after in camera review on ground that evidence would not be admissible at trial). 34 As for defendants' attack upon the court's decision to review the report in camera, we suspect that it has been waived. Shortly before trial the government moved for in camera review. The court granted the motion one week later. So far as we can see, defendants did not object to the order and made no motion for reconsideration. Such inaction, particularly within days of the commencement of trial, presumably precludes defendants from challenging the order before us. See Reilly v. United States, 863 F.2d 149, 160 (1st Cir.1988) (when a trial judge announces a proposed course of action which litigants believe to be erroneous, [and] the parties detrimentally affected ... [fail to] act expeditiously to call the error to the judge's attention, right of appeal is waived). 35 Assuming, without deciding, that defendants' claim is viable at this stage, it cannot succeed. We accord the district court broad discretion in protecting the rights of parties through the use of in camera review of a witness's medical history. See United States v. Grey Bear, 883 F.2d 1382, 1393 (8th Cir.1989) (in camera review of witness's medical records permissible exercise of discretion where direct and cross-examination of witness elicited the relevant information); Sterling, 742 F.2d at 527 (no abuse of discretion where trial court refused to grant defendant access to government witness's psychiatric records on ground that evidence would not be admissible at trial, choosing, instead to conduct in camera review). Given the court's pre-trial decision to disclose to defendants what, in our estimation, were the most salient portions of the report, we find no abuse here.
36 Defendants also sought to educate the jury about Kevorkian's psychiatric history by calling a psychiatrist to testify to the significance of the terms hysteroid dysphoria, splitting, and borderline personality disorder. 10 The district court barred the proffered testimony, finding that it was not relevant to any issue in the case and amounted to a general, and therefore impermissible, attack on Kevorkian's credibility in violation of Rule 404(a). 11 The court also suggested that the testimony would not assist the jury in the manner contemplated by Fed.R.Evid. 702, 12 but, rather, would undermine its ability to assess Kevorkian's credibility. 37 A trial judge has wide discretion concerning the admission of expert testimony, and we sustain such decisions where there has been no abuse. Peckham v. Continental Cas. Ins. Co., 895 F.2d 830, 837 (1st Cir.1990). In our view, the district court did not abuse its discretion here. The expert testimony consisted of Dr. Green's explanation of the terms hysteroid dysphoria, splitting, and borderline personality disorder as they are understood by the psychiatric profession. Neither of defendants' experts had met Nancy Kevorkian and, consequently, neither was prepared to comment professionally upon her mental health, particularly as it may have been in 1987. In addition, nowhere in the record is it suggested that defendants' experts had reviewed any of Kevorkian's grand jury or trial testimony, or had any opinion about her current ability to perceive and tell the truth. 38 Quite apart from the fact that the expert testimony bore no relation to Kevorkian, personally, is the necessarily tentative nature of its conclusions. It defines psychological terms as a medical textbook might, listing a group of characteristics suggestive of borderline personality disorder and sketching for the layman a profile of the typical hysteroid dysphoric person inclined toward splitting. The testimony describes tendencies only, cataloging a range of behavior that one so diagnosed might or might not, sometimes, exhibit. 39 The bearing of these generalizations upon Kevorkian, personally, is questionable, in the extreme. The risk of their injecting collateral and confusing questions into the proceedings and subverting the jury's credibility determination, on the other hand, was considerable. In addition, to the extent that the testimony was, in effect, little more than a verbal rendition of the disclosed portions of the 1987 hospitalization record, it, too, was excludable on relevancy grounds. See supra, at 81-83. 40
41 In barring Kevorkian's medical records and the observations of defendants' expert from evidence, the trial court noted that proper cross-examination will give this lay jury a good feel for this woman. And if in fact she turned on these particular individuals and fabricated [her account of defendants' participation in the payoff scheme,] ... the normal engine of truth discovery will obtain. Before us, defendants argue that no opportunity for proper cross examination was afforded them, and that, as a result, their rights under the United States Constitution were violated. 42 The Sixth Amendment guarantees criminal defendants an adequate opportunity to cross-examine adverse witnesses. United States v. Owens, 484 U.S. 554, 557, 108 S.Ct. 838, 841, 98 L.Ed.2d 951 (1988); United States v. Berrio-Londono, 946 F.2d 158, 160 (1st Cir.1991). And a government witness's psychiatric history is, under certain circumstances, a proper subject of cross-examination. United States v. Rivera-Santiago, 872 F.2d 1073, 1084 (1st Cir.1989). The right to cross-examination is not absolute, however. Berrio-Londono, 946 F.2d at 160. The confrontation clause guarantees  'an opportunity for effective cross-examination, not cross-examination ... in whatever way, and to whatever extent the defense might wish.'  United States v. Noone, 913 F.2d 20, 32 (1st Cir.1990) (quoting Owens, 484 U.S. at 559, 108 S.Ct. at 842) (citation omitted). Once the defendant has been afforded a reasonable opportunity to question a witness' veracity and motivation, the trial judge enjoys broad discretion in determining the scope and extent of cross-examination.... Berrio-Londono, 946 F.2d at 160 (quoting United States v. Garcia-Rosa, 876 F.2d 209, 237 (1st Cir.1989)). 43 We consider first whether defendants were given an adequate or reasonable opportunity to examine Kevorkian. Before her cross-examination began, the government moved to prevent the defense from asking Kevorkian about any aspect of her psychiatric history. The district court refused the government's broad request, ruling that the defense was free to inquire about Kevorkian's psychological background--the nature of how she was feeling and her psychological problems generally--including her suicide attempt, hospitalization, and the contents of the psychologist's report, as far as she had discussed them with defendants. 13 The court expressly held out the possibility of broadening this approach, proposing to reassess its initial ruling on a question by question basis and adding that, should Kevorkian affirm any aspect of her psychiatric history, maybe we can go further. 44 Defendants chose not to exercise this option. During the more than two days of cross-examination, they asked Kevorkian not one question about her psychological difficulties. 14 In light of this, we are perplexed by defendants' contention that the court's order violated their constitutional rights. In our view, defendants were afforded a more than adequate opportunity to examine Kevorkian. 45 As for the trial court's limiting the scope of examination to matters discussed by Kevorkian with defendants, on this record we cannot find abuse. The court explicitly offered to revise its initial ruling, depending upon Kevorkian's responses to questions about her mental health. That defendants posed no such questions precludes them from arguing any impropriety to us. 15 In sum, defendants received their due under the Sixth Amendment. 16
46 While the disclosure and admission of Kevorkian's psychiatric history presented the district court with a series of thorny decisions, we believe that defendants received a fair trial. In so ruling, we recognize that the district court's evidentiary rulings were highly discretionary, particularly given the pivotal role assumed by Kevorkian's credibility in this case. But, although the suppression of Kevorkian's psychiatric records and the expert testimony curtailed defendants' impeachment of Kevorkian, we find that by granting defendants partial disclosure of Kevorkian's medical records and permitting them some leeway to cross-examine her about her mental health--as well as expressing a willingness to go further--the trial court afforded defendants an adequate opportunity to exploit Kevorkian's psychiatric history before the jury. 47 We turn now to the sentencing issues presented by this case.