The expert evidence
34As I have said, Professor Petchkovsky was the plaintiff's treating psychiatrist following her discharge from Lismore Base Hospital in July 2013. In a brief report written on 4 September 2013, Professor Petchkovsky noted that the plaintiff "has made an excellent recovery and is currently on helpful medication" (which he identified). He said, in a passage which was initially rejected on objection, but admitted after Mr Dupree cross-examined Professor Petchkovsky on it, that in his view the plaintiff "is fully competent and capable of managing her own affairs including matters regarding her solicitor."
35Thereafter, in January 2014, Professor Petchkovsky provided two reports. One was expressed to be in draft. The plaintiff's solicitors wrote to Professor Petchkovsky asking him to explain and expand certain aspects of it. There was some hint of criticism of this, and of the revised report that was produced. I do not accept that there was anything in any way improper in what happened. The questions that were put were entirely appropriate, as I have said seeking clarification and expansion. It was made clear to Professor Petchkovsky that he was not being asked to alter his opinions. It is equally clear that Professor Petchkovsky did not do so.
36After that letter had been sent, Professor Petchkovsky produced a final version of his report. In that report, Professor Petchkovsky made a number of points. He said that the plaintiff "is in stable remission, and getting adequate treatment and support ... is capable of weighing up, in an adequate fashion, the range of financial, social, relational and ethical factors involved in her settlement ... [and there were] no factors like cognitive impairment or impairment of social/emotional intelligence secondary to active Mania or Depression that would impact negatively on her capability to understand proceedings and give instructions".
37Professor Petchkovsky noted that he was required to express an opinion as to "legal incapacity" (he had been given material that would assist him to understand this concept) "especially with regards to being able to give instructions with regards to the current Court proceedings". He concluded:
"I am therefore very satisfied that she does not have legal incapacity, and can give proper detailed and specific instructions with regard to her estate [sic] and its management."
38Mr Dupree criticised the use of the word "estate". However, to the extent that this indicates some want of understanding on Professor Petchkovsky's part, it appears to be something shared by Dr Nielssen, who used the same expression.
39Professor Petchkovsky said that the plaintiff's prognosis was "very good". He continued:
... . Risk of major relapse (depressive or manic episode that is so severe that it requires hospitalisation) over the next 2 years is low. With the support of regular appointments, any prodromal (less severe) deteriorations will also be much less likely, and if they occur, can be picked up and rectified early in the piece. With mindfulness training combined with regular support, Vanessa's resilience can improve even further.
40As I have noted, Dr Nielssen was at some variance with Professor Petchkovsky as to the precise identification of the disability that is afflicting the plaintiff. However, and again as I have noted, he agrees that it is presently in remission.
41Dr Nielssen reported what in his view was a problem:
"However, there was evidence of subtle poverty of thinking and impairment in capacity for abstract thinking during the recent interview that was consistent with the presence of a chronic form of mental illness."
42He said, further:
"I believe her decision-making ability is affected by impairment in her capacity to realistically appraise her position because of residual impairment in her capacity for abstract thinking arising from her underlying mental illness."
43Before I turn to the balance of Dr Nielssen's comments, I should note that there appears to be some circularity in this process of reasoning. In the first quotation, Dr Nielssen suggests that the subtle poverty of thinking and impairment in capacity for abstract thinking was consistent with the presence of chronic mental illness - i.e., as I understand it, an indicator of the presence of mental illness. However, in the second quotation, Dr Nielssen appears to be saying that it is the existence of that mental illness (which, he had suggested, was demonstrated by the thinking problems to which he referred) that caused the impairment in thinking. The same condition appears to be both cause and effect.
44Regardless of that perhaps overly literal interpretation of what Dr Nielssen said (and accepting, if I have been "rather literal", then on his view that may be indicative of some chronic form of mental illness affecting the giver of these reasons), there are, to my view, very significant problems with Dr Nielssen's diagnosis. He was asked in cross-examination to explain the "subtle poverty of thinking" to which he referred. Specifically, he was asked to identify the particular questions and answers that enabled him to identify the presence of mental illness.
45Dr Nielssen referred (T73.25) to what he said was the plaintiff being "doggedly set on the amount of $1 million". When asked to identify where that was recorded in the report, he was unable at first to do so, referring to a passage where in fact it had been he who mentioned that sum.
46When pressed on the point, Dr Nielssen referred to another paragraph of his report, which said no more than that the plaintiff had "confirmed that she had discussed entering a financial settlement with [the defendant] and...wanted to accept his offer of one million dollars ...". There was no other material to which Dr Nielssen was able to point which showed that the plaintiff was "set" on that amount, let alone that she was set in some way that could be described as "dogged".
47In short, when one considers the whole of Dr Nielssen's evidence, including the opportunities that he was given to explain and expand upon the somewhat abrupt and conclusory statements to which I have referred, he was unable to support them in any way which enables the Court to make an assessment of his reasoning processes and their validity.
