Amended Disability Motion No. 12-11213 CA11 US Eleventh Circuit

Case: 12-11213 Date Filed: 08/09/2012 Page: 1 of 42 (1 of 43)

UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
ELBERT PARR TUTTLE COURT OF APPEALS BUILDING
56 Forsyth Street, N.W.
Atlanta, Georgia 30303
John Ley
Clerk of Court
August 07, 2012
For rules and forms visit
www.ca11.uscourts.gov
Sheryl L. Loesch
United States District Court
207 NW 2ND ST
OCALA, FL 34475
Appeal Number: 12-11213-C
Case Style: Neil Gillespie v. Thirteenth Judicial Circuit, F, et al
District Court Docket No: 5:10-cv-00503-WTH-TBS
The enclosed copy of the Clerk's Entry of Dismissal for failure to prosecute in the above referenced
appeal is issued as the mandate of this court. See 11th Cir. R. 41-4.
Sincerely,
JOHN LEY, Clerk of Court
Reply to: Walter Pollard, C
Phone #: (404) 335-6186
Enclosure(s)
DIS-2 Letter and Entry of Dismissal
Case: 12-11213 Date Filed: 08/07/2012 Page: 1 of 2
IN THE UNITED STATES COURT OF APPEALS
______________
No. 12-11213-C
______________
NEIL J. GILLESPIE,
lllllllllllllllllllllllllllllllllllll lllPlaintiff - Appellant
versus
THIRTEENTH JUDICIAL CIRCUIT, FLORIDA,
GONZALO B. CASARES,
ADA Coordinator, and Individually,
DAVID A. ROWLAND,
Court Counsel, and individually,
JUDGE CLAUDIA RICKERT ISOM,
Circuit Court Judge, and individually,
JUDGE JAMES M. BARTON, II,
Circuit Court Judge, and individually, et al.,
llllllllllllllllllllllllllllllllllllll llDefendants - Appellees,
BARKER, RODEMS & COOK, P.A. et al.,
llllllllllllllllllllllllllllllllllllll lllDefendants.
__________________________________________
Appeal from the United States District Court
for the Middle District of Florida
__________________________________________
ENTRY OF DISMISSAL: Pursuant to the 11th Cir.R.42-1(b), this appeal is DISMISSED for want
of prosecution because the appellant Neil J. Gillespie has failed to pay the filing and docketing fees
to the district court within the time fixed by the rules, effective August 07, 2012.
JOHN LEY
Clerk of Court of the United States Court
of Appeals for the Eleventh Circuit
by: Walter Pollard, C, Deputy Clerk
FOR THE COURT - BY DIRECTION
John Ley
Clerk of Court
August 09, 2012
Neil J. Gillespie
8092 SW 115TH LOOP
OCALA, FL 34481
I am returning to you unfiled the papers which you have submitted. This case is closed.
Sincerely,
Reply to: Walter Pollard, C
Phone #: (404) 335-6186
PRO-3 Letter Returning Papers Unfiled
John Ley
Clerk of Court
August 09, 2012
Neil J. Gillespie
8092 SW 115TH LOOP
OCALA, FL 34481
I am returning to you unfiled the papers which you have submitted. Your appendices to your
motion for accomodation are returned unfiled because these cases are closed.
Sincerely,
Reply to: Walter Pollard/aw, C
Phone #: (404) 335-6186
PRO-3 Letter Returning Papers Unfiled
August 7, 2012
John Ley, Clerk of Court
U.S. Court of Appeals for the 11th Circuit
56 Forsyth St., N.W.
Appeal Nos. 12-11213-C and 12-11028-B
Dear Mr. Ley:
Please find enclosed for filing Appendixes 1-3 to my to Consolidated Amended
Motion For Disability Accommodation, etc. submitted yesterday, August 6, 2012.
Also enclosed is a Certificate of Service.
On July 27, 2012, and again on July 30, 2012, I wrote you that my Consolidated
Amended Motion for Disability Accommodation was forthcoming, but it was delayed due
to disability and declining health. I am sorry it took until August 6, 2012 to submit. I also
regret the delay in providing the enclosed Appendixes 1-3.
I apologize for any inconvenience caused to the Court by my delay.
Thank you for your consideration.
/ /1

// .
eil J. G

8092 SW Ilsfh Loop
- Ocala, Florida 34481
Enclosures
cc: Catherine Barbara Chapman, Esq.
Ryan Christopher Rodems, Esq.
-------------
NEIL J. GILLESPIE,
ESTATE OF PENELOPE GILLESPIE,
CASE NO.: 12-11213-C
Appellants/Plaintiffs,
vs. CASE NO.: 12-11028-B
THIRTEENTH JUDICAL CIRCUIT,
FLORIDA, et al.
Respondents/Defendants.
/
Certificate of Service
I HEREBY CERTIFY that a PDF of Appendixes 1-3 to Consolidated Amended
Motion For Disability Accommodation, etc., was emailed August 7, 2012 to Catherine
Barbara Chapman (For Robert W. Bauer, et al), at catherine@guildaylaw.com, Guilday,
Tucker, Schwartz & Simpson, P.A., 1983 Centre Pointe Boulevard, Suite 200,
Tallahassee, FL 32308-7823.
Gillespie respectfully requests Ms. Chapman forward a PDF copy to Mr. Rodems
because Gillespie cannot afford due to indigence and/or insolvency to mail a paper copy
to Mr. Rodems. Gillespie cannot have email or telephone contact with Mr. Rodems
because of Mr. Rodems past misconduct toward Gillespie. Gillespie respectfully requests
Ms. Chapman also forward to Mr. Rodems a PDF copy of the Affidavit (Jul-30-12) and
Notice (July-27-12) in support of this motion.
Ryan Christopher Rodems, Esquire
(For himself, his law partner, and his firm Barker, Rodems & Cook, PA)
Barker, Rodems & Cook, PA
501 E. Kennedy Blvd, suite 790
}
Tampa, Florida 33602
NEIL J. GILLESPIE,
CASE NO.: 12-11213-C
vs. CASE NO.: 12-11028-B
FLORIDA, et al.
_______________________________/
APPENDIX - 1
CONSOLIDATED AMENDED MOTION FOR DISABILITY ACCOMMODATION
WAIVER OF CONFIDENTIALITY
MOTION FOR DECLARATORY JUDGMENT - APPOINT GUARDIAN AD LITEM
Exhibit 1 The ADA does not apply to the Federal Judiciary
Exhibit 2 Social and Psychological Implications of Dento-Facial Disfigurement; Macgregor
Exhibit 3 Affidavit of Neil J. Gillespie, panic attack July 12, 2010, Judge Martha Cook
Exhibit 4 Plaintiff's Amended Accommodation Request, ADA, March 5, 2007
Exhibit 5 Medical History of Neil J. Gillespie
Exhibit 6 Exhibits 6.1-6.17, Doctor letters and medical evaluations of Neil J. Gillespie
Exhibit 7 Velopharyngeal inadequacy - Wikipedia
Exhibit 8 Psychosocial Implications of Congenital Craniofacial Disorders; Gillespie
Exhibit 9 Psychotherapy for Persons with Craniofacial Deformities; Bennett-Stanton
Exhibit 10 Deficits in short-term memory in adult survivors of childhood abuse; Bremner
Exhibit 11 Hahnemann University Hospital ER, Aug-20-1988, Gillespie head trauma/TBI
Page - 1
The ADA Does Not Apply to the Federal Judiciary
The ADA does not apply to the federal judiciary, a fact not known to Gillespie
until he was informed April 10, 2012 by Chris Wolpert, Chief Deputy of Operations, U.S.
District Court for the Northern District of California. Mr. Wolpert emailed Gillespie in
response to his query, and wrote in part, "My understanding is that the Americans With
Disabilities Act does not apply to the Federal Judiciary." Mr. Wolpert appears correct.
A review of Title II shows the ADA only applies to a state or local government:
Title 42 - Chapter 126 - Subchapter II - Part A - 12131
As used in this subchapter:
(1) Public entity
The term "public entity" means
(A) any State or local government;
(B) any department, agency, special purpose district, or other
instrumentality of a State or States or local government; and
(C) the National Railroad Passenger Corporation, and any commuter
authority (as defined in section 24102 (4) [1] of title 49).
Prior to that time the following judicial officers and court personnel in the U.S. Eleventh
Circuit led Gillespie to believe that the ADA applied to the federal judiciary.
a. On March 16, 2012 Gillespie received a phone call at 1:43 p.m. about the ADA
from Brenda McConnel, a Supervisor in the Eleventh Circuit. Ms. McConnel was
responding to Gillespies call about the ADA initially directed to case handler Walter
Pollard. Ms. McConnel advised Gillespie to file a motion and provide supporting
documentation for his ADA accommodation request, but did not inform Gillespie that the
ADA did not apply to the federal judiciary. Gillespie served a motion for accommodation
under the ADA in this Court April 7, 2012. Gillespie also made the following ADA
requests and/or inquiries in the Eleventh Circuit:
1
Page - 2
b. James Leanheart, Court Operations Supervisor, U.S. District Court, M.D. of
Florida, Ocala Division, prior to, and during the litigation.
c. Sheryl L. Loesch, Clerk, U.S. District Court, M.D. of Florida, by letter dated
April 5, 2012. A copy of the letter is attached as Exhibit 8 to Consolidated Notice of Pro
Se Electronic Case Filing Prohibition by District Court, submitted July 27, 2012.
d. The Hon. Anne C. Conway, Chief District Judge, U.S. District Court, M.D. of
Florida, by copy of the letter to District Clerk Loesch . Gillespie also wrote to Chief
Judge Conway March 22, 2012 about the Courts failure to disqualify Mr. Rodems as
counsel. Gillespies March 22nd letter is an exhibit to a Rule 59(e) Motion to Amend the
Judgment in District Court case no. 5:10-cv-503-oc (Doc. 60).
e. Blair Patton, Supervisor, N.D. of Florida, by telephone April 3, 2012.
None of the above judicial officers or court employees informed Gillespie that ADA did
not apply to the federal judiciary. Chief Judge Conway responded by letter April 25,
2012 and wrote I am in receipt of your correspondence dated March 22, 2012. Since this
case is not assigned to me there is nothing I can do to assist you. A copy of the letter is
attached. District Clerk Loesch has not responded to Gillespies concerns. This conduct
in the Eleventh Circuit is inconsistent with the effective and expeditious administration of
the business of the courts, and conduct prejudicial to the administration of justice.
United States District Court
Middle District of Florida
George C. Young Courthouse and Federal Building
401 West Central Boulevard, Suite 6750
Orlando, FL 32801-0675
Anne C. Conway
Chief Judge 407-835-4270
April 25, 2012
Mr. Neil J. Gillespie
8092 SW 115
th
Loop
Ocala, FL 34481
Re: Gillespie v. The Thirteenth Judicial Circuit, Florida, et al.
Case No. 5:10-cv-503-0c-10TBS
Dear Mr. Gillespie,
I am in receipt of your correspondence dated March 22,2012. Since this case is not assigned to
me there is nothing I can do to assist you.
Sil1cerely,
./ .. { l ~ / 1
nne C. Conway U
SOCTAI.. }.:,l) r:':"CEGLC;}ICAL !::HICA'l'IC:S OF DENTO-:'lLCIAL DI3i'IGURSmri'l'
*
**
Frances C.
One of the that has al'flays str'Jck me as ironic is the fact that,
of all the the field of physical disability and rehabilitation,
tte large D::'ouP 0::: D :::-scns in our society .'lith fncial deviations, Le.,
. s f'i t
is included. In this they
are the mar?inal or peonle.
When I my on the psycholobical and sociological aspects
of facial c.eformity some twenty years ago, in searching the literature I was
surprised to discover in all the studies of the psychological aspects
of physical disability problecs of etc., there was practically
no of the face. In 1953 a by Parker and others
1
of the
social-psychological research on to physical and illness
contained but references on facial deformities, and these were listed in
2
the subject index under the rubric "cosr:!etic.
1l
A subsequent survey by Wright
in 1960 included five references to studies involving iacial disfigurement.
Even today, by with other types of disabilities, attention
given to the facially disfigured is In campaigns for the handicapped
*Presented at conference "Psychological and Ecological Implications of
and Dento-Facial DisfigJreffient and Its Impact on the
Well-Being of the Individual," National Institutes of Health,
Bethesda, Md., November 17, 1969.
*t-Research Scientist, InsUtute of Reconstructive Plestic Surgery,
New York University Center, York, N.Y.
v, I . % I
2
-2
,
ci ther to raise fund8 or to cnccurn::;c their" employT:;cnt, the focus is on
amputees, p,'lr::lplesics, blind, the deaf, those wi th cereb::al 'palzy, and
so on - persons with sorce f\L'1ctional or organic impairment. '1'11e victims
of such disaLilitics even be seen or interviewed on television, but
never a person with a facial dis[iguYe'T:ent. Even at most national and
international conferences on disability or rehabilitation, facial disfigure
ment as a oatego=y is omitted.
Disability has been defined as any condition which prevents one from
performing the activities of caily living. Yet the insbility of the
facially disfigured to lead nor:I:al lives tends to be over"looked because
they are able-bodied, can work, and can physically accomplish
the basic routines of daily living.
The more I pursued my investigation of patients whose faoes were
marred, repulsive to look at, or though less severe
were stimuli for jokes or ridicule, the paradoxical I fO\L'1d the omis
sion of this large group. As I interviewed and follofted patients in need
of plastic surgery, prosthetic devices, and orthodontic work, it became
abundantly clear that defects of the face can be one .)f the most tragic
handicaps a person can have. It is quite true that there is some
functional problem, the physical ability of the facially disfigured is not
impaired. His handicap is social and psychological.
It is not within the scope of this paper to go into the social and
psychological significance of the face end its role in human relations.
This has been treated elsewhere.
3
,4 It is enough to say that the role of
the face in our interactions with others is the crux of the problem for
anyone whose face deviates from the norm. Coupled with our cultural
...3
cmp1":!l.sis on cxternul physical nttrnctiver.css, Hnd conforr:lity,
the of the facially handic;:lpped lie squarely in the area of mental
health.
One might supcose t::lat the psychic distress caused by disfigurellient is
in direct to its severity. But this is not the cuse. In an
interdisciplinary stud7 of facially disfibJred Fatients at New
York Univer.sity College of Z.:edicine (1949-1952), we found that, for those
whose evoked ridicule, bordered on caricature, stimulated jokes,
and were of the psychological was exceeaingly
great. In fact we found that many patients ....ith such deviations were in
worse psychological had more behavioral disoraers, and were more
maladjusted than those the kinds of deformities that were distressing
to look at or tended to elicit strong emotional reactions such as pity or
revulsion.
This is not to say that our gTossly disfigured patients were well
adjusted. But we did find that they complained less bitterly than the
mildly disfigured and vere more passive -- or perhaps more resigned. Wnile
many variables are involved in determining adjustment to facial deformity,
one important factor seems to be the consistency of responses which can be
expected from others. Our investigation showed that the "grossly disfigured
individual feels that he can almost always count on a negative response
wherever he goes. It may be surprise, pity, curiosity, or repulsion, but
seldom, if ever, is it one of immediate approval. Since he expects a
negative response, he is usually prepared and has developed overt or covert
techniques of coping with situations. On the other hand, there are types
of deformitie5 which are not so conspicuous, such as a missing
-4
ear or a Clalformatiol'! ... ts a oS rrhese may be no ticed one
time but not the next. In certain si tua a particular type 'of deformi ty
rnn;y be lauehed at or evcke an tipathetic feelir:[,3; ur:der 0 ther concH tions it
may be ignored or not even noticed. In general, the responses are
erratic unpredictable, and individuals such deformities appear to be
held in a hair-trigger and precariol,s position: They are never quite certain
what will happen. They alternate feelings of relief and tension, and
adjustment to their situation is made difficult. Predictability and con
sistency of then, may be one of the important factors which
permit the grossly deformed to adjust, whereas unpredictability and incon
. t t fl' f . t ,,3 (pp. 86-87)
S1S ency response seem 0 re1n!orce ee 1ngs 0 anx1e y.
Persons with dento-facial seem to fall in this latter
category. The Ferson with buck teeth ("Bugs Bunny syndrome"), for instance,
or a chin is less apt to be with compassion than as a target
for teasing, nich.-names, or caricature; for, as Aris totle said, "The thing at
which we laugh is a defect or ugliness is not great enough to cause
suffering or injury. Thus, for exanple, a ridiculous face is an ugly or
misshapen face, but one on which suffering has not Yet for the
victim derisive laughter is one of the most potent and destructive instru
ments men can use, and the shame, anger, and distress it can generate is
immeasurable. These reactions to derisive laughter apnear to be universal.
The Hopi Indians, well aware of its effect, could and did deliberately drive
an offender in the to insanity by the simple of laugh
lng at bim.
We do not will not know, I suppose, how many lives and
of those vith noticeable and dento-facial have
-5
however, haV0 some knO'tdedge of persons who have reported and spd:en of their
particular problems in this Roosevelt, whom I knew well,
reported in her wri tines her feelin[;3 about being what she called an "ugly
duckli::lg." She had a miserably unhappy childhood and young adulthood, and
had to long and valiantly before she at last succeeded (overtly at
least) in overcodng her feelings of inferiority and shyness. (I have often
wondered whether she would have become the great person she was had she not
had this visible handicap.) During her years as First Lady caricatures of
her we=e legion -- always with larce protruding teeth. Although so late in
her she finally had relief from this. She was in an automobile
accident lost, as I recall, three or four of her front teeth. Following
dental restoration she told me with delight what a fortunate
accident it had been, because at last she had straight front teeth.
Even in the absence of stereotyping, .there are two other handicapping
aspects associated with dento-facial deformity. In the first place, the
area in and around the mouth is both emotionally and strongly con
nected with one's self-image. As an instrument of speech and eating, as
well as a mirror of emotions, it also has unique soci.3.1 and psychological
implications and symbolic meaning. Any abnormality in this area. therefore,
is not only highly visible and obtrusive but -- as research has shown
tends to evoke a type of aversion which is both esthetic and sexual.
A second handicapping factor has to do with the degree to which such
defects interfere with the flow of social interaction. The man without an
arm can partially hide its absence in a sleeve; a cripple in a wheelchair
-6
ca:1 attend a di nne r \.. i tr.out r;enerati nc uneo:1incss. Eut the same cannot be
said for with f&.cial defects. Because in normal interaction the eyes
attend the face, any can be distracting and produce uneasiness
for the afflicted and non-afflicted alike.
As social scientists pointed out, sFontaneous interaction requires
certain skills and rules on the part of both participants. But spontaneity
is inhibited by the relle of "not noticing." Not to notice dento-facial
')\"S: )
irregulari tics is especially difficult, for, as Goffma...'1 points-ou-t, liThe
closer the defect is to the communication upon which the listener
must focus his attention. the smaller the defect needs to be to throw the
listener off balance. These defects tend to shut off the afflicted individual
from the stream of daily contacts, transforning him into a faulty interactant,
either in his eyes or in the eyes of others.
1I5
References
1. Barker, R.G., Wright, B.A., Meyerson, L., and Gorrick, M.R.: Adjustment
to Physical and Illness: A Survey of the Social Psychology of
Phvsiaue ar.d Bulletin 55, rev., Social Science Research
Council, New York, 1953.
2. Wright, B.A.: Physical Disability: A PsycholoRical Annroach, Harper and
Eros., New York, 1960.
3. F.C., Abel, T.M., Bryt, A., Lauer, E., and Weissmann, S.:
Facial and Plastic A Psychosocial SrJdy,
Charles C Springfield, Ill., 1953.
-7
4. Goffrr:un, E.: '1.\:0 Sl;.dj ,,:-; in tr.t> S0cioloe:v of In
Co., 1963.
5. Goffman, E.: Alienation from interaction, IIuJT:2.n Relations, X: 52, 1957.

