All right. Doctor, would you resume the witness stand, please.
Robert Huizenga, the witness on the stand at the time of the evening adjournment, resumed the stand and testified further as follows:
The record should reflect that Dr. Robert Huizenga is on the witness stand undergoing cross-examination by Mr. Kelberg. Good morning again, doctor.
You are reminded, sir, you are still under oath. Mr. Kelberg, you were playing a videotape which you have stopped at a particular location at the court session yesterday.
Yes, your Honor. And my intention would be simply to ask Mr. Fairtlough to start the tape up and continue watching the videotape.
All right. And before you do that, ladies and gentlemen, the parties have asked me to mention to you that in viewing this videotape this is the raw footage that was later made into finished product. There are starts and stops and that may not be apparent to you in watching it, so you should also pay attention to the real time counter which is in the lower right-hand quadrant of the screen so that you can note when there is a start and a stop.
Just some very brief questions before we get to another video.
CROSS-EXAMINATION (RESUMED) BY MR. KELBERG
Doctor, first of all, I want you to assume that that video series of tapes was shot on May 25, 1994, and all of that was shot in the course of one day with additional taping that day involving the introductory remarks that Mr. Simpson is going to make as part of the ultimate finished product which I have not shown for purposes of questioning you. First of all, doctor, in viewing this videotape did you see Mr. Simpson limp as you say he limped in the same fashion you saw him limp on June 15th, 1994, in a situation that led you to describe it as like Tarzan's grandfather?
There was no clear walking sequence in this area, so I can't actually assess that, but he definitely does have a lot of the same disabilities I talked about.
You saw him in a walking maneuver forward and backward during the course of the exercise, did you not?
My specific question then to you again is, sir, did you see any evidence of the same kind of limp that you say you saw on June 15th that led you to describe Mr. Simpson as walking like Tarzan's grandfather?
In this tape he has an altered cadence but his limp more pronounced when I saw him on 6/15/94.
KEY QUOTEDoctor, would it be safe to say that none of the activity that you witnessed in this video segment would create the kind of adrenaline rush that you testified one might expect if a person like Mr. Simpson were enraged; is that correct?
This video would not create an adrenaline rush, this workout video, unless he was very, very nervous about going in front of the camera to give, you know, some of his prepared lines.
And so would it be accurate to say, doctor, that again no circumstance here would have caused the kind of adrenaline rush that can lead to exertion beyond normal capability that one might see if a person is in an enraged emotional state; is that correct?
When a person is in an enraged emotional state presumably they have more adrenaline than what he would have for this sort of exertion which the body would still need to call up some mechanism for the exercise, but no, I think that that is a fair statement, he wouldn't have the kind of adrenaline rush you would if hypothetically you are enraged.
Doctor, just a couple other follow-up things. No. 1, you found that document, the February 5th, 1995, letter that you sent to Mr. Douglas, you went through your files and you brought it to my attention this morning that you had found it. I just wanted to make sure that is on the record.
No. 2, that you have provided to me--yesterday you provided one page, what is page 215 from some textbook describing as the topic "Clinical picturing of rheumatoid arthritis"?
And you also provided to me two pages, pages 876 and 877, of a chapter--chapter 52 from a textbook of rheumatology. The chapter is by a physician, a rheumatologist, is he not, Dr. Edward D. Harris, Jr.?
And doctor, these are some of the materials you relied upon in giving your answers to some of my earlier questions?
I don't know Dr. Harris. He obviously wrote this chapter, but I can't--I can't talk about his qualifications, but he certainly did write this chapter in the book.
Assuming he is a board certified rheumatologist associated with Stanford University's school of medicine and presently he is on a sabbatical writing--part of a team of doctors writing a whole new textbook on rheumatology, if Dr. Harris had reviewed Mr. Simpson's records that you've provided and the report on x-ray examinations of Dr. Martel, and all of the other materials that you've reviewed, and concluded that Mr. Simpson was not suffering an acute episode of rheumatoid arthritis on June 12th, 1994, and was not suffering an acute episode of rheumatoid arthritis on June 15th, 1994, when you saw him, would you accept Dr. Harris' opinion over your own, given his specialty, assuming that that is in fact his finding?
