Court Opinion

ID: 9495777
Source: CourtListenerOpinion
Date Created: 2023-08-05 16:10:07.362957+00
Date Added: 2024-06-11T17:57:11.583030
License: Public Domain

BRIGHT, Circuit Judge,
dissenting.
I respectfully dissent from the majority’s reversal of the district court’s five-year downward departure based on Melroy Johnson, Sr.’s extraordinary physical condition. The majority has substituted its perception of the facts for the thorough findings of an experienced and able chief district court judge. The district court did not abuse its discretion; the court made its factual findings with care and discernment. This panel should afford proper deference to those findings. Furthermore, the majority fails to clarify the applicability of United States v. Rabins, 63 F.3d 721 (8th Cir.1995), despite the district court’s repeated expressions of uncertainty on how to conduct § 5H1.4 downward departure analysis under Rabins.
The majority concludes that the district court’s finding that Johnson suffers from an extraordinary physical impairment “resulted from an improper application of the law.” However, after cursory citations to Rabins and United States v. Krilich, 257 F.3d 689 (7th Cir.2001),2 the majority opinion does not explain what a proper application of the law would have been. Instead, it conducts its own assessment of the facts and concludes that “Johnson’s physical impairment, although concededly serious, is not extraordinary.” This type of determination is precisely the sort that should be left to the sound discretion of the district court. The distinction between labeling a physical condition as “serious” or as “extraordinary” is best done by the finder of fact.
As the Supreme Court recognized in Koon v. United States, 518 U.S. 81, 98, 116 S.Ct. 2035, 135 L.Ed.2d 392 (1996), “A district court’s decision to depart from the Guidelines ... will in most cases be due substantial deference, for it embodies the traditional exercise of discretion by a sentencing court.” Koon laid out the proper role for the sentencing court in resolving whether departure is warranted by the facts of an individual case:
To resolve this question, the district court must make a refined assessment of the many facts bearing on the outcome, informed by its vantage point and day-to-day experience in criminal sentencing. Whether a given factor is present to a degree not adequately considered by the Commission, or whether a discouraged factor nonetheless justifies departure because it is present in some unusual or exceptional way, are matters determined in large part by comparison with the facts of other Guidelines cases. District courts have an institutional advantage over appellate courts in making these sorts of determinations, especially as they see so many more Guidelines cases than appellate courts do.
Id.3 It is the job of the district courts, not the appellate courts, to find facts. United *828States v. Searcy, 284 F.3d 938, 943 (8th Cir.2002).
There can be no valid contention that the district court failed to make a “refined assessment” of the facts in this case. A review of the sentencing transcript reveals the thoughtfulness with which the court approached its duty. At the initial sentencing hearing, Johnson presented the court with a letter from Dr. Diane K. Werth, the doctor who treated Johnson at the Sioux City emergency room on March 10, 2000. The government introduced a declaration from Dr. Ronald Ilvedson, staff physician at FMC Rochester.
Based upon this initial showing, the district court denied Johnson’s motion for downward departure. Treating Johnson’s oral allocution as a motion to reconsider, the district court continued the sentencing in order to give Johnson an opportunity to present additional medical evidence. At the next sentencing hearing, Johnson offered a letter from Dr. Arthur S. Leon, a physician at the University of Minnesota. The government did not dispute the substance of Dr. Leon’s report or Dr. Leon’s statement that Johnson was “seriously infirm,” in accordance with the use of the term in the example given in Guideline § 5H1.4.
Again, the district court continued the sentencing after indicating that it wanted to know whether cardiac rehabilitation was available in the Bureau of Prisons. A third sentencing hearing was held on July 26, 2001, during which Dr. Ilvedson and David Good, the associate warden for medical services at FMC Rochester, testified via video conference at the district court’s request. Only after hearing arguments at three separate hearings, receiving the opinions of multiple medical experts, and applying its own experience in sentencing cases did the court conclude that for the purposes of Guideline § 5H1.4, Johnson had an “extraordinary physical impairment.”
Throughout the sentencing transcript, the district court indicates its desire to proceed cautiously and with a complete understanding of the issues. After initially denying Johnson’s request for a downward departure, the trial court reconsidered its position, stating:
I have some uneasiness that there may be medical testimony out there that might change my opinion .... [M]y one rule in this job is I do like to sleep well at night, and I would not sleep well at night if I didn’t give the defendant — that’s not a legal principle, but that’s a very important principle to me, sleeping well at night, and I have sufficient reservation which I had when I started reviewing the motion for downward departure that there may be medical information there that might change my opinion.
(Sentencing Tr. 12/20/00, 52-53).
During the second sentencing hearing, the court did not have evidence on whether or not the Bureau of Prisons made cardiac rehabilitation available to prisoners. Not wanting to simply assume or guess, the court again continued the hearing in order to take testimony from Bureau of Prisons officials via video conference.4 At the *829third and final hearing, the district court unequivocally found that Johnson had an extraordinary physical impairment.5
Despite this careful and thorough factual record, the majority opts to disagree with the district court by classifying Johnson’s physical condition as serious but not extraordinary when “assessed in the light of the situation the defendant would encounter while imprisoned.” The majority concludes that the district court’s finding of extraordinary medical condition is not fairly supported by facts in the record. Under that view, according to the majority, the district court abused its discretion in its role as a finder of fact.
