0001
1
2
3
4
5 IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
6
7
8 THIRD JUDICIAL DISTRICT
9
10
11 IN THE MATTER OF F.M.
12 3AN-02-00277 CI
13 ________________________/
14
15
16
17 VOLUME I
18
19 TRANSCRIPT OF PROCEEDINGS
20
21 March 5, 2003 -- Pages 1 through 198
22
23
24 March 10, 2003 -- Pages 198 through 223
25
0002
1 HEARING REGARDING BURDEN OF PROOF THAT
2 DEFENDANT IS MENTALLY ILL AND REGARDING
ADMINISTRATION OF MEDICATION
3
BEFORE THE HONORABLE MORGAN CHRISTEN
4
Anchorage, Alaska
5 March 5, 2003
6
7
8
9 APPEARANCES:
10
11
12 FOR THE PLAINTIFF: Jeff Killip
13 Assistant Attorney General
14 State of Alaska
15 1031 West 4th Avenue, Suite 200
16 Anchorage, Alaska 99501
17
18
19 FOR THE DEFENDANT: James B. Gottstein
20 406 G Street, Suite 206
21 Anchorage, Alaska 99501
22
23
24
25
0003
1 CONTENTS
2
WITNESSES: DIRECT CROSS REDIRECT RECROSS
3
FOR THE PLAINTIFF:
4
RACHEL HUMPHREYS 16 48 50
5
MIKE MYERS 52
6
7 DR. ROBERT HANOWELL 58/66/
70/88 96
8
DR. NICHOLAS KLETTI 101 108
9
FOR THE DEFENDANT:
10
11 FAITH MYERS 114 153 156
12 DR. GRACE JACKSON 164/167/
181 189
13
DR. LOREN MOSHER 170 179
14
15 EXHIBITS: ADMITTED
16 FOR THE PLAINTIFF:
17 1-7 -- photos of Faith Myers' apartment 47
18 8 -- one-page document handwritten by Faith Myers 55
19
FOR THE DEFENDANT:
20
C -- report on the analysis of the olanzapine
21 clinical trials 185
22 D -- materials received from FDA under
Freedom of Information Act 184
23
24 L -- articles received from Dr. Grace Jackson 191
25 DECISION BY THE COURT 192
26
HEARING ON MOTION FOR EXPEDITED CONSIDERATION 199
27
28
29
i
0001
1 P R O C E E D I N G S
2 4403-41
3 8:52:51 AM
4 THE COURT: We're on record in Case No. 3AN-03-277.
5 It's a case regarding Faith Myers. Mr. Gottstein, before
6 I go any further, I'll just state your appearance. Mr.
7 Gottstein is present, for the record, as is Mr. Killip for
8 the State. Your client requested this be an open hearing,
9 is that correct?
10 MR. GOTTSTEIN: That's correct. She's not here yet,
11 though, and she's supposed to be here. So, I don't know
12 what the hang-up is. Dr. Kletti, wasn't she --?
13 THE COURT: Right. She has the right to be present.
14 DR. KLETTI: Right. She was scheduled for
15 transportation to court this morning.
16 THE COURT: I was told that you all were ready. I
17 didn't realize that you weren't. We need to wait for her.
18 So we'll go ahead and go back off record and do that.
19 Well, actually, maybe I'll take up some housekeeping,
20 first, but we're not going to proceed in substance with
21 her, certainly.
22 I just have the one exhibit list. Counselor, do you
23 have --
24 MR. GOTTSTEIN: The respondent's?
25 THE COURT: Yes. Do you have an exhibit list, Mr.
0002
1 Killip?
2 MR. KILLIP: Your Honor, given the accelerated pace,
3 the witnesses just showed up. I had a chance to speak
4 with one for almost an hour yesterday, but there are two
5 more I haven't had a chance to talk with and one of them
6 presented me with some photographs. I don't have an
7 exhibit list that I've generated yet, but I can do it
8 right now.
9 THE COURT: Okay, that's fine. We can do it when we
10 go off record for a minute. As long as Mr. Gottstein has
11 it and has a chance to take a look, that's fine.
12 MR. GOTTSTEIN: Your Honor, I would note under AS
13 47.37.30(a)(6) that the petition must list the prospective
14 witnesses who will testify in support of commitment or
15 involuntary treatment, and only Dr. Hanowell was listed.
16 And I would object to any witness other than the one
17 specifically listed testifying.
18 THE COURT: All right. The objection is noted, but
19 again, I'm not going to make any substantive ruling until
20 your client gets here. My intention is to stay on record
21 just to get some housekeeping taken care of.
22 MR. GOTTSTEIN: Can I respond to that, Your Honor?
23 THE COURT: No, not yet.
24 MR. GOTTSTEIN: Okay.
25 THE COURT: Because we're not going to get into
0003
1 substance yet. I just want to make sure I have
2 everything, so that I can make use of the next few
3 minutes.
4 I have one exhibit list; I'm going to get another
5 exhibit list. I don't have witness lists. Mr. Gottstein,
6 you made reference, I think, to one in our telephone
7 conference we had the other day?
8 MR. GOTTSTEIN: Yes.
9 THE COURT: Maybe I could get that much done, so I
10 could be reviewing those while we're off record. Do you
11 have one Mr. Killip?
12 MR. KILLIP: I can give it to you verbally?
13 THE COURT: Sure.
14 MR. KILLIP: Yeah, we've got Dr. Hanowell, Dr.
15 Kletti, and the three family members that were noted in
16 the original, initiating petition, that filed the initial
17 petition.
18 THE COURT: Okay. And they are?
19 MR. KILLIP: Rachel.....
20 THE COURT: Is it Humphreys?
21 MR. KILLIP: Humphreys.
22 THE COURT: Yep.
23 MR. KILLIP: Michael Myers and Arial Myers.
24 THE COURT: Michael and Arial?
25 MR. KILLIP: Yeah. All those names are in the
0004
1 pleadings that Mr. Gottstein has had.
2 THE COURT: Yes. I have read the pleadings.
3 The only other thing I think I could do before your
4 client gets here, sir, is to let you both know that since
5 this has been necessarily very rushed, I wanted both of
6 you to know that I have had a chance to read all of the
7 pleadings that you both filed, including the pleading that
8 you just filed this morning, a minute ago, Mr. Killip.
9 And I have had a chance quite early this morning to read
10 the deposition transcript that was given to me. I have
11 not had a chance to read all the attachments to your
12 motion, Mr. Gottstein, but I've gone through all of the
13 pleadings. All right? I thought you might want to know
14 that before we get started.
15 I don't think there's any other housekeeping I can
16 take care of until your client gets here, unless there's
17 something that you --
18 MR. GOTTSTEIN: I don't know if you consider the
19 telephonic testimony of Dr. Mosher housekeeping or not,
20 but that might --
21 THE COURT: No. I think it's an evidentiary ruling,
22 and I don't want to take it up anymore than the other
23 objection, before she arrives, but thank you for reminding
24 me of it.
25 Mr. Killip, anything else you think we can -- that
0005
1 comes to mind that we can take up before she gets here?
2 MR. KILLIP: I don't think so, Your Honor.
3 THE COURT: No? All right, well then, I'm going to
4 go ahead and go back off record. I apologize to you all
5 to keep you waiting, but Ms. Myers absolutely has a right
6 to be here, so we will wait. We'll stand in recess.
7 (Off record.)
8 8:58:46
9 THE COURT: We're back on record. You're Ms. Myers?
10 MS. MYERS: Yes, Your Honor.
11 THE COURT: I just need to confirm for the record
12 that you are present, you have the right to be present.
13 It is my understanding you choose to be, so thank you.
14 Are we ready to proceed then, counsel?
15 MR. GOTTSTEIN: Yes, Your Honor.
16 MR. KILLIP: Yes, Your Honor.
17 THE COURT: All right. Mr. Gottstein, has your
18 client received a copy of the petition?
19 MR. GOTTSTEIN: I believe she has. Haven't you?
20 MS. MYERS: I received a great many copies. I
21 wasn't able to read through all of them.
22 THE COURT: Okay. Mr. Gottstein, could you move the
23 microphone closer. I'm not going to be directing too many
24 questions to your client, but I want to make sure we have
25 a good recording.
0006
1 You said you received a great many copies. I
2 couldn't hear the rest of your response.
3 MS. MYERS: I received this to read.
4 MR. GOTTSTEIN: Your Honor, some of that's from me.
5 Did you receive anything, the paperwork from the hospital,
6 when they initiated this?
7 MS. MYERS: The hospital gave me a list of my
8 possessions that they put in storage and they gave me --
9 after I requested it several times -- a copy of the
10 petition that listed what someone thought was grounds for
11 having me screened and picked up at my home by the police,
12 which took away my civil rights.
13 THE COURT: Okay. I wanted to make sure you had a
14 copy of the petition. It sounds like you have received
15 it. Is that correct, Mr. Gottstein?
16 MR. GOTTSTEIN: Well, she's received stuff that I've
17 given her, but let me show -- and there may be some
18 confusion about what the extant petition is. I think Mr.
19 Killip mentioned that in his opposition yesterday. There
20 seem to have been one that lists two items down at the
21 bottom, and one at lists three.
22 THE COURT: Okay, why don't you take a minute and
23 review them with your client for the record. You're both
24 at counsel table and I think you have them right in front
25 of you. I want to make sure that she's seen both of them,
0007
1 if you would, please.
2 MR. GOTTSTEIN: Well, Your Honor, I guess I would
3 like to know which one you have.
4 THE COURT: I think I -- Mr. Killip, which one are
5 you proceeding on? Are you proceeding on the petition
6 where your witness has added a handwritten note at the
7 bottom?
8 MR. KILLIP: Yes.
9 THE COURT: Okay. Thank you.
10 MR. GOTTSTEIN: Have you seen this? Were you given
11 this?
12 MS. MYERS: I was given that, but is it the one that
13 was signed by my daughter and Arial, or is this the one
14 that was signed by Dr. Hanowell?
15 MR. GOTTSTEIN: Dr. Hanowell. Now, there were two.
16 There was one that had the two --
17 MS. MYERS: I couldn't read that last.
18 MR. GOTTSTEIN: Okay.
19 MS. MYERS: Okay.
20 MR. GOTTSTEIN: Were you given this?
21 MS. MYERS: Yes, I have a copy of that.
22 MR. GOTTSTEIN: Okay. And you have a copy -- I'm
23 showing her the petition for court approval of
24 administration of (word indiscernible -- simultaneous
25 speech).
0008
1 THE COURT: Thank you, counsel.
2 MS. MYERS: I was never given anything saying that I
3 agreed to use psychotropic medication.
4 MR. GOTTSTEIN: Right. But, were you given this
5 document?
6 MS. MYERS: I was given that document. I did not --
7 I did not have a court order to be given psychotropic
8 medication, which is my legal right.
9 MR. GOTTSTEIN: And she has been, actually, Your
10 Honor.
11 MS. MYERS: I have been medicated, Your Honor.
12 THE COURT: All right. Today?
13 MS. MYERS: Against my will.
14 THE COURT: Today?
15 MR. GOTTSTEIN: While she's been in the hospital.
16 THE COURT: All right. I need to know whether or
17 not you're able to proceed today. Are you under the
18 influence of any medication that affects your ability to
19 proceed today?
20 MS. MYERS: I don't think so, Your Honor.
21 THE COURT: Okay.
22 MS. MYERS: I'm a bit hungry, because I did not wish
23 to eat the food, just in case.....
24 THE COURT: Um-hmm.
25 MS. MYERS: .....that would be damaging to my
0009
1 thought processes, also.
2 THE COURT: All right. All right. Mr. Killip and
3 Mr. Gottstein, are you in agreement that we are proceeding
4 under 47.30.73.735 today?
5 MR. KILLIP: I must confirm that, but that sounds
6 correct.
7 MR. GOTTSTEIN: For the -- the commitment part of
8 it.
9 THE COURT: Correct. Not for the administration of
10 the medication, but just for the commitment.
11 MR. KILLIP: Right.
12 THE COURT: All right. And so the other thing --
13 and I apologize for doing this in a little bit of a
14 mechanical way, but we're all here, I think, having tried
15 to digest these pleadings, and in your cases generate
16 them, in very short order. So I just want to make sure
17 we're on the same page.
18 That is my understanding, and it's my understanding,
19 Mr. Killip, that you're proceeding here today -- you're
20 seeking an order -- well, two really. One requiring
21 involuntary, or allowing involuntary commitment for a 30-
22 day period?
23 MR. KILLIP: Yes.
24 THE COURT: And then the other, which is a separate
25 issue, is the administration of the medication.
