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Little Red Lies Case-file #6 - Part 5

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LITTLE RED LIES Part 5
Author: G. Waldo
Rating: Case-fic’. Some angst. Mentions of violence. Hurt-comfort. Light humour, and of course Jane-pain. Characters: Jane/Lisbon friendship; Jane/Cho
Summary: The trial and the tribulations...
Disclaimer: Not mine though I wish he was.

*Please note that although I have done some research into court-room proceedings and lawyer-speak, I am no expert at either. I have only been in a court-room twice in my life (once to render testimony on behalf of a friend and once on behalf of myself – neither one a murder trial!) I have listened to how lawyers talk in court and I suspect it varies widely. In my experience, one seemed competent while the other came across an idiot.
CBI

Williams approached the witness stand and, linking his fingers together, asked “You have testified today that in your professional opinion, Mister Jane has completely recovered?”

Miller drew her head up, mentally readying herself for anything Williams might throw her way “Yes.”

“Well, that is good news, isn’t it? But tell us, Doctor Miller; did Mister Jane at any time while under your care, act in a violent way?”

“Well, when patients have undergone trauma such as he-“

“Excuse me, Doctor Miller, but we understand Mister Jane had gone through stress – and that he had already hurt himself, that has already been made clear. What we would like to know is if Mister Jane at any point while under your professional care as his psychiatrist acted out? With violence? Toward anyone? Toward you perhaps?”

Miller cleared her throat. “There was...one incident.”

“Incident?” Williams repeated. “Hardly a sufficient word to describe what it reads in your own report, is it?” Williams retrieved his notes from the prosecution’s table and flipped to the page he wanted. “Shall I read it to you directly from your own report on file or are you willing to be forthright with us and tell us exactly what happened?”

Miller took a deep breath. “One week before he was discharged, Mister Jane...became violent in the common room.”

“I see.” Williams raised his eyebrows as though to say to the jury isn’t this a surprise? “Violent in what way?”

“Patrick attacked one of the orderlies – he threw a chair at him and tried to escape. It was a delayed reaction to one of the medications he was on, Patrick would never-“

“But he did, Doctor Miller, he did. You say he threw a chair. Sounds innocuous enough but was the orderly injured?”

“He received a concussion.”

“And this orderly was up on his feet the following day?”

Miller stared coldly at Williams. “No. He was hospitalized.”

“For how long?”

“Nine days.”

“And I’m assuming he was awake for those nine days? He was conscious?”

“No. For five of those days the man was in a coma. He awoke and several days later he was discharged.”

“I see. So throwing a chair at someone and causing them to be hospitalized is a normal state of affairs for a patient under your care?”

“Of course not, he-“

“Patrick Jane was under your care, Doctor, and you have just stated to this court that only one week prior to his discharge – a patient that according to you was nearly fully recovered - hospitalized a man who did nothing to him what-so-ever. Or had this orderly hurt Mister Jane in any way?”

“No. It was the medication that made Patrick do that.”

“Were there any incidents prior to this very serious one?”

“There was one other, very minor incident.”

“And what were the circumstances of that violence?”

“It could hardly be called violence. Patrick pushed another patient.”

“Oh? Why?”

“That patient kept bothering Patrick, wanting to see magic tricks and other...entertainment I suppose. Patrick kept refusing, finally pushing the fellow to make his point.”

“So Patrick pushed the other patient down? Tripped him? What?”

“Patrick pushed him against a wall.”

“And were there words exchanged?” Williams asked quietly.

Miller knew Williams had the details in his hands. “Patrick threatened him.”

Williams spun around to face her and demanded “Stop beating around the bush, Doctor Miller – and tell us the whole truth! What did Patrick say to this other patient whom he pushed up against a wall?”

Miller swallowed hard. “Patrick said that if the man did not stop bothering him then he would...kill him.”

“Kill him?” Williams repeated loudly for the jury. “Kill him? Patrick said he would kill him?”

“Yes, but he didn’t mean it. We had taken him off the drug and he was going to be fine.”

“Oh, he was going to be fine? Which drug by the way, and when was he taken off it – before or after the incident with the chair?”

“We had decided to put Patrick on methylphenidate2.”

“The brand-name, if you please, Doctor.”

“Next Generation Rytalin.”*

“This drug is used for what?”

