It's An Outrage

by Lucy Puryear, M.D.

"Woman Who Cut Off Baby's Arms to be Released," Houston Chronicle, November 7, 2008. Dee Schlosser was arrested in Dallas, in November of 2004 for cutting off her daughter Maggie's arms, resulting in her death. In the aftermath of the Andrea Yates case in Texas, several women have been found not guilty by reason of insanity after killing their children. All of these women, including Schlosser, were psychotic at the time of the killings. Schlosser believed that by cutting off her daughter's arms she was making a more perfect offering to God. The police came to her home and found her soaked in blood humming along to a hymn.

Schlosser was sent to a state mental hospital where she received treatment and continued to be under the jurisdiction of the court. According to law, persons found NGRI (not guilty by reason of insanity) must remain in a state mental hospital indefinitely until it is determined by their psychiatrist that they are no longer a danger to themselves or others and can be maintained in outpatient treatment. Schlosser will be released into the community where she will be mandated to meet with a psychiatrist weekly. She will no longer be allowed to have contact with her other two children, and may not be in close proximity to any other children. It is unknown where she will live when released. She will remain under the jurisdiction of the court permanently and will be forced to return to the hospital if she again becomes dangerous.

Understandably the prosecutors of Collin County are unhappy with her release and wish the laws were different. Understandably the citizens of Dallas are unhappy that she may released into their community. Understandably there may be some renewed talk about having the laws changed. Maybe Dee Schlosser should have been committed to a state psychiatric facility for the rest of her life? It is an outrage that a mother who killed her children is free to walk the streets.

I am going to ask you to believe that Dee Schlosser should be released and be free to live what ever kind of life she is able to piece together for herself. She is no longer psychotic, she is on medication, she will be monitored by a psychiatrist to make sure that she remains well. So why should she remain in the hospital; just so our sensibilities are appeased? That's a waste of money. Her being in the hospital does not protect you or your children. Dee Schlosser has no intention of coming to your house to cut off the arms of your child.

Many of you would say she should be in jail, or even executed for what she did. That would solve the problem. She did something bad and she should be punished. Does it matter that her brain was malfunctioning? That the blood flow to certain areas of the brain were increased where they shouldn't have been and decreased to other parts? Was this happening to her because she chose to be crazy or decided that hearing voices and was a good idea?

Let me ask you to fantasize for a moment. What if you had a hundred and four degree fever and you became delirious. You were hearing someone walking into your room in the middle of the night and when you looked up you saw a masked man carrying a gun. You reached for your gun on the bedside table and shot. Only later when your illness was treated were you aware that you had shot your husband. Death penalty? Think that's not possible? Hallucinations happen all the time with high fevers and brain infections. Your brain is malfunctioning.

Let's speculate again. You are driving in your car and have a heart attack. You swerve off the road and plow into a group of people standing on the corner of the street. A mother and her young child are killed. Death penalty? Clearly you didn't do this on purpose. Your heart was malfunctioning and caused behavior that was out of your control. Let me go a little further. What if you knew you were at risk for heart disease but declined diet and exercise and didn't take your heart medication because you didn't like the side effects. Death penalty? Surely you knew you were at risk for a heart attack. In fact you doctor warned you on numerous occasions. The fact that you had a heart attack isn't all that surprising. Are you responsible for those deaths?

Mental illness is a brain disorder. The symptoms are behavioral, and often the symptoms are horrific. No one wishes to be mentally ill, anymore than someone asks to have diabetes or heart disease or meningitis. And untreated the symptoms of mental illness can be deadly, just like any other medical illness. Not just for yourself, but as I described above, for others. Why do we treat the mentally ill as criminals?

Dee Schlosser will never live a care free life. She must live with the knowledge and memory of killing her child. She will no longer be able to care for or have contact with her other children, and her marriage ended in divorce. What kind of life will she have? Can you imagine waking up every day to that horror? As a matter of fact, most mothers who have killed their children eventually end up killing themselves.