0010
1 MR. KILLIP: Correct.
2 THE COURT: So, Ms. Myers, I'm required to inform
3 you and will on record that if the State seeks a
4 commitment beyond 30 days, which Mr. Killip has made clear
5 he is not doing at this point, but at this point -- yes?
6 MR. KILLIP: We don't have a petition filed.
7 THE COURT: Right. So, if they do, then you're
8 entitled to a full hearing or a jury trial. And I want to
9 make sure that you understand that. And that we had Mr.
10 Killip's comment that that's not his intention today.
11 Mr. Gottstein, I have a waiver in the file to have
12 this hearing be on the usually statutory, 72-hour period
13 and I want to make sure I recite into the record what
14 occurred, because the three of us, two counsel and I had a
15 telephone conference Tues -- Mon -- Tuesday? Monday.
16 MR. GOTTSTEIN: Monday.
17 THE COURT: Monday. I beg your pardon. This is
18 Wednesday, yes. So, for the record, I want to make sure
19 that I just take a minute to say that I had a conference
20 call with counsel and with Mr. Gottstein on Monday
21 evening, which is right when I learned that this petition
22 had been filed and that Mr. Gottstein had filed his
23 motions. I think he filed them, though correct me if I'm
24 wrong, the preceding Friday at a hearing at API that
25 Master Duggan was not able to accommodate the length of
0011
1 hearing he thought was going to be entailed by your --
2 your requests that your motions be heard. Is that
3 correct?
4 MR. GOTTSTEIN: Your Honor, the motion to dismiss
5 and pretrial brief was filed before 9:00 AM on Friday, and
6 I believe the motion in limine was filed before 10 on
7 Friday.
8 THE COURT: All right, that's fine. And Master
9 Duggan recommended that this be kicked over to the
10 Superior Court directly here. It's my understanding that
11 you agreed with that recommendation. That was your
12 request?
13 MR. GOTTSTEIN: Yes, Your Honor.
14 THE COURT: Okay. I just want to make sure that the
15 record is also clear that we are operating under some
16 fairly significant time constraints. I was able to take
17 this hearing up yesterday, on my calendar I could have, at
18 any rate, but didn't because I had not yet received your
19 motions or Mr. Killip's oppositions. I required that Mr.
20 Killip file his opposition by yesterday, by I think noon
21 or midday, anyway, and he did that. And I have received
22 them and I think I explained to you both, already, that I
23 have had a chance to review them. But -- and I moved a
24 trial otherwise set for today so we could accommodate this
25 hearing today. It's a very important matter and I wanted
0012
1 to get to it just as soon as I could get to it. But the
2 other problem we've got is that Mr. Gottstein is leaving
3 town, later this afternoon, so we're trying to get this in
4 as quickly as we can.
5 All right. Do either one of you want to add
6 anything that we discussed in our conference call the
7 other day? Am I missing anything?
8 MR. GOTTSTEIN: Well, I think we've got the
9 telephonic participation matter still pending for Dr.
10 Mosher. Dr. Jackson has already been approved, but we
11 have the pending motion for the telephonic participation
12 of Dr. Mosher.
13 THE COURT: Okay. I'm going to take that up as we
14 come to that witness.
15 Mr. Killip, anything else from the telephone
16 conference?
17 MR. KILLIP: I think our position would be,
18 generally, we don't have an opposition to telephonic
19 participation, but it's our position that the issue is
20 really -- or the issues are limited to the commitment
21 criteria and the petition on the meds, and that's it.
22 We're not here to challenge medical science. So, to the
23 extent that Mr. Gottstein is going to call these clients
24 to challenge how medicine is practiced in Alaska, we have
25 a standard, open objection to that.
0013
1 THE COURT: All right. Well, I certainly take
2 telephonic testimony all the time. And so I don't have
3 any problem with that. Certainly it's not opposed, so to
4 the extent you want to call this witness telephonically
5 and just want a ruling on that for planning purposes, I
6 can tell you I don't have any qualms with that.
7 MR. GOTTSTEIN: Thank you, Your Honor.
8 THE COURT: And I'll grant that motion. But I don't
9 want to take up any of the other issues regarding the
10 witness until we come to the witness. Okay?
11 All right. So, Mr. Killip, that means since we've
12 clarified which statute you're proceeding under and we're
13 all in agreement, then that you have the burden of proof
14 here, to go forward, to prove the necessary elements by
15 clear and convincing evidence. So sir, I need to know how
16 you intend to proceed. Are you going to call these
17 witnesses you just referenced?
18 MR. KILLIP: Yes.
19 THE COURT: All right. Are you ready to do that
20 now?
21 MR. KILLIP: I could start with Ms. Humphreys, Your
22 Honor.
23 MR. GOTTSTEIN: Your Honor, I renew my objection to
24 Ms. Humphreys. She wasn't listed, as required by the
25 statute.
0014
1 THE COURT: And you think you've been prejudiced by
2 that in some way?
3 MR. GOTTSTEIN: Yes, I haven't been able to take her
4 deposition. I mean, she wasn't listed.
5 THE COURT: But she's one of the people who signed
6 the original petition, or provided the information for
7 that?
8 MR. KILLIP: Yes, Your Honor.
9 THE COURT: Is that the basis for her testimony now?
10 MR. KILLIP: Yes.
11 THE COURT: All right. I'm going to allow her
12 testimony, then.
13 MR. KILLIP: Okay.
14 THE COURT: Is she here?
15 MR. KILLIP: Yes.
16 MR. GOTTSTEIN: Now, are all the other witnesses
17 going to sit in during the testimony, or should they --
18 THE COURT: I'm, sorry, but I don't know who these
19 people are who are in the back of the courtroom. Do you
20 have other witnesses who are here who you are planning to
21 call to testify?
22 MR. KILLIP: No.
23 THE COURT: All right. Well it certainly is a
24 public hearing, by your client's waiver and the public is
25 welcome to attend the hearing. If there are other people
0015
1 who are going to testify, they should be seated just
2 outside until the time comes for them to testify.
3 MR. GOTTSTEIN: Okay.
4 MR. KILLIP: Um-hmm, yeah. I would ask that Dr.
5 Kletti be our advisory witness, be allowed to stay.
6 THE COURT: Yes, that's fine.
7 MR. KILLIP: He's going to testify, also.
8 THE COURT: All right. Well, I think there's some
9 objection about that, but we'll come back to that.
10 MR. GOTTSTEIN: But you're going to rule against it,
11 anyway.
12 THE COURT: I haven't heard the reasons for it, yet.
13 Your witness?
14 MR. KILLIP: I'm sorry?
15 THE COURT: Your witness?
16 MR. KILLIP: Yeah.
17 THE COURT: I'm waiting for your witness to come
18 forward.
19 MR. KILLIP: I'm sorry. Yeah, the State calls
20 Rachel Power.
21 MS. HUMPHREYS: Humphreys.
22 MR. KILLIP: Excuse me, Rachel Humphreys.
23 THE COURT: Yes, please, I'm sorry. This is a
24 foreign environment for you. Why don't you come right on
25 up here and sit at the witness stand, please?
0016
1 MS. HUMPHREYS: Okay.
2 THE COURT: Try to make yourself comfortable, to the
3 extent that's possible in a courtroom. If you come right
4 around to this chair please, ma'am, and remain standing
5 and raise your right hand, we'll administer the oath,
6 please.
7 THE CLERK: Do you swear or affirm that the
8 information you are about to give in this matter before
9 the court is the truth, the whole truth, and nothing but
10 the truth?
11 MS. HUMPHREYS: I do.
12 THE CLERK: Okay. You need to get closer to the
13 mike, please. State your name, spelling your last name
14 for the record.
15 MS. HUMPHREYS: Rachel HUMPHREYS, H-U-M-P-H-R-E-Y-S.
16 THE COURT: Ma'am, please try to speak into the
17 microphone as we're proceeding, as best you can. And Mr.
18 Killip, you may inquire.
19 MR. KILLIP: Thank you, Your Honor.
20 RACHEL HUMPHREYS
21 testified as follows on:
22 DIRECT EXAMINATION
23 BY MR. KILLIP:
24 Q Ms. Humphreys, how are you familiar with Faith
25 Myers?
0017
1 A She is my mother.
2 Q Okay. Is it fair to say that this is -- is it
3 difficult to be here today?
4 A Oh, yes.
5 Q Could you tell me, what's your understanding of
6 what, if any, mental health issues your mother may have?
7 A She's been sick since I was a kid. My dad said that
8 it was schizophrenia, paranoid schizophrenia.
9 Q And can you tell the court whether you've lived with
10 your mother over a period of time and what the -- I guess
11 the summary of what those dates are?
12 A I lived with her growing up.
13 Q Okay. Until what age, approximately?
14 A I think I was 18, something like that.
15 Q The usual age.
16 A Yeah.
17 Q And how old are you now?
18 A I'm 30.
19 Q Okay. And what, if any, personal observations did
20 you make during that time about your mother's mental
21 health?
22 A Growing up, she, you know, she seemed fine. She had
23 times when I was told that she was sick and we had to step
24 in and help out more and take care of household type
25 duties more, and not upset her.
0018
1 Q Okay. And how would you characterize your love for
2 your mother, assuming that that is the case?
3 A I love my mom.
4 Q Okay.
5 A She's different than some people, and that's okay.
6 Q How would you characterize your concern for her
7 welfare?
8 A I am concerned for her welfare. I want her safe.
9 Q And since you left the home when you were about 18,
10 can you summarize, I guess, the general observations that
11 you've made of her mental health?
12 A She pretty much continued about the same as she
13 always had, until she moved up to Alaska and she got
14 divorced from my dad. And I moved up here in '97, and she
15 seemed to be about the same, you know. She was still
16 working and still functioning about, you know, the way
17 everybody does.
18 And I think it was the spring of '98, or it was
19 about Mother's Day, she started getting really -- she
20 started staying at my house. She didn't want to stay in
21 her own house anymore. She said there was a gas leak, and
22 so obviously I didn't want her to stay in her house if she
23 had a gas leak. And I actually overheard her on the
24 telephone. She was taking care of my children, because
25 that was her profession, she was a daycare provider. And
0019
1 I heard her on the telephone, telling someone that she
2 hadn't been on her medication and she was having some
3 problems. And she said that right in front of me and I
4 was really upset. And so I was trying to find other
5 daycare, and then suddenly she got really sick and that
6 was the first time I think she voluntarily went to the
7 respite care at API.
8 And then -- then she -- I'm sorry, I'm having a hard
9 time remembering all along. She seemed to be doing pretty
10 good. She had ups and downs. Her last time that she kind
11 of had a down spiral was, I think it was 2000. And at
12 that time she ended up choosing to be living in her car at
13 the Totem Theater, she was staying in her car. And she
14 came over to my house to use my shower, and we were going
15 to have Thanksgiving dinner the next day. And she came
16 over for Thanksgiving dinner and started telling my
17 children that it was okay to rebel against authority. And
18 so I asked her not to come back to the house, because I
19 couldn't have her telling the children that it was okay
20 not to follow what the police told you to do.
21 And I really limited my children's involvement with
22 her at that point. More recent -- and then she -- in
23 December of 2000, she was involuntarily placed at API, and
24 she was there until spring. And that time she seemed to
25 be doing great. You know, she had --
0020
1 Q After her release?
2 A Yeah, after that. Yeah. She had an apartment and
3 she seemed happy and she had a boyfriend and life seemed
4 to be going really well. And I was visiting her very
5 regularly. I had the two grandchildren with me. I guess
6 this was -- this was after the kids were born, so 2001,
7 they were born in August. And I was visiting her very
8 regularly at that point. Probably almost once a week or
9 once every two weeks, I think. At least it was a couple
10 times a month, I know. And she seemed to be doing very
11 well.
12 And just before she told us that she was being
13 kicked out of her apartment, and she seemed to be unsure
14 why --
15 Q When was this, approximately?
16 A I think it was August or September of 2002.
17 THE COURT: Can I back up, Mr. Killip? Just
18 chronologically, you said when she was released in the
19 spring of 2000, she was doing very well.....
20 A 2001.
21 THE COURT: I beg your pardon, 2001 -- yes, you did
22 say that. 2001, she was doing very well.
23 MS. HUMPHREYS: She seemed to be, yeah.
24 THE COURT: Was your impression -- was she employed
25 at that point?
0021
1 MS. HUMPHREYS: No. At that point I think she went
2 on social security. I'm not sure, exactly, when that was.
3 THE COURT: Okay.
4 MS. HUMPHREYS: She never held another job that I
5 know of, after taking care of my kids.
6 THE COURT: Okay. Pardon the interruption.
7 MR. KILLIP: Thank you, Your Honor.
8 Q I think you were talking -- you were going to
9 describe what happened in April, or excuse me, August of
10 2002.