“For anxiety. In my opinion the standard bupropion and amitriptyline – commonly known as Wellbutrin and Elavil- were not having enough of an effect on his depression and agitation problems, so we decided to put him on Rytalin2 as a short term supplement.”

“Including the Rytalin2, how long was Patrick on this drug regime? How many weeks before the incident?”

“The first week he was put on bupropion and amitriptyline . Five weeks into his treatment he was put on the Rytalin2 for a duration of ten weeks, then we stopped it.”

“Because...?” Williams spread his hands.

“We were worried about the possible increasing adverse effects. Patrick was already showing some counter-effects so it was thought best to discontinue the drug.”

“Counter-effects meaning side-effects? Negative side effects?”

“Yes.”

“Are those were?”

“Hyper anxiety, insomnia, night terrors, headaches, heart palpitations...”

Williams checked his notes. “Mm, you forgot to mention a few, Doctor.” He said with a hint of correction. “Let me read them for the benefit of the jury so there is no mistake. Other serious side effects include: self-injury, paranoia, hallucinations, panic, personality changes, delusions and aggression.” Williams verbally underlined the last word. “And once the drug is discontinued, how long can these counter-effects last?”

“Days or weeks, it is different from patient to patient. The other drugs have the potential for the same adverse effects but Patrick had showed no sign of them.”

“Clear something up for us, Doctor. Do these drugs cause a person to act contrary to their normal patterns of behavior?”

“No, these are not little personalities in pill form. They do in some cases cause a person to act out behaviours already present. For example just as most people have some capacity for fear, a drug such as Rytalin2 can enhance those feelings of fear by acting on the adrenergic – the adrenaline - receptors in the brain.

“What that means is though Rytalin2 was developed to reduce the feelings of anxiety by reducing the amount of adrenaline taken up by the brain, in some people the body responds by flooding the system with massive amounts of adrenaline – it is tantamount to an allergic reaction. Instead of a calming effect, the anxiety or fear or what-have-you increases.”#

“So in your professional opinion, in Mister Jane this drug had the opposite effect – the counter-effect – causing him to act aggressively.”

“Yes.”

“Are you absolutely sure, Doctor?”

“Yes, I am absolutely sure.”

Williams granted her a small, indulgent smile. “You’re sure? When two other colleagues on staff disagreed with you, noting so in their own reports?”

“It is not unusual for two physicians to disagree on the treatment of a patient with Patrick’s type of Post Traumatic Stress. Doctor Field disagreed and so did Doctor Van Brenner but Doctor Mercerau agreed with me.”

“Let me quote to you from the report of the doctor’s that did not agreed with you, Doctor Miller- “

“I am aware of what’s in those reports.”

Williams ignored her comment and read aloud. “”In her decision to remove Patrick Jane from the Rytalin2, it is my professional opinion that Doctor Miller is acting in what I can only term as a knee-jerk fashion by removing her patient from the drug methylphenidate2 before it has had sufficient time to come to its full potency. Although the patient has had two incidents of violence, it is my belief that this aggression is not due to his drug regime either in combination or alone”.”

Williams looked at her. “At the time Patrick Jane was under your treatment, how many years had you worked as a psychiatrist, Doctor?”

“Four years.”

“Four years. Doctor Van Brenner had accumulated twenty more years in his psychiatric profession and yet you ignored his opinion.”

“I did not ignore it, I considered it and disagreed. Doctor Brenner did not like to deviate from conventional therapy and in Patrick’s case, conventional therapy was not working, that’s why the board decided to call me in – I was versed in new therapies.”

“How can you be so sure conventional therapy would not have worked in say, another few weeks or months? How can you be sure that Patrick’s aggression wasn’t simply a part of his natural make-up? He was only under your charge for eighteen weeks, yet you assert that you were able to make that kind of determination with less than five months of knowing him.”

“Patrick was in a controlled environment. I saw him almost every day, worked with him six days a week for hours each session. I came to know him very well.”

Williams addressed the jury. “Long enough, Doctor Miller claims, to know without a shadow of a doubt that Patrick Jane was not an aggressive man with tendencies toward violence. Long enough that somehow Doctor Miller, by an act of what would seem to me to be a type of osmosis, claims she knew everything about him.”