May 12, 2002
Paid Notice: Deaths MACGREGOR, FRANCES COOKE
MACGREGOR-Frances Cooke. With apologies for the delay to her friends and colleagues, it is with regret that we advise
that Frances Cooke Macgregor, an expert on the psychological effects of facial deformities, died on Christmas Eve (2001) at
her retirement home in Carmel, California. She was 95 and died of congestive heart failure. She was a renowned social
scientist whose research and writing on the social and psychological significance of facial differences was the first
acknowledgement of disfigurement as a disability. Her publications document 40 years of research. Mrs. Macgregor was born
in Portland, Oregon, but grew up in San Rafael, California and earned a bachelor's degree in economics from the University
of California at Berkeley in 1927. She moved to Massachusetts several years later and in 1933 married the late Gordon
Macgregor, an anthropologist for the U.S. Bureau of Indian Affairs. They later divorced. While they were married, the
Macgregors visited Indian reservations around the country. A professional photographer at the time, Mrs. Macgregor took
pictures that captured daily life on the reservations. Those photographs, published in 1941 in a book entitled, ''Twentieth
Century Indians'', helped prompt Congress to devote more money to Indian reservations. Other pictures Mrs. Macgregor took
over the course of a year in the small Massachusetts town of Hingham, were also published in 1941 in a book called, ''This Is
America'', with text written by her friend, former first lady Eleanor Roosevelt. In the 1940's, Mrs. Macgregor moved to New
York City and did graduate work in anthropology at Columbia University under Dr. Margaret Mead. Mrs. Macgregor
obtained her master's degree in sociology at the University of Missouri in 1947. Her work on facial disfigurement began
during World War II while photographing patients at the Ellis Fischel Cancer State Hospital in Columbia, Missouri. Shortly
after the war, she met plastic surgeon Dr. John Marquis Converse, who helped repair the shattered and burned faces of French
and English pilots. His specialty coincided with her interest in social and psychological ramifications of facial disfigurement.
Dr. Converse accepted her suggestion to conduct an exploratory study of his patients. At that time, the existing literature on
physical disabilities was limited almost entirely to functional impairments: the loss of a leg, blindness, deafness and so on,
and the problems of physical rehabilitation. As for those whose faces happen to deviate from the norm, there was and is, a
special irony with which they must contend. Their problems have their roots in the inextricable relationship of the face to the
person and its role in human relations. Moreover, it is a situation made even worse in a society whose frenetic efforts to look
young and beautiful makes looking different a social stigma-a stigma that has the potential for social and psychological death.
Her work led to the World Health Organization adding facial disfigurement to its list of disabilities. In 1951 The Society for
the Rehabilitation of the Facially Disfigured was established. Now known as The National Foundation for Facial
Reconstruction, the Foundation helps fund the work of the Institute of Reconstructive Plastic Surgery at New York University
Medical Center. Mrs. Macgregor remained in close touch with Dr. Joseph G. McCarthy, who became Director of the Institute
following the death of Dr. Converse in 1981. The innovative streak in Macgregor drew the attention of the Russell Sage
Foundation where she did a threeyear study at the New York Hospital, Cornell University School of Nursing in order to
introduce social science into the education of nurses. She published a textbook, ''Social Science in Nursing; Applications for
the Improvement of Patient Care'' (Russell Sage Foundation, New York, 1960). She became a full professor teaching at
Cornell University Medical and Nursing School from 1954 to 1968 then rejoined the Institute of Reconstructive Plastic
Surgery at NYU Medical Center. In 1991, Macgregor moved from New York City to Carmel, California. She continued her
consultancies adding legal clients as well as medical colleagues and patients. Magregor's last research efforts focused on
iatrogenic illness. Years before it was frontpage news in the New York Times (Sunday, December 19, 1999), she wanted her
philanthropic funds to go to studying medical errors caused by physicians and other health professionals. On the same page as
the continuation of The New York Times article of December 19, 1999, ''Breaking Down Medicine's Culture of Silence'', the
Institute of Medicine estimated that between 44,000 and 98,000 Americans die each year as a result of medical errors.
Macgregor had already contributed to studies by the Institute of Medicine and also the Harvard Medical School in her name
through the aegis of The Commonwealth Fund. She has left her estate to The Commonwealth Fund who will administer the
Frances Cooke Macgregor Awards for further study of iatrogenic illness. At a private ceremony on January 4, 2002, Frances
Cooke Macgregor was buried at the family burial plot beside her father, mother, brother and nephew at the Mt. Tamalpais
Cemetery in San Rafael, California.
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IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT
IN AND FOR HILLSBOROUGH COUNTY, FLORIDA
GENERAL CIVIL DIVISION
NEIL J. GILLESPIE,
Plaintiff and Counter-Defendant, CASE NO.: 05-CA-7205
vs.
BARKER, RODEMS & COOK, P.A., DIVISION: G
a Florida corporation; and WILLIAM
J. COOK,
Defendants and Counter-Plaintiffs.
-------------_/
AFFIDAVIT OF NEIL J. GILLESPIE
Neil J. Gillespie, under oath, testifies as follows:
1. My name is Neil J. Gillespie, and I am over eighteen years of age. This
affidavit is given on personal knowledge unless otherwise expressly stated.
2. Circuit Judge Martha J. Cook is presiding over this lawsuit.
3. I made a request for accommodation to the Thirteenth Judicial Circuit
under the Americans With Disabilities Act (ADA) to Gonzalo B. Casares, the (ADA)
Coordinator. On Friday July 9, 2010 Court Counsel David A. Rowland sent me a letter by
email that denied my ADA accommodation request. Mr. Rowland denied my request less
than one business day prior to a hearing I was scheduled to attend.
4. On Monday July 12,2010 I attended a hearing at 10:30 AM before Judge
Cook in this lawsuit. While attending the hearing I suffered a panic attack. I informed
Judge Cook that I was ill and needed medical attention. Judge Cook excused me. This is
exactly what Judge Cook said:
Page 1 of3
3
6 THE COURT: All right. Mr. Gillespie, you're
7 excused. Thank you.
(Transcript, July 12,2010, page 6, beginning at line 6)
5. Deputies of the Hillsborough County Sheriffs Office saw I was in distress
and offered assistance. Tampa Fire Rescue was called. Corporal Gibson was by my side
and walked me to the lobby of courthouse where I waited for the paramedics.
6. Tampa Fire Rescue arrived and I received medical attention at 10:42 AM
by EMT Paramedic Robert Ladue and EMT Paramedic Dale Kelley. Later I obtained a
report of the call, incident number 100035129. The narrative section states "found 54yom
sitting in courthouse" with "tight throat secondary to stress from court appearance". The
impressions section states "abdominal pain/problems". The nature of call at scene section
states "Resp problem". A copy of the report is attached to this affidavit as "Exhibit A."
7. Because the Court denied my ADA accommodation I appeared at the
hearing without one and became ill and was excused by Judge Cook, who continued the
hearing without me, thereby denying me by reason of my disability to be excluded from
participation in or be denied the benefits of the services, programs, or activities of a
public entity, or be subjected to discrimination by any such entity in violation of law.
8. I received a document from Judge Cook dated July 29,2010 "Notice Of
Case Management Status and Orders On Outstanding Res Judicata Motions" and "Notice
Of Court-Ordered Hearing On Defendants' For Final Summary Judgment". A certified
copy of the document is attached to this affidavit as "Exhibit B". The document begins
with a false account of my panic attack and medical treatment on July 12,2010. Judge
Cook wrote: "[t]he Plaintiff voluntarily left the hearing prior to its conclusion.. .loudly
Page 2 of3
gasping and shouting he was ill and had to be excused." At footnote 2 Judge Cook wrote:
"Mr. Gillespie refused medical care from emergency personnel when called by bailiffs
and left the courthouse immediately after learning that the conference was completed."
8. Upon information and belief, Judge Martha J. Cook knowingly and
willfully, with malice aforethought, falsified a record in violation of chapter 839, Florida
Statutes, section 839.13(1) if any judge shall falsify any record or any paper filed in any
judicial proceeding in any court of this state, or conceal any issue, or falsify any document
filed in any court or falsify any minutes or any proceedings whatever of or belonging to
any public office within this state the person so offending shall be guilty of a
misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this 27th day of September 2010.
STATE OF FLORIDA
COUNTY OF MARION
BEFORE ME, the undersigned authority authorized to take oaths and acknowledgments
in the State of Florida, appeared NEIL J. GILLESPIE, personally known to me, or provided
identification, who, after having first been duly sworn, deposes and says that the above matters
contained in this Affidavit are true and correct to the best of his knowledge and belief.
WITNESS my hand and official seal this 27th day of September 2010.
C ~ ~
Notary Public
~ ~ CECIUA ROSENBERGER
State of Florida
f,.: ~ Commission DO 781620
.; Expires June 6, 2012
80ndId TtIU TIGf FIil ........701.
Page 3 of3
Page #1
Incident Number: 100035 129; Incident Date: 7/1212010; Patient: Gillespie. Neil
Printed By: MOLINA. LAURA Admin Asst (000) on 712712010 7:49:45 AM
TAMPA FIRE RESCUE (EMSID: 2911; FDID: 03072)
808 Zack St.
Tampa, FL 33602
(813) 274-7005 x
TAMPA FIRE RESCUE Incident Date: 07/12/2010
Incident Number: 100035129 Patient 1 of 1
RESCUE 1 shift: B
GILLESPIE, NEIL 54 YEAR OLD, MALE
PAST MEDICAL HISTORY: Depression, Diabetic, Hypertension
ALLERGIES: None ;
MEDICATIONS: unknown pt doesnt know names;
ASSESSMENT: 10:42
Patient Conscious.
NO External Hemorrhage Noted; Mucous Membrane Normal
Central Body Color Normal
Extremities Normal
WITHIN NORMAL LIMITS (Airway, Breathing Quality, Accessory Muscle use,
chest Rise, Radial pulse, Skin Temp, Skin Moisture, skin Turgor, cap
Refill, Pupil size and Reaction)
ALS Assessment Done to rule out NOC at Dispatch.
SECONDARY ASSESSMENT - INJURY:
CHEST - No Injury:. Left breath sounds are clear to auscultation.
Right breath sounds are clear to auscultation. Breath sounds are
equal. Heart sounds: Normal.
NARRATIVE:
R1 found 54yom sitting in courthouse. pt a&ox3, skin w&d, pt cc tight
throat secondary to stress from court appearance pt states, lungs
clear bi-lat, sa02 100%, pt blood sugar 179mg/dl, vitals as shown in
flow sheet section, monitor shows sinus rhythm w/ no ectopy noted, pt
denies being in any pn, secondary found no acute findings, advise pt
multo times to be transported to hospital pt refuses transport and
states he would rather go to his Dr. pt signed refusal and advise to
call back if any issues occur w/ full understanding.
TREATMENT:
10:42 pulse:120 Regular and Rapid Resp:16 Respiratory
Effort:Normal BP:148/96 Rhythm:NSR Sa02:100% (on Room Air)
Blood Sugar:179 Ectopy:NO GCS:4 spontaneous; 5 oriented; 6 obeys
= 15 Responsiveness:Alert painseverity:O
10:42 Sao2, successful, 1 attempt, LADUE, ROBERT EMT-Paramedic
(PMD514678) (unchanged) (100 room air)
10:43 Blood Glucose, KELLEY, DALE EMT-paramedic (PMD49960)
(unchanged) (179mg/dl)
10:44 ECG 4 Lead, successful, 1 attempt, ENGINE 1 (unchanged) (nsr
w/ no ectopy)
10:48 pulse:110 Not Assessed Resp:16 Respiratory
Effort: Normal BP:153/86 Rhythm:NSR sa02:100% (on Room Air)
Ectopy:NO GCS:4 spontaneous; 5 oriented; 6 obeys = 15
Responsiveness:Alert painseverity:O
No Venous Access
No Medications Done
IMPRESSION:
primary Impression: Other secondary Impression: Unknown Other
Impressions: Abdominal pain / problems
INCIDENT INFORMATION:
Incident location: 0000800 TWIGGS ST E Tampa, Hillsborough, FL 33602
'EXHIBIT
IJL
Page ##2
Incident Number: 100035129; Incident Dale: 7/12n.O 1 Patient: Gillespie, Neil
Printed By: MOLINA. LAURA Admin Asst (000) on 7127/20107:49:45 AM
TAMPA FIRE RESCUE (EMSID: 2911; FDID: 03072)
808 Zack St.
Tampa, FL 33602
(813) 274-7005 x
Nature of call as dispatched: chest pain Nature of call at scene:
Resp Problem (Anatomic Location: Not Known) (organ system: Not
Known) (primary symptom: None) (Other symptom: Not Known )
(condition code: other)
Disposition: Non-Transport Evaluation only
Type of exposure on this run: None
07/12/2010 10:36:35 Call Received
07/12/2010 10:37:24 Dispatched
07/12/2010 10:38:50 Depart
07/12/2010 10:39:51 Arrive location
07/12/2010 10:40:00 patient Contact
07/12/2010 10:40:00 Assume Patient Care
07/12/2010 10:56:31 Available
Response to scene: Lights and sirens
Lead Crew Member: LADUE, ROBERT EMT-paramedic (PMD514678)
Crew Member 2: KELLEY, DALE EMT-paramedic (PMD49960)
ASSISTING:
ENGINE 1,
PATIENT:
GILLESPIE, NEIL OOB: 03/19/1956 54 YEARS OLD.
white, Male, 285 lbs
8092 sw 11Sth lOOp
ocala, FL 34481
SSN#: 160-52-5117
BILLING INFORMATION:
work Related: NO
Next of Kin Name:, () Address: City: State: Z; p: Phone:
SSN:
NFIRS:
Exposure #: 000 Incident Type: 321 EMS call, excluding vehicle
accident with injury Action Taken: 32 provide basic life support
(BLS)
N None
property Use: 599 Business office
RESPONDING UNITS:
suppression [Apparatus:l personnel:4]
EMS personnel:2]
other [Apparatus:O personnel:OJ
Includes no mutual aid resources.
Human Factors Involved: N None
other Factors Involved: N None
Impression: 00 other condition of patient: 2 Remained Same
Census Tract:
Page 113
Incident Number: 100035 129; Incident Date: 7/1212010; Patient: Gillespie, Neil
Printed By: MOLINA, LAURA Admin ASSl (000) on 7127120107:49:45 AM
TAMPA FIRE RESCUE (EMSID: 2911; FOlD: 03072)
808 Zack 51.
Tampa, FL 33602
(813) 274-7005 x

SIGNATURES:
signed By: LADUE,
Last Modified By:
PM
ROBERT EMT-paramedic (PMD514678)
MILLER, LILAH Admin Asst. (000) on 7/23/2010 1:46:04
..
***** Addendum / Data correction Added
(000) on 7/23/2010 1:46:07 PM *****
by: MILLER, LILAH Admin Asst.
(-) :
124(+): Last
1:46:04
125(+): PM
141000
Modified By: MILLER, LILAH Admin Asst. (000) on 7/23/2010
..
- r ' ~
r-
CIVIL LAW DIVISION
NEIL J. GILLESPIE,
Plaintiff, Case No: 05-CA-007205
Division: G
and
BARKER, RODEMS & COOK, P.A.,
A Florida Corporation, and
WILLIAM J. COOK,
Defendants.
------------_---.:/
NOTICE OF CASE MANAGEMENT STATUS and
ORDERS ON OUTSTANDING RES JUDICATA MOTIONS
THIS CAUSE came before the Court for case management on July 12, 2010. Both parties
appeared for the hearing; however, the Plaintiff voluntarily left the hearing prior to its conclusion, stating
his objection to the case management conference, demanding status of ADA claims already addressed by
the court administration, objecting to the physical presence of opposing counsel, objecting to this Court
presiding in this matter due to his "notice of filing" of a purported lawsuit against the 13
th
Judicial
Circuit,l and finally loudly gasping and shouting he was ill and had to be excused.
2
Prior to the Plaintiff s
voluntary departure, the parties were asked by the Court for a status update on this case and to list for the
Court those petitions and motions presently outstanding. Subsequent to the hearing, the Court reviewed
the 11 volumes, paying specific attention to Court orders that substantively disposed issues. In so doing,
it was clear that certain of Plaintiff's re-filed motions are res judicata - matters that have been
"definitively settled by judicial decision.,,3 Having considered these re-filed motions, the Court hereby
ORDERS AND ADJUDGES:
13
th
lRegarding the Plaintiffs "noticed" lawsuit against the Judicial Circuit, it is well-established law that the
Plaintiff's filing does not present legally sufficient grounds for this Court's disqualification or recusal from this case.
See Dowdy v. Sa/fi, 455 So.2d 604 (Fla. 5
th
DCA 1984), 5-H Corforation v. Padovana, 708 So.2d 244 (Fla. 1997),
May v. South Florida Water Management, 866 So.2d 205 (Fla. 4
t
DCA 2004) and Bay Bank & Trust v. Lewis, 634
So.2d 672 (Fla. 1st DCA 1994). This objection was addressed in the Court's July 27, 2010 denial of disqualification.
2 Mr. Gillespie refused medical care from emergency personnel when called by bailiffs and left the courthouse
immediately after learning that the conference was completed.
3 Black's Law Dictionary, 7
th
Edition.
EXHIBIT
Page 1 of 7
1-8
1. Plaintiff's "Motions to Strike CMC" (6-14-10) were DENIED prior to the July 12, 2010
hearing.
2. Plaintiff's Motion for Rehearing (7-16-08) is DENIED. The judge to whom this rehearing
motion was directed removed himself from the case and the subsequent judge has, in .her
discretion under Rule 2.330, denied reconsideration of the orders of proceeding judges (see order
dated June 22, 2010).
3. Plaintiff's "Amended Motion to Disqualify Counsel" (no date provided in Judge Barton's
order) and "Emergency Motion to Disqualify Defendant's Counsel" (7-9-10) are each
DENIED. The Plaintiff's original attempt to disqualify Defendants' counsel was first denied,
with prejudice, on May 12, 2006. When a Court dismisses a motion "with prejudice" that means
that the motion in question is "finally disposed ... and bars any future action on that claim.,,4
Additionally, pursuant to the doctrine of res judicata, these motions must be denied.
4. Plaintiff's "Motion to Declare Complex Litigation" (5-3-10) "Motion to Disclose Conflict"
(5-5-10). and "Motion to Disclose Ex Parte Communication" (5-5-10) were each addressed and
DENIED in the July 16, 2010 order denying disqualification of Judge Cook, the Plaintiffs
motion for which referenced these matters.
5. Plaintiff's "Motion for Leave to Amend," citing ADA (4-1-10), "Motion for Leave to
Amend" (5-5-10), "Motion to Consider Prior ADA Accommodation," (5-3-10), and "Motion
to Stay Pending ADA" (6-14-10) are each DENIED. Even if ADA applied in the fashion which
the Plaintiff sought to employ it, a stay would be unnecessary as that is the point of the protection
- to allow a "person with a disability who needs an accommodation to access court facilities or
participate in a court proceeding.,,5 Court administration has informed the Plaintiff that the nature
of his ADA requests, thus far, involve "the internal management of pending cases,,6 - in other
4 Black's Law Dictionary, 7
th
Edition.
5 13
th
Judicial Circuit Website, accessed July 22, 2010:
http://www.flj ud 13.org/dotnetnuke/BusinessOperations/CourtFacilitiesSecurity/ADAAccommodations.aspx
6 See July 9, 2010 letter from administration, as copied to all parties.
Page 2 of7
words, Plaintiff s issues are the subject of "case management." Moreover, excepting Count 1,
Plaintiff's breach of contract claim against Defendant law firm, all of the Plaintiff's pleadings and
answers have been disposed and amendment is thereby impossible. See Order Granting Motion
for Sanctions (7-20-07), Order Granting In Part Defendants' Motion for Judgment on
Pleadings (11-28-07), Final Judgment (3-27-08), Order Determining Amount of Sanctions
(3-27-08), Order Granting and Denying in Part Defendant's Motion for Judgment on
Pleadings (7-7-08), Final Judgment as to Defendant Cook (7-7-08), Order Granting
Defendant's Motion for Writ of Garnishment (7-24-08), and the Order from Second District
Court of Appeals (2D08-2224), opinion and mandate. See also Florida Rule of Civil Procedure
1.100(a).7
6. Plaintiff's "Motions for Reconsideration" (6-18-10 and 6-23-10) were duplicative and
DENIED by this Court's discretion on June 23, 2010. Plaintiff's "Motion for
Reconsideration" (6-28-10) filed after entry of that denial is DENIED, as it is duplicative of the
prior two motions, and is disposed by res judicata.
7. Plaintiff's "Motion Dissolve Writ" (5-3-10) is DENIED as lacking legal basis. The Defendants
are entitled to this Writ by a final judgment and a judgment granting motion for sanctions;
moreover, the Second District Court of appeal has affirmed and issued a "mandate," which means
this Court has no option but to enforce the judgment.
8. The Plaintiff's "Motion for Order of Protection," (no date provided in Judge Barton's order)
renewed in his "Motion to Cancel Deposition" (6-16-10) is DENIED. The Plaintiff has
repeatedly been the subject of Motions to Compel by the Defendants during the course of these
proceedings, and has ignored Court orders requiring his participation. The Court will not accept
these or any further attempts by the Plaintiff to avoid the Defendant's right to discovery in this
7 "There shall be a complaint or ... petition, and an answer to it; an answer to a counterclaim ... an answer to a
cross claim [if applicable]; a third party complaint [and answer, if applicable] ... no other pleading shall be
allowed."
Page 3 of7
case and to bring this matter to a close. Non-compliance with the Court's orders is grounds for
dismissal of the Plaintiff s remaining count with prejudice.
9. Each of the Plaintiff's "Motions to Disqualify" against the undersigned have been DENIED by
separate order of the Court, the most recent of which was entered July 27, 2010.
10. The Court RESERVES JURISDICTION to consider the following motions:
a. Plaintiff's "Motions to Compel Discovery" (12-14-06,2/1/07,4-1-10, and 6-23-10)
b. Plaintiff's "Claim for Exemption" (8-14-08 and 5-3-10)
c. Plaintiff's "Motion for Contempt" (no date provided in Judge Barton's order)
d. Plaintiff's "Motion for Order to Show Cause and Contempt" (no date provided in
Judge Barton's order)
e. Plaintiff's Motion for Sanction" (4-28-10)
f. Defendant's "Motion for Proceedings Supplementary for Execution" (no date
provided by Defendants)
g. Defendant's "Motion for Examination Pursuant to Section 56.29(2)" (no date
provided by Defendants)
h. Defendants' "Motion for an Order to Show Cause as to Why Plaintiff Should Not
Be Prohibited from Henceforth Appearing Pro Se," received July 27, 2010.
11. These motions shall not be set for hearing until the Court has first ruled on the Defendant's
outstanding motion for Final Summary Judgment.
12. The Court GRANTS the Defendant's request to set a mandatory hearing upon their outstanding
"Motion for Final Sumnlary Judgment," served upon the Plaintiff January 23, 2007.
8
Both the
Defendants and the Plaintiff are ORDERED TO APPEAR on September 28, 2010 at
11:00a.m. The hearing shall be for no more than 30 minutes. The hearing will be held at 800 E.
Twiggs Street, Hearing Room 511, Tampa, Florida, 33602. The Court shall not grant any
continuance, or any motion for reconsideration or rehearing of this order setting hearing.
13. The Court will allow the Plaintiff to appear telephonically, but it is his responsibility to file a
timely written motion no later than September 21, 2010 and for him to provide, at his own
expense, for the services of a notary on his end of the phone, since it may be necessary to swear
8 Pursuant to Fla. R. Civ. Pro. 1.080, the question of whether or not a receiving party facilitates acceptance of papers
(i.e. refuses to accept certified mail and/or federal express deliveries) is irrelevant; the question is the "good faith" of
the party who is attempting to produce the document, which can be proven up by delivery receipts and/or any other
evidence of legitimate attempt at service. In addition, "the certificate [of service] shall be taken as prima facie proof
of such service in compliance with these rules." Fla. R. Civ. Pro. 1.080(t).
Page 4 of7
him in for testimony. Should the Plaintiff fail to arrange telephonic appearance, then his in
person appearance is mandatory. Should the Plaintiff voluntarily forfeit his appearance by failing
to attend, call in, or not participate in good faith (including failure to provide the required notary),
then the hearing shall proceed in his absence and the Court may consider sanctions for his non
appearance.
14. At this mandatory hearing the parties must also be prepared to discuss the effect of the "Order
Adjudging Contempt" entered by Judge Barton on July 7, 2008. This order found that the
Plaintiff had ability to comply with the "Final Judgment" entered on March 27, 2008 and that
the Plaintiff violated the terms of that order by failing to complete Form 1.977 Fact Information
Sheet. The Plaintiff was ordered to complete the sheet and to serve a copy to the Defendant no
later than July 11, 2008. If the Plaintiff did not timely submit Form 1.977, as ordered, then
pursuant to the "Order Adjudging Contempt," "the Court shall dismiss" with prejudice, the
Plaintiff's last remaining claim (i.e. Count 1, Plaintiff's breach of contract claim against
Defendant law firm). Because this dismissal sanction may render hearing on the Defendant's
"Motion for Final Summary Judgment" to be moot, the parties are ORDERED to provide
proof to this Court that this prior contempt sanction has been addressed.
15. A separate notice of hearing on the motion for summary judgment accompanies this order. Copies
will be sent to the parties at the address provided to the Clerk of Court.
DONE and ORDERED in Chambers at Tampa, Hillsborough County, Florida, on July m, 2010.
~ ) ~ t ~
Martha J. Cook
CIRCUIT COURT JUDGE
Page 5 of7
CIVIL LAW DIVISION
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NEIL J. GILLESPIE,
Plaintiff,
and
Case No:
Division:
05-CA-007205
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Defendants.