11 A Oh, right. That's -- we were helping her move out.
12 We were concerned that she didn't seem to have a place to
13 move to. But, you know, she was going to be evicted, so
14 we had to help her move to something, you know, so we were
15 helping her move. And in that process, we opened one of
16 the big cupboards and there was several, I'm going to say
17 maybe nine medicine bottles in her cupboards, mostly full.
18 And we asked about those and she said that she had been
19 weaning herself off of her medication. And so --
20 Q How was she doing at that time?
21 A She had been seeming okay, but she wasn't taking as
22 good a care of herself and she was pretty passionate about
23 -- she said she was being abused by people. Specifically
24 by her boyfriend and also by -- I don't know exactly who
25 she had said that my dad had abused her and it was just a
0022
1 really -- that was something that she was really upset
2 about. But if you avoided the subject, which I tended to
3 do, we could get along quite well. And our visits were
4 mostly just time for her to see the grandkids and just
5 kind of a, you know, a friendly, family visit.
6 Q Okay. You said that over the years you have noticed
7 kind of an up and down, kind of pattern.
8 A Yeah.
9 Q Now, in your estimation, and based on the picture
10 you had, where did it look to you like it was going?
11 A It looked like she -- before we had suspected -- I
12 had suspected that maybe she was not taking her full
13 dosage or something, because of her -- some of the things
14 that she was saying and some of the -- sometimes she
15 wasn't taking as good a care of herself. And that's just
16 like, it was always one of the signs, that she wasn't
17 doing so well, is that she would not take as good a care
18 of herself. You know, she wouldn't wash her hair as
19 often, or just little things, you know. But, it was just
20 one of those signs that we kind of knew might be pointing
21 to that. And when we found out that she had all that
22 medicine, we had told her that she should tell her doctor
23 that she's not using it and return it. Because our
24 concern was that somebody else might take it and get sick.
25 Or, we didn't know what. Or to dispose of it, somehow.
0023
1 And it's my understanding that Arial called her doctor,
2 because she knew who he was, and told him that she wasn't
3 taking her medicine. And then I was told that he was no
4 longer going to be her doctor, because she refused to take
5 her medicine.
6 And I asked her where she was going to go, when she
7 didn't have a place, and she said that -- a couple of
8 times she said that she was just going to move to Seattle
9 and change her name and be homeless. And I said well, we
10 didn't want her to do that because we were, you know, we
11 were concerned about her. And she said she'd check in and
12 she'd call. But it appeared that actually she was
13 planning to go stay at these cabins in Hope, and then she
14 was going to stay with her friend Rowena (ph) on the
15 weekends.
16 And so she did that, and she would call on some
17 weekends, and I think we got together a couple of times
18 since then. The ones I remember were just before
19 Christmas and I just took Alyssa (ph) over at that time.
20 And she seemed to be okay. She had some presents for the
21 kids and we just had a nice little family gathering type
22 thing. And then I didn't really hear anything until
23 January, I heard from Arial that --
24 Q January of this year?
25 A Yeah, of this year, that they had to get her an
0024
1 apartment. That they'd received a phone call from my
2 grandfather that said that she had no place to live and no
3 vehicle and so they told me that they got her an
4 apartment.
5 And I heard from mom -- well, actually I was gone
6 the night of the 7th, but my husband received a phone call
7 from her and she was at Harley's Cafe, which is real close
8 to our house. And she wanted me to come visit her there
9 and talk to her, but I wasn't going to be home until
10 really late. And so he told her that since it was going
11 to be so late, he didn't, you know, that I wouldn't be
12 able to see her that night. And so she wanted me to come
13 the next day, to her apartment. So I --
14 Q And approximately when was this? What day,
15 approximately?
16 A That was the 7th, it was a Friday.
17 Q Of which month?
18 A I'm sorry, February, February. So the 8th I had a
19 really busy day planned so I couldn't manage to get over
20 to see her until the evening of the 8th. And so I just
21 stopped in briefly to let her know that I would have more
22 time on the Monday, the next Monday, and that I planned to
23 visit with her then. And so that was the first time I saw
24 her apartment.
25 Q Where is her apartment? Or where was it? Or where
0025
1 is it?
2 A It's off of Spenard, kind of area. It's kind of
3 between Spenard and Northern Lights.
4 Q Okay. So that general area.
5 A The first -- she -- there was a big thing under her
6 table and she said it was a bug condo. She was teaching
7 somebody about bugs. I'm not real clear who. And so she
8 had set up this thing under her table. And I asked if
9 there were real bugs in it, and she said no. Because she
10 knows I don't like bugs.
11 Q How would you characterize your overall impression
12 of her apartment at that time with respect to cleanliness
13 and.....
14 A It was really -- it -- well, to me, it was really
15 dirty. There was piles of stuff everywhere, and it's a
16 small place. And so, you know, to some degree, well you
17 go it's a small place and she has a lot of stuff. But
18 there was piles of dirt and pine cones and pine needles,
19 and stuff in corners, and there was that bug condo thing,
20 looked like garbage type stuff in there, and just, I don't
21 know. And she was cooking something on a disposable pie
22 plate, which --
23 THE COURT: On a what?
24 MS. HUMPHREYS: You know, the pie tin that you would
25 get, you know, one of the disposable aluminum ones?
0026
1 THE COURT: And that was on the stove?
2 MS. HUMPHREYS: Yeah. And I was a little
3 overwhelmed, so I decided to come back Monday and as I
4 thought about it, I thought well, gee, I wonder if she has
5 everything she needs. So then the Monday that I went to
6 visit, the 10th, I went in and asked her for a tour of her
7 apartment, with the intent to give her the things she
8 needed.
9 MR. KILLIP: Excuse me, Rachel. Can you tell us
10 your perception of how your mother was doing, at that
11 time? On these dates?
12 A She was really quiet on Saturday, happy to see me.
13 Monday she seemed kind of distracted when I went to visit
14 her. And she got a little upset when I was asking -- you
15 know, cause I said, so do you need this or do you need
16 that. She started to get a little defensive. And I told
17 her that my intent was to give her a housewarming present
18 of some of the things that she needed. So I -- she had no
19 food in her refrigerator. No food, nothing in the
20 refrigerator, except looked like some clothes and some, I
21 don't know, some stuff.
22 THE COURT: In the refrigerators?
23 A I don't know. Like a bundle of something on one
24 side and it looked like some clothing.
25 THE COURT: In the refrigerator?
0027
1 A Yeah.
2 THE COURT: Okay. I'm just trying to understand
3 your testimony.
4 A And there was nothing in the freezer but a block of
5 ice, so I asked her if she'd eaten breakfast and she
6 hadn't. And so I said let's go to the grocery store. Her
7 laundry was being done in the sink in the kitchen, and a
8 bunch of it was wet on the floor. And the condition of
9 the apartment was pretty much the same as, you know, just
10 what I saw the day before. And she didn't have a shower
11 curtain, so I told her I would get her one of those. And
12 asked her about dishes, and pots and pans and she said she
13 didn't really have anything. So we went grocery shopping
14 and I had some coupons and we bought some stuff. And I
15 asked her what kinds of things she needed, cause I knew
16 she had some -- well, you know, I wanted her to eat what
17 she would eat. I didn't want to buy stuff she didn't want
18 to eat. And so we went and we went grocery shopping, and
19 it seemed like she had a -- she was really distracted
20 during that whole trip. It was hard for her to decide on
21 things. And so we got her all the stuff that we thought
22 she needed and got her some quarters so she could dry her
23 laundry.
24 And we went back to her house and she left some of
25 the bags of groceries outside on the porch. And I said
0028
1 you need to bring these in and put them inside and put
2 them away. And she thought that they were for Dorance
3 (ph). And I said no, this is because you don't have food
4 in your house; you need to eat.
5 THE COURT: She thought they were for who?
6 Q She thought --
7 A Dorance, her boyfriend.
8 THE COURT: Oh.
9 A And I said no, they're for you. I had noticed that
10 she had been putting food out for the animals. She said
11 they were for the stray animals. And I said that -- I
12 tried to make clear that the food was for her and not for
13 the animals and not for -- she said she also fed homeless
14 people. I said that I wanted to be sure that she was
15 eating, because I was providing for her.
16 And I went back Wed -- I went back later and I
17 brought her some meat from our freezer -- we had a freezer
18 full of meat, and so I took over some meat and some pots
19 and pans and I don't know, some stuff.
20 I went back Wednesday cause I'd got her a shower
21 curtain and some other things and I -- when I came up to
22 her front door, there was all this stuff blowing off of
23 her door, and garbage piled off to one side of the door,
24 and lots of pans set out for the animals. And a cabbage
25 was hanging from the side of the house, off the front
0029
1 door. It had been cored and it was hanging off by a piece
2 of plastic or something. There was mail that was opened
3 that wasn't hers on the door, and I mentioned that. And
4 there was other mail that was hers and some money in a bag
5 and some stuff. And I asked her what the mail was doing
6 outside, and she said it was there for someone to take to
7 the post office. So I said I would take it to the post
8 office and mail it for her. And I asked about the other
9 mail that wasn't hers, and I said you know, you can't open
10 other people's mail. And she said she didn't do it and I
11 said okay. And I asked about the cabbage and she said
12 that was for the moose. She had promised a little moose a
13 cabbage. And I said you cannot feed a moose from your
14 front door, somebody will get hurt. If you really really
15 have to give the moose a cabbage, you should take it out
16 into the woods where it's not going to hurt anybody. And
17 she agreed -- she seemed -- she was agreeable that day.
18 Kind of still -- I don't know how to describe her.
19 Pleasant.
20 But when I looked in the house, there was all this
21 stuff hanging outside, and when I opened, you know, I
22 opened the door and she was cutting up some potatoes into
23 a pan that I -- you know, to cook. And I opened the door
24 and there was all this garbage in the house. And -- all
25 over the front -- you know, you open it and there's the
0030
1 kitchen, and it's all over the kitchen. And I said Mom,
2 what is the garbage from? And she said well, it's from
3 the garbage can -- or what is all this? And she said it's
4 garbage. And I said well, why -- where did this come
5 from? Because it wasn't -- any of the boxes were nothing
6 that I had purchased for her. I mean, I knew what was
7 there from the time before and it was nothing I had got
8 her. And she said well, it's garbage. I'm looking for a
9 book. And so I -- I said you can't have garbage in your
10 house. You know, there was piles of it. It was like,
11 separated into different stuff. I don't know.
12 I asked her if she still had food. I gave her the
13 things I had come to give her and I left. I didn't spend
14 much time, that time.
15 I came back Friday --
16 Q That would have been the 14th?
17 A Valentine's Day. And Arial was with me. And some
18 of the front porch was cleaned off a little bit. There
19 was no more cabbage, there was no more money out there,
20 there was no -- but the pile off to the side was still
21 there, covered with like a tarp or something, it looked
22 like, but it was clear. I don't know what it was exactly.
23 Q Arial is your sister-in-law?
24 A Yes. And I had the baby with me -- my baby. Well,
25 she's 18 months. And we went by. I kind of was just
0031
1 checking to make sure she still had food. I wanted to
2 make sure she still had stuff to eat. It really disturbed
3 me that she had no food the first time. And so she said
4 she was getting ready to go get a battery and I offered to
5 take her because she was all ready to go. And I asked her
6 if she got her shower curtain up, and on the way to go
7 check that out, she -- and to make sure she had enough
8 hangers -- because I'd given her hangers, too. The time
9 before she'd only had one hanger. And so the closet -- to
10 check to see if she had enough hangers or if she maybe
11 needed more, there was a cake and a strawberry sitting on
12 top of the shelf of the closet. And I said well, what is
13 that? And she said that's for the critters that come to
14 visit me. And it looked like some watercress or some of
15 the greens that I bought her wilted on the floor of the
16 closet. And I said mom, you can't have -- you can't be
17 feeding things in the house. You're going to have all
18 kinds of creatures and critters and problems. And she got
19 really upset and she said you can't tell me how to live.
20 You live by your standards and I'm going to live by mine.
21 And I said but, mom, your landlord is not going to allow
22 you to stay here if you don't maintain a certain level of,
23 you know. And she said well, this is my place, I paid for
24 it, and I can do whatever I want here. And you keep your
25 house the way you want. And she kind of got after Arial
0032
1 about what she felt Arial was not as good about doing.
