v.
Floyd
2025 IL App (1st) 160406-U SECOND DIVISION June 17, 2025
No. 1-16-0406
NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1). ______________________________________________________________________________
IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT ______________________________________________________________________________
THE PEOPLE OF THE STATE OF ILLINOIS, ) Appeal from the ) Circuit Court of Plaintiff-Appellee, ) Cook County. ) v. ) No. 10 CR 12502 ) MARCUS FLOYD, ) Honorable ) Timothy Joseph Joyce, Defendant-Appellant. ) Judge Presiding. ______________________________________________________________________________
JUSTICE HOWSE delivered the judgment of the court. Justices Ellis and Cobbs concurred in the judgment.
ORDER
¶1 Held: The judgment of the circuit court of Cook County finding defendant fit to stand trial is reversed; the trial court is directed to conduct a new retroactive fitness hearing because the nonpattern jury instruction on amnesia given to jurors effectively negated evidence about the impact of amnesia on defendant’s ability to assist in his own defense; the cause is remanded for further proceedings consistent with this judgment.
¶2 Following a jury trial the circuit court of Cook County convicted defendant, Marcus
Floyd, of first degree murder for the death of Chicago Police Department Officer Thomas
Wortham IV (hereinafter, “Officer Wortham”) and the felony murder of the co-offender in the crime that led to Officer Wortham’s death, defendant’s cousin, Brian Floyd. Brian Floyd was killed by Officer Wortham’s father, Thomas Wortham III (hereinafter, “Mr. Wortham”), a retired
Chicago Police Department officer, as he was trying to stop the crime, which occurred in front of his home. The jury also convicted defendant of attempt (first degree murder) of Mr. Wortham.
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Mr. Wortham also shot defendant several times while attempting to stop the crime. As a result of his injuries defendant developed retrograde amnesia of the crime. Due to defendant’s amnesia, before the trial of the charges the trial court held a trial before a jury of six to determine defendant’s fitness for trial. The fitness jury found defendant fit for trial. Following trial, the trial jury found defendant guilty of the crimes charged and the court sentenced defendant to two consecutive terms of life imprisonment.
¶3 Defendant appealed both the judgment finding him fit to stand trial and his convictions.
We reversed the judgment finding defendant fit to stand trial and remanded for a retroactive fitness trial, with instructions. We retained jurisdiction over the appeal to consider any preserved claims of error in the retroactive fitness hearing and defendant’s appeal of his conviction should it be found defendant was fit to stand trial. People v. Floyd, 2019 IL App (1st) 160406, ¶ 62. On remand, the trial court conducted a retroactive fitness trial and a jury again found defendant fit to stand trial. We allowed supplemental briefing to address allegations of error in the retroactive fitness hearing. The parties have fully briefed the issues surrounding the retroactive fitness trial.
¶4 For the following reasons, we reverse the judgment of fitness for trial and remand for further proceedings consistent with this judgment.
¶5 BACKGROUND
¶6 The underlying facts of this case may be found in our dispositions of the appeals of codefendants Toyious Taylor (People v. Taylor, 2017 IL App (1st) 150726-U) and Paris McGee
(People v. McGee, 2017 IL App (1st) 150838-U). In light of our holding we once again focus our
discussion here on the retroactive fitness trial and only briefly recount the circumstances of the offense to the extent necessary to understand the retroactive fitness trial.
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¶7 On the night of the occurrence, Officer Wortham left his parents’ home in Chicago after visiting them. Mr. Wortham watched from his front porch as his son got on his motorcycle. Mr.
Wortham saw defendant and Brian Floyd in the middle of the street. Officer Wortham rode his motorcycle to where they were in the street, stopped, and spoke to them. Mr. Wortham saw Brian put a gun to Officer Wortham’s head. Mr. Wortham yelled for the men to get away from Officer
Wortham and Brian turned and pointed his gun at Mr. Wortham. Brian yelled at Mr. Wortham to get back into the house. Officer Wortham then shouted “Police,” and Mr. Wortham instantly heard gunfire. Mr. Wortham ran into the house to retrieve his gun and told his wife to dial 9-1-1.