Let me let you in on a secret. Every single one of you reading this has a mental illness, has a family member with a mental illness, or knows someone who has one. And if you don't know someone who does that's simply because they don't talk about it. The stigma of mental illness is so great that we can't face admitting that we are all affected. This is not unlike epilepsy in earlier times. Until the cause of and treatment for epilepsy was discovered family members were hidden in asylums, attics, and weren't allowed to marry into good families. That is where mental illness is today.

Dee Schlosser deserves to be released if she is no longer suffering from her symptoms. She is medicated and no longer poses any danger to anyone. Don't worry, if you feel the need for her to be punished she already has been. She will continue to suffer every day of her life no matter where she is living. She needs our prayers. And we need to pray that some day we can find the cause of and a cure for mental illness so that no one kills their child because they're sick.

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Forensic Psychology and Dangerous Women

by Larry A. Morris, Ph.D.

When I was approached by my agent, Claire Gerus, to write a book about women who commit violent crimes, I spent a long time considering her proposal. I had concerns. Sure I had been working as a clinical and forensic psychologist for over three decades and had lots of experience with women who murder, maim, and molest. But most people think of men, not women, when they think of violent criminals.

Even though a couple of my previous books, Males at Risks: The Other Side of Child Sexual Abuse (1989, with co-authors Bolton and MacEachron) and The Heterosexual Male: Lust in His Loins, Sin in His Soul? (1997), explored issues of interpersonal violence from a male’s perspective, the controversial finding that males can be victims of child sexual abuse and other violence perpetrated by females was also examined.

Over the years I received both praise and condemnation for suggesting that girls and women sexually abuse children, especially boys, at a rate much higher than “official” reporting statistics documented. The voices of condemnation were the loudest and most persistent.

Even now, with the media full of stories about attractive female teachers molesting grade-school boys, I am dismayed by the number of voices who try to minimize the rape of male children by female teachers by calling it something else—an affair. Even some of my male friends and colleagues joined the chorus of gender-biased sexual expectations with a refrain straight from the male socialization hymnbook: “Oh Lord! Where in the hell were these women when I was in grade school?”

If I decided to write a book about mothers, sisters, and daughters who assault, commit murder, and sexually abuse children, I knew I would be sticking my neck out again, even further this time, by exposing the darkest of the dark side of femininity. I knew I again would be faced with proponents of the pervasive cultural stereotype that women are victims, not perpetrators, of interpersonal violence. The voices of dissent would be back. In force. And, as my thirty years of experience as a clinical and forensic psychologist taught me, some women can be very dangerous.

One of my colleagues, a victim of a female stalker, suggested I should pack “heat” like she does, if I decided to write the book and make public appearances. “Don’t leave home without it,” she quipped. “And wear your body armor,” she added.

As a forensic psychologist, I have evaluated hundreds of violent criminals and testified in court numerous times. The most frequent cases involve questions about the defendant’s competency to stand trial and/or issues of insanity. Competency generally refers to an accused’s ability to understand legal proceedings and to assist legal counsel in his or her own defense. While most people think insanity is a mental-health term, it is a legal term in the courtroom and, in most states, is defined by an individual’s ability to know the difference between right and wrong at the time he or she committed the crime.

For example, a murderous mother could suffer from a serious mental illness, but if she knew what she was doing when she killed her children was wrong, she is not insane according to the law.

Because the interface between law and psychology in insanity defense cases is often like a bad marriage, forensic mental health experts often squabble about their differing opinions.

It is also common for forensic mental-health experts to evaluate defendants in order to assess their risk for committing additional violent crimes and the defendant’s chances of responding favorably to psychotherapeutic intervention.

As a clinical and forensic psychologist I have been able to draw from both areas of expertise to address these very important questions.

In spite of society’s tendency to view most female and male criminal behavior differently, I attempt to handle all forensic cases with the same level of objectivity and dedication as any criminal case, regardless of gender. I ask the referral source the same questions about the purpose of the evaluation, review countless documents related to the case, conduct incisive interviews with the defendant, and consult to the referral source about my evaluation findings and opinion about the case. I also interview others related to the case, if appropriate; administer psychological tests, if helpful; write a report, if requested; and testify in court, if summoned.