2 And she said, you know, you don't keep your house real
3 clean to me or, you know, just stuff like that. And I
4 said well, I kind of -- okay, you know, well..... I said
5 well, you at least need to clean up the garbage outside
6 because, you know, that can't stay there. And I said you
7 need to really -- and it looked like when we came in that
8 there was food -- those trays that had been set out for
9 the stray animals outside were inside under like, the
10 kitchen table. And I said you're not feeding those strays
11 in the house, are you? And she said no. And I said well,
12 you've got to be really careful. Somebody's going to get
13 hurt by you attracting all these stray animals. I said
14 they're wild animals. Somebody's going to get hurt. And
15 she said well, animals were better than people, because
16 animals, you know, you know -- so she refused to think
17 that any animal would hurt a person. And she said that if
18 they did, that the people deserved it, or something like
19 that, you know. It wouldn't be her fault. It wouldn't be
20 anything to do with the fact that she'd been attracting
21 them by setting out this food.
22 And I tried to explain to her that she wasn't the
23 only person there. The apartments -- there's four on each
24 one, and there were, like, three of them. And I said
25 there's a lot of people here, who could be hurt by this.
0033
1 And she got really really angry then. And at that point -
2 - and this has never happened before, but at that point, I
3 was actually afraid that maybe she was going to hit
4 somebody. And so I just kind of asked Arial to open the
5 door --
6 Q Excuse me. Let me just stop you there. What, if
7 anything, did you observe about your mother's conduct
8 towards your baby?
9 THE COURT: Towards your what?
10 Q Towards her baby.
11 A She -- I was holding my baby and she was so angry,
12 and she was like jumping, and she kind of, like, started
13 to move towards me, but she stopped. And she was just so
14 angry and she started screaming at us that -- and she said
15 that children are monsters and she started screaming at
16 Alyssa, you know, Alyssa, what I'm talking about. Lyssa
17 knows. And I got really concerned at that point.
18 Q Who's Alyssa?
19 A My 18 month old, that I was holding. And I told her
20 at that time, I said mom, I can't come back. This is too
21 much. And I had -- I said Arial, you need to open the
22 door. And Arial was concerned, also, and so she wouldn't
23 let -- she wouldn't go out ahead of me. She instead chose
24 to stand in the middle while I got the baby out. But I
25 had intended for her to go so that I would -- because
0034
1 she's pregnant, and I didn't want her to, you know, I --
2 I've never felt like that, but it was just everything
3 about the atmosphere was like she was so angry and I
4 thought she was going to hit somebody.
5 So we left and she followed us out of the place,
6 screaming at us and she said she didn't want a ride from
7 us and I was nothing but a do-gooder and just to -- and
8 she just screamed at us until we completely left. And
9 neighbors were kind of watching and..... And that was
10 pretty much the last time I saw her.
11 At that point, I didn't know what to do. I was
12 really concerned. We toyed with the idea of asking at
13 that time for screening, but we had made another
14 appointment to go to a class to find out, maybe, some
15 options. And that was the following Friday. And so we
16 decided to wait and see what we could do.
17 And I got a phone call, I think it was Wednesday,
18 the next week. I think that was -- Wednesday or Thursday,
19 it might have been. And that was from the landlord's
20 wife. Or, not the landlord, the manager's wife. And her
21 name -- Florence. And she introduced herself and she said
22 please take your mom away. We're afraid of her. She's
23 scaring everyone here. She's -- we don't know where she
24 came from, but please take her back to your house, because
25 she's -- we don't know what to do. The police have been
0035
1 over here. And she was so distraught, it was hard to find
2 out what was really going on. I tried to ask her what was
3 going on. So I called Arial and Arial said she'd talked
4 to Wally, who was the manager, and she had gotten, I
5 think, a little more clear idea what was going on. But we
6 held off until we went to the class on Friday and then we
7 went in for the screening. Because we didn't -- we had
8 asked for -- we went to find out about guardianship and we
9 asked if we could go for the three day -- the quicker one,
10 and they said no. And so we decided the best thing to do
11 was to have her screened. And then we decided -- and then
12 we pursued with the other guardian paper -- I don't know
13 how to say it. We -- I petitioned for the guardianship
14 thing.
15 Q How would you characterize your concerns for your
16 mother's welfare at that time?
17 A At the time -- which time?
18 Q At about February 19th.
19 A I was really worried. I thought, well, maybe she
20 was just having a bad day Friday and, you know. But then
21 when I heard from her neighbors, I was really worried.
22 Because I thought, she was going to be evicted. I have no
23 doubt that they weren't going to let her stay there if she
24 had anymore problems. I thought, she's going to be at
25 loose ends again, you know.
0036
1 Q Right
2 A I didn't know what was going to happen.
3 Q So what happened nex -- following February 19th?
4 What's the next thing that happened?
5 A After the class on the Friday, we went to a
6 guardianship class, to find out what we could do. And we
7 went to the probate and they told us that we couldn't go
8 for the quicker one, we had to just file a regular thing.
9 We decided that we would file for the screening and
10 then we ended up doing that at night, because I had to go
11 get my children. And the time, they told us, would be at
12 least an hour, and that would have -- I wouldn't have had
13 any way to get my kids. And so we -- they said we could
14 come back that night, so we did. And after we handed the
15 paperwork to the police and the police called us and said
16 to go back and lock up her place. And when we went in to
17 make sure all the stuff was turned off --
18 Q Now, this date, again, would be what? February --?
19 A It was the Friday. It must have been the 21st.
20 Q Okay.
21 A When we went in, I noticed the closet was open and
22 there was a light coming out of the crawl space. And I
23 thought that was strange. And the crawl space was ajar.
24 And so I opened it, so that I could turn off the light,
25 and there was -- in the crawl space there was a sheet laid
0037
1 out and a pillow and some blankets in a bag, and a bunch
2 of bags set out, and books open, and some snack bars and a
3 liter thing of something. I don't know what was in that.
4 I assumed water, but maybe it was soda, I don't know. And
5 then just like this whole little room set up down there.
6 And it's not in the house, it's under the house. It's
7 directly under this set up -- there was some clothes down
8 there -- was the plastic that covers the ground. It's
9 just -- and you could tell that other people kind of used
10 it for storage, you know, in some of the other units, but
11 it was just like, you know, storage type stuff. It wasn't
12 like -- I don't know how to explain it. You know, like
13 normal things you keep in storage, camping gear, you know,
14 that kind of thing. So --
15 Q So, what did it look like to you?
16 A It looked that somebody was staying down there. And
17 -- it was really -- at that point, I was pretty upset. So
18 I turned off the light and I came out. We noticed that
19 the -- when we came in to do all that, the landlord asked
20 us to check for signs of fire, because he said the fire
21 alarm had been going off two or three times a day, for
22 several days.
23 MR. GOTTSTEIN: Object. For what purpose?
24 A He just asked to see if there was something wrong
25 with the fire --
0038
1 THE COURT: Did you object?
2 MR. GOTTSTEIN: Yeah, I object. I mean, I don't
3 mind her saying that, but it's hearsay.
4 A He asked us to look for fire -- cause of fire.
5 MR. GOTTSTEIN: But, the part about --
6 THE COURT: I'll allow her just to describe what you
7 did within the apartment.
8 MR. GOTTSTEIN: (Indiscernible -- simultaneous
9 speech.)
10 A Okay. We noticed that all the ceiling fans had been
11 dismantled. We noticed that the fire detector, smoke
12 detector had been -- the lid taken off and no battery in
13 it. We did find a Hibachi -- small cooking stove with
14 papers on it and a box of empty matches on top.
15 THE COURT: Inside?
16 A Inside.
17 Q Anything else inside the Hibachi?
18 A I don't know, just some cardboard. Oh, there was --
19 when you took the papers out, there was some, like, ashes
20 in it. Big, flakey ones, you know?
21 Q Um-hmm.
22 A Not the little ones like you'd get from a wood fire.
23 We found a note on the table that was -- had some Cheetos
24 on top of it and some little stuff. And it was kind of
25 disturbing.
0039
1 Q Can you describe that note?
2 A It was about a little boy who told the truth and
3 went away and no, he didn't go away. Instead he came back
4 and he cut off his mommy's head. And something about a
5 star and it was just this, like, I don't know, little
6 story or something.
7 MR. GOTTSTEIN: Object. Relevance.
8 THE COURT: I'm going to allow it. If your
9 objection is relevance, I'll overrule that. But I'm not
10 sure, Mr. Killip. Could you please elicit this further?
11 I don't know if we're talking about a handwritten note or
12 handwriting that could be recognized. Or if we're talking
13 about something out of a published book. I don't
14 understand this testimony.
15 A It was handwritten.
16 THE COURT: Could you further explain that? The
17 note?
18 Q Could you describe -- yeah.
19 A It's on an 8 by -- you know, the normal sheet of
20 paper. And it had been written in, like, permanent black
21 ink, type marker.
22 THE COURT: It was a handwritten note?
23 A Yes.
24 THE COURT: Could you recognize the handwriting?
25 A It was printed, and I'm real familiar with Mom's
0040
1 cursive handwriting; I'm not as familiar with her printed
2 handwriting.
3 THE COURT: Okay. That's what I needed. I think I
4 understand now. Thank you.
5 A Okay.
6 Q Thank you. Yeah, what else did you observe about
7 the apartment, at that time?
8 A We checked to make sure the stove was off. We
9 noticed these little offerings. Well, I say offerings,
10 because I don't -- that's what they looked like. Little -
11 - like little shrines or something, little -- one had a
12 picture next to it and some food set out and some, like,
13 little pebbles, or something. And one had -- I mean, they
14 were just all different ones. And they were kind of all
15 through the house.
16 Q Pictures of what? Do you recall?
17 A There was a picture of Mom next to one, actually
18 two, I think. And --
19 Q Okay.
20 A Little food, you know, next to them.
21 Q Everything that you observed on that day in her
22 apartment, what did that tell you about what you thought,
23 how she was doing?
24 A I was really disturbed by seeing all of this. I
25 didn't know what that was. Just that it was -- I think
0041
1 the thing that disturbed me the most was the crawl space.
2 But, there was a sweater in the heater -- baseboard type
3 heater. There was some sweater shoved into that. Just
4 the whole place, kind of, you know, she's always lived in
5 small places and she's always had to compensate by putting
6 her stuff in piles -- you know, stacks, or in whatever way
7 you can. But I was concerned because none of this looked
8 like anything she usually did. And these little offerings
9 throughout the house, and the food throughout the house,
10 and the -- it just didn't look good. And there were,
11 like, these little natural areas set up with the pine
12 cones and little box -- like, empty boxes of something
13 with little things in it. And just everywhere, there was
14 just these little piles of stuff. And they're not normal
15 piles, you know what I mean? When I say -- you know -- I
16 don't know. It just seemed strange. I was really worried
17 about her, at that point.
18 Q Okay. And based on your contact with your mother
19 over the years, how would you characterize your assessment
20 of how she was doing, relative to how she's done
21 throughout?
22 A Her -- when -- growing up, she would, kind of have
23 the little ups and downs, and that never really affected
24 anyone more than just the little bit of having to take
25 care -- you know, take up a little more, or to take more
0042
1 care what you said, but the last few years, each time has
2 become more and more upsetting. Like when she became
3 homeless the last time. But this time was the first time
4 that we had -- this is the worst I've ever seen it. I've
5 never seen her get so angry with her neighbors. There
6 were -- one of the neighbors handed us a sign that she had
7 left outside on a tree. Or that they said she -- you
8 know. And the call from the landlord, saying that she was
9 threatening people.
10 The -- in November there had been a call from SeaTac
11 police saying that she had refused to get on -- go through
12 the security at the airport. Actually, the airport called
13 first and wanted me to talk to her so that they could get
14 her on the airplane and by the time I got home, because I
15 wasn't home at that time, by the time I got home to call,
16 I don't know. The police called then and said that they
17 had taken her into custody because of it. And just
18 everything has been so much more -- so much worse. And,
19 you know, some things I write off as, you know, just being
20 eccentric, and some things I go, this is not just
21 eccentric, this is unhealthy.
22 Q Ms. Humphreys, so what happened next after February
23 19th? When was the next time you went back to her
24 apartment, if you did?
25 A Oh. We went back the day after we secured her
0043
1 apartment, because we wanted pictures of where she was
2 sleeping down in the -- or, I assume -- I don't know if
3 she was sleeping down there, but the little area in the
4 crawl space, so we took pictures the next day. And that's
5 the last time I've been over there.
6 Q And who went with you at that time?
7 A Arial went with me and Michelle also went to help
8 with the pictures. Her name is Michelle --
9 THE COURT: Is Michelle a friend, or family member?
10 A Yes, she's a friend of Arial's.
11 THE COURT: Okay.
12 Q And did you take any photos on the 19th?
13 A Not on the 19th. We took them -- we did take a
14 couple of photos on the 14th, of the outside and the
15 kitchen area.
16 Q Okay. So photos were on the 14th and the 21st,
17 then?