There are two reasons the majority’s conclusion is particularly troubling. First, the district court could not have been more certain in its ruling that Johnson suffers from an extraordinary impairment. It is difficult to imagine what more evidence the district court could have heard on this matter. The factual record is replete with medical evidence and specific findings. Second, while the district court expressed no doubt about its factual conclusions, it expressed great uncertainty about the legal conclusions it made: “And it’s I think the most difficult departure area that I see where it seems more unsettled and more ambiguous at least to me. And I hope maybe if there is an appeal that we do get some clarification.” (Sentencing Tr. 7/25/01, 136).6 The majority does not elucidate exactly how the district court erred in its application of the law, despite a clear invitation by that court to review its legal conclusions and clarify the law.
At the first sentencing hearing, the district court presented its understanding of the downward departure inquiry: first the court determines whether the defendant has an extraordinary medical condition *830based on factual information, and then the court decides whether that condition is present to such an exceptional degree that it is sufficiently outside the heartland of typical cases. See United States v. Reinke, 283 F.3d 918, 923 (8th Cir.2002) (explaining the “heartland” analysis under the Guidelines and Koon). The three questions from United States v. Rabins apply to the second prong of this analysis. The government agreed with the court’s understanding of how to conduct its departure inquiry.7
Having found that Johnson had an extraordinary medical condition, the district court turned to the “much more difficult question” of whether or not to depart. In this decision, the court looked to the three questions presented in United States v. Rabins for guidance. The court proceeded to make findings about whether or not Johnson’s extraordinary condition fell outside the heartland of typical cases. The district court was quite frank about its uncertainty regarding the state of the law:
Well, I’m comfortable with my finding that Mr. Johnson suffers from an extraordinary physical impairment. I’m a lot less comfortable about the additional rulings I’m going to make now. And I — you know, I’m not sure what the exact test is, and I’ll just be honest about that. I don’t know whether the three factors in Rabins survive the Koon decision or not. And if they do, I don’t know whether there has to be a yes answer to all three to make a departure.
I am going to make a departure. And if the Rabins three questions survive and there have to be a yes answer to all three, I’ve already indicated no to two of the three. So I concede error in my departure.
(Sentencing Tr. 7/25/01,135).
Despite the district court’s repeated expressions of uncertainty about this circuit’s case law on departures for extraordinary physical conditions, the panel opinion takes no steps to clarify the situation. If anything, it further muddies the waters by conflating the factual finding prong of the departure analysis with the heartland analysis prong.
The majority relies on the three Rabins questions in its assessment of whether Johnson suffers from an extraordinary physical impairment. However, as the district court recognized at sentencing and as the government acknowledged, the Rabins factors are used as a means of measuring whether extraordinary conditions are present to such an exceptional degree that they fall outside the heartland of typical cases as a matter of law. The questions are not tools for interpreting medical diagnoses and prognoses.
The district court found the first two out of three factors discussed in Rabins, 63 F.3d at 729, weighed against a departure. The district court observed that both factors addressed Johnson’s physical condition vis-a-vis imprisonment, and that a high level of care available in the Bureau of Prisons would take care of defendant’s medical needs. With regard to the third Rabins factor, the court found that Johnson’s physical condition had a substantial present effect on his ability to function. The court then made the more general finding that Johnson’s medical condition fell “outside the heartland of defendants that I see.”
*831The majority notes the district court’s “uncertainty whether all three of these questions must be answered for each defendant or whether a positive answer to only one or two of them would suffice.” At the conclusion of the opinion, this is still an open question. Leaving this matter unresolved in a published opinion is a great disservice to sentencing courts. At a minimum, the majority should have clarified the law-a proper function of federal appellate courts.
In addition to not clarifying the state of the law, the panel opinion indicates that all three Rabins inquiries are to be evaluated in terms of imprisonment. The extraordi-nariness of a physical condition is to be “assessed in the light of the situation the defendant would encounter while imprisoned.” There is nothing in the Rabins decision to support this reading. The third question is simply, “Does the physical condition have any substantial present effect on the defendant’s ability to function?” Rabins, 63 F.3d at 729. Furthermore, the government does not share this perception or argue this position before the panel. In its brief, the government described the third Rabins factor as “a factor which has nothing to do with incarceration.” (Government’s Br. at 48).
Finally, the panel opinion does not resolve the difficult matter of how to measure the “heartland” of typical cases in these types of departures. The majority intimates that the heartland is to be judged in terms of the overall prison population, but does not explicitly articulate its view. The district court considered this issue and ultimately concluded that the heartland is to be assessed based on the sentencing court’s expertise, i.e., based on the heartland of defendants that it sees. Again, the sincere uncertainty of the district court has been left unresolved in a case that squarely presents the matter for review.8
As the discussion in this dissent emphasizes, I believe that the sentencing judge in this case carefully assessed and made findings of facts, including those of credibility, and applied those facts to the law as it appeared to him.
In the area of imposing sentences, Congress and the Sentencing Commission have removed much of the discretion from sentencing judges and have handed it over to non-judges, such as probation officers and United States attorneys. Nonetheless, the district court judges retain a critical role in making findings, assessing credibility, and relying on those findings to *832impose the sentence. Those duties are important and even awesome.
I say to the district court judge in this matter, and to other federal district court judges who impose sentences: do not surrender those duties and important functions, notwithstanding disagreements with your appellate colleagues, such as in this case. These functions belong to the district court, need to be in the district court, and should remain there.
I respectfully dissent in this matter because the district court’s factual findings deserve deference from this panel and the majority’s treatment of this case offers far more questions and ambiguities than resolutions.9

