UNITED STATES DEPARTMENT OF JUSTICE
BUREAU OF PRISONS
Committed Name NAGELL, Richard Case
Register Number 0-1029-H
REPORT OF PSYCHIATRIC EXAMINATION
I. IDENTIFICATION: Nagell is a 36-year old male who has been committed to the US Medical Center for Federal Prisoners for psychiatric evaluation under provisions of Title 18, Section 4244, USC. He has been charged with the offense of bank robbery.
A commitment order from the US District Court for the Western District of Texas, El Paso Division, orders that Nagell be observed and examined with reference to his mental competency to stand trial. The committing court further requests that the report of the findings and conclusions be in writing for the benefit of the court in making a judicial determination of Nagell's mental competency. Although competency at the time of the alleged crime has not been requested, an opinion will also be offered in this regard, since it is felt that this is a pertinent part of the complete psychiatric examination in an observation case.
II. SOCIAL RELIABILITY: A psychiatric history was compiled by interviewing the patient who is judged to be reliable and supplementing the information given by the patient with confirmation from various sources. This included observations by ward personnel, a review of all of the court proceedings and the numerous hearings that Nagell has had and this includes a review of the opinion of the US Court of Appeals, verification of previous military service with a summary from the US Army Hospital, Tokyo, and all pertinent data in his central file.
III. PRESENT SITUATION: On the 20th of September, 1963, the patient allegedly entered the State National Bank in El Paso, Texas and thrust a .45 caliber revolver through the window and allegedly pointed it at a woman teller and exclaimed, "This is a real gun, lady." When the teller allegedly fled from the window to take cover, it is further alleged that the patient fired two shots into the wall above the head of the teller and then he left the bank and went to his automobile which was parked in the vicinity of the bank and was there apprehended by the El Paso police. He was convicted and sentenced to 10 years; however, prior to his being convicted and sentenced, he was sent to the US Medical Center for psychiatric evaluation. On the basis of the psychiatric evaluation performed at that time, he was found to be competent to return to the court for sentencing. As stated previously he received a ten year sentence. Following sentencing, it is alleged that he took an overdose of drugs in the El Paso county jail and was then transferred to the US Public Service Hospital at Fort Worth where it is alleged that he refused to cooperate with the hospital officials. He was subsequently transferred to Leavenworth where he continued to serve his sentence until recently when the US Court of Appeals for the Fifth Circuit reversed his previous conviction with instructions that a new trial be granted.
The court in El Paso then committed him to the Medical Center for evaluation prior to his new hearing. Information from the US Attorney's office in El Paso indicates that on or about the 9th of April, 1966, that Nagell barricaded himself in his jail cell and refused to come out. The 18th of April, 1966, Jesse L. Dobbs, US Marshal from San Antonio, Texas talked to Nagell and was able to get him to agree to leave his cell and was thereafter transported to Springfield, Missouri.
When first interviewed shortly after arrival at the Medical Center, the patient stated that he intended to cooperate to the fullest extent; however, when asked if he had any questions, he said, "Yes." He then asked if the psychiatric reports would be made available to the US attorney and when he was told that this was the common procedure, he stated that he would not cooperate. It was explained to him that this was the normal policy and procedure and that the US Attorney would make available to his attorney, the defense attorney that is, any information that was transmitted from the Medical Center to the US Attorney. That is to say, copies of any report that we make to the US Attorney would be made available to the defense attorney for Nagell. This failed to calm the patient and he persisted in stating that he would not cooperate. A review of the record indicates that this has been the pattern that Nagell has followed in the past. After a few days, Nagell was called down to my office and I explained to him that the problem that the court presented to me in his regard [sic] and the tests and observations that I intended to make in order to resolve these questions. He was advised that I would resolve these questions with or without his cooperation, but that he would not be forced to take any tests that he did not care to cooperate in taking. After thinking the matter over for a few days, Nagell elected to cooperate to the fullest extent and has answered all questions put to him and undertaken all tests requested of him.
