Friday, July 3, 2009

Prosecution Post-Mortem—What I Still Want to Know

Methinks the trial of former child psychiatrist Dr. William Ayres is moving along far quicker than anyone anticipated. In what came to me as somewhat of a surprise, the prosecutor, Deputy District Attorney Melissa McKowan rested her case-in-chief on Wednesday.

Now that the prosecution has rested (after a one-day recess due to the unavailability of a witness until that final day), defense attorney Doron Weinberg will now be “controlling the show” and the case will now become that of “dueling experts” and “character witnesses,” and I suspect that naturally some of those character witnesses will be colleagues of the good doctor, along with former patients, prepared to testify that “he didn’t do anything to me!”

(Of course this will carry no weight whatsoever if the former patient character witness is a female.)

There are a couple of knowledge gaps that, if filled in, may help a juror in believing the witnesses with more confidence. I understand that perhaps some of these concerns are things that cannot be brought into evidence, or addressed in rebuttal, but I’m going to throw these ideas out there, much like a good defense attorney, and see how many might stick.

Knowledge gap #1: Did Dr. Ayres see troubled girls? What did their physical exams consist of? What were their “icebreakers” on the table of models that so many of the trial’s witnesses have testified to? Survivors of Dr. Ayres’ therapy can’t recall anything “girly” on the table—just models and puzzles geared toward boys’ interests.

(Imagine the horror of Dr. Ayres playing with a Barbie doll to break the ice with a young girl. Ick. Just ick.)

Knowledge gap #2: Regarding Stephen’s testimony, I believe that two reports were erroneously filled out at the Petaluma group home, and by accident or inattention or lack of education on the part of the person filling out the reports, Stephen’s name was attached. He adamantly testified that the incidents described in the reports did not happen, and that no, he did not forget or make a false claim because the incidents did not happen to him! Period!

So who did the incidents happen to? How many other boys named “Stephen” or “Steven” or any other way of spelling that name were at the group home at the time? What was the position of the person who filled out the report? Was that person a witness to the incident? Why wasn’t Stephen’s counselor’s name on the reports?

Still sticking with Stephen (whom I believe could be a problem witness if someone on the jury bought into Weinberg’s “lack of moral turpitude” remarks during opening arguments), I have gone on record being grateful that McKowan was able for Stephen to introduce testimony about how much he might have given up by choosing to testify. He really had nothing to gain (other than his peace of mind)—he very well could have lost his place at the Jamestown fire camp if there had been a fire! He was in San Mateo County’s custody for some time before he testified. He will not be doing any less time for testifying.

Knowledge gap #3: Harping on the lack of wearing gloves—I’ve already written about how things used to be, when I was in nursing school in the early 1980s, that we were discouraged from wearing gloves for assisting patients after elimination because we didn’t wear gloves to take care of our own poo, so why is someone else’s poo so poisonous? With HIV and AIDS and increased knowledge regarding blood or bodily-fluid borne pathogens, medical personnel (which of course is not only nurses but also M.D.s) have updated their own standards of practice and adopted universal precautions, even if that goes against what he or she learned in school. A clinician would have to have been on an island without any communication to not know about universal precautions! So if Dr. Ayres had not worn gloves to examine boys' genitals in the 1960s and 1970s, that was standard practice back then. But by the end of the 1980s, universal precautions were the medical standard. There is no arguing with that.

So what’s the significance of the good doctor not wearing gloves? Other than protecting himself and the boys from possible bodily fluid-born infections, go back to what Dr. Lynn Ponton said. “A physical exam is
not for the doctor’s benefit.” By touching the boys’ genitals, skin-to-skin, that sure tells me we are dealing with an intimate situation and exams that were done for the doctor’s benefit—in other words, his own sick fantasies and arousal.

What if this had been gloveless internal exams of female patients? There is no question that is not proper, has not been proper, even before universal precautions!

Knowledge gap #4: Sometime during closing arguments I hope McKowan is able to remind the jury of the nature of one of the in-statute witnesses’ “gay sex” when he was in third grade. How did Dr. Ayres’ exam influence the boy? Well, gay sex was a sort of reverse euphemism for “playing doctor.” The boy simply learned how to do a genital exam, something he had no business experiencing in the first place. There was really no better way to describe what the boy and two friends had done (not all at the same time!).

