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  “Why would they want to do that?” asked Dr. Young.

  “I was studying math, and it was well-known that I was studying,” said Mr. Drury. “A girl was investigating the case when I was in college. She turned up dead.”

  Dr. Young and Dr. Pine scribbled notes. They tried to glean whether Mr. Drury understood basic courtroom procedures and whether he had ideas about how to proceed with his case. He did: he wanted to go to trial. If found guilty, which seemed almost certain, he’d be handed a longer sentence than if he simply took a plea.

  “I’m not going to plead out to something I didn’t do. I’ll testify. How can they not believe me? I’m telling the truth. I don’t have time to expose myself to nobody unless it’s a woman I like.”

  “There are witnesses. They may also ask the two little girls to testify,” said Dr. Pine. “With your history, why would the jury believe you and not them?”

  “People can assert anything, but if they don’t have proof, you can’t put a person in jail,” he said.

  “Why would they lie?” asked Dr. Pine.

  “I don’t know.” He stopped to think. “Maybe they’re involved with the same people who drugged my milk.”

  “How likely do you think that is?” she followed up.

  “I’m not sure. It’s just a guess,” he said.

  “What kind of sentence do you think you might get if you go to trial?”

  “My time has been served,” he said.

  “No, it hasn’t,” said Jim.

  Mr. Drury could not get past his assertion that he was telling the truth and his belief that if you tell the truth you don’t go to jail. Dr. Young and Dr. Pine agreed that his inability to see things more realistically made him unable to understand the likely consequences of choosing to go to trial. For now, they agreed, he was unfit.

  Our third defendant of the day was no more the criminal mastermind of my misguided forensic fantasies than the others. A deaf-mute religious Jew, he had communicated in writing to the officers who’d arrested him that he was the terrorist Mohamed Atta, a Pakistani Nazi, and an employee of the Israeli secret police—the modern trinity of a disorganized mind. When Dr. Young asked, with paper and pen, how he wanted to proceed with his charges of menacing, he refused to answer. He would not acknowledge her other questions either.

  “This is very important,” she wrote to him.

  “To you it is very important,” he finally scribbled. “To me it is not.”

  She found him unfit.

  When we finished at Bellevue, Dr. Young and Dr. Pine invited me to a late lunch. We ate turkey burgers at a diner on Second Avenue along with an administrator they’d run into in the hospital lobby as we were leaving. The three gossiped about their colleagues, paying cursory homage to the idea that they shouldn’t be talking that way in front of an intern. I had no idea whom they were discussing anyway. I’d been happy to be included in their lunch plans, but I felt uncomfortable there, like a girl among men. When lunch ended, Dr. Young said we were finished for the day and that I should go home. As I left the group to take the subway back to Brooklyn alone, Dr. Young put her hand on my forearm with some urgency. “You should always carry ID,” she told me. “And if you ever get arrested, don’t say anything to the police.”

  I did jury duty once, in the 1990s, when I lived in Manhattan. The courthouses there are regal, with marble pillars and careening stairways. The Brooklyn criminal courthouse was disappointing in comparison. It looked like any modern office building. On my first morning at the court clinic, I waited before the lobby’s metal detectors, which were preventing throngs of impatient visitors from making their way to the elevator banks. Dr. Young came in and saw me waiting in the long and slow-moving line. She motioned me toward her and a much shorter queue. “You can go in the employee entrance with your Kings County ID,” she told me. We both passed through the staff metal detector and rode the elevator together to the thirteenth floor making small talk. The sleek elevator moved quickly in response to the press of its buttons, and the spotless corridor into which we emerged was cooled by central air-conditioning. Imperious or not, it was much more pleasant than our G Building.

  “Today you’ll meet the master’s-level forensic students,” Dr. Young offered. Sometimes she sounded syrupy and like a Texan, although she was a northerner. “That will be nice for you.”