Based on his past suicidal attempts history and his recent history of barricading himself in the El Paso jail, on admission to the Medical Center, Nagell was housed on the acute psychiatric ward where he could be held under maximum security and close observation. He showed no suicidal tendencies during the period of observation nor any tendency to act out, therefore, he was subsequently moved to an open population ward where he is presently housed, and will likely remain housed there until the court calls him and returns him to El Paso for his new hearing.
IV. PAST HISTORY: Nagell was born on August 5, 1930 in Greenwich, NY and resided for a number of years in Albany, NY and completed junior high school and high school in that city. He enlisted in the US Army at Albany August, 1948 on his 18th birthday and remained in the military service until his resignation in October, 1959. Nagell states that this was not a forced resignation and that he resigned for personal reasons, namely that his wife insisted that he resign. Following his resignation from the Army, his place of residence has been in Southern California.
His father is allegedly deceased and no information is available about the father. His mother resides in Los Angeles, California and alleges that she has not seen her son since August of 1963 when he is said to have stated that he did not wish to have anything more to do with his family because of its interference. She is reported to have remarked that her son had a brilliant career in the Army until severely injured in an accident in November, 1954 and that after the accident he underwent a severe personality change and has been in continued difficulties since then.
Nagell married a native of Japan while stationed in Tokyo, Japan. They were married on March 24, 1958. His wife secured a divorce from him in Los Angeles, California in November, 1962 and is presently residing with his two children in Los Angeles. Nagell reports that his marital difficulties started sometime in 1959 and continued through the time of divorce.
Nagell entered the US Army on his 18th birthday on August 5, 1948 and was honorably discharged as a sergeant in Fort Benning, Ga. On August 1, 1951 in order to accept a commission in the US Army Reserve Corps. He was commissioned a Second Lieutenant on August 2, 1951 and continued to serve until he resigned his commission as a Captain in October 29, 1959 in Fort Dix, NJ. It is alleged that he served the nation honorably in Korea, being awarded the various campaign ribbons, the Bronze Star, and the Purple Heart with two clusters.
While on active duty in the army, he was involved in an airplane crash November, 1954 and following the crash, it is alleged that he was in a coma for a period of time. Nagell himself confirms that he was in a coma. After recovering from the accident, he was returned from active duty. The record indicates that he has had some definite physical and mental problems, both stemming from severe injuries sustained in the airplane crash.
While serving in the US Army in Japan in 1958, he was referred for psychiatric evaluation because of his attitude over being reported for having his Japanese fiancee in the bachelor officers' quarters and one month later was referred for examination for having made complaints about alleged security violations directed to the Department of the Army rather than through channels. They returned him to duty and reported that they could find no disease. It is speculated that they meant no psychiatric mental illness. Following his resignation from the Army in 1959, he was judged to be disabled 50% and was placed on a disability pension. The patient has continued to consult various hospital facilities since his discharge and on July 16, 1962, he was admitted to the Wadsworth Veterans Hospital in Los Angeles, California in what was alleged to be a self-inflicted gunshot wound in the chest.
With regard to his employment, Nagell states that he was an investigator with the Department of Employment, fraud section, in Los Angeles, California from December 14, 1959 until March, 1961 when he accepted a job as an investigator with the California Beverage Control Board, remaining at this employment until June 18, 1962. It is alleged that he was fired at a later date for stating to the press that the Los Angeles vice squad was "shaking down" too many businesses.
The record also alleges that he worked for approximately one year for an unpopular political party. The unpopular party being implied as the Communist Party. Nagell, in the course of his interview, emphatically stated that he was not and had never been a communist. He further stated that the association was alleged to have been made because he had carried some communist propaganda material for distribution in Mexico at the request of a friend. He admits that this was poor judgment and feels that he was used.
V. PHYSICAL EXAMINATION AND LABORATORY TESTS: On physical examination he was found to have a well-healed vertical scar on the left side of his face. The neck also revealed a well-healed tracheotomy scar. The balance of the physical examination was within normal limits.