The young man is question is definitely heterosexual, and has never had a true “gay sex” relationship. It sucks that there was no proper description of what this survivor’s gay sex at age 9 really was—what the game consisted of before his exposure to Dr. Ayres, and how the game changed after a visit and his own “physical exam.”

Knowledge gap #5: One of the prior bad acts witnesses described Ayres holding what he presumed was a medical book with black and white photographs of naked boys. Perhaps the jury will wonder more about that book? The witness described the book as having captions and the boys were not posed. Which one of the not allowed as evidence books fits this description?

Knowledge gap #6: Self-inflicted errors: Perhaps it was a clever strategy to subpoena Victoria Balfour. Perhaps she should have been deposed a long time ago to see if she had anything of value for either side. But for Weinberg to bring her up during cross-examination of one of the “propensity to molest” witnesses might have a juror or two wondering. No doubt someone wrote down her name; Weinberg even spelled it for the court reporter. That’s going to be something someone might bring up during deliberations? If this person was so important to mention, why didn’t we hear from her or more about her? Is this a case of a defense attorney throwing crap on the walls and hoping some sticks? (That view gets my vote.)

Knowledge gap #7: We know the good doctor saw patients referred to him by the juvenile system. Why have none been called? Are they all out-of-statute? Are their records sealed? Or did Dr. Ayres only molest middle- or upper-middle class boys?

Because of the great cross-pollination we have going between T & T and the
Watchdog site, a few of the defense witnesses have been revealed. We all know about controversial memory expert Dr. Elizabeth Loftus (not an M.D.-type of doctor, but a Ph.D.-type doctor). The prosecution is pretty much going to have to accept her as a “memory expert” because of her profitable history as an expert witness for the defense.

But a couple of the others might just be easier to
not accept as expert witnesses. Dr. Marvin Firestone will be testifying that Dr. Ayres does not “fit the profile” of a pedophile. Geez, with what we’ve heard in court, if Dr. Ayres doesn’t fit the profile, who does?

Dr. Firestone is also a resident of San Mateo County who is probably not too terribly objective where Dr. Ayres is concerned. According to
The Patient Advocate, in a post at the Watchdog site, here’s the low-down on Firestone: Dr. Firestone provides medical-legal consultation and neuropsychiatric evaluations for the Courts and the legal community and has served as expert witness on numerous cases involving head injuries and post-traumatic stress syndromes, conservatorship needs, testamentary capacity and mental competency in civil, probate and criminal matters.

Please read the previous sentence carefully. Did you read anything about being an expert on who fits the profile of a pedophile? Me neither. Challenge this expert witness’ credentials, Ms. McKowan!

Granted, if Dr. Firestone uses the information posted on’s “
Profile of a Pedophile,” Dr. Ayres isn’t a perfect fit—but what criminal ever is?

That article has, in bold text, the following subheads
: Pedophiles Often Prefer Children Close to Puberty, Pedophiles Work Around Children, Manipulation of the Innocent. Hmmmmm. Describes Dr. Ayres pretty well …

The article concludes with the following paragraphs:
Pedophiles work hard at stalking their targets and will patiently work to develop relationships with them. It is not uncommon for them to be developing a long list of potential victims at any one time. Many of them believe that what they are doing is not wrong and that having sex with a child is actually "healthy" for the child. Almost all pedophiles have a collection of pornography, which they protect at all costs. Many of them also collect "souvenirs" from their victims. They rarely discard either their porn or collections for any reason.

One factor that works against the pedophile is that eventually the children will grow up and recall the events that occurred. Often pedophiles are not brought to justice until such time occurs and victims are angered by being victimized and want to protect other children from the same consequences.

In an article titled “
A Profile of the Child Molester,” the reader will learn there is no tidy, one-size-fits-all description of the “average” pedophile. But this article observes that most pedophiles are male, take jobs where they have easy access to children, and most often choose kids on the brink of puberty.

article offers several characteristics to look for. Pedophiles “appear to be trustworthy and respectable. Has good standing in the community.” They “are usually family men, have no criminal record, and deny that they abuse children, even after caught, convicted, incarcerated, and court-ordered into a sex offender program.”

