Opinion
No. 14-05-00921-CR
Opinion filed August 23, 2007. DO NOT PUBLISH. TEX. R. APP. P. 47.2(b).
On Appeal from the 212th District Court Galveston County, Texas, Trial Court Cause No. 03CR2734.
Panel consists of Justices FROST, SEYMORE, and GUZMAN.
MEMORANDUM OPINION
Appellant, Martha Burks, was charged with aggravated assault after she stabbed her five-year-old daughter. A jury rejected appellant's insanity defense, found her guilty, and sentenced her to twenty years' confinement. In appellant's sole issue, she contends the evidence is factually insufficient to support (1) the jury's rejection of her insanity defense, and (2) the jury's finding that she possessed the requisite culpable mental state. Because all dispositive issues are clearly settled in law, we issue this memorandum opinion and affirm. See TEX. R. APP. P. 47.4.
I. BACKGROUND
Appellant does not dispute that she stabbed her five-year-old daughter, S.B., with a knife on September 6, 2003. It is also undisputed that appellant has a history of mental illness. Over the years, she has seen various professionals, been hospitalized numerous times, and intermittently taken medication. At the time of the stabbing, appellant and David Burks had been married thirteen years, had three children, and lived in Texas City. David testified regarding appellant's mental problems and the incident at issue. He first noticed appellant's problems early in their marriage. For many years, she alternated between normal and irrational behavior. From 2001 to 2003, appellant was hospitalized several times. In February 2003, her problems became more frequently manifested. Appellant had recently returned to Texas City after temporarily living with her mother in Louisiana. She obtained her own apartment, but David allowed her to visit the children, who had remained with him. However, a court ordered a ninety-day commitment after appellant forcibly took S.B. and her twin brother from their babysitter. Despite David's objection, appellant's psychiatrist released her early, and she returned to the family's home in May 2003. Subsequently, consistent with a recurring pattern, appellant quit taking her medication, and her problems escalated. She previously offered various excuses for her refusal to take medication. But, this time, she informed David that "voices" told her to quit taking it. When David insisted she take it, she claimed Jesus had healed her. In late August 2003, she retrieved S.B.'s twin brother from school because the voices told her to go to Dallas. However, she turned around upon realizing she knew no one in Dallas. In the days leading up to September 5, 2003, appellant exhibited additional strange and "manic" behaviors. One evening, she showered fully-clothed and then lay on the kitchen floor. On one occasion, she rolled in mud and excrement in the dog pen. She also urged the children to kick the dog. At one point, David found appellant sitting on the toilet, eating feces, and smearing it on her face because "the voices" told her to "eat shit." Appellant spent considerable time reading her Bible and subsisted on cigarettes and coffee. David estimated she did not sleep for nine or ten days before the stabbing. On September 5, 2003, David took appellant to see her psychiatrist, Dr. George Sloganhoff. After appellant's examination, David relayed his concerns to the doctor. David felt the doctor was dismissive towards appellant's condition because the doctor did not order hospitalization. Appellant became irritated that David spoke with the doctor and requested the keys to his truck, ostensibly to smoke a cigarette. However, she left in the truck. David took a taxi home and found appellant in the backyard staring at the sky. That evening, she remained incoherent and unresponsive to her family. She mostly smoked cigarettes, drank coffee, and read her Bible. S.B. watched cartoons and colored. David fell asleep while watching television in his bedroom. Shortly after midnight, David was awakened by screaming, followed by S.B.'s cries. He ran to the living room where appellant was sitting on the couch, howling like a wolf, and holding a steak knife. He knocked the knife from her hand, cuffed her mouth, and asked what she had done. Appellant responded either, "We have killed her. You can save her" or "I have killed her. Now you save her." David ran to S.B.'s bedroom. She lay on the floor and was moaning, pale, bleeding, and entering a state of shock. David summoned emergency personnel and applied pressure to one of S.B.'s wounds. In the meantime, appellant had gone to the back yard, so David locked her out. Police officers eventually transported appellant to the Texas City jail. S.B. sustained two stab wounds: to the back and chest. She was hospitalized for four days, but fully recovered with no recollection of the incident. A court imposed a protective order precluding appellant from physical contact with the children, who continued to live with David. After appellant's arrest, pursuant to the trial court's orders, she was evaluated by two psychiatrists relative to the insanity issue. The doctors reported conflicting opinions on whether appellant was legally insane when she stabbed S.B. At trial, the parties presented extensive evidence concerning appellant's mental state at the time of the incident, including the testimony of both doctors. The jury was instructed regarding the insanity defense and given the option to find appellant not guilty by reason of insanity. However, the jury found appellant guilty of aggravated assault, thereby rejecting the insanity defense.II. REJECTION OF INSANITY DEFENSE
