Stone was taken aback. He was used to more deference.
“No, no. You are defining competency. I am well aware of what competency means. Mister Louis is a Ganser sufferer. That means the issue is not whether he is competent, but when he is competent. Mister Louis is competent to stand trial, except when he is actually standing trial.”
Yergin coughed. “Would you repeat that?”
“Certainly,” sad Stone with more confidence. “Mister Louis is a competent adult able to do anything that competent adults do, including understanding criminal charges and assisting a lawyer in his own defense. But once such a charge is made against Mister Louis, and he finds himself in a court of law about to be prosecuted for a crime, Mister Louis loses all semblance of competency.”
“And how do you know that this loss of competence will occur when Mister Louis is tried?”
“Because he has Ganser syndrome.”
“And how do you know that?”
“Because of the manifestations of incompetence at trial, of course. It’s diagnostic. The principal effect of Ganser syndrome is that the sufferer becomes incompetent to stand trial, but only once the trial begins. Or, of course, if he were remanded for trial, it would be the same. The symptoms could evince themselves at any time. Naturally, we are still doing research on the etiology of this disease.”
“Naturally,” said Yergin dryly. He turned to Sussman.
“Look, Mister Sussman, answer me this. Is your client, in your opinion, presently competent to stand trial?”
“Your Honor,” Sussman said, “it appears that my client is presently aware of this proceeding. My impression is borne out by the psychiatrists’ reports, which state that he is presently competent. Our concern is for what will happen once a trial actually begins.”
“Then maybe we should go to trial and see what happens,” said Yergin. “I mean, if the man is competent right now, that’s all I need to hear. How does that sit with you, Mister Karp?”
It sat very badly. Yergin obviously wanted to move this case, and he was playing into Louis’s hands. Without a formal finding that Louis was malingering and not suffering from a purported Ganser syndrome, he could stage another bizarre episode at trial and go through another round in his game.
“Your Honor, I think it is essential that the court make a finding as to whether the defendant does indeed suffer from so-called Ganser syndrome. This is the first time the conclusions of the Bellevue Hospital psychiatric staff have been challenged in this case. I think the court will agree that if it can be shown that Mister Louis is not in fact a sufferer from a mental disease that makes him incompetent to stand trial, the disposition of this case in the future will be quite different from what it would be if we simply remanded him at this time.”
Yergin got the point. “Very well, Mister Karp. You may resume questioning.”
Karp turned once more to Stone. “Doctor, one last question. As the defendant sits here now, is it your opinion that he is competent?”
Stone said “Yes.” Karp sat down. The judge offered Stone to Sussman, who declined to cross-examine. The court broke for lunch, and at two Karp called Dr. Milton C. Werner to the stand.
Werner liked testifying in court. His expression was benign, his carriage confident as Karp went through the preliminaries of identification and qualifications, and established that Werner agreed with Stone completely about Louis suffering from Ganser syndrome. Then Karp began to dig the pit.
“Doctor Werner, is there anything that might possibly indicate that the defendant does not suffer from Ganser syndrome?”
“No, sir, this is a classic case. In fact, I have just had a paper accepted for the journal, Forensic Psychiatry, that uses this very case as a-how would you put it? — a diagnostic paratype of this disorder.”
“But surely, Doctor, some psychiatrists might disagree. Some psychiatrists might suspect on present evidence that Mister Louis is no more than a clever malingerer.”
“Well they might, but if they did I would be glad to tell them they were wrong.” Werner chuckled at his little joke.
“So you would expect unanimity on this diagnosis among competent experts in forensic psychiatry?”
Werner checked for an instant before answering. “Um, yes, among competent experts, yes.”
“And is this reflected in the medical records pertaining to the defendant, Mister Louis?”
“Yes.”
Karp walked over to his table and picked up a sheaf of folders. “I notice, Doctor, that each time Mister Louis was examined, in Nineteen-seventy, in Nineteen-seventy-three, and just recently, all the examining physicians concurred in the diagnosis. Is that true?”
“Yes.”
Karp handed him the file. “This is Mandeville Louis’s file as delivered by you, pursuant to the subpoena. Please look through it, and would you confirm for the court that it contains the reports of all the psychiatric examinations performed on Mister Louis during his several stays at Bellevue?”
Werner thumbed carefully through the file. “Yes, they’re all here.”
“There were three stays and two reports for each stay. Correct?”
“Yes, that is correct.”
“Now, Doctor, as one of the directors of Bellevue and as an official of the state of New York, are you conversant with the procedures under which competency is established under New York law?”
“Yes, I am.”
“And, so you are aware that it is a violation of New York State law to suppress or conceal the results of a psychiatric evaluation?”
“Yes, I am.” Werner was tense now. He had stopped his genial beaming after each question.
Karp handed Werner a sheaf of papers from one of his folders.
“Doctor Werner, would you tell the court what that document is?”
Werner paled when he read the first page of the document.
“Ah … it appears to be a psychiatric evaluation of Mandeville Louis.”
“Very good, Doctor Werner. It is a psychiatric evaluation of Mandeville Louis, written by Doctor Emmanuel Perlsteiner of the Bellevue staff. But it was not included in any of your original reports to the court, nor was it included in the subpoenaed material. Nor did you choose to include Doctor Perlsteiner’s other two reports on Mister Louis. Doctor, is it not a fact that you consciously suppressed these reports because they did not confirm your diagnosis, because they were adamant in their conclusion that Mister Louis was, and is, a blatant malingerer?”
“No, that’s not true, he … Doctor Perlsteiner is, well, he actually hasn’t kept abreast of modern developments in the field, and as an elderly man, he …”
Werner’s voice faded. Karp thought, Thank you, thank you. An invidious dig at your colleague’s credentials is precisely what I wanted. You’ve broken the White Wall, you asshole, and now your credentials are up for grabs, and so are Bellevue’s, not to mention the integrity of your system.
Karp lifted his folders toward the bench. “Your Honor, I would like to present as evidence these psychiatric evaluative reports on the defendant, written by Doctor Emmanuel Perlsteiner. Doctor Perlsteiner is quite certain that Mister Louis is completely sane.”
Yergin’s brow looked like corrugated cardboard. “Mister Karp, do you mean to tell me that we don’t have those reports?”
“Yes, Your Honor. Every year since his first evaluation, Mandeville Louis was examined by Doctor Stone, Doctor Perlsteiner, and Doctor Werner. But only the reports by Doctors Stone and Werner were sent to the court, for obvious reasons. This court never knew about the dissenting reports.”
From the stand, Werner tried his last shot, a desperate one.
“Your Honor, if I may. It seems to me that this Mister Karp is presuming to make judgments about the competency of psychiatric staff that lie outside his purview. I must strenuously object on behalf of the Bellevue staff.”