It appears that Dr. Firestone will be fairly easy to dismantle, provided DDA McKowan has done her homework or has her own “what is a pedophile expert witness lying around for rebuttal.

Another expert witness, Dr. Gilbert Kliman, is expected to testify that what Ayres did was within the standard of practice for psychiatry. What is sad about this fellow’s involvement is the fact he’s worked with molestation victims who were the prey of priests (no pun intended). So it seems he may be just like any other defense witness—willing to put your sense of what’s right and what’s wrong to the side for the almighty dollar.

McKowan had better ask how much these experts are being paid. She wisely opened that door with Dr. Ponton, so keep up that strategy.

Look, I understand that the practice of medicine is incestuous. I know that it takes more than an act of God for any physician to say that one of his or her colleagues made an error, let alone that person committed a crime, a betrayal of trust between doctor and patient (one could argue that both the victim’s family and the pedophile’s family is betrayed, too.). Being a mandated reporter is not something these people take seriously.

Having an “expert witness” who has also worked with the accused takes even more credibility away from what he or she has to say. How many of those expert witnesses can live with themselves, saying what they are prepared to say, after reading depositions by any of Ayres’ survivors?

Perhaps the good doctor would have a better chance of convincing a jury that he’s not a pedophile by obtaining an expert witness who hasn’t ever been on the faculty of the same medical school, or who’s known him for a long time.

The biggest thing about this whole sad case is common sense. I have a feeling common sense doesn’t play much part in the law though. This case is all very simple: If your son had gone to a psychiatrist for the reasons the witnesses (all of them) went to the psychiatrist, would you be comfortable with what had been done to your son, most of the time without specific consent. It’s utterly understandable if one of the boys had voiced a concern about the normalcy of something he was experiencing as part of adolescence—let’s say, for example, wet dreams, pubic hair, or a lump in his testes. What does a penis and testes have to do with concerns over ADD/ADHD?

Think about it: how many times did the doctor betray his patients’ and their parents’ trust? First, most did not give consent for a physical exam in the first place. NO ONE gave consent for a genital exam; none of the parents were given a report regarding their son’s physical exam, let alone genital exam, and the boys themselves weren’t really told why they were getting the exam as it fit in their presumptive diagnosis. (Please? Self-esteem issues and you need to fondle a kid’s genitals? I didn’t even go to medical school and I can see that’s wrong!)

What questions do you have that you’d like to have come out in testimony. Don’t worry about admissibility; the courts will take care of that. What do you need to know to help you believe in Dr. Ayres’ guilt or innocence?

And in the off-case that Dr. Ayres would take the stand in his own defense, what would you like to ask him?

Readers, please remember to keep your comments on-topic. This is a case about child molestation—keep your comments confined to issues concerning Dr. Ayres and the survivors of his “therapy.”
Friday July 3, 2009: No Court Today, But Will Ayres Take The Stand Next Week?
Last former patient testifies in trial of Dr. William Ayres
Defense begins in molestation trial


Anonymous said...

I would ask Dr. Ayres why he said in his deposition in Steve Abrams' civil molestation suit that he had "never asked a child to take his pants down."

Anonymous said...

Wonder if Marvin Firestone has read the book by Dr. Richard Gartner. Director of the Sex Abuse Clinic at the esteemed William Alanson White in New York City. Gartner has written about pedophiles who become doctors because of the easy access to kids.


From "Beyond Betrayal" a book about male sex abuse, by Dr. Richard Gartner:

Many child abusers are attracted to careers and avocation that make them special in the eyes of the community. They may be teachers, clergy, scoutmasters, choirmasters, coaches, Big Brothers, child care workers, doctors or other health workers or civic leaders. These positions can help an abuser gain access to children and serve as a cover for the abuse they commit. Serving in these roles can also be a form of insurance, so if they get caught, they’ll have ample support and plenty of advocates to state unequivocally, “This person could never hurt a child.”

The Patient Advocate said...

H CaliGirl,

I have a few questions after after reading this terrific post.

One: Will you please do the closing arguments?

Excellent! Please lord let McKowan read this!

I too feel the case has missed some of the complexity as you stated.

I only hope that those jurors can see the long trail of victims and understand that no other doctor such as Hugh Ridlehuber M.D. who was in practice for nearly as long as Ayres ended up in the same position.

