Darkness Visible: Text Only

When it was only three weeks after Andrea Yates had wrestled her five children into a bathtub and held them underwater until their last breaths bubbled to the surface; when her hands were relatively damp with their murder, so to speak; when she was still gripped by the delusion that drowning her children was a moral act and urgent intercession needed to snatch them from the devil and send them to heaven; when she was still grimly eager for her own execution, believing death and her own eternity in hell were preferable to her children’s damnation; when she was still wandering the logic of psychosis and speaking its language, Phillip Resnick’s students in forensic psychiatry were there–right there, in a conference room at the Harris County, Texas, jail, watching as Dr. Resnick prompted Mrs. Yates to describe that terrible morning.

And the forensic psychiatry students were still observing months later, after Dr. Resnick had concluded that the thirty-seven-year-old Mrs. Yates was legally insane when she murdered her children on June 20, 2001, and he had agreed to serve as an expert witness for the defense. By that time, the students beheld a very different Andrea Yates. The anti-psychotic drugs had taken effect; by then, she was weeping and moaning and achingly lucid. She was left with the horror of what she had done, minus the fevered, apocalyptic reasoning that had convinced her to do it.

Strong stuff for these students, three fully trained psychiatrists who had come from around the country for a one-year forensic psychiatry fellowship–a CWRU joint program with University Hospitals of Cleveland, where it’s based–directed by Dr. Resnick. Strong even for Dr. Resnick (ADL ’59, MED ’63), a much-honored forensic psychiatrist and recent recipient of the American Psychiatric Association’s prestigious Isaac Ray Award for outstanding contributions to forensic psychiatry. The CWRU professor of psychiatry, director of forensic psychiatry, and adjunct professor at CWRU’s law school has provided evaluations and consultation in hundreds of murder cases–from Susan Smith to the Unabomber–and has served as an expert witness at dozens of trials.

Though he considers himself hardened from exposure to these cases, details of the Yates tragedy still move him. “Her seven-year-old son, Noah, struggled,” Dr. Resnick recalls in a soft voice. He sits in his office in University Hospitals’ Hanna Pavilion, a room that looks like a small parlor dotted with tiny Manet reprints. “He got his head above water and shouted, ‘I’m sorry, Mommy,’ and then she pushed him back under and finished killing him. I find that little detail so poignant and horrible–that he apologized, because he assumed his mother was punishing him.”

But in forensic psychiatry–where the rubber of mental health meets the road of law–one can’t get detoured by emotion for long. Within minutes, Dr. Resnick displays the wry wit that helps relieve the terrible gravity of his work. He’s talking about Jeffrey Dahmer, who lured sexual partners to his home, killed them, pleasured himself, and then ate them. Dr. Resnick had worked for the prosecution, arguing that Mr. Dahmer had bizarre sexual drives and went to extremes to fulfill them--but still, the case did not fit the legal definition of insanity, because Mr. Dahmer knew these extremes were wrong.

“Dahmer wanted partners who would do it his way,” Dr. Resnick says, breaking into an unexpected chuckle. “I always like to describe necrophilia as never having to say you’re sorry, because your partner doesn’t complain.”

Teacher First

In conjunction with his work at CWRU, Dr. Resnick is the director of the Court Psychiatric Clinic at Cleveland’s Justice Center. There, he directs the evaluation of some 1,400 felons every year. His fellows and other students work along with him, learning to prepare meticulous reports about the mental state and legal culpability of these felons. Dr. Resnick also helps them sharpen their presentation skills, preparing them for the day when they have to defend their opinions in court.

On a recent Thursday morning at the clinic, three fellows, one undergraduate student, one medical student, and Dr. Resnick meet in an office behind a waiting room filled with orange-suited inmates. As Britta Ostermeyer, a fellow who was trained in psychiatry at Columbia University, reads a report about a patient, Dr. Resnick listens impassively and offers a few suggestions. Suddenly, he leans forward.

“Let’s cross-examine.” Dr. Resnick’s tone begins to hector. “Doctor, I’m interested in your perspective on impulse control.”

“Yes,” Dr. Ostermeyer says, laying her report on the table.

“Doctor, would you say that most patients are good, fair, or poor when it comes to impulse control?”

“Yes!” Dr. Ostermeyer shakes her head as everyone in the room begins to laugh. Even Dr. Resnick stops playing the role of attorney going for the jugular and laughs.

It is Dr. Resnick’s intense scrutiny of his fellows’ and students’ work that wins their admiration. “He’s internationally known, yet he teaches his students one-on-one,” Dr. Ostermeyer explains. Other programs might have renowned professionals running them (though few have Dr. Resnick’s credentials), but Dr. Ostermeyer says that his fellowship is the only one in the country where students get such hands-on supervision. “First, he teaches you to write reports with complete medical certainty. Then he cross-examines you to make sure you’ve thought your opinion through and are confident of it.”

Though most cases don’t go to trial, it is the forensic psychiatrist’s report that often generates the most controversy if they do–and a good attorney will lay siege to the forensic psychiatrist and try to discredit her during cross-examination. Dr. Resnick tells his students that their reports must not only be sound, but that their testimony must also be philosophically consistent from one case to another and demonstrate a similar approach to psychiatric issues, no matter which side is paying the tab.