NOTICE OF COURT-ORDERED HEARING ON
DEFENDANTS' MOTION FOR FINAL SUMMARY JUDGMENT
TO: Neil J. Gillespie, pro se (Plaintiff)
8092 SW 115
th
Loop
Ocala, FL 34481
Ryan Christopher Rodems, Esq. (for Defendants)
400 North Ashley Drive, Ste. 2100
Tampa, 33602
YOU ARE NOTIFIED that a hearing on the Defendants' Motion for Final Summary Judgment,
filed and served upon the Plaintiff since January 23, 2007, has been ORDERED by the Court (see
"Notice of Case Management Status and Orders on Outstanding Res Judicata Motions," entered
July 29, 2010).
At this mandatory hearing the parties must be prepared to address the ORDER ADJUDGING
CONTEMPT entered by Judge Barton on July 7, 2008, as instructed by this Court's prior order.
Both the Defendants and the Plaintiff are ORDERED TO APPEAR before:
JUDGE: The Honorable Martha J. Cook
PLACE: 800 E. Twiggs Street, Hearing Room 511, Tampa,Florida, 33602.
TIME: ll:00a.m.
DURATION: 45 minutes
DATE: September 28,2010
Should either party fail to attend or to participate in good faith as described in the "Notice of
Case Management Status and Orders on Outstanding Res Judicata Motions," then the hearing shall
proceed on the merits without that party. All parties will be required to abide by the Rules of Civil
Procedure and follow appropriate courtroom decorum.
A copy of this notice has been furnished to the parties on the date of this NOTICE.
Page 6 of7
The parties are further advised that failure to appear or to comport with either the "Notice of
Case Management Status and Orders on Outstanding Res Judicata Motions" or this "Notice of
Court-Ordered Hearing on Defendants' Motion for Final Summary Judgment" may constitute
contempt of court, which could result in the imposition of sanctions, including without limitation fine,
incarceration or dismissal of the action with prejudice.
DONE and ORDERED in Chambers at Tampa, Hillsborough County, Florida, on July 29, 2010.
/hLLLU/U. if' ~
Martha J. Cook
CIRCUIT COURT JUDGE
If you are a person with a disability who needs any accommodation in order to participate in this
proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact the
Administrative Office of the Courts, Attention: ADA Coordinator, 800 E. Twiggs Street, Tampa, FL
33602, Phone: 813-272-6513, Hearing Impaired: 1-800-955-8771, Voice impaired: 1-800-955-8770, e
mail: ADA @fljudI3.org. at least seven (7) days before your scheduled court appearance. Ifyou are
hearing or voice impaired, call 711.
Page 7 of7
IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL
CIRCUIT IN AND FOR IDLLSBOROUGH COUNTY, FLORIDA
NEIL J. GILLESPIE,
Plaintiff, CASE NO.: 05-CA-7205
vs..
BARKER, RODEMS & COOK, P.A., DMSION:C
a Florida corporation, WILLIAM
1. COOK,
- ....
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Defendants.
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PLAINTIFF'S AMENDED ACCOMODATION REOUEST:;; :x
AMERICANS WITH DISABILITIES ACT (ADA) ca
...,
Plaintiff requests an accommodation under the Americans With DisabilitierAct
(ADA) and states:
1. Plaintiff was detennined totally disabled by Social Security in 1994.
2. Defendants are familiar with Plaintiff's disability from their prior
representation of him. Defendants investigated his eligibility to receive services from the
Florida Department of Vocational Rehabilitation (bVR). DVR detennined that Plaintiff
was too severely disabled to benefit from services. Defendants concurred, and notified
Plaintiff of their decision in a letter to him dated March 27, 2001. (Exhibit A).
Defendants were also infonned of Plaintiff's medication for depression by fax dated
October 6, 2000, Effexor XR 150mg. (Exhibit B).
3. Plaintiff has the following medical conditions which are disabling and
prevent him from effectively participating in court proceedings, including:
a. Depression and related mood disorder. This medical condition prevents
Plaintiff from working, meeting deadlines, and concentrating. The inability to

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Gillespie v. Barker, Rodems & Cook, }- .A., case no. 05-CA-7205
concentrate at times affects Plaintiff's ability to hear and comprehend. The
medical treatment for depression includes prescription medication that further
disables Plaintiffs ability to do the work ofthis lawsuit, and further prevents him
from effectively participating in the proceedings.
b. Post Traumatic Stress Disorder (PTSD), makes Plaintiff susceptible to
stress, such as the ongoing harassment by Defendants' lawyer, Mr. Rodems.
c. Velopharyngeal Incompetence (VPI) is a speech impairment that affects
Plaintiffs ability to communicate.
d. Type 2 diabetes. This was diagnosed in 2006 after Defendants'
representation.
4. Prior to the onset of the most disabling aspects Plaintiff's medical
condition(s), he was a productive member of society, a business owner for 12 years, and a
graduate of both the University of Pennsylvania and The Evergreen State College.
5. On March 3,2006, Ryan Christopher Rodems telephoned Plaintiff at his
home and threatened to use infonnation learned during Defendants prior representation
against him in the instant lawsuit. Mr. Rodems' threats were twofold; to intimidate
Plaintiff into dropping this lawsuit by threatening to disclose confidential client
information, and to inflict emotional distress, to trigger Plaintiff's Post Traumatic Stress
Disorder, and inflict injury upon Plaintiff for Defendants' advantage in this lawsuit.
6. On March 6, 2006, Mr. Rodems made a false verification the Court about
the March 3, 2006 telephone call. Mr. Rodems submitted Defendants' Verified Request
For Bailiff And For Sanctions, and told the Court under oath that Plaintiffthreatened acts
of violence in Judge Nielsen's chambers. It was a stunt that backfired when a tape
recording of the phone call showed that Mr. Rodems lied. Plaintiffnotified the Court
Page - 2 of4
1.70
Gillespie v. Barker, Rodems & Cook, f:A., case no. 05-CA-7205
about Mr. Rodems' perjury in Plaintiffs Motion With Affidavit To Show Cause Why
Ryan Christopher Rodems Should not Be Held In Criminal Contempt Of Court and
incorPorated Memorandum Of Law submitted January 29,2007.
7. Mr. Rodems' harassing phone call to Plaintiff of March 3, 2006, was a
tort, the Intentional Infliction ofEmotional Distress. Mr. Rodems' tort injured Plaintiff
by aggravating his existing medical condition. From the time of the calion March 3,
2006, Plaintiff suffered worsening depression for which he was treated by his doctors.
a. On May 1, 2006 Plaintiffs doctor prescribed Effexor XR, a serotonin
norepinephrine reuptake inhibitor (SNRl), to the maximum dosage.
b. Plaintiffs worsening depression, and the side affects of the medication;
lessened Plaintiffs already diminished ability to represent himself in this lawsuit.
c. On October 4,2006 Plaintiff began the process of discontinuing his
medication so that he could improve is ability to represent himself in this lawsuit.
d. On or about November 18, 2006, Plaintiff discontinued the use of anti
depression medication, to improve his ability to represent himself in this lawsuit.
8. Mr. Rodems continued to harass Plaintiff during the course of this lawsuit
in the following manner:
a Mr. Rodems lay-in-wait for Plaintiff outside Judge Nielsen's chambers
on April 25, 2006, following a hearing, to taunt him and provoke an altercation.
b. Mr. Rodems refused to address Plaintiff as "Mr. Gillespie" but used his
first name, and disrespectful derivatives, against Plaintiffs expressed wishes.
c. Mr. Rodems left insulting, harassing comments on Plaintiffs voice mail
during his ranting message of December 13,2006.
Page - 3 of4
Gillespie v. Barker, Rodems & Cook, r.A., case no. 05-CA-7205
d. Mr. Rodems wrote Plaintiff a five-page diatribe of insults and ad
hominem abusive attacks on December 13, 2006.
9. Plaintiff notified the Court ofhis inability to obtain counsel in Plaintiff's
Notice ofInability to obtain Counsel submitted February 13, 2007.
10. Plaintiff acknowledges that this ADA accommodation request is unusual,
b:ut so are the circumstances. Defendants in this lawsuit are Plaintiff's fonner lawyers,
who are using Plaintiff's client confidences against him, while contemporaneously
inflicting new injuries upon their former client based on his disability.
WHEREFORE, Plaintiff requests additional time to obtain counsel, a stay in the
proceedings for 90 days. Plaintiff also requests accommodation in the form of additional
time to meet deadlines when needed due to his disability.
RESPECTFULLY SUBMITTED this 5
th
day of March, ,2007.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy ofthe foregoing has been
furnished via US Mail to Ryan .C. Radems, attorney, Barker, Rodems & Cook, P.A., 400
N Ashley Dr., Suite 2100, Tampa, FL 33602, this 5
th
day of March, 2007.
Page - 4 of4
172
BARI<ER, RODEMS & COOK
PROFESSIONAL ASSOCIATION
ATIORNEYS AT LAW
CHRIS -A. BARKER
Te lep hOlle 813/489 .. 1001
300 West Platt Street, Suite 150
RYAN CHRISTOPHER RODEMS
Facsimile 813/489 .. 1008
WILLIAM]. COOK Tampa, Florida 33606
March 27,2001
Neil J. Gillespie
Apartlnent C-2
] 121 Beach Drive NE
St. Petersburg, Florida 33701-1434
Re: Vocntiollal Rellabilitntion
Dear Neil:
I am enclosing the material yOll provided to us. We 11ave reviewed tIlem and, llnfortllnately,
we are not in a positiol1 to represent you for allY clainls yOll may have. Please understatld tllat our
decision does not 111ean tllat your claims lack nlerit, and another attorney might wisll to represent you.
If you wisll to consult witll another attorney, we recolnlnend that you do so immediately as a statute
of lilllitations will apply to any claims you Inay have. As you know, a statute of linlitations is a legal
deadline for filing a lawsllit. Tllanl( you. for the opportunity to review your Inaterials.
Sincerely,
\Villialn J. Cool{
WJC/rnss
Enclosures
1.73
'EXHIBIT'
I:
Fax
From: Neil J. Gillespie
1121 Beach Drive NE, Apt C-2
St. Petersburg, FL 33701
Phone/Fax: (727) 823-2390
To: William J. Cook, Attorney at Law
Fax: (813) 228-9612
Date: October 6, 2000
Pages: just this page
Re: ACE Check Cashing deposition
o Urgent o Please Reply o For Your Review
Comments:
RE: Current medications
Effexor XR 150 mg (depression)
Levoxyl 0.075 mg (hormone)
STATE OFFLOFlIOA )
COUNTY OF HiLLSBOROUGH)
THIS IS TOCERTIfV THAT THE FOREGOING IS ATRUE
AND CORHfiCT cot'1 Of Tf DOCUMENT ON FILE IN
MY OFFICE. WITNESS MY ANO Of!FICIAL SEAL
THIS 31.v1"" DAYOF ,toT 201
0