  We entered the office. It was narrow and colored in neutral tones, with a hallway that ran parallel first to a small waiting area and then to four cubicles followed by a space in the back with some chairs. Five people who looked as if they might be master’s-level students were sitting in the chairs, and after Dr. Young waved at them and entered her office—the only self-contained space in the clinic—I introduced myself as the new psychology intern. They were duly impressed. The career options for master’s-level forensic psychologists being limited, they were all contemplating doctoral programs themselves. They asked me where I went to school and wanted to know something about it. When I told them my program’s theoretical orientation was psychoanalytic, they looked at me as if waiting for a punch line. They were very young, these students from the John Jay College of Criminal Justice, and most of them lived in the far reaches of almost suburbia with their parents. I guessed from the fact that I was expected to sit with them that our roles at the court clinic would not diverge. I had finished all of my doctoral course work, for God’s sake, and yet here I was stuck beside the master’s students. It felt like a demotion.

  With the arrival of Dr. Wolfe my mood improved. I said hello and reintroduced myself, reminding him that we’d met the previous winter when he’d interviewed me. He said he remembered and welcomed me to the court clinic before announcing to the group that he would be teaching the Tuesday seminar, which was apparently a weekly occurrence. That morning he would talk about the history of the fitness to stand trial.

  Forensic psychology textbooks trace the idea of fitness to stand trial back to seventeenth-century England. In those days, criminal defendants who refused to respond to the charges against them were given a sort of pretrial during which a jury would decide whether they were “mute of malice” or “mute by visitation of God.” The first verdict decreed them willfully obstreperous and was met with physical punishment that could end only upon response to the charges or death. The second initially applied to the physiologically deaf and mute but was eventually broadened to include the lunatic. The lunatic, forgiven his silence, was exempt from torture.

  While the textbooks talked about the seventeenth century, Dr. Wolfe explained that he located the origins of competency in the year 200 and the Talmudic concept of the shoteh. The shoteh displayed disorganized thinking and behavior. He was exempt from following Jewish law, could not enter into a contract, and was exonerated from punishment. With the establishment of the United States, similar ideas came to be loosely reflected in the Constitution, not only to preserve the rights of the individual, but also to avoid making a mockery of the court system, whose players and tasks would certainly lose dignity in the process of trying someone quite obviously out of his mind.

  The rights guaranteed criminal defendants by the Constitution had been fleshed out over time, and so, too, the definition of fitness to stand trial. The U.S. Supreme Court, Dr. Wolfe told us, established the modern-day competency standard in 1960 with Dusky v. United States. Milton Dusky—a thirty-three-year-old chronic schizophrenic accused of being an accessory to the kidnapping and rape of a teenage girl—was initially deemed competent by a judge whose own standard was simply that a defendant be oriented to person, time, and place (that is, know who he is, when it is, and where he is). The justices later overturned Dusky’s conviction on the grounds that this judge’s idea of fitness was incomplete and that Dusky, whose psychiatrist had observed that he was unable “to interpret reality from unreality,” had not indeed been fit to stand trial. The Court established that “the test must be whether [the defendant] has sufficient present ability to consult with his lawyer with a re
asonable degree of rational understanding—and whether he has a rational as well as factual understanding of the proceedings against him.” Once treated and found fit according to these standards, Dusky was retried and reconvicted, though with a much lighter sentence the second time around.

  Dr. Wolfe told us that in 1974 the New York courts had elaborated on the Dusky standard, requiring that a defendant meet six basic criteria in order to be found fit. The first three were relatively easy to ascertain. A defendant must know who he is, where he is, and when it is, or be, as the jargon goes, “oriented in all spheres.” He must be able to perceive, recall, and relate—to communicate effectively about his life and the world and about the charges against him. He must be able to understand the role of the court principals and procedures, at minimum knowing or being able to learn what a judge and jury do.

