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Industry-Provided Depositions

Antonio Cipollone, Individually, and As Executor of the Estate of Rose D. Cipollone, Plaintiff, - Vs - Liggett Group, Inc., Defendants. Transcript of Proceedings. Afternoon Session. Civil Action No. 83-2864 (Sa)

Date: 03 Mar 1988
Length: 88 pages
85853504-85853591
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Fields

Type
DEPO, DEPOSITION/TRIAL TRANSCRIPT
Alias
85853504/85853591
Area
LEGAL DEPT FILE ROOM/TRNSCRPTS & EXHBTS
Recipient (Organization)
Usdc District Nj
Named Person
Cipollone, A.
Cipollone, R.D.
Recipient
Sarokin, H.L.
Date Loaded
12 Feb 1999
Named Organization
Lig, Liggett
Loews Theatres
PM, Philip Morris
Author (Organization)
Stryker Tams
Webster Sheffield
Wilentz Goldman
Arnold Porter
Brown Connery
Budd Larner
Greenbaum Rowe
Lig, Liggett
Lor, Lorillard
PM, Philip Morris
Shb, Shook,Hardy & Bacon
Author
Bleakley, P.K.
Cohn, D.J.
Darnell, A.M.
Decker, F.
Drozdowski, R.F.
Edell, M.Z.
Kearney, J.
Naar, A.S.
Northrip, R.E.
Parrish, S.
Payne, E.K.
Silfen, T.E.
Sirridge, P.M.
Litigation
Stmn/Produced
Site
N14

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~.; TiI;: J:~....~.~~L.3 rrtr s1 ~si. r• l h• `Crt C'..)~J.:\i :.i~,:a ~ Z a ~'I. y -i . T ~ . 'a~2Jr~Ct1i. T.T y/P it:nAk}T C:v~J Act.i.un NO. 3-3-:?f3a4 (SA) - - - - - - - - - - - - - - - - - - : C~:iVti~tiu 1.~.iLw:JLJT'tiL, ins1via+1a3 Zy, an3 as Exscutur af the Eatate : Tm'I2r..R1PT QF S of R©ag D, Cipullonep P R~~E1":) 111 C, Plaint3ft, I : Newartc, New Jeszei LICG:':T GRaUPr I.'4C.4 a 3eYaware Corporation; PHZLIP ; Marc•r, 3, 1980 hcOaiZZa, IN"COitI'0.714A.TBD, a VirqlAla Cirporc3ti.'3tlj $nd t AFMNOOi'3 S;SSS:}:+ tp'3~~~:'~cESt • iF'C tt' •, a ty:sa Xork t3azan3an-.::. r1') :1:)RU :i• it'..1. aAA J.*~ a.ll Lt4Xri:~.~=,1 •• AI? 0 Cd`. R?`t I. C BS: iriDS:iP i'aC 1:.,itJ~ ~;l=:r t?~: r;G & Stu?.t: r E; ~~. , "aiZd" i'1T.JUli.G, +.iV.d:/.'if1;1 & sP1Ti.:.eA/ i:.,J• I Bi : flilNti `•{• :)iiR:.i:+LL, r•.rS'~. i At::orttLy'z for tt'se b POWt R, SS.ti:• / B., n" r - -, r, L r. `s ~ ~ ur+ iL t~ !a . ,~ :. s~.4~ 1 '>i..,A ~ ~n n... ~..,., ~..•~ y- ts r.tZ1V ASi~~t•~i~'.L+ Attorneys for the Dofen3an., pailip Piorris. Pureuan4 to Section 753 Title 28 tfn,ite3 SL•atdz Code, tho tul3owing tranocript ia riifaeci to be an accuratc record a.s tnken stanoyrapn •al in the abav-- ntitiad pruceeb±ngs. n ~Sp P:3V:.i,IS 'P. LqgS, C. S. R. Wficiai Court Reporter -nii:ed StatC-,,, Dsatrict P.Q. Boz 2559&, NeNerk, l3ew Jersey 07101 tS.:IYLs..IS i'. LIJ,; 1Sr CGR L JCt". ::JL' ii. 13~JS^. ~~ ,.'"•t>r:
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1 2 3 4 5 6 7 a 9 10 11, •4 13 14 t s 16 1-9 21 22 23 24 25 A ; p kE rs a xi N C Z S : ( 4.7at1 Fi t3 ej) LsRa&NMU'r1, L2flW°, SHITi3, RAVIN, DA1tIS ik BY : AL Aa 5. 14 ANR , LS;~. , -an3- WEBSTER & SHEFFSfiLa, E545. r FY s DOIiALD 3. C{3ilt;, ES{2.. JhMCS Ez,ARhZ'Y{ M., tR&:IC I S D Eti t{E, n, CS Q i Attiorrieyb for Defondant, Ltggett. BRWN & COMtL.TLY, ESOS.. BYt RNYH= F. DP.OGi)CWSKI, ESQ. s Rtttyrney3 Lor DefendanC pYtiiip mac s 1r.. a~Y::~~ai:t{t T.A.::s Ec"n.s. i BY ; MITii ri. ?AYl:i-;., V.SQ. , -and- a~J3E , MIRDY & 3ACOi:, ESQa. r B 7 : S`iiTl y:; FAY2SZ:itI I if~ wj. , tZOB:.Xa u• N OR~TL3RiPt `.:i0. J PATf:.IUCir M. &iicRIDGL, ES~. hi:torae~~q'.: xar ~3$IyCIl~:.`inC~, , •.fJl~1• S:.i..~i~ f'{.~1 i l:I a:Ii] lIV1.1Y.~.fJl~1 P'rIY:,LISl T. LE'rdlS, CSR 4 JCANau M. -kia;3STJYN, CSi
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, t 1 2 3 4 5 6 7 8 9 i0 2a 13 14 15 1G 17 19 20 21 22 23 24 25 :3el it~i AFT E R 240Ci ti 5 E 3 S 1 0 N Tzis+ CLwM: Ali ri4e. (The iollawing takaz place oucL vE the pre:~enco of tae jury.) TI?E COiSRT: SnssuboJy wanted to see me? MS. Y1ALM3s Yes. At aidQbA.-? TF3E COURTr Yes, :~:.. wJI 3t.z ~'li yet t3r, I:urxrncy. (`i`he foltuwiny take;L~ piace a;: I~ide6ar. ) Tii"6: COUAITi What: b; ingri you hore7 MS. WA:,.A::RS: Ju3y;~, 3t'z ~ay u;2derztan3:na Chut :::. N4aCiye',s ~LYi`.L~?la] LO go lz'j~.:D o:1 N'ttat Lh.t~ ~ ws._nc3z~ t!ie fa4c La5aL xa:; iilvOiVGd in a;z aQ t OZc;,1' ie acCiJIa ri c in IW9 alaI z1he uad iui4c phobiWs `.:iat c'teve:cop:.•j a~ a reau1t of tnat car acciden;.. He dUn',. Lave a ptoL~iezu ,ait;i z.hat ac al-!. W3 do hava aprob3eas witli any te.itimony rsgarc3iny the tact that aba had a aaparata and independent 3ayauit urising cxst of thnt autrsmobiiQ accir3ent. I understand and, I nay be incorrect, that Mr. Xearney doe3 intend to try to elicit that through this witnesa. ,IF. RaARi,XX: I dv. TIIE GOLiii f Wijj ? aR. Ti:ARti :YL Be.Catl:So ~ I T.;t.riE: it Is re.sr•an}_ to niz.; ?IiYI,LIw T. LE:I:S, CSR & J0AlINE M. kO:ISTOINr CSR
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1 2 3 4 5 6 7 6 9 1I 11 12 1 13 14 15 35 17 113 19 20 22 22 23 24 25 3867 opiniort ic, two re:,~~c:ts, crltiCally reiavanL. 11, .3 naa taztiiiec3 that "4,¢u a;a 2):a itt'Larviewr with hti: t:iat he csme to rht: coac.,Lusio,i thttt z'r:c exhibited withdrawai UyiuPto=z when shQ stuppe3 ri-wflkinc3 in Auqust of 1931. Those withdrauraIs syraptoma he said were qrumpinesa, irritabilityp inner tension, nervousnesz, things like tbat. I'm entftlec3 to dewnztrmte that at the time he con3ucted thatt interview in order to attack his croaibiiity,* J:T„ L>rCifir t`+. 3i:L2ct{ Y.?ZcZ!~ Qi?5.711Ol2, fi$ ti~-JLC `t+:AGJ h$t Wtt~~,ila,: oc not 3:2E.' hfzL ii:iy di thCize zy33j}tCHRs beyoX C."i1af1J. f3:a aaic3 in hij depo~iitlcsrn tiiat haJ ite: know.r about Lc:L:4, taay wauid be i::p:)rtant, tneyr wau:d be ao:nethirig ;ie wQu.i:q fF7i1ow-up oi3, aJ:nGtairtg lle liot2iJ aaK moLs: qi9Qs.r.io;1': a°r3~)ut. T.,ey were a favczur -- Ti3E Ct}J:T s The : sct aac utaL tel a iawsuit? Fiii. MJAU:':'.~"+Yi Ni.k. Tli$ fact, $he i1:3tj1 ai.: tl)t33-L' C~Ca)G'C Lymp: owi, po~;t-•rraui:iscii pnat-aylvJrume. 'fbO C0:3RTc l.et.'s foau:.~. Tze obZeccz::n is reference to eEriother iawsuit. Do you -- ars you going to refer to anothex one? MFt. &EF,&NSY s - Yes. THS COIIF.Ts Tbat's a long aay to get there. MR. RLM17GYs' Ivsrss3 two point:~;. I-di3n't get tO the becond ana yet., The :wTVV.1d point 1W ya14iGL in -t1./Yz LakidY14 :711e .~l• i.7LtttTJ, +.r.`JR R jojk:~i'i~ M. LiVUa,n3l~~rry, bSf'.
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I L I 2 3 4 5 6 7 $ 9 io 12 13 14 15 iC 17 16 19 20 21 22 23 24 25 3u11.~ 8 c.taiwad zentnl anguiah nnc1 the ciaiN3sd tr,at sbe'j nervou:; t,z a re4uit nF the car accidant. I'4 erititied to dswnstrste at tuz tiraa he to:;k that #ntarviaw he didn't know that thiti woman had dona preciasly wbat sae's doing in this case, whicn is institute another laarsuit and claim that aha 2,ad phobiaz, uarvousne:;3 and xntarr,a.i tensiona, the naza as -i.a this caa$. In order to demonstrato, Judgs, that there ws.s a -- nott s patLern. :aut tiaaL a pzyct)iatrist acsuiL conzidc:, -- remsiaber Xr. -Er3eii ta?k4d about hi3 expc:rti;~e in zeiiability Qc tuc~ in+uzra&tiorn that cEia wa.3 yiving, tie waw ab,ie to r$'r`.i.@ii) tt':e to detEtrm.ltlf3 ttiL• rele.abi.i.ctf oJj bh~G'~ ~riiGl~it~blon JGSM gave aL the i'1 r.o.i1p-alZ~'.~.aY cZ cfe~~r;~~rang r;:.Li4bility to in.Eormat°1*;jn that zi7e goi ai~L taat interview wouid be wciether or not he k7ew Z=,;, t1iat: tIuW i:nat she coaweiacac: a l.aa~ uit,, which wsa bLi1a in progresa in tii:+C: peiiOd it'b LoJOLber, lF2 i+l1ic is1iE .: izo c.;i.t.tiiL:.i a nez'1oua.rlea:3. TOS COiJRTs Does the fact she claims mental .ar:gui~~i in a lawsuit have anything to do witb his opinion? MR, KEARtMYs Wel.t, in addition, -ahe went to pgychiatrists, she did tne aarae thing that ahe's doing here. And I'ia entitled to dsmGnstrate he -c7iic3n't even know thaL, be dia37'r ai:k it, he didn' t inquire. AnJ ho ua~;n't tGij it by tr,Q lawyeLii. Re wasn' : told by mrs. Pi:YLLiS Z'. LUIS, CSR & ,:fUts.:12,4:; A. ~iJL'aiatd, CSrZ
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1 2 3 4 5 6 7 8 9 10 1I 12 13 14 15 16 27 13 19 20 21 22 23 24 25 3n89 Anc: it caii:; fnto queacios3 bota his teGuni-4ue in coaJuuLinS the interview and -his op:nion tha,, t:ne ha:i wiLhc3rawal aymptoma aa a re ;ult oL cigarette si:,akin, a.a appflzed to as a result of the lawauit. He said that, veil, I could see -- on direct he said I could see by tbo way she iooiced and what ai3et told Me, she used body languaga, she raas talll.ng the truth, I want to demon~;tiate tnat he vhou?d have inquired ini.o .:.rsa;, anJ he didn't do it. a'ciL COUR^: I' 11. ieL y;,u. Annj I take it ttiere i6 no ubjEction ja::r:g to an:I you Y,ave no Wjectioi3 tv t4e f4;:tS. Iw_i;., aasGtain the .obje:.ticrn a:: to reLecence t:, ;.ile ins::::.tuLion o, ar,othLr unre.ated 3awauit. It ha~z c.jme very liprobative value but certr:inly Ltje pcLauJice QJtvel9ia4 it, I c;WtWan~ thi4 ;jury eo get ttte iMj,:U' ts ;;iou ..wL sue':z, yoin~ arouad maiciny z ai~;a 4lfiiai:! Lawauae :;na Li,a1-A4 a c?aim ::n anothe: iaw4uit. A perzors can have two -iut=obi3e acaictc3nta and c2aim menta3 anquiah growing out of each one and there is nothing inconsistent about that. I dcrn't tbiAk the fact that ahQ started a lawauit is sufficiently probative to bring it out, t'11 sustain the ~ obje4tion only .ai,, it ;gErtaina to the inztitutian of the ~ C.? i.ewzuii:. VI MR. NOxTi3RIPx Ma} I be hQar~; a;, well? PdYi,LIS T. :,EWZS, C5R -,& J0AANE H, H0JSTOP,, C5R
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L 1 2 3 4 5 6 7 8 3 10 11 13 14 15 16 17 13 19 20 21 22 23 24 25 a E: COUR'1 I ~.`e3. MR. T2OaTERIP: I think it goes not oniy to tniz; vrtneral aredibility an3 his te3tif'y:ng aboat bow Iirc, Cipollone l*baved at her deposition and what ghe sai8, bat i: also goes to the credibility of Mrs, Cipoilone herself. Many of these c1aiw and appearances at doctors Mr. Bearney will be going into and sumaariex and aateriala wcra zatat.&.3s obviausly put tctgetho: for a 14wauit. I thinx t1e'it i:.i aw.i3 lESt}e in t~'h:.s a^.it:aa I10~". UI:ly (it Di.. j::£tt?T:.t c1'ed.tiilli.y S:"a 4,10 to:.;tifie:, buz: a_'ao K&r:i. 4i~):2ct0ili:~5 Cre:.'i).)l.iity. I t,hink tYie fdc:i- t«13eCt tj'iaza ciitina ace :Raw"a &nJ ti2iz ir,ior;zaLion i;:, gx•: en i.n the ca:,:,ext 0=' ancther ?aaauit i:s so:;i2th:~ng tflsr. Lfai:i jury is era;.it..:ed to wei~;ii and r.'.znr..adt:r in 4eco1:aininq r.ri~c~~~~llty of izar teatimbily iIS tt'i.t5 csae. Ii.2, i:tatil,r_Y t i fal3.rik ttia::' z pEli Cici.ii,&Ciy yc2 witera th.:4 w.tau;~;s, Judgu. t,a:~ 1:-i s:fo:,t 0pi:,ej ab~:::;. credabiiity and aLouE: Wbnr: mignt iiavO =i.ivri4ad her as. a depuaitio:t. KR. SLE&NLEYt There is still another iactor, wl,: ch iu that she nakea very epecific alaim:a in thic other co.3p2aint at)rout the precise aymptwcs that abe -waz suffQraav GD V and zhey--are virtually identical to eo.ae of the gyzpto.H:> ~ t1t W that Dr. Jaffe aayb are the product of cigarc~t:~ _~ of V ~ tr,:~aaco depe:.3sncy. AncS there iu nu otnc:r w8y tor us to PiiYLL.S T. L.EWSS, CALIR & 3OA4?'y^ I3. Ii,:)JSTu:3, CSR
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3 5 6 7 a 9 1G 11 12 13 14 15 16 17 I~3 19 20 21 22 23 24 2;z 3391 e3tah3 iaii on zhe recozi3 oi tnij ca:ic preciaely wur:t zy4c, toZu ;L,142 Ciai:3L'd SiFno2'i 55fe ti+eG~ thf1t' 1cs~{doi3j.t 4i1C3 1wa1:+ ZSTiYinC'j.. Taere is no other way to do it; Glye's not with uz. Tt3Z CAI3RT: Did she f ile ansvrers to interrogaCarie:.? MFt. BI.EU:.gY; She didn't aay that. She fi.lea a csanpl.aint in a courthou.e .in which she a2leged spacific ,-YMp=o:A3. HL. P.;:6'ir;;1::Yt we can t7o 46- Wi.~',Y:J1.1L ~r2L: c:?:.ip13: iZ~. we c:~is'iz'G :ro it witr.v1t two 1G=te.E; t:7:3t her r3UCi:v.~, 5O:lt, tc~ 9ia4tyE:C. Btlttl Qt 1ifiliCrt weLe in 155I, one of ti,"I1C;l '-daz a mere, April '31, ts:ree zronLtis bvl-ore ttixa gen:.iewan ii; d1a~;Io3iny :ie.,3: 17ciV,'i:3g tbL' 5c3za 4y;z?tcJ:.i4; arI:! C! a113ing iC' a aL a rezu.i v of stos>pi&cj :awocing. Tiioa-a .ietterz; -- THE CO:.~R2': Taat: wy go to tha crej.,Oility of W,i4t a'r.e hai said, out I do:c't think t1ha+.: the fact that ~Ile starced anoz :er law.~ui;. os:. to be brougst oat to ii-::~ ju~y# wt. KSAZt:::Y r All riyiit:. 14.w.i:i1 not do tlCra~, but 1 can uge these latter•a that reflect -- or from the doctor say3ng she, in April of '81, she waa ABrvous, she wau enxioua, post--traumatic streas syAc3ro", rhat's chronic, it continues. -xhe only vay I can do It through the letters. ap THE Ct}JIRT: %Any r,bjuc:Liua to that? HR. KEAR:xSY: Ve never knew that. IKS, WALx:;R_1-% We don't :1ave an oi.~jectiori to L~4e P:iY.'sr'c.Is i• i,,.i'~ Ji3, CsZ & vc'aI121it:: i•., SE?U,~'iT3',v0 CSi1
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I 2 3 4 5 S 7 8 10 11 z W~ 16 17 19 20 21 22 24 25 faLzual infor;aation in tho ietc.er, only t'r.ey not bc 3452 It3troduced in evideaLe. A21d, numbAr tko, any reference to them not. Ynclude refereace to the i8ct ti:ey attorney in corviection with that. XR. nALrrAKLLYt That can be done. were *ent tQ an .R. REhRNEY: The docuwQnty I have have the attorney on 'em. MR. ED^LL: Show it to the witnezz, not to the j'3 i j° . VaL, COU RMs it' ~jj rjor the deFenr3ant:;' CasE. Tttez in i101J, V,:.. EvFk~t~t~i': T v:1iy have thez in b:,owap3. Pu:. J[tiu coL3,id.'l'i: :3il.3ii thCm to t1Te ,jj~,f a:'sysii::y, .:eY3rdiesa AU LAe'Yl're I10.'t in ev2denCe. ti R. B;,:A,~tiuXi's Ae .iong a5 yau're rIOL going to yo ti'7L°ir u:iLa, a3-u--iC3T1Cyi aa tho iawa33iti 1l'a'il':, 2.C~,C'it IG. CaU";t 4e hive Geeat a:ivwtnv- a iot of ;.iling:,. f:R. .EDEi,i.: •Threa !"vp.ie ace ta3,kiny at onc e. KS. -WF,,LTERSs Tba faat they'-ze to an attorney becaune they bava the attornQy's naae. THE CAJRTs The Yitness vill be confront8d with it, -=no r.fereitce to the fact it'S a lawyer, no referctnce to tiie fact that it'r3 a .:ak°au.6t. D1R. ED:,L:0s So we underiytand, he can azk the wirness were yQu aware of her tre4t=ent witt: do~tor PHYLLiS 'i'. :. 54iM, CiR & JJAN+I;; N. Ha:IS~`0:i, C :R
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Z 2 3 • 5 6 7 6 9 10 3x 12 1 13 14 15 15 17 }s 29 20 21 -22 23 24 25 3093 Go-i,iitl"'s:?. 2$U~ IvdjTl' C: Y+E.''it I WZ3cz. i3R. BLZAXL~Y z Are you awa re that he a~,aid 4:;LI waL suffering fror.e the goliowing syzptows. f33. WAL; ERSt Tha t' s i ine. Mx. RBAILNEY i I' 1l need about three IDintttes, Judge, to find tiha : lett+er. As S_aaid, I vau going to u" the blowup. MR. EDEL:.s I have an objection to u:ing any bloaup uy Hr .:earney a!; a docuzezt no : be i n g i:i tr:x3uc z d iz eviuer,ce. TE-lE COURT: IL• cart't ae s6oun to tiie iury. Mti. B~.St.X:~:Yz I want to raneiti »:y request that Lhc 3ury be il2al;.ructed -4a L;, the norAai cou;.Zie of Lakinc3 t*icti ha"tiTe now 11:it(t'71ed to tfli:3 wli:riet;.c asL E.'1:.Sa LaQ ent:r.~ ~wra~~IC3 enya9inq i.n a tisade ab.out Zrow hio depoal;.s.an w8a ao zonc; and grue:ing and how outzaged an,! anluwtifiej it 13t1:3. t1Ild I Lliirik jury .`s'tlo`1lG{ bv'' irlilhrtlGi.Ei.1 il:,!`ty that the cour~.e oi Jeyowitiqaj in ttaia ca4e was routine, that every"y -- all the pa=txes in this case took _deponitlons that lasted soveral daira and no adveree ingerencea shoulr2 be dawn aqainst either party of that discovery. ~ P.R. -WEuL: +Your Honor, they opened the door. t9r. V OD tn Rearney kook thinqG out of cGntext and real them to thill.~ W Cn W wAtneis. it tni&; witne:is then put i.aeza in ca;SLext, hs's W PttYL;.*. a.a T. Lai~i,S, CSR ~ SOANt4E N. F#Ot35?'rJti, CSR