::'$:",J PAT fRANK
.. . OF:ACUIT COURT

/.: 1.74
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Page - 1
Neil J. Gillespie, medical history (partial) August 6, 2012
8092 SW 115th Loop CORRECTED Aug-14-2012
Ocala, Florida 34481
DOB: March 19, 1956, Philadelphia, PA, Thomas Jefferson Hospital.
Congenital disorder: unilateral cleft lip (L), cleft palate, eustachian tube defect (L), retracted
eardrum (L).
Medical Conditions ICD-9-CM Code
Post Traumatic Stress Disorder (PTSD) 309.81
with PTSD related panic attack in response to
stimuli associated with a serve stressor
Anxiety disorder due to medical condition 293.89
Dysthymic disorder (chronic depression) 300.4
Depression 296.3
Cleft palate with unilateral cleft lip (L) 749.21
Facial disfigurement, scaring 709.2
Velopharyngeal Incompetence (VPI) 528.9
Voice disorder, hypernasality 784.43
Retracted eardrum (L) 384.28
Eustachian tube defect 381.89
Hearing loss 389.90
Diabetes (mellitus) NOS, Type 2 diabetes, adult onset 250.00
Brain trauma, head injury from a mugging (1988) 310.20
Prosthesis
Speech bulb obturator. In September 2001 my palatopharyngeal musculature had changed where
I could no longer insert the obturator in my mouth.
Omni ADV hearing aid, serial no. 36-95-300004 (no longer functional)
Medical history
1. Craniofacial surgery, age three months, Misericordia Hospital, Philadelphia,
Dr. Duncan, 18th & Walnut Streets, Philadelphia.
2. Palate surgery, age two years, Thomas Jefferson Hospital, Philadelphia, Dr. Duncan.
3. Speech therapy, age eight years, Easter Seals Center, Levittown, PA.
5
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4. Orthodontic treatment, 1968-1974, Temple University Dental Clinic, Philadelphia. Fitted with
a removable retainer with a prosthetic left lateral incisor.
NOTE: Additional reconstructive surgery was scheduled at Temple University Medical Center,
including bone graft and pharyngeal flap procedures, but was canceled due to denial of insurance
coverage based on a preexisting condition clause of my private insurance policy. That was in
1974 when I was 18-years old and graduating high school. The insurance policy was bought
from a local insurance agency, paid for with money earned cutting lawns. After reconstructive
surgery was canceled, my life took another path. I did not follow my contemporaries to college,
but worked as a steel mill laborer at the U.S. Steel Fairless Works. Following a layoff a year
later I worked in the restaurant business, and later in the car business.
Eleven years later in 1985 I was able to reschedule the bone graft surgery. The pharyngeal flap
surgery was delayed until 1990. I also entered the Wharton Evening School in 1985.
Bullying. Like many children afflicted with a congenital craniofacial disorder, I experienced
disability-based bullying, and physical assault. Disability-based bullying caused me severe
depression and anxiety from my earliest days. I became an Eagle Scout December 3, 1971. The
Boy Scouts allowed me a modicum of normalcy and chance for success in an otherwise
physically and psychologically abusive school environment.
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Adult Treatment Time-line
Beginning at age 29 I continued rehabilitation with better insurance (Blue Cross), and income from
my car business. I estimate that from 1985 forward I spent at least $100,000 out of my pocket for
treatment and rehabilitation of my congenital craniofacial disorders. This list is representative and
does not include every treatment or provider. There are too many treatments and providers to list,
and many records are long gone.
Philadelphia, Pennsylvania
5. July 22, 1985 Consultation with Joseph Kusiak, MD, Plastic and Reconstructive Surgery,
American Oncologic Hospital, Central & Shelmire Avenues, Philadelphia, PA 19111.
Examination; proposed surgical plan and medical team.
6. 1985-1987 Dr. Sharon Wainright MD, Psychiatrist, 22nd & Walnut Street, Philadelphia. I
was a private-pay client in ongoing weekly or biweekly visits for general anxiety, and anxiety
related to medical treatment. After Dr. Wainright left private practice I saw other therapists,
including Dr. Harriet Wells, as a private-pay outpatient client at the Institute of the Pennsylvania
Hospital in Philadelphia.
The challenge for mental health providers is shown in a paper by Bennett and Stanton:
Psychotherapy for Persons with Craniofacial Deformities: Can We Treat without Theory?
(Cleft Palate-Craniofacial Journal, July 1993, Vol. 30 No.4)
Page - 3
7. August 1, 1985 Marilyn A. Cohen, BA, speech pathologist, The Cleft Palate Program,
Childrens Hospital of Philadelphia (CHOP), 34th and Civic Center Blvd., Philadelphia, PA
19104. Speech evaluation (re-evaluation March 30, 1989).
8. August 12, 1985 Harvey M. Rosen, MD, DMD, Reconstructive Surgery, Pennsylvania
Hospital, Philadelphia, PA 19106. Surgery scheduled; bone graft and rhinoplasty.
9. March 10, 1986 Rosario F. Mayro, DMD, DDS, 1830 Rittenhouse Square, Philadelphia, PA
19103. Pre-surgical orthodontic alignment. Ongoing treatment. Referral for periodontal surgery.
10. April 22, 1986 Mark B. Snyder, DMD, periodontist, 220 South 16th Street, Suite 900,
Philadelphia, PA 19102. Periodontal surgery. Ongoing treatment.
11. August 12, 1986 Reconstructive surgery (bone transplant), Dr. Rosen, Pennsylvania
Hospital. Closure of oral-nasal fistula; bone graft to alveolus of nasal floor; septoplasty. Bone
graft donor site, left hip.
12. December 15, 1986 Reconstructive rhinoplasty, Dr. Rosen, Pennsylvania Hospital.
Developed breathing obstruction following surgery.
13. July 6, 1987 Peter Randall, MD, Hospital of the University of Pennsylvania, 3400 Spruce
St., Philadelphia, PA 19104. Consultation, obstructed breathing. (no consensus).
14. April 20, 1988 Dennis G. Sanfacon, DMD, 1829 JFK Blvd., Philadelphia, PA 19103.
Completed prosthodontic treatment (five unit bridge), stabilized surgical site. Was supposed to
last 20 years; failed Feb-17-2005 (17+ yrs.). Barry Korn, DDS, endodontic treatment.
15. Aug-20-88 Head trauma, street mugging, lost consciousness, taken by police car to
Hanemann University Hospital ER, see report. Sutures to close laceration to right outer eye,
severe head pain. Suffered traumatic brain injury, loss of cognitive and motor functions for
several weeks, difficulty speaking and forming sentences.
Within several months I thought I recovered from this brain injury, but now that assessment
appears incorrect. This injury diminished my business ability, and I have not held substantial
employment since. Today I do not have a bank account because I cannot manage one. I went
from self-sufficiency to total disability in 1994. My inability to manage funds resulted in two
bankruptcy proceedings and homelessness. The bankruptcies are:
Chapter 7 bankruptcy, discharged January 7, 1993, case 92-20222, U.S.
Bankruptcy Court, Eastern District of Pennsylvania.
Chapter 7 bankruptcy, discharged March 5, 2003, case 02-14021-8B7, U.S.
Bankruptcy Court, Middle District of Florida.
I have been indigent and/or insolvent since I first filed bankruptcy December 31, 1991.
Page - 4
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Florida
16. May 26, 1989 Consultation, D. Ralph Millard, Jr., MD, FACS, 1444 NW 14th Avenue,
Miami, FL 33125. Surgery scheduled, obstructed breathing and velopharyngeal incompetence.
17. December 14, 1990 Surgery, Dr. Millard, Jackson Memorial Hospital, Miami, FL. Cleft
rhinoplasty with submucous resection, pharyngeal flap. Resolved breathing issue somewhat;
pharyngeal flap failed a few weeks later.
18. December 19, 1990 Consultation, Felipe Martinez, MD, FACS, 1350 SW 57
th
Avenue, Suite
210, Miami, FL 33144. Developed ear infection following surgery.
19. May 5, 1993 Consultation, Mutas B. Habal, MD, FRCSC, FACS, and Jane Scheuerle,
Tampa Bay Craniofacial Center, 801 W. Dr. Martin Luther King, Jr. Blvd., Tampa, FL 33603.
Diagnosis: velopharyngeal incompetence. Recommendation: surgery to re-graft alveolus of nasal
floor with bone from skull, and to perform another pharyngeal flap procedure (declined, poor
risk/benefit analysis after consulting with Dr. Wainright).
20. June 1, 1993 Consultation, Pamela Kynkor, MS, CCC, Speech-Language pathologist, Beth
Ingram and Associates, Inc., 3450 E. Fletcher Ave., Tampa, FL 33617, Speech evaluation.
21. June 4, 1993 Consultation, Noreen P. Frans, MS, CCC-A, (dispensing clinical audiologist),
Better Hearing Services, 2312 West Waters Avenue, Tampa, FL 33604, (813) 935-3446. Some
hearing loss, no recommendation for intervention.
22. August 23, 1993, Social Security determined that I was totally disabled. Social Security
found that I became disabled under their rules on January 17, 1992. On August 1, 2012 Social
Security wrote that there was no need to review my case. However I would like to work if I
could find suitable employment.
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Oregon
23. May 26, 1994 Robert W. Blakeley, Ph.D., speech pathologist, Oregon Health Sciences
University, CDRC, Portland, OR 97207. Diagnosis: velopharyngeal incompetence.
Recommendation: speech obturator (reduction program), then surgical intervention. Peter Lax,
DMD, fitted a temporary obturator during twelve appointments from May 26, 1994 through
April 11, 1995. (good result)
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Washington
24. January 22, 1995 David R. Zielke, DDS, MS, Suite A-103, Allenmore Medical Center, 19
th
& South Union, Tacoma, WA 98405. Endodontic treatment, tooth 18, supports speech obturator.
Page - 5
25. March 22, 1995 Susan Porter, MA, clinical audiologist, Hearing Healthcare Center, Inc.,
3525 Ensign Road NE, Olympia, WA 98506, (360) 491-9733. Hearing evaluation with test
results showing a significant conductive hearing loss in the left ear. DVR.
26. March 26, 1995 Herbert C. Thomas, MD, MS, Pacific Northwest Otolaryngology, 4540
Sandpoint Way NE, #320, Seattle, WA 98105, (206) 527-5366 (examiner, Susan A. Wilcox,
MACCC-A). Medical evaluation and clearance for a hearing aid. DVR.
27. August 17, 1995 Barry L. Kimmel, MSCCC-A, Hearing Healthcare Center, Inc., 3525
Ensign Road NE, Olympia, WA 98506, (360) 491-9733. Provided hearing aid, Omni half shell
with K-amp, left. DVR.
28. November 11, 1995 Eric F. Pinczower, MD, Assistant Professor, Department of
Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, WA
98195, (206) 548-4022. Velopharyngeal incompetence/pharyngeal flap surgical consultation.
29. November 15, 1995 Jeffrey E. Rubenstein, DMD, MS, Director, Maxillofacial Prosthetic
Clinic, University of Washington Medical Center, D683 Health Sciences Building, Seattle, WA
98195, (206) 685-2344. Velopharyngeal incompetence/obturator consultation and maintenance.
30. November 21, 1995 Craig S. Murakami, MD, Assistant Professor, Department of
Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, WA
98195, (206) 548-4022. Pharyngeal flap surgery consultation.
31. November 21, 1995 Kathryn M. Yorkston, Ph.D., Speech/Language Pathologist, University
of Washington, Seattle, WA 98195, (206) 543-3134. Velopharyngeal incompetence consultation.
32. December 18, 1995 Jeffrey E. Rubenstein, DMD, MS, obturator reduction procedure.
33. February 28, 1996 Dean Wiese, MD, 410 Black Hills Lane, #C, Olympia, WA 98502.
Primary care physician. Consultation for otitis media/serous (recurring ear infection)
34. March 19, 1996 Allen D. Hillel, MD, Associate Professor, Department of Otolaryngology-
Head and Neck Surgery, U of Washington Medical Center, Seattle, WA 98195, (206) 548-4022.
Speech-hearing clinic, fiber-optic nasendoscope, Dr. Yorkston.
35. March 19, 1996 Jeffrey E. Rubenstein, DMD, MS, obturator reduction procedure.
36. August 22, 1996 Jeffrey E. Rubenstein, DMD, MS, obturator reduction procedure.
37. August 29, 1996 R. Dean Russell, MD FRCS[C], (ear, nose, throat, head and neck) 403
Black Hills Lane SW, Suite F, Olympia, WA 98502, (360) 357-6314, 1-800-270-6314.
Consultation, ear fluid build-up, ear tube procedure.
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Florida
Page - 6
38. November 12, 1996 William N. Williams, Ph.D., (Speech-Language Pathologist) Director
and Professor, Craniofacial Center, University of Florida Shands, Room D8-30, Dental Sciences
Building, Gainesville, FL 32610 (352) 846-0801. Consultation, velopharyngeal incompetence,
obturator reduction plan, surgical options.
39. November 12, 1996 Glenn E. Turner, DMD, MSD, Associate Professor of Prosthodontics,
Director, Maxillofacial Prosthetics, University of Florida Shands, College of Dentistry,
Gainesville, FL 32610 (352) 392-4294. Consultation, velopharyngeal incompetence, obturator
reduction plan, surgical options.
40. November 21, 1996 Dr. Nixon, Endodontic Specialists, 3201 SW 34
th
Ave., Ocala, FL
34474. Endodontic treatment, tooth number three. (supports speech prosthesis).
41. November 25, 1996 William N. Williams, Ph.D. Videofluorographic evaluation, University
of Florida Shands, College of Dentistry, Department of Oral Biology.
42. February 4, 1997 nasendoscopic assessment, Drs. Williams and Turner, Shands.
43. February 4, 1997 M. Brent Seagle, MD, University of Florida Shands Clinic at Park Avenue,
1015 NW 56
th
Terrace, Gainesville, FL 32605, 1-800-749-7424, (352) 395-6810, consultation,
velopharyngeal incompetence, surgical options; palatal extension or pharyngeal flap.
44. February 6, 1997 David J. Zaner, DMD, 2825 SE 17
th
Street, Ocala, FL 34471. Periodontal
surgery (crown lengthening), tooth 18. (supports speech prosthesis).
45. February 27, 1997 Glenn E. Turner, DMD, MSD, Associate Professor of Prosthodontics,
Director, Maxillofacial Prosthetics. Completed prosthetic restoration of tooth number three.
(supports speech prosthesis).
46. March 25, 1997 Stephen H. Dunn, DDS, 9401 SW SR 200, Suite 101, Ocala, FL 34481,
(352) 873-2000. Prosthetic restoration of tooth 18. (supports speech prosthesis).
47. May 9, 1997 Bayfront Medical Center (ER), 701 Sixth Street South, St. Petersburg, FL.
Experienced sudden hearing loss (L), accompanied by bleeding in ear & mouth.
48. May 14, 1997 Alan M. Gall, MD (otolaryngologist), 2299 Ninth Avenue N, Suite 3B, St.
Petersburg, FL 33713, (813) 321-3344. Follow-up consultation, removed ear tube.
49. May 23, 1997 Dr. Gall, follow-up appointment. Noted improvement. Scheduled hearing test
in July to measure hearing loss. (not completed).
50. August 22, 1997 contacted J. Douglas Bremner, MD, Assistant Professor of Diagnostic
Radiology & Psychiatry, Yale University School of Medicine; and Dr. Dorothy Lewis,
Dissociative Disorders Clinic, New York University Medical Center, following their appearance
Page - 7
on the ABC Evening News, Health Report, August 18, 1997, the segment Growing up damaged,
by John McKenzie, ABC News. I wrote in part to Drs. Bremner and Lewis:
Thank you for your recent appearance on the ABC News Health Report with John
McKenzie entitled "Growing up damaged." I am interested in additional information
about the subject, including diagnostic recommendations.
My interest is personal. Born with a craniofacial disorder affecting both speech and
appearance, I was subjected to severe psychological abuse, both familial and societal. At
age 41 I am currently disabled with "mental health issues," but I do not believe an
accurate diagnosis has been made in my case.
Dr. Bremner responded September 12, 1997 with an offer, one that later did not materialize:
Thank you for your interest in our research program on victims of childhood abuse and
the brain. If you or anyone else is interested, you can stay for free in our research unit and
obtain financial compensation which more than offsets travel expenses, as well as a
comprehensive diagnostic and biological assessment, including brain imaging. You can
call 203 737 5791 for information.
Dr. Lewis responded September 4, 1997 and wrote:
Thank you for your letter of August 22,1997. Unfortunately I do not know of someone in
your area who specializes in the complications of craniofacial disorders. I am sorry I
cannot be of more help.
51. December 4, 1997, the Florida Division of Vocational Rehabilitation (DVR) notified me by
letter that I am too severely disabled to benefit from vocational rehabilitation:
During our meeting we thoroughly reviewed and discussed your evaluation reports. It has
been determined that you are not eligible for vocational rehabilitation services because
your disability is too severe at this time for rehabilitation services to result in.
employment. This decision was reached 12/4/1997.
Previously DVR on May 29, 1994 prepared for me an Individual Written Rehabilitation Plan
(IWRP) after a long evaluation process. The DVR plan had three objectives:
Objective 1: Neil will be able to speak for up to 8 hours without rest or complaint of pain
and deterioration of vocal quality.
Objective 2: Neil will develop a marketable skill as a general practitioner.
Objective 3: Neil will obtain employment as a general practitioner. (medical doctor, MD)
I also received DVR services in Olympia, Washington, in 1995, one year of education at The
Evergreen State College, and a hearing aid.
Page - 8
52. March 21, 2001, Mr. Rodems law partner, William Cook of Barker, Rodems & Cook
reviewed my case with DVR, DLES case no: 98-066-DVR, and wrote me March 21, 2001:
We have reviewed them [DVR claims] and, unfortunately, we are not in a position to
represent you for any claims you may have. Please understand that our decision does not
mean that your claims lack merit, and another attorney might well to represent you.
Mr. Cook previously represented to me that he would represent me with DVR, as set forth in
Plaintiffs First Amended Complaint, 05-CA-7205, paragraph 43.
53. December 31, 1997 John A. Ferullo, DDS, 1 Progress Plaza, #1340, St. Petersburg, FL
33701-4353. (813) 822-8101. Initial visit, pending prosthetic restoration of tooth no. 19.
(supports speech prosthesis).
54. February 20, 1998 David D. Whitaker, DMD, 111 2
nd
Ave. NE, Suite 1102, St. Petersburg,
FL 33701, (813) 895-7519. Endodontic treatment, tooth no. 19. (supports speech prosthesis).
55. September 4, 1998 Selina Kassels, Ph.D, Licensed Psychologist (PY0005229), Florida
Center For Cognitive Therapy, Inc., 2745 State Road 580, Suite 103, Clearwater, FL 33761.
Consultation for Post Traumatic Stress Disorder (PTSD), Dysthymic disorder (chronic
depression), Anxiety disorder due to medical condition, etc.
56. 1999-2005, Dr. G. Anthony Figueroa, MD, 1201 5th Ave. N., Suite 300, St. Petersburg, FL
33705, telephone: (727) 895-4500. Dr. Figueroa was my primary care, from January 1999
through June 2005. Dr. Figueroa offered me a part-time job in his office, on the business side,
however the office manager, Julie, refused to cooperate, and the job fell through. Julie was later
replaced. Dr. Figueroa encouraged me to reestablish contact with my family, which I did, ending
a nine year break. Dr. Figueroa treated me for depression at various times with Effexor,
Wellbutrin, fluvoxamine, paroxetine, lexapro, and cymbalta. When I was homeless Dr. Figueroa
generously offered to pay a deposit on an apartment for me, but I declined.
August 10, 1999 Spoke with Dr. Figueroa that my obturator causes pain in mouth, and I
fear being unable to wear the appliance in the future, and deterioration of the appliance.
December 18, 2002, low speed car crash, became very tired (possibly pre-diabetic) and
nodded-off while driving. This happened while driving as an independent contractor
document courier. The income did not cover expenses. The total loss of my car ended the
employment, and left me homeless, since I was living in my car and motel rooms.
57. September 2001 (temporarily homeless) Unable to wear speech prosthesis. Speculate that the
palatopharyngeal musculature changed to where I could no longer insert the obturator in my
mouth, and I could not wear it anymore. I had a marked deterioration in speech.
58. September 6, 2000 through June 30, 2005 Robert S. Pastorius DDS, 3864 Fifth Ave. N.,
Saint Petersburg, Florida 33713. Numerous procedures, fillings and extractions. Feb-17-05,
Page - 9
extracted #11, removed five unit bridge made in Philadelphia (14. April 20, 1988 Dr. Sanfacon)
installed flipper. June 30, 2005 Dr. Pastorius felt I was not enthusiastic enough and he was
hesitant to proceed with further treatment. Referral from Dr. Figueroa.
59. May 15, 2001 Randall T Hedrick, DDS, 4957 38
th
Avenue N, Suite E, Saint Petersburg, FL
33710 tooth 30, endodontics (root canal).
60. September 2002 - February 2005, I was homeless during this period in Tampa, Florida. I left
my apartment in Brandon Florida over harassment from neighbors, young people who made life
intolerable, from verbal harassment to leaving dog feces on my doorstep. One time they set off
an explosive device at my door and I reported that to the Hillsborough Sheriff.
After leaving the apartment I lived in motels if I could afford a room. Sometimes I slept outside
if the weather was good. Sometimes I lived in my storage unit at Shurgard in Tampa, where my
furniture was stored. I met another homeless man there, James Worley, we became friends, and
we have remained in contact. (James step-father killed his mother when James was about 14
years old, and he has been adrift since). For a week or so I lived at a Salvation Army shelter in
Tampa. In February 2004 I bought a 1990 Dodge minivan for $600 and converted it to a living
space. I lived in the van until I moved to Ocala in February 2005. I still own and drive the van,
and may live in it again. The mortgage holder on the family home where I currently live notified
me that it will soon begin foreclosure.
61. April 4 2002 David M. Pedley, DMD, Oral Surgery, 3810 Fifth Ave. N, St. Petersburg,
Florida 33713, remove root (apicoectomy) of tooth no. 12.
62. April 1, 2005, Gregory G. Langston, DMD, MSD, Periodontics & Implant Dentistry 8487
Fourth Street North, St. Petersburg, Florida 33702, gingival biopsy, evaluate for dental implants.
63. March 3, 2006 beginning on this date an attorney by the name of Ryan Christopher Rodems
has directed, with malice aforethought, a course of harassing and bulling conduct toward me that
has aggravated my disability, caused substantial emotional distress and serves no legitimate
purpose. On March 3, 2006 Rodems called me at home and started an argument over my motion
to disqualify him. Rodems ridiculed my speech, and said you dont talk like a lawyer. Rodems
threatened to use his knowledge against me from prior representation that I spent a $2,000 car
rebate on dental work. While this expenditure was lawful, Rodems was trying to upset me.
Rodems later made a false affidavit about the call to the court, and accused me of threatening to
attack him in Judge Neilsens chambers. The matter was investigated by Kirby Rainesburger of
the Tampa Police Department, who found I did nothing wrong. Mr Rainesburger also said
Rodems was not right and not correct for representing to the court as an exact quote language
that clearly was not an exact quote.
Mr. Rodems has intentionally inflicted severe emotional distress on me which has affected every
aspect of my life and the life of my family. I have sought medical treatment for depression and
other injury caused by this severe emotional distress.
Page - 10
I believe Mr. Rodems has an earlier edition of this medical history document from his law firms
prior representation of me. Mr. Rodems knew that I considered taking my own life, from his law
firms prior representation of me. Therefore Mr. Rodems knew I was severely impaired.
This is from the transcript of my deposition May 14, 2001 in the Amscot lawsuit when Mr.
Rodems firm and partner represented me. This transcript is in the court file in Hillsborough Co.,
Gillespie v. Barker, Rodems & Cook, case 05-CA-7205, see Exhibit 4, Verified Notice
of Filing Disability Information of Neil J. Gillespie filed May 27, 2011. From the deposition of
Neil Gillespie by John Anthony representing Amscot Corporation:
From pages 31-32
22 Q Have you ever tried to take your own life?
23 A No.
24 Q Do you recall ever saying that you would consider
25 that under oath?
1 A I've considered it. Yes.
2 Q When is the most recent time you've made that
3 consideration?
4 A I think about it from time to time.
5 Q Even now with your medication?
6 A Pardon?
7 Q Even now with your medication?
8 A Yes.
Surely Mr. Rodems reviewed this transcript in representing his law firm and law partner.
64. May 16, 2006 to February 26, 2008 consultation with Dr. William N. Williams, Ph.D.,
(Speech-Language Pathologist) Director and Professor, Craniofacial Center, University of
Florida Shands, Gainesville, FL, for velopharyngeal incompetence, my speech prosthesis
(obturator) no longer fits, I cannot wear it any longer. Glenn E. Turner, DMD, MSD, Director,
Maxillofacial Prosthetics tried to make a new obturator, he failed; then another failed attempt by
Dr. Fong Wong, BSD, DDS, MSD, Assistant Professor, Department of Prosthodontics.
At the beginning of treatment I was unable to insert my old obturator in my mouth due to a gag
reflex. Dr. Turner said this would be a problem in making a new obturator. Dr. Turner said there
was no physical reason for my gag reflex or choking sensation. He said my gag reflex was
caused by a psychological issue. He said this would complicate and delay the construction of a
new obturator. After almost two years of effort, neither he nor Dr. Wong were able to make for
me an obturator. Dr. Turner offered the name of Dr. Kelly at the Moffitt cancer center in Tampa.
Due to the choking issue and travel distance I declined to pursue another speech prosthesis.
65. March 2006 to October 2007, Dr. Michael Rowley MD, West Marion Family Medicine,
4600 SW 46
th
Court, Ocala, Florida 34474, primary care, closed practice to become hospitalist.
Treated me for diabetes; depression and PTSD, with Effexor XR, and propranolol,
Page - 11
August 25, 2007 West Marion Hospital ER, severe back pain following the death of a pet
at UF College of Veterinary Medicine under awful conditions. (Aug-13-07). This
incident of pain continued though October 1, 2007. Also treated by Dr. Rowley.
66. September 16, 2009, untimely death of my Mother, proximate cause of this lawsuit. This has
caused me significant emotional distress. Mr. Rodems has ridiculed my reference to this fact,
including statements to Colleen Jenkins of the St. Petersburg Times, in a story January 22, 2010,
Client-turned-adversary accuses Tampa law firm of conflict in judicial bid. Online at this URL:
http://www.tampabay.com/news/courts/client-turned-adversary-accuses-tampa-law-firm-of-
conflict-in-judicial-bid/1067460
67. November 2009, Dr. Karin Huffer, 3236 Mountain Spring Rd. Las Vegas, NV 89146,
Americans with Disabilities Act, ADA accommodation advocate and designer.
February 17, 2010, Dr. Huffer prepared my ADA Assessment and Report (ADA Report)
for the Thirteenth Judicial Circuit, Florida, submitted February 19, 2010 to Mr. Gonzalo
B. Casares, ADA Coordinator, in Gillespie v. Barker, Rodems & Cook, 05-CA-7205.
DSM-IV Multiaxial Assessment (Axes I-V)
Axis I: Depression 296/3, Post Traumatic Stress Disorder, 309.81 with
chronic and acute symptoms anxiety.
Axis II: N/A
Axis III: Velopharyngeal incompetence, Diabetes Type II Adult Onset
Axis IV: Legal
Axis V: Global Assessment of Functioning (GAF) prior 85
GAF with stress from legal system 60 in court
Dr. Huffers report shows the following: (These are selected passages, see the full report)
Brief History: Mr. Gillespie suffers from Chronic Depression as diagnosed by Cesar R. Gamero,
M.D. in Ocala, Florida, 2009. Dr. Gamero also concurs with earlier diagnoses as does Karin
Huffer, M.S., M.F.T., of Post Traumatic Stress Disorder and recognizes that Mr. Gillespie
suffers from velopharyngeal incompetence that worsens when he is stressed. This presents a
barrier to managing effective communication during litigation. The Social Security
Administration found Mr. Gillespie totally disabled in 1994.
Mr. Gillespie has been in need of ADA Accommodations since commencement of his legal
actions. The fact that he was not protected by the ADA created an inaccurate perception of him
to the Court and clearly demonstrates that Mr. Gillespie did not have equal access to the
litigation proceedings or due process of law. The Americans with Disabilities Act should have
protected Mr. Gillespie when he was first in litigation. With accommodations, he may well have
avoided the severe trauma he suffers today.
Page - 12
IV. Interference with Major Life Activities:
A. Functional Impairments:
Mr. Gillespie is functionally impaired in the areas listed below. It is important to note that Mr.
Gillespie's impairments are largely invisible. He may appear to be functional on a superficial
level even when he is not. Mr. Gillespie's functioning is the highest when he is in supportive and
safe environments. His functioning deteriorates when he is in non-supportive, unsafe, or
intimidating environments or when he is under any perceived time pressure or stress. His
impairments are dramatically intensified during litigation.
Mr. Gillespie cannot sustain concentration due to depression and symptoms of PTSD in the
form of flashbacks, emotionally arousing and exhausting intrusive thoughts triggered by
reminders of the traumatic events.
Mr. Gillespie cannot sustain a communication path if interrupted, distracted, or threatening
body language is used toward him. Such circumstances result in cognitive disorganization,
dissociation, and an inability to integrate and process information. Mr. Gillespie cannot
sustain a progressive chain of communication under stress due to his congenital speech
problem. This communication is critical for litigation.
Mr. Gillespie cannot open mail or address matters pertaining to his legal case without
extreme anxiety. This slows him down when he faces deadlines. He cannot manage large
amounts of hard copy documents. He must have the time to scan documents for management
purposes.
Mr. Gillespie cannot sleep normally, rest, or recuperate due to Post Trauma Stress symptoms
including nightmares and startle responses (i.e., he jumps when doorbell rings). He has
hyperreactivity/hyperarousal and she can't eat or sleep or digest food normally.
Mr. Gillespie is easily hyperaroused on a physiological level, especially when feeling
overwhelmed or under any perceived time constraint or threat. Hyperarousal makes it
impossible for him to think clearly and make logical and knowing decisions when under
extreme pressure.
Mr. Gillespie is unable to withstand stress without triggering moments of dissociation. He
may be unable to consistently remember the words that are spoken in Court and cannot
perform verbally to participate in his legal case without assistance and accommodations.
Mr. Gillespie is vulnerable to neuroanatomical effects that can be devastating, i.e. decreased
hippocampal volume and hyperadrenia. Hyperadrenia influences all of the major
physiological processes in the human body and has a host of physical, emotional, and
psychological effects. Physical impairments may be induced when stress is protracted and
unrelenting.
B. Physiological impairment - Symptoms:
Page - 13
Often overlooked by judicial personnel are well-established physiological changes experienced
with PTSD, that seriously impair a persons ability to function during litigation without
accommodations:
Psychophysiological Effects
Flashbacks;
Startle responses;
Hyper-reactivity/hyper-arousal
Neurohormonal Effects
Fear and extreme anxiety; Hyper-vigilance, unable to relax or have peace due to intrusive
thoughts/emotions; Stress hormones reduce and down-regulate receptors, causing a feeling of
being numb/exhausted and freezing the ability to process information and respond.
Serotonin-dependent Effects, Depression
Memory Impairment, Dissociation; Mr. Gillespie must use energy to fight the natural urge to
deny the reality put before him; Traumatic intrusive thoughts threaten to crowd out the issue at
hand during legal processes; Increased opioid response; a numbing hormone intended to protect
the traumatized from pain must be overcome to deal with the legal issues at hand; It is an
exhausting emotional "swim upstream" to stay focused and attentive in the . courtroom, critical
data is missed, and nuances escape the person with PTSD.
February 19, 2010, I submitted my ADA accommodation request (ADA Request) with a
Notice, and the Courts ADA form in Gillespie v. Barker, Rodems & Cook, 05-CA-7205.
October 28, 2010, Dr. Huffer wrote a letter documenting the abuses in my case.
Dr. Huffer is the author of Overcoming the Devastation of Legal Abuse Syndrome, and a founder
of Equal Access Advocates (EAA), and Legal Victim Assistance Advocates (LVAA).
Due to my indigence and/or insolvency, I can no longer afford Dr. Huffers services. Dr. Huffer
however remains a part of my support system.
68. July 12, 2010 I had a panic attack during a hearing before Judge Martha J. Cook at the
George E. Edgecomb Courthouse, 800 E. Twiggs Street, Tampa, Florida. Judge Cook refused to
follow the directives of Court Counsel David Rowland on ADA accommodations. Mr. Rowland
wrote to me July 9, 2010 and said the ADA coordinator could not moderate Mr. Rodems
bullying behavior toward me. Coincidentally on July 9, 2010 I submitted an emergency motion
to disqualify Mr. Rodems, and handed it to Judge Cook at the start of the hearing on July 12,
2010, but she refused to consider the motion and I suffered a panic attack.
I felt a sudden onset of intense panic and terror. My symptoms included choking, palpitations,
sweating, shortness of breath, chest pain, nausea, abdominal distress, feelings of unreality,
feeling dizzy, unsteady, and feeling lightheaded. I felt an urge to escape danger.
Page - 14
When Deputies of the Hillsborough County Sheriff Office (HCSO) saw I was in distress they
offered assistance. I believe HCSO Corporal Gibson was present, along with HSCO Deputy
Henderson and perhaps others. Tampa Fire Rescue was called. Corporal Gibson stayed by my
side and walked with me to the lobby of courthouse while I waited for the paramedics.
Tampa Fire Rescue responded, and an assessment was done at 10:42 a.m. by lead crew member
Robert Ladue, EMT Paramedic (PMD 514678) and crew member 2 Dale Kelley, EMT
Paramedic (PMD 49960). Later I obtained a report, incident number 100035129, which stated in
the narrative section found 54yom sitting in courthouse with tight throat secondary to stress
from court appearance and advise pt mult. times to be transported to hospital and pt refuses
transport and states he would rather go to his Dr. pt signed refusal. The impressions section
noted abdominal pain/problems. The nature of call at scene section noted Resp problem.
After the panic attack I drove home and spoke with Dr. Karin Huffer by telephone at 3:03 p.m.
and told her about the panic attack. At 3:36 p.m. I responded to an email for legal representation
from attorney Pedro Bajo in Tampa. This is what I responded:
Mr. Bajo,
Would you consider just evaluating my motion to disqualify Mr. Rodems, with no
representation? Thank you.
Neil Gillespie
69. July 2008 to present, Dr. Cesar R. Gamero, MD, 9401 SW Highway 200. Building 2000,
Suite 2004, Ocala, FL 34481. Dr. Gamero is a primary care doctor who treats me for diabetes,
anxiety, depression, and all other medical issues. Tried Sertaline for depression and Clonazepam
for anxiety but the side effects were to severe. Also Mirtazapine for depression, and Pristiq. Also
Nuvigil to improve wakefulness and concentration. For diabetes and high blood pressure,
lisinopril, metformin hydrochlorothiazide.
Nuvigil works to focus my attention and temporarily overcome depression, but the side affects
are significant and include severe headache, insomnia, sweating, dry mouth, constipation,
dizziness, altered sense of being, and mood changes such as increased agitation, irritability and
exaggerated sense of well-being. I also found Nuvigil not reliable. Sometimes it worked, but
other times it incapacitated me. Nuvigil is also relatively expensive. My last prescription for 15
50mg tablets cost about $80. Samples of Nuvigil are available from Cephalon, the manufacturer,
and from Dr. Gamero, but the sample size is 150mg. That strength (150mg) incapacitated me and
led to extreme headaches. Attempts to cut the 150mg tablet into a smaller size may result in an
uneven dose, and reduced effectiveness, according to the pharmacist.
Nuvigil is the replacement for Provigil, which patent has expired. The U.S. military provides
Provigil to military pilots on long missions to keep them awake. Provigil has other off-label uses.
Generic Provigil is also relatively expensive; Walmart quoted me $588.68 for thirty (30) 100mg
tablets on July 18, 2012. This was a $398.78 savings off the $987.46 full price. This cost is
prohibitive for me.
Page - 15
Current health issues
I become easily confused and distracted. This is especially true when I leave home. When my
lawsuit began in 2005, I had the ability go to the law library and do research for about one hour.
Now when I go to the law library I am overwhelmed by the environment and cannot do anything,
other than to hand the librarian a list of cases I found in outdated books at home and return later
to pick up the copies.
Short term memory deficit. I am unable to read more than a few words at a time and type those
words on the computer. This makes legal work very time consuming. I believe short term
memory deficit causes a hearing problem in court.
Lack of concentration. I loose focus often and find it difficult to concentrate. Sometimes I
become overwhelmed. At that point I stop and rest, or switch to another task. It takes me a long
time to do things.
Hand-eye coordination deficit. My ability to do ordinary tasks is declining. My mind thinks of
the task, but my hands and body do not respond like they used to. Many years ago I worked part-
time as a banquet server, but I became too slow was unable to continue. I was not able to set
tables or serve food quick enough, and my stamina declined. Assembling documents in my
lawsuit has become difficult. I am only able to do so with computer-assisted technology.
Forgetfulness. I have become very forgetful. This is a problem while cooking food. While
heating soup on the stove, I soon forget about it, until I smell the food burning. This has resulted
in the destruction of pots.
I compensate for forgetfulness by making lists, and leaving items in plain sight in the same
place, so the location is impressed in my memory. This results in a home that looks very
disorganized to the casual observer.
Diabetes. I become very tired when my blood sugar is too high. My ideal blood sugar level is
110. Records show my blood sugar level May 25, 2011 at 8:41 p.m. reached 245. This was a
week before a civil contempt hearing June 1, 2011 before Hillsborough Judge James Arnold.
This was a very stressful time. Through a series of ex-parte hearings, Mr. Rodems presented
false testimony and obtained June 1, 2011 a warrant for my arrest on a writ of bodily attachment.
Velopharyngeal Incompetence (VPI). I can no longer wear my speech prostheses. The June 2,
1993 assessment of Dr. Jane Scheuerle, Tampa Bay Craniofacial Center, explains this issue.
Social life. I live alone in a small two-bedroom retirement home with my pet bunny. My social
life is limited to an occasional Thursday morning breakfast at a local restaurant with retired men
who live on my street in Oak Run, a retirement community. The Thursday morning breakfast is a
weekly event, but attending weekly is too stressful, so I go about once a month.
Page - 16
I also have a telephone relationship with a woman in Miami that began in late 2008. We have
never met in person. She is retired and cares for both her elderly parents who are in their mid-
eighties and very ill. Otherwise I stay at home and work on my case.
Hearing deficit. This appears related to short term memory deficit.
Telephone recording. My short-term memory is poor. My ability to accurately take notes is
severely reduced. Even my concentration during a conversation is impaired. So recording a call
allows me to listen to the caller a second or third time for a better understanding of the issues.
This is in addition to another issue, that opposing counsel once misrepresented the contents of a
call to the court. When I was caring for my Mother who had Alzheimers and other ailments,
recording calls from the doctor allowed me to accurately understand the call and follow the
doctors orders. That is how I began recording calls. Sometimes the recording program
inadvertently records my screams as I sit at my desk, cursing this lawsuit and legal system.
Website as a coping mechanism. In my ADA accommodation request made February 19, 2010 in
Hillsborough Co. lawsuit, I described how I would create a website to help find counsel. While I
did not find counsel, I met people with stories of legal injustice, and we support each other.
Combinations of disabilities. A study by the World Health Organisation shows depression is
more damaging to everyday health than chronic diseases such as angina, arthritis, asthma and
diabetes. Researchers found if people are ill with other conditions, depression makes them
worse. Somnath Chatterji of the World Health Organisation led the study. The most disabling
combination was diabetes and depression, the researchers said. "If you live for one year with
diabetes and depression together you are living the equivalent of 60 percent of full health,"
Chatterji said in a telephone interview. News of this study was reported by Reuters on September
7, 2007. The study is reported in the Lancet Medical Journal, Vol. 370 No. 9590 pp 851-858.
On February 19, 2010 I made requests under the Americans with Disabilities Act (ADA),
including this one.
ADA Request No.6: Mr. Gillespie requests time to scan thousands of pages of
documents in this case to electronic PDF format. This case and underlying cause
of action covers a ten year period and the files have become unmanageable and
confusing relative to Gillespie's disability. Mr. Gillespie is not able to concentrate
when handling a large amount of physical files and documents. He is better able
to manage the files and documents when they are organized and viewable on his
computer. Mr. Gillespie will bear the cost of converting files and documents to PDF.