We will first consider appellant's contention that the evidence is factually insufficient to support the jury's rejection of her insanity defense.A. Standard of Review
A defendant bears the burden to prove the affirmative defense of insanity by a preponderance of the evidence. See TEX. PEN. CODE ANN. § 8.01(a) (Vernon Supp. 2006); TEX. CODE CRIM. PROC. ANN. art. 46C.153(a)(2) (Vernon 2006); Reyna v. State, 116 S.W.3d 362, 366 (Tex.App.-El Paso 2003, no pet.) (citing Meraz v. State, 785 S.W.2d 146, 150 (Tex.Crim.App. 1990)). The essential question is whether, at the time of the conduct charged, the defendant, as a result of severe mental disease or defect, did not know her conduct was wrong. TEX. PEN. CODE ANN. § 8.01(a); Reyna, 116 S.W.3d at 367; Plough v. State, 725 S.W.2d 494, 500 (Tex.App.-Corpus Christi 1987, no pet.). The insanity issue is not strictly medical but also invokes legal and ethical considerations. Bigby v. State, 892 S.W.2d 864, 877 (Tex.Crim.App. 1994) (citing Graham v. State, 566 S.W.2d 941, 949 (Tex.Crim.App. 1978)); Reyna, 116 S.W.3d at 367. Expert testimony may aid the jury in its determination of the ultimate issue, but does not dictate the result. See Graham, 566 S.W.2d at 949; Reyna, 116 S.W.3d at 367. Only the jury can join non-medical components that must be considered in deciding the ultimate issue. Bigby, 892 S.W.2d at 878 (citing Graham, 566 S.W.2d at 949); Reyna, 116 S.W.3d at 367. Because circumstances of a crime are always important in determining the accused's mental state at the time of the offense, the jury may consider such evidence as her demeanor before and after the offense, attempts to evade police, attempts to conceal incriminating evidence, expressions of regret or fear of the consequences of her action, other possible motives for the offense, and other explanations for her behavior. See Graham, 566 S.W.2d at 951-52; Torres v. State, 976 S.W.2d 345, 347-48 (Tex.App.-Corpus Christi 1998, no pet.). Ultimately, determination of the insanity issue lies within the province of the jury, as to credibility of witnesses and weight of the evidence, as well as the limits of the defense. See Bigby, 892 S.W.2d at 878 (citing Graham, 566 S.W.2d at 952); Reyna, 116 S.W.3d at 367. In examining factual sufficiency of the evidence to support a jury's rejection of an insanity defense, we review all the evidence relevant to the issue to determine whether the judgment is so against the great weight and preponderance of the evidence that it is manifestly unjust. Bigby, 892 S.W.2d at 875 (citing Meraz, 785 S.W.2d at 155); Reyna, 116 S.W.3d at 367. We will overturn the jury's decision only when insanity is undisputed or resolved to one end of the spectrum outside the realm of discretion. Reyna, 116 S.W.3d at 367 (citing Bigby, 892 S.W.2d at 878).B. Expert Testimony
To support her factual-insufficiency challenge, appellant primarily cites the contrasting testimony of the experts who evaluated appellant. As explained below, both doctors agreed that appellant suffered from a severe mental disease and heard voices which commanded her to slaughter S.B. However, the doctors disagreed regarding the appropriate diagnosis and whether appellant knew at the time of the offense that stabbing S.B. was wrong.1. Dr. Michael Fuller
Appellant presented testimony from Dr. Michael Fuller, an associate professor of psychiatry at University of Texas Medical Branch in Galveston. When appellant requested pre-trial evaluation by a psychiatrist, the trial court appointed Dr. Fuller. He reviewed most of appellant's medical records from previous hospitalizations and met with appellant, her mother, and David. In October 2003, Dr. Fuller conducted four separate interviews of appellant, lasting about one hour each. During the first interview, she expressed guilt and remorse about hurting S.B. She recited a previous diagnosis of bipolar disorder. Dr. Fuller testified bipolar disorder causes a person's emotional state to alternate between severe depression and severe euphoric, delusional psychosis. Appellant said she experienced a severe episode of mania and heard voices for three or four weeks before the stabbing and had not slept for many days. During a subsequent visit, Dr. Fuller also recognized symptoms of a previously undiagnosed "dissociative disorder," which occurs when one has learned as a child to mentally separate from overwhelming trauma. During a prior hospitalization as a teenager, appellant recalled she was raped at age seven or eight by her older brother, and her mother beat her when she mentioned the rape. Dr. Fuller found her recollection was credible. Appellant, her mother, and David told him that appellant had a history of sexual promiscuity — behavior consistent with sexual abuse as a child, bipolar disorder, and borderline personality disorder, which is associated with a dissociative disorder. Further, David reported appellant once curled up in a ball saying, "mommy, don't hit me" after he yelled at her — an incident highly suggestive of dissociative disorder. Over the course of the four interviews, Dr. Fuller