After Mr. Wortham ran back outside with his gun he saw a red car in front of his home facing the wrong direction on the one-way street. The passenger was outside the car yelling “Get in.” Mr.
Wortham told the passenger to “get away from there.” The passenger got back into the car and the driver backed the car away. Mr. Wortham testified he thought the passenger fired a gun at him before the car reached the intersection. Mr. Wortham hid behind his daughter’s car, saw
Officer Wortham’s gun on the ground and picked it up so that he then had a gun in each hand.
Defendant and Brian were facing Mr. Wortham. Mr. Wortham saw a gun in Brian’s hand. Mr.
Wortham opened fire and saw both men go down. Mr. Wortham saw Officer Wortham on the ground approximately 20 yards away. The State elicited testimony that in addition to being shot multiple times Officer Wortham’s injuries were consistent with being hit by a car and dragged.
¶8 Before the first fitness trial began the trial court granted the State’s motion to bar the testimony of a defense witness who would testify as to why a defendant’s ability to recall the incident that is the subject of the prosecution is relevant to that defendant’s ability to assist in their own defense.
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¶9 At the first fitness trial, Dr. Matthew Markos, a forensic psychiatrist, testified for the State. Dr. Markos testified that his clinical forensic psychiatric opinion to a reasonable degree of medical and psychiatric certainty following his examination of defendant was that defendant was
“mentally fit to stand trial.” Dr. Markos took defendant’s amnesia into account in reaching his opinion. Dr. Markos testified defendant had reported amnesia and “in order to be able to assist his counsel, it was important for me to determine if he has the capacity to learn and retain new information.”
¶ 10 At the first fitness trial Dr. Markos testified he asked defendant questions to determine if
defendant had any knowledge of the crime itself and details pertaining to the crime, what the source of defendant’s information was, and whether defendant had the capacity to learn and retain new information. Dr. Markos testified that defendant clearly demonstrated the capacity to
learn new information from extrinsic sources and retain and remember it; defendant had the capacity to communicate with his attorney and cooperate with his attorney to obtain information;
defendant did not have ongoing amnesia for day-to-day events and recent information, and the amnesia was “just for the arrest incident circumscribed and capsulated.”
¶ 11 At the first fitness trial the State asked Dr. Markos about a second fitness examination he conducted of defendant. Dr. Markos testified in part as follows:
“Again his memory was—pertained only to the arrest incident, and I did ask him additional questions again in order to determine a very important clinical issue, which is does he have the capacity today as we sit as it relates to his current fitness, the ability or the capacity to learn and retain new information and if he has the capacity to follow day-to-day events in his life at Cook County jail.”
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¶ 12 Dr. Markos testified there are special factors and added “amnesia, per se, does not equal
unfitness. Amnesia, per se, does not deem someone unfit.” Defendant’s attorney objected but the trial court overruled the objection.
¶ 13 The State also called Dr. Christofer Cooper to testify as an expert at the first fitness trial.
Dr. Cooper had examined defendant regarding defendant’s fitness to stand trial. Dr. Cooper testified that the “issue at hand” was defendant’s ability to understand what his attorney had informed him about what happened during the offense. Dr. Cooper stated that the “fundamental
issue” on the question of defendant’s fitness to stand trial was defendant’s ability to retain information that had been extrinsically reconstructed from an external source by, for example, being told information by his attorney. Dr. Cooper opined that defendant was capable of assisting his attorney in his own defense because defendant “can learn, retain, process, logically evaluate anything that’s presented to him.” Dr. Cooper’s expert opinion after twice examining defendant was that defendant was fit to stand trial.
¶ 14 After both parties rested the trial court proceeded with the jury instruction conference.