Some forensic cases require a fairly quick evaluation and a brief interaction with the court. Many require countless hours of work and lengthy adversarial encounters. Case files can fill a warehouse. Interviewing defendants and others associated with a case can go on for hours. Court testimony can stretch into days. Even though forensic work can be grueling, I always look forward to the next interesting and challenging cases.

As a clinical psychologist, I specialized in treating victims and perpetrators of interpersonal violence, especially child sexual abuse. My clinical work helps me understand both sides of the tragedy of trauma. Seeing the terrible damage done by childhood abuse, I am not surprised when I find a history of trauma in my forensic cases. And, yes, more women are victims than men.

As I continued to consider my agent’s book proposal, I thought about presenting cases of girls and women who murdered and/or committed sexual crimes with an eye toward understanding and prevention. I opened my forensic files of dangerous women to see what I could find. Their stories were compelling. I decided to write the book. We settled on a title: Dangerous Women: Why Mothers, Daughters, and Sisters Become Stalkers, Molesters, and Murderers. It has been released to the public. Should I strap on a new set of body armor? . . .


Larry A. Morris, Ph.D. is a clinical and forensic psychologist who has been in private practice for more than thirty years. He is the author of four books including The Male Heterosexual, plus book chapters in A New Psychology of Men and Adult Survivors of Sexual Abuse. Dr. Morris lives in Tucson, Arizona.

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New Mystery Man Coming Friday

We hope you read our last Mystery Man column, a collaboration from a dynamic duo in cracking cold cases in Texas. Our next guest contributor comes from the desert and is an expert in cracking the criminal psyche. Tomorrow, look for our 11th Mystery Man, a clinical and forensic psychologist. He spent part of his summer in the hills of old Colonial Mexico conducting personal research on the pleasures of tequila.

For more than thirty years, he has evaluated and treated victims and perpetrators of interpersonal violence. In doing this work, he has performed hundreds of forensic evaluations and testified as an expert witness in state and federal court in cases of murder, rape, assault, domestic violence, and child sexual abuse.

He is the author or co-author of four books. The cover of his most recent publication inspired him to consider developing a line of autographed cutlery—oh, yes, he does have a great sense of humor.

Read what this man has to say on the subject of women in crime this Friday, right here at Women in Crime Ink.

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Buggers!

by Andrea Campbell

Forensic entomology, the study of bugs as related to death, is a relatively new science. In the past, investigators thought bugs were a nuisance, something to be washed away or disposed of as quickly as possible. But the relationship between dead bodies and maggots is nature’s way of recycling—the way a corpse becomes simple organic matter.

Death carries a universal scent that attracts hundreds of insects and other arthropods as they set about the body to feed and lay eggs (usually in the bloody areas first). The life cycles of the insects that take place on the deceased are fixed and precise. Those characteristics make it a good tool for investigators called forensic entomologists.

It’s funny then how a form of forensic entomology was practiced as early as the thirteenth century, yet took so long to come to fruition. Story has it that a murder in a Chinese village was the result of the victim being repeatedly slashed. Witness questioning was going nowhere. In frustration, the magistrate ordered all the village men to assemble, each bringing his own sickle. Standing in the hot summer sun, flies were attracted to just one sickle because of the blood residue and tissue fragments clinging to the blade and handle. Confronted with this evidence, the owner of the sickle confessed to the crime.

Insects have helped to solve many crimes. The unique activities of the insects, paired together with the arrival of different species and different forms of species, act as a predictable time-clock that can be traced backward for estimations. The order in which the insects arrive is called succession. Succession is the idea that as each organism or group of organisms feeds on a body, it changes the body and makes it attractive to the next group, and, so on. For example, within ten minutes after a body is dead in open air, flies arrive and lay thousands of eggs in the mouth, nose and eyes of the corpse. The eggs hatch into larvae, also known as maggots, in twelve hours up to three days and the maggots feed on tissues. Since maggots go through three phases on their way to becoming adult flies, the entomologist tracks their development and makes calculations backwards in order to determine the date and time the eggs were most likely deposited.

The Importance of Blow Flies

Blow fly eggs, collected from human remains and analyzed, can provide investigators with an accurate estimate of time between death and discovery and allow them to better target their investigative efforts.