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1 2 3 4 5 6 7 $ 9 10 11 12 r la 14 Z r, 16 17 10 19 20 21 22 23 24 21 3U94 GriLltlf3d to GIo tiZafi.. Rgairt, I uLrongly resist any su+:h charse during t.he p-andancy a; hiL witnevs. If you w4nt to do it on Honclar after we're done, fine. I thiAk to do it during the coc:r6e of this witness' testimony is inappropriate and will prejudice his testimony--,and our case unduZy. TF3E COt3RTs Yes. One thing I aust aay frankly to you, becauae I've gotten little grumblir,gs of this, Z'ra ncd;t rjo:.rs-~ to teil t.hi3 jury, Uccauje I'm not ao sure it's aLCUraie, to say that the extent: of the -3spo:aitlun; Lhrst weru -tai~sn in thiz caze Waz acceptabie an5 is norzalZy c3c-y,~. I "y Ssy depozition:~- are apprapriat`, 'raut MR. MELL: I tiiinEc tI33t'y foL th-v jury to claci.: _, reopectFuZly. :.9 E C0 UI'.T: I dun't even knw JU it'4 a jury gue4tion but ?''m not going to aay anythi.ng ta the jury tLat I don't ~~zeve MySeif and I'W rtO_ ;6n 6J:o L-sW;: the ic.ngtti of: ttie4e depasitions are custouuary ind are ac:cegtahlP. HIt. BLEAKLEY: Your 8onor, I've had depositiona in casQS, in many cases in which I was the defendant and ty cliant, chief exQeutive dapositions, was taken for 25 anc7 30 days. 8o it.ig, in ,fact, routine. And I can provide you with examp2ea from :ay ovn Qxperi$nce. Tngr$ io notuiny on this record that 3u3tifiea any coaclu:iun that the num!,)ar or days that any vitnenz wgz PnYLLIa T. UPWIS, CSFr 6 JOANt13 N, ZJ.IJ10'rar CrR
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1 2 3 4 5 6 7 a S 10 11 13 14 15 16 17 15 29 20 22 22 23 24 25 3395 3epo4ed waj it;praper in the abzence ox tsn ob~oction be.ng rai6ed at the ti~ro an3._;,u:.tean8d by tha r4qi4tcate Qr :;ooe court. Taat hazn't hoppQne3. THE COJRT: Pir3t af a13, the length of the d8positionu really are not a jury iasue. I don't think the jury ahould draw any .infQrencs €ram the length of the deposition. My reTuctance ia to aay soraething to the jury that 's r3iqn:. nJL e2i:C3aPC, iiy:+4ii a. tt'i4-- fda:t Gr tr:e prtzcLlciu. r;lut tnc a,rizwer to tne sejuez;L i;~ t13ibi 1 will givo soa,:: rek;uewt. I will not give it now uecsu3e tnink it ca1;'.:r4 sca:~ ~t.zinc~, on thl.s pat•ticuiar witne54 and I' i3, do tr you ra3-in;l M4 on 1ion+3ay, when wouid wL iecume s:bat I hopW w:ial be neu:.ra.z. &Z:3 nO:. ofr+gnSl ve tU anIf pkarty. RR. CO:3;vz I would iike to put. one thing on the record, yincc Mr. K$arneh waaa't there when be aazd be roa3 Lf1 i:w; zo the w:tncii~s ou:L oi csncedc. Th4 rec.)rd xii.i ;;;-)ask aa L•o iL.~,Lif k,Ut Zsay _:t3aL did not uc:cur. My recoilect,ion is on two occasions the witttess chan$ed.his testimany. f3u; I just wanted to put that on the iecord becausa lir, Xe$rney raan't httre and tbat `r y rec:aliection of the record, but ,i E will speait for itsalf. pt,R. drXAXI.Z~'s I have one more issue that I dir3n't ~ Gb t4ink -- Mr. Edell shottld hear t'rsi4. Mr. Edei i aay,~; isa w GII objects to the uje of any blowup oi sometair.g tn4t ian't U1 , PiiYz.:,IS T. LEYt'Iw, CS:Z & J41'::d:di. tM, FiWSTi?,:, C: R
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L 1 2 3 4 5 6 7 8 3 20 j1 12 13 14 ls 1( 17 19 20 21 22 23 24 25 J 3 a!) rL::civeci 14 e;r&W.nw? I dun't ui2w~r:~t~ac~ tncs: obQection. ,C don';; unr3ersca;i:9 tiizt objectiun at a1.1. F,ia've taad dezonztrai;ive e',%idence --- MR. CJ!:LLY I didn'tt nettu charts and thing4 1ike thmt, Mr. B2aakiey. Mk. 8E,B1SLwY: I wasn't sure what you meant. MR. EDx.,LL: In the contexL• of cross-exaziination. TH:COITRT s That an ezbfbit, before anything can be ~;iIowrn t;; i:i'te ,j:1£y, riaz CO be wti Ov idcn,~;c:. I tilir,k 1'vcj r;Y kf3 it t l`l a7c ~; F30::dlt1 C3 a. N"I. BLwAKI,i;Y: Ii you have .4 b:oWu; tin4t you':C g:.irn3 to zhow tQ taa jsry ct ba:~ut;~ia:3 cil~ wi.tn<:4z wjil tea;.ify abDur, .t d.oc.in't hai°e t:: ba in tvldence. 3:>r.n :11'Je dotlt i L. T H •u CO :}Fi°: uil.tt3;;a lt';+ .lt an exu~bi~ ha,~ to br, it to ba az:;-r~li;-3ibie o: JDrOiJaL3-'}" s`LJ:AiLr~ia.3'. lqF.+.. =B:.utS.rLaLGYt Tne17 r'~m -baf.~ieti fisjalii. I want to confront thisrrritneas or any other witnesa with something be's rritten. I don't vant it in evidence, I want to conF~ront him. If the witne54 says, yeo, i did, wby can't I ahov ablor+up to the jury? CPJ THE LOU^Ts Prcrbably i£ ho •cknow•3e:2ge3, becauae V then .it'r; in ewidance. GD ~ W ~ w R.F;. B.r.+F;AKL+y: an{.' G"Xt),ibi `. Lsn' C Dut tne 3i:c3LOSavnt Pi3'z'"LItu ^l. LF:i7l':ir C.i+,'R 6 .TG?1TN..F'~ P1. C51
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3897 i i 3 4 5 6 7 a 9 10 16 17 is is 20 21 22 23 24 25 is. TI}E C3JRT1 Exactiy. MR. F3;.EAKL:.Y: We'3.i -take i-% up at. the T8E COURTs LeL's qo. Bring tham in. (The Pol2owing takes place in the presence of the jury.) T5C :i.i.RXi All rise. T=i::- Pi.ea;;-Q i3i 46Sa te:3. Mr, ne=ne1. .i I: R 0 ii E El . ,7 A FF I:r pxa?vioctziy i:urPoin, rC:aslVaL.::. ia X1sv ;a 3Y fi~?t. uE~R;a~:Y i Q Gaod aitern3on, Dr. ,Jaft:. Ytia ti2,L~'.~.'J oTl d1ZC''C~ deyen3oiice and abaut yithdzaoeaJl ayzptom:~ and yvu bais3 that ciqarettc amoking can causa paycica2 dependence and can x*suit in withdrawal aysaptoms, right? A On direc; , yes. Q You also talked about, I Delievc, heroin aad alcohol. m ~ They can zauac: pny3ical dependrtnce an d resu:ta in W C!1 witadraWal byMp-%.a-a:., in ZbMw c&6e3, correcc? I"a I A YeJ. P:;Y:.rI,,I..~~ 't'. S,VISi CSR ~ J3AIi't1L 143. Ii0J5TO:i, CaR
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1 2 3 4 5 6 7 8 9 10 11 16 17 2s 19 20 21 22 23 24 25 3afro - Cru,.~~;/Kearney 3393 Q Isn'r iL aiso correct, t}iouyh, doctor, that a person cars b* pnxoicaiiy depQndont on caffeine? A Yez. Q And caffeine is in coffee? A Caffeine is in coffee. Q And caffeine is in certain soft drink>,, right? A Yea. Q Lsn'r it also correct, doctor, that mi33iona of people 3:L): Caa,G~el"a (3aj1eClO$nzE'? T:3t7'L tisal. A r3ovead~; vn a+.110ii yuu -- I tilinic Lha~ tiia'c Woula pto~~;y :~ tzue: ye,:~. Q rrat yo13 catY't br2y w::ei.::£L or not pilyriiC3i o:3 caffe.-Lsie 1z stronyei L:,aa phvzicai dependsnce on nicozitie, iiL y'.'%iir Y18w, i:f1i'L'eC`.f:? A Tii0 term `StrongerO or 'ieaz etro3tger" very, verx, dlftiGUit to ua& when Gomparing typO6 Oz dCp3n3tDC2. Q Riqht. A i think on the extremes we certainly can, on the exkre~s. We can certaiuly, in some ways, juclgca it troYa wnat p*op3 a do to alleviate physicrai depeFZdenc:e, about how bcthered tY:ey are by it, but it's diff.iccuit to cowpare. Q And that would be true for a coai>urison of phy4a4ai PiIYLLES T. L:4:S, CSR & J011.*FNt; M. rlOJS:,~OI,, CSk
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3 4 5 6 7 8 9 10 11 12 r 13 14 15 3. 6 17 is 19 20 21 22 23 24 25 Jafte - Cross/&earney 3899 dependence, in your viee, on tobacco and phymical depeiidertce on I,eroin or a:~cQho1, rtamely tuat you can't cozipare the strength -- A Ho. Q - of that -dep$ndence„ Is that right? A I think it'b not fair to say it in quite that Nay, Mr. Kearney. 0 Doator, you're of the view, aren't you, pbysical or wita+3rawa1 vym,>tora, ; roa nizti::ITle ZG LtnJ[7i:a9tic att;i r.e,'Lr• ; hraaten:, pMys2ca1 well-~being? Isn't ttsat car cect? A Weli, it I said it precisely that way, Ishuuid bava perhai>:; said dxi'fei:er,tly. I know Iwrul.:e tslat at one timQ. It's c-erta.fnly never r3ra=Lic and it'a ne•aer Eai:ai, isct t.heYo are tiwa_ when it'w beLter to try to be k+~:iu PMCia3. Q Are you Yinfnhad? I'm torry. A 2 Lhink I gav8 you t;o answer thaL I tairik I evea ;arotp tba~: myse:,f vncet but it pro~a:~iy shr~u;~c~ have been expre::aea cares precisely. -it-uhouid have been phyaica2l well-being thdZ really -- that can be ambiyuoux. It really gsane that nobody ever die3 frcua nicotine withdrawal. Th.at'a what tnat t~ You wrote ir, Drug'Addicts and .33rug AbuLe, wAich was yoir chapter in Gsod~aan and Gillm.:n, which i3 the phar"cologfcaI basi4 for thocapeutioL -- aad lrou wrote tizot iZ 1955 and you FRYL;JZS .. LEwS3i CSR fi 3JF.:;N.E H. 80:'a'n?v, CSR
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i 2 3 4 S 6 7 a 9 10 11 12 I 13 14 16 17 13 19 20 21 22 23 24 25 Jaf£c - Croszlr,oart3Qy 3900 wrvcef with&aw4i f rc.a nicotino in undrbZatic a;s:i n-2vVr i.hraatnn:: physica.i ue:l--©eing. You wxote t't13t 2n Gacxi,aa:z and GYI1man at that time? A That'a riqat. MR. ED:LLi Mr. Eearney+ can we have a copy of that? MR. AgAF'.tT2Y: S;:r e. 4 Z'm referring now to your chapter in C;oodssan and GiZIman I ciave r.;srked tnat tcrr purpu;e:r vf dafea3ar,ts' jc,int: t•ria.1 exitib.it 2276. A.nd, dnztar, i'm yai:aq to aik you if tOiw i4 correcL: '~nete is ur,;.c:rtaartcy about wiia: factora are 3ez rae dtop ba; lc. I:,ava tO rea3 tha a51e:ti,i Ct:: .th:it. "La6i~ation or the U_,0 of tobacco Mai be f0l.iowea by $yi)dCoi:a+`'..' In your view Ltiat.#~; cat'T'C3cz? A Wny don' f we go on and 1111 iook at w'uat you've reaJ. Q '-But it vz:riea gra$tly f roA person to person in intensity and in zpecific ai9n.: and symptoa$. There ic lrtncerteinty ibout what factors are responsible for its variabS3ity and virtuaiiy no information on what 3tvels of eupozura are required to induce phyzicel-dependence in :uan." You wrote tnaL in Goo3ua.1 and Gil1man in '£:~j cflrrect? PEi:TaL.$s T. Lt.rIISj, L«i}: & JAANUME A. C:':?L
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1 2 3 4 5 6 7 a 9 10 3 1 12 14 15 16 17 iit 19 20 21 .22 23 24 25 3a;La - Cross/Keazney 3301 A ;'d rat.lzar rers3 what I wrot,e myiel€ Wfora Isey ye~;. xiIR. EDLLI',t It I may pa;,:, thiE up to tae Witne3t;7 TB% COJR`I': Any oajactior.7 M.Ft. RFxiRIM"Ys Not at a12. TH5 C+3URTa All right. MR. REAR:~'~Yt Pago 557, left hatad colu=. paragrapa. A 557, iast paragraph? Q CQr re-.t. Ldst A 3ey:.rxnarz,;, "Aizz iiic context of iormal ce:iaatian pra3ra:a %h-a uL;a of ;;icoLezx (Ju4, now hvai.tabla," that's the ,ia::t p:zragrapl: on page 5:,i. tj,~V,: a--- zraC We reading i°ram ir.a z;;ao MMc a L ti ~1 A I ti:3T1'L Ce3i. Lttttw cozupare dociirnamrir.:3. ~ ?br, c6e ;:ar;~ paragrapl; iz, "Cazi3aLio4 iro:a u3o af A No, LLIa;~':, in Lhe mic33ie3 of ~.ha coiulan. Thir, 1z trte whole page. This iis the 1ast paragraph, this ia tht last ~0 paragraph on the tirat column, Vt 4 I gaid last paragraph lefthan3 side. Tnat's this ; paragraph. ~ ~ A Firut coluwvn. ~ 0 We gott thaL- stralgn::, The parzqrapa .t:~4L begIn=; thw way I jut'L rgad it. $k.?YyLIS T. CSR & 3OXIdiE P#. E10i3.~'i"i`O.Ir CSR
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Jaffe - Cro;w/g$arney 3342 / L 2 2 3 5 6 7 8 9 10 12 13 14 15 16 17 18 ls 20 21 22 23 24 25 A '11'iiaL's -_ yrTu r::ad 1C a3 it t.73ii~: writie tl. Q ;iZanh you. Is it cvrrtct t4at az cf 1!~35 virLUUliy no intor"tion on what leve2s of exposure ara rer.~uired to Lnduce pkiy4ical dependence in nurn? Iu that cc;rrect, that there wa3 virtually no information on what 1evel& of exposure to eiqarette aooke Yas reguirod to inducQ phyjical depens3ecxcc? A Y iI tC, L C:}:3 C. eV- 1:3 k':1 i C 7: 1 i. W3:; Wt.~t i. f.t ri . 0 i:: -1b r'A iI%-. ,iw cor rewt. Ke iiad sji:e ajca of tapp: rbut WZyD41. .Yi. Ch%Duit#At#L ita1~3 .:ia.4.U viri.uCrlly xn4Swil• If .L ha1.i 1NJ:i.~ u~ace IWoul3 say we dori't ilave any idaa ot now iitt,ie it tit}~.eL'r. rAie, E"iCi;a?`-.'- tl:ai,: oE ilpi3C:r e.LL1"E.':~u:i, k':..'i:. tt i.aike:i. You LaYe to read ;.lie wi1ole chap'6ar to Sel an icli~3 of what we k;t~yw ci how 'Lit;Lle i:: taKti:: 0.4% zor~.~h:ae, ft~,r 1itiae it takeu of -baibit.arate~;, Now i.xttle iL• rakcs to induce with Benxoclimzepine 0 Doctor A -- biat witb reOpec:t to tokacco, correct, we really don't know about inducinq the -low lave2s of dependence. rn that aen.,;e, i :'s correc;:. ~ ~ 04 Q If you follow the top of the next c:alu~Dri. U1 G.~ A Yea. ~ N P?I1uisZS T. LD4I3t CaIZ 6 JJ-V:NZ H. HJJS-20`:I, Ca1R
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I 3 4 5 6 7 8 3 10 13 12 14 Ia 16 17 3c 19 20 21 22 23 24 Jaffe - Croz-a/tte"rney 3943 Q you wrote, in Fsome ca:zrtz; it iG uncertain whethar the gpocii.c probiera re,~re:;en;.~ an effect oi withs3rawai or ~ rwturn to the otabua quo thrit ezizte3 before thc: inciividlial stextrr3 au2okiag. Isn't that correct? A Correct. Q And you are sti33 Qf that opinion today? A It is true in gome _ca6es, yes. Q AL3 rigbt. And that is, that you can't tell when you iCdE.' 'n"?'mptou.;i oCQJr aLCe: k;ad"at'a'!e. st'.7i2a c,Ttis~i'sF)C] W(~:~.~1EI' .~T It13i -ia3t iz cataa"'L Uy (}tty:iica. withdrdwc+~.' of the t2: a~ nicotine or waether ifi :a siFaply a return ta the Etatu3 quo, the way che person waa uefore they atarcrd siao'r:inyi iwaTr that riqal~? A it1 scvae Ca.3O:.; ::ha:: iz~ txuL°. Q In 6umrs caae::, sygiptozis that peopae repart a'r'ter tnc:y b;.oppvJ sravkiny cuulri zioply bca the ;eauit cis f:ustrati~)n and bLiisy upaet aboU~- giVin9 Up SOMLti,ing taac tMiy uave u;;Qd frequentily or yivinq up, az thcy 6ay, an object that they like or thatt they wnnt, #.zn't thati correct, and not of anytbinq that they want to do with nicotine? A DiA I Write that in Goodawn snd rillmar%? m = Cn Od Q Did you write -- 1 ~ A It -- I don't dis4tiree but did I Wr it$ .f t. W Q Goodman -and Giiiman is very lonq. I don't kncw srae:ythiug you wrote. I am nut uaying yuu wrote it. A.:binq 25 P:1YLL.r .a i. LEc~I5t CSR & JOJ1NIrS i•i. BqJST'0t:s CSR
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, L I 's 4 5 f 7 8 9 1 0 11 12 13 14 16 17 1a 19 20 21 22 23 24 2s Jaffs - Crd3z;/gearney 3904 yoa iL" it's correct. A Zi you ws11 r$ztate your queat«o1z, I will. txy, to be re5ponaive. Q Isn't it also cor rect that symptona that people mwy report, that they teel when they give up smoking, could be the reau3t of fruutratinnz and feeiings that they have about giving up any ob3$ct that they 11ka, or that they have uz~el for a poriod of time; isn't that correct? A Sow.c of ZaEe sjts~JGGi,i:i are ao..~@ztzae:i b~.'£rl ti1,ii3li ridYe a r3j?cLi;.ive bt:havioz iritexZU~t~J. So=. m»are are w:ten usua21y zuure tran:i:ent3 wt,en yju in:erxupt behavior than you ae~: with nicUtine: but in some --- to so,uv uegr$e, you are coz'rBCL•. You zozaetia3z sez itriLaL3+ ity when yos inLe,•rru~-A: an ortgoing beiiav,ior. Q T:)Q1ieve you t.e4rifies3 un direot about .tioavch1rig ca4~.Le3 D3r1 Ill R. Yuu ere 2ami.:.iar witiz Laat tArm? A i a;a faiui.liaz v+itt) the tei'ai. Q That ia the Diagnostic and Statistical Manua2--- I always wiii have trouble with the rrord --.III R, aeaning Revis"? ~ A Revised. ~ ~ ~ Q Cata: out in 1987? ~ ~ A Ye3, ~+ Q rt was pit out by the Amer.Lcan Pjycaiatric Asaocia;:zon? P;tyL~.I~ T. CSR JJaAtya:: M. 1IJU3=u, CSIR