The defense placed on the record its requested instruction based on section 104-16(b) of the Code of Criminal Procedure of 2012, which provides in part:
“(b) Subject to the rules of evidence, matters admissible on the issue of the defendant’s fitness include, but are not limited to, the following:
(1) The defendant’s knowledge and understanding of the charge, the proceedings, the consequences of a plea, judgment or sentence, and the functions of the participants in the trial process;
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(2) The defendant’s ability to observe, recollect and relate occurrences, especially those concerning the incidents alleged, and to communicate with counsel.”
(Emphasis added.) 725 ILCS 5/104-16(b) (West 2016).
The trial court declined to give the instruction. In pertinent part, the trial court instructed the jury as follows:
“Matters on the issue of the defendant’s fitness that you may consider
include but are not limited to the following: Defendant’s knowledge and understanding of the charge, the proceedings, the consequences of a plea, judgment or sentence and the functions of the participants in the trial process; the defendant’s ability to observe, recollect and relate occurrences and to communicate with counsel; the defendant’s social behavior and abilities; orientation as to time and place; recognition of persons, places and things and performance of motor processes.
Amnesia does not per se make a person unfit. A person is unfit to stand trial if, because of a mental or physical condition, he is unable to understand the nature and purpose of the proceedings against him or he is unable to assist in his defense.” (Emphasis added.)
¶ 15 Following the first fitness trial, the jury found defendant fit to stand trial.
¶ 16 On appeal from the fitness jury’s verdict, defendant argued, in part, that he received ineffective assistance of counsel where his attorney failed to object to the State’s witnesses stating an erroneous standard for fitness and the trial court gave the jury an instruction that bolstered the erroneous testimony and misled the jury as to the standard for fitness to stand trial.
Defendant also argued that the trial court erroneously barred the defense from calling an expert
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1-16-0406 witness to testify as to how defendant’s amnesia affects defendant’s ability to assist in his defense. In the first appeal, we found that:
“Regardless, our supreme court directs that amnesia of the alleged offense will not always render a defendant unfit to stand trial. Stahl, 2014 IL 115804, ¶¶
34, 39. We note that our supreme court did not hold that amnesia, alone, will
never render a defendant unfit for trial. Instead, our supreme court recognized the relevance of amnesia of the alleged events to a defendant’s ability to assist in his or her own defense. Id. ¶ 38 (recounting testimony by attorney-expert describing how the defendant’s amnesia as to the relevant events could negatively impact his ability to assist defense counsel). Our supreme court concluded there were ‘a number of factors *** that should be considered on the issue of fitness’ including the defendant’s ‘inability to communicate with counsel because he cannot
recollect his actions and mens rea surrounding the incident.’ Id. ¶ 39. Thus, ‘under article 104 of the Code, amnesia as to the events surrounding the crime does not per se render a defendant unfit to stand trial. Rather, the fact that a defendant cannot recollect the incident at issue is just one of the circumstances that may be considered in determining a defendant’s fitness.” People v. Floyd, 2019 IL App (1st) 160406-U, ¶ 50.
¶ 17 We held that the trial court’s instruction failed to identify a relevant factor in the fitness determination and, as a result, the trial court’s instruction misled the jury and failed to correctly state the applicable law. See Stahl, 2014 IL 115804, ¶ 39. The missing factor was the defendant’s ability to relate and recollect the incident alleged. Floyd, 2019 IL App (1st) 160406-U, ¶ 51. We found that the error prejudiced defendant. Id. ¶ 52. We found that the State’s experts’ testimony
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1-16-0406 and the prosecutor’s argument in combination with the court’s erroneous instruction left the jury with the firm impression that it should consider defendant’s ability to recollect information communicated to him by his attorney and that it need not (indeed should not) consider defendant’s ability to recollect and relate the occurrences of the incident alleged. Id. We also found that the trial court abused its discretion in barring defendant’s expert’s testimony as to how defendant’s lack of memory affected defendant’s ability to assist in his own defense. Id. ¶ 54.