  The second three criteria were less black-and-white, leaving room for debate among assessors. A defendant must be able to establish a working relationship with his attorney. He must be able to choose rationally among the various legal alternatives available to him and to understand the possible outcomes and consequences of each choice. Finally, he must be sufficiently emotionally stable to maintain coherence throughout the stressful process of a trial. Varying widely across jurisdictions, anywhere between 1.2 and 77 percent of those referred for competency evaluations are found unfit. Dr. Wolfe told us that the Brooklyn forensic team deemed more defendants incompetent than those in any other borough. He was obviously proud of this—of the integrity they brought to the justice system and the protection they provided these defenseless defendants—which made me excited to be a part of it, too.

  When Dr. Wolfe finished, he returned to his cubicle. It was still early. “What happens now?” I asked one of the others.

  “We wait here,” he said. “When the doctors go down to the holding cells, they take us with them, two at a time, to watch.”

  Dr. Wolfe overheard. “Actually,” he chimed in, “I’m going to treatment court this morning. Only one of you can come. Any takers?” I had never heard of treatment court, and I did want to go but wasn’t sure what the etiquette was in the group. I waited, though not very long, to see whether anyone else volunteered. When no one did, I stood up, and Dr. Wolfe and I made our way out of the office to ride the elevator downstairs.

  Was I expected to know what treatment court was? Was I supposed to have any idea whatsoever about forensic psychology? I’d figured the rotation would expose me to a branch of my field I knew nothing about, but was that also the expectation that the rotation had of me? I must have looked uneasy because Dr. Wolfe asked, “Everything going okay?”

  “Yes,” I said, but then decided to lay it all on the line, my inexperience and inadequacy: “So what is it we’re doing this morning? What is treatment court?”

  Dr. Wolfe did not look aghast. He explained in his paradoxically good-natured and cantankerous way: “The court recognizes that nonviolent drug offenders aren’t necessarily criminally minded but that they commit crimes to support their drug habits. Locking them up doesn’t make a whole lot of sense; they’re just going to go back to using and crimes that support using as soon as they get out. So they offer an alternative: do a drug treatment program rather than serve jail time. If they complete the program and stay clean for a certain amount of time, the charges are wiped from their record. We’re called to evaluate the defendants eligible for treatment court when their lawyers think there might be mental health issues. So the woman we’re going to see today, we need to find out, first of all, whether she’s interested in a program and, second, if there are psychological issues that need to be addressed in order for her to complete it successfully.”

  This didn’t quite make sense to me, because developing a drug problem was in and of itself evidence of a whole host of messy psychological issues. But I knew I had to shift my thinking according to context. The courts were probably concerned only about the most pronounced psychotic symptoms—hallucinations and delusions and such—and those were what we had likely been called in to assess. I resented having to make this adjustment. It felt like selling out. Still, having little knowledge about or faith in the offerings of the justice system, I was surprised that such a reasonable thing as treatment court existed. I let my bad feeling go and thought instead: fantastic.

  The person we sat down across from in a small space adjacent to one of the building’s many courtrooms was less enthusiastic. Maria was thirty-nine and frayed. She was Hispanic, pretty if too thin after years of taking in less food than heroin—about two hundred dollars’ worth a day, she told us, rolling up her sleeves to show us the track marks on her arm. She was on methadone now. “I wouldn’t be able to sit here and have a conversation with you if I wasn’t,” she told us. She’d started drinking and cutting herself at a young age, soon after her uncle began sexually abusing her, and then an older friend introduced her to heroin, which she eventually began prostituting herself to get, conceiving two children that way. Both were living with their grandmother. Her eyes teared up and she looked ashamed when she told us this, and I felt remorse about being there, an unnecessary interloper on Dr. Wolfe’s work. She said she wasn’t much interested in a program, and Dr. Wolfe asked why. She answered, “I was the middleman in a drug buy, a B felony. I’ll get one to three months. A program is five times that long.”

  “Sad,” I observed as we left. Maria had this traumatic history that she relied on drugs to numb herself against, and she didn’t know that therapy might make that numbing less imperative.

