Observing details and documentation are important to hygienists too
By Ann-Marie DePalma, RDH, MEd, FADIA, FAADH
For years, I have been a fan of mystery and crime dramas on television, as well as at the movies. With shows such as “CSI: Crime Scene Investigation,” “NCIS,” and “Hawaii Five-O,” and previously “24,” I continue my interest in the genre. But I never thought I would actually be a part of a real-life crime drama, and that my dental hygiene background would make me an important part of that drama.
It all started when I received my jury summons. When I arrived at the courthouse, the judge informed us the case would be a criminal case and would last approximately 2.5 to 3 weeks (an unusual case, since most were completed in a few days). Juror after juror went to the sidebar with the assistant district attorney and the defendant’s attorney present. The judge asked each juror additional questions to the ones on the form and, depending on the answers, was either seated as a potential juror or released to the jury pool room to await another potential trial.
My turn came up, and I approached the bench. Yes, I did have a few issues with the case, but not sufficient enough to keep me from being seated, so I became juror 10.
The next morning we were met at the elevator by a court officer who proceeded to bring each juror into the jury deliberation room. No one talked; we were all strangers to one another, checking cell phones, watching the clock, or reading magazines. Cell phones are not allowed in the court so we had to turn them off before proceeding into the courtroom.
Usually, on TV or in the movies, the jury is present and, when the judge enters, all will rise. In this case, the judge, court officers, lawyers, defendant, and interested visitors, all rose when the jury walked in — a very weird feeling indeed, one of many I was to experience as the trial progressed.
The judge restated his instructions, explained that the trial would last 2.5 weeks and, upon jury deliberations, a 12-person jury would be finalized. The four other jurors would be selected at random to serve as alternates. No one would know who would be the alternates until the deliberation process began. Opening arguments by both sides were to be delivered, and a “field trip” to the crime scenes would follow. The indictments against the defendant were breaking-and-entering and murder in the first degree. Murder in the first degree is premeditated murder or murder with extreme cruelty. Extreme cruelty would be used in this case due to the number of wounds on the victim.
The district attorney and defense attorneys each gave their opening statements, both in dramatic fashion, reminiscent of many a television drama.
Upon completion of the opening statements, the jury was escorted to a waiting bus, along with court personnel. We were informed that we could not use cell phones or discuss the case on the bus. Since we were still strangers to one another, no conversation ensued for the half hour ride to the crime scenes.
Very ominous feelings began to settle in. Upon entering the community where the crime occurred, the bus received a police escort. We were definitely part of a drama. The jurors were escorted off the bus and taken to the first crime scene, a small convenience food store where the breaking and entering and robbery had occurred. We entered the store and viewed the surroundings and were then escorted with several police officers down the street into a residential area and the back of a three-family home. A small patio with chairs and overhead grapevine was present.
The district attorney tried to open a basement bulkhead door, but it was locked. We had to wait for the owner of the building to arrive and open the door. There were approximately 25 people in the small yard shaded by the grapevine waiting to enter the basement and we had to enter in small groups. Again, the eerie silence was undeniable.
We were informed by the attorneys to view the basement, which was small, dark, and cluttered, and imagine people living there. It also contained a very small back room that attorneys said to focus on. They advised us to note all things present in the room and exit the room by backing out and to notice what we could see of the room as we exited.
As dental professionals, our eyes are skilled to view the entire mouth and note any abnormalities, but here I was out of my comfort zone. What do I focus on? What am I looking for? Luckily, we had notebooks that the court provided, but at the end of the day, those remained in the court’s possession.
Our trip back to the court was as quiet as the trip out, with an escort again to the city limits.
Once back in session, we began the actual trial. Prosecution witness after witness took the stand, starting with initial police officers on the scene, progressing to the owner of the house, to the store owner who spoke only Portuguese and needed an interpreter. The final two witnesses of the first day were a cabbie who had picked up the defendant at approximately the time of the crimes and a homeless drug addict who occasionally slept in the basement with the defendant and others.
The cabbie presented as a credible witness but the homeless man had a variety of versions of the events, depending on who was questioning him — the prosecution or the defense. In fact, at one point he admitted having been unconscious and waking up to find the victim on the floor covered in blood but didn’t know how he got there.
The second day of the prosecution’s witnesses led to testimony from another drug addict whose home the defendant and his girlfriend, along with the victim, often frequented. The defendant’s girlfriend, who was also the mother of his 3-year-old son, also took the stand. Her testimony was vague since she said she “couldn’t remember a lot.” When the prosecution showed her the written testimony of both the homeless man and herself, which was taken the day after the incident, she recanted her memory lapse and agreed that was how it happened.
At the end of the day, after what we thought was “all clear,” the judge dismissed the jury from the jury room. I needed to visit the restroom before leaving. Several other women entered, one crying. As she was crying, she said, “I tried my best,” and I recognized the voice as the defendant’s girlfriend. I rushed out of the room as fast as I could, not looking at the others, and spent the rest of the night contemplating my situation.
Should I tell the judge or not? We had been instructed not to have any contact with the defendant or the witnesses during the trial. What if I didn’t say anything and the defendant’s girlfriend did? What problems could I cause for the prosecution? A definite ethical dilemma.
As dental professionals, sometimes we are caught in ethical dilemmas — to inform patients of their disease process or not, or to discuss treatments that may or may not be in the best interest of the patient. What would you do?
I decided that it would be best to tell the judge. Upon arriving at the courthouse the next day, I spoke with the court officer who relayed a message to the judge. I was then called into the witness box and sworn to testify to the truth with the defendant looking right at me and both lawyers present.