415-13
Rev. ]-8]
AMERICAN ONCOLOGIC HOSPITAL
CHART COpy PROGRESS REPORT
Notll prairllss of caslI. complications. chanilll In dlaposls
condition on dlscharill. Instructions to patlllnt
GILLESPIE, Neil #74123
7/22/85
The patient is a 29 year old white male referred by Dr. Carver
who is status post left unilateral 'Class IV lip and palate repair
at approximately age two years old. He is unclear about the details
of the degree of his defects, the surgical procedures, who performed
this, or exactly where it was done. Apparently, after the initial
bout of surgeries to repair the lip and hard and soft palate, he had
no further surgical intervention. He had no ongoing follow-up for
this problem. At approximately age 13 to 14 years old, he underwent
orthodontic treatment at Temple University Hospital's Dental School
and this ultimately resulted in the placement of a retainer with a
prosthetic left lateral incisor. He has worn this since that time.
He notices drainage of food into the left nasal floor. His left and
right nostrils are opened, although the left is somewhat stuffy and
occluded.
His main concerns upon presentation are related to the persistent
cleft in the left alveolus, the draining fistula, and the possibility
of foregoing the need fOD a prosthetic device. In addition, however,
it is obvious on confronting the patient that he has a moderate amount
of nasal deformity, flattening of the left side in the premaxillary
region, and lip distortion, particularly at the vermilion. In
addition, the patient has a significantly hypernasal speech pattern
with ~ b v i o u s velopharyngeal incompetence.
On physical examination beginning externally, the patient has
a slightly large nose with a small dorsal hump. The size of the nose
is slightly larger than proportional to his face, although not
exaggeratedly so. The right alar dome is full. The left alar
cartilage is posteriorly and laterally displaced and somewhat
hypoplastic compared to the left side. The left alar base is
also laterally displaced. The nostril sill is flattened, and there
is an obvious fistula between the distal nasal floor and the oral
cavity. The left columella, likewise, is somewhat hypoplastic and
twisted. The upper lip scar is well healed and appears to be a
LeMesurier or Tennison-Randall type repair. The upper lip tubercle
is preserved, but the vermilion border is somewhat irregular.
Length appears, however, to be satisfactory. There is a-lateral
orbicularis bulge of the left upper lip. Internally, there is a wide
cleft of the left alveolar ridge at the level of the lateral incisor
with a fistula into the nasal floor. This runs posteriorly and nearly
to the end of the secondary palate. The soft palate has a linear scar.
it is very short, and there is lateral movement but no central movement
of note.
continued...
6.1

GILLESPIE, Neil
Page Two .
7/22/85
My impression and recommendation to the patient generated
three specific areas of interest. One relates to the scar revision
of his upper nose and the relationships of his nasal tip, nose,
and secondary deformities in this area. The second area of interest
in importance is the alveolar cleft with the naso-oral fistula.
The third area is the palate with obvious velopharyngeal incompetence
and a foreshort and scarred palate.
My initial recommendations will be that the patient undergo
orthodontic evaluation. I will arrange for him to see Dr. Rosario
Mayro for evaluation as well as x-rays to assess his occlusal
relationships. It also should be noted that he, in general, had
a fairly satisfactory occlusal relationship.with some lateral collapse
and crossbite on the minor segment on the left and evaluate his
adequacy as a candidate for bone I think he would
qualify. Subsequent to this, I will have him see Dr. Harvey Rosen
concerning the actual surgical procedure and also he will be seen by
Miss Marilyn Cohen, a speech pathologist with special interest in
patients having cleft lip and palate for an evaluation concerning
feasibility of posteropharyngeal flap in a patient of this age group.
Concerning the external revisions, this can be accomplished concerning
the upper lip, possibly at the same time as the fistula closure with
orlllcularis redirection, a revision of the nostril sill and the
lateral alar base, and also possibly tip rhinoplasty or this can
be accomplished at a later date with a formal rhinoplasty in concert
with other procedures. In addition, the vermilion border should be
repaired. This can be done by Z-plasty technique.
The patient, therefore, will be seen by the consultants and a
general plan with timing'for surgery, etc., will be made. We will
arrange to make these arrangements and follow-up with the patient.
No letter.
M.D.
econstructive Surgery
JK:bsm
T--8/1/85
D--7/23/85
ep s1ak,

PENNSYLVANIA HOS- TTAL
,
The Hospital I Founded 1751 '',
DEPARTMENT FOR SICK AND INJURED
HARVEY M, ROSEN. M,D, D,M,D,
EIGHTH AND.SPKUCF; STREETS
Head, Se,lion of Plastic Surgery
P.ADELPHIA, PENNSYLVANIA 19107 gtiTie 3H,301.50uth Eighth sr
. PHONE (215) 829-5643
-
H, ROBERT CATHCART, President
1?A
August 12, 1985
I etV1
Lj-)-?7 /8&
',., :.",
Joseph Kusiak, M.D.
American Oncologic Hospital
Central " Shelmire Avenues
Pennsylvania
,.',
19111
".
RE: Neil Gille.pie
Dear Joei"" ,
This lllorning your patient, t-lr. Neil Gillespie, was seen in
consultation regarding his secondary cleft lip and palate deformi
ties. His major concern at this point in time is the edentulous
space in the region of the left lateral incisor which necessitates
wearing a removable appliance. This area has never been bone grafted.
On physical examination there is the obvious stigmatA of an unilateral
left sided cleft lip and palate. Examination of the lip reveals poor
aligrunent of the vermilion border. There is lack of muscle continui'ty
high in the lip. Nasal examination shows a deviated septum with the
body of the septum in the left nasal airway and the caudal end pre
senting in the right nasal airway. There is a base. Tho
alar sill recessed. There is a slumping of the left alar rim.
Tht:: right lower lateral cartilage is hypertrophied compared to the
left lower lateral cartilage. Intraoral examination reveals an
edentulous space in the region of the left li1teral incisor. There
is an obvious oronasal fistula. There a slight posterior cross
bite in the lett posterior segment. There is marked velopharyngeal
escape.
I to Mr. Gillespie that in order for nim to have a
bridge appliance made 60 thathhe could be rid of his removable ap
pliance, an alveolar bone graft would be necGssary. Whether or
not the posterior cro86bite should be corrected prior to this time
is up to Dr. Mayro. At the time that the bone graft is per
formed lip revision could be done as well. At a secondary procedure
a posterior pharyngeal flap And naaal reviaion could be performed.
and The Institute. III North 49th Street I Philadelphia, Pennsylvania 19139 I Telephone (215) 471.2000
6.2
.__ _........._ . ---_..__

..
.
.71,':. ' ,
Joa.ph Kuaiak, M.D. -2- Auguat 12, 1985
Thank you for referring K%G11leQpie. I looK forward to 41a
him with you.
Sest revarda.
Sincerely youre,
Harvey M. Rosen, M.D., D.M.D.

cel Rosie Mayro, D.M.D., 1830 Rittenhouse Square, Phila., PA 19103
Ma. Marilyn Cohen, Facial Reconstruction Center, Children'.
Hoapital, Philadelphia, PA 19104
u: 10-,,,
\.
I
11155
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
THE CLEFT PALATE PROGRAM
34th and Civic Center Boulevard
Philadelphia. Pa 19104
(215) 596-9120
Don LaRossa. M. D., Director
September 12, 1985
Joseph Kusiak, M.D.
American Oncologic Hospital
Dept. of Plastic Surgery
Dept. of Surgery
Central and Shelmire Ave.
Philadelphia, PA 19111
RE: Neil Gillespie
B.D. 3/19/56
Dear Joe:
Thank you for referring Neil Gillespie for a speech evaluation. I
had the opportunity of evaluating this gentleman on August 1, 1985.
had a history of a unilateral cleft lip and palate repaired some
>" 1me in early childhood. He is presently wearing a dental shell which
l'ls obturating to some degree an anterior parallel fistula. He has
had a short course of speech therapy during his early school years.
Mr. Gillespie's speech is characterized by hypernasality with nasal
escape. hypernasality is accentuated when he removes his palatal
appliance but I do not feel that the fistula is the prime cause
the hypernasality or the nasal excape. Occlusion of his naris with
the appliance in place greatly improves the overall quality of his
speech and generally eliminates the hypernasality. His articulation
is well within the normal range.
On direct physical examination, he appears to'have a deep oral pharynx'
with a short but mobile soft palate. He has an active gag reflex,with
l'
fairly good lateral wall motion. I would suspect that he would do
- fairly well with a posterior flap given his age the .
,
prognosis is guarded. I discussed this recommendation with Mr. Gillespie
0'
and also informed him that there is the possibility even with the
posterior pharyngeal flap that there may not be an improvement in his
speech and that he could possiply require speech therapy following
the flap. I do not feel he would benefit from a course of speech
therapy at this point in time as this appears to be an anatomic defect.
>.' :
1:,,:,:9PlASTIC SURGERY: Peter Randall, M.D., Don LaRossa, M.D., Linton Whitaker, M. D., Ralph Hamilton, M. D., R:Barrett Noone, M.D.,). Brian Murphy,
, ,:" Arthur Brown, M.D. SPEECH PATHOLOGY: Marilyn Cohen, B.A., Marilyn Bernhard, M.A.; DENTIST."" Rosario Mayro, D.M.D., 'Imes Schweipi;
D.D.S.; QTORHINOLARYNGOLOGY: William Potsic, M.D., Steven Handler, M.D., Ralph Wetmore, M.D.; AUDIOLOGY: Richard Winchester,
Ph.D.; PEDIATRICS: Patrick Pasquariello, M.D.; SOCIAL WORK: Susan Freimark, A.C.S.W.
6.3
(2) RE: Neil Gillespie
If you would like further confirmation of the problem, I would
recommend proceeding with nasal pharyngoscopy rather than lateral
static x-rays.
Thank you for allowing m ~ to participate in Mr. Gillespie's care.
With best regards,
Sincerely yours,
Marilyn A. Cohen
Speech Pathologist
MAC/med
cc: Harvey Rosen, M.D.
Rosie Mayro, M. D. t..""
Rosario Felizardo Marro, D.M.D.
Practice Limited to Orthodontin
Harch 31, 1986
Dr. Harvey Rosen
Pennsylvania
Suite 309
700 Spruce Street
Philadelphia, PA., 19106
Re: Neil Gillesoie
Dear Harvey:
Mr. Neil Gillespie has began orthodontic treatment
in preparation for bone grafting. I anticipate that
he will be ready for surgery in the month of August,
1986. Gillespie will be in touch with you
to set up a definite date
Please do not hesitate to call me if you have any questions.
i
Best regards,
Sincerely yours,

Rosario F. r:layro, D.J.LD.
RFi'1:er
cc: Dr. Joseph Kusiak
1830 Rittenhouse Square, I-A, Philadelphia, Pennsylvania 19103 215-735-5211
,: ....
6.4
-- ;kld
Oral Dli/g.'S/S
'.f.JYI)1 f!, I-)M 1),1\
III JII I ',IX: III f'J I II ejmll 9.111 i
Pllli 1\11111'1111\, III V;\NI/\ I')K)')
APRIL 22) 986
ROSARIO F. MAYRO) D.M.D.
1850 RITTENHOUSE SQUARE
PHILADELPHIA) PA 19103
RE: NEIL GILLESPIE
DEAR ROSIE:
AT YOUR KIND SUGGESTION I EXAMINED YOUR PATTFNT" NEIL GILLESPIE"
TODAY TO EVALUATE THE EXTENT OF GINGIVAL RECESSION AND PLAN
CORRECTIVE SURGICAL PROCEDURES. THIS THRITY-YEAR OLD MAN IS IN GOOD
GENERAL HEALTH. HE IS CURRENTLY UNDERGOING ORTHODONTIC TREATMENT IN
YOUR OFFICE AND A MAXILLARY BONE GRAFT IS SCHEDULED LATE NEXT SUMMER
WITH DR. ROSEN.
THE PATIENT HAS SEVERE GINr.IVAL RECESSION IN THE LOWER ARCH EXTENDING
FROM THE LOWER LEFT FJ RST PREMOLAR TO THE LOWER RIGifT FIRST PRfMOI_AR.
THERE IS ALSO SEVERE CERVICAL EROSION WHICH APPEARS TO BE SECONDARY
TO OVERZEALOUS TOOTHBRUSHING. IN THE UPPER ARCH THERE IS RECESSION
AND MUCOSAL MARGINAL TISSUE ON THE CANINES AND RIGHT LATERAL INCISOR.
THERE IS ALSO A HIGH MAXILLARY FRENUM BETWEEN THE CENTRAL INCISORS.
THE PATIENT HAS MINOR COMPLAINTS OF SENSITIVITY WITH EXTREMES OF HOT
AND COLD IN AREAS OF RECESSION.
As WE DISCUSSED" I WILL BE PROCEEDING WITH CORRECTIVE MUCOGINGiVAl
PROCEDURES IN ORDER TO THF. DENTOGINGIVAL JUNCTION AND
PREVENT FURTHER RECESSION DURING ORTHODONTIC TREATMENT. IN AR E A 5
WHERE SENSIVITITY IS A PROBLEM OR THERE ARE COSMETIC CONCERNS" THE
PROCEDURES WILL BE DESIGNED TO OBTAIN COVERAGE OF EXPOSED ROOT
SURFACES.
6.5
DR. ROSARIO MAYRO
APRIL 22J 1986
PAGE Two
I SEE NO PROBLEM WITH CONTINUED TOOTH MOVEMENT IN THE UPPER ARCH. I
WOULDJ HOWEVERJ ACTIVE ORTHODONTIC TREATMENT IN THE LOWER ARCH
UNTIL AFTER I HAVE COMPLETED THE MUCOGINGIVAL SURGERY.
I LOOK FORWARD TO COLLABORATI NG WITH YOU IN THE TREATMENT OF TH IS
VERY CHALLENG ING CASE. I WILL KEEP YOU POSTED ON Mi<. GILLESP I E I S
PROGRESS.
,./'
I
i \1 ,/
/';
MARK SNYDERJ D.M.D.
MBS:MEB
CC: HARVEY ROSENJ D.M.D.J M.D.
" ,:-'
1". t.. L:, ...
PeriodontICS and
Ora/Diagnosis
MARK BSNYDER, DMD, PC
_. ---_.._._----
220-sc5JTH SIXTEENTH STREET SUITE 900
PHII.ADELPI /lA, PLNN5YIVANIA I(JIOY
(21': ':>46 O/?9
JULY 3" 1986
ROSARIO F. MAYRO" D.M.D.
1850 RITTENHOUSE SQUARE
PHILADELPHIA" PA 19103
RE: NEIL GILLESPIE
DEAR ROSIE:
I AM PLEASED TO REPORT THAT I HAVE COMPLETED PERIODONTAL SURGERY ON
YOUR PATIENT NEIL GILLESPIE. A BAND OF KERATINIZED GINGIVAL TISSUE
WAS PLACED FROM THE LOWER LEFT SECOND PREMOLAR EXTENDING ACROSS THE
ANTERIOR REGION TO THE LOWER RIGHT SECOND PREMOLAR. IN THE UPPER
ARCH THE MUCOSAL MARGINS ON THE ANTERIOR TEETH WERE ALSO REPLACED BY
KERATINIZED GINGIVA. NEIL TOLERATED THE PROCEDURES ~ X T R E M E L Y WELL
AND HEALING HAS BEEN UNEVENTFUL. INCIDENTIALLY" THERE HAS ALSO BEEN
SIGNIFICANT IMPROVEMENT IN HIS PLAQUE CONTROL.
I HAVE RECOMMENDED THAT NEIL BE SEEN ON AN ONGOING BASIS FOR
PERIODONTAL HEALTH MAINTENANCE APPROXIMATELY EVERY FOUR TO SIX WEEKS
DURING THE ORTHODONTIC PHASE OF HIS TREATMENT. I WILL EE SEeING HIM
AGAIN SHORTLY BEFORE HIS SURGERY WITH HARVEY ROSEN. HIS PERIODONTIUM
IS CURRENTLY HEALTHY ENOUGH TO WITHSTAND THE RIGORS OF ANY
ANTICIPATED TOOTH MOVEMENT.
i
THANK YOU FOR REFERRING THIS MOST CHALLENGING CASE TO ME FOR
TREATMENT. IF I CAN BE OF ANY FURTHER ASS ISTANCE" PLEASE DON 'T
HESITATE TO CALL.

JUL 0,,1986
CC: HARVEY ROSEN" D.M.D." M.D.
.._._ ...._,
6.6
I ...