obtained information from appellant regarding the "voices." During the first meeting, appellant reported the voices claimed her torment would cease if she complied with their commands to stab S.B. When Dr. Fuller asked if S.B. was an intentional victim, appellant responded "no, she was just there." Appellant was unable to clarify the origin of the voices. During the second visit, appellant reported that the voices waged a battle between good and evil within her, and she feverishly read the Bible to find answers to these torments. Several days before the stabbing, the voices told her she was "lower than dirt" and instructed her to eat dirt and feces. Dr. Fuller believed appellant ate feces because David also mentioned the incident. Dr. Fuller testified that eating one's own feces is caused exclusively by profound psychosis or brain damage because that act is incomprehensible in every culture. Dr. Fuller described the last few minutes of this interview as "chilling." Appellant relayed that Satan told her she is a star and must slaughter her children to resume her destiny in the heavens. During the third meeting, appellant assured Dr. Fuller she had literally been a star in earthling form. In the heavens, other stars denigrated her because they were required to skin their children alive to resume their place in the heavens while she was compelled to only sacrifice her child. In addition, appellant repeated psychotic statements involving "clang like associations," such as "lame" and "lamb" and "baby alone" and "Babylon." She interjected that God created her as a vessel to capture demons. By the last visit, appellant's thoughts had changed into perceptions with a Christian background. She expressed she had been chosen by God, and the voices at the time of the stabbing originated from God. She again referenced her notion that God used her as a vessel to store demons and prevent them from injuring other people. Dr. Fuller ultimately concluded that, on the night appellant stabbed S.B., she was extremely psychotic as a result of uncontrolled bipolar disorder, which had driven her to absolute mental and physical exhaustion. She believed the war between good and evil transpired within her, and God commanded her to slaughter S.B. to fulfill appellant's destiny. Until the moments surrounding the stabbing, she had known right from wrong and resisted commands to harm her child. However, in the moments surrounding the stabbing, a combination of the severe psychotic state and a dissociative episode separated her from the act she was commanded to perform and she could not discern right from wrong. In short, she "snapped." Her howl after stabbing S.B. most likely reflected an end to the dissociative state and realization of what she had done. Accordingly, Dr. Fuller opined that appellant was legally insane when she stabbed S.B.2. Dr. Victor Scarano
The State presented testimony from Dr. Victor Scarano, who is assistant professor and chief of forensic psychiatry services at Baylor College of Medicine Department of Psychiatry and also an attorney. After Dr. Fuller rendered his report, at the State's request, the trial court appointed Dr. Scarano to evaluate appellant. Dr. Scarano met with appellant and reviewed some of her medical records, a statement given by David, a police-department tape recorded at the Burks' home, a videotape of appellant's "booking" into the Texas City jail, a recording of appellant's transportation between the Texas City and Galveston County jails, appellant's letters to family members, and Dr. Fuller's report. Dr. Scarano testified that he evaluated appellant for four hours on November 24, 2003. Appellant told Dr. Scarano about her previously "recovered memory" of sexual abuse as a young child by her brother. Dr. Scarano implied that he was skeptical of this claim based primarily on the lack of corroboration. Appellant told Dr. Scarano she did not eat or sleep for a week before the stabbing and had eaten dirt and feces. However, Dr. Scarano doubted she ate feces for several reasons. He found inconsistencies in appellant's and David's recitations regarding this incident. Moreover, Dr. Scarano explained that a person who would eat feces must be so "terribly demented" or "absolutely totally psychotic" as to require hospitalization. Such person would be unable to function and could not drive a car, make coffee, act guarded with a doctor to avoid hospitalization, or engage in lucid conversation just hours after stabbing her daughter Cactions appellant performed around the time she allegedly ate feces. Dr. Scarano and appellant also discussed the "voices." She reported that evil voices said she must kill her children to shine like a star. She initially resisted, knowing it was wrong to hurt her children. However, she ultimately stabbed S.B. in the abdomen and back and yelled, "I did it. I did it." Appellant stated she was "crushed" because she knew this act was wrong. Dr. Scarano believed appellant heard voices. However, he found inconsistencies in appellant's and David's various statements regarding the time-frame for the voices. Further, he questioned appellant's accounts to Dr. Fuller regarding the source of the voices for several reasons: a psychotic person hears one voice — not a morass of different voices; voices are usually derogatory; ordinarily, the origin of voices does not