Doctor, did you prescribe the Xanax for the stress that you assessed on June 15th for Mr. Simpson?
Now, doctor, I want to discuss a few things that were touched upon by Mr. Shapiro. First of all, when you said no oldtimers NFL, there are oldtimer hockey games, aren't there?
And in fact one of these typical defensive actions in hockey is something called checking, right?
And one type of checking is to slam your body into the body of the opposing player and the two bodies go slamming into the boards, right?
Mr. Kelberg, whether or not other sports have oldtimer games is interesting but not real productive here.
All right. Perhaps I should have objected as irrelevant on the NFL, but I will move to something else.
So I thought you said you billed Mr. Simpson's insurance company for the care you provided. That is a misstatement?
We billed sag and then typically, you know, we ask the patient to pay the remainder.
So all of your patients have to be patients who can pay your bills; is that correct?
You charge--charge based on examinations or lab tests that are done in the office.
And if I came to you--maybe I better not choose myself--if somebody came to you for a first evaluation, what would be the typical cost of such an evaluation?
Well, in general, doctor, you described what is a general initial evaluation Beverly Hills standards Mr. Shapiro asked you about. What is the cost of that?
I would say something like for a thorough physical exam, somewhere around a thousand dollars, 600, a thousand.
Now, doctor, you said in response to Mr. Shapiro's question that you cared about Mr. Simpson?
I--I have--you build a bond with patients. When you see a patient and you evaluate them, you have to care about them. If you don't care about them, you really wouldn't be able to be their doctor.
KEY QUOTEAnd isn't it that care, that closeness you develop with the patient, that can subconsciously influence those subjective evaluations that you admitted on cross-examination doctors make, such as in Mr. Simpson's case?
Objection, your Honor, calls for speculation and expert opinion of a psychiatrist.
Doctor, when you develop a closeness and fondness for a patient, in your opinion can that affect your objectivity in evaluating the patient's case?
Anything is possible, but you have to fight to try to minimize that or eliminate it.
For example, doctor, isn't it the case that physicians are taught to send family members to independent doctors for evaluations because of concern that your relationship with the patient may cloud your judgment?
Incidentally, you talked about a family doctor. There is a specialty of medicine, a board certified specialty called family medicine; isn't that correct, doctor?
Are you--well, you talked about some residency program. Are you familiar with whether cedars has a residency program in family medicine?
Now, doctor, you were asked some questions about whether or not Mr. Simpson went to Dr. Jobe and to Dr. Maltz before June 12th of 1994 in some effort to set up a Defense to the crimes, and you indicated to your belief he did not, correct?
On the other hand, doctor, if you assume, hypothetically, Mr. Simpson murdered his ex-wife and Mr. Goldman, would you agree that he would have a motive after the crime to come limping into your office for the visit arranged by his lawyer, Mr. Shapiro, in an effort to make it appear that he may have physical limitations to his ability to have acted on June 12th?
Doctor, would you agree that you did not--there was no way that you could determine objectively on June 15th whether Mr. Simpson's limp, that caused you to believe he moved like Tarzan's grandfather, was legitimate or one that was put on in an effort to convey a condition that was weaker than he truly was? You had no objective way to determine that, did you?
KEY QUOTEThere is an objective way to attempt to evaluate that by looking at joints, and it appeared to me, given his left knee and what didn't appear to be a problem in the video, his right ankle, sometimes a limp can intensify when you have two weight-bearing joints that are affected, as you point out. And I absolutely have to agree with you, there can be malingering on certain levels in orthopedics, but that was my best determination at the time.
By the way, doctor, you talked about some difficulties with the jail. You were able to get Mr. Simpson to Cedars-Sinai medical center for the biopsy, correct?
And in your opinion his care was not compromised in any way, was it, with respect to evaluation of that lymph node for possible sign of cancer, correct?
Umm, if there had been an acute problem it might have been because I really couldn't get access for several weeks into the jail.
Your Honor, I'm going to ask Mr. Fairtlough--I was going to ask Mr. Fairtlough--could I ask Mr. Harris to help me out to put something on?
Doctor, I'm going to show you a couple of pictures--I am going to do so right now.
I haven't had a chance to review this text yet, your Honor. It is going to take me a little bit of time. I am not an expert.
I don't know--Mr. Harris, is it possible you could turn it ninety degrees? Can you back it up possibly--that was better. I think you had it. I'm sorry. All right. We are going to get dizzy. That is fine.
Doctor--and I can bring you the text--I just want to be able to show it for the ladies and gentlemen of the jury--do these appear to be hands of people suffering from various stages of rheumatoid arthritis?
Mr. Simpson did not have joint deformity of any degree similar to even the lower photograph, let alone the upper photograph, did he, sir?
Certainly not the upper photograph where you have in this stage ulnar deviation. I really can't evaluate the proximal--the lower picture to compare that very well.
