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When Should Advanced Diagnostic Evaluations In Brain Imaging Be Used?

Disclaimer: This article is in response to questions frequently asked of Mr. Cobb and is an unedited dictation transcript. Just like talk to text on your smartphone, there may be misspelled words or sentence fragments.

The time to do use advanced diagnostic evaluations and make that decision is upon an initial consultation. Most lawyers are not set up for that. They do not know what to look for, and they have not been trained. I am fortunate in that I do know what to look for and that I have been trained. Our intake interview process uses a red flag system. When someone has enough red flags that mean it is time for me to have a discussion with that person about the potential need for brain imaging in their case. I will give you an example of some red flags. If someone did not graduate high school and they did not complete their G.E.D. They have a history of several speeding tickets that are not criminal in nature between the ages of letting us say sixteen to twenty.

Then by the time I am called, they have had a minor drug charge, perhaps disorderly conduct, or some other charge, but when I get them, say they have their third charge. That case is flagging all over the place. That person is flagging all over the place. Why? Did not graduate high school, that person may have a lower IQ. If that person did not graduate high school and did not complete GED that is a warning flag, the fact that they have an arrest and a prior criminal history that is a warning flag. I ask certain questions about whether or not family members have had any drug problems. We use these five flags to look and find out if that person is suitable for that type of mitigation.

If in fact, they are, then we make a referral and an evaluation is scheduled. They will need two to three days to do the actual evaluation itself, and I am always pushing for the earliest appointment that they can possibly get. Sometimes you will have a case where you do not have anything like that at all, but you have somebody who has a perfectly normal life, and then you find out they have done some horrific thing, or something stupid, and they are sitting there scratching their head going I do not understand. I do not know why I did that, I have no excuse. They are surprised and blown away. If it is a serious case where something like that has happened, then that person may be a candidate for brain imaging. For example, the thirty-four-year-old veteran I spoke of who had seen significant combats.

By all accounts was a perfectly normal and decent human being, comes back after his deployment and service as a contractor and has a sex offense. The two do not seem to fit in the same place. Normal people do not develop an interest in underage minors, sometimes young children. People with normal brain images, they do not have those types of problems. Where we find serious charges, someone is guilty of that charge, and then we need to do a brain imaging evaluation because it is going to be highly unlikely that person is going to come back with a normal set of brain images, and if they do, it will be the first time in my career. That would really surprise me more than anything.

I am not asking for perfection, I just expected that I would find some that were on the cusp between normal and abnormal brain scan. Actual experience has shown that they have been highly abnormal one hundred percent of the time. That really surprised me.

Do You Have Other Examples Where Use Of Neuro Sciences Or Brain Imaging Led To A Favorable Resolution In A Criminal Case?

Perhaps the most striking example of how powerful brain imaging-based mitigation can be involved someone I cannot name, but we will just say that this individual was a rock star in the military during a time of war. One of the most effective members of our military I have ever run across. This person was so well thought of that when a drinking problem was uncovered, the military did not blink an eye. They immediately put him in a twenty-eight-day rehabilitation program because they thought it was the right thing to do. Yet less than thirty days later I was speaking with him because he had a no contact order as part of a federal domestic violence by strangulation charge that arose during an alcohol-fueled bit of binge drinking. His career was on the line. We did a proper diagnostic evaluation and the results were striking.

This individual who was one of the highest performing members of the military I think I have ever run across in my life, he had a brain injury. In fact, had several traumatic brain injuries. When these types of evaluations are done, traumatic brain injury only counts as one brain abnormality no matter how many TBIs the person has. This guy had a very specific pattern of both injuries and other problems in his brain that I suspect they do not know were service related. Sure enough, he began following the treatment that was recommended. He was very skeptical, particularly skeptical when they wanted to put him on very powerful medication. But he did it anyway. Two weeks before his case was scheduled to go to court he called my office out of the blue.

We did not have an appointment or anything scheduled, but I took the call. And what he said was both thrilling and chilling at the same time. It was thrilling because it was working. He said, “Mr. Cobb, I just want you to know I’m grateful and wanted to thank you because for the first time in my life I know what it’s like to feel normal. I don’t feel high, I don’t feel buzzed, I don’t feel like I’m having medication side-effects, I just feel normal”. He went on to tell me, “I could walk by the counter in the privacy of my home with what used to be my favorite alcohol sitting right on the counter and I would shrug my shoulders and walk away. I have no interest in drinking. It doesn’t even interest me. I have no craving, unlike when I got out of the inpatient treatment and the craving was so intense.” He said, “Now it’s just gone, I don’t have it at all.” That is what was chilling.

This guy did not even know what normal felt like and had been living that way for I do not know how many years, probably since adulthood. Yet he was still able to function at a very high level and serve his country. Charges ended up being dismissed in his case. This was one of my early brain imaging cases from a long time ago. It has been just over ten years. Has he been in trouble again? Not at all. Last time I checked, I did not ask him, I asked his wife does he drink anymore. She started laughing. She goes, “Sir, he hasn’t drunk at all since he went to that clinic and they started giving him that medicine. I haven’t seen him touch a drink since.”

As someone who grew up with a father that had a serious alcohol disorder that was never effectively treated, to hear someone say my husband came back to me, he does not even want to drink, that is music to my ears. Anytime that I can help somebody with an addictive or a mental health disorder or a legal problem at the same time, then I feel like I have done something useful for the day. That is my mission in Florida criminal law.

Disclaimer: This article is in response to questions frequently asked of Mr. Cobb and is an unedited dictation transcript. Just like talk to text on your smartphone, there may be misspelled words or sentence fragments.

For more information on Advanced Diagnostic Evaluations In Brain Imaging, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (850) 466-1522 today.