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Nakamura v. State9/26/2000
may think of killing somebody, but I know I will not act it out. It is against my better judgment, and I have to answer to God. I am a very religious person, and I go to church."
Mr. Nakamura is very insistent that "I'm not damaged. I'm not unstable. I am well and normal. I'm just standing up for what is right." He denies any significant neuro-vegetative system symptoms and states, "I just need to exercise more, as I'm gaining weight because I'm eating more." He states his "stress" right now is mostly financial, but even this is "not cause for alarm, as I know I will win in the end. I'm confident that I will win."
He states that he is not hearing any voices at this time, and he denies any ideas of reference. . . . He still maintains, however, to this day, that the United States military is involved in a plot to control people's minds. He still admits to being homicidal, but as mentioned earlier, he makes the distinction that he "thinks about it" but is very sure that he is not going to "act on it."
He is oriented, and there are no significant or compelling evidences that there are any memory deficits or any other "organic" deficits. There are no other significant complaints at this time.
Dr. Ponce further opined that Nakamura has a pre-existing condition, and mentions only the IRS garnishment as a recent exacerbating factor:
History and review of records shows a diagnosis of paranoid disorder as early as 1988 by Dr. Trockman, his treating psychiatrist. It would appear that this condition did not really disappear or remit entirely, as he continued to have difficulties with supervisors under different work conditions. In summary, the diagnosis of schizophrenia, paranoid type, episodic, with inter-episode residual symptoms appears to be quite appropriate in this case. This condition was exacerbated by the garnishing of his wages by the IRS.
A diagnosis of schizophrenia, paranoid type, is clinically a more or less longlasting condition characterized by episodes of remission, but at this time Mr. Nakamura certainly is not stable, and he needs to be treated with a combination of anti-psychotic medication and behavioral cognitive therapy.
At this time, unless a trial of anti-psychotic medication and behavioral cognitive therapy is tried, I do not think that he will be ready on January 22, 1996, to go back to his usual and customary job . In addition, he has made clear what his conditions are, in that if his wages are garnished and if he still continues to work under the same foreman, he absolutely will not go back to work. If the employer reportedly will not accede to his demands, then he will resort to a legal action.
Mr. Nakamura needs anti-psychotic medication and behavioral cognitive therapy to deal with his impaired reality testing, delusions, ideas of reference and persecution, as well as ongoing hostility toward his supervisors and other persons of authority. The expected outcome of the anti-psychotic medications as well as the behavioral cognitive therapy should result in a diminution of his feelings of being persecuted, as well as a diminution in terms of his delusions[,] ideation, anger and hostility.
In a letter to the Employer dated October 28, 1996, Dr. Shimizu disagreed with Dr. Ponce's diagnosis of "schizophrenia, paranoid type, episodic, with inter-episode residual symptoms." Dr. Shimizu stated, in pertinent part, that Mr. Nakamura has not been observed by me to have psychotic features such as auditory or visual hallucinations, bizarre delusions, social withdrawal, deterioration in hygiene and grooming, unusual behavior.
Mr. Nakamura was administered the Minnesota Multiphas
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