. N.tion's Fint HOIpit.11 FoundN 1751
/
DEPARTMENT FOR SICK AND INJURED HARVEY M. ROSEN. M.D. D.M.D
He.d. Section of PI..tic Suraery
EIGHTH AND SPRUCE STREETS
Suite 3H. 301 South Eiahth Street
....ADELPHIA, PENNSYLVANIA 19106
H. ROBERT CATHCART, Pruidenl
(215) 829-5643
May 18, 1987
Randall, M.D.
University of Pennsylvania Hospital
Four Silverstein
3400 Spruce Street
Philadelphia, Pennsylvania 19104
RE: Neil Gillespie
Dear Peter:
I have asked Mr. Neil Gillespie to see you in consultation regarding
a secondary cleft nasal deformity. Mr. Gillespie had been referred
to me by Joseph Kusiak for a bone grafting procedure to his residual
alveolar cleft. When first seen by me he had a very large nasal pal
atal fistula with a significant alveolar defect. In addition, he had
a rather severe cleft nasal deformity with a large amount of velopharyn
geal insufficiency. A pharyngeal flap was discussed, but he declined
this and wanted to concentrate on the bone grafting of his alveolar
cleft as well as some secondary nasal surgery. He was operated upon
last spring, at which time he underwent bone grafting of his rather
,..-extensive alveolar cleft and, at the same time, repositioning of the
nasal septum and nasal' spine in the midline. He did followinq
these procedures, and approximately six months later he underwent
a rhinoplasty procedure involving further work on his septum with
only minimal resection, reduction of a dorsal nasal hump, and reduc
tion of his left alar flaring. As a Desult of the last mentioned
maneuver, he has developed some blockage of the left nasal airway due
to excessive buckling of the lower lateral cartilage. It is-significant
to note that prior to his nasal surgery he denied having anY}di,fficul
ties wi nas';ll br
7
athing.. For reason. no
to the " is
and the nasal septum was not more .' .
',' '., - ..
I would appreciate your thouqhts on his residual problem. If you
think further significant improvement can be obtained, and if he is
agreeable, please do not hesitate to proceed with any surgery that you
think advisable. ..
Thank you in advance for seeinq Mr. Gillespie. Best regards.
Sincerely yours,
hrnr/eg
.nd The Institute. 111 North 49th Street I Phil.delphi., Pennsylv.ni. 19139 I Telephone (215) 4712000
, ,,-:t:. I ' '1
. '. I,,):, .
6.7
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA
4TH FLeOR - SILVERSTEIN PAVILION
3400 SPRUCE STREET
PHILADELPHIA, PA. 19104
(215) 662-2000
JONATHAN E. RHOADS, M.D. DON LAROSSA, M.D.
CLETUS W. SCHWEGMAN, M.D. RICHARD N. EDIE, M.D.
BROOKE ROBERTS, M.D. LARRY W. STEPHENSON, M.D.
PETER RANDALL, M.D. JOHN L. ROMBEAU, M.D.
JULIUS A. MACKIE, M.D. GORDON P. BUZBY, M.D.
L. HENRY EDMUNDS, JR., M.D. ALI NAJI, M.D.
LEONARD D. MILLER, M.D. June 17, 1987 W. CLARK HARGROVE, III, M.D.
CLYDE F. BARKER, M.D. V. PAUL ADDONIZIO, M.D.
RALPH HAMILTON, M.D. CLIFFORD W. DEVENEY, M.D.
HENRY D. BERKOWITZ, M.D. KAREN E. DEVENEY, M.D.
HAZEL I. HOLST, M.D. IRA J. FOX, M.D.
LINTON A. WHITAKER, M.D. JOHN M. DALY, M.D.
ERNEST F. ROSATO, M.D. MICHAEL H. TOROSIAN, M.D.
LEONARD J. PERLOFF, M.D. scon P. BARTLEn, M.D.
JAMES L. MULLEN, M.D.
Suite 3H
301 S. Eighth Street
Phi1ade1phLa, PA 19106
RE: Neil Gillespie
Dear Harvey:
Thank you so much for your letter concerning Mr. Neil Gillespie.
This certainly sounds like an interesting and rather difficult
situation. I would be very pleased to see him. I will
certainly keep you in touch with any plans, and do appreciate so
much information.
Thanks again.
Peter Randall, M.D.
PR:spd
cc: Kusiak, M.D.
Neil Gillespie
6.8
FOUNDED 1855
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
THE CLEFT LIP AND PALATE PROGRAM
34th and Civic Center Boulevard
Philadelphia, PA 19104
(215) 596-9120
Don LaRossa, M.D., Director
Pam Onyx, Coordinator
March 30, 1989
Don LaRossa, M.D.
HUP
RE: Neil Gillespie
DOB: 3/19/56
Dear Don:
I had the opportunity of reevaluating Neil Gillespie on March 30, 1989. The
speech evaluation is essentially unchanged since his last evaluation in 1985.
Mr. Gillespie's speech is characterized by hypernasality with consistent
nasal escape. On direct physical examination the palate appears to be short
and slightly immobile. Articulation is within the normal range.
I would recommend nasoendoscopy to confirm velopharyngeal incompetence and
to evaluate the degree of lateral wall motion. Mr. Gillespie was counseled
regarding the options for correction of his hypernasal voice quality, includ
ing the use of dental prosthetics and posterior pharyngeal flap. I also ex
plained to Mr. Gillespie that the prognosis after placing a posterior pharyn
geal flap are somewhat guarded in an adult and that he may continue to have
some persistent hypernasality requiring additional speech therapy. I believe
Mr. Gillespie is interested in proceeding with a nasoendoscopy and will be
contacting you after he receives notification from your office.
Thank you for the opportunity of participating in this patient's care.
Sincerely yours,
'
,/' ,/-' '., /'
- _-:;rh ~ r C /

Marilyn E. Cohen
Speech Pathologist
MEC:sam
cc: Mr. Neil Gillespie
PLASTIC SURGERY: Peter Randall, M.D., Don LaRossa, M.D., linton Whitaker, M.D., Ralph Hamilton, M.D., Harvey M. Rosen, M.D., Joseph F. Kusiak, M.D., R. Barrett Noone,
M.D., ). Brien Murphy, M.D. SPEECH PATHOLOGY: Marilyn Cohen, B.A., Marilyn Bernhard, M.Ed. DENTISTRY: Rosario F. Mayro, D.M.D., Dennis G. Sanfacon, D.M.D., Barry
S. Kayne, D.D.S., Stanley Horwitz, D.D.S., Howard M. Rosenberg, D.D.S. OTORHININOLARYGOLOGY: William Potsic, M.D., Steven Handler, M.D., Ralph Wetmore, M.D.,
Lawrence W. C. Tom, M.D. AUDIOLOGY: Dan F. Konkle, Ph.D. PEDIATRICS: Patrick Pasquariello, M.D. SOCIAL WORK: David ). Beele, M.S.W., A.C.S.W.
GROWTH/ANTHROPOLOGY: Nancy Minugh-Purvis, Ph.D. GENETICS: Elaine H. Zackai, M.D., Donna M. McDonald, M.s. PATIENT EDUCATION: Pamela H. Onyx, B.A.
NURSING: Kelly Gould, R.N.
6.9
li. 'Ralph Millard, Jr., M.D., F.A.C.S.
thony Wolfe, M.D., F.A.C.S.
Walter R. Mullin, M.D., F.A.C.S.
December 3, 1990
23 Sweetgum Road
Levittown, PA 19056
Dear Mr. Gillespie:
Arrangements have been made for your admission to Jackson Memorial Hospital,
East Tower, on Thursday, December 13th, 1990 between the hours of 12:00 and
2:00 p.m., for surgery the following day. Please be prepared to pay the
hospital a deposit of $4400 toward payment of your final bill. However, they
may accept insurance forms in lieu of payment. Please let us know at once if
you prefer to be admitted on the morning of surgery, as we would have to arrange
for your lab work to be done prior to the day of surgery.
Also, we've arranged for Dr. Millard and his Resident, Dr. LaTourette, to see
you in our office on Wednesday, December 12th at 10:00 a.m. for medical workup.
Please send us your insurance forms with "insured section" completed and signed.
This will help expedite the processing of your claim. Be sure to find out and
let us know if your insurance company requires precertification for planned
surgery. Contact Marisol in our office as soon as possible regarding this
matter.
Kindly confirm these arrangements upon receipt of this letter. If we do not
hear from you by December 12th, we will assume that you are unable to go ahead
at this time and we will find it necessary to remove you from the schedule
until we hear from you again.
Enclosed is a list of special instructions which should help answer some of
your questions. If we can be of further assistance, please feel free to call
upon us.
~ u r s .
Chris Montoto
Secretary to Dr. Millard
6.10
D. Ralph Millard, Jr., M.D., F.A.C.S. 'The Plastic Surgery Centre
Plutic and Re.:onsl:ruc:tivc Surgery Tel. (305) 325144.
Anthony Wolfe, .M.D., F.A.C.S.
1444 N.W. 14th Avenue Miami. Florida 33125 Walter R. Mullin, M.D., F.A.C.S.
December 6, 1990
Christy Barcelona
Pennsylvania Blue Shield
Pre-authorization Request
P. O. Box 890041
Camp PA 1708900041
Re: Neil Gillespie
ID: D5ll5395
Group: 20l63C
TO WHO-I IT HAY CONCERi'J
The above natmed patient was seen in consultation by D. Ralph
Hillard, Jr., M.D. on May 26, 1989 at which time reconstructive.
surgery was scheduled.
The patient \Vas born with a tmilateral cleft of the lip and palate
including nasal distortion lvith difficulty and nasal
escape, secondary to tIle cleft. TIle proposed surgical procedure
lvill be cleft rhinoplasty lvith submucous resection, possible pharyngeal
flap and cleft lip correction, procedure codes: 30520, 40720 and 42226.
Dr. Hillard's fee for these procedures lvill be approximately $3,900.00.
Dr. feels very strongly that this surgery is functional i."1
nature.
We will greatly appreciate receiving pre-authorization for this surgical
procedure. We will also appreciate your expeditious attention to this
request as Hr. Gillespie's surgery is scheduled for Dece.'nber 14, 1990.

Marisol Pardo,
Insurance Secretary

6.11
JUN 29 1993
MUTAZ B. HABAL., M.D., F.R.C.S.C., FAC.S.
PLASTIC AND RECONSTRUCTNE SURGERY
801 W. Dr. ".rtin L ICing, Jr. BIwI.
Telephone: 813/231HH09
Tampa, FL 33603-3301 FacsOnBe: 813/.238-1119
May 5, 1993
RE: NEIL GILLESPIE
To Whom It May Concern:
Neil Gillespie is a pleasant 37 year old white male patient
seen 'today for the first time at the Tampa Bay Craniofacial
Center. He brings with him today an organized synopsis of the
multiple operative procedures that he has undergone, initially
in Philadelphia and the last in Miami.
The patient presents with velopharyngeal incompetency and is
leaking air both posteriorly and interiorly. The palate is
short and does not appear to have much activity. Prior to
preparing Mr. Gillespie for a surgical procedure, I would like
to do a complete visualization of his problem to see if the
pharyngeal flap needs to be removed and enough time allowed
for the tethered flap to adjust, or if a complete flap with
two small posts on each side is appropriate in order to allow
him to communicate and be understood despite his hypernasal
speech which at the present time cannot be comprehended.
These operative procedures will be discussed with the patient
following the visualization procedure which has been scheduled
at st. Joseph's Hospital on 6/1/93 and again in consultation
with Dr. Scheuerle. I will see him prior to the procedure on
5/26/93 at 1:45 p.m.
Should you have any questions, please do not hesitate 'to com
municate with us.
Sincerely,
/U V/
Mutaz B. Habal, M.D.
(dictated but not read)
MBH/bbd/5-8
6.12
June 2, 1993
Department of Communication Sciences
and Disorders
College of Arts and Sciences
University of South Florida
Robert E. Williams, Ed.D.
4202 East Fowler Avenue, BEH 255
certified Rehabilitation Counselor
Tampa, Florida 33620-8100
Department of Labor and Employment Security (813) 974-2006
Divisional of vocational Rehabilitation
FAX (813) 974-2668
11213 B North Nebraska Avenue
Re.: Neil J. Gillespie
Dear Dr. W i l l i a ~ s ,
Thank you for your letter of inquiry concerning Mr.
Neil Gillespie's health and employment status and
potential. Each of your five questions concerning Mr.
Gillespie's diagnosis and treatment plan is listed and
addressed below.
1. What is Mr. Gillespie's disability (ies) and what
is the level of severity? -.,.
Mr. Gillespie has sustained the surgical results
of mUltiple treatments for a congenital cleft lip and
palate. While he is facially intact, he retains several
incomplete elements of the sequelae of this congenital
dysmorphology. Because of the oro-nasal fistula and
velar limits, Mr. Gillespie is utilizing extreme measures
to make his speech intelligible. He is applying undue
stress to the laryngeal and pharyngeal musculature a
control the normal air stream. Because of his extra
effort in striving to meet the demands of society, he is
at risk for damaging his larynx. Also, the unnatural
openings between the nose and mouth invite incidence of
infection and irritation to sensitive tissues that were
never meant to associate in this way. Exchange of food
stuffs and secretions between the two cavities must be
stopped to promote complete healing and maximal function.
2. What is Mr. Gillespie's functional level? What
physical limitations (e.g., speaking, hearing,
communicating, etc.) are imposed by the disabilities?
Because of his present oro-facial-pharyngeal
status, Mr. Gillespie is not advised to use his full voice
in long-term verbalization. That is, prior to closure of
the fistulae, and correction of the palate, he would be
ill advised to lecture, or undertake pUblic speaking. He
can communicate intelligibly on a one-to-one basis and as
such he displays an astute mind with considerable . ~
experience with interpersonal communication. This level
of communication is possible due to Mr. Gillespie's
conscientious and accurate speech articulation. When he
attempts to use a stronger (louder) voice, the increased
'<\MPA ST. PETERSBURG SARASOTA FORT MYERS LAKELAND
UNIVERSITY OF SOUTH FlORIOA IS m AFFIRMATIVE ACTION I EOUAL OPPORTUNITY INSTITUTION
6.13
air pressure increases the hypernasal resonance and
thereby decreases the effectiveness of his speech. He
looses intelligibility and fatigues rapidly.
Because I have no objective data on his hearing
status, I can only be suspicious that it is currently
within normal range, but also that he has sustained the
effects of early, untreated middle ear effusions that
usually result in conductive hearing loss during infancy.
effort was seen yesterday at the Tampa Bay Craniofacial
Center for assessment of the current status of his
congenital orofacial cleft condition. Mr Gillespie is
experiencing severe speech expression problems due to
inadequate intra-oral and oronasal structures. Although
he has had several surgeries in an earnest attempt to
resolve this problem, none of the procedures have
completed the treatment he requires in order to produce
clear verbal communication..
3. What is the probable future course of the
disability (ies)?
If untreated, Mr. Gillespie rjsks irritation and
abuse with abrasion to the laryngeal tfssues, continued
irritation to the upper airway and mutual irritation and
possible infection to the oral and nasal mucosa due to the
uncontrolled exchange of cavity contents during every day
living activities.
4. Are there any work environments that must be
avoided?
If untreated, Mr. Gillespie must work in settings
that provide minimal irritants to the nasal, oral and
pharyngeal mucosa. He must avoid excessive drying of
those tissues and the linings of the larynx. He must not
shout, use his speaking voice in excess, or be exposed to
excessive or continual loud noise because of both the
hearing factor and the need to override the noise with use
of a loud voice.
5. will treatment ease, alleviate, or remove the
disability (ies)? If so, what treatment is recommended?
Treatments are available to alleviate the current
problems and remaining dysmorphologies that underlie the
problems cited above. However, the exact mode of
treatment requires an objective examination of Mr.
Gillespie's intra-oral, oro-nasal, and oro-pharyngeal
structures. The approach that has been suggested by the
Craniofacial Team at the Tampa Bay Craniofacial Center
includes the following steps.
A. - out patient hospitalization for nasendoscopy to
determine the present cause of immobility in the soft
tissue of the soft palate and to visualize the extent of
the nasopharyngeal gap. If the last surgical result has
modified over time, it mqy be desirable to surgically
modify the present condition by severing any tethering
tissue that is limiting palatal function. Prior or
sUbsequent to the hospital experience, a complete
aUdiological assessment would be helpful to rule out any
middle ear dysmorphologies connected with the congenital
problem. .
B. - Clini9al observation indicates that following
this careful, objective examination, Mr. Gillespie will
need surgical correction of (a) the anterior oronasal
fistula; (b) bone graft to complete the maxillary alveolar
arch; and (c) 'secondary palatoplasty to form a pharyngeal
flap to reduce the hypernasality. [Please note that the
order in which these are listed assure that the separation
of cavities, the continuation of the airway and the
skeletal support of soft tissue modification will prevent
any' future deterioration of these same tissues.] ,. ".,'
, . c.' :.-Following surgeries to correct all the current
interfering dysmorphologies, Mr. Gillespie will need to
'.' have sixmontlls of speech therapy to'assure' that he no
.'c longer over-activates his larynx and' learns to utilize
;. fully 'th.e're-confiqilred oral and oro";;pharyngeal ,,"
:: structures. '"," '
.. ,;':::;Due to his current physical disability Mr. Gillespie
is ':experiencing rejection in job applications . It is the
opinion of the Craniofacial Team that correction of the
'identified sequelae of the congenital dysmorphology, this
young may will be able to find employment in any current
or emerging job site that requires his type of skills. He
is competent in matters of business, and has a keen
interest in dealing with He may seek employment
in human service areas, personnel management, or
counseling whether in business or in some specialized area.,
of human communication. As a student at the University of
South Florida and a promising contributor to our
community, this young man needs support to pursue
. appropriate treatment for the remaining dysmorphologies of
his mouth, throat and face. ' .
Please let me know if I can be of further assistance
. to you in your efforts to provide the needed assistance to
Mr Gillespie.
t.."',
euerle, CCC-SLP
Professor
co-Director, Tampa Bay Craniofacial Center
m
OREGON
I-IEALTI-I SCIENCES UNIVERSIlY
CIIII..I) I)EVELOPMENT & REHAUIfJTA'Il0N CENTER
1'.0. Box Portland, Oregon 97207-0574
Services for G1., ildre1l u,itb Special J/eallb Needs
l}1lfl..ersity AjJUfated Plugrllll1
June I, 1994
RE: Neil Gillespie
This 38 year old I1lan has a repaired unilateral cleft lip and palate. His primary surgery was
done in Pennsylvania and he had SOITIe secondary work including a pharyngeal flap for
speech, in Florida.
Since speech treatlnent for serious hypernasality has been unsuccessful up to this point, the
patient came to Ine for consultation about a speech plan.
Examination shows objectionable hypernasality with moderate nasal emission of air which
markedly weakens all 16 air pressure phonemes. Use of the fiber-optic nasendoscope on May
26th verified that the pharyngeal flap, done three years ago (for speech), has pulled loose.
The treatment plan is to utilize a telnporary speech prosthesis (for circa two years) to
markedly obturate all sounds froln entering the nasal cavity. After normal oral resonance is
obtained and Inaintained for about four to five ITIonths, an obturator reduction program would
begin whereby the throat and palate 111usculature would be "challenged" by slowly making the
obturator sl11aller, in stages. At the end of approximately two years, it is expected that oral
nasal resonance anti oral air pressure would be close to normal limits and that pharyngeal and
palate 111usculalurc \vould have inlproved considerably. This is expected to nlake the patient's
velopharyngeal systenl nluch Inore anlenabie to a surgical procedure to substitute for the
speech prosthesis \vithout c0l11promising the patient's nasal airway.
Respectfully sublnitted,
Robert W. Blakeley, Ph.D.
Professor of Speech Pathology,
Director, Craniofacial Disorders Progralll

6.14
Craniofacial Center PO Box 100424
Health Science Center Gainesville, FL 32610-0424
Telephone: (352) 846-0801
Fax: (352) 846-1539
e-mail: Wiliiams@dentaLufLedu
Clinic Report: Videofluoroscopic assessment of the velopharyngeal port during
function for speech
Re: Neil Gillespie
Dental No.: 18-80-41
Medical No.: 10-44-032
This forty year old white male was seen on November 25, 1996 for a videofluoroscopic
assessment of his velopharyngeal port during function for speech. Mr. Gillespie is currently
wearing a speech bulb obturator, and his speech resonance frequently alternates between
hyponasality and hypernasality. The purpose oftoday's filming was to determine the size,
configuration and placement of the bulb in the nasal pharynx to determine if alteration of
these factors can improve his overall resonance quality. The nasal pharyngeal structures
were coated with a thin barium sulfate solution to aid in defining soft tissue contrast.
Records were obtained in the lateral and frontal (A-P) planes with and without the speech
bulb obturator.
Detailed analysis of the film revealed the following conditions:
1. Without the obturator the soft palate is mobile, demonstrating a movement pattern
appropriate to the several speech samples Jared produced. Although there is good velar
mobility, contact with the posterior pharyngeal wall is not achieved. That is!, a consistent gap
of 10 - 12 mm exists between the elevated velum and the posterior pharyngeal wall during
speech.
2. The depth of the nasopharynx, as measured along the palatal plane from the posterior
nasal spine to the posterior pharyngeal wall is 25 mm. This compares to the norm of 24 mm
2 mm/SD revealing Mr. Gillespie's nasopharyngeal depth to be well within normal limits
for his age.
3. The configuration of the posterior pharyngeal wall is nearly vertical above and below the
palatal plane, a pattern well within normal limits.
4. An A-P view revealed symmetrical mesial movement of the lateral pharyngeal walls
approximately 25 - 50% of the distance from rest to midline.
6.15
2
Neil Gillespie
Fluoroscopic assessment of VP Function for Speech
November 25, 1996
In summary, Mr. Gillespie presents with a speech pattern characterized by near normal
resonance but which frequently alternates between hyponasality and hypernasality. He is
currently wearing a speech bulb obturator and today's assessment revealed placement and
configuration to be near optimal.' Without the obturator, Mr. Gillespie's speech is
significantly hypernasal and although the velum elevates appropriately there remains a
consistent gap of 10 - 12 mm during speech. In order to further define whether any
improvement can be made to the speech bulb obturator or if a secondary surgical technique
might be a viable consideration, a nasendoscopic assessment should be conducted.
If I can be of any further assistance in the interpretation of this film please call me at (352)
8 : ; ~ ~ 1
W. N. Williams, Ph.D.
Speech-language Pathologist
cc:
Mr. Neil Gillespie
1121 Beach Drive, N.E.
Apt. C-2
81. Petersburg, FL 33701-1434
Mr. Glenn Turner
P.O. Box 100435 JHMHC
Dr. Brent Seagle
P.O.Box 100286 JHMHC
Medical, Dental, Center Records
o
]. Douglas Bremner, M.D.
Yale University Departments of Diagnostic Radiology and Psychiatry
School of Medicine
Diagnostic Imaging
Yale-New Haven Hospital
20 York Street
New Haven, Connecticut 06504
Yale Psychiatric Institute
POB 208038, Yale Station
New Haven, CT 06520
(203)737-5787 FAX7857855
email, j.bremner@yale.edu

8/14/97
Thank you for your interest in our research program on victims of childhood abuse al1d
the brain. If you or anyone else is interested, you can stay for free in our research unit and
obtain financial compensation which more than offsets travel expenses, as well as a
comprehensive diagnostic and biological assessment, including brain imaging. You can
call 203 737 5791 for information.
Also look at our web site at http://info.med.yale.edu/psych/org/ypi/traumaltauhome.htm
Thanks again.