18 A Um-hmm. Or 22nd.
19 Q So it'd be the 22nd? Okay. And based on your
20 recollection, was there much of a change in the place
21 between the 19th and 22nd when you returned to take photos
22 for the second time?
23 A No.
24 Q Not really?
25 A It was the night of the 21st, and we just went back
0044
1 the next morning to take pictures.
2 Q Oh, I see. Okay.
3 Your Honor, if I may approach the witness. I'll
4 show these to Mr. Gottstein first. I've got some photos,
5 that I've marked Plaintiff's exhibits 1 through 7, and it
6 looks like they're generated on several photos per page.
7 So we probably have twenty-ish photos.
8 THE COURT: All right.
9 MR. GOTTSTEIN: Do you have a copy for me?
10 Q No, those are the only ones.
11 THE COURT: Let me take it one step at a time. Have
12 they been marked, counsel?
13 MR. KILLIP: Yes.
14 THE COURT: Okay. So, are they marked 1 through 7,
15 each page?
16 MR. KILLIP: Yes.
17 THE COURT: All right. Let Mr. Gottstein take a
18 minute to take a look at them, please.
19 THE COURT: Mr. Killip, how much longer with this
20 witness, please?
21 MR. KILLIP: Just going to have her talk about the
22 photos, and that's it.
23 THE COURT: All right. Why don't we do -- when we
24 get that far, just so you know, then I'll take a quick
25 break, so people can stretch their legs. Mr. Gottstein?
0045
1 MR. GOTTSTEIN: Yes, I was concerned about the time,
2 too. I mean, how much time does he have for his case,
3 since we have a limited -- ?
4 THE COURT: Okay. Well, let's get through this
5 witness, and then we can set our watches. Have you had a
6 chance to look at the photos?
7 MR. GOTTSTEIN: I haven't seen all of them yet. No,
8 Your Honor. It seems like I should be provided a copy,
9 though, Your Honor.
10 THE COURT: Well, you're being given an opportunity,
11 now, to look at them, sir. Mr. Killip are those -- I
12 don't know what you're got there. Are those contact
13 sheets, or can color photo copies of those be made after
14 the hearing, so that Mr. Gottstein has a complete record?
15 MR. KILLIP: Yes, I believe so.
16 THE COURT: Okay.
17 MR. KILLIP: I don't have the capability at my
18 office to do that. I can do black and white.
19 THE COURT: All right. I don't know what they would
20 depict, or whether that would be useful, but I'll take a
21 look at them here in a minute. Ma'am who actually took
22 the photos?
23 A Arial.
24 THE COURT: All right.
25 MR. KILLIP: If I may approach, Your Honor?
0046
1 THE COURT: Yes.
2 Q Ms. Humphreys, I'm handing you the exhibits marked 1
3 through 7. Will you please take a look at those? Do you
4 recognize what I've handed you?
5 A Yes, these are the photos that we took. Or Arial
6 took while I was there.
7 Q And so these are the photos that Arial took when you
8 were present?
9 A Yes.
10 Q And they were taken on which date?
11 A These ones are marked 2/14, so they were taken on
12 the 14th. The rest of them were taken --
13 Q What number is that, is 2/14?
14 A Number 1.
15 Q Okay.
16 A And the rest of them were taken that Saturday. Have
17 you had a chance to look at each one of those photos?
18 A Yes.
19 Q And are each one of those photos a fair and accurate
20 representation of what you observed of your mother's
21 apartment, at the time the photos were taken?
22 A Yes.
23 Q Your Honor, we would move for admission of State's
24 exhibits 1 through 7.
25 THE COURT: Any objection?
0047
1 MR. GOTTSTEIN: None, Your Honor.
2 THE COURT: All right. 1 through 7 will be
3 admitted. Can I look at them, please?
4 (Plaintiff's exhibits 1 through 7 are admitted.)
5 Q Ms. Humphreys, I just want to ask you one question.
6 You referenced the note on the table, about the boy and
7 the mother. Did you recognize that note in any of those
8 photographs?
9 A Yes. It's in some of the photographs. We did move
10 the stuff off of it to take a picture of the note. And
11 the note on the manila file was not in the house; it was
12 handed to us by the neighbor.
13 Q I see.
14 A And her name and photo number is on the --
15 THE COURT: Is that the sign you're referencing?
16 The sign on the tree?
17 A Yes. The sign on the tree.
18 THE COURT: What does -- is that depicted in one of
19 these photos?
20 A Yes, it's on a manila envelope, and it says
21 something about tree spirits and killing is too good for
22 you, or something.
23 THE COURT: All right. Do you have anything further
24 for this witness, Mr. Killip?
25 MR. KILLIP: No, Your Honor.
0048
1 THE COURT: All right. Mr. Gottstein?
2 RACHEL HUMPHREYS
3 testified as follows on:
4 CROSS-EXAMINATION
5 BY MR. GOTTSTEIN: Yes, thank you. I know that you love
6 your mother very much. And you want to do the best that
7 you can for her. Isn't that correct?
8 A Yes.
9 Q And if -- and you believe that -- that having her
10 admitted and having her have to take her meds is in her
11 best interests. Is that correct?
12 A Yes.
13 Q And isn't that because the doctors are telling you
14 that's the best thing?
15 A I have never spoken with her doctors, in a sense
16 that they could tell me anything.
17 Q Um-hmm. Wouldn't it be true that if it turned out
18 that the medications were really damaging her or had the
19 potential for really damaging her, that that would change
20 your mind about --
21 MR. KILLIP: Your Honor, I'm going to object again.
22 It's the State's position that science is not being at
23 issue today. It's whether the Department has met its
24 burden for each of the petitions today.
25 THE COURT: Overruled. You can answer the question.
0049
1 Did you get what the question was?
2 A The question is about --
3 THE COURT: If you had reason to believe that the
4 medications could be harmful, would that change your
5 opinion?
6 A I think that this last -- however long without being
7 medicated, she's been the worst she's ever been. And the
8 medicine seemed to make her cope better.
9 Q What if the medications that she's been getting
10 really are the cause of some of her problems, at this
11 point. Would that change your mind?
12 A I don't see how the medicines could have affected
13 her when she's not been on them for so long. This is the
14 worst she's been, and she's not been on any medicine. I
15 asked her that week of the 12th through the 14th
16 somewhere. And she said no, she had not been on any
17 medicine.
18 Q And how long do you think that she hasn't been on
19 her medication?
20 A We found several, like nine or ten of these almost
21 full bottles in her apartment in August of 2002.
22 Q Okay, thank you. Now, you've had the chance to
23 observe your mother now. Doesn't she seem all right now?
24 A She sometimes does seem okay. It's an overall of
25 how she's doing, you know.
0050
1 Q You mentioned that you filed a petition for
2 guardianship. Has she been served with that?
3 A I'm not sure.
4 Q I have no other questions.
5 THE COURT: Just for the record. As you know, Mr.
6 Gottstein, you're entitled to know everything that's in
7 the court's file. I don't have a petition for
8 guardianship, either.
9 Anything further for this witness?
10 MR. KILLIP: Just briefly, Your Honor.
11 THE COURT: All right.
12 RACHEL HUMPHREYS
13 testified as follows on:
14 REDIRECT EXAMINATION
15 BY MR. KILLIP:
16 Q Ms. Humphreys, are you interested in knowing about
17 your mother's progress?
18 A Yes.
19 Q Okay, so if -- how would you describe your interest
20 in getting information about her progress?
21 A I would like to know how she's doing. I can't --
22 it's hard for me to make any judgments of what to do, not
23 knowing how she's doing overall. The little visits that I
24 have don't really tell me how she's doing.
25 Q Okay. Have you -- can you describe what, if any,
0051
1 efforts you've made to try and obtain that information?
2 A Well, the doctors can't tell me anything, so.....
3 Q And what's your understanding, the reason for that?
4 A Obviously that that's a doctor-patient privilege.
5 Q Okay. It's that permission thing. That's your
6 understanding?
7 A Yes.
8 Q Okay. Thank you.
9 THE COURT: Anything further for this witness, Mr.
10 Gottstein?
11 MR. GOTTSTEIN: No, Your Honor.
12 THE COURT: Mr. Killip, this witness may be excused.
13 Yes?
14 MR. KILLIP: Yes, thank you.
15 THE COURT: All right. Thank you, ma'am. You may
16 return back to the gallery.
17 Your next witness, please?
18 MR. KILLIP: Thank you, Your Honor. I want to call
19 Michael Myers. And I will get him.
20 THE COURT: All right. So, my understanding, Mr.
21 Killip, is that you're going to be given another -- until
22 11:00 and that will leave two hours.....
23 MR. KILLIP: 11:00.....
24 THE COURT: .....for Mr. Gottstein.
25 MR. KILLIP: Okay. This will be a short witness.
0052
1 THE COURT: Okay. I'm going to step off the bench
2 for just a minute. So we'll be off record for about two
3 minutes.
4 (Off record.)
5 10:13:21
6 THE COURT: Mr. Killip?
7 MR. KILLIP: Yes, Michael Humphreys.
8 MR. MYERS: Myers.
9 MR. KILLIP: Excuse me, Myers.
10 THE COURT: Could you please stand, sir, and raise
11 your right hand?
12 THE CLERK: Do you swear or affirm that the
13 information you are about to give in this matter before
14 the court is the truth, the whole truth, and nothing but
15 the truth?
16 MR. MYERS: Yes.
17 THE CLERK: Would you please state your name,
18 spelling your last name for the record?
19 MR. MYERS: Mike Myers, M-Y-E-R-S.
20 THE COURT: Have a seat. And if you could scoot the
21 microphone so that you're comfortable and to speak right
22 in it.
23 Mr. Killip, you may inquire.
24 MR. KILLIP: Thank you.
25 MIKE MYERS
0053
1 testified as follows on:
2 DIRECT EXAMINATION
3 BY MR. KILLIP:
4 Q Mr. Myers, how do you know Faith Myers?
5 A She's my mother.
6 Q Okay. And you're familiar with these proceedings,
7 as you were a party to initiating them? Is that correct?
8 A I'm not sure how it all works, but I'm fairly
9 familiar with it.
10 Q Okay. And how would you describe your level of
11 happiness being here today?
12 A My personal level, well, I'm not happy about it at
13 all, but I don't think it's really relevant.
14 Q Okay. And how would you describe your concern for
15 your mother today?
16 A Well, mom's not doing very well. She's not taking
17 care of herself. She hasn't been for quite some time.
18 For years, a couple years. And she gets off and on and
19 off and on. It kind of spirals and it gets worse, gets
20 better. I don't know. I'm concerned about her, but
21 there's not much I can do, really, for her, because, you
22 know, all I can say is Mom, you're doing this, or Mom
23 you're doing that. I mean, I'm her son, I'm not her
24 parent.
25 Q Yeah. Your Honor, I don't know why I couldn't be
0054
1 given a copy of this.
2 THE COURT: I don't know what you've just handed Mr.
3 Gottstein. There was nothing stated on record. Is that
4 an exhibit that's been marked?
5 MR. KILLIP: Yeah, exhibit No. 8 that I marked, that
6 I just handed to Mr. Gottstein.
7 THE COURT: Okay.
8 MR. KILLIP: Which I just received about an hour
9 ago, so I haven't had a chance to make a copy of it.
10 THE COURT: All right. Are there any other exhibits
11 you're going to offer today?
12 MR. KILLIP: No, Your Honor.
13 THE COURT: All right. Mr. Gottstein, why don't you
14 take a minute to read it over. It looks like it's a
15 single piece of paper for the record. Is it a handwritten
16 note or letter?
17 MR. KILLIP: Yes, handwritten note.
18 THE COURT: Marked as 8, I take it?
19 MR. KILLIP: Yes. If I may approach the witness?
20 MR. GOTTSTEIN: Jeff, could you let Faith look at
21 it?
22 MR. KILLIP: Oh, sure.
23 May I approach, Your Honor, Mr. Myers?
24 THE COURT: Yes, you may.
25 Q I'm handing you what's been marked as Plaintiff's
0055
1 exhibit No. 8.
2 A Yeah.
3 Q Can you take a look at that please?
4 A Yeah.
5 Q Do you recognize it?
6 A Yeah.
7 Q Can you tell me what it is?
8 A It's a -- it's like a little story she wrote.
9 Q That who wrote?
10 A I'm sorry, that my mom, Faith, wrote.
11 Q And when did you first see that?
12 A She gave it to me in API, like, two days ago.
13 Q Okay. And so you recognize -- does it look any
14 different from when you first got it? Any alterations or
15 deletions since you first received it?
16 A Except for the yellow thing that's been added here,
17 that's it.
