Defense expert: “Clinically probable” Donald Smith suffers CTE, affects behavior

Jacksonville, FL — Not only did Donald Smith have abnormally small and large portions of his brain, but he suffered brain trauma, according to an expert witness for the defense, who’s arguing that some of those abnormalities affect Smith’s behavior.

He’s one of several expert witnesses the defense has called so far, to try to make their case that Smith cannot control his impulses, and acts without regard for the consequences despite knowing right from wrong.

FULL COVERAGE: The trial of Donald Smith

Dr. Geoff Colino testified as an expert in forensic neurology for the penalty phase of this trial, where Smith could be sentenced to death for the 2013 murder of 8-year-old Cherish Perrywinkle. Colino told the jury Smith told him that in the weeks leading up to Cherish's kidnapping, rape, and murder, he was feeling like he was "skating on thin ice" and knew we "was going to fall through". Smith reported not sleeping, smoking crack virtually non-stop, taking other pills, hallucinating, and experiencing other effects.

Colino ordered several brain scans in order to get a more complete picture, and they were shown to the jury. Colino highlighted areas where Smith’s brain is larger than normal, all formed during development ahead of puberty.

“I can’t tell you what caused it, but I can’t see how there would be a choice in these things happening to him,” he said, in response to a defense question about the theme to the State’s case- that Smith was making choices.

Among the areas affected is the thalamus, which Colino says deals with a wide range of important tasks like regulating aggression, making decisions, maintaining a sleep cycle, and other areas. He says Smith’s poor decision making was in clear, as evidenced by his using crack cocaine and other drugs within a couple of weeks of having a heart attack.

Other areas of Smith's brain were abnormally small, according to Colino. Among the areas affected are those dealing with memory, inhibition, and learning from undesirable experiences. Defense Attorney Charles Fletcher asked if that could explain how Smith could face criminal punishments for sex crimes, but continue to offend. 

“If he does not learn from that, this explains why,” he said.

Colino also noted areas where he believes there was trauma to the brain, although he could not say what caused the trauma or when it happened. Based on Smith’s history and the symptoms, Colino believes it’s “clinically probable” Smith is suffering from CTE- which has gained attention in recent years through concussion awareness, especially among football athletes. To understand the impact of CTE, Colino told jurors to think of Smith’s ability to not act on an impulse, as a bicycle break.

“The cable is so frayed and stretched as to be nearly non-existent, non-functional. He can’t control his behaviors,” Colino said.

During cross examination, State Attorney Melissa Nelson pointed out that the same decision making area in question also governs the decision to deceive- with the state arguing Smith clearly planned and carried out a ruse as part of this crime. She then questioned Colino further about the cause of the brain trauma specifically, pointing to an area in his deposition where he said that could have been caused by a cardiac event. It led to a heated line of questioning, with Colino now saying that’s not the case, and that if he misspoke in the deposition, it’s because he only had two days to prepare and he was “sick as a dog” with the flu.

“You are making a very big deal about my saying yes,” Colino said.

“No sir, I’m making a big deal about the fact that you’re an expert witness offering an opinion to this jury,” Nelson said.

“I’m saying that, as a human being, I may have said yes, either not fully processing the question or because I had the flu, yes,” Colino said.

As highlighted by Fletcher, Nelson did not question the brain scans themselves. Multiple witnesses testified that the EEGs and information they had studied connected to Smith- dating back to the 1970s- do not show any evidence of brain trauma.

Looking beyond the physiology, a psychologist and pharmacologist also testified to try to round out the defense’s picture.

Forensic Psychologist Dr. Heather Holmes, who testified with an expertise in sex offender evaluation and treatment within the incarceration setting, diagnosed Smith with several personality disorders, including major depressive disorder, severe cocaine use disorder, pedophilic disorder, antisocial personality, and borderline personality features.

With the pedophilia, Holmes says there’s still no clear idea what causes it in any given offender.

“I can’t pin the tail on the donkey. I wish to God I could, but we just don’t know,” she said.

She says Smith had an “inappropriate” relationship with his mother, who was “enmeshed” with him and overprotective, including paying his drug debts and funding prison protection. Despite that, Holmes says Smith had a “privileged” upbringing, and there was no clear incident she could see as being any trigger or explanation.

But because Smith had not been receiving regular treatment, Holmes says it’s safe to assume his pedophilia was getting worse as he reinforced it over time with action. The same is true of Smith’s drug use, with him having a tendency toward smoking crack cocaine.

“Due to the combined effects of chronic substance abuse and use disorder that was from childhood through current, multiple major psychiatric disorders, chronic cocaine binge use or crack cocaine binge use, including the recent addition of the psychiatric medication- that Mr. Smith would have been impaired to the degree that his normal judgement, skills, and ability were profoundly diminished,” says Dr. Daniel Buffington, a clinical pharmacologist who testified as an expert in pharmacology.

Buffington says records showed him that, over time, there was an increase in the intensity of medication needed to manage Smith. At the time of Cherish’s murder, Smith reported not only using crack cocaine, but also a drug under the generic name Quetiapine or brand name Seroquel- which he got illicitly through his drug dealer’s sister. He says that combination could have created a “dangerous storm”.

Severe cocaine use alone, according to Buffington, could lead to paranoia, delirium, psychoses, and homicidal and suicidal thoughts, among other things. He says it also means the drug user will have problems with hygiene, communication, planning, judgement, and similar areas.

On cross examination, Assistant State Attorney Mark Caliel confirmed that Buffington’s opinions on Smith’s state were based essentially only on what Smith reported to him, because there was minimal documentation of his drug activity, since most was not legal. Buffington said Smith appeared to be honest and forthcoming through their conversation, and he’s trained to look for exaggerations or withholdings in his conversations, although Caliel says other witnesses have classified Smith as deceptive and manipulative.

Smith’s drug use started young, with Holmes testifying that his step-father was a psychiatrist, who gave Smith prescriptions during his pre-teen years. From there, testimony has said Smith used marijuana, alcohol, LSD, and cocaine.

Holmes says Smith’s personality disorders don’t prevent him from being able to control his impulses, but drug use lowers inhibition.

Holmes says Smith admitted to her what he did, but that he showed no acceptance of responsibility at any time before then, sometimes blaming his lawyers and sometimes blaming his victims. 

“He told you he blamed Cherish Perrywinkle for having had to kill her, didn’t he?” asked Nelson.

“Yes,” Holmes responded.

“He told you that he looked back, she got in the van, and he thought, quote-‘F***, I’m a convicted sex offender, how am I going to explain this’,” Nelson followed.

“Yes,” Holmes said.

She further confirmed Smith showed no signs of remorse while speaking about what he did.

While the defense has presented that, in the days ahead of Cherish’s murder, Smith tried to get himself committed under the Baker Act- saying that shows he couldn’t control himself and wanted to get help- the state says there are several other incidents in his past where Smith rejected treatment. That includes failing to abide by a treatment program that he agreed to when he was released from civil commitment.

Dr. Joseph Wu, an expert in the field of neuropsychiatry added to the testimony on Wednesday saying Smith was in the cented of a “perfect storm”. Between Smith’s brain abnormalities, traumatic brain injury, neurodegenerative disorder, history of sexual trauma, physical abuse, and neglect.

“All of which combined to create an individual who’s going to have catastrophic failure in impulse control,” Wu said.

All of this medical and psychological information about Smith was released in open court with his consent, as part of the defense strategy.

WOKV and Action News Jax continue to follow every development in this penalty phase. Stay with us for continuing coverage.

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