M.D.
Assistant Professor of Diagnostic Radiology & Psychiatry
Yale University School of Medicine;
Research Physician, YaieNA PET Center,
VA Connecticut Healthcare System;
Director, Trauma Assessment Unit,
p{
tZ7J,.tl if)
ttJ7fi

t'lf ?"
'-1.12
6.16
o
ABC Evening News, Health Report, August 18, 1997. Peter Jennings introduces,
Growing up damaged - by John McKenzie, ABC News - (JM)
JM - It is a time ofadventure, a time ofdiscovery. It's long been known that what
children see, and hear, and feel, can have a powerful impact on their development. But
only now are scientists beginning to understand just how powerful
Dr. Dorothy Lewis, New York University: We realize that the consequences actually can
affect the brain's anatomy, the structure ofthe brain itself: and then it can affect the way in
which the child adapts for the rest ofhis life.
JM - At Yale University scientists are conducting pioneering research on the
effects of child abuse;
Dr. Douglas Bremner, Yale University: Being physically injured, having broken bones,
bruises, trips to the hospital, having objects thrown at them, sexually assaulted by
relatives.
JM - Researchers discovered that kind ofabuse produces physical changes in the
brain, including one area called the left Hippocampus. Researchers found the abuse results
in the Hippocampus actually shrinking, and by as much as 20 percent. For victims the
affects can be profound.
Dr. Douglas Bremner, Yale University: They have behavioral problems, they have
increased aggression, they can't form lasting relationships, they have trouble keeping jobs,
they intrusive memories and night mares that make it almost impossible for them to lead a
normal life.
JM - Scientists believe that repeated abuse causes stress in the child, and the
production of stress hormones. Too much ofthese hormones can damage, even kill nerve
cells in the brain. And scientists are discovering the abuse need not be physical.
Researchers affiliated with Harvard University tested people who had been subjected as
children to severe psychological abuse, subjected to repeated screaming, and yelling, and
harsh critical language. The results were startling. Guxtaposed brain scan images appear)
This is a scan ofa health brain, and this from someone who was verbally abused as a child.
Although subtle, you can actually see a difference. Right here in the pathway linking the
left and right hemispheres ofthe brain. In the abused, the area is smaller, narrower; that
can lead to hyperactivity and impulsive behavior. And the effects appear lasting.
Researchers find these brain abnormalities in adults well into their forties and fifties.
Dr. Dorothy Lewis, New York University: And its something that we don't know ifwe
can reverse.
JM - Revealing evidence that a child's brain may be much more vulnerable than
ever imagined. John McKenzie, ABC News, New Haven, Connecticut. (end).
August 22, 1997
Dr. Douglas Bremner
PET Center
950 Campbell Avenue, lISA
West Haven, CT 06516
Dear Dr. Bremner,
McKenzie entitled "Growing up damaged." I am interested in additional information about
the subject, including diagnostic recommendations.
age 41 I am currently disabled with "mental health issues," but I do not believe an accurate
diagnosis has been made in my case.
Having earned a BA in psychology, my understanding ofbrain development
suggested the possibilities reported by the ABC News Health Report. However I have not
been able to locate a practitioner knowledgeable about this condition, or willing to
perform a bran scan. Your suggestions are appreciated.
Thank you again for your consideration.
Sincerely,
@[?))1
Neil J. Gillespie
1121 Beach Drive NE, apt. C-2
(813) 823-2390
o
September 17, 1997
J. Douglas Bremner, MD
Assistant Professor ofDiagnostic Radiology & Psychiatry
Yale University School ofMedicine;
Research Physician, YaleNA PET Center,
VA Connecticut Healthcare System;
Director, Trauma Assessment Unit,
POB 208038, Yale Station
New Haven, CT 06520
Dear Dr. Bremner,
Thank you for your letter and accompanying information about Post Traumatic
Stress Disorder (PTSD). Pursuant to your offer ofa comprehensive diagnostic and
biological assessment, including brain imaging, I would like to schedule an appointment.
Last Friday I spoke briefly with Susan Insell at the number you provided (203-737
5791). Ms. Insell was unable to offer any definitive information. Kindly advise when this
appointment could be scheduled.
Thank you again for your consideration and patience.
Sincerely,
(Q)[?JW
Neil J. Gillespie
(813) 823-2390
9-I Z fj 7 e z: l.f",
Sou';'"",,", - s'-<- A -k.eNe..( )-fy Ikue.....
- sle r; <fA+- 0/ /1,0)'(
/Is Ie/.. /Ji<. /Jf<c,<-tP4) .Le H4-) u-III 5/"'.4. )"cl .....
&R..iJ.. bAd !15U '1t/,t',;./'_5 /1&Jf J};/Jf ,f.
NYU
Medical
Center
550 First Avenue, ~ ~ ~ I ~ Y ~ o ~ 1 514
Cable Address: NYUMEDIC
Department of Psychiatry
(212) 263
6208
September 4. 1997
1121 Beach Drive NE, Apt. C-2
Dear Mr. Gillespie:
Thank you for your letter of August 22,1997. Unfortunately I do not know of
someone in your area who specializes in the complications of craniofacial
disorders. I am sorry I cannot be of more help.
Sincerely.
Dorothy 0 now Lewis. M.D.
Professor
DOL/vh

6.17
o
ABC Evening News, Health Report, August 18, 1997. Peter Jennings introduces,
Growing up damaged - by John McKenzie, ABC News - (JM)
JM - It is a time ofadventure, a time ofdiscovery. It's long been known that what
children see, and hear, and feel, can have a powerful impact on their development. But
only now are scientists beginning to understand just how powerful
Dr. Dorothy Lewis, New York University: We realize that the consequences actually can
affect the brain's anatomy, the structure ofthe brain itself: and then it can affect the way in
which the child adapts for the rest ofhis life.
JM - At Yale University scientists are conducting pioneering research on the
effects of child abuse;
Dr. Douglas Bremner, Yale University: Being physically injured, having broken bones,
bruises, trips to the hospital, having objects thrown at them, sexually assaulted by
relatives.
JM - Researchers discovered that kind ofabuse produces physical changes in the
brain, including one area called the left Hippocampus. Researchers found the abuse results
in the Hippocampus actually shrinking, and by as much as 20 percent. For victims the
affects can be profound.
Dr. Douglas Bremner, Yale University: They have behavioral problems, they have
increased aggression, they can't form lasting relationships, they have trouble keeping jobs,
they intrusive memories and night mares that make it almost impossible for them to lead a
normal life.
JM - Scientists believe that repeated abuse causes stress in the child, and the
production of stress hormones. Too much ofthese hormones can damage, even kill nerve
cells in the brain. And scientists are discovering the abuse need not be physical.
Researchers affiliated with Harvard University tested people who had been subjected as
children to severe psychological abuse, subjected to repeated screaming, and yelling, and
harsh critical language. The results were startling. Guxtaposed brain scan images appear)
This is a scan ofa health brain, and this from someone who was verbally abused as a child.
Although subtle, you can actually see a difference. Right here in the pathway linking the
left and right hemispheres ofthe brain. In the abused, the area is smaller, narrower; that
can lead to hyperactivity and impulsive behavior. And the effects appear lasting.
Researchers find these brain abnormalities in adults well into their forties and fifties.
Dr. Dorothy Lewis, New York University: And its something that we don't know ifwe
can reverse.
JM - Revealing evidence that a child's brain may be much more vulnerable than
ever imagined. John McKenzie, ABC News, New Haven, Connecticut. (end).
August 22, 1997
Dr. Dorothy Lewis
Dissociative Disorders Clinic
New York University Medical Center
540 1st Avenue
New York, NY 10016
(212) 263-6208
Dear Dr. Lewis,
McKenzie entitled "Growing up damaged." I am interested in additional information about
the subject, including diagnostic recommendations.
age 41 I am currently disabled with "mental health issues," but I do not believe an accurate
diagnosis has been made in my case.
Having earned a BA in psychology, my understanding ofbrain development
suggested the possibilities reported by the ABC News Health Report. However I have not
been able to locate a practitioner knowledgeable about this condition, or willing to
perform a bran scan. Your suggestions are appreciated.
Thank you again for your consideration.
Sincerely,
( Q ) ~ W
Neil J. Gillespie
(813) 823-2390
Velopharyngeal inadequacy
Classification and external resources
ICD-9 528.9 (http://www.icd9data.com
/getICD9Code.ashx?icd9=528.9)
eMedicine ent/596 (http://www.emedicine.com
/ent/topic596.htm)
MeSH D014681 (http://www.nlm.nih.gov
/cgi/mesh/2011/MB_cgi?field=uid&
term=D014681)
From Wikipedia, the free encyclopedia
(Redirected from Velopharyngeal incompetence)
Velopharyngeal inadequacy (VPI) is a malfunction of a
velopharyngeal mechanism.
The velopharyngeal mechanism is responsible for directing
the transmission of sound energy and air pressure in both the
oral cavity and the nasal cavity. When this mechanism is
impaired in some way, the valve does not fully close, and a
condition known as 'velopharyngeal inadequacy' can develop.
VPI can either be congenital or acquired later in life.
1 Terminology
2 Relationship to cleft palate
3 Classification
4 Causes
5 Treatment
6 References
7 External links
Different terms can be used to describe this phenomenon in addition to velopharyngeal inadequacy. These
terms and definitions are as follows:
Velopharyngeal insufficiency: The inability of the velopharyngeal sphincter to sufficiently separate the
nasal cavity from the oral cavity during speech.
Velopharyngeal incompetency: When the soft palate and the lateral/posterior pharyngeal walls fail to
separate the oral cavity from the nasal cavity during speech.
Although the definitions are similar, the etiologies correlated with each term differ slightly; however, in the field
of medical professionals these terms are typically used interchangeably. Velopharyngeal inadequacy is the
generic term most often used to describe the functionality of the velopharyngeal valve.
A cleft palate is one of the most common causes of VPI. Cleft palate is an anatomical abnormality that occurs in
utero and is present at birth. This malformation can affect the lip, the lip and palate, or the palate only. A cleft
palate can affect the mobility of the velopharyngeal valve, thereby resulting in VPI.
Velopharyngeal inadequacy - Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Velopharyngeal_incompetence
1 of 3 7/29/2012 8:08 AM
7
The most frequent types of cleft palates are overt, submucous, and occult submucous.
While cleft is the most common cause of VPI, other significant etiologies exist. These other causes are outlined
in the chart below:
VPI flow chart compiled from the following sources: Johns, Rohrich & Awada, 2003 and
Peterson-Falzone, Karnell, Hardin-Jones,& Trost-Cardamone, 2005
A common method to treat Velopharyngeal insufficiency is pharyngeal flap surgery, where tissue from the back
of the mouth is used to close part of the gap. Other ways of treating velopharyngeal insufficiency is by placing a
posterior nasopharyngeal wall implant (commonly cartilage or collagen) or type of soft palate lengthening
procedure (i.e. VY palatoplasty).
Conley SF, Gosain AK, Marks SM, Larson DL (1997). "Identification and assessment of velopharyngeal
inadequacy". Am J Otolaryngol 18 (1): 3846. DOI:10.1016/S0196-0709(97)90047-8 (http://dx.doi.org
/10.1016%2FS0196-0709%2897%2990047-8) . PMID 9006676 (//www.ncbi.nlm.nih.gov/pubmed
/9006676) .
Johns DF, Rohrich RJ, Awada M (2003). "Velopharyngeal incompetence: a guide for clinical evaluation".
Plast. Reconstr. Surg. 112 (7): 18907; quiz 1898,1982. DOI:10.1097/01.PRS.0000091245.32905.D5
2 of 3 7/29/2012 8:08 AM
(http://dx.doi.org/10.1097%2F01.PRS.0000091245.32905.D5) . PMID 14663236
(//www.ncbi.nlm.nih.gov/pubmed/14663236) .
McWilliams, Betty Jane; Peterson-Falzone, Sally J.; Hardin-Jones, Mary A.; Karnell, Michael P. (2001).
Cleft palate speech. St. Louis: Mosby. ISBN 0-8151-3153-4.
Hardin-Jones, Mary A.; Peterson-Falzone, Sally J.; Judith Trost-Cardamone; Karnell, Michael P. (2005).
The Clinician's Guide to Treating Cleft Palate Speech. St. Louis: Mosby-Year Book.
ISBN 0-323-02526-9.
Willging JP (1999). "Velopharyngeal insufficiency". Int. J. Pediatr. Otorhinolaryngol. 49 Suppl 1:
S3079. DOI:10.1016/S0165-5876(99)00182-2 (http://dx.doi.org
/10.1016%2FS0165-5876%2899%2900182-2) . PMID 10577827 (//www.ncbi.nlm.nih.gov/pubmed
/10577827) .
Several Examples of Velopharyngeal Inadequacy (http://www.FauquierENT.net/voicenasal.htm)
Retrieved from "http://en.wikipedia.org/w/index.php?title=Velopharyngeal_inadequacy&oldid=496889991"
Categories: Congenital disorders
This page was last modified on 10 June 2012 at 11:56.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may
apply. See Terms of use for details.
Wikipedia is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
3 of 3 7/29/2012 8:08 AM
The Evergreen State College
Olympia, Washington
Psychosocial Implications of Congenital Craniofacial Disorders
Lifespan Developmental Psychology
Jerry Shulenbarger, Ph.D, faculty
Winter quarter, 1995
"I just wanna be normal Doctor, give me that old fashioned normality"
--Actress Uma Thurman as Sissy Hankshaw pleading
to Dr. Dreyfus in the film "Even Cowgirls get the Blues"
Submitted by Neil J. Gillespie
8
Dedication
To Dr. Robert W. Blakeley
Professor of Speech Pathology
Director, Craniofacial Disorders Program
Oregon Health Sciences University
Child Development & Rehabilitation Center
Thank you
Your effort and treatment on my behalf have
given me the voice to make this oral presentation
Table of Contents
Page 1 Introduction
Page 2 Birth
Page 6 Freud
Page 7 Hi story
Page 9 Teasing
Page 12 Speech
Page 15 Bibliography
Final Page Reasearch Outline
Introduction
My interest in the subject of the psychosocial
implications of congenital craniofacial anomalies is
personal. I am afflicted with a unilateral cleft lip and
palate. I welcome the opportunity to write and speak on the
subject to promote further public understanding. The
process also provides me with greater self-awareness.
This report will focus on persons with congenital
anomalies as opposed to acquired disfigurement. Acquired
craniofacial disfigurement results from accidents, fires and
illness. The psychosocial implications for each group vary
and I will note them throughout the report.
My presentation will include photographs of persons
with various examples of craniofacial disorders. Unlike
other disabilities, facial disfigurement is to a large
extent visual, and a picture really is worth a thousand
words.
I will begin this paper with the story of a young
mother and the birth of her son. I'll also discuss Freudian
implications, historical background, the subject of teasing
and speech concerns.
In America, about 4 million babies are born each year.
Between the 7th and 8th week of gestation, the nasomedial
process completes the fusing of the philtrum of the lip.
This fails to occur in about 1 of every 700 live births,
resulting in about 5,700 new cleft cases per year.
Page-l
Birth, the beginning of mother-child relationship
I would like to begin this project by considering the
thoughts of a young mother, Rita Brzozowski, and her
reaction to the birth of her son, Adam. Rita's story
appeared in the May/June 1992 issue of AboutFace, a
craniofacial support group newsletter. Rita begins,
"For most people, having their first child is
an exciting event. There are the usual
concerns about what could go wrong, but a
normal, healthy baby is expected. When our
first child, Adam, was born this was not the
case. It started with a discernible hush in
the delivery room. "Just a hare lip",
replied my obstetrician. Not able to see the
baby's face, I tried to recall anything I
knew about this condition ... When I saw him,
my heart sank. This was not the perfect baby
I had envisioned - the one with the rosy
checks, delicate lips and upturned nose.
This baby's face was disfigured ... As I held
my newborn son, all I could see was this
defect ... I felt I was in a dream and held
someone else's child."
Later Rita would say, "My ego had suffered a major
blow. I did not feel pride in showing my baby to others.
Even a trip to the pediatrician was a challenge to my pride
Page-2
and vanity. In the waiting room I would keep Adam's face
hidden over my shoulder."
My information indicates that Rita's experience is not
unusual. Brantley and Clifford (1979b) found that mothers
of children with cleft lip and/or palate reported
significantly greater negative recollections of the
postnatal period than mothers of normal children. Other
reactions have been more negative, including abandonment of
the child. This is particularly true in Russia (Blakeley),
Korea and to a lesser extent, China (Li). All of this
information points to an important fact: The interaction
between mother and child is a critical factor in determining
the psychological adjustment of these children.
A recent study entitled The Role of Maternal Factors in
the Adaptation of Children with Craniofacial Disfigurement
was completed at Harvard Medical School and Children's
Hospital, Boston, MA (Campis, DeMaso, Twente, 1993) and
reported in The Cleft Palate-Craniofacial Journal (January
1995). This study hypothesized that maternal adjustment,
perceptions, and social support would better predict child
adaptation to craniofacial disfigurement than medical
severity. Of the 77 children (ages 6-12) in the study, 33
had cleft lip and/or palate, the other 44 had a more severe
deformity. The study found that maternal adjustment and
maternal perceptions of the mother-child relationship were
more potent predictors of children's emotional adjustment
than either medical severity or maternal social support.
This study also reported that the degree of facial
Page-3
disfigurement had no relationship to child or maternal
perceptions, but that having a comorbid severe medical
condition was related to greater behavior problems in
children. This study cited nine prior studies which
indicated that children with craniofacial disfigurement have
difficulties in psychological adjustment and two studies to
the contrary. The study also cited other conflicting
information in almost every category. The major limitation
of this study was that the evaluation of child adjustment
relied on parent report. Also, with a predominance of upper
SES families in this study, caution is the word regarding
generalization of findings.
Another study I found was done at the University of
Washington School of Medicine in Seattle, entitled
"Psychological Functioning of Children with Craniofacial
Anomalies and Their Mothers: Follow-up from Late Infancy to
School Entry" (Speltz, Morton, Goodell, Clarren, 1992). In
this study, 23 mothers and their 5- to 7-year old children
with craniofacial anomalies (CFA) who were assessed in an
earlier study (Speltz, et al., 1990) were followed. Despite
the small sample size and high rate of control-group
attrition, this study is important because longitudinal
research on the psychological development of CFA children
and adolescents is almost nonexistent. The results of this
study indicated that a (1) a sizable minority (18%) of the
children with CFA had clinically significant behavior
problem scores; (2) individual differences of CFA children
were predicted by observational measures of earlier mother
Page-4
infant interaction; (3) mothers of CFA children with visible
defects reported less favorable social support than mothers
of CFA children without visible defects.
One interesting aspect of this survey was that the
potential predictor variables used were based on
observational measures of mother-infant play and teaching
interactions. These measures are infrequently used in CFA
psychological research despite their widespread application
in other areas of developmental psychology. Also, mothers
of CFA children reported higher levels of emotional distress
and greater marital conflict than controls, as reported on
standardized questionnaires. In the Child Behavior
Checklist (CBCL) portion of this study, girls with CFA had
mean scores above the 85th percentile for their normative
group, but boys with CFA had mean scores very near their
normative average. In addition 18% of the CFA children had
CBCL scores above the 95th percentile, indicating the need
for clinic-referral for psychiatric problems (compare with
non-CFA children at considerably less than 5%). The
researchers suggested that the mother's child-directed
orientation during play with her infant or toddler may
predict maternal behavior problem reports up to 4 years
later; higher levels of child-directed play skill were
associated with lower subsequent CBCL scores.
As we have seen from the foregoing information, there
are early psychological implications for persons with
congenital craniofacial anomalies. Juxtaposed with acquired
disfigurement in later life, these implications are unique.
Page-5
Freudian Considerations
From a Freudian psychosexual developmental perspective,
cleft lip and palate offers some interesting considerations.
These considerations involve the first psychosexual stage,
the Oral Stage.
"According to the theory, from birth to age one, the
mouth, tongue, and gums are the focus of pleasurable
sensations in the baby's body, and feeding is the most
stimulating activity." (Berger, 1994)
Feeding an infant with cleft lip and palate presents a
challenging set of physical circumstances. "Children with a
cleft palate cannot create sufficient negative pressure to
suck milk, which is expressed from the nipple between the
upper and lower gum pads, because of the absence of a
palatal seal" (Berkowitz, 1994). One mother described each
feeding of her cleft palate infant as a "nightmare"
(AboutFace January/February 1993).
In addition to feeding problems, surgery of the lip,
palate and gums of an infant presents an opportunity for
pain and trauma. Presurgical orthopedic alignment
procedures as well as postsurgical concerns are another
source of possible interference with oral stage development.
In addition postsurgical feedings are sometimes especially
difficult.
I feel that the above issues place an afflicted infant
"at risk" for possible oral stage fixation. This is not a
concern with craniofacial disfigurement acquired later in
life.
Page-6
Historical Perspective
Dr. Benjamin M. Spock, in his latest book A Better
World For Our Children, provides a poignant example of the
negative attitudes confronting persons with congenital
deformities. On page 21 of his book, Dr. Spock relates a
story told by his mother and the impact the remarks made on
him. "She taught us that sinful thoughts were as harmful as
deeds, and to touch ourselves "down there" was not just
sinful but might cause birth defects in our children. After
four years of medical school and four residencies, I thought
I had long outgrown such teachings, but I recall when our
first child was born I returned from the hospital's nursery
to my wife's room to exclaim happily, "Mike has ten fingers
and ten toes!"
Attorney Allen Fagin spoke at the 1992 NFFR Conference
on facial disfigurement and noted that until recently a
number of major American cities had "ugly laws" that imposed
fines on "unsightly" people who were seen in public places.
An example was the Chicago municipal code which, until 1974,
fined persons who appeared in public who were "diseased,
maimed, mutilated or in any way deformed, so as to be an
unsightly or disgusting object".
In addition, I found examples dating from Medieval
England. One example dating from the late eleventh or
twelfth century is the first evidence for both cleft lip and
palate in British archaeology. "Despite the inability to
breast-feed, and the possible social stigma, the individual
had survived into adulthood" (CPJ).
Page-7
Another example is found in documentary evidence from
sixteenth century Kent. The document, with an illustration
of the child, is dated 1568. This document is interesting
for two reasons. While descriptive of the facial cleft, the
document clearly repudiates the child's mother for being
unmarried. The headline of the document proclaims "The
forme and shape of a monstrous child", and describes the
cleft lip as "the mouth slitted on the right side, like a
Libardes [lizard's] mouth, terrible to beholde". The
document also proclaims "A warnying to England", describes
the mother, one Marget Mere as, " ... being unmaryed, played
the naughty packe, and was gotten with childe ... " The
document suggest that this deformed child should be a
warning to those indulging in a sinful life, and thus move
them to repentance.
Page-8
"Teasing"
I'd like to begin this section with a brief quote from
the book "Beauty is the Beast, Appearance-Impared Children
in America", by Ann Hill Beuf. "On Monday, March 1, 1988,
an American sixth-grade student walked into his elementary
school classroom and shot himself. He did this because his
classmates had teased him about being overweight". Clearly
the time has come to address the problem of "teasing".
The first step in confronting the issue of "teasing" is
to give this activity a more appropriate name: Verbal
Assault, based on disability or appearance.
In a sense, it is easy to understand why children
verbally assault those who look different. As Dr. McCurdy
states in his book "The Complete Guide to Cosmetic Surgery",
"Young children are extremely perceptive of differences in
appearance, and, as they are relatively uninhibited in their
social interactions, such differences are freely pointed
out" .
Sociologist Macgregor notes that derisive laughter is
also a potent and destructive force. She writes "These
reactions to derisive laughter appear to be universal. The
Hopi Indians, well aware of its effect, could and did
deliberately drive an offender in the community to insanity
by the simple punishment of laughing at him".
Two other groups of unlikely offenders are health care
providers and teachers. "When a child is born with impaired
appearance, many hospital staff members employ the term
F.L.K. ("funny looking kid") to describe the infant to one
another (Beuf). "Use of the "F.L.K." term constitutes an
Page-9
act of objectification. So does any use of language that
refers to the child by his or her disorder such as "the
cleft palate in room 320" (Beuf). "That is, by focusing on
the master-status of "person-with-impai red-appearance " and
thus ignoring the traits possessed by the child as an
individual, the stigmatizer manages to reduce the victim to
the position of a thing rather than a person" (Beuf).
Trivialization was used by some doctors to remind the
children of people who were worse off than they were, with
comments such as, "You're lucky you don't have cancer."
Surely doctors do not set out to wound the feelings of their
young patients, but they have been taught in medical school
to judge the seriousness of a medical problem in terms of
its life-threatening nature.
In a New York Times story on physical disfigurement,
author Jill Krementz said that while many of the disfigured
children she interviewed received support from their peers,
a few were teased mercilessly or even attacked by
schoolmates because of how they look. "The only children
who had a really painful time from their peers were the ones
who had facial disfigurements," Ms. Krementz said, adding
that children who are missing limbs or have other
disabilities are more likely to receive comments on how well
they are doing.
Krementz's observations have been noted by Macgregor
who states;
" ... there are two other handicapping aspects
associated with dento-facial deformity. In the
Page-IO
first place, the area in and around the mouth is
both emotionally charged and strongly connected
with one's self-image. As an instrument of speech
and eating, as well as a mirror of emotions, it
also has unique social and psychological
implications and symbolic meaning. Any
abnormality in this area, therefore, is not only
highly visible and obtrusive but - as research has
shown - tends to evoke a type of aversion which is
both esthetic and sexual.
Teachers are another source of problems for afflicted
children (The Providence Sunday Journal). Examples cited by
Beuf include a teacher ridiculing a student who lost a
contact lense and another who's home-room teacher didn't see
the harm of a student being called "Dumbo ears" because of
protruding ears.
Legislation such as the American's with Disabilities
Act, the Rehabilitation Act of 1973, and the recently passed
Washington State bill # 5474 on Disability Discrimination
should be utilized to prevent the abuses cited in this
section. Parents must be willing to fight for their child,
Beuf emphasized, "and why they don't is sometimes a
mystery" .
Page-II
Speech
Speech is a mirror of the soul; as a man speaks, so is he.
Publilius Syrus, circa 42 B.C.
Speech is a concern that separates cleft palate from
some other craniofacial disorders. The psychological
implications of speech present challenges to the afflicted
individual from infancy through adulthood.
Cleft palate children are at risk for language
development problems. A screening device to address this
issue was the subject of a recent study. The "Parent
Questionnaire for Screening Early Language Development in
Children with Cleft Palate" is the title of the paper.
Thirty subjects, 16 to 30 months of age received the
MacArthur Communicative Development Inventory: Toddler
(CDI:Toddler). A control group was also tested. Both
groups received a speech language screening. Results
indicated that the CDI:Toddler was a valid screener of
language development.
The cleft group demonstrated evidence of delays in
expressive language development. The cleft group had a mean
vocabulary of 177 words, compared with 288 words for the
control group. The cleft group used shorter, less complex
sentences. Intelligibility was poorer in the cleft group.
Within the cleft group, hypernasality ratings of moderate
and severe were associated with expressive language delays.
Page-12
Adult cleft palate populations are also at risk for
impaired speech concerns, when related to employment, as
demonstrated by two studies. "From a psychological
standpoint Neiman and Duncan emphasized the importance of
speech. This study revealed that speech was the single
factor that adversely affected the selection of prestigious
jobs even in the presence of a facial disfigurement. It
would appear that speech should be given top priority."
(Lehman, Jr., MD, 1993)
I spoke with Dr. Lehman about this study, where photos
of persons with both unilateral and bilateral cleft lip and
palate were shown to a personnel manager. Also presented
were tape recorded voices, both normal and hypernasal
speech. The hypernasal speech was much less likely to be
viewed as having the communication skills needed in the
marketplace.
Another study was conducted by Dr. Jane Scheuerle at
the Tampa Bay Craniofacial Center. In this test adult cleft
palate subjects voices were tape recorded, both preoperative
and postoperative. The recorded voices were presented to a
panel of three business persons for evaluation as employees.
The results favored the postoperative voices unanimously.
Adult speech issues were also noted at the First
International Symposium for Long Term Treatment in Cleft Lip
and Palate at the University of Bern, Switzerland. "When an
adult does not speak correctly, those around him notice it
immediately, and speculate whether or not the affected
person is of normal intelligence. For this reason, we feel
Page-13
that correct speech has many important consequences." (J.
Weissen, 1979) "From the beginning our team considered
speech evaluation and speech therapy as most important,
because receptive speech, i.e. that which one hears, is
dependent on the entire environment (i.e. 360 degrees) as
opposed to the operative cosmetic result which is only
visual, i.e. maximal field of 180 degrees." (Weissen
& M. Bettex, 1979)
Goffman's view of craniofacial handicapping conditions
expressed the subject especially well. "The closer the
defect is to the communication equipment upon which the
listener must focus his attention, the smaller the defect
needs to be to throw the listener off balance. These
defects tend to shut off the afflicted individual from the
stream of daily contacts, transforming him into a faulty
interactant, either in his eyes or in the eyes of others".
Sigmund Freud was an individual who suffered acquired
speech impairment. In April, 1923, Freud underwent surgery
for palatal cancer. More operations followed in the fall
and Freud was compelled to wear a prosthesis. He had
trouble speaking and was rarely free of discomfort (Gay).
Page-14
Bibliography
1. Robert W. Blakeley, Ph.D., Professor of Speech
Pathology, Director, Craniofacial Disorders Program,
Oregon Health Sciences University, CDRC, Portland, OR
Personal communication and photographs.
2. The Cleft Palate-Craniofacial Journal (CPJ),
January 1995, Volume 32, number 1, American Cleft
Palate-Craniofacial Association (ACPA). "The Role of
Maternal Factors in the Adaptation of Children with
Craniofacial Disfigurement" by Leslie Campis, Ph.D.,
David Ray DeMaso, M.D., and Allison White Twente, Ph.D.
3. CPJ, January 1995, Volume 32, number 1, ACPA, "Parent
Questionnaire for Screening Early Language Development
in Children with Cleft Palate" 1993, Nancy Scherer, Ph.D
and Linda L. D'Antonio, Ph.D.
4. CPJ, November 1994, Volume 31, Number 6, ACPA, "Medieval
Example of Cleft Lip and Palate from St. Gregory's
Priory, Canterbury", by Trevor Anderson, M.A.
5. CPJ, September 1993, Volume 30, Number 5, ACPA,
"Psychological Functioning of Children with
Craniofacial Anomalies and Their Mothers:
Follow-Up from Late Infancy to School Entry" by
Matthew L. Speltz, Ph.D., Kathi Morton, Ph.D.,
Elizabeth W. Goodell, Ph.D., Sterling K. Clarren, M.D.
Page-IS
6. Dr. Benjamin M. Spock, "A Better World For Our Children"
National Book Network, 1994
7. National Foundation For Facial Reconstruction (NFFR),
Conference Proceedings of 11/18/92, "Special Faces:
Understanding Facial Disfigurement."
8. AboutFace newsletter, May/June 1992, Vol. 6, No.3,
Rita Brzozowski, "A Mother's First Lesson", cover story.
9. Weissen, J., Speech Therapist, Department of Pediatric
Surgery, Inselspital, CH-3010 Berne. Proceedings of the
First International Symposium, Long Term Treatment in
Cleft Lip and Palate, August, 1979, University of Bern,
Switzerland.
10 Jim Lehman, Jr., MD, AboutFace Newsletter, March/April,
1993, "Ask a Professional" column and personal
communication.
11 Ningyi Li, MD, DDS, Professor and Chairman, Department
of Stomatology, Qingdao University Medical College and
Hospital, Qingdao, Shandong, The Peoples Republic of
China. Personal communication.
12 The Complete Guide to Cosmetic Facial Surgery,
John A. McCurdy, Jr., MD FACS, 1981, Frederick Fell
Publishers, Inc.
Page-16
13. Ann Hill Beuf, "Beauty is the Beast; Appearance
Impaired Children in America", 1990, University of
Pennsylvania Press.
14. Kathleen Stassen Berger, liThe Developing Person Through
the Life Span", third edition, 1994, Worth Publishers
15. Samual Berkowitz, DDS, MS, FICD, liThe Cleft Palate
Story", 1994, Quintessence Publishing Co., Inc.
16. The New York Times, Thursday, October I, 1992, "Parent
& Child" by Lawrence Kutner.
17. Frances Cooke Macgregor, M.A., Social and Psychological
Implications of Dento-Facial Disfigurement, 1969
18. The Providence Sunday Journal, October 7, 1990, by
Rosemary Jones of the Allentown Morning Call.
19. Thurston County Works in Progess, November 1994,
Legislative Report Card, Disability bill
20. Cleft Palate and Cleft Lip: A Team Approach to Clinical
Management and Rehabilitation of the Patient. 1979,
W.B. Saunders Company
21. Sigmund Freud, Introductory Lectures on Psycho-Analysis
Page-17
1966, W.W. Norton & Company, Inc., Peter Gay, intra.
22. Dr. Jane Scheuer1e, Co-Director, Tampa Bay Craniofacial
Center, Tampa, Florida, personal communication 1993.
23. Goffman, E., Alienation from interaction, Human
Relations, 1957.
Page-18
Dr. Blakeley is a pioneer in the use of speech obturators to correct velopharyngeal
incompetence, the hypernasal speech associated with cleft palate.
April, 1994 Multnomah Athletic Club, Portland, Oregon
right: Dr. Robert W. Blakeley, Ph.D, Speech Pathologist
left: Neil Gillespie, age 38
My speech obturator made at Oregon Health Sciences University (OHSU)
under the direction of Dr. Blakeley.
m
OREGON
I-IEALTI-I SCIENCES UNIVERSIlY
CIIII..I) I)EVELOPMENT & REHAUIfJTA'Il0N CENTER
1'.0. Box Portland, Oregon 97207-0574
Services for G1., ildre1l u,itb Special J/eallb Needs
l}1lfl..ersity AjJUfated Plugrllll1
June I, 1994
RE: Neil Gillespie
This 38 year old I1lan has a repaired unilateral cleft lip and palate. His primary surgery was
done in Pennsylvania and he had SOITIe secondary work including a pharyngeal flap for
speech, in Florida.
Since speech treatlnent for serious hypernasality has been unsuccessful up to this point, the
patient came to Ine for consultation about a speech plan.
Examination shows objectionable hypernasality with moderate nasal emission of air which
markedly weakens all 16 air pressure phonemes. Use of the fiber-optic nasendoscope on May
26th verified that the pharyngeal flap, done three years ago (for speech), has pulled loose.
The treatment plan is to utilize a telnporary speech prosthesis (for circa two years) to
markedly obturate all sounds froln entering the nasal cavity. After normal oral resonance is
obtained and Inaintained for about four to five ITIonths, an obturator reduction program would
begin whereby the throat and palate 111usculature would be "challenged" by slowly making the
obturator sl11aller, in stages. At the end of approximately two years, it is expected that oral
nasal resonance anti oral air pressure would be close to normal limits and that pharyngeal and
palate 111usculalurc \vould have inlproved considerably. This is expected to nlake the patient's
velopharyngeal systenl nluch Inore anlenabie to a surgical procedure to substitute for the
speech prosthesis \vithout c0l11promising the patient's nasal airway.
Respectfully sublnitted,
Robert W. Blakeley, Ph.D.
Professor of Speech Pathology,
Director, Craniofacial Disorders Progralll