¶ 18 We found that there was no genuine dispute defendant understood the nature and purpose of the proceedings against him and therefore the fitness hearing hinged on whether defendant could assist in his own defense. We found that absent consideration of defendant’s ability to recollect the offense, the jury had no real basis upon which to decide defendant’s ability to assist in his own defense, making the outcome a virtually foregone conclusion. Id. ¶ 53.
¶ 19 We reversed the judgment and remanded with instructions for the trial court to hold a full retroactive fitness trial in accordance with our order. Id. ¶ 62. We instructed the trial court to
allow defendant’s expert’s testimony at a retroactive fitness trial. Id. ¶ 54. We also held that “the trial court must instruct the jury on all of the factors listed in the [fitness] statute that may be considered in determining a defendant’s fitness for trial” and that the determination is to be made based on the totality of the circumstances. Id. ¶ 57 (citing 725 ILCS 5/104-16(b) (West 2018)).
We directed defense counsel to object and the trial court to rule on the objection “if the State’s witnesses restate an erroneous standard” for determining fitness. Id. ¶ 57.
¶ 20 On remand the trial court held a retroactive fitness trial. Before the trial began the defense filed a motion to exclude certain testimony by the State’s witnesses. Specifically, defendant sought to bar the State from presenting expert testimony that “someone who suffers from amnesia can gain ‘personal knowledge’ of a past event by a process called ‘extrinsic memory
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1-16-0406 reconstruction’ which involves listening to others describe events that have been erased from memory.” The motion complained that the State’s experts had previously opined that defendant
was fit to stand trial because he could learn about the events of the crime from “second-hand accounts” and that would create “personal memories” that defendant could use to assist in his own defense. The defense argued this “theory” of “extrinsic memory reconstruction” is not
generally accepted in the relevant scientific community. The trial court denied the motion. The court believed the testimony proffered by the State’s experts was consistent with Stahl. The court deferred ruling on a separate defense motion in limine to bar testimony that misstates the factors used to determine fitness.
¶ 21 The State called Dr. Erick Neu, a licensed staff psychologist with Forensic Clinical
Services (FCS) for the Circuit Court of Cook County, to testify as an expert witness. Dr. Neu is board certified in the specialty of forensic psychology. He testified that forensic psychology is a specialty in psychology addressing “psycholegal” issues, meaning “a legal topic that has a psychological component” including, for example, fitness to stand trial. Fitness to stand trial is a
“legal term, but there’s a psychological component to it, whether somebody is having symptoms
of mental illness or cognitive impairment that *** prevents them from being able to understand the proceedings or assist in their defense.”
¶ 22 According to Dr. Neu, FCS exclusively conducts court-ordered mental health evaluations to address “legal issues that have a mental health component, such as a defendant’s fitness to
stand trial.” Dr. Neu gratuitously added that FCS is “always impartial.” The majority of evaluations Dr. Neu has conducted in his over 20 years with FCS have been fitness to stand trial- related evaluations. Dr. Neu described a fitness evaluation as determining “does the defendant have symptoms of mental illness or cognitive impairment that renders them either unable to
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1-16-0406 understand the nature of the proceedings and/or unable to rationally assist Counsel in their defense.” A retroactive fitness evaluation is significantly similar to a fitness evaluation except that a retroactive fitness evaluation looks at a particular time frame in the past. Dr. Neu received
a court order for an evaluation of defendant to determine his “retrospective fitness at the time of August [2015.]” Dr. Neu’s evaluation of defendant consisted of reviewing defendant’s medical records and a face-to-face meeting with defendant. Dr. Neu created a written report of his evaluation which assisted him in his testimony.
¶ 23 Dr. Neu testified that after the offense defendant was taken to the hospital with “severe, severe injuries” that at one point required defendant to be resurrected but the records did not document head injuries. Defendant was not shot in the head and did not receive blunt force trauma to the head. The hospital treated defendant for “acute physical injuries.” Defendant was transferred to a different hospital for continued care and eventually defendant was transferred to a different hospital and placed in a rehabilitation wing. In June 2010, defendant received a psychological screening when he was placed in the rehabilitation wing. That psychological screening concluded that defendant was alert and fully oriented to place, time, and situation. Dr.