Blow fly eggs are small (2 to 3 mm), whitish-yellow, and somewhat elongate. During warmer seasons they are easily visible to the naked eye found packed into natural body openings and wound sites in large numbers. During colder months, however, their numbers may be few and difficult to locate, buried within recessed locations. Blow fly eggs typically hatch within one to three days depending on species and environmental conditions. Dissection of egg samples and analysis of the stage of embryonic development may further depict the time since oviposition—creation—and, therefore, the time of the victim’s death.

Within 24 - 36 hours, beetles arrive and feast on the dry skin. After 48 hours, spiders, mites, millipedes, and wasps arrive to feed on the bugs that are already there. Entomologists today recognize six decomposition stages.

Bug behavior can also indicate whether the victim was killed indoors or out, during the day or night, in warm or cold weather, in shade or sun. Bugs scattered and laying dead near remains have also told the story of a women who died from a drug overdose. The cocaine chemicals within her body had been passed onto the bugs.

Case Story: Insect Trail

The body of a woman was found in a wooded area near the District of Columbia. There appeared to be no evidence of foul play but as part of police procedure, the scene was photographed. It was late summer and the dead woman was dressed in a tube top and slacks. Since her clothes were intact the possibility of a sexual assault was not taken into account.

Despite peaceful surroundings, her advanced stage of decomposition meant that the medical examiner would have a difficult task. The body had been lying out in the open for about ten to twelve days. Larvae were in the eyes, around the nose and mouth, in the chest area, and on the palms of both hands. The dead woman was identified immediately and because of the condition of the body, pressure was put on the authorities to release her corpse for a speedy burial. A limited autopsy indicated the cause of death was unknown and the body was turned over to the undertaker.

Typically, that would have ended the investigation, but one detective remained puzzled. The question about time of death bothered him. The victim had been reported missing a few days before her body was discovered on the trail, but the detective wondered, why was her body so badly decomposed? And because of the advanced decay, her autopsy had been less than exact. Finally, three years later, the detective contacted a forensic anthropologist, showed him the photographs and asked for a second opinion.

The anthropologist asked all the normal questions and studied the photographs. He told the detective that considering the time of year, the larval activity in the photographs was consistent with the medical examiner’s time of death estimate and asked if police had a suspect. The detective was dumbfounded. He explained that the lack of evidence for violence led them to rule out murder and they hadn’t bothered to look for suspicious persons.

“Of course there’s evidence,” the scientist said, pointing to the pictures, “You just showed it to me.” Because of his forensic training, he had immediately recognized the significance of the larval activity in the palms of the hands. In the pictures the surfaces on both arms were clearly free of maggots, but the flies had laid their eggs in the deep lesions across the width of her palms. This signifies the kind of injury that is associated with someone who is defending against a knife attack.

The detective was stunned. “But how can you be sure the hand injuries aren’t just something that happened when she fell?”

He pointed to the chest area in the top photo. The decomposition, he said, suggested something else. “Maggots don’t swarm like that unless they have something to feed on. . . . Look at the body, I think you’re going to find she was stabbed in the chest.”

After much persuading, the detective convinced other officials. Her body was exhumed by lantern light in the middle of a snowstorm. This time the examination was more complete. Soft tissue was simmered away gently for a clearer view. Unmistakable blade patterns were found in the bones of the hands and in the chest. A new death certificate was issued, and the manner of death reclassified to homicide. Homicides are one crime where there is no statute of limitations. As long as the case is unsolved, it is considered open to scrutiny and further investigation.

Excerpted from Detective Notebook: Crime Scene Science
graphic: Cleveland Museum of Natural History

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Mothers Who Kill

by Lucy Puryear, M.D.

I can imagine few things more horrific than a mother killing her own child. Mothers are warm, kind, nurturing people who would rather die than have anything happen to one of their precious children. But as we know all too well mothers do kill, and unfortunately it's all too frequent.