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3 4 5 6 7 a 9 10 11. 12 1 13 14 i3 IG 17 1a 19 20 21 22 23 24 23 .?af £e - Cro:WEearney 3905 A Yez. 0 I aZ going to show you, Ucctvr, ustatcm<nt co.Main:J i.cY DStI III A, wi;ich appe;trs at Page 1350 of .D5t: III R. S_area, in any given c4se it is difficuYt to diatinguiah a withdrawal affect trom the axargence of paych4logicai trait* that were zugpreuae3, contro.Zier3 or a2tered by the tffectu of nicotine or fro:a behavorial reaction such a3 fruatration. Do you agree with that s:ta4esrsn:.? ii I ihiai: I wrCiCt.' `.t. Q Jo you agree witZ it? A Y4 ~;. Q D;7 you :,ti3:l ayreo wztt it today? A I ttrir,k we Ju6t agreeo Witr; it in the previvu~; patcagrarn, ycx:,. 5x~.' Cf2ue:; aLe dltficl:?t to fi,eil, you hl1CWf WAa: thu nri,ins oi a given Sympt-on are. Q A r.ith.il:avai :;y:apt-ola r-nat is rejpcctrj:l by a;Wi.:tL:.• couici be the rezuit vz -that parzon'a juLit fruz;:ratio:, over giving up a habir= correct? A in the apeciEic case that particu:ar aymptom tbat couid be, yes. Q Isn't 2t carrsct, Doctor -- withdraw it. ~ ~ You taIke3 .,ibout the etfect of physical depanuen,:ev.1 on Ki:z. CipU3.Eoi]L4ts ai3ilaty to szvV ~~ak,ine, an3 you ta:.k+: a.baut the facr, thar- she was phy:ilcali}• depandent, ba:ied i:3 W1 PT-4i.JU1 1. L..i4ZS, C:3R « t.iVANIYa L'+{• fiJi3:37 '.~:~/ V~;R
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z 2 3 4 5 6 7 8 S 10 11 12 13 14 15 110 17 13 19 20 21 22 23 24 25 safie - Cza:,3/Xuarrtey 39U5 your view, ia part at ieast, da the part shg witt,cirbxal ~;y°'wp.om~; when she stoPaed smukint,~ in 13031? A In parl•, ye,z. Q aren't I correct that psychiatrists are of the viaw that they don't know whether or not, and to what extent the witbdrawal syndru+ae affects soxebr~ly's ability to stop smoking? A You are a5king -- the way you asked the question pL'i7i7..~b'iy 8iake5 iCt iz;,.X}3Slbie to SI3:~iic:t . 1 caz sake it ea:;istr. Iwii.i :i:3<ia you anJL'acr staremcr2C in tt.2e i3ia{3r1G.S:S.c S1:at.is3tical Na12ilAi III, Ze':::ic:i~ Page +51. Cr,M~i ica:..O:I3. i'xta~.'thei. severo ni.::utine w.it:,riraNal d,:.reaseZ ttte abil;::y tQ or reiaaY7 abs:inen:. Xro;, t3faokfncs ii: Linka,~ow n. Ir, that ane oz List; se&tu~n=:> tZlc7t yOll draztc:3? A No. Q Yau undarstand that that sLatement is conzained in the Diagnostic and Statistical irlanuaJ.. Correct? A I didn't taca11 the vpeciPic 9tatamertr, but, you knov, I aaau" that you will be able to demonstrat• that it is XQaiiy in there, Q You don't icnow -- you don't know wiie~aer or not t.i,uL afi.atelii(LF2Lt p$ztuining to :i';:v@ra 121Co;:inE' S.'1.t}idC$wa;t Pi3Y:,u1S T. LE',M, C'S:1 & and it3 i 0; sSi1L 'r{, H0U.1:1112X)•I, CSR
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1 2 3 4 5 6 7 a 9 10 2l 1 13 14 16 17 13 19 20 21 22 23 24 25 3aFie - Crd:::.lltigarney 3937 effewt on an abiiity -- pcraun'3 abi.i:ty to stop zirao'r,ing. yOu d0n't; kn&.t a.i* you Sit hErr, WFaBtrsCr Lhat is in DSiz rII Fii A T1aat i$ what Isaid. Q - ©kay. MR. KE1*sR!,*1"i't May have I approaoh the bench? TI3Z CL}L'R'Z`: Yes. Q I a~s shs.aing you a co7y of the DSM and Pags 151 and direct yok;r 8L'Len:.iOn i;a the to~P oi t:~e P49a. A {gltrie::; cfimpi2ez.1 Q Can we ayrce tii";. ti,st statement ia cOn~;3irreca in the Uiaqno:;tiG ansi Sta;.izticnl Manuai.? A NJw 1d4 Ci3a agZ4.'C`s ~ D: zd yo;i participaLa Sn the s3ral"t:.ng of t.izzae tl~g Diagnoutic ai,: Statistic:ai. Kanua.t? A I parLicxpa-6ad, Q ok4y. 3.Z it your testizony ir. V4s5.• vU4{l. 'JLC. Cipol3a:~~'~ r,;.cotine witbdra+wai, in your view, decreas&h her abi2ity to atop amoking? A It's hard to know the contribation of any ont factor :n a apgcif ic caee. Iwoitid have said that by 1gS6, at the time this -w,d:~.drafte3, we had abae reasonabiy good evidence thet wrxt.zdrawaJ, does play a role in peap:.e's caisecity to xtu-) and to rgMain abatinent. IVould nct agree with it. Ps3YLs'.IS T. LVlS, CSF; & JOVN'?7"~ ti. HOUS:orl, CS ;
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2 2 3 4 5 6 7 8 9 io 11 12 jafLu - Craas/i,,$arnay 3903 1 tih 'nk tYat haJ Ibeen :a-sro ac-ive, izicbt have been abia to petauade tYre ccr.r.aitrge that that SLaLeLaonr i:; an uszdrar5tat•emvnt og wiiat ia linowil. So -" A I am stating in g+sneral, wtbatber niootiAe decrea$es the ability to decrease or remain abstinant I don't tbink thac ia unkncrdn. It is sti31 a valid ctatement. Knowier39e develops all the time. Talas"e Fiify. now a ntLYl~eL Lif St.1.Sd.lE,•:a 0:'! +.ie Cc3f+,dC7,'Cj of 4u'Di:.itute nico:.ine to redsc:a zelap:~e ana to increa:iia the ;.ikc1,L tao~ ~:.hat ivup:Lc can and will strrp arzd re:aa-in ab4tineat, bac you askeci ute a mo:e specific questaosi and ;f 1 13 1 you repaa~~- it, L .14 is 16 17 la 19 20 21 22 23 24 25 Q Nj7 qi2est.1t4Ti 1'u LCi IFtake it C.Zes1rS Yi::3 :ai:iaCjree id.1,t:2 t.CiaL wL.d:.C~'~'@i1L S ~ OKay, DoLb'-.or, peoaie caa functior, wt;~.i.e the-y arQ quittinq sLaakinyF S.sn't that tLue? A Depcnds on the environmental demands, They can funation. Some are impairtd, depQndrng on the detaaneis, but _tor the most part, the $n3ver is yas. p The parsan who is stopping amoking can go to work? A aepor,ds on the taak. The answez is yes in ffiost Sii~s3Cioi13. 117Q.r.a are swe s.ltua.i(7ri-. wneaQ i1 tie'JU1d not watlt PrMi.I6 T. :.F":;=..t'i, C.: R 4 .7rJr'1,Py«i'". F'1. T•.~.:3r C.SFi
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1 _2 3 4 5 6 7 $ 10 3:. 1^ 4 13 34 I :i 16 17 it! 19 20 21 22 23 24 25 -.;affe - L'r03::f.;earney 3909 so2cbcdy to work arid itop 4wa,ciny. Q A person can dci.ve a car A i' e::. Q -- vAen they stop amoking? A Yea. Q Tbere_ia no law against it? A bto. Q A r3oczor can perform 3uzgery xrh;.l e':ie is stcspping Quz rect, ai tEZ he baa srapt;~vd u.aokin; ? A I rvosidn't wani: niz to ogera:.e on ae. Q Tttere i:: no iaw againz;t ic. A N3 law aya:r._-t operatinq on peop3e w;ae:i you ahave i;topped tanir,g uAr01ti ur aico:oi. You can go -- everybody can ba o;1 wirh:°.rawal. I have S2eri and hCares of thoae r,tcr iev. Bu~ Lhe €act of the matLer, there art atorie:~- of tne doctors baakang becau.5c rhs :y -iicwe not ha:Al a drink. I have not p~:~lcu?~~1y :ieCal if f b;t L .T, Cle'.ii rCi ot 2:. Q Woulci you rather have an operation from a doctor wbi aa-, atopping ffimoking or a doctor who Ya3 in alcohol withdrawal? A I vou ict tather not have an operation f rQm-either of thoue doctors. 0O U1 (~ i3ou.~c~ you xaL'ner ihave your taxicab driver to be bo:~eLodv~ ~ rrlc) ia etopping aracl:ing or ane wuo 43 in hero.n rrith3ravall ~ ~ A i.3 New :'ork? PiiYLLIS '"'. LLVIS, C.~'iR & .301.N2r M. H0Uu Oi:, CSn
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.7afiC? - Crtlii:./:Q."irae]I 31910 AiZp.,:3c te . 1 Q 2 3 4 5 6 7 a 9 10 12 1 i. ia l.C 17 2s 19 20 21 22 23 24 2s A St~>p,4ing smu1~.ing make•.: pevrie sngry anJ irrlLub1e ar+d the LaXi drivOr:~ in t;ew York are so angry an3 i:r.LtabiE. I am nat svre. I have to think about it faz a while. I aan tell you this -y- Q Mayt>0 we wi23 g®t back to iL. A Fine. ~ Yo4 ha:re at.ated, thQugij, in your writ ingz that the C' ypi:. e; . 3i 4ImaCl s i,i 't.' X zi't.'::: e1 f, =,.c1C. A I niiJa':.' bave :~Iaj 3tt t>"e P3.3Ce, Y0:.a. I h.1JE: tJti~:MJi ft 61x,q3::I vf t;::LIG:.eu. 0 Izn' "6 ,i= a iact. thaL V.a. CiP3ila:zC':; fai.,l,iy iNC:1.:Jei .~..~ ••••• A yL,. ~ -- m'.q:3t I[`.7i: B1Ttia i c"tve i36~if.''rva-3 Li)'.' w,LL.jaJruK:.i ::WIL Z.If: r0lays:d tu yuJ in yOur Intez ;rir-eu Wir.r. :-tar T-:31= uilQ sa.ild siia had in "aZ? A Z think that is probably trua, yes. p They aight have been ao mild that nobody observed it; isn't that r igat? A b}o. I think that that is really not right. Let we -- but rath$L than beating around wi;;i3 word gamea, 3et ra° 'EQy that the;~e aie subtie, they are not dr3t astar.. Tlaey are d.iff*-i.ca~ t to de::lac:t. P::Y:.;ji:3 T. LE'41S, CSR ,fr. JOA.tiFE Fi. L'~t a"T J',~, CSR
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1 2 3 4 5 6 7 a 9 10 I) ~ r: .~:1- 12 14 15 16 17 14 10 20 21 22 23 24 Jaffe - Cro3Li/~earney 3911 IF p€3pie --tay quic:Z, you don't knov t'tJey are irr,t4abie or may not knoya they can't concr:ncr.a,;o, but tL,eir iaa,ily mwwwOzs r:ight not have notxcad s:ra ha3 any withdra4ai sytaptma at all, yes. Q The duration nf withdrawal ayzaptvms iu really quite ahoztar thun those that are custo.Taarily assoCiatad with hsrain, e2cohoIl and cocaine withdrawal; isn't that riqht, that you ta!ked about on direct? A iI dJ ns i ti t3 i 31 ri ci o. Q Azi I corre-Ct or 3Q you aqree srit;: thiL star-eujenz. in Aa. E.:3i,LL: s`>3}v: Q Mit. XEARZN~ :;Ys Page 150. Q llO y,.~!j s16-il1 have rrc bocY,? A `1 e3 . Q The 6s:;l:`sK.' 1:iC&rcivii2y 39j3rlc3a:.L tci lbach a t'1ea2k VltallTt LilE'.' firtit 24 haurs aiter casjation oZ tQb4cLo use? A Tsll mst whare we are on tbis. Q I will try to, althovqh we have not had 8uccesa in past. I will point it out to you. A Middle? {~ Start az the top+bf tbe paragrapa. A Okay. t r.e 25 ( Q in many i:eavy ciqarttte3 ~~aokar:~, changaz Ln mood ar.,3 PI3XLLZS T. LEtiiti3, CSR 4 J4A.PyitC !i„ H:):1SOTONr CSR
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1 2 3 4 5 6 7 a .9 13 11 12 I 13 ~ 14 35 3s 17 13 19 20 21 22 23 24 25 Jai:fe - Croa4/Kearney 3912 pe :for:aaace that are re,atel tc wii.ta3rawai can be de;.eQted tiithin tuu houra -afteL the Iast toi:~acco ur.e. Tne benae of craving apj~aars to reach a peak within 24 bours after ceguation of tobacco u:e, and gradually declines thereafter ovar a few dmys to several Keeks. In any given c.auae it's difficult to dictinguiah a withdrawal effect from the emergence of psycbological traita that were suppressed.* controlled or offerreri by the effecta ol nicotine or fro:~ sa iaezavioriai raa(:cion froz tt3a uL't a t:ei ~afotcer. Mv qae~LiviI i:i: DO yuu ag,ee w:til the ~itatelaenG t4ac: the senae of craving reacheu a peak rn 24 houzs ayter ce,3L~aticn of toijaLco use and than .3ecl.tnaz over a few dayL tQ bEVeral wc:ak3? A i think tnal. . in tY,w averaye cazie thaw vouLd oe a tra~.y btateoenL, ye:. Altr:ough craving can bo evoka.3 by ccrr.d3.tion keyy in the anvi ros~ien;:, riocyn'r ZeLn cravir,g gjt:-~ away. I tbir,k =tbis is referring to the craving that ii, a mnniPagtation of nicotine witndraval. a 8ut you would agree that tae worct effect ia over in a few hcsure or a day or ao and the effect of withdraYa]l ia -atmo6t entirely over in a few weeksf da you agree witb it? ~ ~ A I don't know what you mean by "taYe worzt ef£ect.' tlha:: ~ do you mean? PHY'hi,Ii T, LxMYu, CSR b ;1qAa«L' 14. So~ai'.1' t7o CSR
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I 2 3 4 5 6 7 a a 10 11 12 13 14 15 16 17 13 29 20 21 22 23 24 2S 3913 ~ Vt:iataver the wa: ar. etfects are t.hat A persWI Vouic3 17avcr when v'hey Ztup umokiny. A Tne worzt effect -- Out of -contest 1 a.ra not sure I knW what it Moana, 'the rrorat efE*ct.• 0 :*r u3 talk about your testicsony with rtapect to btooe Cipollone ancd phyuicai withdrawal aymptoma. You c-annot aay, Doctor, that Hrs. Cipollone wa.~i phyaicaily dependent at all time3 in her lifea irWz thaL rig u~? A 1 Car;nvt ~iay W1tb d.roc:t evrdQnce. There abvi~u.::y :~ sow indirect i:ind:: o€ tair.c:r. ~ 5o at rany partir;ular time say in 19F1, 3..959, yau can't :xay tizau Cipv:.ione wa~i phyL-ica:c3y dt~peadan:z at Lait parLacuiar pairs~ f:x tirao irt her iife, ca:, yo•a? A You c4rl oray infec it f r o u other behav ivr6. You ian ~ c d1rQwt1y. Q In f,3Ct, yOu Cc3t]'t ZLi, CiDIs. .iiae w,, l7.Zl5ic :iiy evaa at raozt ruxn4B 4a.a her iite. You can't, yive us tbat opinion? A You can infer 1t, You can't shov it dirtatiy, Heaninq, you csn't indicate that ahe had withdraval symptoaa once a week. Q NoW, dcctar, in -4iddit3on, you can't say that Robe Cipolione fexp^rienced withdzawa.i Gymptom~, from to"cco becausa of u: e of tobacco? PH4'LLIS T, hX;Za, CSR 3t3A4Nu X. FiO.3ST.}t., CSR
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3 2 3 4 5 6 7 II 9 10 11 12 I 13 14 15 16 17 13 19 20 21 22 23 24 2:+ .3aCie - Cros:,/Kearney 3914 A Are you -- tttat's a queatiprj? Q AL any ti.,Ac- prior tU 1931? You cannot : ay t~iat she hed withdra•.`ai ayr3i~Lom3 a:: any time pr ior to 1931? A I think that a clinician taight make an inierence that ahe had sr,za. i can't r.tat.ao with a reasonable degree of cartainty. But I can't stata that she had t4a whoi* rangr of withdrawal syraptorrs prior to M1. Q I t3uew.; I Mtgnt have Miscod tilat. what iz it you can't state? My queztiUn wa5t You can't not zay Ltat I;c~c Cipos.~cna':: vrithdraual -- ext7eiienced withdrar:ai sy=:aptc:az at any t:iza in her 13Le prior to 1531? A W311, you knjrw, you keep ja,ing tha plural, N'ow, sone tainr , arauny those Sy2pto= _are an extr€me crmving. Tuat can be a :;y4P;:OM. 5~io Uaa tua:., you know, fiozi to Li:ae at vttrioua pointa in hcr awvki;ig hi:cto.y. I think you can Zake ratzuunabie in4erenccs froz uome of things she did say. Q What you're saying is tbat she aaid that in your iatrrrvi.w with her, that she craved cigarettes at variou:: pointa in time? A And she bahaved as if nhe haQ* an urgent need for cigaret;,ea. She did th.tnq:i that suggzsted it wazi zora than Iuz~t an occa yronui cigai•eL•te for rciaxation. She touY. PI3YuLIS T. LEiiIS, CSR ic JUAt~i.::; t4. ti„S.%,
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2 2 3 4 5 6 7 8 a Ii 12 I3 24 15 IrG 1^ 19 20 21 22 23 24 25 Jaf'fo - Crrsa5lKearncy 33:5 cigar2t•te butt~ oaL oi' the garbage to jrjox:: tiiya• a tlhink a ci7.13LCiGii'I i.nf'L°r tl3a:. :,33e h3:5 1AUTe :.h:n t~~c average degree of eraving aad f:Lat siio wuwn'L 3;~iny it just for pYe"urab3e ralaaa: ion. Q An3 sae told you about taiu buzl,naz3 of taking a cigarette butt out of_rhe garbage can in your interrriew with hcr in December of '83# which rss after ute fiied this lawaui't, corraizt? T ::s:.;:, LlraL.. Q And LFlZt lwda t.:,'' i2?t',.eL'v'seY: k'2t#'t LSS2 ic7!'viyer:. t?:'L°it;s i;, CorC'eC16:? A tea r 2 t"knci yoQ don't kncw ho~e zaany tiwes un,3 ijid tllat., you? A a.>, ~ 33a':.. iT. ;i4vG~ D{:(sn on.:4 VnLe? .~ Cou..d tu.Ave bee" t,niy ianve. t! And l3at7ii;C ye.~t3 tG3::itiiy, i1T1 ..t<'=)Jz;1t1U:! •••' Page throea' KFt. XBF.R~.'~I: -Fsga 355. ~ -- in answcrr to tbi3 quastion. •Do you know of any otl;er ocaasions prior to 1981 vhan you would tastify Mra. Cipollona sufferad from tobacco withdrawa3, syndro;oe? *AI45'4:R: t3ci: There were none where I voU:d b~~ willing to tE,3;:ify for certainty that she experiencea tobacco wit•ridrawsi ayndro'ka• ? PM:;.rlYS T. LE~ZSr CSR 4 JOXiN:':i? ~t. fs~La~i~i~I, CSR
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i 3 2 3 4 S 6 7 a 30 11 13 t4 15 16 1? 19 20 21 22 23 24 25 Jasfe - Cioss/Kearney 3916 r/;..r.~ri.or, i:1 {r&haV yvul i.eatZiaony Ladaf? A W0il, i ir:a t, 3et rae x esd tr,st and then X' 1l -- i t T tai~;~y? Q Surely. A Thank you. Q After reading it, dyCtor, can you now question, is this your tedti.mony7 an awe r my A Tiiat ia ray te.Aimurty then, it iZ My teat.ilaony nc>v. # T'llank you. FY You +;eep aakiny tn+' qutzt.toEj jynjrorae, ~~x~.ng ~t up ,j:th flli:t e.ie;~SL':2t of t27t~.^' ~ f:~<IL "JW1C, W;iCil 3"-. 0C+'1eit~3 C&-Q'Ji[l~. W:Iac i:34+-J after xhJt i:: :c y4a ;wz' 1dLerC;ICe ba:;@d or. With Qtlaer Um'Oker's that Ihad th'.;) Gpportuaity to talk aGauL other L;yMp:,=~; that she uaVO cr,ad S;; >so~ezi;~:r, I Woua:3 have perhap:~ eifrited an3 vith :;oze .LI~E: ~ l!'~{3G': L'd aaC2 T aclMC f3f -f3e UtiG+Z C1~.'QG'ilt.;'. .'3f L:utt You doa't have the syndrome with one symptop. Sdxever, one symptom can be u3ed to make inFerQr,ces. And I think $he had that kind of extresae -craving that go$a with --withr7rawol, rather than with seeking of the relaxing or more OD ~ refnforcinj tffeLLz of an occazioaal cigerettea. That's ~ CJ'1 W what 1tried to usy then and now. ~!t Q But you had tiia opportur,wty to ta.&;t; to har, yoj PUYLL1S T. LShT1N, CSR i 3'~A~3iw~ M, WOJSTON, C3a