Allegation after allegation. Why? If it was so right how did Ayres end up in that chair in the court room?

One thing that fits the profile of a pedophile is that Ayres has chosen to live so close to his old office building. You merely look at the list of occupants on a sign firmly planted out in front of the old office of the Peninsula Psychiatric Associates and walk 50 steps and you are in front of his rented condo on the very same street. I suppose I could have my camera in hand and back up enough and get both the office and his condo building in the picture. That is how close it is!

One must think that of all the places to choose to live he wants to be that close to his old empire, he felt he had established the PPA group, had a locked up safe for heavens sake, and he still wants to look at the building.

That is the biggest trinket he kept, the scene of the crime tucked away in sight of his very view everyday. To relish and relive what he did to those innocent boys.

I can think of no bigger momento for a pedophile than to occupy a condo within a birds-eye view right where he committed the crimes.

I believe the victims. I know how difficult it must have been to sit in that court room, in the hall, the anxiety.

If Ayres did take the stand questions I would ask are:

Other than a stethoscope and blood pressure monitor, did you have any other medical supplies?

Did you have exam “gowns” such as those made of cloth or paper?

Did you have a changing room?

Did you have an exam table?

Did you ever think to use or purchase latex medical grade exam gloves?

Did you have a sink with a faucet in your office?

Did you wash your hands prior to examining patients without using gloves?

Did you wash your hands after examining patients without using gloves?

Thank you again for a wonderful article.

Anonymous said...

It will be interesting to see what the defense presents...

Anonymous said...

iAyres molested many juveniles

Earliest known juvenile: Alan Y in 1969

While on probation, 14 year old Alan Y stole some beers from a story. A judge ordered Alan into therapy with Ayres. Ayres molested Alan Y on the first visit.Also, according to Alan, the good doctor expressed both surprise and displeasure that he had developed pubic hair.

When Alan went back to court, he told the judge he refused to go back to Ayres, without telling him why. According to Alan and his mother, the judge yelled at him and gave him a choice: Continue seeing Ayres or go to Juvenile camp. Alan chose the camp. Alan reported the molestation in person to the San Mateo PD in July 2005, after seeing a news story about Steve Abrams' civil suit. Alan died three months later in a motorcycle crash.

Also, an inmate in Folsom State Prison around 1994 told a pscyhiatric nurse that Ayres had molested him in a court ordered session.

Also, some of us know of at least TWO other juveniles who were molested more recently by Ayres who have not gone to the San Mateo PD and never will.

We also know of a juvenile sex offender whom Ayres "undressed" a number of times during therapy in 1995. Although two therapists tried to report the"physicals to CPS, they were thwarted.

Our friends in law enforcement believe that there are many more juveniles out there who were molested than we can possibly know. They believe they have not come forward for a number of reasons .

1) juveniles tend to be more macho and do not want anyone to know they were molested

2) Many of the juveniles are now inmates in state prison and haven't even heard that their old molester has been arrested.

3) Many are dead or messed up on drugs. (The same can be said for many of Ayres' non-juvenile patients. )

4) Ayres may well have made bargains with the juveniles. Law enforcement folks have told us that they believe that Ayres might very well have told juveniles, " If you allow me to do this to you, I will recommend that you not be sentenced, or get a light sentence."
Victims who accepted this bargain may be loathe to come forward for fear of being arrested.

5) In Ohio this year, identical twin pediatricians Dr.Scott and Mark Blankeberg were arrested for molesting young boys - many of them juveniles. The juveniles told police that the Blankenbergs offered money and drugs in exchange for sex. Seems to us that this is something Ayres might have tried as well. We already knew he wooed many, many victims with presents (which has not really come up in the trial.) Ayres bought one boy two or three record albums a week. What would stop him from going to the next level?

6) According to San Mateo Juvenile Judge Pat Bresee, Ayres was always the lowest bidder for contracts to treat juveniles at Hillcrest Juvenile Hall. Sounds like he was pretty desperate to get his hands on those boys.

7) In April 2006, Ayres told San Jose Mercury News reporter Sean Webby that he liked treating juveniles because he was attracted to their dangerous behavior.

8) According to his medical colleagues, Ayres liked to smoke pot back in the 1970s. We don't think it would be too farfetched for him to offer a joint to a juvenile in a session. Maybe things developed from there.