Laboratory findings: Kolmer and VDRL, non-reactive. Urinalysis, negative. X-ray of chest, normal. Skull X-ray May 19, 1966 was reported as follows: Sutures about the left psychomatic arch and the left mandibular condyl and also to the left of the right mandible. The calvarium otherwise was found to be intact and there was no evidence of any recent or old fracture nor of abnormal calcifications noted. The electroencephalographic report indicated that it was within limits of normal variation.
The psycho-diagnostic impression based on the psychological testing was that of a paranoid personality.
Psychological testing failed to show any evidence of an active psychotic process or show any evidence of an impairment suggestive of a cortical brain damage. The psychologist's report added that the findings do, however, point to significant functional, emotional problems which appear to be of long standing and which definitely interfere, particularly under conditions of stress, with this man's ability to function at a level commensurate with his intellectual capacity. In his opinion as a psychologist, the patient has been both neurotic and has had characterological problems which, he infers, have at times reached psychotic proportions.
The final paragraph of the psychological report states that little or nothing would be gained for society or for Nagell by continued incarceration in a penal institution. He further states that, in his opinion, Nagell will require psychiatric hospitalization and long-term individual psychotherapy.
I might conclude that the psychological report was essentially in agreement with my clinical evaluation of this patient.
VI. PSYCHIATRIC EXAMINATION: The patient presented himself for his interview neatly groomed. His production of talk appeared to be logical, progressive and without any indication of autism. He appeared to be somewhat tense and anxious throughout the interview but on subsequent interviews, appeared to be more relaxed and comfortable. He was oriented with reference to time, person and place. He appeared to be of better than average intelligence. His judgment and insight appeared to be fair. There was no evidence of any hallucinatory phenomena or delusionary thought trends.
The patient did show some compulsivity and rigidity in his thinking. Nagell himself admitted that he had some psychiatric symptoms and stated that he has never denied that he had such psychiatric symptoms.
Nagell also displayed a very moralistic attitude and pattern. He kept emphasizing throughout the various interviews that his whole purpose in entering the bank in El Paso, Texas when he is alleged to have attempted to rob the bank was for the purpose and sole purpose of getting psychiatric treatment.
Nagell states that he had tried for admission to the VA Hospitals just prior to the alleged bank robbery. He stated that after getting married, his wife insisted that he resign, which he did in 1959 and that his adjustment to civilian life was very difficult and made more difficult by his marital problems and finally resulted in his marriage breaking up in the Spring of 1962 which had a very traumatic effect on him. He alleges that his wife left him twice and after she left him for the second and the last time, that he lost his job in June, 1962 and noticed that he was starting to get nervous and emotionally unstable, that he got and quit two jobs after that because he couldn't concentrate. He felt that he was slipping and finally, that he tried for admission to a VA Hospital just prior to the alleged bank robbery that he was desperate for some type of psychiatric treatment for his psychiatric symptoms of nervousness and emotional instability and inability to concentrate.
VII. DIAGNOSIS: 000-x44 paranoid personality associated with features of a paranoid state, presently in remission.
A paranoid personality is characterized by many traits of the schizoid personality, that is a tendency of avoidance of close relationships with others, an inability to express direct hostility, coupled with an exquisite sensitivity in interpersonal relationships and with a conspicuous tendency to utilize a projection mechanism, expressed by suspiciousness, envy, extreme jealousy, and stubbornness, all of which Nagell displays.
A paranoid state is a type of paranoid disorder under the classification of paranoid reactions which in turn fall under the general classification of psychotic disorders. The paranoid state is characterized by paranoid delusions. It lacks the logical nature of systemizations seen in paranoia; yet it does not manifest the bizarre fragmentation [and] deterioration of schizophrenic reactions. It is likely to be of short duration, though it may be persistent and chronic.