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I 2 3 4 5 6 7 8 9 10 1? 12 1 33 L _ 14 15 16 17 181 14 20 21 22 23 24 .3afft - CrasalKoazncy 3917 :n"CrVieweJ bet? A I dida't have tPae opportunity to gu back to tht dsy wnare uhe w4i taising the ofgarettes out of tiaa garbage an3 saying whaL e1aa did you hava? What other aymptous did you have? Q Sut yov hoa the opportunity to ask her, she wau there? A Yos, I did. Q In faot, that wa3 your jQb, wasn't it? A. I dvn': know th3t it Wa;; my jars tO ye;, ci~:;.sAi3.z csf aing:.e day of her life. It cirtasnIy $eema like you war.t ma t:, beiie•Ye it uas iAr job to go througa *very day of her iite. Z uaed an and aquar;:-or ior w4liat uzualiy .take:; ton iaittu`Zle-;~ anJ i tnuug:zL at a yood jc:ib. Ooviouzily, I wuu.id i:avc: c:onc: aetter with fi.vL ciays of depozitian. I didn't do tha;:. Q Doctur, i4 waz your ja!~~ to eiicit withdrawal symptozz f ro~~ he.a. Cipo^ ioac? A I appreciaie you toiif.ng me luy job. : did the interview. Q Yr,u var* Qslcod to give an opinion ahe waa addioted, -weren't you? A I save that opinion. 0 akay. ~, Now, sija told you in aecerahar tnat when &,hr 25 1 ztopp-ad smokinq, wtlioh va:s a year and a ha3f or tvo yea::a Pi?YLLIS T. _LUiSr C;.zI: 4, JrJAi4tq2A, PJ. E~ 13iJf:i ~.: i2
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1 2 M s 4 5 6 7 8 9 10 21 12 14 11 16 17 3b 19 20 23 22 23 24 25 Jaf£e - Crrrzsnearney ;918 ag~, t2~at ~ac; i0ic 1asj c;a.iuz than ubkal, i~:ta s,ad inner tonoion, .;he felt yraraY,y and sbe feit irritsb+e. Ic, Lfla;; riqnr,? A I think abe gavo ma some otlier tbings as well. Q What other things? A 8ha3:1 ve go over it? Q Tel1l me Wb3t other tbing3 she told you. A Are yoU tQ3iiuq me that you gave mv a eo;apltte list? Q WEiai.: ctze: tahing: did vhe te1L yos t:zat zY;,~-4 ie.ix :n lga 1, wnun Z:3c stuppe:d smuKirig? A a'ii get ay nctoz~. ~ Let`~u raakL it clear wisat we're lavki.ny ior. What otha: withdrawal .~ympt~:; c3i3 aze Way z;.<< felt w: ;kn -S:,e nto~lpej zMvkYno3 in 1931? 'N wt}.l, tbart waa crav.ing, tLare was, sanae cf laas tl.:.a b,:inq calo, inab'.lity to concentratQ, fealiny oi f.uZtratifln, dizc:ontent, hur.rer, ox t•hinking abouL c.igace:.tez more tnan u~.:ual., Fiu4tazy feelings in your cheut, 3tunger, moxe craving, -minaing a aigArette, irritability and anger, so there are a few. Q And you determined when she eaid _that to you that that -- all of t.iiose rhing~- were caused by her stoppir.q smaking, is tha;: -corrQa., and were witUdraws3z syrsptozz frflra her szokinij? Tz that right3 A S:ze 0aad that in eactz of ci.osQ it':i co:a;,)ared to the way $iiYWLiu T. 1,E'rTI34, CSR & JCFut: 2 t'I, CISJ!1:
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I -2 3 4 s 6 7 a 3 10 11 12 1 13 1$ IS 3s 27 19 20 21 22 23 24 25 Jafxa - Cro3s/Zearncy 3919 that you uaually fe.it just #seiore you stopped. vid y;4u feei izor* of thoae? 7nat'a th: vay the queationz are phra;.Qd. hnd Iriade the 3nferenca that raure likely rvan noZ, giveii that patterzs, that they were probably Withdrawal symptoaa. She did say when I amoked a cigarette I felt nort ca1m, le.!5ri grumpy, which is usually a kind of indieation that their raspun:,ive to the nicotine arid tobacco. Q W,0S.i, dGC:.CU:, IJ4;;L it a corre: L tilia;- ya;j d.~.n't kn~u fl;2Ci.Ac:: Or nut sae was riare grumpy as a re4uIL -- in 3931 wiler, :~iie zt8ppea sa,okiag than isha waz nornaliy qruiapy? Zan't titat ziyat, you dirin't anost that aL the timc you fnzervi€sved iier an;3 -.cams: to that apin+an? A ;:.e way you azik the :Ju«cian ,ir. compaLcd za --iie way yuj u;;uaily -are, wiae.z you atoppeci, were you mare lrri;:abie, Ware azgry? :"ia a a a recor::1%-.ruction of scarn.-at;ling a yaa: bL>zora. A11:1 z;.~F; jciiil Siae wo:.:; 3aoXa, b:4i;f.`d .`?n ti3o is1:3,Y s:23 uc.ualiy falt, prei;u,.~ab~y, aL tiae txme zhe stop,ped ;i:aoking. XR. F.SAMa1"Ys May I-hava a-aoakent, your Honor? TBE CAJR'P: CBrtaitxly. (Pause, ) GD ![1t, RS~i~Y: ~'3Z ra$e if I can get it iater. ~ vr ~ 8y `R. W CD 0 You were no~ aware at the tir2a you ConJsLte3 the P~dY2,,~.T.a~ T. LE"ri'IS, CSR & .34r'~:~=~I~ 2'i. R0JS202v, C'S's:
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s 1 2 3 4 5 6 7 8 9 10 11 12 13 16 10 ls 19 20 21 22 23 24 25 Jatze - Cro;;:./Kearaey 3923 interview that Nis, Cipo12oi7t had bee:j utldez 4:,e care ot: a Dr. LOa for a ners•oua zond.ii:ion through at laa-or Ap. ia, Juno of 1931. Ian't that rig:it7 A I was not aware at the ruae of uy diagnosi,s that she Wa~; under the care of Dr. Lee. Q At tha time of your diagnosf.s you were not avare of that. you were aot aware also that she ha3 been receiving mLJ2cat-iail t<t: S2eSviuSF'tc':i;i3 YiG%z S3r. 'uowti,.j`. 1.:iTI1t Lit3t ~v ig :iL? A i;aas i'i3t awa.i; 6hc: wa.; ..xec:civ:nq sae;lic:.tir,n at thta t3mo t.hat I~nt6r;rie~ac3 ,er or of tisc r.ime. 0 You were no- awsl-e -- you haci -aaked hcr u:~ot:~~r c~r n~;: bhe wa:; receivilnc_ we3:catsar:.i, ha,3n't yrsu7 A I uyuaiiy do. I do7'rt ror..311 ani•thiny that'a 4ot in Lho re,jsrt ar t: i, point. I;: s:, four yaar® ago. Q Ari3 you had aor Wn~.,tnzr or raoz-she ara:~ ~,C:;inj ~ Ltei'liqai Juti:to- or p~iY'C.Fiia:rii:t A I don't rccali. Q -- at or about the .-t3mo Abe atopped smoicing? ~ I uaualiy don't ask about specific apeciblties. I aak OD about nedicQ2.and araotional probitma. TAer€ are just so ~ many spe4ial.tiszf did you sao an opthamoiogist, ~ 1'Youi08t3rg8aft# I Mig.1t -i(iiao 3oiZ7@tn1tiX. d I aska:a, did you .3.1a'JC9 pr3uiera:; and than if sY,e PHM"isl5 T. LEaiT&, CSR b JvF~ilf:+: zi. I~JU~i;) i;, G,3R
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t L 1 2 3 4 5 6 7 8 9 10 3? 12 1' J 14 a. S is 17 28 19 20 21 22 23 24 25 JaEfe - Cros3/Rearnay 3~22 te.ilz mq about prualQ;zz, I xouid gei,craily fi~liow-u2 and sny, 4ic3 yQu see so;ao.ody? Again# if I didn't eiicit the prQble;a, : dxdai't find nut. 0 WBli, you did alieit trora nar that in '81 she uas irritable and gruffipy and shc vas angry. You juss: told uai when she &topped amnking? A W'bon sho discontinuad the smoking compared to her usLa! state at that tima, r) iuld are you 3aying A Sfle wai zoro irr.itabie,, more an,^ry. ~R. £tiJAI:i.~L: Iwou1+3 a4~% tir. Kaarney ta iet zb4* 1J~ t[ie i:S i Li1-i . t'itte lir4,tuR':;t'.+Vi t iI idUv3toq.lTiQ. A Sne Kaa ai.1 cst those ttinga. Q Yuu novw: a2.kad bor wno;:her oc not Zha wa4 seeing a p,ychiatris;: wifiiiin ten usonti:z lafore fur anw1oj3I1C~'ar' and nerves -8Cej tr:itaililiLYi' 1e 1 Fi5is:j pC3Cspie atoot1C diU1Cultieaf med1CCi.1, I obvfcxfsly asktd ber about alcoholirsm, other probleA3, drin't us7ualiy tsk people were you _aeaing a ps}•chiatrlbt day? Or did you bappan to get your brain operated on. -not the kind of thing you do .in, an interview, You ask, they tell you, you Yiatien. And zincc had~Z't, men;.ivnetd the3a thingt;, I didn't ~ she ap tn say Jty tha~: day, d2d ' V you happen to see a p:~ycrYiatriaL? %o, I uid not, 11r. rA N PHYLLIS i. Li.y9.IS, CSF; b J0,'VU:N' M. 3iJUS-3'i72;, CaR
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r 2 2 3 4 5 s 7 $ 9 10 11 12 13 i4 15 lG 17 1:3 19 20 21 22 23 24 25) JaUe - Civsa/i~earney 3'~'2 2 ;~~4Xr3t~~. Q DocLur, you azkcd 'rirs. Cipoiipav, dadn't you, to reiote 411 oi he: candicIonz, zo3ieal histary, coiaditioni t,I')-- woui.d be relevant, not simply wbat.. she believed rei.atad juat to her smoking? Isn't that right? A b]o, I don' 1: thf nk so. I don't think I did. Q Do you rscall this question being ask+ad Of yoct -.~ G' r,2. -Pieaae. AM. Pciye 1037. Yoa c'i3 aav. Uru. Cipo.i:one, did yaa, oiiiy ~:o roLat-c.a to you t#"4J:rt in her GT&.'cllLa3. 11ist:}a"j/ k:)it:il 1i.)i? bt~'.::ovecy aiqi:t re.',at.o to szo;;ir,~5? "~v;3v ,:~, :s xs3at's curtecL. ~ve~~;criin~? 'Qlj::" 'lIJNs YOu aSk<3:1 tl0r. abuu-~- ');1 ::: IOi:; To tue ba~it ot yuar reLwi~.~c::aoci, Ur . aTdL~:, d26 Kii)C: fi)y,.Antio27 a0y Co.1d2t1A3S WiliCli G:U:".iaeacaj in and CGlatliiiltj YtGrv Z.'l"Urtiy l1T)1.k1 at' 14."azt v6'r,°f `3ii:lrtiy before the time that she had her first lung surgery for which she was under fairty constant trtataent?" You: answer waz no. XR. EZZLLr Did you say 1037? aD MR. rM'-.A.Ni Y: 1037 ailc3 1038, yQ4. V GD LI Q Did she ment.:.oa at any time Dr.Nel,iic Lee to you ? W AS"iaiJE3t : iFi). ~ PI11Lwj.J T. i.z:Y:i;:t CSK & .SOAs<iMr, M. HOU.TC}r1it CSa
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Jazfe - CrosslNearney 3)23 1 2 4 S 6 7 8 9 10 1, 12 13 14 15 16, 17 18 19 20 21 22 23 24 25 wyou do recali you askeJ about: meaicai hi:.Lory xnd tirj. Cipoaoae c3ic3 nat t301`aciur, 5he ba;3 b-oe" under the treatment of ]r. .deiiie Lee? A She dic3 not mention it or deny it either. Q She did not mention sLe vas undQr the treatment of Dr. -:Carluccio up until at Iea: t tsuveaber of 1980? A Na, ehe didn't. t? Okay. You t"k uhat zne said about her nervousnea:: and _;6rritab.:.iItJy jAt rhat inte: view atid car.xe ti,) tiye cQnciuE,:cc] t~Iat 2:2)Z3t. *.dwt: Ct3t1'v"0:e by IYE?f Sto}`>i3121y .~'am-Csiiil'i-> j corL'ti`cL? A No, S.t wd4i nuf:L just hez nervousze~f-4-and irrit;4riliLy. Nervouinez,~, ir t ir,abi::ity, cravin~j, disf i4:zi ty in r.oncentrat:iar, .incrQaaed hung~.~r. Kind of a grouj? af :iyal)`..cmi's l.aJa:. ~2uiZq +...' ~4 LiteG . Q C;.he- than craving/ wfiicf¢ you dtVcrzbaJ aa a want to Tlave a cigarfi°L:.e, ail of t12o~je oth@1 you At'tCfl`:rtdte~ to her "cttop1%aftg ~~Jkiitt3r tlt?'.' .;ilsttlriy A I thc,ugtzt -1t -waa a reai;o.-3.3bid iniorence„ ye4. Q Ac that time i+ou -did uoL know that sbe hoH been trea;.ea since May of 1979 -- we1.i, withdrawn -- since Noverabex 24Lt7, of 1980 thrcrugfi January 2Sp 1981s by E7r. C4aries Carluccio, and that he hed s9iaqnoeed her as having post-traumatic aLreas disorder. YoJ' d:dn't know it at the ti"3 ~ You su!)_-equvritly have .IearneJ xt? rHt1L1.Ji.N J.a L.~~Ir7J.S# CSR & 47QANa:1.i• [".iOVJi3N/ Cil:S
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1 C 2 3 4 5 7 8 .9 10 2I 12 I 13 ~ 14 15 2f 17 33 19 20 21 22 23 24 25 JafLo - Cro,;zlKea:ne_r D;4 Q And tuaL it wa:: his v.iew tbat alI her aym..taw:~ were subzccjucnt to har accidcnt on ?i&y 9. 1979, and it was niw view since that time, ahe had bacome c3opresscd, phobic and anxio4z, had difficulty in slaopSng, sba had an appetite loss, and diffioulty functioning cYSt ot her i=ediate tiove area, were you aware of that at the time that you came to thc cUi)c1uZS.oA-1 t.14C uijaL ,i10 toa.d you in 'Cii Wa;, t~~~ resui4 ~f bc: -~:~akiny? ~ Hnve you e°aee bocozao awar:: u; tbat7 Fx Y(2g -, . ~ AnC tha,,: tcse progno~;i~; waii, far xra. Cipolivna, a-,: of Aprii 1, gu::da3, anci the racoxmania+:.ionj weca conzitrue wicAa outpatient psycbottiara?j zapdortiva paychot1Fe•r&Py a:j po~cnotrr~t~io~. i'7ere you aware oi that ai: 4--:1L tiakt t..T1~t yOU irsterviewad bar and carra to the conclution fbat her qrumpinoss and ircitabiZity vas the reault of her atopping stmoking? A I don't know how to answer it bacauso it -vaun't ju3t qruzpines;.~ and irzitability, but to try not to get into thij~ 00 kirxd oz tKiing, I was~ unaware nf tih:at Dr. Catluccio tiad V tj G'1 written at either the t.irae of my dapo:;xi.ion o: at the ,ti:ae ~ I'IM.LZS .. 'uE:7lS. CSFi 4 JOA{4:i; 9. 1.iDt1O-Z'C1:1f CSP
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I 2 3 4 S 6 7 8 9 10 11 la 14 15 15 ia 19 20 21 22 23 24 25 daffe - Cras::/Kearney 3925 of my r4~por t. 0 Aid you were unawara t:fa;t itl March o£ '81p Dr. Lte deacribed Mrs. Ciyollone's syrrpresm:, froz th:e cac thit way. accident Since Rpril, 1980 she had come_back to ses me a fe;r times. Ser syaptoms remained the sauae, i.e., aervous, irritable and 3epresaed. Sae still could not go out without the terr ib.ie fear uf thQ car. Si2e dlz~v <Jp d'in.'s o::f t3:1.:} diarrhea zacon,3ary to her anxiety. You Ws:e.n't &vdXC: tijuL Dc. Leo nZia tr)st: to s3y about Nrs. 'Ctpolioae in the spring Q:' 1fia3? A ~ Dr. jaffe, I aaaL to read a seck:ioa ui yoj: and 4ee i~ that rcfre4i,e:- your recolzectioa that you d_cl a8~. Ara. Cipu1:Lone in your Srzrerview i£ she lhad any psychiatric pro~le:a:~ va: ore i;topping, 151 -- :;to~). Lng smoKir,q .ir: ' 4 J. 3iu you kncra rxE any prior cunditrona that ane b3d thdt could have caused the aymptomathat abQ zaid were caused by cigarette smoke ce$aation? Anstier s I did nat. My answer identif ieg -soc:e causa, atntes same prior condition that led ne to beiieve thrst that -prior candkItion could oxpiain this -conateLlat ic>n G: a,Yiiip:€1H:3 that ahe r'L'p JL'L`ed MFl:L'!1 -Z'10 StC}ppad $L7vtilt23. QZestion: You did::'t ask her vi:ether shs had baen Pt:YuL15 T. Li~I3I~, CSIi & JflANi1~; 61. FOCiS~`t7t-;, CSp;
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+ I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 -22 23 24 25 Jaffe - CcoualY,earney 5~26 under r.raat;4ant by a psyc:7iatrist in La~ year b2fore Au,u:.t, 1931 fvr atti= corldation, dicl you? An~Jw ar s 1 bo.iieve I anked so;w qsastionz~ re.:ate3 to tbat. Ia that correct? ~ I juat testified to that, I aak8d people about saedtc33 and emdtionml illnesse%, and that is ffiy general kind c+f tbing. I oiD,r:.au:=.Ly ha:3 aske3 iiei abjur aicobaliam and the faraiiy and ber own, but I toid you t'r,es2 an3 ncxw that I don't recall the apQcific kinds of quest;on:;. 1 rarely abouc wiia;t zj~ac:ali3ts du, Yca ZeQ* because people ttavL icrta oi' praa'sea; Eor waich they do not EssE:~i Qfi:he: any tiii-'tiikC3:- he.lj. or thfly aeEA tile iKLO;ig i88j2Cd.; he1p, and azkinq abu-1t apeciuzi.sta doeWn't uften -- i3 nW~ often produc;.ive dn4 it takes time. I asked, do you h~ive arty tte:3icai proble:::, teil Vie about emofi.ional pro:,ic=.:. I do zpecifically aak about alcohol. somatimej prob2eAC, depending $o, I have that you do ask and Q She di3n't t.ali A S4c0 bsdr.'t tel i S-Qven ask if you had any other drug on the patient. not changed and I anawered the Ques :ion not just thinga about smoking and -- yCOu? me. 0 AbuuL CZr1uJCioi P;:YLu;S T, 11Ei4Y3, CSP. L JoF~j:i13 ?j, H~JSTv ~, C5a