To say I was nervous would be an understatement! The judge asked a number of questions, conferred with the lawyers, and the defense attorney conferred with his client. All agreed that I did the right thing coming forward, but that since I acted appropriately and it would not cloud my judgment, I was to remain on the jury. And here I thought I had a great excuse to be removed!
The next witness was a woman who lived in an apartment in the building. She detailed the events of that night; she had heard arguments and screaming, which terrified her. She moved a few days later and was currently living out of state, and the prosecution had brought her back for the trial. After her testimony, the next witnesses were the crime scene investigators.
They took the jury through all of the evidence found at the scene and on the defendant and others involved. Now I knew why I wasn’t challenged or removed from the jury. All of the information presented was scientifically based. Not only did I understand from the science perspective what they were discussing, years of watching crime dramas finally paid off! From the blood spatter at the scene, to photos of the scenes, to anatomical descriptions of the victim and his wounds, to DNA evidence (including bite marks on food and saliva samples on drinks), we were transported in time to the day of the event. Details and documentation were important to the investigation.
Documentation is vital to the dental professional’s care and provides the evidence for all that we recommend and do for our patients. Documentation is a key to positive outcomes.
After all 17 of the prosecution’s witnesses had taken the stand, the defense called only one witness — the defendant himself. A belligerent “tough guy,” he argued with his own attorney, was incoherent at times, added information that wasn’t pertinent to the case, and laughed at the jury.
What the defense attorney was thinking when he put him on the stand is beyond comprehension. But that is like our patients — they deny their disease process even with the presentation of evidence to support our case for treatment. Are you and your team presenting a coherent case for your patients?
Another curve awaited me as I sat in the jury box. After closing arguments by both the defense (the murder was self-defense) and the prosecution (the 41 exhibits would provide the answers we needed), the judge instructed the jury on rules of law for an hour.
A foreperson needed to be selected. The judge eyed the jury and selected me! I guess coming forward with my ladies’ room incident had made an impression on him, one I didn’t really want to have.
I sheepishly asked if I could decline while the defendant glared at me. The judge understood and asked another juror who accepted.
Our deliberations began with four women as alternates sitting in the room across the hall from our deliberation room, with only reading materials available to them. We were sequestered in the room with a bar across the door and pizza for lunch.
We had to decide if it was self-defense, murder in the first degree, murder in the second degree, or manslaughter as one verdict while also deciding on the second verdict of whether the defendant was guilty of breaking and entering.
We decided to deal with the murder indictment first, which had to be unanimous. After initial discussions we voted and the jury was deadlocked. Additionally, the forewoman of the jury was having difficulty with managing the group and asked to be removed from the position. We informed the judge of our situation and after having been brought back into the courtroom, he assigned another foreperson, this time a man, and dismissed us for the day, asking us to return early the next morning for a full day of deliberations. Our instructions were not to discuss our situation with anyone, including family members.
Our discussions the following morning with our new foreman centered on the definitions of each of the murder convictions, what each meant in this case. With all of the evidence presented, we knew that it was neither a self-defense killing nor manslaughter, so that was an easy discussion.
Our difficulties centered on the defintions of first and second degree murder. We agreed that it was not a premeditated murder; it had happened during the course of an argument between the defendant and victim and possibly others. Due to the extent and nature of the victim’s wounds — knife wounds through lungs, heart, liver, and arteries — extreme cruelty could be considered and was discussed extensively.
Murder in the second is a nonpremeditated murder, usually occurring during an assault and was also discussed.
We reviewed all aspects of the evidence presented and again took a vote; this time a unanimous decision for murder in the second degree. With the murder discussion complete, we proceeded to consider the breaking and entering/robbery charges. Since the prosecution had spent most of its case focused on the murder, the state did not adequately build a case for the robbery. We were all in agreement that the defendant probably committed the crime for drug money, but that there was insufficient evidence to convict. We voted to declare him not guilty on the breaking and entering; it didn’t have to be unanimous, but was anyway.
We reported to the judge that we had reached a verdict and the short, yet long walk from the deliberation room past the defendant and lawyers to the jury box ensued. The judge asked the familiar “Mr, Foreman, have you reached a verdict?” and the familiar response, “Yes, we have, your honor,” followed by a reading of the verdicts.
After the reading, due to the fact that this had been a murder conviction, the judge polled each individual juror as to their decision. The defendant muttered something to his attorney and stared down the jury. The judge gave us final instructions and we were escorted out another door back to the deliberation room. The judge would be handing out sentencing at that time and would be with us shortly.
Once back in the jury room, we all exhaled a sigh of relief and for the first time in days, chatted about light-hearted events. The judge soon appeared and thanked us for our service and said that he had sentenced the defendant to 15 years without the possibility of parole, the maximum sentence that could be imposed. My journey into the law was finally over!
What did I learn from this experience? Most of the crime dramas that I have enjoyed all these years are often true to life (with fictional information thrown in to liven the story). Dental hygiene and the sciences are intertwined in ways not initially imagined. The trial was reinforcement that documentation is essential to all that we do and the need to be observant to details that we may see in our patients’ oral cavity even in the course of our hectic schedules. Every detail is important to our understanding of the patient’s health and our treatment recommendations. What have you observed today?
Ann-Marie C. DePalma, RDH, MEd, FADIA, FAADH, is a Fellow of the American Academy of Dental Hygiene and the Association of Dental Implant Auxiliaries, as well as a continuous member of ADHA. Ann-Marie is currently a business/clinical advisor for Jameson Management, Inc., a comprehensive coaching firm, and also presents continuing education programs for dental team members on a variety of topics. She is collaborating with several authors on various books for dental hygiene and can be reached at [email protected] or [email protected].
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