1. The patient is judged to be competent to stand trial. He knows what he is accused of and can account for his movements and he knows that the court views the act as a crime no matter what his own views may be. He further knows in some realistic measure the kind of trouble he can get into if found guilty and, finally, it is felt that he can cooperate with and assist counsel within reasonable limits. His examiner is aware of Nagell's history of failure to cooperate in the past. However, the type of cooperation he has displayed during his present hospitalization at the US Medical Center resolves any doubt that I may have had on this score.
2. With reference to the question of mental competency at the time of the alleged crime, the patient is judged to have been not mentally competent at the time of the alleged crime. This opinion was arrived at using the criteria for criminal responsibility that is used by the US District Court for the Western District of Texas, El Paso Division. Their criteria is as follows:
1. Whether the defendant was able at the time of the offense to distinguish between right and wrong, and
2. If he was so able, whether he was incapable by reason of a mental disease or defect of adhering to the right and refraining from doing wrong.
This examiner is of the opinion that Nagell was able at the time of the offense to distinguish between right and wrong but that he was incapable by reason of a mental disease (paranoid state) of adhering to the right and refraining from doing wrong.
Whether or not there is any evidence of brain damage cannot be stated or disputed. I can point out that on the basis of my examination and my laboratory findings including an EEG and psychological testing that I did not find any evidence or finding suggestible of brain damage.
It is evident from the record and from interviewing the patient that psychiatric symptomatology whose etiological basis appears to be slowly building up stress, perhaps secondary to the plane crash in 1954 subsequently due to marital difficulty, slowly began to become evident perhaps as early as 1959 when he first was brought up for psychiatric evaluation in the US Army hospital in Tokyo. This marriage finally broke up in the Spring of 1962. He had difficulty adjusting to civilian life after leaving the Army which he left apparently at the insistence of his wife. It is significant that in 1962, he entered Wadsworth Hospital for a chest wound which the record at one point states was self-inflicted and which Nagells implies that his wife shot him. It is further significant that the patient himself became aware that he was getting nervous and that he couldn't concentrate. Further evidence of his increasing instability was the signing out from the VA Big Pines Hospital and his attempting to get psychiatric treatment at the hospitals but being unable to cooperate with them in getting it. It appears that he wanted to qualify whatever treatment he got. It is fairly significant that he attempted to get psychiatric treatment in such unusual fashion, that is by allegedly entering a bank and firing two shots into the wall. His personality pattern at all of his past court hearings as well as in his past hospitalizations in which he displayed a hysterical nature and a stubbornness would lead one to believe that the patient was and has been mentally ill.
In resumé, then, the psychiatric symptomatology began some time in 1959 with symptomatology suggestive of paranoid personality and proceeded under ever increasing stress to a paranoid state at the time of the alleged crime, and persisted until fairly recently with a slow remission to his present paranoid personality. A paranoid personality is not a psychotic state; it falls under the general category of personality pattern disturbance. The depth of the psychopathology of a personality pattern disturbance allows these individuals little room to maneuver under conditions of stress except into actual psychosis. It is the opinion of the psychiatric examiner, in closing, that this is exactly what took place, namely that Nagell, a lifelong paranoid personality under slowly building conditions of stress, went into an actual psychosis (paranoid state) and subsequently went into remission, and is now again a paranoid personality.
IX: RECOMMENDATIONS: As indicated above, Nagell displays some manifestations of a personality pattern disturbance which, if he is to be rehabilitated and achieve some degree of adjustment in life, would seem to indicate some type of out-patient psychiatric treatment such as long-term psychiatric therapy. I do not see any indication at the present time for any long-term in-patient hospitalizations. It is conceivable at the present time that Nagell could and would undergo out-patient treatment on a voluntary basis; however, under a period of undue stress in the future, it is conceivable that he could discontinue voluntary out-patient treatment. Some form of supervision that would insure his continued out-patient psychotherapy for at least a year would be highly desirable.
/s/ Joseph F. Alderete, MD
Chief, Psychiatric Service