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Jaffe - Cro-5zlKearney 3927 I 2 3 • S 6 7 8 io 17. 12 1 13 14 15 3d 17 18 19 20 21 22 23 24 25 A Stie di3a't tell me ai~auz. Dr. Leo or Dr. Car1uccio. Q sll2intG you, Doctor. %;i3t is yozL•-trau;aa'Lic Ltre3a i',,;jndroxe? A Psychiatrfc diagnozis. Q Khat are the symptoms of it? A Varies. Q Do yos know vaat her syaaptoas were? A I kno-.r the symptoias that from my re:oi3+action Dr. st10 ua:3, 3s3Cr$a.ed Qpp4cite. ZnxioLyr difficuiwy ataan ahe had to thir,H rtb3ut goin5 1nc:0 a car. ~ Okay. DQC:LOr', if!'t Lt.a talk a IiLtIt3 alioG''sL DJF1 III n. 43y the way, would art espezt on ad3.iction or toL,i;.co de?endeace kncrw waat tiie p'zrase D.Sa iil Qear:t? A CouId you ztty it Again? 4 F agnc. In your viea, would ;jWzaaL)ody who holds n4"elr our az an expQrt in tobaccs dependence kno%, w;lat *%,.be te,- Da:# I I Z R z+3atta7 A Not necesuarily. Woulcd you like an exasple or should we go through, you ask the question and I will giYe you an ansver. Q Am I Correct _tftaL the tobacco depeadencte and vithdrawal -WaB nOiL in DSM I? ~~ C1T A Correct. W C1T dA Q A.nd it wa3 not in nSM II? .~ PHYLLI3 T. LZWIS, CSR & JOANN-:, M. CaP,
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1 2 3 4 5 6 7 s 10 1 13 14 1:: i6 17 13 19 20 21 22 23 24 25 J~rEe - Cro~:~l1:E~rney 392i3 Cr~rr~".. A Q An3 it caae into DSA 111 R when DSn ZzI R wA3 pabliahed in 1933; i:: that ._right? A That is right, Q And the withdrawal gymptoms that were containec9 in Dy,.4 III R faz tobacco dependence were changed in DSHi III R, which waa puh3ishec3 in 1987; correct? A That ia true. hi1l now 3 lltld`t'.zt;:Ant,3 i.Ilr1:: tne 13LC+ WUciiil:~ on DSa IV; Yz tha:. righL? m . _.: ~~,~~, io true. Q C3:aY. t3:3J @c^3wh OJje 0r tbi? AriltlatZo l+'3i..'ttic.it. Si:ri3t'' &1B©rdG:u o31s?: tiu"3f' clnd t$~`.'tita `LF1$."t. Oltt ano:i"ler t.it+lt' art:: Aia i.LlZ.`. Y3,gfl`.? A prvbaby y truQ, ye,~. Q F'o. eXa;Apit:, hozpae;cuas i ty wau in DSm I I aa ~ d.Laoz dy r or Menw4l c34'Livdar? A Iz$aliy -doFl't know hcow 1ltin.Jk+axu,alty Vat1 listad in DSa-i ZI* Q In any evQnt, it carae oct of DSM IZTs Carrect? A I really don•t know what they did with hnmoaexuality in DSM III R. I knoav there waa controversy about -it and I icno.r that they modiiied the ter2 and there rtts considarable arq=er3t about it. Q There waz controversy. Iz even vent to tae poin;. oi Pt7.YIli,TS T. F,EW.£St C'3R & .3JAtv`:ir:, Id. ...t'aR
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5 6 7 8 9 10 I 3 3< 1? 3C 17 19 20 21 .2Z 23 24 25 Jafze - Crosz/Rearney 3929 having a votu az an APA meaLing in '73, N-lerica3z Pvychiatri.. A43'ocZatlo:Z meQting? fa i e:J . Q 2aay det+erjoinad whether it vent in or out tsased on this vott4 A I am not aure it wstnt in or out on the vote. I seme.:k)er the vote but I don't rewember ..- beceu$e I xaz not on the advisury camraittQe tor tbat. 0 T:ie :.nc3.usion ot t•abacco do;air`..ii2nc:e in :)Jii 111. R~n w~~J you aald? A Yez. Q That was a CaatzL•T Cii CL3ijivtivera}% tG~? A rL 9dit j ti 1Ti3 tt; C:' OLr' Cont L Gi VE: r 311 buL P1 o t c'1m,4a3 iy Q3 t 0i L' t: : pes3.::,iQ 3ift t7` P::-Yc`.L3YaLr.c Q YaFi' t i t a Y2'iwtj Di;lcLoC # tnere were dizj,3utt"c'. ElEiit7nc3 p~y:.aiatri~~~ and clinic:a.rc~:.-. peop:.e wilo treat patient;, p;ijf::alatb':i. CZ ltl~i:icirt~~ over Ui.°. ZnC1Jal,~a of r3ependence in DSM ZXI R? A There were soae peopie who fe2t it probab1y suovid not be in. There were considerably more vbo .foLt it should. Tbere werca also some arquuents about precisely the form in which it ought to be inciudec3. 0 Aii right. Who ~4z-- Dr. Spitzer? A Ur. SpitrEr ia the chairman of the -- guoaz it'w cai_e3 the ta6k forcea to zevxse DS , i1? an3 trie i:aisk force to PHYi.i.If'i T. LE-4ISt CSR tt J'JAIJ:bs 1FS. Ei7~1f"ixUNl Ca:7
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~.7affe - Crozs/xearney 39?D 1 2 3 4 5 6 7 8 9 1 o 11 12 13 is 16 17 I6 15 20 21 22 23 24 ji M revis2 DSH III R. Q C`r,ay. And ai:e you aware tnut Dr. Spitler ::ade thi5 statement __ i3R. EDELLz May we be aern at side bar. Pieaae? THE COQRTt Yes, (The followinq takes place at uide bar.) MR. 5aELb: I-am going to object to Mr. bearnay paradir:g the bt,ataments in front flf tnem, tbr staLe:nont:: of oC.1av poVpIe. 1 ta4n'c 4Z ZIAnk lLlz Zf t~nori i:; a itarne3 treat:ise he want3 to c:z u~~-exar~ine on tciat iz in i4burc anJ he haa to '1ay a tvundatior., Out ae can't bring in t;'t:e rsaaes of jortleoody elje, an unicia:rtif ie:a p:rsion, a4ber than t.he iact he wa5 execut-ive 3irectUr or whattevcr _it wa.~, wiLrl nL yualiiicationa noce::sariiy wiLb regard tu cuis Partieu:car subject and say, r3u you knuw he 3aid cai;~. i'!iZ . R :ae1s11Y ".'ui: Your i3r3nS}z* ..Kr. .;'r'Ve:l a~rbuwliLy c:~nc3~3e3 hiL; diiect exaramm:,ion on the point of all oi zne prganitationa who contend that tobacco can cause a tobaccv dapsndance, if you recall it. In addition_to that, during the diract there v~iu .ratcranca to tobacco being included in the WHO aaterial in m the P,PA diagnostic rAanuai. Ut ~ 3 a:a en; it.2ed to de,ao;,srrato to the jury lio:r zhQsaw V thirrg~ uu ;y;~~~denec:. Tiiat they arc a c~i.ter of cor~trover~y. ~ ?IiY:.LIS T. riSidIS. CSft rK •70A,i'tir^. A. :d3J.`.:i .)P0 CaR
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z 3 4 S 6 7 a 9 10 11 12 1 23 14 16 3. 7 1B 19 20 21 22 23 24 25 Jafte - CrQ3.-/Kearney 3.931 iuat _uniike or contrary to Mz. Sde:c;.'s suggccr.ion an3 the DocLor'a tezts.xony on dirQCr, thaL the gare inoluzion of the5a ter:a.r in theze rsanua3.: does not aean a corYjen.,uz. It does not mean about the matter -- it doei not desionstrate aaientigic reliability or validity. I am entitled to demonstrate how this happenz, that tho people who wrote it had -- wpy it was put in there and how it wua really deveicpa:3, fieYd trials and so on. it ir;: not exte:ide3 cra31:r but certain?y Wac:,7 Ni:. Sca~.L1 r*i5ed an clirect titat tobacco depctr.deriaa i5 a ceccrgriized d.irieaue or di::order, mental siisorder, I am en :.i taeJ to to the jury that there uas no reii"ie valid undErp4nnicris for thAL. T'hat it wa£ awaLi.er 0i ct3ntrU'vk.'r;:il aS1C'rilq aCt ti9C.' t111Q -iL caaie ifl. That t.he.'t: arC CFidngo3 in it. h$2. MZa.,T.,i Your bonot t I 381 not saying l1€t Cdi3 '4 do ;.ra Iniean -- but i*ik caa't bring in utatenLiiLz of a dc,ueS-, peopias unic9enr_i:,iu3 ai; to qualiEicraLions thac ace t3ear~a~. If there are statements and learned trsatiseu, tneri I a.m not saying he shouldnOt be able to do it, but I aa seying, weil, Hr. Ede11 said there are organixations, one msn, two men, three men, four sen, a c3ozen. Tuat is not the te.t for crono-axaas.siiation. If he ha:: an txperic to cc>rne here and say thare are muny o€ uj in our pi of esb;.on wuo don t t f eel L-hat way, ths t PIIi'LL,I3 'J"'. Z,E'r;TSi CSR i.301,Ii;~C I~. HO:J +SJi3, CSR
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3 7 3 4 5 6 7 a 9 10 11 12 13 14 15 I r 17 18 19 20 31 22 23 24 210 jsfle - CrdaslKearney 3332 13 not txearzay, but thure is hearsay ArIu tilere are eXC@j?wlona. .~.. REAaUTCY: -Ttsat mi6zej the point. The point fs that the juen who drafted r.kia ~-- I will talk about what the 2ea wbo drafted thiz did aad thought. Ttiat is wnat I wi2Z talk about. Not a learned treatise issue at this stage at alY. I ha ve Scue - TiiZ COURTs L$t uL taik about it. Iz this d x ument that you are now dQaling with conceded to bv a iearned tzeatise? MR. FBARN;'Y: No. T:zis. is w:.$t z;nte.u3 to do. TKIS CD=.3i::': fijakin(~ about the manuai that be is ncs'.r lookin- at. r3R. ~3~.EtSL~s': I ttrocigat when you were impaacning a wiL.7eza you could c:cnfron4 him with anythiitg. I cantt =inu9=ne anr ccilng ti,at i:; n::= a c:.as::ic crca--,!~x3mination a.; cnnfronting thi~ dowcor vith a state:aan~- made by uomebj~y else and asking vhe:her he-is aware of it and whether he agraes or dtsagreea how can that bt improper =--- THE CC}tJRTs Sure -- MR. VDF.LL: Can't raad it to the jury. HR. BLEAKLEY: -- to the witnesa kR. C0FI,3s Your that ha;,zaened ali. wiLia Fir. E:ie1S. Pi3YLI:IS T, LE't1'!5o CSR ~ J04N:f2 iS. HOJSi".^.:41 tiSR
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1 2 3 4 5 6 7 S 9 I a ii 1-7 34 16 17 15 19 20 21 22 23 24 25 ,3affe - CrvaalKearncy 3933 Afi. II'JV&KLZy: z)one for four weyr,.j. ?;ii. XsiAuR:'c.7~'1t: Done for f oLir weeit:.i. They hJd CieVer aeon it, Itever au;.horad it, hadn'r rgceivaa ::vp.:e~i _- MR. SLZAB:LEYa For four weeks he reac3 dovuments; to witneaae:: when he kneu perfcatly-we2i the witness never saw .St, The jury aaw it over and ovar and over Again THE COUR'P: Take it easy. Ca2m down. I a.:r not aaying that he _cannot. be sao;an the dC1Cil:ile:ZC i:~ree M7xttl ii, taio"t.`, it S:C.len 1;:c1il 1)e re3d. MR. WY1et11C'r he 's3g:eC.'3 -- YIULi1C2 you 1ike ze to show you 100 examks+e:; o:. 3nc:c3etace-,, in waiclh M:. EJLl1 ies:i z3;aer.hing cnw tbe jury sW: taere aa,3 wat.cheJ it t:)ei7 sald, ~o you sec it, du you agi_e? ::M COUR1i cBuL it w:a in evidenoe. MR. IJl+LtLal,.rJY: It .Ia6 nV4 in eviLiGInLG. Cvi~a~11 1KE 4i3en it aa37e been, an~ ~C'. )3LS"L..n'.Y: I r't8iS@a tl'iaCt i:a3t1a. aa~ Ti3Z C3JRT: Then I was coasigterat. I thought in ary rctlinqs that the only time that contents could be discioQed in the question was ii it wau in tvidence. OD ~ MR...ELEIaL: )Ahzoiureiy. ~ W I csn~ t t+el iave the.:e are the namc Ut peopia who ~c~ Gic3:., Ul W bar, after side bar, after roide bar zaid i-,+a can't cio iiL. or P3YLLI3 T. LWI S, CU;t k JOAFdNS M. S.lUJ! li j4 CSfi
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r . I 2 3 4 5 6 7 S J 1 10 12 I3 14 15 15 17 13 19 20 21 22 23 24 25 Jafte -- iro4s/Kearney 3934, read it, nnd once iL'~i in e•oidgnca -- not onay oa4w ir'z ln evidence, I had to do it their exact w&y. xitw C3UR'.c': Let u3 put it this wsy ILR. REAI3tLXs Let me --- sorry -- I am entitled to msk the question. It is oro3a-exazinatisrn on the p-oint that there a.s a concensus about the 3.nclu3ion of cigarette swk:.ng as tobacco dependence, and I a,a entitled to say Doctor, ir: it a Lact tkt'at p:sjTcliiatr-iW4`J 13atie -- i.4aLt p.,~iirhlaft.Y.1Jti.'rr y- ^,ertaiTi j7'::yC:hiiitrl:;'.3 arS of the Viva L.`tit, "Tf'+ey thiriK it' s a b:.g niuta};e aad even danqerouu, • to put to:L!4icco dupcn3e.yce in that, ";.haL tae mair, arguz,ertit is that tiuere are a lot of t:jinq.,~ pecp,ic wanL to jive-, up and are unaaie to, g:;'_t bt2tLer, a:l:: c37os:u1aLe, f:or QX8I3ks1e. mhat i~i a sta;.amen~, a:de by RoiQrL 5i~ltzcr, wtw thi-- witnas:~ al.ceaJy sus.a, Ju,3ye, wa5 t:je cnairiaari of t~ia YVitalifiJ.i.4ece on <Ie1(.ir3~1 ~i1(.ir3~1~ iir3~1~i 1J.71i III R. I 4.~ $nr.itied to ck:raons4rAte that waa not the c:ar,cdnsub -- THS CJt3RTs I am not barring you from posing tht queAtiwn that way. it would be inapprnpriate, did Doctor So-and-So way thisr until he acknovltdqos who Doctor So-and-So is and ~ wt3ether he is a recognized -~ ~ MR. C02.d: He did say it, he is, in c:rarge or ~ ~ revieing. Pi1YLL7S T. LEIVISt CSR & J©AN;i;: H. }iO:7ST4t<< CaR
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2 3 5 6 7 8 3 10 11 I2 3,3 14 },3 15 17 38 Zg 20 31 22 23 24 Jsfge - Cro3slKearnay 3935 T41iZ CO;1Ps s Lay a fcsundat iori. 0r:3;+. ~itber way, (2nd of side "r.) (Tho fol3.ou.ing take:: p1 ace in the presence oP tha jury.) BY MR. KZAR?'ZY s Q Dr. Jaffe, you know Dr. RaberL Spitzar, correct? A Ye3 . Q You wvrKou W#.ti3 indae'j, :.he co;U:.:ictec: tnyc" r3evi::ed 'JS1d-I1:I, carrec,L3 A i`hat'6 r'1qn;. 0 Aiid the naue of taaL comaiittoo was w:;:aO It waa ca,e cozzi:.Lea oii nowenciacu_Q Ot t.iQ A7cericar, PSyLalatric A s'S '1..2 G:3. Is t: f12i z L» c? C r*G.` '.`. ? A I tllinK tkhat it. would be easier ir I Ionkea at it. I`:a . very baJ witii the narae:; aL• cor,mittee6 T t1i ba t3appY • ?t+s riy.zt tiexc. S'l'1 look it ud. i'va Wy r1ave 11, rigb: there. Q Let me give you this docuMenr, vbicb Imarked as -- A I know I was on the ac9visory co=ittee on a specif ic subgroup of disorders. And it's advisary to awork group or ~ n tabk force to revi~b it. Tbo apQCif ic title. I dr,n't ~ G.~ know. Maybe the atc3viaozy coamittee on _auv.::,anca aWsc or ~ drug depencience, SoMOth-1r1g .i4ke i:aat. 2 5 PHYLi.IS T. I,LUIS, C.taP% b JOA?o21:: M. I30USTi3;~. CSR
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JaZL'•e - Croza/xaarney 3936 t L 3 2 3 4 5 6 7 a 20 1i 12 13 I~4; 15 16 17 18 19 20 21 22 23 24 25 Q Okny. A But we could read t,1le exact tit3e. Q We don't nead tbe exact title. A Cood. Q Teli us who Dr. Spitzer is? A Dr. Spirser is the chairman of the - I beiieva the wvrk group 4o rcvise DSH-IZZ at the time and he's ai.o a aember of edch of the adviaory co&%itGeas. That means pe pd.'',:.2Cipt3LG':i iLl tat3 C~.GS utt2ll:~ of t17;j Q H03 ari axpert cri nomenclatuze, w'z3ich i~ the nazzing os: dist}"st2Or3 and .,"~Qi.tii1C,' LFt7 017 Ctit°rLo3 iOr w:)uiGi.7'iL you say chd:? Sl =til.i, ye3, STR:J, yi:.J. Q IL:2d iX;' v'c.rf:ain.i.y ls can t'xp$rC 2Cn teraz ol the deVt3It9PzanL rJf ;?iM-I1Z. t=e wau the rA3~(3r J1t1d Ltti1il'!d i.:1Q develo.men:. Qf JSM-Z1I. xzn't tbat a.fair s.ttienent? F: wit:i i, a~ a ciisir:asn of the work gr ~UP iiC took rcaponaioxiity, gor advicL frc4 the variouz sUr@. 0 Are you aware that Dr. Spit3ar has -- NR. BDELLs Your 8onor, I don't think that that's proper foutndation for this fallvwing question. TFIE' CY?JRT: I'll Prarmi.t it. Overruled. a GO ~ ~ ~ Q Ac® you aware thaL t4r is:aue oi wiiether or nvt toba=m F:3XL:,Ta T. LL"WZF., C5R L JOANt7i. H. CwR
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1 2 3 4 5 6 7 8 9 10 12 { 23 ?4 15 16 19 20 21 22 23 24 25 Jaffc - Croz;jtxeacaey 3937 depandence ailouiC3 i,7@ int3.tsded in D52f-II2 waa to be aci:2a a:, the unnual mee:.in<} of the Amarioan P3ychiatrlc ConVcntion naxt May and that Dr. Spitzer bzknox3edgeJ tnat Mar.y psychiatrists have gone up in amoke over it? Are you eware of that? A That's hypar-bubhly. Thet's hype for the prQas. I don't thinic, you know Q Are you aware _- A ThaL'l'.: :,J»t t3f a figuro of no puyc:iasz:2wC v~cit i1' Itl SMC?i4a. Ir y:~u're s4yirty trIat So;Ae pZychiatr,f: t;i were a tif.t3e annoyed, suse. Q Are yQJ au}are ta.<:c he 4aid that rils}', lacarlir,g t:;e p:,yc:xia.''.riSts that woJi3 g~ uj> in sZukC, tbat they thinY. it't: a big wicta+te ana even dangerous? iie say:; the uain arguraerz;, iw that there aro -& :cot of thing,, peopie want to 9lYl3 lIp aa:: A:'Q lb:.abi@.' t:;j buf:LC°.r, v22d ZJi e x=pie. Were yUs n»are rhat he _za3e that sta:3wLnt? A There were -- there wag a psychiatriat who wrot• suc., n letker, ye... Whether there was more than ane, I can't eay. 0 You're aware that there-was an arquiaenz about whether or not tobacco dependence -shou3d be included in D8M-III? OD A Thore were peopiii'wt~+~ raised flhjections of the kinds v X Cn ttiat he de:.•cribac3. They certainly weran't in taa majority.~ v T,lt othor thing is tilat we gIv;_;, sez iou:, ea.• anu Q FIMLI;, T. LB'WIS, CSR & JOAS;1u M. HOnSTO:i, CSR