All right. One last thing before getting into another video. You talked about having a test done for toxoplasmosis, correct?
What was your information and the source of the information as well? That is a compound question so let me break it down. No. 1, did you receive some information regarding a cat exposure on the part of Mr. Simpson?
I'm going to have to go review my notes. That is my recollection, that there was--that he did at some time have exposure to a cat, yes.
It is--I don't know if it is the entry. The lab report--I can tell you what page, if you will give me just one--
Why don't you direct the doctor's attention so he doesn't have to spend the whole morning.
That he has a positive history of cat exposure. I don't remember the exact situation, but apparently that was something that I noted down. Obviously in the differential of adenopathy of a swollen lymph node that would probably be a test that we ordinarily do anyway in a wide battery of tests looking for a cause of a swollen lymph gland. And the fact that he had cat exposure may have just heightened whatever small suspicion there existed initially.
My question, though, doctor, is did you get specific information? Well, Mr. Simpson, do you have a cat in the house? Do you have friends whose house you visit where you have been exposed to a cat? When? Any specific information? Did you inquire of him?
He gave me enough information that I felt it was important to run tests that he had been exposed to a cat.
Your Honor, I will move to strike as nonresponsive. The question is what specific information did he give you?
I don't recall the specific information, just enough that I made that note, so I can't answer that exactly.
Obviously in order for me to write it down my feeling must have been that he had had recent exposure to a cat. Typically I will write down exposure to a cat or I would have written down exposure to a kitten since obviously kittens have a higher incidence of transmitting toxoplasmosis. And if he had, I'm sure I would have noted it, or if he would have changed kitten litters I also would have noted that or whether he had exposure to various other sources, but that basically was something that I wrote down and that is all I really recall on it, just what is in the note.
Just your custom and practice, though, to write it down, would indicate to you what proximity in time to June 15th are you focusing on for such exposure to cause you to run the test?
Umm, my recollection that it was a minimal exposure and a relatively past exposure, but again, I don't remember the exact--I would have to speculate on that.
And there is nothing more that you can recall in substance, even if not specifically--
One last thing. X-rays. I think you said on direct that at least you didn't use one x-ray, but you said x-rays, and I'm not sure it is one or meant to be more than one. Were x-rays taken on June 15th, 1994?
Trying to further evaluate a possible cause of his lymph node under his right arm.
No. I physically brought it to the head chest radiologist at cedars and asked him.
We don't take orthopedic x-rays in our office, and basically, given the time constraints and the fact that he had no urgent need to see an orthopedist for those problems, given the prioritization of his health problems, those things weren't done.
And no urgent need, including no evidence on June 15th, that suggested to you an acute onset of rheumatoid arthritis, correct?
There was evidence of significant joint problems. There was no evidence that getting x-rays would help those joint problems and that that was a cost efficacious appropriate thing to do given his schedule and his needs at that time.
But my question is no evidence of an acute onset of symptoms of rheumatoid arthritis requiring you at that time to have him evaluated?
At that time all I knew is that he had a rheumatologist and that he had continuing joint pains, and as I've told you before, my suspicion of a flare, slight or otherwise, really came later when the full details of the case became apparent to me. As I said, when he came in the office, he was limping, he had joint complaints that I elicited, but really that wasn't the focus of his complaints. And I proceeded accordingly based on my assessment of the prioritizations of his health problems.
One last topic, doctor. Another video. I'm going to ask, your Honor, that a video which has on the label the letter "N" hyphen "Sat," S-A-T, "No. 1," 4-5-94. 60 minutes, NSA, William Bearden, Bearden Company, 31 March, 1994," be marked as I think it is 522.
The significant amount I am going to play is, I would say, your Honor--I think it is about ten minutes or less.
And your Honor, if I don't do this now I will probably forget, there were several photographs duplicated off the elmo that I did not mark yesterday as exhibits. I'm going to ask that they be marked--perhaps we can do it at the recess with the appropriate designation.