There are mothers who kill because they want revenge against their boyfriends or because they are desperate to keep the man they love. These women, like Susan Smith, the mother who drowned her two children in the lake while they were asleep in their car seats, are criminals. Although women like Smith (pictured right) may have many mitigating circumstances that make them feel desperate and alone, all of them have alternative choices besides killing.

There are some women who, feeling trapped in an untenable situation, decides that the only way out is suicide. But before they do this, they take the lives of their children. This sounds illogical to you and me, but consider the tragic case in Texas where a mother hung her four children before hanging herself. She was a 25-year-old Mexican immigrant, who had a restraining order against her common-law husband for domestic violence. She was working at Wendy's in order to support herself and her family. She was depressed, financially in crisis, and away from her extended family.

It is believed that this was an example of altruistic filicide, motivated by a mother's love and her belief that her children's deaths were better than leaving them in this world without a mother. Were this woman to have lived she would have been tried for murder, but is she the same type of criminal as the examples above?

Today is the seventh anniversary of the Yates children's death at their mother's hand on June 20, 2001. She was tried, convicted, and sentenced to life in prison with the option of parole after 40 years. Due to non-factual testimony by Dr. Park Dietz, the State's highly paid expert, Andrea Yates was given a new trial five years after her original conviction. This time the jury found her not-guilty by reason of insanity. She was sent to a maximum security state psychiatric facility in Vernon, Texas. She was no longer a criminal.

What few realize is that Ms. Yates remains under the jurisdiction of the courts. Although no longer in maximum security, she will remain in a state hospital until a judge determines that she is no longer a danger to herself or others. Even if she were well this is unlikely to happen.

So why rehash the Andrea Yates case? Yes, I testified that she was psychotic at the time of the drownings (hearing voices speaking to her from the TV, believing that she was invaded by Satan and that he was trying to ruin her children through her and send them to hell) but I've had many arguments with others who believe that although mentally ill, she was responsible for the killings and should be punished. I'm not going to continue to try to change the minds of others about this particular case.

I do want to talk about postpartum psychiatric disorders, which are real and treatable. In the case of postpartum psychosis, if recognized and treated, mother's and children's lives can be saved. Andrea Yates is not an isolated case. There were two more incidences reported in Texas within a few years after the Yates tragedy. Those are just the cases that made the news and only in Texas. These were also women who heard God or Satan speaking to them and believed killing their children would somehow save them or save the world. Putting these women in jail or executing them will not stop maternal filicide from happening.

It is estimated that between 1 and 2 women per 1000 deliveries will develop postpartum psychosis. This is a psychiatric emergency. The psychotic thoughts revolve around the baby and often include thoughts of harming the child and themselves. The only way to treat these disorders is through prompt diagnosis and medical treatment. A mother who is psychotic should never be left alone with her child.

Criminologists and forensic psychiatrists are desperate to understand why people commit crimes and how to prevent them from doing so. Many criminals have been so damaged in childhood that changing their character and behavior is impossible. But postpartum psychosis and infanticide is preventable.

Andrea's treating psychiatrist took her off her anitpsychotic medication two weeks prior to the drownings. She was seen by him two days before the drownings. Although mute and catatonic he sent her home. She had been hospitalized twice, and despite medical records that doccumented she was still paranoid and ill, she was released. It is not noted in the records that at any time anyone asked her if she had thoughts of harming her children.

On June 4-7, 2008, Houston was host to the 22nd annual conference of Postpartum Support International. Supported by the Yates Children's Memorial Fund (YCMF) of Mental Health America of Greater Houston (MHA) and Texas Children's Hospital, over 300 attendees heard lectures about about postpartum psychiatric disorders, their recognition and treatment. The more we educate health care providers, mothers, and those who love them the more lives will be saved. The more we talk the more mothers will feel safe to speak out loud the confusing feelings they are experiencing. The more we destigmatize postpartum psychiatric disorders and make it safe to ask for help, the fewer tragedies will end up on the front page of the newspaper.

Andrea Yates was not a woman destined to be a killer. She came from a good family, was highly educated, and loved her children enormously. It could have happened to you or me or to any other woman who delivered a baby. Society let her down. Doctors let her down. Our criminal justice system initially let her down.