18 Q Okay. Okay. Your Honor, we would offer that
19 Plaintiff's exhibit No. 8 at this time.
20 THE COURT: Any objection to 8?
21 MR. GOTTSTEIN: No, Your Honor.
22 THE COURT: Eight will be admitted.
23 (Plaintiff's exhibit 8 is admitted)
24 MR. GOTTSTEIN: I'd like a copy, though.
25 THE COURT: You'll be given one.
0056
1 MR. KILLIP: Okay. I have nothing further for Mr.
2 Myers. Thank you.
3 MR. GOTTSTEIN: I have no questions.
4 A Am I done?
5 THE COURT: Hang on. Your name is Michael Myers?
6 A Um-hmm.
7 THE COURT: Do you know who Eric C. Myers is?
8 A That's my son.
9 THE COURT: All right.
10 A Little creepy, huh?
11 THE COURT: I have nothing further.
12 MR. KILLIP: Thank you.
13 THE COURT: You may be excused, sir.
14 MR. KILLIP: The State calls Dr. Hanowell, and I
15 will get him from the hallway.
16 MR. GOTTSTEIN: Your Honor?
17 THE COURT: Yes, counsel?
18 MR. GOTTSTEIN: Well, I guess I should wait for
19 counsel to get back.
20 THE COURT: Yes, he's just stepped out, I think, so
21 one minute.
22 Who is this witness, please?
23 MR. KILLIP: This is Dr. Robert Hanowell, a
24 psychiatrist at API.
25 THE COURT: Mr. Gottstein?
0057
1 MR. GOTTSTEIN: Yes, I would ask that Dr. Kletti be
2 excused, Your Honor.
3 MR. KILLIP: Yeah, we would ask that he be granted
4 permission to stay as State's advisory witness.
5 THE COURT: You may stay.
6 MR. GOTTSTEIN: May I speak further on this, Your
7 Honor?
8 THE COURT: Yes.
9 MR. GOTTSTEIN: You said you read the deposition, so
10 I think you understand some of the problems that went on
11 here. And I'm just concerned that Dr. Hanowell's
12 testimony may influence Dr. Kletti's testimony, who is
13 also listed. And I don't know why he would need an
14 advisory witness here for Dr. Hanowell.
15 THE COURT: Well, we don't want to spend a whole lot
16 of time on this, but just quickly. What I didn't
17 understand from the deposition, Mr. Killip, I think
18 because it wasn't stated, because both of you understood,
19 what is the relationship of these two physicians, please?
20 MR. KILLIP: Yeah. Dr. Hanowell is staff
21 psychiatrist at API.
22 THE COURT: Yes.
23 MR. KILLIP: And Dr. Kletti is the medical director.
24 So, for -- he supervises all of the staff psychiatrists
25 and he's responsible for the implementation of the
0058
1 services -- the medical services that are provided there.
2 THE COURT: All right. I think it's appropriate
3 that the witness -- that both may stay.
4 Sir, you need to stand, though, please, and raise
5 your right hand.
6 THE CLERK: Do you swear or affirm that the
7 information you are about to give in this matter before
8 the court is the truth, the whole truth, and nothing but
9 the truth?
10 DR. HANOWELL: Yes, ma'am.
11 THE CLERK: Would you please state your name,
12 spelling your last name for the record?
13 DR. HANOWELL: Robert Hanowell, H-A-N-O-W-E-L-L.
14 THE COURT: Counsel, you may inquire.
15 MR. KILLIP: Thank you, Your Honor.
16 THE COURT: If it's easier, you may inquire from
17 counsel table, either way.
18 MR. KILLIP: Okay, thank you.
19 THE COURT: But scoot the microphone closer. Thank
20 you.
21 DR. ROBERT HANOWELL
22 testified as follows on:
23 DIRECT EXAMINATION
24 BY MR. KILLIP:
25 Q Dr. Hanowell, your name and your occupation, how
0059
1 long have you been so employed?
2 A My name is Robert Hanowell. I'm a psychiatrist at
3 API, and I've been employed at API since December of 1997.
4 Q And briefly, what are your responsibilities there?
5 A I am currently staff psychiatrist on the Susitna
6 Unit, and have been -- have been for most of my time at
7 API. For approximately a year and a half, I was attending
8 staff psychiatrist on the Chilkat Unit.
9 Q Okay. And can you briefly explain how API is
10 divided with these units? Susitna Unit, what does -- you
11 know, what does that mean?
12 A Yes, sir. Susitna Unit is a unit for individuals
13 who will be having greater lengths of stay than a few to
14 several days. Those individual who will be staying only a
15 few to several days would be treated only on the Denali
16 Unit. If someone's going to need a greater length of
17 stay, they would be transferred to the Susitna Unit. If
18 they're going to need a very lengthy period of stay, they
19 would eventually be transferred to the Katmai Unit. The
20 Chilkat Unit is a unit for adolescents.
21 Q Okay. Thank you. And briefly, can you explain or
22 describe your education?
23 A Yes, sir. I received my Bachelor's degree in
24 biological sciences from the University of California
25 Davis in 1985. Pardon me -- pardon me, yes, in 1985. I
0060
1 received my M.D. degree from Loyola University Stritch
2 School of Medicine in Maywood, Illinois. In June of 1989
3 I subsequently did a year of internship at a program at
4 LaGrange Community Hospital in LaGrange, Illinois.
5 Subsequently I did four years of psychiatric residency at
6 -- through the University of California San Francisco
7 program in Fresno, California.
8 Q Okay. And are you licensed to practice psychiatry?
9 A Yes, sir.
10 Q And for how long have you been so licensed?
11 A I've been licensed in the State of Alaska since
12 December of 1997. I've held previous licenses in South
13 Dakota and California.
14 Q So, how long have you practiced psychiatry?
15 A Including my period of residency training, since
16 1990. Excluding my period of residency training, since
17 1994.
18 Q Okay. And your education and training in psychiatry
19 includes pharmacology?
20 A Yes, sir.
21 Q Okay. Have you ever been qualified as an expert in
22 the field of psychiatry before?
23 A Yes, sir.
24 Q Approximately how many times?
25 A I'm uncertain of the precise time, but more than 100
0061
1 times.
2 Q And do you diagnose and treat mental illness on a
3 daily basis, on your job?
4 A Yes, sir.
5 Q And that includes pharmacologically, with
6 medications?
7 A Yes, sir.
8 Q And is your testimony today, on these petitions, is
9 it going to be offered based on your clinical observations
10 and overall professional evaluation, in light of your
11 training and experience?
12 A Yes, sir.
13 Q Okay, thank you. Your Honor, we would offer Dr.
14 Hanowell as an expert in psychiatry, at this time.
15 THE COURT: I want him to clarify his last question.
16 You said that you were going to testify today based upon
17 your clinical observations. Do you mean clinical
18 observations of this patient? This litgant, Ms. Faith
19 Myers?
20 A Yes, Your Honor.
21 THE COURT: So, you have had an opportunity to
22 observe her while she's been at API?
23 A Yes, Your Honor.
24 THE COURT: Could you just elaborate just a little
25 bit about the extent of your contact with her while she's
0062
1 been there?
2 A Yes, Your Honor. I did the initial admission
3 psychiatry assessment on Ms. Myers. That was on February
4 22nd. I have met with her on three additional occasions,
5 as well. I've also interacted with her on a less formal
6 basis on a much more frequent basis, seeing her on the
7 unit, and greeting her, etc.
8 THE COURT: Mr. Gottstein?
9 MR. GOTTSTEIN: Yes, Your Honor. I object as to his
10 qualifications with respect to psychopharmacology. And
11 may I examine -- question the witness further?
12 THE COURT: Yes.
13 VOIR DIRE EXAMINATION
14 BY MR. GOTTSTEIN:
15 Q Isn't it true that -- let's start with the older
16 neuroleptics -- are harmful and of limited efficacy on
17 knocking down psychosis?
18 MR. KILLIP: Your Honor, again I would object,
19 standard objection. We're not challenging the practice of
20 medicine, here. If he has a specific concern about how
21 API is practicing medicine, then he has an opportunity to
22 file a complaint, allege a cause of action and pursue
23 that. But we have two petitions before the court today,
24 and the only issues are criteria for commitment and the
25 criteria for administration of psychotropic medications.
0063
1 Have they been met? So we would object to the relevance.
2 THE COURT: The line of questioning that I want you
3 to pursue, that I've given you permission to pursue right
4 now, is qualifications of this witness as to psychotropic
5 medication.
6 MR. GOTTSTEIN: Psychopharmacology. That's exactly
7 what I'm intending to do.
8 THE COURT: All right.
9 MR. GOTTSTEIN: I asked a question about certain
10 medications.
11 THE COURT: Actually, you asked his opinion about
12 the efficacy of the medications, I think. And I want you
13 to just focus on his qualifications, please.
14 MR. GOTTSTEIN: Well, it seems to me, Your Honor,
15 that knowledge about the efficacy is part of his
16 qualifications.
17 THE COURT: I don't agree. I'm not going to allow
18 him to answer this question.
19 MR. GOTTSTEIN: Okay.
20 THE COURT: Please move on.
21 Q Okay. Dr. Hanowell, I think you said in your
22 deposition that you attended a conference at Alaska
23 Psychiatric Institute at which Robert Whitaker spoke. Is
24 that correct?
25 A I attended part of the --
0064
1 MR. KILLIP: Your Honor, I object again. I know
2 where he's headed. Robert Whitaker is a journalist from
3 Boston, no medical training. He wrote a book about --
4 it's entitled Mad in America and takes studies -- pieces
5 of studies that suit his argument, out of context, and
6 he's selling it -- this pitch of, basically, medicines and
7 psychiatry are inappropriate. Specifically with anti-
8 psychotics. They don't work, they shouldn't be used. And
9 this is a lay person that's telling, you know, he's
10 expressing his legitimate right to express an opinion, but
11 this is not the forum to be examining a journalist from
12 Boston's view of how psychiatry should be practiced at
13 API.
14 MR. GOTTSTEIN: Your Honor, may I speak to that?
15 THE COURT: Yes.
16 MR. GOTTSTEIN: There were a number of specifics
17 that were mentioned, and I've got a list of them, although
18 the actual references aren't there, but actually -- those
19 are in the -- some of those are in the brief and the
20 attachments.....
21 THE COURT: Yes.
22 MR. GOTTSTEIN: .....and some of them -- and I
23 believe Dr. Hanowell testified that he has not read any of
24 these studies. And therefore I don't think he should be
25 qualified as an expert on these.
0065
1 THE COURT: Okay. I read the deposition transcript
2 and I read your briefs. And there were a number of
3 studies listed. I think what he testified to is that he
4 couldn't recite these studies off the top of his head.
5 That's my recollection of the testimony. But what I'd
6 like you to focus on is not entering into a debate about a
7 book that may or may not have been written by somebody
8 from Boston. Because we cannot accommodate that today and
9 still give your client her due process rights.
10 What is appropriate is identifying what skill and
11 training this witness has in the area of -- the second
12 part of the petition, which is going to be relevant,
13 regarding his opinions on administration of psychotropic
14 drugs. You can ask about his skills in that area, his
15 training in that area. That's what's appropriate right
16 now, please, sir.
17 Q Have you had any specialized training in
18 psychopharmacology?
19 A To the extent that I attend psychiatric residency,
20 yes, sir.
21 Q Okay. I don't think he's qualified, Your Honor.
22 THE COURT: All right. Mr. Killip?
23 MR. KILLIP: Yeah. Well, we renew our offer to
24 qualify him as an expert, Your Honor.
25 THE COURT: But, what are you wanting to qualify him
0066
1 an expert for, specifically?
2 MR. KILLIP: Psychiatry, which would include --
3 THE COURT: I don't think he's been challenged in
4 that regard. I think Mr. Gottstein's challenge is just
5 specific as to his credentials for testifying regarding
6 the efficacy of these drugs. Yes?
7 MR. GOTTSTEIN: Yes, and safety. And long-term
8 outcomes.
9 THE COURT: Can you spend another couple minutes
10 talking to -- or eliciting testimony from this witness
11 about his knowledge of the studies regarding long term
12 outcomes from these drugs?
13 MR. KILLIP: Okay. Thank you, Your Honor.
14 DIRECT EXAMINATION (continued)
15 BY MR. KILLIP:
16 Q Dr. Hanowell, is it fair to say that the -- there
17 are more studies out there than the ones listed by Mr.
18 Gottstein in these litigation documents that you've seen,
19 on the issue of pharmacology and efficacy?
20 A Yes, sir.
21 Q Okay. What's your best guess as to how may studies
22 are out there on the efficacy of, for example, anti-
23 psychotics?