Anonymous said...

I posted a longer comment about juveniles but it didn't go through.

Ayres saw many juveniles and many were molested. The SF Chronicle talked about a victim who was molested in 1969 by Ayres during a court ordered session. The boy refused to see Ayres again, so the judge sent him to Camp Glenwood. The boy never told anyone what happened until he saw the news story of the civil suit in 2005. He drove straight to the police station to give his statement.

Additionally, a San Bruno therapist tried to complain to San Mateo Childrens' Services in 1995 that Ayres had given "physicals" to a juvenile sex offender. CPS thwarted her complaints.

Other pedophile doctors like Dr. Scott and Mark Blankenburg got away with molesting juveniles in Ohio by offering them money and drugs. What would stop Ayres from doing the same ?

One family knows of another juvenile who was molested but he refuses to go to the police. There are in all likelihood hundreds more like that out there.

And remember, many of the juveniles are now adult men in state prison. Chances are they don't even know Ayres has been arrested.

Anonymous said...

Funny you should pick that "Santa Claus is a Pedophile" photo.

Several victims have described Ayres as looking like a shifty Santa Claus.

Anonymous said...

That can be a question you ask even any expert witness about a pedophile.

Although they don't fit the complete profile isn't true that anyone and sometimes someone we don't expect is a pedophile?

Even the Easter Bunny?

Sprocket said...

It's my understanding that there are a total of 41 MALE individuals who have come forward and accused Ayres of inappropriate, sexual contact while under his care.

That's an overwhelming number of victims, and it's my opinion there are at least twice as many if not more victims that chose not to come forward and talk about painful experiences.

There are some alarming facts about pedophiles that many people may not be aware of. This excerpt is from a book by former FBI profiler Roy Hazlewood & Stephen G. Michaud, Dark Dreams, profiling sexual sadists.

DARK DREAMS, Pages: 105-107


I'm sure many readers will be surprised to learn that in my experience the two types of sexual offenders with the most characteristics in common are sexual sadists and pedophiles.

This seems counterintuitive, I know. Most pedophiles are not physically violent, while the sexual sadist is very likely to be so. However, when you look at these two more closely, certain striking similarities emerge.

First, a clarification of terms. Pedophile and child molester often are used interchangeably, but they are quite different. Pedophile, in psychiatric usage, describes an individual who is preferentially attracted sexually to a prepubescent child (generally thirteen years of age or less). However, a pedophile does not become a criminal until he molests a child. It is entirely possible for a pedophile to act out his sexual preferences only in his mind or with a consenting adult or paid partner who plays the role of a child. That is not criminal behavior.

Child molester is a legal term used to describe any person who sexually molests a child, which most definitely is criminal behavior. All child molesters are criminals, and a pedophile who acts out against a child consequently is a child molester. The adult male criminal pedophile deliberately preys on children.

Here is how he and the sexual sadist are alike:

Continued in next comment, PART 2:

Sprocket said...


* Both are ritualistic sexual criminals. They have highly developed fantasy lives and carry out their crimes according to a script.

* Both are highly motivated (their crimes give them deep satisfaction) and they invest great amounts of time, money, and energy to their criminal behavior.

* Neither experiences remorse or guilt. The sexual sadist believes that his victims deserve to suffer. The pedophile doesn't believe he's caused harm to the child.

* Both are highly practiced at rationalizing their behavior and consequently are poorly motivated to change.

* Both recognize that society abominates them, and they take steps to study their deviant desires and behaviors to better understand them and to evade arrest.

* Both collect theme-oriented pornography and/or erotica that serves to complement their preexisting fantasies.

* They possess average or better intelligence and social skills. They mesh well in society. Friends and associates are surprised and supportive of them when they are identified.

* Both are likely to commit incest with their natural children and will molest stepchildren or other minor relatives.

* They record their criminal sexual acts. This provides them with a means of reliving and improving on their criminal acts.

* Their rate of recidivism is much greater than for other sexual offenders. They tend to be model prisoners and consequently are released more quickly and, having learned nothing from their punishment, quickly begin practicing sexual deviance gain.

* Both are highly narcissistic.

* Both have a low threshold for sexual boredom and involve their victims in progressively offensive and demeaning behaviors.