. It is entirely unclear how the majority intends future district courts to conduct § 5H1.4 downward departure analysis. The majority does not reconcile the Seventh Circuit's analysis in Krilich with the Rabins decision. For example, it does not explain how Krilich's focus on whether the "prison medical facilities [can] cope” with the defendant’s medical problem should be incorporated into the three Rabins questions. Krilich, 257 F.3d at 693. Simply citing these two decisions does not provide the type of legal analysis the district court in this matter requested.

. The above statement from Koon reminds this writer of a comment made by the late Chief Justice Warren Burger at New York *828University's summer session for appellate court judges in 1969. Chief Justice Burger, in response to this writer’s inquiry about federal appellate court judges reviewing sentences imposed by district courts, stated in substance that appellate court judges know very little about sentencing and those sort of decisions should remain largely in the purview of experienced district court judges.

. The court stated:
On the other hand, you know, I don't have a crystal ball, and I don't know the answer to the question. And I think the *829answer to the question for me might be dispositive of how I would rule. And because this is an important matter, I hate to just take a guess as to what the answer is because I think both sides are entitled to something better than my best judgment on it when I think there’s an answer.
(Sentencing Tr. 5/26/01, 81).

. The district court stated:
Well, I find — first of all, I'm going to adopt as my factual findings in the case Defendant’s Exhibit AA, the medical report by Dr. Leon, and I basically adopt the entire report as my factual findings, but I want to focus on the last page including the summary, and Dr. Leon indicates Mr. Johnson has multiple medical problems, the most serious of which is severe coronary artery disease which has resulted in two heart attacks and a left ventricle of the heart replaced by scar tissue and is therefore nonfunctional — over half of the left ventricle of the heart is replaced by scar tissue; and, therefore, the left ventricle is nonfunctional.
And based on all of the medical findings by Dr. Leon, I find that the defendant easily meets the requirement of extraordinary physical impairment. To me that's an easy call.
Now, whether or not I should depart is a much more difficult question. But on the central question of whether he has an extraordinary physical impairment, I find that he does. And I find that by — beyond a reasonable doubt in my mind that he has an extraordinary physical impairment even though I only have to make the finding by a preponderance of the evidence. I find that the evidence is overwhelming that this defendant has an extraordinary physical impairment.
(Sentencing Tr. 7/25/01, 119-20).

. At another point during sentencing the court asked the government:
And my first question for you, Mr. Dee-gan, is I've never been clear as to whether or not the answer has to be yes to all three [Rabins] questions, whether you can balance the three. It really doesn't say that — it just says these questions must be answered for each individual defendant .... [Ujntil the Eighth Circuit clarifies it, I find it ambiguous.
(Sentencing Tr. 7/25/01, 121).

. At the second sentencing hearing the government stated, "[OJnce you find an extraordinary physical impairment, then you ask those questions that Judge Arnold laid out to determine whether it's the type of extraordinary physical impairment that the guidelines are talking about in 5H1.4.” The court responded, “Okay. That's my understanding. We're on the same wavelength there." (Sentencing Tr. 5/29/01, 67).

. The following statements by the district court reveal yet another unclear area in this type of case:
I think I've virtually read all the other Eighth Circuit cases on this departure as well as a smattering of cases from the other circuits.
One of the issues I have is there’s kind of a theme that you see in these cases which is ... the fact that the cases talk about whether or not somebody can receive adequate treatment for their condition in the Bureau of Prisons.
Here is my kind of overall question for you. I've never exactly understood what the significance of that is in terms of this downward departure. In other words, it doesn't seem that it’s a prerequisite. In other words, you don't have to find some incredibly obscure condition that the Bureau of Prisons has never heard of or doesn't believe they can treat in order to have discretion to grant the downward departure, at least that's my understanding.
But, on the other hand, this issue about how the Bureau of Prisons would deal with the medical condition and their ability to treat it seems to come up in virtually eveiy case. So I'm wondering, if it’s not a requirement, exactly what is the significance of the ability of the BOP to treat the condition?
(Sentencing Tr. 12/20/00, 35-36).

. It is ironic that the dissent in Rabins notes the district court as saying it would “be delighted to have some more specific guidance from the Eighth Circuit” on the issue of whether a deteriorating physical condition due to HIV-positive status can be a factor considered for downward departure. 63 F.3d at 733. The dissent in Rabins faults the majority for not providing that requested guidance. Here, too, the sentencing judge sought guidance on appeal but obtains only apparent rejection of his careful, thoughtful findings.