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I y 3 4 5 $ 7 8 9 1.D IZ 13 14 15 16 17 13 19 20 .21 -.22 23 24 25 Jaffe - Cro:~islltiEa.ncy 35300 eouz i~cry .:nd to eve:1 a ininar i t;~ of V6~~ ~ L r~'r+u obje;;t, to hear Waat tAose ob'jections are. We'vL gone over .tLQ,e kinda of thin,a and ve -listert, yea. Q Doctor, are you aware of the fact that sevQrai iiiveatiqatocs, researchers have published articiee criticizing the list of withdrawal cymptoaa& for tobacco :ua; were included by this committae in D3K-III? A Yu :, I am. Q And the; incluue 4uch peflP:e az Dr. JD:uti i:aqae:. W V i V~ 4 1. L A Yec). Q 2.: said .tna;. 14.4e AA?`t ..,;Oulci daLete rrom Lne 1int c,f w;LLadrawai symp;.amz .kea3a4iiu, dresuaine:;s 4nd diaasde:i5, c;zrrect? A if3:ttt:3 1Ct1uC it'u` lic3id. VitiL: +,~''J:$21tt -33akf: 3iis"1 rlcji3C, ~ And yju Dr. Murray Jarvic4 in your ciirect e~a.~i na t iot~? A yas. Q And you underatand that be'z oi the view that drowaine;:6 was not a valid withdrawal ffiyxptom of cigaretto smokingr altbough it had been reported nnd included in DBM-IIZ au a wi.thdrawal symptQr.a? A I'o no: aware of what Dr. Jarvick said. lie aight have ~Oa;d tbat. IL yOa aaF3 snoW = t.qe coatext, I`li be abie tv PHXLLIS T. LERia, CO-A & JOA'I':L !•3. IIOJ~': Ja, C5R
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1 2 3 5 6 ) 8 9 10 13 12 14 3r IG 17 lf 19 20 21 22 23 24 25 Jaffe - C:OUalRearney 3~39 rea~.pon3 to ic. I wa:~ unaware of that. Q In aiiy event, those wit•Y.drawals, they're tat;en troza 314 to 3f:, correct? A It waa p:oDab2y a aistake. I'lI be happy to reiZ you vhy. 1Lid I wrote to Dr. Huqhes about that. We've studied thauaandz; and thousa:3d4 of people. He stuiSied 50 or 100. ~ ~'i3e ~+ithuia~ul -- go auaad? h Go a'13e3u. Q Wit:n;3rawa1 syiaptoia;; for aicohol antl ha-CC7ijZ 2n ;~~Gi-I? I l1aven' e. ci7anged, havc- they? ~. tio, z:.ej didn' i:. Tuey coU1d have. I ;,lean, wr coU:d iY4ve pu:t irn a dr;aen mure sympto:.s for each of :ho:;e t• h.in(,.: bu, you have to lisait the nu2lasr o; syl~ptozy -- Q Ono of ttic rea:;oriz --- A -- tuat you };ufi in. Q Gne of the reaaon1 for inclu!;ir,n of tobacco 3epenience in DSM-I1I-xas to put the psychiatrist in a better position to ponsib3y get inaurance payments for treating smokQrs. Isn't thar r iq2it? A No, I don't think that had much to do with p:,yca.iutristz. It ha'i to do more Kit:, -- do you want tco liafi:en to t'r,is anZWcr? Q I " i i u t e n i nq . PSYLLIS T. LEWIS, CSR i, ,70Ai+T~d~ M, t1OJS.CO,:i, CSR
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I L I 2 3 4 5 6 7 8 9 110 i2 13 1.1 is 16 17 1€3 19 20 21 22 23 24 Jafse - Grosa/Aearnay 3340 h Tt:dSi:: yJ~.1. Q I.ay t}iiz right now, ber,au.~ie Iwan~. 4o-move the axa,ainat-ion a:ong, I iasve to apoiogize to you becauaa -- I'i3 go to the table and get nateriais. IwanL to mova irt along as quickiy as I can. I isea.n no discourtauy at all to you when I qo over and gst an exhibit. And I have been concernac3 about that through the examination, Dr. Jarvick? A I'ta Dr. ,Iaffa. You might ha'+re noticod thut at tiraM5 iwa2k kxac;k i iku Lr,i:, i€3 an stLem;at not to turr, my baci:? A vYJt fqppeYa7a{iirXL iU YalneV4.J..:a lyJ. ~ Ilaatln ~~~;~lut~eiy no di6rcr-5pL}ci to yvu, D;:G I war::, to 3ue it X i:.T.ll"i C,;Nr my "+3tk3r2£x.15 to IiaoV.°. it i3i:=:lg t'1.~ qt2lceily 8::r I can. A ALI rigryt. Q ki J.d ~ wia aI E3 wo wc rC 7 A he wOce speakin~a tckwst Wrjsfiher or nOC thi5 W4i directw,J to get ttec for psychiatrists. 8ince I know this issue with soue degree of intioacy, I can assure you that the issue xaa around this. We see Qaople. I've seen thea~, svsrybo3y iaas saen them. Wa have been holding canaultationc on them of people who huve had a lurng out to continue to smoke, people who have cardiac suryery wa4 co7tinue:3 to smoxe. aney need soaie &ntervcnLiun PFiY:I:uIS i. 1+~~iJ f C.9T~ & JO.kNi,:i ~i. HOUJl0i'1p CrSR
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1 2 3 4 5 6 7 E D 10 1i I 2 ! 13 3: 15 16 17 13 19 20 21 22 23 24 25 Jaffe - Cros4/xearney 3941 -be4asZ,e it'3 ciear t•hat they 3oubs.e the rate at sauicis thay' re going to die if they vnntinue to ::x4oke. It would be. very nice if we could nama What it iz that we're trying to intervene about, to give it a name Wcause usua3ly you tAve to give that what ira it you're treating? What arO yau spending all tbim tice for? We'ru trying to icESp somebody alive by getting them to dYScontinae thia behavigr. What's the behavior? Zt WaZn`t r:+ tiiore at all. ir.erz wa~4 no m e nt:.::: ~: a.il in DSH-iE. It wa;;n't even there a3 rr Q Righ4. A Anc3 zo it nad to tx: in an3 if it 1ieiped peupi e gert sr,;vc of reirl3urao~ent fo.r tho5e cs5G3 whe:e inte:vantiori wa:: p~yc :iatri:;~~, I neaacsca, 6o &a it. It aa_ noL likely to be can aa;;u.a you. Q But there wa: d,rjouazion4, waan't therce, a1zong zi3e pyrci~ia.ri~:.~ on the co=ittee and ot3;erz jri tlie that it was naL put into DSN-I1i it would be more dizi:icuit tor treaters, be they gsychiatrists or othera, to got reimbursezent from Medicare or inzurancQ compazics for saoking Cessatioil programs? Isn't that a satter that was discussed? A Taat is a matter athat, oaas diacusoed and mo3t weren't gsychiatrirvta. Q YQU te~;i.ified ors dlrect 8xaminations doctor, thar th,,~ Pi3V,vIS T. LEIti'iS, CSR & JOANNC PY. f#UU51`:3N, CSP.
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I 2 3 4 5 6 7 a 9 10 12 f 7.3 341 15 16 17 13 19 20 21 _22 23 24 25 Jaffe - Crou4/Rearney 3942 purpoae of tae Diagrso:~tic anJ atatiat.Lcal Manual wss Lo see vLat kindz of rlisorr3eru peop3.* have. I don't want to put uordn in your moatth but do you tecalk aomething to that affect, thafi was ona of tne purp-oaes in develnping a diaynostic manual? A It was to lay out the range of things that people have so that when they coae in witb a comglaint., one wn aake a dia5nosf.s and categorize it. It's: a3tatiwtical saanual az 1ie 1i .::., dI ~g l:aiak i c . Q It wua uaiigryed to 5ee nus msny peopl;: :4ave tn.iz p : otj a ~-:a? A CJr.e of ii:s paZpa.!aez; waW for epic3exiology and aru~:~atic~, ic]c~iC~3 COCL'LC~. Q vou're awar,:- aft.:er DSH-IiI vas proaulgaraJ, thaL iiicty con3v.Z`cec4 the "oricsn Pjychiatri*t A„soociatiora fieid rewi:s of it..s vaaidi.zy and reiiabis.ity, coriec.? A Tney 3id suc-ii #:ielc3 tauts, ciirect. Q Ir. wasn't after tne cpanual wa3 pui)Iianed, is that wrIar you're saying? A I believe some of them were done before it was pw4liahe;3. Q And thoae field t4uta irtvolvtd about ;2,60p patianta, Z U1 12,600 parientu were seen !.n the field tests, correct? (Z w A TYfnt's right.. cn Q j%nd 12,603 patzents would have been c3lagnosQu u~ing C:he PHYi,LI.S T. :Lr1J3.S, CSR & a"O;W'.v. i:. HOU3TJU, CSR ~ ~
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I 2 3 4 5 6 7 8 9 Iv 11 1 13 14 16 17 18 19 20 21 22 23 24 Jacfe - : rojs/K4srney 39113 criteria 3et out in thu wavnostic and Sraziszicai M-anua1 Xt3L' any num:?e'r tit: 4iciClrtit?rs, me7it:$i C3i:it3r4;i:r3 or disturbaaCe.: t.brit are in that book, big thicx vook, carrec:t? A Bf q thick book? Q The took I gave you .bviore. A No, this 3P,. Tae green ie that. Q Thia one right here? A Tha t 'a it. ;~ JVls°d of t-lie 1.,~.,Z+3D tjt3i.i-eI2t-:r :3tIa W(?:S3 aecl2 in ii2J:+D xon't it cotzect "at only 13 werA g:vcii thr :Ii3;ji'sir:::,1 ~~ ot LS}l~dci:J G3epeCiJen:L by triz d4cLvx ~, c7i1i3 ~J; j~CiticiCL 1 aL~ L2:23 CCs~~ ~33: t in tza'1oU5c ficid tec-,ta 7 r1, iiit~ L`}.L2t Y" rttati2cr of C{}11:3o, _.fi yGt9 reaa e.,Sn-xi=, tize. 0 x:.: a fOOLrlOta. It- OIn practice Liziy ~il:, prcsbcbly be u~ieJ only f4r taoaa people aee&ing Ctuc:::«1eT2t:~ ft3r toJ:icco depk:iyJeati.e QL in LaiJ.ie dLlerC: pe.~)p3s wuj have had s haart aLtiac:it or .1un3 taken csu-_ are continuing to sraoke." Zt aas not Qtir intent -- tba-reason fcr the footnote Ss aince you don't`go out, intQrview 12,400 peopie and aus3deniy find that the rate of mental dieordar hax doua,ied. Thar- wadn'ti' tne intent. Tue intent was waat I F,afd it we6. ts7a yQU raiy;it a1so Know, S`:a zure, t:yAt Dr. Hu~ile4F PL3y:,:.,IS T. LE~~'I5, CSF~ & 30~?~:;u M. HOU:TQIJ, CSR I
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I 2 3 4 5 S 7 $ 9 10 11 1'' L 14 16 17 1e 19 20 21 22 23 24 25 J3f ae - t:roi's6/~'•eaLr2@`y 3 -S 44 ca.ap:.aint ra",s if you u:;Q UGH-2Ii and ,igaor4J t}i4t, too raanf people woa.lci D, diagno5ed ao tcrbacco dependPnca. But at any ra::e, to bo aeQurate, what they did wiaen tbope 12,,000 poa~.~ie ware interviewed waa follow DSM-XII and its intsnt, but the onject vasn't to do thia and give an extra diagnouia except. in thoas special cases where it seerled appropriate, wuerer the smoking wa. a kr:y issue. That wrcs -- you're familiar with that footnota, I'ua iiurz. Q 2'aal~- 61e,~va't c~sacije Lhe fact Lhut 1::je peopie who r,avc uaod in the field reptlrLe4 only 11 o;:t af 12,000? Fr Tuef did what-- Lhey vere 6uppused to do; they fo.3.owed D•a".1-I . I . 0 T"Lta;iK yoa. You t.alked, I rblnk, &uvut on dirocC exaiaS.nation Mra. Cipollone omoking adc3itivnai cigarrtttes after zae awit.c11C.1 to Truz' -iI'1 1g74, bCl:ai't-i iIYyj z~)o1't ti1e:t? A She LsAid that to we, ye~,. Q Pardon my back for a minute but X'o going to go get something and ask you to tall the jury what is it that sr:c said to you about bow atuch she amokad arouna the -time thst she switched to True. _What --is it aha said to you? A Sile aaid -- how many of -those do you $mokQ? t3p to about two pacw3 a day. I_actually -amoked mure, I thiak she said, bccauae of Liie tow tiar. TnaL':: w;tiat 3ae roid jA2 in tlYe PfiYLLIS ^s. Li,RxS, CSR €c 3OAMNi M. HOJST4ti, CSF;
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1 2 3 4 5 6 7 g 9 10 11 12 13 14 1.5 a$ 17 18 19 20 21 22 23 24 25 3asfe - Cross/xe3rsYCy fntervicw. Q Sne actUaliy adJe3 beCau::e it wa., iow tae? 3345 A I--- that is a note in Ay interview. Thatt:; what -- I don't know wbether rshe said that, I said that at this point:, JuUt too 10.19 agcr. Q How did she knw in 1983, when you interviewed ber, that the reason she increeaed her conaumption of cigarettes wa.:; bsoaua® she aaitcced-to low tar? A i'z nciz zayiirq tlat she taigat Y~,a4e yaid Tsrsuked "- re becau:;e ttiey were .'tow tar. I thougnt they would 'ae saier, that',i. what soe vaid. Q Fro-m that conclu6iun or fcoia that ract, you drew the coric;.saiaa that kirs. Cipol.lonu szaokod ciy^arette3 priwari3.}t tor nicotine and une wantcd tu get tha same a.caount oi nicotir:o e:ren rhough sht switciieci to a iower tar? A Wo. I naid, I bc:iieve, t:hat I c3idn't f in3 that supri.ing. b"L-io aeeine3 to find itt supriz:ng. 0 Waat cnncS.uzioa3 did you dcaw from that, if any? A 'Phat slie probably Wau adjuating her nicotine intake to aame degree. Q And ihcreaziny her nm4king in order to adjust her nicotinra Intako. Ia that your vitw? A She aeemed a lit~ia surprised that s;ha actua2ly amoiceJ more at that _tiure when I intervieWO,3 ber. Q Ara you aware oP the fact or were you awart of trie fact B:I~.'LLI5 T. LE4IS, CSn b JOAN:!£ A. EOUSIxaW, C3zY
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1 _Z 3 4 5 6 7 8 J 1C I I 12 1 13 14 Va 17 28 19 20 ' 21 22 23 24 -~ 5 ; aFfe - Croaz.lAearltoy 3s46 at =Y}e ti;ae that ir.a reported -- 2eL ific witAiraw that. Sae awitc:h&-d frora wiiat., whaL•t ciqarette Lo srue, 5tir'q3,nio S3ima to True? A I'd have to Iook. I think that may be the -caae. Mo. I think the one rigtit hefore that was Far:iazen't- recessed filterm. Q aid y" have occas::on to review her med,ical recorda in -thi5 C.AJz? A Zt I d;.J, it sj;r3d. I ai.r3ht 6a:*e L~Lin arl;:: 01 til;3. .L rE'i:i;.i3~,~e!' 68eyfig Drs Carau::ci.:li"- IIG, Itf3ini I aala Soiaje L'ecGires'L: fI'oul Di. Car1UCci0 arid Dr. c3exi+$ LeQr I Cion't reully recalJ. Wnethcr. I've iieen otherG or not. PraizY.i;{, : 3=., c.an't recal.4. °~,~ Af e V V:1 awaiL o.' t.hC' l:'i'i.':: t31G`i'it sh:e ret?o:: a.QC3 on Ha rch 22, IV74, to Dr. i.dw4y that she Y1a;; smJk iii~ Gr1L p:3cK Zt ddyi taa4.`s i-.larci~ of '?4, and triac: in waaL laokz; iike Apr ii or July Vf 175e ,CE.'j?+3rtf..'.1 t1"z3L `a'iie W.::i 3::.J~.irtts ti~rcu--~uarter~ ol' apack of True cig3rcLte..i? Are yoa uk&rc, of that? A A3o. Q You were not aware of the Esct until this moment that her medicnl reaorda rQfiected that cha either smoked the same nu=or of aigarettea or ioLaer when she axitciiac2 to True? A i'>i, aware fro:a the depozstion:~ or at 3ca:~t the PF;1'LI,xs T. Lrl4is, t;sr.,. & JQA}d:yL A. Ca%
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I 2 3 4 5 6 7 10 ~ 13 L _ 14 15 1V I? 18 19 20 21 22 23 24 ~5 r Jatfe - Crouz/Kearney 3547 implit$tioiis of tiio +~~~~a~itacra¢ that she z:,.~etxme~ told her physicianz or w:Ien A;he was ad:aitted, that sna uau Smokinz3 fewer cigaray_tes thsn zhe rerorted to ;ae. P.ut I never 8aw or at leaat Z_don't recall at this maXant Whether I ever saw the acrual medical recorda. Q Are you aware of the fact that Dr. Hedonia'a medicai rocords of Krs. Ci.pollone, dated January 2, '76, reflect3 the folic;wing: Szokeo or acsoker three - four cfqarattea a dc~y? i1v:rC Yt3ii F3wti:L: 0L taLat? A i14. Q Ttzat waz in J; aLa.y rrf '76? Fs :~:r* Iwa:ia't a'`llatdre of 1t. ~ DLi3 y,a a.~ik F+zv. Cipo.:3one'z iaw;r*ers, r3L t:ir; cxz.: tt,w:, you conducted the irltarview WIs:i1 KrZ1. C~~.~I?ona, to reViea her ~7adical recwrd., c.o liee W~dt her sxakir.g hrzLory w3i7 A Na, I didr>-' L. Q AnJ to 3i!,2 Nitio::ing hi.v:.ory zhe gave br::uro b:O6l91A tl12 lad:1t2i t ? A Fto, I didn't. Q Is it customary vben you diagnose a patient for you to review ttae pert3.nent -medical recozds, _i.e. medical recordw pertinent to tbe reason you're speaking to that patient? pp tn A Depandc, on the cJ«Lr&i, reaily, depends on the purpo:ae, U~1 W depena;: on a lot: o44 L.I.Lntj:;. £ut it i;; u~Uaily not. tupicx4! V ~ in W.rrst situAt.tosls. I havQ don,-% ii:. ~o~c;:iffie~ raviewe:3 terz PIM"C.IS 'i'. Z,E47,a, CZ;R & 3OAN.IS M. 1i3USTON, CSI:
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1 2 3 4 5 6 7 8 S 10 1~ 6 13 14 15 20 21 22 23 24 25 aafic - C:'o:,;;i/1:e4rnay 3343 yc:ars' kortu Oi rO::Orcj:; 1,1 a ::ogapixcatac3 eMae r»nCl in s;o:.ict caEae;~; juz;t cioESn't s4ezi apprapria:.c, enough 16 enougiz. 0 You balieved it wasn't &PproPriate in t•hi3 casQ? A it didn't cccur to ae to ask for all the aedical reca:d:; so I could 2isak -at wbat she aaid to met na, it did not. Q Dr. Jaffe, on your direct Qxaminaticn you talked 4bc:Uc brain chemistry. Do you reca3.3l that? A i'es, -a And you taiked about, nicc_ine'::, aftecs; on brain crre:-Ai:~try. ~.~ I r3~=.ir? Q t'~ I i".G>rreCt tYib1L vir':LYaliy t3fiytili:3;j Lhat you rOa.;Lr anyr.ainq thrs~: y" aruel:, anything that yQu dQ csu,~;a.5 cbe:aicai activity sn the brain? ~i Ir 3.t dus&n't, ycu're dea3. q A~ I ccrrcct exorciuing caujcs ca;:4iical accivity? A i'm aurt even thinkin3. Q lrKlead, cro3a-axarainr,i..icn vauaa6 chemical sLtll.vity3 THF, CDLtR?: Daz't -bet on it. A Def inittly. 4 At least on one? A I hope -on one af -us ehemical activity is in the brain. Q When you're iaughinq, this causez the r*leuse of cb*Aicalu in your brain, cor rect? A Even if you slecp you're brain iz active and thcsQ PHYLLIS fi. LWZ a, CSR ii JoA:)?3 r M. BO's3aTONt CSii