And doctor, I'm going to ask you to assume that this is Mr. Simpson at the end of March, 1994, at a motivational seminar for a product called Juice Plus and he is going to be introduced and he is going to be speaking to a group at this motivational seminar. And the portion I'm going to have Mr. Fairtlough play will include a discussion by Mr. Simpson of his past problems and his present health as he views it.
Your Honor, I'm going to object to his comment. It is improper. It is not a question.
Proceed. You have made your objection and it is on the record. Proceed. I take it this is a set-up.
Doctor, you have had a chance obviously to listen to that, the history as given by Mr. Simpson of his premedical status where he no longer had to take any of the pain medication. Would that suggest somebody who is in a condition better than as you described him, based on his walk, Tarzan's grandfather?
Okay. It sounded like based on his statements, if you can believe everyone that makes an advertisement, and certainly being around the raiders, we used to laugh about it in the locker room, the products that they would support, and do something totally different, including wearing shoes that were totally different than the sponsor that they were endorsing on TV and taping over the logo and various other vitamin products which they readily admitted were worthless, that they then went out and pitched. However, given--if you assume that pitchmen can be taken at your word, then I think obviously he was doing better, but it is very misleading when he says he had acute flares of rheumatoid arthritis, which is based on the history I have gotten from Dr. Maltz and Dr. Jobe, something that they both--again, I wasn't there. It is very difficult for your doctor, with all due respect, to make a diagnosis on paper. Medicine isn't practiced that way. Usually what you do is you take a history and you do an examination and then you come to a diagnosis and fortunately medicine hasn't gotten to the stage yet where you call up a professor that writes a chapter and over the phone you make a diagnosis. We still do rely on history and physical and medicine, at least to the best of my knowledge, based on my training at Harvard. However, it is very misleading, because if you believe the rheumatologist, if you believe the orthopedist, and I have no reason to doubt their reports, stating that when they both last saw him, in 1993 in July he was having an acute flare of rheumatoid arthritis which was so severe he had difficulty bending down to tie his shoe, but I have no reason to doubt their report. And if you believe that report and if you also believe that the medication he was on, sulfasalazine, has some disease remitting qualities, it is a disease modifying agent in rheumatoid arthritis, it is not surprising that he might be doing quite well, because at the time that he gave that motivational speech he was on a significant anti-rheumatoid arthritis medication. Also, the disease rheumatoid arthritis--again I'm just a jack-of-all-trades, and I probably wouldn't know--has a fluctuating course, and that really would be my comment on that tape.
Doctor, you were apprised this tape was going to be played before you came into court this morning, didn't you?
Well, you were told that there was going to be a motivational speech made of Mr. Simpson making this, didn't you?
All right. Let me ask the this way then, doctor: You are saying Mr. Simpson was merely a pitch man who was lying to the people, what he said about his health was not true based on your experience with the raiders? Is that what you are saying, doctor?
Doctor, you are saying, are you not, that Mr. Simpson, when he is giving his medical condition up there, is lying to those people, that in fact that does not represent his condition? Isn't that what you are saying by relating this to your experience with the NFL players.
Doctor, you are suggesting that Mr. Simpson is not being truthful with these people regarding his medical condition because he views himself as a pitchman for a product as a result of which he is willing to say things that are not true to please the people paying him to make the speech? Is that what you are suggesting.
I cannot get inside Mr. Simpson's head. I do know that he had a lack of understanding of his rheumatoid arthritis. He constantly denied the fact that he had rheumatoid arthritis. He did not want to see himself as an arthritic patient. And so I can't say whether it was, a, a full lack of understanding of his disease that led him to not understand the possible effect of the anti-rheumatoid arthritis medication he was taking at the time of that speech or whether he was knowingly misrepresenting to make money. I have no idea and I am not qualified to say.
Well, doctor, if he was being truthful about his condition, that he wasn't making false statements just to please somebody paying him, then in fact he is saying his condition is such I don't need the pills any more as of this time? Isn't that what he is saying?