We can't stop every mother from taking the life of her child. There are those who do so that we can find no explanation for why they made that choice. And those mother's should be punished. There are many who say that Andrea Yates got away with murder, that she should be punished and suffer for what she did. She does, every day when she opens her eyes and remembers Noah, John, Paul, Luke, and Mary, and remembers how they died.

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Free Will: Too Much of A Good Thing?

by Lucy Puryear, M.D.

As a teenager I struggled with authority. Yeah, me and every other adolescent who's walked this earth. I balked against anyone telling me what to do, when to do it, or what I ought to think about it. It's my body, my hair, my education . . . so leave me the hell alone. I swore when I had my own children I would never repeat the "sins" of my parents.

And then of course I had my own kids and I knew they needed guidance and gentle influence, and sometimes even some not so popular rules. "No, you can't stay up until two on a school night, no you can't go to a party where there are no parents, no you may not speak to me that way. . . ." And their response to me is the same one I gave my parents: "I can't wait until I'm eighteen and you can't tell me what to do anymore."

What you realize as an adult is that it's not so simple. There are not automatically unrestricted freedoms that come with adulthood. There are still rules, and expectations, and societal norms, and even laws that must be followed. And as I tell my children, "No, you don't have to do what I say, but there are consequences to not doing so." If you break my household rules you may get grounded or lose your allowance. If you break societal laws you may do jail time or worse.

The dilemma comes in our society where the government was founded on individual rights of free speech, freedom of religion, the right to bear arms (rights currently being hotly debated), versus the needs of the larger group to be protected from someone's individual rights. Is it okay for you to threaten me with bodily harm as an expression of your right to free speech? Is it okay not to wear a helmet when you ride your motorcycle, if after you squash your brain on the highway, my tax dollars are used to take care of you?

Nowhere is the tension between freedom of religion--an individual's right to choose--and societal laws and norms greater than in the case of the polygamists in Eldorado, Texas. (Women and children after being removed from the compound pictured below.)

So what's so wrong with polygamy? If a woman chooses to be one of five wives, shouldn't she have that right? Not my choice to do so but then no one is asking me to. I assume the FLDS church is just fine with my decision to stay away from them. They're not knocking on my door trying to recruit me as wife number six. So why don't we just leave them alone to practice their religion in peace?

I can think of a lot of religious practices that seem very strange to me. How about taking communion on a Sunday and believing that it is truly the body and blood of Christ? (I actually do believe in that as a practicing Episcopalian, but I'm also willing to admit others might think that practice quite odd and non-sensical.) How about the Jewish practice of circumcision, which is a religious ritual but practiced now by Jews and non-Jews alike? You don't think cutting the foreskin off of a baby's penis a little barbaric?

Where do we draw the line between free will and the safety and well-being of others? The FLDS group from Eldorado believes that they are upholding God's prophetic vision for them to live their lives in plural relationships. The United States has laws that make polygamy illegal. However these groups have been practicing polygamy for decades and mostly have been left alone to practice their religion. But this case hinges on the well-being and protection of minor children. And that's where the issue of free will becomes very important.

We do not believe that children under the age of eighteen (a somewhat arbitrary cut off) have the right to free will. I think mostly because we think they're not mature enough or wise enough to exercise their rights using good judgement. And that's often true. Ask any child whether they thought going to school was a good idea and you'd get many who'd opt for the "only if I feel like it and there weren't any tests" track. So as a society we have chosen to subsume the rights of the child under the rights of the parents. And in the Eldorado case the parents have chosen to allow their underage young girls to be married to much older men and to participate in sexual activity, often against their will. Most of society calls this child abuse, and this is why the children were removed from the compound. Child abuse trumped the right to practice your religion without obstruction from the government.

It will be interesting to see how this case turns out. I think many will be surprised to see that most of the women and children will be allowed to return to the compound. It could be a worse fate for some of these children to be taken away from their mothers and sent to foster care. That can't be the answer for what's in the best interest of these children. And it may be astonishing to many that if given the choice, most of the women would choose to take their children and return to what they consider a safe and nurturing home.