“The other side will always be looking for your own language to shove down your throat,” he warns them. “If you say in one trial that suicide is hard to predict and in another that someone should have been able to stop a suicide, that inconsistency will follow you. If you don’t have true integrity, you won’t succeed as a forensic psychiatrist.”

Dr. Resnick has never been tripped by inconsistency in his many appearances as an expert witness. He faced the most intense legal battering of his career when he testified for the defense in the case of John Salvi, the antiabortion activist who murdered two women at a Boston abortion clinic. The prosecution called attorneys general around the country looking for inconsistencies in Dr. Resnick’s work. It even paid to have old, untranscribed court reporters’ code converted into written records, something that usually happens only when a case is appealed. As the trial began, the prosecuting attorney asked Dr. Resnick about cases in which he’d been an expert witness up to twenty years earlier. But even though Mr. Salvi’s insanity plea failed and he was convicted for murder, the prosecution failed to tarnish Dr. Resnick’s reputation.

Dr. Resnick thrives under the harsh spotlight of these high-profile cases. Even in the midst of a fierce cross-examination, he retains his calm, patient demeanor. “He is formidable,” says George Parnham, Mrs. Yates’s attorney, “and able to explain a case to the jury in understandable and precise terms. The prosecution attempted a debate with him, but he more than carried the day relative to his own testimony.”

Still, Dr. Resnick is bothered by the misconceptions that high-profile trials engender. The public has gotten the idea that many criminals waltz into court faking insanity and waltz right out again, but Dr. Resnick says this is false. Only one percent of felony trials involve an insanity plea, and only fifteen percent of these win–and eighty percent of them win because the prosecution doesn’t contest the plea. On the other hand, the public has misguided notions about the mentally ill fueled by television dramas and media hype. The fact, he says, is that fewer than three percent of mentally ill people are violent. It is only the lawyers whose clients are most likely to fit the legal definition of insane–a word psychiatrists no longer even use–who bother to develop an insanity plea.

Nevertheless, legislators often make law based on one high-profile case. After John Hinckley attempted to assassinate President Ronald Reagan in 1981, a law was passed that made the criteria for the insanity defense tougher. “Please,” Dr. Resnick says dismissively. “Insanity is just a little pimple on the face of justice. It’s not going to make the streets any safer to crack down on the insanity defense.”

Trailblazer

Dr. Resnick was first drawn to the dark side of psychiatry when he worked at a military hospital from 1964 to 1966, between medical school and his residency. One year, he ran a women’s ward and got to know two women who had murdered their children during major depressions. He was struck by the depth of their grief and the challenge of helping them.

“Some people are inappropriately guilty when they’re depressed,” Dr. Resnick says. “They say, ‘I masturbate and I feel so bad about it.’ You have to tell them that it’s nothing to feel bad about. But when someone kills their children, you can’t tell them that they’re distorting reality because they’re depressed. You can’t tell them that what they’ve done is no big deal.”

Dr. Resnick became intrigued with the subject of child murder and embarked upon an intensive study. He read the world literature on the subject while he was a resident and won a grant to have papers written in thirteen languages translated. He wound up writing a monograph that divided child murder into five different types–and coined the word “neonaticide,” for the killing of a newborn. The monograph is still the most commonly cited work on this subject worldwide.

After he completed his residency at University Hospitals, in 1969, he became an academic psychiatrist in the CWRU medical school. However, by 1975, he decided to make forensic psychiatry his niche–and carved his way into the profession largely on his own, as there were no forensic psychiatrists in Cleveland to mentor him. He took classes at CWRU’s law school and absorbed information at national meetings. By 1979, he applied for federal money to create a forensic psychiatry fellowship and, since then, has trained forty-three fellows. Many now run similar programs at other universities.

“Dr. Resnick has been my ‘forensic father,’” says Charles Scott, who attended the CWRU/UHC fellowship in 1995-96. He is now chief of forensic psychiatry at the University of California at Davis. “He prepared me extremely well, watched over my career, and helped foster my academic development. He is one of the few people I have ever met that I can truly say changed my life.”

Dr. Resnick loves teaching and training and takes on many criminal cases just to expose his fellows to a rich variety of legal and psychiatric issues. He gets many more requests to consult or evaluate than he accepts, but he accepts about forty cases each year. He specializes in insanity (“I love a good, complicated insanity case,” he declares), psychiatric malpractice, and malingering–specifically, malingering cases in which accused criminals fake mental illness in an attempt to escape culpability. He has worked as often for prosecutors as defense attorneys. And he has walked away from both, at times, after he’s studied the evidence, interviewed the accused, and concluded that he can’t help the legal team make its case.

All in all, he’s put together a career he loves so well that he spurns thoughts of retirement. “I’ve exceeded my expectations,” Dr. Resnick says thoughtfully. “I’m decently bright, but I was not an amazing scholar as an undergraduate. My MCATs were not on the high end, but I found a niche for my ability to be articulate and analytical and logical. There’s been a wonderful match between my inherent skills and the needs of the field.”

Kristin Ohlson’s last story for CWRU Magazine was “One Breakthrough at a Time,” in the winter 2002 issue. The Cleveland writer’s work has also appeared in the New York Times, Discover, and Salon.com, among many others. In August, Hyperion will publish her memoir, Stalking the Divine.