Neu testified that defendant “was described as having his attention and concentration as well as his comprehension” and there were “no significant impairments” to his immediate and remote memory. Defendant’s recent memory “was described as mild to moderately impaired.” In this screening defendant stated, about the incident, “ ‘they said he shot a cop. I don’t remember. I was shot by a cop.’ ” Defendant was diagnosed with “cognitive disorder, not otherwise specified due to anoxic encephalopathy.”
¶ 24 Dr. Neu testified that a July 2010 psychological note from the rehabilitation hospital states that defendant denied feelings of depression or anxiety and that his first memory before the - 10 -
1-16-0406 offense was his going to high school. At the end of July 2010 the rehabilitation hospital discharged defendant. The discharge summary stated that defendant received “ ‘comprehensive rehabilitation for mobility, [activities of daily living,] and cognitive impairment, secondary to anoxic brain injury due to cardiac arrest as complication of [multiple gunshot wounds.]’ ”
Anoxic brain injury is injury to the brain that occurs due to a lack of oxygen.
¶ 25 After he was discharged from the rehabilitation hospital defendant was admitted to
Cermak Health Services for ongoing medical treatment. Dr. Neu testified he reviewed medical records from Cermak to look for things of clinical significance to his evaluation, “which was to see if there was concerns about [defendant’s] memory or cognitive functioning documented.”
The records “did not document any significant concerns about [defendant’s] intellectual or cognitive functioning” in November 2010. Defendant received occasional mental health
evaluations and “on no occasion was he described as requiring mental health treatment.” In particular defendant received a mental health evaluation in October 2011 after stating he was
feeling down and suicidal, but defendant reported to the evaluator only “medical concerns and not mental health concerns.” The evaluator reported they did not observe any symptoms of mental illness.
¶ 26 The October 2011 evaluation described defendant as fully oriented to time, place, and situation, as having normal speech and appearance, and that defendant’s thoughts were organized with “adequate insight” and “adequate judgment.” The evaluation concluded that defendant was not in need of mental health services. The evaluator “did not document any difficulty [defendant]
had communicating with her” nor did she document any difficulty she had understanding him or any cognitive impairment. Subsequent evaluations also “documented that there were no mental health issues that would prevent [defendant] from being transferred” and there were no observed
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or reported symptoms of mental illness. Again, later an evaluation contained “no mention of cognitive deficits” and reported that defendant did not appear to have difficulty understanding his evaluator. Specifically in August 2012 the evaluator reported that defendant “does not really
have any [self-reported] mental health concerns” and did not document that the evaluator observed any mental health symptoms or notable cognitive impairment.
¶ 27 Dr. Neu opined that defendant’s past medical records documented “significant improvement” with respect to his injuries at each subsequent medical facility. The retroactive fitness evaluation was to evaluate defendant as of August 2015, but Dr. Neu also reviewed defendant’s medical records after 2015. He testified he did this as part of his retroactive fitness evaluation because “the early end of those additional records are important because they’re within a couple of months of the timeframe that I’m interested in.” Dr. Neu testified that they contained no history of defendant receiving mental health treatment. The records after 2015 did
not describe defendant as either reporting or exhibiting any significant cognitive deficits or intellectual impairments. Defendant “was not deemed to require mental health treatment or any type of medication for mental illness at any time.”