48Mr Dupree submitted that Dr Nielssen was an expert in the field of psychosis and that Professor Petchkovsky, on his own admission, was not. The first point may be accepted. It is clear that Dr Nielssen has made a particular study of psychoses, and that he has been heavily involved in professional development in this field. But to say that Professor Petchkovsky is not an expert is wrong; and a fortiori so, to say that he conceded this. The submission rests on what in my view is an incomplete and selective reading of the transcript. I set out at first the questions and answers from T42.18-.25:
Q. So would it be a correct understanding of your last series of answers that you don't hold yourself out to be an expert in psychosis?
A. No. I don't hold myself out to be any more of an expert in psychosis than any of my other colleagues.
Q. But do I understand it correctly from that last answer that you don't say to His Honour that you are an expert in psychosis?
A. No. I don't say to His Honour that I am an expert in psychosis.
49I turn to what Professor Petchkovsky said, on the same topic, at T58.1-.7:
Q. Well, you accept that he is an expert on psychosis, don't you?
A. I accept that he is an expert on psychosis insofar as every psychiatrist by the nature of their profession and training has to be an expert on psychosis and if they're not, they should not be practising psychiatry, so of course I expect--
Q. Thank you.
A. --accept that.
50It is perfectly clear, considering Professor Petchkovsky's evidence in its totality (and not selectively) that he was asserting that it is necessary for any psychiatrist to be an expert on psychosis and that he himself had the expertise that is possessed by psychiatrists generally. It is equally clear that, in the second answer given on page 42, Professor Petchkovsky was saying no more than that he did not hold himself out as having any expertise over and above that of any psychiatrist in the field of psychosis. To put it another way, Professor Petchkovsky is to be understood, in my view, as accepting only that he did not have the degree of expertise that, undoubtedly, Dr Nielssen does have.
51In my view, Professor Petchkovsky is abundantly qualified to express the opinions that he does.
52In considering the extent to which there is a conflict between Professor Petchkovsky's evidence and that of Dr Nielssen, it is necessary to bear in mind that the former is, and for some time has been, the plaintiff's treating psychiatrist. To my mind, that has given Professor Petchkovsky an invaluable opportunity of observing the plaintiff on repeated occasions, and of forming (in an entirely appropriate professional way) a relationship in which she has some degree of confidence in him, and in the course of development of which he has been able to assess her in a more detailed way than it was possible for Dr Nielssen to do in the one hour that he spent with her.
53I accept Professor Petchkovsky's evidence, and, to the extent that it is necessary to do so, I prefer his evidence to that given by Dr Nielssen.
54I should note that there was an attack made on Professor Petchkovsky, on the basis that he had not set out matters of history in his report. That is certainly correct in relation to the first and brief report of September 2013. It is simply incorrect in relation to the two later reports (the draft and final reports of January 2014). In each of those last two reports, Professor Petchkovsky sets out verbatim what appeared to him to be relevant matters of history. In the sections of the report on which Mr Dupree relied (which stated that there was "nil" psychiatric or medical history), it is clear, as Professor Petchkovsky said, that he was saying that there was no relevant psychiatric history other than that noted at length in his report, and no other relevant medical history.
55Again, in my view, this submission involves both a selective reading of what it was that Professor Petchkovsky said and, equally, a deliberate overlooking of much of what is clearly to be found in his last two reports.
56The effect of Professor Petchkovsky's opinion is, as I have said, that in his view the plaintiff is not suffering from any legal incapacity (insofar as that question lies within the professor's field of expertise), and is in a position to give proper detailed and specific instructions in relation to the litigation. That appears both from the last two reports and from his evidence in cross-examination. I see no reason to doubt it. It may be noted that Dr Nielssen does not express an opinion to the contrary. He says, at most, that the decision making ability is affected by what he perceives as impairment in the plaintiff's thinking capacity. But as I have pointed out already, that passage of Dr Nielssen's report is both circular in its reasoning and not linked, by any process of reasoning that I can discern, to such shreds of evidence as Dr Nielssen was able to point to in support of it.
57It is of course correct to say, as Mr Dupree submitted and as both the experts recognised, that the illness may manifest itself again in the future. Professor Petchkovsky's view is that the plaintiff's regime of medication and other treatment is keeping the illness under control. Dr Nielssen appears to agree with this. There may come a time when that does not happen: either for some medical reason which has not been explored, or perhaps (more simply) because the plaintiff decides to discontinue her medical regime without seeking appropriate advice. But if that happens, and if there is thereby some impact on the plaintiff's ability to give instructions, one would expect her legal advisers to realise this.
58Before I leave the medical evidence, I should note that Professor Petchkovsky did refer to the opinion expressed by Dr Nielssen that the plaintiff's decision-making ability is affected by some impairment in her capacity for abstract thinking. Professor Petchkovsky did not agree that there was residual impairment. He said that abstract thinking impairments are features of acute mania and depression, but resolve when the acute phase lifts. He said, further, that the acute phase had lifted.
59Professor Petchkovsky was not, as I recall, cross-examined on that particular expression of opinion. Nor was Dr Nielssen asked whether or not he agreed with it. Accordingly, even if one were to think that Dr Nielssen's views should be given significant weight (and for the reasons I have indicated, I do not), the ultimate view, on which so much reliance has been placed, seems to me to be answered by this aspect of Professor Petchkovsky's evidence, which I accept.