  Dr. Wolfe agreed. He said he was going to recommend a program rather than jail time despite what she’d said. Maybe she’d take it once she had more time to think. “She’s an unusual case,” he said. “She seemed reachable.” It seemed regrettable that we would not be the ones to try to reach her. On forensics, I quickly got it, we weren’t that kind of psychologist.

  I went back upstairs with Dr. Wolfe, and we found Dr. Pine, whom I’d met at Bellevue, waiting for him. Dr. Wolfe went to the back to collect one more student, and the four of us plus the lawyer Jim Danziger were off to see another defendant in the basement holding cells where most of their business was conducted. I felt energized by the pace of the morning and all the things I was learning that were new to me. “We’re assessing a female defendant today,” said Dr. Pine. “Young and charged with assault in the third degree. Grabbed a woman’s breasts.”

  Our group rode the elevator to the lobby and then took a long flight of cement stairs down to a very cold and vast underground complex. We signed in with the guards, went through more metal detectors, and were admitted to a holding cell, a large room painted steel gray with metal bars like a jail cell on a movie set. The female defendant was brought in, no laces in her shoes. The officers uncuffed her before she sat down across from us. Dr. Pine introduced us and explained why we were there. The woman’s name was Katrina, and she was nineteen years old and jailed at Rikers Island as she awaited trial. She rocked back and forth on the bench, smiling and looking off to the side as if at someone, though we five were seated across from her. She knew her Social Security number and her birthday and that she’d earned a GED. She also knew that she’d been hospitalized for psychiatric reasons for the first time at age fourteen, by her mother, and that she’d since been readmitted at least fifteen times.

  “What are your symptoms?” asked Dr. Wolfe.

  “Nausea,” she answered.

  “Any voices?” he followed up.

  “All the time,” she said. “They annoy me. Say, ‘Katrina did this, Katrina did that.’ ”

  “Are you hearing them now?”

  “Yes. I’m trying to figure out how they’re there, everywhere I go.”

  “Do you recognize the voice?”

  “It’s the same person all the time. A lady’s voice. Bothering me.” She looked off to the side again and laughed.

  “What’s funny?” asked Dr. Pine softly.

  Katrina didn’t answer.


  Jim Danziger—who was not technically required to be there and had very little official business during the course of any evaluation—sat scanning and highlighting an issue of The New Yorker as if it were a used textbook. He’d been representing clients like Katrina for longer than I’d been alive, and like Silly Putty laid over newsprint, he bore the stain of their mannerisms. His questions often tumbled out abruptly and in response to stimuli the rest of us were not quite privy to. “So what happened the day you were arrested?” he asked.

  “I went to a department store to buy something.”

  “Why’d you grab this woman?” Jim was less gentle than Dr. Pine and Dr. Wolfe, and I got the sense that while they liked him, they didn’t often appreciate his interruptions.

  Katrina began laughing again. “She’s lying. She’s a good liar. She’s a lying liar. A good lying liar.” Katrina was very fat and wore orange sneakers. Her flesh shook all over as she laughed.

  “What do you plan to do about the charge?” asked Dr. Wolfe.

  “Fight it,” said Katrina.

  “What would your defense be?”

  “I’d tell the truth.”

  Dr. Wolfe paused. “So what did happen then?”

  “It’s like, I just kept passing by her, and she probably thought I was stalking her. She hit me first. It was a fight.”

  “Do you want to go to trial?” asked Dr. Pine.

  Katrina looked off to the side again. She said, “I don’t know why they’re so eager to put me in jail!”

  Dr. Wolfe redirected her, and she explained to him her understanding of courtroom procedures and participants. When he praised her, she looked directly at him for the first time before blurting out, “To tell the truth, I do that all the time and walk away!” She went back to laughing with the companion the rest of us could not see. Like the defendants I saw at Bellevue, she was not oriented to reality and would be found unfit.