Doctors split on transient global amnesia diagnosis

Day 3 of the murder trial continued Monday reviewing the medical history of the former Northeast Lakeview College librarian who opened fire on his colleague, Donald "Devin" Zimmerman, two years ago tomorrow.

Christine Crowley, Alan Godin's then-wife; Dr. Michael Arambula, pharmacologist; and Dr. Brian Scop, general forensic psychologist, were called to testify. The two doctors have been examining Godin since his arrest.

Godin, 64, entered a plea of not guilty Thursday by reason of insanity caused by transient global amnesia, defined by the Mayo Clinic website as "a sudden, temporary episode of memory loss that can't be attributed to more neurological condition, such as epilepsy or stroke."

Both doctors said the main symptom of transglobal amnesia is its effect on the ability to form new memories.

Arambula, who first interviewed Godin on Dec. 8, 2008, said he believed the shooting was caused by transglobal amnesia, which can be classified as insanity because it is a mental disease.

Arambula said his evaluation of Godin took 3 1/2 hours as he reviewed social, occupational, surgical and current medical history. He conducted a review of Godin's medical records after the interview.

During the interview, Arambula said he studied Godin's emotions, speech, memory and body language. He said he also went over the crime in detail.

Scop disagreed with Arambula's diagnosis, believing Godin may have been depressed, but didn't have transglobal amnesia.

He said he also studied Godin's eye contact and speech and performed an executive exam, which tested Godin's ability to make decisions and change subjects.

Scop said Godin performed perfectly on the exam, saying he was very intelligent.

The doctors also studied an MRI, a magnetic resonance image, of Godin's brain. Scop said he saw white matter changes in some areas of the brain, but that is common in people ages 65 and older.

Godin also has a history of high blood pressure, which the doctors in their examinations tried to connect to the amnesia.

Arambula said he saw a connection between Godin's high blood pressure and headaches to transglobal amnesia.

Scop said the two have been associated, but there is no clear effect. He also said Godin had uncontrollable hypertension, but it didn't hold much significance in transglobal amnesia.

Godin's legal team, John A. Convery and Julie K. Hasdorff of Hasdorff & Convery, P.C., brought Crowley to testify to Godin's history of transglobal amnesia, thought to potentially account for an episode of memory loss in a 2006 incident.

Crowley said she and Godin had been married 25 years and divorced amicably in November 2009.

"We speak about once a week on the phone," Crowley said when asked if she and Godin were still friends. "And I visit occasionally."

Crowley said she met Godin in 1983 in a community theater in Massachusetts where she played a small acting role and Godin was the stage manager. They married in 1984 and remained in Massachusetts until 1990.

She said they moved to Kansas City when she was offered a job at Johnson City Community College.

In 1997, then-Chancellor Robert Ramsay offered Crowley a job at Northwest Vista College to build a high-tech library there.

Crowley said Godin was the "trailing spouse" and "very supportive."

Before leaving Kansas City, Crowley said they searched for a job for Godin at the San Antonio Public Library. She said the library said, "Don't call us, we'll call you," but never called.

She said Godin did some acting and worked for some temporary agencies, including working as an essay reader for state exams.

In spring 2005, she said he worked as a full-time editor but was laid off a week before his 60th birthday in January 2006. "It was quite a blow," she said.

In fall 2006, Godin began working at Northeast Lakeview College library as an adjunct librarian. The same year was Godin's first incident of transglobal amnesia.

Crowley said she and Godin were shopping for a gas barbecue grill at Home Depot, but settled on a grill in Boerne, close to where they lived.

She said the grill was in a big box that wouldn't fit in either of their cars, so they called her friend to take the grill to their home.

Crowley said the couple emptied the box piece by piece, and Godin started putting it together. She described the process as a "comedy of errors" because they had to make four trips back to the store to get missing parts.

Once the parts were all there, she said Godin continued working into the evening to put the grill together.

Crowley said she was in her home office when Godin came in and said he would continue with the grill the next day, then went to his office to pay bills and balance his check book.

She said he came into her office and asked her, ‘Is this your ATM receipt?' from a nearby gas station. She said it was and he returned to his office.

She said Godin came in a second time, asking her the same question about the same receipt.

Crowley said she asked, "What are you talking about?" and told him he'd come in earlier asking the same thing.

She said he came back a third time, and that time, they began to argue.

She said it ended when Godin said, ‘Nevermind. I'm tired. I'm going to bed."

On their way to bed, Crowley said Godin looked into the living room, saw the barbecue grill and said, "What the (expletive) is that? Where did this come from?"

Crowley said she thought he was joking and said he didn't remember the friend helping them bring the grill from the store.

She said she thought he may have had a stroke but ruled it out because his speech and movement were fine.

She said they went to bed and in the morning, she asked him about his confusion the night before.