Could I ask if Mr. Harris can print this picture and then I'm going to show the book to the doctor so he can see it up close.
Doctor, I'm showing you this book--your Honor, may the printout be marked as I think we are at 526?
The initial pictures, as the text describes, a synovial proliferation of the MCP joints to a lesser extent of the proximal interphalangeal joints. If you look at his hands and the swelling there, and we can argue about hard versus boggy, as well as, you know--I think that they are roughly comparable. We can argue about exactly what their origin is.
And you feel comfortable with your expertise in rheumatology to do that; is that correct, doctor?
Well, doctor, I wanted to ask you when Mr. Shapiro on direct examination was asking you a series of questions about causes of cuts and so forth, did it ever occur to you to say it is outside my field of expertise?
Doctor, did you ever feel it was outside your field of expertise in answering any of the questions posed to you by Mr. Shapiro?
With respect to any questions asking for the opinion of the injuries sustained by Mr. Simpson, did you feel that to offer an opinion on such a subject was outside your field of expertise?
When you were asked hypothetical questions by me, did you ever say, with respect to the blunt force trauma injuries to Mr. Goldman and the abrasions to Mr. Simpson, that it was outside your field of expertise to offer an opinion and therefore you should not offer an opinion?
You may answer the question, doctor. Have you ever said that, it was outside your field of expertise?
I think when we showed those autopsy photos I may have said that. I don't have--you will have to kind of read back that question.
Doctor, if you felt that in answering any hypothetical question asked by me it was outside your field of expertise, did you feel you could say so?
Did you feel that if it was a question calling for an opinion outside your field of expertise, that you could answer that it was outside your field of expertise and you could not answer the question?
I think as a base line for my testimony I have said I wasn't an expert in these various areas. You have asked me many, many questions in every area of expertise. Some of the areas you asked me questions actually, quote-unquote, don't have, as you put it, a board certified specialty, and one of those would be the area of the cuts, but there were--there is no board certification for someone that evaluates whether--when someone walks into an office, you know, it is a knife or it is a glass cut to an out-patient. Obviously forensic pathologists deal with that, but that is an area that we see a lot, and so I offered an opinion, but that is all it was based on, the experience that I did give you, and you asked me many other hypothetical questions, some of which you know, I gave you as truthful an answer as I could. But there were instances where I may have said things that in fact I didn't have any direct knowledge of, and I can think of, you know, one such question that I was staying up a little bit last night thinking about, and that was when you asked me if someone had brutally killed two people after I had said that Mr. Simpson was under a lot of stress, if they brutally killed two people would there be a lot on their mind. And as I was thinking about that last night, I have--that would be my opinion. If I put myself in my own body, I would think that that would be true, but then again, I have never talked to a convicted murderer, I have never had any contact with a murderer that was convicted at any point in my life, and really there is an example where I should have said, you know, I really don't have any idea what type of emotional reaction a cold-blooded killer has. Because when I was thinking about that late last night I think that is one of the things that I did regret saying that I definitely did say.
My question to you was, doctor, did you feel that you could say it is outside my field of expertise, I can't answer the question? Did you feel that that was an answer you could give in a court of law as a witness having taken an oath if it was a question that you felt was outside your field of expertise?
That is the question. Yes or no. Did you feel you could or did you feel you couldn't?
I felt that it was my responsibility to try to answer the questions as best I could, given the caveat that everybody knew what my credentials were and weren't.
And the fact that this is a criminal case versus your past experience in civil litigation, how, if at all, does that affect the kind of report you were to prepare?
I was told that my records were not going to be passed over and that I had to prepare a summary. I have never ever been asked that request previously in my professional career.
Have you ever been retained by an attorney, either for the plaintiff in a civil personal injury action or a Defendant, an insurance company, for example, to evaluate a patient and give a report to the requesting party of that evaluation?
I have in a handful of cases reviewed charts in legal matters often about sports medicine and anabolic steroids.
If I have done that, it has been very rarely and I really can't remember a case right off the top of my head. It is possible that I have done that once or twice.
When you have done that, have you prepared reports for the party requesting you to review the record?
I just can't remember a case where I've had a patient come in who--well, maybe I can remember one case or two cases, and I must have prepared a report for them.
Now, doctor, you did see what you said I think originally was the commercial video?
And all of the aerobic exercise that we see in that type of environment is included in the commercial video. Some of what we saw because, they didn't multiple takes, is not included in the commercial video, correct?
And the commercial video has Mr. Simpson taking golf swings and shooting a basketball and so forth; is that correct?
But there is no segment of this commercial tape dealing with the aerobic exercises of the type we were looking at in the exhibit, which is--has--I'm sorry. Let me rephrase the question. The commercial tape does not have all of the aerobic exercise we saw on the exhibit?
But it does have at least one segment of each type of the activity? Is that a fair statement?