* Most sexual criminals slow down with age. There is no known burn-out age for these two offenders. Unless stopped, such men will offend well into their sixties or seventies.

* They have greater numbers of victims than other sexual offenders. Once these men begin to act out criminally, they will assault until they are caught.

* They are predominantly middle-class offenders. This is another reason why other people are surprised when they are identified.

Anonymous said...

Well Sprocket, that would be the description that hit the hammer on the nail, the nail names AYRES.

Marvin Firestone should have a reading of that before he says Ayres doesn't fit the profile....

What a wammy.......

CaliGirl9 said...

I sure hope Deputy District Attorney Melissa McKowan has a copy of that book in her possession right now ... Firestone should be an easy "expert" witness to discredit.

Did Ayres submit to any sort of psychological exam in the preparation of this trial? Because the victim who brought the first civil trial was forced by the defense (Ayres) to undergo numerous psychological and psychiatric exams in that case ... sure would be interesting to know how Ayres ticks ...

Maybe something in the rebuttal case ...

Anonymous said...

Sprocket said:

Both are likely to commit incest with their natural children and will molest stepchildren or other minor relatives.


God help his son Robert.

Sprocket said...

Clarification: I was quoting from a book by a former FBI criminal profiler who studied these types of criminals for most if his career.

Not EVERY child molester or sexual sadist has all of these traits. There has been no evidence whatsoever presented in court that Dr. Ayres molested his children.

From my understanding of CaliGirl9's reports, Ayre's son Robert has been there in the courtroom to support his father.

Anonymous said...

Can't the prosecutor bring in the fact that he never gave a physical to a girl?

It's too bad that some of the boys who got the proctology exam did not testify.

Sprocket said...

Anon @ 8:25 am:

When planning the strategy for a case, counsel has to decide what is the best way to present what they do know about the alleged abuse/charges.

I don't think it would help the prosecution's case to put a female witness (or several) on the stand to say they were not given a physical. It takes away from the focus of the case: the actual charges. JMHO.

The only way that I can think of for the prosecutor to bring this into the trial is possibly through closing argument.

Anonymous said...

On Thursday July 2, Weinberg and McKowan were still discussing those nude boy books. The argument centered on whether they would be considered child porn. Not sure why this was being discussed since the books aren't allowed into evidence.

CaliGirl9 said...

Real life prevents me from being at court today …
I’ve been thinking about the rebuttal case that Deputy District Attorney Melissa McKowan must be preparing for.

I hope she has an expert witness who is prepared to talk about “child sex abuse accommodation syndrome.”

There is an expert in nearby Sacramento: Anthony Urquiza, Ph.D. at UC Davis. He would be able to testify as to the reason the memories come back to Dr. Ayres’ former patients in bits and pieces.

I would imagine his (or another expert's) testimony would be admissible to counter the defense's "memory expert," Dr. Loftus.

Anonymous said...

Caligirl: McKowan has already put on an expert about Child Abuse Accommodation Syndrome.

And Dr. Ayres will be testifying tomorrow. This should be interesting. We think the prosecutor is ready for this.

Deep Sounding said...


After mostly taking the weekend off from all of this stuff, I finally started to catch up on my reading last night.

I'd like to thank you for your great coverage of this case, it's always very helpful to know that there ARE people out there who can pause for a moment to consider the people involved in the case.

Trapellar said...

Closing arguments are set for Monday, July 13, 2009

CaliGirl 9: Sorry you couldn't make it to witness Ayres' trainwreck of a performance yourself.

Anonymous said...

San Mateo County Times story today about Ayres "rambling" comments about how he used to run around buck naked with boys in the locker room as a teenager.

Anonymous said...

I could not find the blogs on Marvin Firestone. Plaese help.

I would like to know if Firestone was disqualified as an expert in the Ayers matter.

CaliGirl9 said...

The defense elected not to call him, because the prosecution promised to ask a hypothetical about a child psychiatrist who gave boys genital exams who also owned books with photos of naked boys—thereby getting the disqualified books into evidence. "If you knew a doctor who did/had this, would this change your opinion regarding his being a pedophile?"

And he wasn't really an expert on figuring out who a pedophile really is ... he was just a friend of Ayres prepared to baffle the jury with bullshit.