She said Godin told her, ‘Well, I was hoping it was a bad dream."

Godin sought treatment in an emergency room where he underwent a CAT scan. An abnormality was found and the episode was attributed to transglobal amnesia, but no other episodes since 2006 had been recorded.

Prosecutor Lorina Rummel questioned if the episode of transient global amnesia was the cause of the shooting in 2008.

The two doctors were split. Both said the first case of amnesia while building the grill indicated that his cognitive impairments were still intact because he could still perform a complex job.

Arambula said Godin suffered from automatism and was not fully aware. "The lights are on, but nobody is home," and in this state, right or wrong doesn't register.

He said Godin told him during the evaluation that all of a sudden, he saw Zimmerman on the ground, saw the gun in his hand and put two and two together.

Scop, who evaluated Godin after reading Arambula's report, said Godin reported thinking in his head, "Oh, (expletive)," after realizing he'd shot his colleague.

Arambula said Godin wasn't fully aware until he reached the magistrate's office downtown for processing into detention.

The doctors agreed that memory loss from transglobal amnesia lasts for several hours, but Scop said he did not believe that Godin suffered from transglobal amnesia during the 2008 shooting.

He said there was no witness to Godin's confusion as Crowley was in the previous incident with the barbecue grill, and Godin didn't suffer confusion after the shooting.

He said Godin reported to him that after he realized he shot Zimmerman, he remembered running and screaming, described campus police coming and arresting him, being taken to campus police, being driven downtown, and, therefore, there was no cloudy awareness.

The doctors said transglobal amnesia is rare and a reoccurrence is rarer.

Scop said less than 10 percent of those affected will have a reoccurring episode in the following year.

Scop also differentiated confusion, which he said was indiscriminant, with amnesia, which is directed behavior with purpose to fulfill a motive.

Scop also said the neurologist said it was unlikely to be transglobal amnesia, but Godin's attorney Convery argued that the two doctors didn't evaluate Godin on the same level. Scop agreed that they reviewed the case on different levels.

Crowley said Godin had four surgeries in March 2000.

She said the first surgery was the removal of a section in his colon.

She said he was in the hospital for 10 days and went home.

Crowley said she left for Kansas City and soon after, she got a call from Godin saying he had gone to the doctor for pain in his side.

She said the examiners found a sponge left from the previous surgery, so Godin had to undergo a second surgery to remove the sponge.

Arambula said in removing the sponge, there were complications and Godin lost a lot of blood and needed a blood transfusion.

Crowley said this surgery caused a need for a colostomy, which the first surgery was supposed to prevent.

According to Medline Plus, colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall. Stools moving through the intestine drain into a bag attached to the abdomen.

She said it was devastating, but that the light at the end of the tunnel was that it was temporary.

In October 2000, she said Godin said, "I've got to get rid of this" and had the colostomy reversed.

In 2001, after giving blood at work, Godin found out he was infected with hepatitis C.

Crowley said she didn't know where he had gotten it or how long he'd had it, but Arambula said he got it from the blood transfusion from the previous surgery.

When asked if her husband had suffered from depression, Crowley said he had suffered emotional depression caused by burdens of his surgeries, employment obstacles and financial struggles.

Crowley said they were living on 1 1/2 incomes. "It's tough," she said.

The three witnesses described a number of medications Godin was taking to treat himself.

Medications included herbal supplements bought on the Internet and a GNC store: antiviral, antidepressants, detoxifiers and energy boosters.

Arambula said if a person takes too much, they can become agitated.

In looking at the surrounding issues, Arambula said everything was fine because Zimmerman had gotten a new position that would separate the two, so he said it made no sense why Godin would intentionally show up and shoot Zimmerman.

Crowley said Godin called her after an argument with Zimmerman over an assigned handout and Godin was very upset because Zimmerman accused him of being a slacker, which devastated and embarrassed Godin.

When Scop was on the stand, Convery questioned his report of considering an alcoholic blackout. Scop said he didn't believe Godin had an alcoholic blackout.

Rummel asked for a rebuttal and called Officer Michael Williams Nemcic, shift supervisor for Alamo Colleges police department.

Nemcic was the active shift supervisor at the district offices the day of the shooting.

He was asked if he had contact with the defendant and replied yes.

He said when Godin was in his custody, Godin said, "I know handcuffs are meant for punishment and I deserve to be punished."

Convery asked if he had any recording device or if there were any witnesses to this statement, but Nemcic said there wasn't.

Godin remains in custody in the Bexar County Jail in lieu of a $250,000 bond on a charge of first-degree murder.

The trial continued at 10:30 a.m. today in 187th District Court in the Bexar County Courthouse, 100 Dolorosa St.

For more information, call the 187th District Court at 210-335-2517.