¶ 28 Dr. Neu opined that “during the actual time period that I’m interested in, [defendant] did not appear to have any significant mental health concerns based on the medical records.” He added, that since the time defendant medically stabilized from the trauma caused by the gunshot wounds defendant “had not been described as exhibiting or reporting symptoms of mental illness, and he’s not been described as exhibiting significant cognitive deficits.” Dr. Neu opined
that based on the medical records defendant had a “remarkable recovery” both physically and cognitively. Cognitively, the records from the first hospital in 2010 “describe significant
- 12 - 1-16-0406 problems with his memory and cognitive functioning,” but the later medical records “do not describe any visible or apparent impairment with his cognition. ¶ 29 In November 2021, Dr. Neu also personally interviewed defendant as part of his retrospective fitness evaluation. During the interview Dr. Neu conducted a mental status examination which consists of “a series of questions and observations to assess somebody’s functioning and for signs and symptoms of mental illness.” Dr. Neu found defendant to be “alert and fully oriented.” Defendant had “adequate energy and ability to pay attention.” Defendant knew his own name and what the situation was. Defendant was oriented to time and place. Defendant did not hallucinate during the interview. Dr. Neu found defendant’s speech to be “organized and relevant.” Defendant’s responses to questions were related to what Dr. Neu was asking; defendant did not stray into something else. Defendant’s answers were responsive and there were no obvious psychotic symptoms. Dr. Neu opined that during the evaluation there were no obvious significant cognitive deficits. Dr. Neu reached that conclusion because defendant’s responses were relevant to the question, “meaning he was capable of understanding.” Dr. Neu did not have to simplify his questions. He noted that defendant “was fairly articulate” and gave “kind of eloquent answers to questions.” ¶ 30 Defendant reported to Dr. Neu that defendant had amnesia of the time period near the offense, both shortly before, during, and shortly after the offense. Defendant “also reported some continued mild memory problems” like forgetting names or portions of conversations. Dr. Neu testified that he confirmed with defendant that defendant has not required any treatment for this. Dr. Neu testified that talking to defendant, “he didn’t seem like he was somebody who had significant cognitive impairment” and that “not a single mental health personnel who’s evaluated him since he arrived to Cook County Jail described him as appearing to exhibit any significant - 13 - 1-16-0406 cognitive deficits.” Defendant maintained “adequate attention and appropriate behavior through the evaluation.” ¶ 31 Dr. Neu testified that you have to rely on self-reporting of whether or not someone remembers a specific day or specific incident. Dr. Neu testified “you can never, with a hundred percent certainty, confirm [amnesia] by giving somebody a psychological test or knowing a diagnosis that they have amnesia.” There is no objective test to determine the span of the reported amnesia. Defendant reported retrograde amnesia in that “he didn’t remember a period of time before the alleged offense and a period of time after the alleged offense.” In contrast, anterograde amnesia “is when you have difficulty forming new memories.” Defendant’s amnesia added “an additional element” to Dr. Neu’s “clinical focus during [his] evaluation for retrospective fitness in August 2015.” Dr. Neu testified that when a defendant claims amnesia, what he is “looking for is at the time of the trial, had they recovered enough that they were able to form new memories; would they be able to sustain attention during the trial; would they be able to have conversations with their attorney; would they understand what their attorney is telling them; that they’re able to speak coherently and in a relevant, organized manner with their attorney; would they be able to understand witness accounts and evidence about what happened; would they be able to look at and understand police report description[s] of the alleged offense;” and was defendant able to “make rational and informed decisions about his defense; understand court proceedings; understand the roles of the court personnel; understand witness accounts of what happened; understand evidence about what happened; and so on.” - 14 - 1-16-0406 ¶ 32 Dr. Neu testified, over defendant’s objection, that, “The essence of a fitness evaluation is to evaluate whether somebody has symptoms of mental illness or cognitive impairment, that either causes them to not have an adequate understanding of the nature of the court proceedings and/or causes them to be unable to rationally assist their lawyer in their defense.” Dr. Neu questioned defendant on those issues. Dr. Neu testified, over objection, that, “[D]efendant indicated that he has no memory of the actual alleged offense, but he did express understanding of the charges. He indicated that