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First appendix | Third appendix
The subject, Claude Legrand, is undoubtedly suffering from dementia. The condition has already advanced to a stage which would prevent him from following the evidence or arguments in a criminal trial. He would be quite incapable of instructing his counsel on points arising from that evidence or those arguments. The condition is irreversible, so there is no prospect of M. Legrand’s ever being fit enough to stand trial for the offence of which he is accused or, indeed, for any serious criminal offence.
I have had the opportunity to read the statement of my esteemed colleague, Professor Poux, which he furnished to M. Legrand’s legal advisers and, on the questions of M. Legrand’s dementia and unfitness for trial, I find nothing in it with which to disagree. Professor Poux’s opinion is, in this respect, exemplary.
There is a highly unusual feature of the case, however, which I can hardly let pass without comment. On this question, the agreement between Professor Poux and me collapses. Since succumbing to dementia, indeed only in the past few months, the subject has reported hearing a voice in his head. This is the voice of a woman who appears to be younger than the subject by some decades. The subject does not merely “hear” the voice, indeed it seems that it does not address him directly. Rather, he overhears it, and much of what he reports it as saying, while mysterious to him, makes a high degree of sense to someone not suffering from dementia.
In what follows, I propose to refer to the putative source or apparent owner of the voice as if she were an actual woman, though with the caveat that this is an entirely unjustifiable assumption made for convenience only. I have found that attempting to use only such formulations as “the putative source of the voice” tends to make this report almost as difficult to write as it no doubt will be to read. I shall also be using more quotation marks than is consistent with my usual writing style.
It is important to stress that, as the subject reports the phenomenon, terms such as “hearing” and “overhearing” are inadequate to describe it. He says that her memories and some of her physical sensations are accessible to him. The apparent memories suggest that the woman spent much of her time abroad in recent years. Specific memories strongly suggest that she lived for a while in Finland and Poland. The subject did not recognize the places in these memories and does not appear ever to have visited either of these two countries. Of course, that does not mean that the “memories” must have their origin outside his mind. Legrand was the president of a large organization that must certainly have employed Finns and Poles in positions that would have brought him into contact with them.
It would be fair to say that the subject is puzzled and confused by the presence of this voice and its associated memories and sensations. He is quite unable to make any sense of them. Nevertheless, he does not find his puzzlement or confusion distressing. The woman seems familiar to him, though he does not know, or does not remember, who she is. He evidently finds her “presence” comforting. I believe it may be the case that his “access” (as he puts it) to her memories consoles him for the loss of his own.
However this condition might be described — I should be inclined to say that a patient with dementia has constructed an internal (but experienced as external) persona to hold the thoughts, sensations, experiences and (crucially) some alternative memories which are entirely different from the ones he has lost — it is unique in my experience and, so far as I have been able to discover, in the literature. This is where Professor Poux and I diverge.
In my view, this is an extraordinary, apparently unprecedented, case which cries out for closer examination and investigation. Poux insists that the voice is an incidental detail. For him, it is the dementia that really matters. Without wishing to cast the least doubt on Professor Poux’s integrity or professional competence, one can easily imagine an expert witness who identifies so closely with the interest of the party who engaged him that he tends to emphasize aspects of the case which might not, to a wholly unbiased observer, appear to be its most significant. I must stress that I do not accuse Professor Poux of falling into such an error, at least not consciously. In the present case, everybody is agreed that Claude Legrand is not mentally fit to stand trial: un point, c’est tout. The voice in his head distracts from the simplicity and force of that position. Normally, when someone accused of a murder starts to hear voices, the suspicion inevitably arises that he is trying to avoid responsibility for the crime by pretending to suffer from schizophrenia. That is clearly not the case here. For one thing, the subject does not claim that the voice instructed him to act, and he seems to have heard it for the first time only after the onset of dementia and not till several years after the commission of the crime. Nevertheless, one can quite understand why this inconvenient woman is an embarrassment to the defence legal team.
No doubt it has occurred to some member of that team that M. Legrand’s current condition might suggest that he had been in the process of concocting a feigned defence of insanity when actual dementia overtook him and that somehow the details of the fabricated defence became entangled in his current mental state. I am firmly of the view that, even if such suspicions were justified, in the absence of any description of the mechanism by which such entanglement or confusion might have occurred, it is not a suspicion which any conscientious psychological expert witness could responsibly entertain.
And, even if it were otherwise, it clearly remains the case that the subject is not fit to be put on trial.