change from evil to God; and a voice from God does not command a person to commit an act, such as kill her child, and promise a reward. Moreover, appellant told Dr. Scarano the voices were evil and specifically denied they originated from God, as she had eventually relayed to Dr. Fuller. Dr. Scarano suggested that appellant changed her description to Dr. Fuller of the voices from evil to God to help her insanity defense. Additionally, Dr. Fuller had asked why appellant did not report such terrible commands to David or her doctor before the stabbing. She replied that they did not ask the right questions. Notably, several hours after the stabbing, appellant was transported from the Texas City jail to the Galveston County jail and then returned to the Texas City jail. When Dr. Fuller asked why, she replied "I don't know. I guess I just didn't give them the right answers to their questions." Dr. Scarano testified that appellant's twice making a similar statement demonstrated an attempt at manipulation — not florid psychosis. Dr. Scarano also testified concerning appellant's use of the terms "lamb" and "Babylon" in her meetings with Dr. Fuller. Because appellant had focused on reading the New Testament book, Revelation, Dr. Scarano looked for references to Babylon in that book. Appellant's statement that she was a vessel for storing evil and her description of the war between the lamb and anti-Christ mirrored two chapters of Revelation. According to Dr. Scarano, these chapters discuss Babylon as the repository of evil and predict a final battle between the lamb and anti-Christ to remove this evil spirit. Dr. Scarano suggested that appellant obtained some descriptions of the voices from Revelation — not from her mental state when she stabbed S.B. Dr. Scarano also explained the significance of the following items he reviewed: Appellant's Letters On November 1, 2003 (about two months after the stabbing), appellant wrote a letter to her mother stating,I'm all for divorcing David and getting one third of his retirement. I can't wait to move into the cabin. The Lord doesn't want me with David this much. He has shown me. I'm not worried one single bit. I'll be out of here before you know it. I'm thinking a few months and then maybe the state school.However, four days letter, she wrote to David, stating she loved him and was sorry for her actions. According to Dr. Scarano, the letters were indicative of a person trying to plan her future — not a floridly psychotic or demented person. Tape of Appellant's Transportation Between Jails Approximately six hours after appellant stabbed S.B., Texas City police officer Earl Mendenhoff transported her from the Texas City jail to the Galveston County jail. Dr. Scarano listened to a police-department tape of their conversation during the ride. He testified that appellant's voice was calm and goal-directed, her thought processes were goal-directed and logical, and she gave appropriate responses to questions. She did not exhibit psychotic-type behavior or symptoms of mania, such as pressured speech and hyperactivity. In short, she spoke in a "totally normal manner." Jail Videotape Dr. Scarano also viewed a videotape from the Texas City jail recorded shortly after the stabbing. During cross-examination, appellant focused on Dr. Scarano's written report that no "bizarre behavior was noted" on the tape, despite the following actions: appellant undressed and then put her clothes back on; she lay on the floor when she heard an inmate scream in an adjacent cell; and she urinated and defecated in the corner of her cell. However, Dr. Scarano explained the reasons for his notation. When undressing, appellant kept her back to the camera and thus consciously retained a degree of modesty. Further, it is not unusual for a person to become frightened upon hearing an inmate scream in an adjacent cell. Moreover, appellant had not relieved herself for a long time and was "very careful" to urinate and defecate in a corner. Then she moved her mattress to prevent urine from flowing onto it. Dr. Scarano opined appellant was already attempting to bolster her insanity claim. Dr. Scarano ultimately concluded that appellant suffered a mental disease when she stabbed S.B., but he could not clearly define the defect. The voices may have been caused by borderline personality disorder so manifest that she was psychotic. Alternatively, she may have been so depressed due to bipolar disorder that she became psychotic. Dr. Scarano disagreed that appellant was in a manic state or experienced dissociation when she stabbed S.B. However, he concluded that, even if she experienced dissociation, she did not lose the ability to discern right from wrong. Dr. Scarano further disagreed with Dr. Fuller's suggestion that a person can enter a state of legal insanity at the moment she commits a crime and then suddenly return to a state of sanity. Instead, Dr. Scarano opined the voices commanded appellant to perform an act she knew was wrong, but she could not resist. By subsequently yelling "I did it," she effectively told the voices, "all right, already, now leave me alone. I did do it. I did it." Thus, the statement was consistent with awareness that stabbing S.B. was wrong but inability to resist the command. Consequently, Dr. Scarano opined that appellant was not legally insane when she stabbed S.B.