"In what sense?"
"In almost every sense imaginable. They'd replaced the disk of his skull about three months before that, and already his speech patterns had returned to almost normal. His memory still suffered small short-term lapses, and specific words would evade him from time to time, but he seemed to be improving in these areas with each test we administered. His physical coordination was such that I had no problem recommending that he go back to his work as a policeman, so long as his assignment was neither too strenuous nor stressful. In short, his was the most remarkable recovery from traumatic brain injury that I've seen in my twenty years of medical practice."
Washburn nodded, delighted that he had fastened upon Bromley. He'd always been in the picture, of course, but the opportunities for Evan's defense that involved PTSD had always seemed somehow sexier and more compelling. Now, knowing what was going to come out, he started to entertain a small ray of hope that a straightforward medical explanation could produce approximately the same results as a PTSD defense. If he could make his client any kind of a victim, he knew he still had a chance.
"Doctor, did you have an opportunity to examine Mr. Scholler after he was arrested?"
"Yes."
"How soon after?"
"A couple of days."
"And what was his condition at that time?"
"Well, mostly he was suffering from headaches. But he was also experiencing fairly severe disorientation as well as some speech aphasia. All of this is, of course, consistent with trauma to the brain."
"But you have testified that the symptoms of his traumatic brain injury had all but passed by a few months before that, isn't that so?"
"Yes."
"And yet these symptoms seem to have reappeared. Right?"
"Correct."
"And why is that?"
"Because of new trauma. At the time I saw him after his arrest, Mr. Scholler had sustained several new head injuries."
"And how did he get those?"
"He told me he had been in a fight with Mr. Nolan."
"A fight with Mr. Nolan." Washburn half turned to bring the jury along with him. He particularly noted Mrs. Ellersby, canted forward in her chair, rapt. "Doctor, could a mere fight produce these kinds of debilitating injuries?"
"Of course. Any knock to the head can cause severe injuries, or even death. And from examining Mr. Scholler's head, I found evidence-bruises and broken skin-of several such blows. He also had a new concussion."
"Were these injuries enough to make a person pass out?"
"Certainly."
"At the time they were inflicted?"
"It could be then."
"Could it also be later?"
"Yes."
"Thank you." Washburn risked another quick look at the jurors. Everyone was still with him. "Now, Doctor," he continued, "in a case like this one, where there had been previous traumatic brain injury within the past year, might the ramifications of a beating such as the one endured by Mr. Scholler be more serious than in someone without that history?"
"There's no might about it."
"So the symptoms of this kind of beating would be more serious than they would be to someone who hadn't had the earlier trauma?"
"Well, not to say that a single beating couldn't be severe enough to cause significant damage, and even death. But certainly the history of recent trauma would exacerbate any symptoms from the beating."
"And why is that?"
"Because the brain is an extremely complicated and slow-healing organ." Bromley-bless him, Washburn thought-turned to address his remarks directly to the jury. "It's common, in fact it's the norm, for a TBI to cause neurological and physical problems forever. Other scenarios, particularly if they involve bleeding and clotting, can take two to four years to clear up entirely. And even then, there may be scarring and other complications."
"What about blackouts?"
"Yes, of course, blackouts too. Although typically, medical professionals don't refer to them as blackouts. It's not a very specific term."
"Is there a specific medical term, Doctor?"
"Well, there is syncope"-he pronounced it sin-co-pee-"which is more or less simple fainting. Then there are seizures, both epileptic and psychogenic, that is, nonepileptic. And finally there are alcoholic blackouts, where you have anterograde amnesia during or following a drinking binge. All of these would probably be called some sort of blackout by a lay person, and all of them might be affected by TBI."
"And what happens during any of these blackouts?"
"Either one or both of two things: temporary loss of either consciousness or memory."
"And how long can a blackout last?"
"Well, again, that depends. In some sense, lay people might call a coma a blackout, and they've been known to last a decade or more. Most, like fainting or epileptic seizures, last no more than ten minutes."