24 A Probably in the range of hundreds to thousands.
25 Q Okay. And can you describe your training -- your
0067
1 education and training with respect to using these
2 medicines to treat mental illness? Can you summarize that
3 training and education that you have?
4 A Yes, sir.
5 Q During my four years of psychiatric residency, I was
6 trained on the use of these medications, both on an
7 inpatient and an outpatient basis. Not only did I attend
8 innumerable didactic -- well, innumerable lectures on the
9 topic of clinical psychiatry and clinical
10 psychopharmacology, but I also was mentored and supervised
11 by people I considered to be experts in that area. I
12 worked with -- during my residency training, I worked with
13 hundreds of patients, doing psychopharmacology, and being
14 supervised by -- again, by people with tremendous
15 expertise in that arena.
16 I should also note that even subsequent to my
17 residency training, I have attended numerous lectures and
18 seminars on -- involving clinical psychopharmacology.
19 Q Okay. And how would you characterize your
20 understanding and your treatment of mental illness with
21 medications, with respect to how the rest of the United
22 States psychiatric community is doing it?
23 A I always strive to adhere to the standard of care.
24 Q Okay. So, is it fair to say that what you're doing
25 is consistent with your understanding of what is generally
0068
1 accepted today, for treating mental illness with
2 medications?
3 A Yes, sir.
4 Q Okay. Thank you, Your Honor.
5 THE COURT: I'm going to ask a couple questions.
6 Sir, to how many patients have you prescribed these types
7 of drugs?
8 A Since I began residency? Since I began residency
9 training?
10 THE COURT: Yes.
11 A It's difficult for me to say, but certainly more
12 than a thousand.
13 THE COURT: All right. Have you been in a position
14 where you were able to observe yourself and document
15 yourself the outcomes?
16 A Yes, Your Honor.
17 THE COURT: All right. Would you be able to testify
18 about those outcomes and about the side effects that
19 you've seen?
20 A Yes, Your Honor.
21 THE COURT: Would you be able to testify about the
22 extent to which, in your practice, you've seen these drugs
23 be helpful to patients and/or not helpful to patients?
24 A Yes, Your Honor.
25 THE COURT: Mr. Gottstein?
0069
1 VOIR DIRE EXAMINATION
2 BY MR. GOTTSTEIN:
3 Q Isn't it true that normally for these long-term --
4 you consider the long-term prognosis for patients
5 prescribed these medications to be poor for recovery from
6 mental illness?
7 A That's a difficult question to answer. I always try
8 to consider every patient as an individual. So it's
9 difficult for me to answer in general -- a general
10 question like that.
11 Q Have you read any of the studies on long-term
12 outcomes?
13 A Yes, but I couldn't quote them. I couldn't quote
14 specific authors and dates of the studies, etc., but I
15 have read such studies, yes, sir.
16 Q And do they -- what do they suggest in terms of
17 long-term outcomes for people prescribed with these
18 medications for recovery?
19 A I think that again, based on what the articles I've
20 read over the years, I think the literature is a little
21 bit mixed, so it's difficult for me to say exactly what
22 they say as -- collectively.
23 Q I mean --
24 A I think --
25 THE COURT: You may finish your answer.
0070
1 A I think it's safe to say that some people do
2 extremely well with these medications and can even, in
3 some cases, return to full-time work or full-time studies,
4 family responsibilities, etc. And regrettably, some other
5 people do not do as well.
6 Fortunately, we do know that in the past Ms. Myers,
7 for example, has benefited from such medication.
8 THE COURT: I'm going to find that this witness is
9 qualified for the reasons offered and ask Mr. Killip to
10 continue with his examination.
11 MR. KILLIP: Thank you, Your Honor.
12 DIRECT EXAMINATION (continued)
13 BY MR. KILLIP:
14 Q Dr. Hanowell --
15 THE COURT: I'm going to make just a little bit
16 clearer record, if I might, Mr. Killip. Pardon my
17 interruption.
18 I find that this witness is qualified and find that
19 his clinical practice, in particular, because he's able to
20 testify, or says he can, about his use of these drugs in a
21 clinical setting and his observations of their outcomes, I
22 find that that will be helpful to me. And so that's the
23 basis, or at least one of the bases, and probably the most
24 important one for my decision that I find him to be
25 qualified.
0071
1 MR. KILLIP: Thank you, Your Honor.
2 THE COURT: Yes.
3 Q Dr. Hanowell, how are you familiar with Faith Myers?
4 A Ms. Myers is my patient at API, currently.
5 Q And when was she admitted to API, approximately?
6 A On February 21, 2003.
7 Q And when did you first meet with her?
8 A On February 22, 2003.
9 Q Okay. And did you review her psychiatric history,
10 at about that time?
11 A Yes, sir.
12 Q And what was your understanding of her psychiatric
13 history on the date that you met with her the first time,
14 on February 22nd?
15 A I was aware that she'd been previously admitted to
16 API and that she carried a diagnosis of schizophrenia of
17 paranoid type. And that -- and that she'd previously
18 benefited from anti-psychotic medication.
19 Q And can you describe how many times you met with API
20 -- you mentioned it before.
21 A Yes, sir. I've met with Ms. Myers formally on four
22 occasions since her admission, and informally on a number
23 of other occasions, greeting her on the unit, etc.
24 Q Okay. And you feel like you've had -- can you
25 describe what, if any observations -- well, let me back up
0072
1 for a minute. What were the presenting issues --
2 psychiatric issues upon admission to API?
3 A Yes, sir. Ms. Myers had been admitted on an order
4 for screening investigation. In the order for screening
5 investigation, it was alleged that she was exhibiting
6 evidence of psychosis and that she was not attending to
7 her basic needs. It was also alleged that she had been in
8 some way threatening towards fellow tenants and to the
9 landlord at her apartment complex. Her family members had
10 served as petitioners and they were concerned about her
11 well-being and safety.
12 Q Okay. And what, if any, observations have you
13 personally made -- clinical observations -- of Ms. Myers
14 during the course of those four meetings with her, since
15 her admission on February 21st?
16 A Yes, sir. On -- during my meeting with her on
17 February 22nd, my initial meeting with her, she was noted
18 to be angry with me. She initially refused to speak with
19 me. However, we eventually did have a very brief
20 conversation. During that conversation, I did attempt to
21 ask some routine questions that I would normally ask
22 during such an interview.
23 Q Like what?
24 A I did ask about whether or not she'd been having any
25 experiences, such as hearing things or seeing things.
0073
1 Q Hearing things or seeing things that are not
2 objectively present, is that what you mean?
3 A Yes, sir. Yes, sir. And she responded by making a
4 reference to Shakespeare, to Hamlet's soliloquy in
5 reference to Yorik. And I wasn't sure what she meant by
6 that, so I asked her to clarify. And she indicated that
7 Shakespeare or Hamlet had been referring to ghosts. And I
8 said okay, well, does that mean that you have been hearing
9 or seeing ghosts? And she said that she didn't wish to
10 speak with me any further at that juncture.
11 Q Okay. What about your next -- anything else that
12 you observed at that time?
13 A She did appear to have some -- what we refer to as
14 "inappropriate affect." That means that even though she
15 was -- her affect -- her outward appearance of her
16 emotional state didn't appear to match her inward
17 emotional state, as near as I could tell.
18 Q Okay. And when was your next visit with her?
19 A My next visit with her was with the treatment team
20 in the treatment team meeting on the 24th of February. On
21 that occasion, she -- I did observe a number of pieces of
22 evidence that she was suffering from mental illness. She
23 did state that she was aware that she was only going to
24 live for another year and a half. And I attempted to
25 explain that. And she seemed to indicate, at least I
0074
1 understood her to indicate that that had been revealed to
2 her by God. And I asked her more about this. She
3 subsequently became somewhat angry with me and indicated
4 that I should pay attention to my family, because my
5 family was also dying. And subsequently she made
6 reference also, if memory serves to -- she certainly did
7 make reference to the notion that she had -- that there
8 were cameras in her apartment, or had been cameras in her
9 apartment, and that she had been sort of like, more or
10 less, been under surveillance by the government.
11 Q Um-hmm. Okay. Any other observations you made at
12 that time?
13 A She did become rather angry, briefly, to the point
14 of -- just almost to the point of belligerence, but then
15 that -- she was able to deescalate from there.
16 Q Okay. When was your next meeting with her?
17 A That was on, I believe, February 27th, and I met
18 with her briefly, for approximately 15 minutes or so, on
19 the unit, and we discussed the issue of -- again --
20 actually, I really should have added that during both my
21 previous meetings with her, I did bring up the issue of
22 medication. I brought it up again on the 27th, and she
23 again indicated that she didn't wish to pursue taking
24 medication and didn't really wish to discuss the matter.
25 Q Let me just stop you there, for a moment. The first
0075
1 time you brought it up, which would have been on your
2 first meeting, is that correct? During your first
3 meeting? Is that what you said?
4 A I believe I did bring up the issue on the 22nd. I
5 have to say I'm not 100% certain that I brought it up,
6 because she didn't wish to speak with me. So I'm not sure
7 if I even got that far. But I think I did bring it up. I
8 don't recall precisely. But on the 24th I certainly did
9 bring it up, and we discussed the matter.
10 Q Okay. And can you specifically tell us what you
11 told her, and what you asked her, if anything?
12 A On the 24th, I brought up the issue that she had
13 benefited from medication in the past and, you know, asked
14 if she'd be willing to consider that again. She indicated
15 that she would not and really -- by her response to the
16 question and her level of anger, it was clear that she
17 didn't wish to discuss the matter.
18 One of the treatment team members asked her at that
19 point if she believed -- oh, I'm sorry. I should also add
20 that she did make reference to the notion that she didn't
21 need medication, that she needed basically good nutrition.
22 And I'm paraphrasing that. That's not exactly what she
23 said, but something to that effect.
24 And one of the other treatment team members -- I'm
25 sorry, I'm going by memory here -- but one of the other
0076
1 treatment team members said -- asked her if she believed
2 that she had a mental illness. And she indicated that she
3 did not.
4 Q Okay. And by that time, had you formulated a
5 diagnosis -- your own diagnosis for her condition, at that
6 time?
7 A Yes, sir.
8 Q And what was your diagnosis, or what is your
9 diagnosis?
10 A At this juncture, her diagnosis is schizophrenia,
11 paranoid type.
12 Q Okay. Okay, and so the third meeting took place
13 when?
14 A I believe on February 27th.
15 Q Okay. And what happened at that time?
16 A We met briefly and I discussed with her briefly some
17 of the things that were going on with the legal
18 proceedings and I mentioned to her that I might be
19 testifying that day at a deposition. I subsequently again
20 tried to broach the -- or bring up the issue of
21 medications, and she again indicated that she didn't wish
22 to discuss the matter and didn't need to take medications.
23 Q Okay. Well, let me ask you this. What do you -- do
24 you understand your obligations for informing each patient
25 completely about medication options, side effects, choice
0077
1 possibilities?
2 A Yes, sir.
3 Q Okay. And what do you normally do in a situation
4 like this, where you're trying to convey that information?
5 A Well, normally I would try and, again, have a
6 discussion with the patient about the medication and about
7 the potential benefits, the potential prob -- side
8 effects, etc., and we'd reach an agreement. I'd often
9 ask, you know, what have you taken in the past? What do
10 you think has worked for you? What medications, you know,
11 seem to have the least side effects for you? I mean, what
12 medications did you like and did you find helpful? I
13 really try and, you know, engage my -- the person in the
14 process of treatment. I mean, they're an important
15 partner with me in their own treatment. I mean, I'm not -
16 - when it comes to psychopharmacology, it's a joint
17 effort.
18 Q Um-hmm.
19 A At least ideally, ideally it is. I would like to
20 add just one thing, if I may. I didn't mention this. On
21 the 27th I should also add that when we had the discussion
22 about the medications, she did -- or Ms. Myers did make
23 another statement which I thought supported her diagnosis,
24 that being that she believed that someone that she knew
25 may in the past have been replace by an imposter. Not
0078
1 presently, but in the past.
2 Q Okay.
3 A I mean, she believed that in the past he may have
4 been replaced by an imposter.
5 Q Okay, thank you. All right, so the 27th -- anything
6 else you want to tell the court about your observations
7 about what happened on the 27th, the third meeting that
8 you had?
9 A Just that if she had not been defensive about the
10 issue of discussing medications, I would have gone on to
11 discuss -- I would have done my best to engage her in that
12 process of what she felt had been helpful, side effects,
13 etc.
14 Q Okay.
15 A But I was unable to do so, because of her reaction
16 in response to my bringing the topic up.
17 Q And the -- what, if any, evidence of delusions or
18 anything like that do you have, or have you observed?
19 A Well, the examples that I gave. In addition to
20 that, this was observed by nursing staff, not by me, but
21 it was documented in her chart. On March the 1st, Ms.