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2 2 3 4 5 6 7 a 10 31 ~ J ? 14 15 16 17 15 19 20 21 22 23 24 25 zaize - Cro~sj/&earney 394 9 ~ ittie near©z mrc talking to each by releazing aittie cflF3aS.cs`d:i.s ta.lk:ng to other tl$1ITOa, wi11C;2 3.n LLtrn rcikRaat3 othar lit:.le ctiamica.t3. Q And when you're angry, you get a releaae of chewicai:a? A Yes. p When you're axcited und so on, correct? A We could go on for aoma tiure. Q Zt's ncL neco3sary. 71tJ ya3:i bapt3r31i to rEt$i4 thf:'. :i.-'..` YOriC TJ.:93~~ Ti7at.+6 .2a edi.tic.:l, ju~: thlt: P4;;i: TuOSday? I knUW yOu werc in c~Jur L. Mays,d you read iL. Did you r ea3 ir i A 1 was otherwiso "cupied, Q You {3:.Lis7tiL read t.1ita 3clenc:e :;F:ct.lo<a? A :dzi, I K~ it refo::i to -_ M.R. tED'"ML= Youz Hflnor - ~~i Tnz:~ is scl:iiar.ty writiny? MR. ED-l:.L: If we're g01rig to qualiAfy t:,iL; as a 3e,trAed treatisQ, It not, I don't aee the purpose, THb COURTj Sustained. Q Isn't it a fact, doctor, thar cerbohydraten in pasta, for exareple, tuva certain -chemicala in them that break t::e ~ aD brain bloo3 barrier Ad cau5e3 chamical activity in the w ~ brai7? Isri't that right? ~ ~ A I'm reaily r.at an Q:,peA l, on pxcata. I snean. I thin~: I PHYLLiS T. -L9W'.I3, CSR i JCAtdt3F M. FiJUST01i, CSR
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r i 2 2 3 4 5 6 7 a 9 33 12 13 14 1s 1,7 1t; 19 20 21 22 23 24 25 Jaffe - Crass/r,*esrno: 395G know riomeLhiAy about bxain chemi:.try, I know a~:3e:hic:q al,Dut which c3rugs gCr through the bioss3 barrier. ;3ut if you want~.~ to aak m4 what brand of paatar I cannot ans.wer for Vhat'a written in the Nev York Tintea. And iE you put aquestion aaaevhare written in a medical text, mayba Z_-can answQr it. Q Raybe we ca.n take a-brsak now. TF:E COYJRTs That queytion maria ze hungry. :~R. Fii>Ai~:~i.'Yt I H_~k tnot wltnes:i to retd LI13w .; seo i: .ic re£reahQa i:ib ~meacLy aa to what cneu~:w;~i:~ ~re i:a j3as t a. T;iE Gy7UR2: W;: `12 ta4c a 15 winute rec4sy. ^,^ . 1 ~ '1 .u~ s~,.,~.;.~: i dt~n ~ thinK I l.~ do tu;xi:. .CliS.'; ICLE j4i: A 11 r .i (.Rf«ca~,;~. ) T:1; RZDJRf21{ ;, A1 t C i:, t:. m:z n.ry ~.aSd tr~ ~~. P'04~a11 seaw '~ed ~ aaw uJ • .~:cLl ~a . (5i ;L bar. ) MR. F~:7F'.x,Ls Durioq trla break I-va3 given the opportunity to review the learned treatiae. It was say underetandin$ when the offer vus being made that Mr. Kearney wna qoing to eatabiisib that it waa Dr ~ Go Spitzcr's opir,ion th4t, yc>a f:now, it abouid not ha-ve becn w inuiudea or t: at thc criteria vaa di,:farent•. Ut I © i have iUoke3 at th1k; and i L-Link Caia Sa tt;r FHY:.A'..+:S T. .isEW3S., COR & Jt?Favi2 M. "Jr3STO:Ye CSR
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3 2 3 4 5 6 7 $ 9 10 11 13 14 15 16 17 18 19 20 21 22 23 2 A 4 25 Jafl7e - CrarzfXearney 3951 qrovso~t iai,:ixeprepcntacion ti:at I havr* Qver soen, not on.2y in term~) of thii~ Courw, =but in te:mu og w1har hQ reai to t:ie tnea n. first of ai.l, what this is quoting Is a letter writton by Dr. Spitzer where he says the main argument 14 that there are a 1ot of things peop3Q want to give up and are unable to, qo3f, butter and chck:o2ate, for exanpie, reCerrinq to other paychiatrists not hi.mself. THE"- C4JRTi Ye~:i. :~eP.. MCr,ut it]lm iv N:1ftr6 ;tZ. fiLar:2Ry yCflppe3, but wo th.ink those - excuze no -- thoje are very .d{ffsrent. They c:on't involve pily,.~io:o9i:.ni ac3dicfi.ios. 0: v:Churn.fa:. POr mur,y P~eopia, tt,=_ o i3 no rioub4 thaz toisacc~ t.; ad_u•j uf dependsr.ce. F:,z tii;a to hsve su:d aL ttzij ssdQ bar, on t::e rE?ipr~.?:~(2ittaL3Cin LilaL- Dr. .~'aj>lL~.'eC VFs:. qila.t1:•a{b..~ e:i an exj>eit aad to t,3ve u4" this, auggestzag ttist that wa4 Dr. Sj~itZer'4 WordW _tuat 1zt Wd~; in egroement vi.Lra the Stat"cut~ Ont, you knvw, with Lhoae other peoa•ie that cigarette smoking or-_the inability to stop amUkfn9 ib 1iko go2i, butter and cbocolate se outrageous. T!Iy C3I3RTe What do you want to do? MR. lCBARAI£Y t Hay I trrspond? Th4 record aill _refieut: that tniu is what bappened and that tir. Edc11 i4 absaiute.iy 100 percent. ws:ong an3 rhis is a tactio tryfng to break up the cro3s-exominatioa3 P3iiLiiIa T. -LLWtZ, CSR it JORId`.+iO M. FSOUS1'3N, CSR
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2 3 4 5 6 7 8 9 1s 11 12 14 15 16 17 3s 19 20 21 22 23 24 Jaffu - Cro:r!;/Kearr,ey 3~5} Wnat I waid wa-5 that Mr, 5pii:xer had ;aade the 4tatemenc that there were payc;:iia; riats, remember, wno he said were -- !et rae zee the thing -- certain p*ychiatriats in the comnunity of pAychiatrista wao went up in aaoke. i said those pzychiatristc went up in smoke. Naaa1y, the people who wore in disegreement witti it. That their aain argument for baing in disagraement wi.th the inciuaion of ABM III in the aenua3 was that and I rcac3 {~ a ~ 1 Y 4 4 wC.~ J j~r 4H~F LJ~..}.y~l 1.i+NV. j4$ what Sp1NztiI tiiYI1I1 -~. 1;itfi.. + \ 7-. rrw appcaition. aaat SpitLer said r.iie main arguiaent for trie oi~~:aait.ivn wds ti,e follcw;n~. He agree:3. I di3 not i;ay Sp<t::er waa aqaiI1.b% it. h#E3vFti Ctlpre:ieli:.ed Itp tiLSYer :6aad ViS CO:3Rit TDa~- ia tne c:lea_ iu:ptess.iun Igcs: At Lile zide I7c'try 1AR. ~'"."a)K'.i.L2 I IA'JaL' :9t3VQ ti.ilk'tiit a:: a UT l i.~.@ I$ n::~ placra -- .if wc ha,re to ,iiatea vecY ZarcfQl.,y to evary 1~.tt;t nuanca MR. KEARNEY s The point llR, b'13BLLs -- can I f iniuh -- I f ind tbiu abaolutely insulting to the Court and counsel and to the Court and jury and to the witnezs, becaune there waa ciearlyZ v the i2pression t3xat Hr. Xearney +ras trying to make that ~ w 3o;ueiiow Dr. Spitzet, who was participating in a11 tais azd ~ N doing ali :hia, wa!~ part of thoae peopie who 3iaagreed wz.Ln 25 PuYLI.IS T. CSR FA J(?IO:IL A. CSR
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,3afEe - Croaz/xearney 3953 I 2 3 4 5 6 7 fi y 10 ii 12 13 14 15 16 17 13 19 .20 _21 22 23 the irtclsLion of rljoze crttoria, :nc;udiny nicvtina dep`arience in I?ZU 111 R. I think to _ieave thar. a.mprejzsian r,o%i wiien I aa nv~ guing to get a chance to rectify it -till xonday is a groau A3sc'rar&cter of juatice when be, Mr. 8earney# perverted waai I thought the repre3Qntattona were at side bar, wiien I finally get a chance to read the dxu.,ant ?€R. XL-NRPtP:Yi T4e recozd -- I had the docuraeiiC here aL zic3L bas . I ha:i it righ; here. I do,i'r rema=er wk,e~,aer a rela3 it or naL. 1 r~.~y have. I d3 r~csl ~, an:3 tne rrcord viii roziect-, and we ought ,to ac~ck at Liiz record, an3 it will one husWrel percent aut_apurt it, taac: I ayid tttaL he wa:: _sn ex?ezri. :r, no-azzt e:ature, an experi, in t3;e mattcrza of whetlie. or not tt3is diavsio3tic cri::e.ia ahauid be inciudod. r161at 1Was 90x.-tg tL derivc f zo.a :,afie w4 :~ rhst L:i fellow uri*derWtaoJ t'raaL tiierQ was a lack o, con~ieajuz with respect to putting it in the document. That is preciaely what I did: anat I said, and that is what I did on aross-exuaination. There iv a »- T$E COURT: iiow did you get around the hearsay ohjection? The rear.dh we let it in and the way yoa juLLifieu 1't. wa:: .tbi:; was a recognized expa: t irj tzIc 25 1 fieid -- Pt.3`:Li:IS ;. LE`sI:Sr CSR & JC1A::ME H. t3?J::i3'.4 CSR
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I L 1 2 3 4 5 6 7 8 S, 13 al 12 13 14 15 I G 17 is 19 20 21 22 23 24 25 Jafie - Croc~/€,earney 33:i4 MR. 9aiPURa .~'.~i t i2e wa!~. THE CO€3x -51: -- that he wa~ amembet oi this comMit€:Oo, and fhis was suppozed ta " somethrng he said, not somethinq be quoted tlAt &=ebody e3.8e said. How do you qet around the hearsay ot+jectionT MR. KZARNEYs You will look THS COt3FTs It's Iike saying zcrmebody else statea, natfs3fied, and safd, I disagree and don'4 put it in w w MR. r:z3E:.L : ZZ Nr. KeaFney tz~: L•zue L.o i:.i., worjr h~ :;,Aauid haYau no v!i4jectson of the jury getting s,ne it,cpre:,aioa Qf svuat tAe sce.naxia wa. nbout, thut .i€: vaa nutawng more taara Mr. Kearncy asking aixuL Dr, :prtze. i w1e.: wa:~ irn accorc! wicn Lhs c. iteria, who waw in acc©rd wi;:'r~ t:ee a rticlu:~:on oi it and that, in faci,:, tne jury s::ouid be reading r.he Le'c3+9iildeY t?f tahs3 portiof1 of t}ii3 ql2o4i3ti3I7 tiiitt be groa:i?y A1SC:13r&CCerixCbd. MR. r",ZA2:XY; Tucre was absoluLely n:.~Ite of rno~~ zisenaractazizat ions r~f .t~ic Jc~cu~eritc. Ti3a ruc:orc ~will rafiect it, This ig an ontrageous charqe. Waat I said was tM said is, what vas said hera. The witness sa.id bQ vau aware of the controvery and the vit.nesg said xhat the record will reflect be said, think this is an attempit by Mr. Edel21 and the Court shouldn't condone it to d9.srupt the c=ocs-ezaminotivn at tL7.~'.i3 t1IItG?. PBY:.:.,,i sT. LE=3I.rat CSR b ii. C4+.Tj
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1 2 3 4 5 6 7 8 9 10 il 1 13 111 S,5 16 17 18 -19 20 21 22 23 24 35 Jaf£e - Crosa!zearr,ey 3955 I nave no cbjc:cLion to put ttii:7 en~:re dc3c;zraent in evidarcce. I would be dwlig2zLQd to put the docuraent in evidnnce if be xants to atipuiate it goc;~' in Ovic3en,:e. MIt. $DELL: itOs fine with me, THi: COURTs I think, in iairness, what sbould be done is the balance of the paragraph or balance of the entire paragrapb vbould be read for aoupleteneaa. We have been doing it con3iaL+ant throughout the trial and there lb nQ rea4o<, wny tnU piainL•iii: alzauiJn' t do it. 9h.'. CD:1I4 2XCUJC 84t:. Men I warsLed to read tt ducuZeat iur =4r=_atona~6, you suggeztcj that I wait until tiie exsmir3aLiQrn waa over, k'rjich i dici. TLIL CCJ."a`: i'uu wanted to read anor.ner pQrtian f ro:,~ a dvcaL-%ent . `i"':1.IS l:i taC.' i7o:y perag1.9~,.Z ,ii, 2t'8 -- evt3t1 ~COjS. in mid-jentence. Mi2. CO!:?i< It w-h .a .~.ite nQx1`. £i2nt43ni:L but a II Ia :d t3ayld`4v1 you uuggF3a::C°Ci to ~"sL that I:'hoW it tQ :~6r:li, set, ii bo bad an obja,:tiun, and then if he had a: objectx.oti, bring it to your actt.ntion. That is exactly what I did. Zven though I felt jusr as strongly as Mr. Edelt doaa about this, and that was your suggestion to sa, and I think we ought to be consistent in it, that St happens aftsr the examinmt.nn is over. )' 13e haa the right to redirect. Tnat ia tue w&r to do 3t, I thinl:. Tha wiLne3:, couid tirive -- Mr. Ktacney wanted to put PFiYLLI> T. UNlSr Ca11 4 J0ANIIE FS. HCUSTCIN, CSR 1
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, L 2 3 4 5 6 a 3 10 iI 14 15 15 19 20 21 22 23 24 25 Jaffe - Cros:,/Eaarnay 3956 in tiie dtaola .ex},ibit. ar. Eaeli o:,joct4d co .i:.. MR. EDW:,L3 Talking applez and orangaa, Jud~s, wirlzn we are traiking a3aout -- THE C4URTs Lat ae see it. I tni,nk that that ps.raqraph ouqht to ba read anu shouId be read to the jury ntw. MR. BDEuLs I will be happy to read it. MR. REAFttIE-Y: I tiaink that I stated iay objection Lo I ta4ink it' :i c3i~!:;i,r,e-d to preju3fce tr:e eAamination ana preju3ice, dc.ec3dantz,. I wiii read it if the .3Ur3ge r~~uE:~:a rat, to re:;d Ctle onti.re doc=ent. Tis :' COURT: I wiii let Hr. Edcii ttia,~'a it. :iR. No, I will read i t. MR. 4Gitl ; : ip s I4uggaljt in iight Q; tiiis cuilny t:iac tt3e COurL roCortsidEr it: ru:;iny on adV'la:ng tY.4 ji:ry t?tbiliit tae tAti t taai d@po.Ation5 122 tai:,. Ca-~4' 1Jv:E ::aKc?n, chat iiapo:;:r.ion iiracess iL norzai in thsaa cakieu, an3 tliar there waa no tmpropriaty In this. 3'his shouidn't-wait cili Monday, either. KFt. EDELL: What doeE; that have to do with tihat? CD MR. D:•,F.nLEY: I don't undarstand why it =io tha~. ~ ~ the firat time that fir. Ei3eiS haa a probiez with C~ ~ ~ ecapier.an$ua, he get4i w4at he Wantu and an orde. _fro:a tno C'9 Court directin~ uL; to do ccsmqieL•eiye-~js. PHY~'..~L`1S T. LL"WiSt CSR & JO.~..~3Ni E;. EiJJ.3:J1l, C.rah
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I 2 3 4 5 6 7 8 :d 1'3 2z 121 I1 14 IG 17 iv 12 20 21 22 23 24 25 wA-4ffe - Croasl&carney 3957 We tiad aaked the Lour t on a dozen oz -~occar,ion:: for tiirz ,zaiz&- Lhing and -each time your tionor'c~ order was, wait t.i.ii it's your turn. THE C4URT: Tnat ia not true. C?r, dQqo~;itiona, I must h.ave orciere3 a bundred t#mes - MR. 8LEAKi.E1': riot raikfng about depoaitiona. TtiE COURT t We21. =tbia ig entirely diffarent. I thiuk Lhta in very misleading. f think I Kas ft~.::asu:r az to `lie p; or7~er aaJ I utl+:iaY:itai7J your You naVe Made yoQa -objectiont.". You ara tal.king a:),out a single pa-ragzap:,, anr.l I a~~ qQin,~ to direct cojn~;e1 to read i:, ii yt;u c3o not want to haae iL c:o:;au lrrs~a you, I wil, let Fir. EJeIi dra it. MR. REA.:.vY: a wz~j:;d iika tic: tEad c>i bicite txar. ) P:E;. R;ARNi Y: May it pleaEa3 ..hG Coi2ri:t at t.ai:~ tiu{e, I w.iuicl like to reac3 frcxa a:c34cuaen::, Deierldcn;.':' ZKllit)i4 Z4200 cok'5a:3 irQm Nekaweek h1atjazinCi d&CE'u Jallua'ry 8tri, 1979 in an article entit.ted, Beyond heuroyiz by IIav id Gi21=n. OPo2iticsu. On ati13, other grourx33, DSK-II1 has stirred 4 lurious debate, by adding tobacco depen3ency to chapter on drug addiJfcion. The rautiously-worded sect.ion zugge~;4u t'ua4 $mokerw who exi>eriaace dis;.re4~3 over their babit g,uoiify for psychSatric care. FHY;,+L,xS T, LViSr C£R & JfJ?3.~'in*:~ M. F1OI3ST0:7j CaR
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I 2 3 4 5 6 7 8 9 10 11 12 1 13 . 14 15 16 17 1e 19 20 21 22 23 24 ~ "T,4e iuaue w.3s bQ forma23,y Qire:3 at the annual AW ccrivenLfcrn next Mayf and Spi,tzer actinow.eayaj, tha~. m:any pzyChiatri.st& 2:ave gorse up in bmoke over ii:. 'Tney think it is a big -sistake and even dangeroua,' be aaya. "T6e main argument is that there are a,Iot of things people want to give up and are unable to -- golf, butter a1c7 chocolate, for sxaaple. But we thirtk those arcr very differsnt. They dan't involve pzycuo2ogic31 addict,icun or wr.4;a3rawai„ For -"riy peUpxo thcra i~ no dauhL t14a: to!-~acco i6 a tlruy ot d3peridezcQ.l J1: R 0 t4 L' 3 A F F L, resuraed the utandt 1.P.`..1SAS"'ECs`iMii+.."llit..' /..:i C•s:Yl iNViL.J S]S lYIR. L`~.NWNEYi Q DOccOr, You teJtified _t'rsatt nicotin$ 446 Q 3:ug. correct? A S dic3. IM I Q And a drug, in your vi+ew, is any cbe;aical -.agent that affQcts a living procie3s? A That fn a vexy, very broad definition tnAt we us4 in pharasacology tests, correct. OD ~ Caffeine is a drug? Ut A Y'e3. 25 1 0 CoifQe iu a drug? p:3X'LulS T. LEWr5, CSR 4 JrJN,i'~:: W. F.,'~M;TU:e, CS:t
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I 3 4 5 6 7 8 9 10 11 12 1 13 14 15 16 17 13 19 20 21 22 23 24 Jaffa - crosa 3559 A T; erefore, coffoo unJ*r Acas circu"tancey, wosld haeio to b2 th3ught of a:; a rirug. We cestainly teacti our medical vtac3enta xnen peop?e e.ome in wi.th a tachycardia or eomo kind of irregular heartbraut, to take a coFfee history .barcausQ oaffeine aggravates arrhythmiaa and ve want them to know that aoffee is a source of caffeine that aggravatea -arrhythaias. We told bim to take a bistory aWut Coca Cola. i4ot: to worry about Sprita. Teli tno" ottler tnZIL contain caffine and fiell tbeir patiants to avo:,d cafie.ins. 0 In thc sense that Coca Coia ia a d;ugi A In the :en:ac L't1aq: it Conrb2ilcd a drug cauain3 a $: rhy r.hm:.a4. ~ Cafiel.ne :ia:, a pilar;aacologicai eifeat7 A Yaa. Q Cafreine con:,u:aastian a.$o might aff$c~ br.a:.n wave::. Mea"~urud by the 1;ZGf corrcct? ~ Upand.r on how auca you gzva. i3 L3kay. A All of these things dapend on the dose. Q bwt it can, correct? A I am certain that in appropriate donas we can see .changey -in the eiactribencepi3aloc}ract. Q Appropriate dose under appropriaLe coaditioni;, swuga: ca:1 25 1 aii ac t a change in the vaves of an E-":G? gHYLLSS T. LEri"II.S, CSR &J4KN;3n M. fia:JOi~J1dr C5R