There will be much argument over whether or not these women from Eldorado are acting freely. They have been raised in this environment and some would say "brainwashed" to believe that they are subservient to men and that it is their duty to practice plural marriage. Most of all of us have been "brainwashed" by the way we are raised. I'm an Episcopalian, my next door neighbor is a republican, my best friend was raised to believe in astrology and the power of crystals. But I would say we have free will because we have the freedom to choose whether or not we want to continue the practices of our parents. They may be disappointed or even angry if we choose to vote for a democrat, but we won't be banned from contact with the family.

Adults should be allowed to practice whatever religion, or be in whatever relationship configuration they choose, as long as minor children are not abused, coerced, or denied the right to choose another lifestyle in adulthood. When someone who does not have the right to exercise their own free will is hurt, the law needs to intervene. This is true for children, the elderly, and those with serious and persistent mental illnesses. Thirteen-year-old little girls should not be having intimate relationships with men. That is not religious freedom. That is child abuse.

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What Does it Mean to be Crazy?

by Lucy Puryear, M.D.

You may be surprised by my title and use of the work "crazy." That's not exactly a politically correct medical term, but when you listen to a psychiatrist's private conversations it's one that's used frequently. It's shorthand for, "Boy, did I just see someone who was really sick." What is meant by that is that the person in front of us is either acting bizarrely (standing in the middle of the street gesticulating wildly and talking to the sky) . . . listening to voices in his head or responding to visions you and I can't see (if you've ever had a really high fever you might have experienced this; it's called delirium) . . . believes something entirely off the wall (the CIA has planted a bug in my head--remember you have to be careful with delusions, one day the CIA may indeed be capable of that!) . . . or his speech is so unintelligible he doesn't make sense to anyone (the technical term is "word salad," a little of this, a little of that . . .) .

So when I'm speaking with a group of psychiatrists I'm pretty sure we all know the shorthand. But when you are trying to translate "crazy" to a courtroom it becomes much more complicated. The medical and legal definitions are entirely different.

In the Andrea Yates trial I was asked to determine if Yates (pictured above) was legally insane at the moment she drowned her children. So I had to put my medical definition through the lens of a legal one: Was Andrea Yates legally insane at the time she killed her children?

There is no standard psychiatric definition of the word insane and it's not one we use in regular conversation. In a courtroom in Texas insane means the following: does the person know at the time the crime was committed the difference between right and wrong? From a medical understanding of psychotic illness (crazy) that definition is hard to interpret. Obviously the jury found it difficult as well. In the first trial she was found guilty, in the second trial, not guilty by reason of insanity.

To make matters more confusing, the legal definition of insanity changes depending on which state you live in. You can commit the same heinous crime and be insane in Texas, but by definition not insane in Connecticut. Excuse me for saying so, but that's CRAZY. Whereas Texas uses a much older and more constricted definition of insanity (McNaughton Rule), Connecticut uses a more modern definition (American Law Institute). The advocates who worked so tirelessly for the defense in the Andrea Yates trial have been working to have the legal definition of insanity changed in Texas to a more modern standard. Good luck getting that passed in a state that still struggles over the execution of those with mental retardation.

There's a new case getting the attention of the media here in Houston that will test the stomachs of those chosen to sit on the jury. Joshua Royce Mauldin (pictured left) is currently on trial for putting his two-month-old baby daughter in a microwave for ten seconds. She suffered second- and third-degree burns over parts of her body and currently is living with relatives. Mr. Mauldin has pled not guilty by reason of insanity. According to the Houston Chronicle, he has a history of mental illness and claims to have heard voices. He felt a "weird sensation" come over him right before he put her in the oven.

I have not interviewed Mr. Mauldin or consulted with any of the psychiatrists who have. Is he legally insane? I don't know. That's going to be for the jury to decide. The jury will have to make sense of a complicated psychiatric history and conflicting testimony from mental health professionals. Is he crazy? No doubt. Is he sick? Absolutely. There's something seriously wrong with someone who can do that to another human being. But in the state of Texas the defense will have to prove that at the time of the crime he didn't know what he was doing was wrong. In this instance, I bet that will be a hard case to make.

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