he’s been reviewing ‘discovery’ transcripts of his trial and that he *** was able to express an understanding of the allegations against him, based on learning about what allegedly transpired from reading other sources of information.” ¶ 33 Dr. Neu testified that defendant told him that defendant’s last memory before the offense was being at home with his daughter and her mother but defendant did not know how long before the offense that was. Defendant described the accusations against him to Dr. Neu. Dr. Neu testified that he wanted to assess whether defendant was “able to understand collateral sources of information about what happened.” Dr. Neu testified that based on the fact that defendant claimed amnesia it is important to determine whether defendant had the ability to learn new information and retain new information from sources other than his memory. ¶ 34 Dr. Neu asked defendant how defendant could assist his attorney. Defendant answered, “ ‘talk to him.’ ” Defendant told Dr. Neu he was comfortable answering his attorney’s questions to the best of his ability, being honest with his attorney, and considering his attorney’s advice. Defendant volunteered that he could not help his attorney because his lack of memory of the offense caused him to be unable to help his lawyer. - 15 - 1-16-0406 ¶ 35 Defendant recounted some of the testimony from his first trial to Dr. Neu based on defendant’s memory of the trial and from reading transcripts. Defendant correctly described the plea bargaining process and, according to Dr. Neu, “he was able to rationally discuss his decision to go to trial.” When asked why he went to trial defendant told Dr. Neu he was innocent and that although he could not remember the offense, in looking at the discovery he concluded he was just a bystander and that there is not enough evidence that he was involved in a plan. ¶ 36 Dr. Neu’s conclusions from his retrospective fitness evaluation was that “both physically and mentally [defendant] made a remarkable recovery. And since his arrival to Cook County Jail, [defendant] has not been documented at any time as reporting or exhibiting any severe lingering cognitive deficits. *** [A]ll the encounters that he’s had with mental health staff, he’s not been described as appearing slow or struggling to understand what’s being said to him, or struggling to express himself.” ¶ 37 Dr. Neu concluded, including the records of psychological testing done of defendant closer in proximity to the trial, that “at the time of the trial, [defendant] was no longer having significant cognitive deficits.” Dr. Neu opined that defendant is capable of learning and retaining new information that has been extrinsically reconstructed from a source other than his memory, that the reconstruction could be with his attorney, and defendant exhibited an understanding of the legal process. Defendant can learn information and is “able to logically process any information that is communicated to him.” Defendant does not have any cognitive problem, intellectual problem, or psychological problem that would impair his ability to learn what happened through extrinsic sources. Dr, Neu’s opinion to a reasonable degree of psychological certainty was that, “Defendant was fit to stand trial on August 20th of 2015.” Dr. Neu based his opinion on defendant’s understanding of the proceedings, he “demonstrated an ability to have - 16 - 1-16-0406 learned and retained information,” and the medical records show that “by 2015, he did not have significant cognitive deficits that lingered.” Dr. Neu concluded “there was nothing to suggest that at the time of [trial defendant] had cognitive deficits or symptoms of mental illness that would have significantly compromised his ability to understand the proceedings and/or to have significantly impeded his ability to have rationally assisted in his defense.” ¶ 38 On cross-examination, Dr. Neu testified that his diagnostic impression of defendant was “history of mild neurocognitive disorder due to anoxic brain injury.” Dr. Neu was aware that a person can be unfit for trial because of a psychological issue or because of a medical issue. Dr. Neu does not specialize in brain injury as a medical doctor and does not know the criteria a medical doctor would use to diagnose anoxic brain injury. As a psychologist he does not address the severity of an anoxic brain injury. Instead, he is looking for whether the “medical problem produce[s] symptoms of mental illness or cognitive defects that impact the referral issue.” Dr. Neu does not recall ever evaluating a client who suffered from anoxic brain injury. ¶ 39 Dr. Neu agreed that the difference between “mild cognitive disorder” and major or severe cognitive disorder is how well the person functions on a daily basis; that is, how well they care for themselves and how they act. He also agreed that defendant had a history of mild cognitive disorder. Dr. Neu testified that a diagnosis of mild cognitive impairment “tells you nothing as to whether the person is fit or unfit. So it’s not an important part of my evaluation.” Dr. Neu testified that if he were