22 Myers unfortunately became very upset and was reported by
23 nursing staff to become very upset. She became making
24 reference to being pregnant and believing that we were
25 somehow trying to harm her child. At that point she --
0079
1 nursing staff reported to me that she became extremely
2 angry, yelling at the top of her lungs, per their report,
3 and approached -- she apparently reportedly approached one
4 of the nursing staff in a very sort of threatening,
5 menacing way.
6 I asked the member of the nursing staff to describe
7 that to me, and she stated that she had her fists clenched
8 at her side and her body leaning forward and moving
9 towards the person very rapidly, into their personal
10 space. At that point, she did -- the on-call doctor did
11 order emergency medication for her. It was an inter-
12 muscular injection, I believe, of haldal, 10 milligrams,
13 and ativan, two milligrams.
14 Q Okay.
15 A This was done on an emergency basis, because of the
16 nature of the situation.
17 Q I understand. How much medication has the depart --
18 or the hospital provided to Ms. Myers since her admission,
19 other than this crisis, emergency application of
20 medication?
21 A To my recollection, none.
22 Q Okay. And, in your opinion, is Ms. Myers'
23 condition, does it qualify as an organic, mental or
24 emotional impairment?
25 A I do feel that she does have a mental disorder, as
0080
1 defined by the DSM4 or DSM4TR.
2 Q Okay. And what is that, that you just referenced?
3 A That is the Diagnostical -- oh sorry, Diagnostic and
4 Statistical Manual of Mental Disorders, 4th Edition.
5 Q Okay.
6 THE COURT: When you say that you feel she has a
7 mental disorder, is that the same as a mental illness?
8 A Yes, Your Honor.
9 THE COURT: And your specific diagnosis is
10 schizophrenia of a paranoid type?
11 A Yes, Your Honor.
12 Q Does her condition -- excuse me, Your Honor. If I
13 can continue?
14 THE COURT: Yes, please.
15 Q Dr. Hanowell, does her condition have substantial,
16 adverse effects? And if so, what are those?
17 A Yes, sir, regrettably it does. Some examples of
18 this are the reports that Ms. Myers had apparently been
19 having conflict with her -- with the tenants in her
20 building, reports of threatening remarks or threatening
21 behavior in relation to the tenants and the landlord.
22 Other examples are -- would be that it was reported
23 that again, that she wasn't eating well and that she was
24 leaving food around -- leaving food around the house or
25 around the front porch, creating a potential health
0081
1 hazard.
2 It was also reported that she may have been sleeping
3 or staying in the crawl space of the house, which
4 apparently has a di -- or pardon me, the apartment, that
5 apparently has a dirt floor. That, of course, in winter,
6 could be quite dangerous.
7 Q Dr. Hanowell, I don't mean to interrupt, but we have
8 -- I've been instructed we have until 11:00, so we've got
9 ten more minutes. And I've got several more questions, so
10 I'm going to try and move quickly.
11 What is your opinion about whether, as a result of
12 this mental illness, whether Ms. Myers is gravely
13 disabled? Specifically, what is your opinion about
14 whether she is -- the likelihood of danger or physical
15 harm from self-neglect?
16 MR. GOTTSTEIN: Object, leading.
17 THE COURT: I'll overrule it. It's one of the
18 elements he must show and I need to know what this
19 opinion's witness -- do you understand the question? Do
20 you believe that this witness presents a threat of harm to
21 herself or to others?
22 A Yes, Your Honor.
23 THE COURT: Why?
24 A In terms of grave -- her grave disability, that in
25 and of itself could pose a risk to her personal safety.
0082
1 Again, the reports that she was not eating well, that she
2 may have been sleeping on the ground in the crawl space.
3 There are additional reports that in November she
4 apparently had a conflict with airport security in
5 Seattle, resulting in her emergency hospitalization in
6 Seattle. Obviously in this -- in 2003 having any kind of
7 conflict with airport security could be extremely
8 hazardous to one's safety.
9 Apparently during that incident not only was there
10 conflict with airport security, but there apparently was
11 also an incident where she had, according to family, gone
12 out -- walked out towards an area where there was a great
13 deal of traffic, and it was actually at that point that I
14 guess airport security intervened and took her into
15 custody and arranged for her hospitalization.
16 THE COURT: Counsel?
17 MR. KILLIP: Thank you, Your Honor.
18 Q Concerning your opinion about danger -- so you were
19 testifying to danger to self? Is that my understanding,
20 just now?
21 A Danger to self as part of grave disability.
22 Q Okay. And what about danger to others?
23 A This is also a concern of mine and of the treatment
24 team. There have been -- excuse me. Pardon me. There
25 was a report by the family, by the petitioners, for the
0083
1 order of screening investigation. It was reported that
2 approximately a week prior to admission, Ms. Myers'
3 daughter had had a conversation with her, during which she
4 became very belligerent and angry. And Ms. Myers'
5 daughter, Ms. Humphreys, became fearful of her safety and
6 her daughter's safety. She left Ms. Myers' apartment at
7 that juncture.
8 In addition, this incident on March the 1st on our
9 unit makes me also worried. Whenever someone requires
10 emergency intervention with inter-muscular medication
11 because of severe agitation and entering someone's
12 personal space, yelling at the -- reportedly yelling at
13 the top of her lungs, or yelling very loudly, anyway, that
14 is what we often feel is more or less pre-assaultive
15 behavior. And that does make me worried for the potential
16 for Ms. Myers to harm someone else, if not -- if she is
17 not provided the treatment that she needs.
18 Q Um-hmm. Are you aware of a less-restrictive
19 alternative available for treatment for her, presently?
20 A Regrettably, I am not at this juncture.
21 THE COURT: Less restrictive than what, counsel?
22 Q Than API and medications that I'm going to ask him
23 about.
24 THE COURT: Okay. I want to be clear on your
25 testimony, here.
0084
1 MR. KILLIP: Sure.
2 THE COURT: I think I want to know whether or not
3 you're aware of a less restrictive alternative and answer
4 it in the alternative, if you would, please. One level
5 I'm understanding is the question about whether or not
6 this patient should be involuntarily committed, and then
7 it's yet another level as to whether or not you think
8 there's a less restrictive alternative to administering
9 psychotropic medication.
10 A Okay.
11 THE COURT: Can you answer that question?
12 A Yes, Your Honor.
13 THE COURT: In other words, is it an alternative
14 that she be involuntarily committed at API and not have
15 this medication administered to her?
16 A I feel that that would be insufficient to address
17 her needs.
18 THE COURT: Why?
19 A I'm sorry.
20 THE COURT: Is there some water down there? Okay.
21 That's okay. Those are trick pitchers; they tend to flood
22 people.
23 A Yes, it would be -- I guess if perhaps I could kind
24 of --
25 THE COURT: In other words, because we're under such
0085
1 time constraints.....
2 A Sorry.
3 THE COURT: .....let me explain. I want to know,
4 because I have no medical training, I'm just a judge. If
5 this person is -- if you're concerned that the environment
6 is posing a potentially -- a threatening situation to her
7 that could harm her because of where she was living, and
8 moving her, even involuntarily, into API where she's in,
9 what I think you said in your deposition would be a
10 structured environment, where we know she's going to be
11 able to be fed appropriately and not sleeping in a crawl
12 space and what not. Is that an alternate that would
13 provide adequate treatment for her, as opposing to
14 administering that medication?
15 A Regrettably, it would not be.
16 THE COURT: Okay. Why not?
17 A It would be, if I could maybe just draw a parallel
18 between general medicine and psychiatry. It would be
19 similar to hospitalizing the person with diabetes and not
20 giving them insulin or giving them oral medication to
21 treat their diabetes.
22 THE COURT: So you have an opinion that this
23 medication would assist her?
24 A Yes, Your Honor.
25 THE COURT: Is that based upon her history?
0086
1 A Yes, Your Honor.
2 THE COURT: Can you explain that more? What do you
3 know about her history and how she's done with -- on
4 various medications?
5 A I know from personal experience, having worked with
6 Ms. Myers in the -- from December 2000 to February or late
7 January in 2001, Ms. Myers did very well and did exhibit
8 improvement in the symptoms of her illness with a
9 medication called zyprexa.
10 THE COURT: Called -- I'm sorry?
11 A Zyprexa.
12 THE COURT: Okay. Was she able to be -- well, how
13 long did she take it before she was released from API? Do
14 you know?
15 A I believe, Your Honor, I believe it was roughly six
16 weeks, but I -- it may have been a little bit longer then
17 that. I don't recall precisely.
18 THE COURT: All right. Are you able to testify
19 about a longer term? Did you see her after she was
20 released from API so you know how she did when she was out
21 of that facility?
22 A I did not, Your Honor. But her family has indicated
23 that she had benefited from medications on an out-patient
24 basis. I would have been very active in calling her
25 former out-patient doctor at Southcentral Counseling, but
0087
1 she had not been willing to sign any kind of releases of
2 information, except, I believe, to Mr. Gottstein.
3 THE COURT: All right. What about side effects?
4 Has she reported side effects from that drug?
5 A That's an interesting question, because when I first
6 spoke with her about this matter, she indicated to me
7 that, if I understood her correctly, and the family has
8 also indicated the same, that she's indicated the same to
9 them, that it kind of prevents her from seeing danger.
10 And, I guess, from my perspective, it almost seemed like
11 her concern about the medication was that it maybe made
12 her symptoms of paranoia less, so kind of a paradoxical
13 sort of concept of what a -- what a side effect is.
14 However, that was during my first three
15 conversations -- or first -- at least two of the
16 conversations with her. She made reference to -- she
17 didn't make reference to any specific side effects, such
18 as -- she may have mentioned some drowsiness, I don't
19 recall. She may have mentioned some drowsiness, but no
20 symptoms such as muscle spasms or muscle stiffness or
21 tremor, or anything of that nature.
22 On my last conversation with her on March the 3rd
23 regarding medications, she mentioned that she had broken
24 out in hives. And that really surprised me that she said
25 that, because I'd asked her previously about the issue of
0088
1 side effects and so on. Or I'd asked her -- she'd talked
2 to me previously about her concerns about the medication,
3 she never once mentioned that. So that surprised me.
4 THE COURT: Um-hmm. Mr. Killip, I've interrupted
5 you again. Do you have more questions?
6 MR. KILLIP: Yes, thank you.
7 DIRECT EXAMINATION (continued)
8 BY MR. KILLIP:
9 Q Do you believe that Ms. Myers will be -- her
10 condition can be improved by a course of treatment?
11 A Yes, I do, sir.
12 Q And is API an appropriate treatment facility for her
13 condition?
14 A Yes, sir.
15 Q And, to your knowledge, was she advised of her
16 opportunity to accept voluntary treatment, from API?
17 A Yes, sir.
18 Q And she declined?
19 A Yes, sir.
20 Q What group or category of medications are you
21 recommending for her, presently?
22 A An anti-psychotic medication.
23 Q Okay. And you've mentioned zyprexa as being one.
24 You have a few to choose from?
25 A Yes, sir.
0089
1 Q Okay. And your attitude about working with Ms.
2 Myers would be the same? Try and create a partnership
3 with her?
4 A Yes, sir.
5 Q Okay. Concerning your opinion about her capacity to
6 agree to the medications, the hospital has alleged that
7 she is not competent to voluntarily agree to the
8 medications. In your opinion, do you feel that presently
9 Ms. Myers has a capacity to assimilate relevant facts and
10 to appreciate and understand her situation?
11 A Regrettably not at this juncture, sir.
12 Q And that would be based on your previous testimony?
13 A Yes, sir.
14 Q In your opinion, do you feel like she can appreciate
15 that she has a mental disorder or impairment, presently?
16 A No, sir.
17 Q What about her capacity to participate in a
18 treatment decision, by means of a rational thought
19 process?
20 A Regrettably, I don't feel she's capable of that at
21 this juncture, sir.
22 Q What about the ability to articulate reasonable
23 objections to the proposed medications?
24 A I would say that she would not be able to do that.
25 She may have objections, and certainly I would take them -
0090
1 - I would consider them, by all means, I would consider
2 them. But I don't feel that -- in the spirit of that
3 question, I think the answer would have to be no, that I
4 don't feel she's capable of doing that.
5 Q Okay. And one of the requirements of the hospital
6 is to give each patient complete information about these
7 medications, so they are informed. Completely informed so
8 they can make a decision. And Alaska law requires certain
9 information be conveyed to the patient. I'm just going to
10 run through those things. Basically the hospital has to
11 give all information that's material to the proposed
12 treatment, including (1) an explanation of diagnosis and
13 prognosis. Has that information been conveyed to Ms.