Doctor, by the way, you were in the courtroom yesterday afternoon when I read a summary, a transcript summary of what was being--going to be played this morning when we were discussing this as being the last piece of evidence that I would use in cross-examining you? You were in the courtroom, weren't you, sir?
I don't know if I was in the courtroom or not because I didn't hear what you said, so I'm not sure where I was since I didn't--how would I know if I was in the courtroom if I didn't hear what you said?
Doctor, did you leave the courtroom before the courtroom was cleared of all press yesterday afternoon at the completion of court business?
And so, doctor, is it your statement here that if there was a motion argued in the presence of the press, with a representation made by me to the Court as to what this videotape was going to say, if you were here, you didn't hear what I was saying at the time I was making this offer of proof to the Court?
Now, doctor, you said that you wouldn't rely upon a Dr. Harris, and I represent he is a board certified rheumatologist, and a preeminent expert in the field of rheumatology.
You said you wouldn't rely on that over Dr. Maltz and Dr. Jobe who saw him; is that correct?
I said I would not rely on any individual who reviewed a chart without doing an appropriate history and physical at that time and seeing the patient.
In general, doctor, would you rely on a board certified rheumatologist over a doctor who held him out as a rheumatologist who was neither board certified in internal medicine or in rheumatology?
Doctor, would you, all things being equal, rely upon an evaluation by a board certified rheumatologist over an opinion offered on an issue of rheumatology--rheumatoid arthritis from a person who is an orthopedic surgeon or a person who held himself--held himself out as a specialist in rheumatology who was neither board certified in internal medicine or board certified in rheumatology?
Doctor, would you accept the opinion of someone holding himself out as a rheumatologist who was not board certified in either internal medicine or in rheumatology over the opinion of a specialist board certified in rheumatology on the issue of a rheumatoid arthritis acute onset?
The whole issue of experts is very difficult. In medicine you have to see the patient.
There are very--various definitions of an expert, but basically any doctor, to be an expert, obviously needs to be very knowledgeable and needs to have appropriate training, needs to be--have shown proficiency in what he does, and needs to, in addition, have other traits, including caring about people and things of that nature. I mean, there are other definitions of an expert, and just to give you an idea, at Harvard, you know, there is a mean streak in there, and I remember as a student being told there an expert is a bastard from Boston with slides. Just because you've got a big degree doesn't mean everything. You need to see a patient, you need to do the building blocks of medicine, and that is a history and that is a physical examination and an evaluation of all the results. I still think that is the way to practice medicine. I do not know of the other specialist. All things considered, the more training, the more proficiency is superior, but I think it is very dangerous to compare credentials and base a diagnosis based on who has got the longest CV. I think that that is a dangerous step. That is my own personal opinion.
Mine I marked which I have no problem in showing the doctor. May I stay up here to--
Now, doctor, this is the last report from Dr. Jobe, the orthopedic surgeon, prior to your evaluation of June 15th, 1994, correct?
And it indicates that certain x-rays were taken of Mr. Simpson's right elbow, correct?
And it indicates that in the opinion of Dr. Jobe that the x-rays are within normal limits but show early findings of rheumatoid arthritis; is that correct?
Now, doctor, did you receive a copy of a June 28th, 1995, two-page report from a Dr. William Martel, a doctor with the University of Michigan, the letter directed to Dr. Maltz?
And in essence, Dr. Martel is a specialist in radiology which you have identified already as people who specialize in reading x-rays?
And in essence what Dr. Maltz had asked is for Dr. Martel to review the available x-rays of Mr. Simpson from `91, `92 and `93; is that correct?
And there were no other x-rays after the `93 x-rays to provide that dealt with the areas in question; the hands, the wrists, the feet, the elbows, correct?
Now, with respect to what Dr. Jobe has indicated as x-ray findings of the right elbow showing normal limits but early finding of rheumatoid arthritis, was a reading of that x-ray also taken by Dr. Martel? And I will show you the report--and your Honor, may this be marked as 522, please?
The date is July 13, 1993, and he was seen by both Dr. Jobe and Dr. Maltz on that same day, so I don't know whose x-rays, but it probably doesn't make a difference.
