In Dr. William Brownlee's mind, he's just a friend of the court, another witness providing a few medical facts and opinions. He's low-key, kind of homey, with an aw-shucks manner. As an expert witness, it turns out he's a good deal more.
Over the last 16 years, Brownlee, a former deputy D.C. medical examiner and now coordinator of medical affairs at Hadley Memorial Hospital, has testified in more than 700 court cases. With such credentials and experience, but most of all his courtroom demeanor, there now are more than a few Washington lawyers who think that when they need an expert medical witness on the stand, Brownlee is one of the best.
Such an accolade is no small accomplishment in Washington, a town where courtroom experts abound -- psychiatrists to argue about a defendant's sanity, gun experts to testify about the trajectory of a bullet, economists to conjecture about the value of a life and doctors to offer their opinions on the quality of the care allegedly aggrieved patients have received.
Brownlee, 52, for years has testified about the District's murder victims, where the bullets and knives pierced the inner organs and created one more statistic for the FBI.
In a recent medical malpractice case in D.C. Superior Court, he was one of two expert witnesses attorney George W. Shadoan called to bolster his damage claim on behalf of Carol Lee Lally, a poet and a saleswoman at a Washington clothing store who suffered cardiac arrest and permanent brain damage during a 1980 operation. Shadoan had once cross-examined Brownlee when the doctor was testifying against Shadoan's client and came away impressed.
"He was forthcoming," Shadoan recalled. "If you had a valid point, he was willing to concede it.
"I selected him [for the Lally case] for his qualifications," Shadoan said, noting Brownlee's experience as head of the emergency medicine department at D.C. General Hospital for five years and his years in the medical examiner's office. In the Lally case, Brownlee reviewed the medical records and the normal standard of care and later testified about the cause of the cardiac arrest.
After three weeks of testimony, the jury returned its verdict last month: Sibley Memorial Hospital and an anesthesiologist were ordered to pay Lally $6 million, the largest medical malpractice award ever handed down in the Washington area. No decision has been made whether to appeal.
How important was Brownlee's testimony? An opposing attorney found out what the jury though. Jurors had heard more than a dozen medical experts in the complex case. But the one they thought the most believable was Brownlee.
"There are techniques you develop from experience," allows Brownlee, a tall man with a wisp of hair left on top and a face dominated by gold-rimmed glasses and a bushy mustache. "You really try to interpret scientific data into everyday life that most people understand or can relate to. It doesn't make sense to use an inordinate amount of scientific or medical information when there are no doctors on the jury.
"If someone asks me what the survivability capabilities are of a patient, I may relate it to a baseball game and say that they're in the fifth inning, as compared to the last of the ninth. Most everyone knows baseball."
But most of all, Brownlee and others who testify regularly in court say they have one commodity -- their honesty, as they view it -- that must not be sacrificed.
"If your fee is going to be involved in your judgment and your opinions," says Brownlee, "then you shouldn't be a part of the case."
David Shapiro, a 39-year-old psychologist, said he makes it "very clear" to lawyers who hire him that "my opinions are not for hire. Very frankly, I think I've lost some referrals from people who want pre-set opinions."
Shapiro said he is often called on to try to determine whether a defendant was legally sane at the time he allegedly committed a crime, a determination made ever more controversial by the fact that presidential assailant John W. Hinckley Jr. was found not guilty by reason of insanity. Shapiro said his opinions have split about 50-50 for the prosecution and defense. "There have been a number of times," he said, "when I've been retained by one side, but wind up testifying for the other" because his findings did not favor the side that hired him.
James T. Miller of Gaithersburg examines questioned documents, such as possibly forged signatures on wills, and said he often finds that the clients of the lawyers who hired him in hopes of proving some claim are actually lying about the authenticity of the documents in question.
Rare is the expert witness called to testify in a court case who would admit that his or her opinions were for sale, although several lawyers who regularly use experts often privately voice the feeling that the experts their legal adversaries use will predictably testify one way or the other. A handful of "expert" witnesses interviewed for this story -- including a neurologist, an orthopedist and a perinatalogist (one who treats the problems of the unborn in the weeks before birth and newborn infants) -- all said they examine each case independently. In the real world of the Washington courtroom expert, however, some witnesses regularly testify for plaintiffs and others for defendants and one expert's truth can sometimes be another's blatant misrepresentation.
Dr. David Abramson, formerly of Georgetown University Hospital and now head of the emergency room at Southern Maryland Hospital Center in Clinton, testifies regularly for plaintiffs bringing malpractice claims against physicians, but said that most of the time when lawyers ask him to review a potential malpractice case he finds that patients have no legitimate claim.
"I believe any doctor should be willing to look at any case and see whether a reasonable standard of care was provided," Abramson said. "We do make mistakes. We have to own up to them."
Such an attitude has not won Abramson any popularity awards with many of his fellow doctors. "The attitude I get most is grudging respect," the 44-year-old doctor said.
Dr. Harold Stevens, a 71-year-old Northwest Washington neurologist, concedes that doctors do make mistakes and that the patients injured from the mistakes should be compensated, but he also is a physician who thinks that malpractice awards have gotten out of hand.
"Malpractice awards are very expensive for the consumer," Stevens said. "We just pass on the costs like any entrepreneur."
Stevens said he testifies in court about 15 times a year, almost always for insurance companies contesting claims or for doctors in malpractice cases. He testified on three occasions for the government when it contested claims that people contracted Guillain-Barre syndrome as a result of receiving flu shots in the mid-1970s.
In another case, he testified that infants who survived the 1975 Operation Babylift crash of a C5A air transport leaving Vietnam did not suffer brain damage. Sure enough, there were "experts" on the other side of the case who said the babies' brains were damaged in the crash.
Such conflicting testimony, of course, is one of the reasons why litigation is so expensive these days. Medical experts are often paid $150 an hour or more for reviewing a case and then testifying. By the time they are finished their bills may total $1,500 or more. Psychologist Shapiro charges $50 an hour, while documents expert Miller charges $100 an hour for the first five hours and $60 thereafter. Aaron Levine, who regularly represents plaintiffs in damage claim cases, said he spent $40,000 for preparation of experts' testimony in one case that was settled two weeks before it went to trial.
"We're becoming slaves to experts," Abramson concluded. "We've gotten so complex you can't always tell the black hats from the white hats.
"It seems that things that didn't need experts now need experts."