to believe defendant when defendant says that he has no memory of the offense, then he would tell the jury that defendant has a cognitive impairment to his memory. What was significant to Dr. Neu was that from the time he arrived in jail no mental health or medical professional described defendant has having ongoing significant problems with his memory. - 17 - 1-16-0406 ¶ 40 Dr. Neu admitted that he does not know enough about anoxic brain injury to describe the expected medical effects of that injury. Dr. Neu did not say that he could not read the medical records and know if defendant exhibited signs that would be expected from severe anoxic brain injury in the months and years after his injury because that is not the way he looks at things. He repeated that he determines whether, at the relevant time, the person had deficits that affected “both the legal [and] psycholegal criteria” which in this case was retrospective fitness to stand trial in August 2015. Dr. Neu agreed that defendant continues to suffer physical symptoms such as twitching and poor gait that would be expected from someone with severe anoxic brain injury and was on medications for them. But he later added that nothing in the medical records suggests that defendant has lingering significant cognitive impairment that impacts his understanding of the proceedings or ability to assist in his defense. ¶ 41 Dr. Neu agreed that memory loss is common with anoxic brain injury. He agreed that damage to different parts of the brain can affect different parts of memory while leaving other cognitive abilities and memories intact. He admitted that it is not unusual for someone in defendant’s condition to have memory loss for the time of the event but to have retained most of their other cognitive abilities. Dr. Neu agreed that retrograde amnesia from the time of the trauma is associated with the type of injury defendant has. ¶ 42 Dr. Neu testified that he accepted that it is extremely likely that defendant has retrograde amnesia for the day he was shot. There is no therapy to restore memory for someone with retrograde amnesia. Dr. Neu testified, “There can be cases of permanent retrograde amnesia that there’s no treatment that can restore the norm.” Retrograde amnesia would not impact the ability to identify who the judge is or to state what a trial is or what is evidence. Dr. Neu did not ask defendant what he would do if a witness gave false testimony. Dr. Neu stated defendant brought - 18 - 1-16-0406 up his ability to testify in light of his amnesia; but Dr. Neu stated that if a person is not able to testify because they forgot what happened is “not something that’s relevant to my opinion as to whether they’re fit or unfit.” Dr. Neu stated, “What I’m looking at is by the time of the trial, had he recovered enough that they’re able to understand witness accounts of what happened; understand and follow along with testimony; look over the police reports; be able to have conversations with their lawyers. As a psychologist, that’s what I’m asked to do. I’m not asked to say whether or not a person can testify because you don’t remember.” ¶ 43 Dr. Neu stated that his concern is whether a cognitive impairment prevents a defendant from testifying and not whether they are prevented from testifying because they do not remember what happened, and he described the latter as “a legal issue whether or not that prevents somebody from having a fair trial, not an issue that a psychologist decides *** this person can’t testify.” Dr. Neu admitted that “with amnesia, there could be legal reasons why somebody’s unfit, but those are not reasons a psychologist would opine on.” ¶ 44 Dr. Neu testified that when he spoke about defendant learning what happened from outside sources he did not mean that defendant had regenerated his own memory but that defendant has new memories of secondhand accounts, and defendant has no way of knowing whether those secondhand accounts are true or not. ¶ 45 After Dr. Neu testified the State indicated its intent to rest its case and the defense made a motion for a directed verdict. The defense argued that the issue of fitness in this case is surrounded by defendant’s anoxic brain injury “and what it means about his ability to assist his attorney.” The defense argued that the State’s sole witness is not an expert in anoxic brain injury - 19 - 1-16-0406 “which *** is the focus of this trial.” The defense highlighted Dr. Neu’s testimony that defendant is “mentally fit” because “there’s no reason that I’m seeing that he had symptoms of mental illness that rendered him unfit.” The defense argued that the question of whether defendant has a mental illness is irrelevant to this trial. The defense argued the State had failed to meet its burden and asked for a directed verdict. The trial court denied the motion. The defense also made a motion for a mistrial on the ground that there had been testimony about the trial and defendant’s guilt or innocence of the offense. The defense argued testimony about a trial of the offense was prejudicial to defendant. The trial court denied the motion. [1]