All right. So you've said it doesn't probably make a difference. Did you find any indication by Dr. Martel of his assessment of the elbows?
His assessment of the elbows, frontal and lateral views of both elbows, show no significant abnormalities; however, as I'm sure you are aware--
Did you also, by the way, receive from Dr. Maltz a copy of a July handwritten chart entry for an evaluation of Mr. Simpson in the county jail?
If I may have just a moment, your Honor, to find--I'm sorry, your Honor. May I just have a moment to find a report?
Yes, I believe so, your Honor. I'm going to have to get a clean copy and I will get it from another source, but I would ask that this document, which has the accounting no. 505 be marked as 524.
It appears to be a handwritten note of Dr. Maltz', a rheumatology note, and because of the copy that was provided to the Prosecution, I cannot be certain what the month date is, but the day is 2/94. And I'm going to show--perhaps, doctor, at a break, if we get there, if you have a chance to find your copy, maybe it will have the month.
This is Dr. Maltz' handwritten note of an evaluation of Mr. Simpson; is that correct?
And I want to invite your attention to the second paragraph. Can you read what Dr. Maltz has written there?
Does it appear to be: "Main problem presently is classical increased activity of his rheumatoid disease with the left knee being his major limiting factor in terms of pain," I can't make out the next word, "And swelling?
Let me back it up. What is read to begin with, does that sound what it appears to you to be: "Main problem presently is classical increased activity of his rheumatoid disease with the left knee being his major limiting factor in terms of pain," the word we can't decipher, "And swelling."
And that indicates to you, does it not, doctor, that Dr. Maltz, excuse me, believed that Mr. Simpson has evidence of rheumatoid arthritis in his left knee, correct?
It says he has evidence on--this is my interpretation. You will have to Dr. Maltz, it will probably be more appropriate, but if I read that, it says he has got evidence of rheumatoid arthritis with--and this is a different part his left knee--being his major limiting factor. That is how I read it, but you may have read it differently.
Don't you read it as the relationship between the rheumatoid arthritis and the limiting aspect on his left knee?
Well, let's ask you to look then at Dr. Martel's report and see if in the summary he evaluates the left knee x-rays for evidence of inflammatory disease which rheumatoid arthritis would be; isn't that correct?
And in the summary, with respect to the left knee, does he not say the following: "The abnormality noted in the left knee is degenerative rather than inflammatory in nature and probably secondary to earlier trauma."
And that would indicate that Mr. Simpson, at least based upon that x-ray, does not show evidence of rheumatoid arthritis in the left knee joint, but rather has the effects of osteoarthritis from previous trauma, correct?
There is definitely osteoarthritis in his left knee, but we have a biopsy that is strongly consistent of rheumatoid arthritis of the synovium taken in 1991, so I think there is some question about that, and there is some subtleties that I certainly am not in a position to discuss with you.
According to his report the left knee does not show evidence of inflammatory disease; it shows osteoarthritis, right?
That is correct; however, as the elbow, sometimes you can have rheumatoid arthritis in a joint and not have x-ray changes, so I would be very careful--and again, I don't want to present myself as an expert--but I wouldn't jump to simple conclusions based on the fact that an x-ray shows degenerative not rheumatoid arthritis that that joint cannot be involved with by and in rheumatoid arthritis.
All right. Ladies and gentlemen, we are going to take our mid-morning recess at this time. Remember all my admonitions to you. Doctor, you can step down. You are ordered to come back in fifteen minutes. Let me see counsel with the court reporter, please.
In this tape he has an altered cadence but his limp more pronounced when I saw him on 6/15/94.
He constantly denied the fact that he had rheumatoid arthritis. He did not want to see himself as an arthritic patient.
At Harvard, you know, there is a mean streak in there, and I remember as a student being told there an expert is a bastard from Boston with slides. Just because you've got a big degree doesn't mean everything.
You are saying Mr. Simpson was merely a pitch man who was lying to the people, what he said about his health was not true based on your experience with the raiders? Is that what you are saying, doctor?