Miller sat forward, blurting out “Patrick was suffering from an allergic reaction to the drug – it’s rare but it happens, and even if he wasn’t allergic it would have been unethical to keep him on it if that was even a possibility. People can die from allergic reactions.”

Williams did not turn an eyelash to her outburst. “Are you sure that’s what it was, Doctor. Did you have any allergy tests performed on Patrick, to determine if that was the case?”

“It wasn’t necessary. We determined –“

“Excuse me Doctor – “We”??”

“I determined that Rylatin2 was the most likely cause of his aggression. It was the last drug I put him on and it was logical that it was causing the changes in his behavior. Removing it from his regime was the proper decision.”

“In your judgment and no one else’s?”

Miller lifted her chin. “I was his doctor, so yes, in my judgment.”

“Do you admire Patrick, Doctor Miller?”

“Yes. Mister Jane has done very well for himself.”

Williams addressed the jury and Miller, walking back and forth between them, drawing everyone into his argument. “You are a medical professional, Doctor Miller, who since the time Patrick was under your care has been involved in medical research of a decidedly unethical nature. In other words, you were convicted of falsifying research data, making-up laboratory results in order to protect the reputation of another doctor - a scientist – a man whom you also “admired”. Tell me, Doctor, do you like Mister Jane? Do you perhaps find him attractive?”

“What does that have to do with-?”

“Answer the question please.”

“I don’t see the poi-“

Williams sighed heavily over this most trying witness. “Your Honor, will you please instruct the witness to answer the question.”

Gilpin, chin in hand, “The witness is so instructed. Answer the question, Doctor Miller.”

“I don’t see the relevance but yes, Patrick is an attractive man.”

“And you were fond of him? You felt sorry for him. You wanted to help him.”

“Of course I wanted to help him. He was my patient and he was suffering. Patrick was in serious emotional trouble. I want to help all my patients.”

“During his time under your care, you took Patrick on two day-trips and you also spent double the required hours in session with him than with any other of your patients during those months. Double the hours, doctor. Can you explain this discrepancy?”

“Yes. There was hope for Patrick.”

“So you did not hold out any hope for any of your other patients? Seems a little like favoritism to me.”

“Of course not. It may seem callous but often a doctor has to make a choice between spending years of therapeutic treatment and - yes - funds treating a hopeless case or spending those same energies on one with a good chance of recovery, a chance that they’ll be able to reclaim their health and life. I made an ethical choice to help one whom I knew I could help provided I put in the resources and the time.”

“And in your opinion, Patrick Jane was such a patient?”

“Yes. He was suffering from an extreme form of survivor’s guilt and PTSD but I knew he could be helped. He could get well if I could get him to fight for his life.”

“”Help”.” Williams repeated, his tone dripping sarcasm. “Spending double the hours on a single patient we might be able to chalk up to...er...enthusiasm, if you will, for your patient, but a controversial drug and a controversial therapy – this touching therapy – which sounds like hogwash to me, all that touching and more touching, a therapy that is barely recognized in professional circles. And two day-trips, doctor? Two, when none of your other patients received even a single outing during those eighteen weeks that Patrick Jane was under your touchy-feely care?”

Miller herself spoke directly to the jury now. “Patrick needed extra attention if there was any hope of getting him out of that place. He would have become just another sad statistic without my help.”

Williams raised his eyebrows. “Without your help? Just yours? Your magic fingers - no one else’s was capable of bringing Patrick out of his mental and emotional hole but you, Doctor? You did not take any of your other patient residents in Greenlawn on day-trips. On two day-trips I remind you, with the sole exception of Patrick Jane. And not just any ol’ day-trip.”

Williams put his hands in his pockets and jingled the coins he found there as though just stumbling upon an interest fact. “Tell me, Doctor Miller, where were these day-trips? Where did you take Patrick? Don’t bother answering, I’ll tell everyone the kind of therapy Doctor Miller believes in.” Williams checked the notes in his hand. “On both occasions you took Patrick to a fancy, high-priced restaurant where you ate steak and drank wine. Isn’t that correct, Doctor?”

“Yes.” Miller said her voice defiant. “Patrick needed some normalcy. I was trying to remind him that there are things this life worth fighting for.”