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~ 1 ~ 3 4 5 6 7 a 9 io 11 12 1 23 ~ 14 15 16 17 110 2,3 20 21 22 23 24 15 M .IaUe - -crosu 3960 A Not r$«:a4 in the zen:,;e that aoyi; peoplt t'r.znk aiwut. if : nave a i:aazpccn oi sugar you can dstect it, the answnr is n; . 3ut if you take ttm kind of riQount of glucoLa that you take when you do a giucoae tolerance for diahetea, you can eee chan8es. Q And a loud noise can create an alerting respanse on an EEG scaie, can't it? A Load nuise c&n create alerting res_sson:.4 ir, the EEG. Q Sto caU a3mzt,o;3y gettinj oxcited, correc;.? A Q IZI`.; t it .°3 td::to D'JCCC1« f `.a'3C ® fl@'Z rh-,lj Jar G:.tiiZ ba cons,dered a drug? `r. I tiiinf: a very bAy tics-cryey trar. Q Whia t ? A A mLy big fatraiiey bar Aig:iL cosiLain enouga. Pzo'JuU.y ..heobr"ine to eiiecL Dkoiogica.: ~bac:~~s~.:? Q It canta;.css chaaicai~n that afsecL 'living A Hoai. of lY~~ are ct7I1cer12ed .5tr,eJut -.f OGt.i:b _and zt1K55LZii7ce5 ti'la:. contain anviyh chomicaza to be of clinical significance. We are not just talktng about, you knov, -oaQ part in a billion. But we are talking about the kinds that truly Oo ~ have a pYiaxaiacologica3.effect, usually. Cn Q All rig :t. Atid, -DVctr,r, talking AWut heart rateu W ~ Ct again, you &aid cafieine--can cau,&e an increasy in oersrz tz :at*? f'HXLi,15 T. LCgJ.iS. CSri & J.'7A.Z;i~L 4. F3J[iSi'J;", €:wR
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craaa 3s6S / L I J h lncreaLe but aore specificai.ly it aggravaZe~; :rregu~ar 2 hNYrirbeca':.z I>eoj~ie w3.tt1 4*rrityLh3aiSzj t!3a irregular 3 baurLba4t:: are aggr4vaLed by c3tfaine. 4 Q Can alao cauue inarease in heitrt rates in people witnout 5 arrhythmiasi right? 6 A Not that_auoh, no. Certainiy, it y" give enaugh in 7 huge amounts, you will get an incrt&ae. 8ut we are talking 8 rib7ul: ordinary do:je:t, 7n a Coca Cola it probably doean't 9 Si-f*oc:L your bQar: ~be4t, nJ. 10 0 DoCtt3rf CISilfigti.i -iF9 r3re3::;aillc3 f3sltterT2.'a.. 1.au:a1nqf ii ra:".kiag, c3:iaking, riak-takiny, are al.i tbin~:~, con 12 inacea3a or c::an,3o ov aiter heart rzte? 13 A. jaeart::eae rasponjS to the sia~aand~ on tho bUay d: we:i aa ,~-1 t3aarLiL3ca.'~CL)g2c:3i .`igC'22ii:>. YKt3t that 19 S:i39L. SJL' LL^'L•C:. 7: Q i:, it cvrrecfi, wahate,ter caange.i nicoc+ne cauGc,~ in hea_t ZG rate:; at73 u!Le.ijt' pre6zUre, bxnod prg4:.ure is 17 I 11731t~FiiiS::ait~ 1$ A Npi at cZli. Ti1aL 3.5 t2Ot 30. Sii:otint3 Caujoa a cOTi:;i3tnt 19 inaraaae of about aight beata per ainu;.e. It.may not be 20 clinically significant to the point that you would worry 21. about aomebody taving a tacL•ycarditt, but to aay, to have 22 your aeart beating eight tiass a_minutt 24 hours, around the 23 , c.iock, iu ot nQ conaQ4uenc;e. Cerzascily vroulc3 not be the 24 1 kitni of thing you vanL to andoras. You have tco see the 25 I atatemant,~ oz tnat kinc3 in cont.ext. Pf.Y:+uZS T. L121TIS, CSR & E#. HCUSTC;a, C57
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jrstfZe - Csro3;~ 34;+z i l I 2 3 4 5 6 7 a 10 11 12 13 14 1"a 16 17 1a 19 20 22 23 24 25 Q Aro you aware of thQ~ wark of doctor -- of 4aarles -Irwiri, Deve.0iz.,~nts of Psfchtatry, of Duku t#nivcrGity? A Can't 5ay that at this aior;;ent it atrikes afa.a.a iar tone with m€,, no, Q -And of bis article, Cardiac Rate to Cigareitte Saokingy a Study ils,ing Radio Teiemetry7 A No, I don't think I ree3 it. Q Doc:Grn, did you participate in the preparat*&on aP a re?or1h tzi.led, "c,ffacty :,f Swz;,ka.nq anci "ok.nq ;iithJr::ws1- 013 f.iiga : Perforwa nce A Ye:.:, I d;.d, Q Csgaro;.:.e "oRing and ai.llns piiotO A Tba9i':i c:7Z rE3ci:. Q Far our purptla-'a t:rday can 1 refer to that aa the airline pilot, etudy? You'll kno;: rtbat I'rt taiking mb:>a:.7 A 1'e4. Q Ana you were or,es of tne tL; on dpaae: prea:in,3 that. Ia that; eurraar7 A yQa, 0 kre you of the view, doctor, that ilthough nicotine haa been shown to produce smal3l increases in h*art rate and Yrterial pressure, -that is conaidered iariqnificant when comgared to norAwi cardiac demand3 dnd Autput in tha everyday life of a_hoazt.hy piiot? Zi; that a cor recL &ts3tttm#'s12t? PIMLIS T, Lt:iY'ISt CSR & r7UIVE'113 M. RrJi3vr`1'Q>•:,j CSR
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Jaffe - crona 3963 f t 1 2 3 4 S 6 7 8 9 10 1i 12 13 14 15 16 17 is 19 20 21 22 23 24 25 ~ iuat i3 a c-orrect statsaent. By thQ way, ; shouid teli you, -asking ab4ut, cab dcivars. Y'va knrsv, the rest of thaL report, when tziey wera trying to keep piiotsd from araokrng, our committea.said, no, let them amoke, we don't want them flying when they're having nicotine w.ithdcavai. That'a the recomuaendation in that raport. Tney were worried about thr amauAt of carbon nioAoxide interfering with the pilots' capacity to -reapond a;t high ie-vei. And we were wire worriea a:>:7ut r.;;e nic:otine witt,draw;al in the airiine pi:iata' reporL prepared 5y t;i- cance; -- Heart and LuaV InaLicute of tho Nationai ln.^;titute t : U «° ~iiat 111co.iile ldaai k:l1r.7wn t~, p1'ojJce in:.rea.~ej in heart rate ar.ci arteriai przswure: ia~lti3+1 A Relativ6 to tilu da;;,and:: ot ev+eryjay ].:,fc, tbat is correct. Bat it's not correct to say tha;t to have your ht3rt Uc+atir,g four or five beata or bcaL:; Pa: rs•~nu;.e L3fOund tile ciOCk for dTcoZt of ti1e Li;a:~ it'v ot no C,Lf niCwi aiqnificanca. You have to take the things in contex:. Q Do you rcrcall, doCtor, writing an article ca3.ied, '?obacco Use and Tobacco i3iie Diaorder' with Murray Jarvicrk in -- or a+chttpter or something called •Paychopharuaaaiogy, ~ a Geneza.ion of Progr'tt~j"? Ct N W A Ye.;, I remezber that. U1 ~ Q And that review waj done in 1970, correct: ~ PHYi.~T..LB 'f. Ltiiqi5, CSR t, JOA?a21E t1. I3J'JS:3ri, CS::
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J8ffe - cresza 3964 I I A TkIat'a ric}ht. 2 MR. Fiay I approach the ircn:.n, your Honor, 3 an3 give tua doctor a copy? 4 Q Z direct your attention to page 166E3, agdin the bottom 5 paragraph in the lefthand side. 6 A First colunn? 1668, 7 XR. DARDELL: Can wa see a copy, piQa3e? C Thank you. 3 A ye.:i, ulr . 10 Q ^O yo" agrets with tais ,stateraent, *At our present, 1evei 11 of undzxs+'".arld,ii°tgf 3Lfect:; on neurotran.~iwitter3 do nor 12 provirlc significant insigiat:: into the ways in wr:ica nico;.xn3 13 c3inLorc:es srlj~inr3 Yehavior ur pro:2uLez, affect,z founJ u:;*xui 14 or piea:~u:a:ai~t by bmoker3"'r Dn you agres with that I ~, dt s1t emC2;it? 16 1 A T think it's zti~.i yenzral4y true. OL c.->sr3e, th-Mr 17 d.;eaa`t wean w;4at you ti}inr, it means. Zt tuean.~ that w:~: 18 tnink a:i of tanua tra.z=i.ter-3 are i;4i~artanL in one ro:d tic 19 another of all the things that nicotine does; it's 20 p2easuravls +aff$cts, reinforcing sffeeta, alerting sffects. 21 It'e juat that we can't pindown which tranamitter is 22 mosr inportant for wbich effect. It's not that we think 23 that the tran~;mitter; are irrelevant to ell thoae effectc;. 24 The benBEicia1 t+nes, the rewarding effstcta, it's: just that 25 it take.: a long tiae to pin those dovu. FHYLLIS T. LE';i;, :SR & JCA`1tv'E Pi. I33uS_W;, C5?Z
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1 2 3 4 5 6 7 a 9 10 3 1 12 1 '4 Is 3v 17 la 19 -2© 21 -2 2 23 24 25 Jaffe - cra3s 3965 We havc been -Ltudying morph..na far 1JJ yeaX:.. I-% 's only in the xast five or six wG even hava a hir,L a;~ to waich of thc trana:-~i tterz provide morphine-eupr,or ia. We ne;i 15 years aVo, the girst edition of Goodman and Gillman, that morphina affccted lots of tranam#.ttera. But we couldn't +ay Ybieh one: did Which of the aany thinua tLat morphine did. We're gradually ge~.ting there a litt].e bit and maybe Ma'al got tbore with nicotine a little bit. Z13L 1, i~.:f1C to illuicF3 1.v cieilr t:~dv Wili..LE°.' w-!~ dt:;.' i. know -ex3ctly w:iicb :rans::itoter, we have a t(rW hant~. ita RaQ.IL i. zay wkliic:i L,tJL:1 whicij LZ1ing. Q Loe:il1' b i.iyl:+ :aayj, dDfiY.'JC, Ia'rlat. 8t't tutt pre.i4''.ilt J.eVP..L of Ui1vt'L''r:v:.a77'.Yiny~' Lit?aL`Yil'cttS2.i1 Iar'et'?inj d0<:tCfLs t.t7c:t the pre+iCf3:. leve:. o£ un3e,:Ll-a :ding knowiedye a:>aat nicotine's afio~z:_ on neur:~trd~~s;~itt~r~ dccz~ not provide iiiC3rl.ifice'1C'1l: in3.igi:t In w4y;.~ nS.c;,tine reinfurcez am;;4ing beaa:•ior or afiecL-Z or produc:o:; z€'£acta xoiad to be pieasar"..e to hu:aan7 _klaa: ir. zaYUizi -1s -t:~at ali your kna+rie3ge 8bou:t nicotiae affecta on r3eurotranamittera doesn't tell you wisat the +tffec:, of nicotine is on smokinq behavior? A No, that's not what it-aAys at aYl. I know wuat it says. I'll try to sae if I cart -.aommudicate it. :t musans ni6Utine releasez and the paragraph says neuroepinrept3erin, chaiinergic mcana, ralease dopam:ae. And we know nicotine does aoma usaful r;aiiIbgzf help:j pt,,)p1c PRYLuIS T. LEMIa, CSk i: ZOATia113 K. HC3UST:)N, CS:1
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s`affe - +cross 396€ r i 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 t iD 19 20 21 22 23 24 25 concen4ratie, give;; them soSSe kind of rexnforcing affect. ttTe do32'#: iGiloif "ic'Cl c.'if the txan3l3itLer feae:.oos oi IIfrects oll trena:a3tter3 oc vaiciz xeceptors are linke3 ta eacci di thosa ef,fectm. Na know from other drugs "ey're n:,t alwap;.. St':: just one oP those is affected, may Le dif:erent transmitterz~ effect different of theye gunLtions. And wnat that gentenWa was trying to say iu thet : iy;;~; Wvw tw 'r.1low t'tzst nicOI:.ine pro~ILUea t;~e rcl~~::e ~: the-3e ~:.~inys ii. not e trozendvua Lulp. We havea't pinnac: dowa wa:.c6 of tne:~ is connected wi: h waich thiny:.. IMean, We aa"ve soMc ityi~otije:;ec. Wc th:irts abcu4 A1 zayi:aw i' Ddi.zaaac atld tiiia fuC4 nf coi:ine receptor z oc mrtruory r:an be affe~:taj by nico:.ina. It c4rs actua3iy prcave i.eae.ifr ta:it zaybe it':s tne c'ticiingoric, nic:otit,ic rNcl~ptc.a on the citol+ngerfc reC£:,ptCr5 ta.;Z. tiai:.2 -- tk73L it'3 iit til:: ti'iach+:en_,:J:iI rJy iJ:YJA.Ca nicotine s3oe4 that. 8at that's a hypotclcsia. It takes a lony, Ionq time to do tbeue kinda of thinga but we iike to know whicu parts of the brain, whicn transmitters dre involviec3 in which affects of drugs. As I said, we're juat be$inning, after-200 yeara, ~ ~ to get some hints as to how some of the well-studied drugz GD , U1 such as cocaine anc3 mUrphine producatheir various efiecE.c. ~ m Q Docto_, you testifi.ed ttiday or toua; an3 ye.;terJ4y ahout1~ PMLZa T.
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I ~~. 2 3 4 5 6 7 8 9 z^ V 11 12 , L 13 14 15 16 17 1s 19 20 21 22 23 ?. 4 25 Jarl'e - croaa 3967 rho efiacL ozI cigcreLte a-,uoking ori Ruae Cipoilone's ability to stop zzaoking, t+er ahility to cho*:;e i:o atop i;moking. Is that right? A I tbink I talked about hor dapendertca. Could you repaat your -queation? I'a not at;ra I heard it. 4 Do you hava an opinion on whether or not Ro3e xipollone'a cigarette srao3eing had any aflect or, her ability, to cC]tlo:i^ to LitGat.'r zmo,k1lkj *l1Ci heL claii~2s:}' to A Yea:c. Ithink it uhe ha3 never s:xoked, 3ne Wouici.'t haVe s1F3y t3i!`Xicti.tty Ct1oos1ng Llot to cCiritinjo to LOokej certair3ly. I tr:inds that t3lat.' . true. ber..iiavo thatt her free w.:il Ka:z lrap~t*red by virtue o:' her ~~okirtc~. her ability tu =ke a 3acisi3n to stcp ulzoki7g? A I tt,ink what I've t.eati£iej to is that, owe -- w,,je~l ono sQoke:; an;z beco-Mej cie,pendtnL, the aase,3cL of what aastlW, +f you had to b•oii -1t down to e santenco or two, 3fi that taa drug, as a rasult of tho muitipie drug taking and changes in the body and the loarninq, romas the control babavior, so that the individual bbs a--faora xsatrictad, la54 tlrxible ranga o£ cboicas aa to whether to continue to use the c3: ug or not, as sibaparad to someborly who 13 not dopondcanw Qn that drug. Q i3oo;~ that uean in your view that arne hati a ability PI:YLLIS T. --LNra, CSR & -:©ANi'i ; H. HJUST"JF4 CSI2
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1 2 3 4 5 6 7 8 9 10 11 12 r 13 14 15 16 17 13 19 20 21 22 23 24 25 Jsfie - cross 3968 to chooae or ieas f reedors to chooze? A I thin~ that'a what I'm tryinq to say; zhe na3 ies3 freer?= tt? CiiGo3et leab option to chooae. Q is therg a consensus among psychiatriatn and the medi;;al co-minity that free will ig an article of faith rather than a concept that can be explained in sedi.cal termy2 ~ 1 don't know Nhet..her there i.s a consensun. Ph i losophers have been working on free wal.1 and the anstra;;t zinQe tor about 2000 yearw. I don't really know what you mean by tnat consLn; u:: ar sn wtua^ aoatext you're using i,t. Q Are you aVarc?. {jG3Ctor, of tll8 At`{.s' 6 CoziiittC'v rt3t)oLL' en,4,it;,ed, •Tn:~dnity DuLenso in Criminal Tria1ii and L:mit-slzit3n of PSyC:'1iai.Z'iC TabtiLtony*7 t4R. EDLiL: You: Hongr, 1 object to this. t+'e wo:it tArough tbiz on a gsstic,n. T:: COUR','s Nuy don't we ad)ourn for tho 3ay and W-1 can drbcasz that out of tho preaence of the jury? A few remindere for the jury. First of all# as you knoY, we wili not be sitting tomorrow. We will seaume on Monday. I again appraciata if you would be hers at a quarter of ten. I repeAt mlr ubuai adwonitiotts to you. bek ze say one other tharig to you, lac9ie, an3 PHY:.L«i3 T. LWZ-^u, CSR ii Jc7AANL N. HorJS.'"i'Ji4 C5f°.
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r I 2 3 4 S 6 7 8 9 10 11 12 13 14 15 15 3.7 1$ 19 20 21 22 23 24 25 Jaffe - croas 3953 gent3ewen. Under the Ru3es of Court, az we've already inscructed you, the Nrtiej have the r.igh:l to take daisosition4 and you uriouid not -draw any s.ni:Qrence f rum the fact that a deposition or depositiona were actually taken or the langth of thos0 dopa3itions. That ahould not enter intio yoar conaidarration. Other than that, have a dary nice weckend, day flif torsorrow or work, if ttat'a your choice, and we'Si aee you YE'":Z"' Mvilii4y alZ. $ qilaitor of ton. T~Z,: CLE?.iC: All rise. tWaoreupvu Lse jury is Qxcu~,sd and the ftii.lowa.ny takas pisce out o:' the prezencd of the jury.) THr. COii"rt,11; You can ate? down, c3ocrc,r. Anything else? fit'2. $1.StV,i,wyl One th.i1l". I'd 1lke to cJnLiri9 On tne record waat the rschec3ula i:: for Manc:ay and Tse5day. Aa I un3erstand it, we're goiag ta coMpIc:Le Dr . JafSa7 Then we're qoing to havQ tha Dunn vidau _tapcs and :3r. poliay and Dr. Cohen? Kt. ES)ELLs 2hat'a torrect. That is correct. MR. -BLIARLEY r {3kay. Tha t 4y&11 I have. MR, Z?BLLs I may not switch things around but IGo may delete aomething./" I'Ii teli you. ~ W T:IZ CDUR3 s Have a nice waakend. V1 Q7 I' 13 ate you ai 1 guar ter: of ten on Nonday. cz PaYLLIS T. Li:%i rSt CSR 6 JC)7,i;~;ai: i!. IIQJSTh?2i, CgR
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a L I 2 3370 {Triai acj4urne3 until Xonday. March 7r l91ua;3, at 30
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WITNESS DIRECT JEROME JAFFE By Mr. Edell: 3769 By Mr. Kearney: CROSS ' 3826, 3897

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