So you didn't feel misled, did you, by seeing what is actually more footage of Mr. Simpson than is provided in the commercial video, regarding his ability to perform these types of aerobic exercises?
By the way, doctor, in looking at that video, did you see where Mr. Simpson, in some significant amounts, the boxing segments, for example, was able to fully extend his right and left arms?
In my opinion in doing those boxes punches was relatively clear that the fixed flexion contractions were there and he was not able to fully extend his arm in any shot there.
And did you see, at least in some instances, where he was doing push-ups with both his left and right hands, palm to the surface of the floor?
And what is the angle that was required for him to do that and do a push-up as he was doing them, that is, a traditional push-up like the trainer at one point where the trainer was on his knees? What is the angle of flexion?
A traditional push-up you will get right under your chest and you will go, you know, not all the way back ninety degrees necessarily, but you will come close. What he would do is he would kind of manipulate--you could see him kind of stumble a little bit when he would get up and go down and he would get that left hand a little bit further out front so that he didn't have to bring that thing up to ninety degrees so would he do his push-ups with his hands out in front, so that that inability to bring back his hand, he could compensate for that when he did the push-ups.
You--in fact, that would place more weight bearing on the hand in that position than if it were in the more traditional position closer to the chest, wouldn't it, sir?
Make it a more difficult procedure in placing his weight in going down and up, pushing down and up? He has got to exert more effort because he hasn't got his hands in the most opportune position physiologically; isn't that connect?
Now, doctor, my hypothetical on that video was all those shots were done in one day? You remember that, don't you?
And the breaks were maybe six minutes or seven minutes. Did you write down the time?
Some of them were as long as from 16:27:32 to 16:41:06, so again, this is higher math, but that is 14 minutes, but some it looked like were six minutes, I will take your word for that.
Well, no, don't take my word, doctor. If you wrote down the time, you tell us the amount of time of breaks that you wrote down?
And if Mr. Goldman was being attacked by a more powerful individual who had the element of surprise and approximately six-inch long knife at Mr. Goldman's throat, would you expect under those circumstances that Mr. Goldman's physiological response would be an adrenaline rush?
Doctor, would you agree that if a person is threatened with imminent great bodily harm that that is the kind of circumstance which can cause the adrenaline automatically to begin flowing?
And doctor, would you agree that the normal reaction of a human being facing danger is to run from the danger, if at all possible?
Doctor, you have reviewed, in your training as a physician, basic physiology, have you not?
And in basic physiology they talk about the fight or flight response, don't they, sir?
And you learned that the normal human reaction physiologically to a threat of great bodily injury or death is to try and flee if possible, isn't that correct?
Your normal reaction is to try to protect yourself and save your life in whatever manner is possible.
Doctor, if Mr. Goldman had no place to go, he tried to flee and he is flailing his arms backwards in trying to get away from an attacker who is more powerful than he and he is stabbed multiple times with fatal stab wounds, would you agree that he would not have had the opportunity in such an attack that may have taken less than a minute--
Doctor, would you agree that the more rapid the assault, the threat of death or great bodily injury on the human being, the less time the person has to react, either by way of flight or by way of fight?
Doctor, with respect to Mr. Simpson and a congenial football player, he didn't have to get angry or--I don't want to misquote the way the question was asked by Mr. Shapiro. Would you expect that Mr. Simpson, when he is trying to break through linemen who may weight 300 pounds trying to tackle him, was probably not smiling as he did so?
I think that when you are breaking through 300-pound linemen you are in a zone. You know, I don't know if he was smiling or had his tongue hanging out or what, but I don't--I can't answer that.
And that zone is the harnessing of your energies to try and get a peak performance from your muscles to get you through and past, if possible, what is that impeding force of a 300-pound defensive tackle, right?
I think the harnessing is occurring, but there are also many other factors in terms of talent level. You know, if it was just a question of harnessing, you know, a lot of the rest of us would have a shot to play professional ball, so I think that is maybe only a minor component.
I can think of, you know, one such question that I was staying up a little bit last night thinking about, and that was when you asked me if someone had brutally killed two people after I had said that Mr. Simpson was under a lot of stress, if they brutally killed two people would there be a lot on their mind. And as I was thinking about that last night... I really don't have any idea what type of emotional reaction a cold-blooded killer has. Because when I was thinking about that late last night I think that is one of the things that I did regret saying that I definitely did say.
Would you agree that you did not--there was no way that you could determine objectively on June 15th whether Mr. Simpson's limp, that caused you to believe he moved like Tarzan's grandfather, was legitimate or one that was put on in an effort to convey a condition that was weaker than he truly was?
I absolutely have to agree with you, there can be malingering on certain levels in orthopedics, but that was my best determination at the time.
You build a bond with patients. When you see a patient and you evaluate them, you have to care about them. If you don't care about them, you really wouldn't be able to be their doctor.