“Then why not to the Zoo? Or to a nature park, or a museum - or a beach?? No. You bought him a new suite and then took him on a fancy, adult oriented and rather intimate dinner, wining and dining him complete with candle-light.”

“I didn’t take him to a public place because in public places there are often children present and at that time I didn’t think it would good for Patrick to be expo-“

“-And the new clothes? The expensive suit? And new shoes as well? Were they part of your one-on-one therapy, too, Doctor?”

Miller sighed, sat back and rubbed her temples. “Look, I can see where you’re trying to take this but Patrick had no clothes with him at Greenlawn. His home was the scene of an ongoing crime investigation – we did not have the keys and even if we had, we would not have been permitted to enter the house. I had to buy him the clothes. It was either that or Greenlawn pajamas, and I did not want him to feel humiliated in public.”

“And the institute paid for them?”

“Of course not. Allowance for such extras were not in the budget. I paid for them.”

“Oh, you paid for them? So why not jeans and a sweater? Why not a hot-dog stand for that matter? Why a new and fairly expensive suit and an equally expensive intimate dinner – let me tell you, that’s some therapy doctor. That’s some “admiration”. My own wife doesn’t admire me that much.”

“By the way, not that you care, obviously, about my medical reasoning, but I did not allow Patrick to drink wine, it would have interfered with his med’s.”

“Two lovely evening’s out was part of your therapy. I see. Let’s talk about this therapy, this touching-the-patient therapy of yours. – was it conducted in a group setting?”

“No, it was always conducted in my office.”

“Just the two of you – touching and touching some more. That seems a little unnecessarily intimate as well, Doctor. Tell me, how did Patrick feel to you? Did he feel...you know – good?”

Selby stood. “Objection!”

“Sustained.” Gilpin said, sounding weary. “Watch yourself, counselor.”

“Certainly your Honor - my apologies.” Williams said cheerfully, though delighted to have snuck the colorful comment in. “Never-the-less Doctor Miller, from what we’ve heard thus far it sounds to me like you were a little more fond of Patrick than you’d care to admit. From your prescribed therapies you seemed to me to have been enamored with him. I put it to you that you liked Patrick beyond the realm of physician/patient. You liked him so much in fact, you were willing to stretch the rules and your own ethical boundaries and ignore those little parts of Patrick’s personality that did not fit in with your fantasies about what kind of man he was. I put it to you that you chose to ignore his violent tendencies, and that instead you wanted to protect him as one does a lover and not a patient.”

“That’s ridiculous. You’re ignoring all the medical evidence and trying to-“

“-When was his first assault at Greenlawn? Before or after you started the regime of Rytalin2?”

“Before. But it was only natural for Patrick to have been displaying some anger at that time –“

“There seems to be an inordinate number of “but’s’ in your testimony Doctor Miller.”

Miller sat forward once more, appealing to the jury. “Please listen to me.” She pleaded. “At that time Patrick was only just beginning to show emotion again – he had gone through a terrible ordeal – he came home to find his wife and young daughter murdered - they were left cut up and on display.” She thrust a hand out to them. “How would any of you have reacted?? Once his emotions were reawakened, it was only natural he would be feeling some anger and acting out at first, but then, shortly after, he began to show some positive, healthy responses.”

Williams waved to the jury as though to let them know to momentarily indulge her if they must, and that he was okay with it. “How we can believe any so-called professional opinion of yours, Doctor, when you have been shown to be a liar – a convicted liar?” Williams reminded her. “You thought Patrick was non-violent and you thought it was the drug and you thought Patrick was incapable of hurting anyone – well he has been violent, and he has hurt someone. He committed murder. In the light of his violent act against Timothy Carter, can what you think regarding Patrick be taken at all seriously?”

“Because it’s the truth, goddamit! I was his doctor. I knew him as my patient and I never touched Patrick inappropriately - ever. I respected him too much for that.” Miller swallowed her fury and looked across the cold, gleaming floor at the man whose life was being sifted asunder. “And I still do.”

Williams returned to his desk. “I myself have the gravest doubts.” Williams waved his hand again but this time as a dismissal to everything Miller thought or had even ever spoken. “No more questions, your Honor.”

 

CBI

Part 6 soon 

*Although Ritalin exists, Rytalin2 does not.

# I am not a doctor – this is mostly bull$hit!