r? . CC.
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These images were found online and added August 3, 2012 under fair use for illustrative purposes.
The Evergreen State College
Olympia, Washington
Freuds Oral Psychosexual Theory
and Craniofacial Disorders
FREUD AND PHILOSOPHY
Alan Nasser, Ph.D, faculty
Winter quarter 1995
Submitted by Neil J. Gillespie
Page - 1
This paper considers Freud's oral psychosexual theory and persons with a
craniofacial disorder. Information is presented in four sections, followed by my
conclusion.
1. Infantile Sexuality
The Freudian oral psychosexual stage begins at birth. "The mouth, tongue, and
gums are the focus of pleasurable sensations in the baby's body, and feeding is the most
stimulating activity" (Berger). Freud notes that the "[M]ost striking feature of this sexual
activity is that the instinct is not directed towards other people, but obtains satisfaction
from the subject's own body. It is auto-erotic..." (Freud, Three Essays). Freud goes on to
say that, "It was the child's first and most vital activity, his sucking at his mother's breast,
or at substitutes for it, that must have familiarized him with this pleasure. The child's lips
in our view, behave like an erotogenic zone, and no doubt stimulation by the warm flow
of milk is the cause of the pleasurable sensation" (Freud, Three Essays). So, Freud
asserts an oral erotogenic zone and suggests that the flow of warm milk causes a
pleasurable sensation in this zone. His theory states that, "The sexual aim of the infantile
instinct consists in obtaining satisfaction by means of an appropriate stimulation of the
erotogenic zone which has been selected in one way or another" (Freud, Three Essays).
2. Craniofacial Disorder
For this paper I use the craniofacial disorder cleft lip and palate. The etiology of
this congenital disorder occurs between the 7th and 8th week of gestation, with a fusion
failure during the nasomedial process (Patten). The resulting disorder presents an oral-
nasal fistula, often with premaxilla protrusion. In layman's terms this means that the
afflicted individual, internally, has a hole in the palate, or roof of the mouth, resulting in
an unnatural opening between the mouth and nose. Externally, the afflicted individual
Page - 2
has a facial deformity, where the openings of mouth and nose are conjoined. Sometimes
the upper gum line protrudes from this opening (premaxilla protrusion). The afflicted
individual almost always experiences feeding problems and surgical trauma.
3. Clinical Observations.
Feeding an infant with a cleft presents a challenging set of circumstances.
Dr. Berkowitz notes that Children with a cleft palate cannot create sufficient negative
pressure to suck milk, which is expressed from the nipple between the upper and lower
gum pads, because of the absence of a palatal seal (Berkowitz).
In addition to feeding problems, surgery of the lip, palate, and gums of an infant
causes pain and trauma. Reconstructive procedures may include pre-surgical orthopedic
alignment of the premaxilla (infant wears a facial orthopedic device), arm restraints (to
prevent the baby from removing the device), cleft lip and palate closure, and construction
of a pharyngeal flap (for speech improvement). Post-surgical trauma includes pain,
swelling, sutures, additional feeding problems, and wearing arm restraints.
4. Non-clinical observations
One mother described each feeding of her cleft afflicted infant as a nightmare
(AboutFace). Another mother relates the experience with her afflicted baby saying, Few
individuals would try the challenge of feeding him, risking his choking and vomiting on
every drop (AboutFace). These experiences are in stark contrast to Freuds observation
of a normal infant. Freud states, No one who has seen a baby sinking back satiated from
the breast and falling asleep with flushed cheeks and a blissful smile can escape the
reflection that this picture persists as a prototype of the expression of sexual satisfaction
in later life (Freud, Three Essays).
Page - 3
Conclusion
Freud states the following about oral stage developmental fixation: Every
external or internal factor that hinders or postpones the attainment of the normal sexual
aim will evidently lend support to the tendency to linger over the preparatory activities
and to turn them into new sexual aims that can take the place of the normal one. (Freud,
Three Essays). If so, it follows that the clinical and non-clinical observations cited in this
paper point to the possibility of fixation to the oral psychosexual stage of development.
Examples of behavior indicating oral psychosexual stage fixation include smoking,
drinking, eating disorders, and a proclivity to speaking. Thus I conclude that a cleft lip
and palate puts an afflicted individual at risk for oral fixation. Concerning the
legitimacy of the theory, Fisher and Greenberg state in their book Freud Scientifically
Reappraised: Testing the Theories and Therapy, that Freudian oral psychosexual
developmental theory is a valid psychological phenomenon. (Fisher and Greenberg).
Bibliography
1. Kathleen Stassen Berger, The Developing Person Through the Life Span, third
edition, 1994, Worth Publishers.
2. Sigmund Freud, Three Essays on the Theory of Sexuality, Basic books.
3. Samual Berkowitz, DDS, MS, FICD, The Cleft Palate Story, 1994, Quintessence
Publishing Co., Inc.
4. AboutFace, craniofacial support group newsletter, January/February 1993 and
May/June 1992.
5. B.M. Patten, Human Embryology, third edition, 1968, McGraw-Hill Book Company.
6. Seymour Fisher and Roger Greenberg, Freud Scientifically Reappraised: Testing
the Theories and Therapy, first edition, 1996, Wiley-Interscience Publishers.
Psychotherapy for Persons with Craniofacial Deformities: Can We Treat
without Theory?
M. ELIZABETH BENNETT, PH.D.
MARY L. STANTON, B.S.
In recent yrs, Incr..slng number. of experts hev. recomm.nded tMt
psychological support be avall.ble for cle" children .nd their ,.rent Fe.
cle" ,...1. c.nt.... howev.r offer comprehensive psychologlCIII ..rvlees.
This paper pr.sent. lOme conceptual tactor. which may contribute to the
piluclty of psychological treatment. available to cleft children and their
famlll... Shortcoming. In current concepts of emotional dy.functlon In cleft
chlldr.n are dl.cussed, and the effect. of conceptu81 confusion on options
for psychother.py ar. outlined. Suggted directions In p.ychotherapy
r....rch tor clen children are discussed.
KEY WORDS: clfJfting, emotional dysfunction, psychotherapy
Numerous studies have documented psychosocial prob
lems associated with cleft lip and palate. Children with
clefts have been reported to have lower self-concepts than
normals (Broder and Strauss, 1989), lower self-esteem
than nonnals, impaired peer relationships, and increased
dependency on adults (Pil1emer and Cook, (989). In addi
tion, poor body image (Strauss et aI., 1988) and poor
academic performance have been noted in children with
clefts (Richman el a1.. 1988). Teachers have also reponed
that cleft children more frequently display conduct disor
ders when compared with their normal peers (Richman.
1976). Information from surveys of the parents of cleft
children suggests that cleft children master developmental
tasks more slowly and resist separation from parents more
strongly (Benson et aI., 1991).
Given this list of psychological problems and familial
distress associated with clefting, it is not surprising that
numerous authors have suggested that psychological treat..
ment should be available to children with clefts and their
families (Heller et al., 1981; Arndt et aI., 1987; Bjomsson
and Agustsdottir, 1987; Pertschuk and Whitaker. 1987,
1988; Broder and Strauss, 1989). Such recommendations
are so common that cleft palate centers were surveyed
(Broder and Richman, (987) to determine what psycho
logical services were available to children receiving treat
ment at cleft palate centers.
The results of the Broder and Richman survey were
discouraging. Few centers reported offering psychological
treatment for cleft children. Less than SOli, of centers
offered mental health screening interviews, and fewer still
offered short tenn therapy (21%). In 1987, only 13% pro
vided long... term psychological support for children with
clefts or their families. Although these figures may have
Dr. Bennett and Ms. Slanton are affiliated with the University of
Pittsburah. School of Dental Mcdic:inc. Pittsburgh. Pennsylvania.
Submitted November 1992; Accepted January 1993.
Reprint requests: M. Elizabeth Bennett. Ph.D., Department of Rehav
ion1 Science. University of Piltlburgh School of Dental Medicine,
Pittsburah. PA IS261.
improved over the past 5 years, this seems unlikely be
cause of the low priority of mental health services in most
publicly funded agencies.
How is it that psychological services are so difficult to
come by in a population which has consistently been iden
tified as needing psychological care? At least two factors
may contribute to this, including (I) the relatively low
priority of psychological services in public assistance pro
grams mentioned previously, and (2) the inherent difficul
ties of providing weekly psychological interventions to
center populations which may be diverse economically,
geographically. and culturally.
The Problem of Psycbotherapy
While either factor just mentioned may be partially re
sponsible for the generally low level of psychological
services available to cleft children and their families, we
believe there may be a more obvious and troublesome root
to the lack of psychological services. Having determined
that psychological services are a necessary adjunct to cleft
treatment, few investigators have defined which psycho
logical treatments are suitable for cleft children. We could
locate no controlled studies that differentially evaluated
the efficacy of psychotherapy for cleft children or their
families.
As Strupp (1978) notes in his studies of psychotherapy
outcome, it is not enough to demonstrate that psychother
apy is effective in a general sense. Because the major
issue of psychotherapy is behavior change, researchers
must define what is to be changed and how change can be
brought about. In the area of facial deformities, we are
largely unable to answer these questions. What does a
cleft child (or adult) want to change? What should the aim
of psychotherapy be for a cleft child? What are the chief
emotional problems of individuals with faci aI deformities?
Emotional Dysfunction in Cleft PersoDs
A review of the literature provides few answers to the
first question, "What does a cleft child or adult want to
9
Bennett and Stanton, PSYCHOTHERAPY AND FACIAL DEFORMITIES 407
change?" Although we found numerous studies which de
scribed emotional problems in cleft children, many lacked
appropriate control groups. Thus. it is impossible to draw
firm conclusions from these studies because equivalent,
noocleft children drawn from the same sorts of popula
tions may experience emotional problems as well. An
examination of those studies which did employ adequate
or methodologically appropriate empirical techniques
suggest that questions remain regarding what, if any, emo
tional problems typically accompany a diagnosis of clefl
Iip/palate.
For example, Richman ( 1983) reported that cleft adoles
cents did not show significantly more personality or ad
justment problems than did nonnal controls. In addition.
this report noted no significant differences in self-per
ceived academic functioning and social satisfaction in
cleft persons compared with their noncleft peers. Simi
larly, Bjomsson and Agustsdottir (1981) concluded that
cleft individuals were relatively well adjusted socially and
achieved educational levels similar to those of normal
controls. Most imponant, these researchers noted that
their cleft subjects did not believe that their cra.niofacial
defect had significantly influenced their lives.
In contrast, Heller et aI., (1981) reported that a signifi
cant number of cleft patienls report continuing dissatis
faction with appearance, hearing, speech. and teeth. Simi
larly, Kapp-Simon (1985) reported that cleft patients had
poorer self-concepts than normal controls. With regards to
achievement motivation, Peter and Chinsky (1975) re
poned that cleft subjects had significantly lower educa
tional aspirations when compared with their normal peers.
Additionally. McWilliams and Paradise (1973) reported
that fewer cleft subjects were married during adulthood
when compared to their normal peers.
Clearly, there are inconsistencies in the data regarding
emOlionaVsocial dysfunction and clefts. While some re
ports seem to indicate that clefting has relatively insignifi
cant effects on emotional functioning, other data provide
strong evidence to the contrary. Such contradictions have
not gone unnoticed in the literature, leading at least one
author (Tobiasen, 1984) to suggest that consistent, mean
ingful answers to questions about emotional dysfunction
and clefting cannot be answered without sufficient theo
retical specificity. Even if we accept that there are emo
lional problems which occur more frequently in cleft
children than in normal children. Strupp's second ques
tion, "how change can be brought about" cannot be ad
dressed without theory.
How Can Change be Brought About?
This question must be answered in the context of theory;
a theory of how dysfunction develops and how it can be
changed. Although broad theories of personality may be
of use in generating general answers about human emo
tional dysfunction, they may be considerably less useful
in providing specific answers for the facially deformed.
For example, both psychodynamic and social learning
theorists would postulate that emotional distress arises in
part from repeated, painful, developmental experiences.
However, such broad hypotheses tell us little about the
nature of those experiences for facially deformed persons.
It is understandable that researchers have sought a model
more specific to the experiences of cleft palate children to
answer questions relevant to the development and treat
ment of emotional dysfunction in cleft children.
The most popular notion of emotional dysfunction in
cleft children has been that of
6
'reflected appraisals" or 'lhe
"looking glass selr' (see Shrauger and Schoeneman. 1979,
for a review). From this lheoretical viewpoint, cleft chil
dren are at a developmental disadvantage emotionally be
cause they incorporate a negative societal view of facial
deformity into the self-concept. Researchers into cleft
palate issues have noted support for this concept of emo
tional development in the extensive literature on physical
attractiveness. This large and frequently cited literalure
suggests that 'there are far-reaching social benefits to be
ing physically attractive, and severe negative social conse
quences for those who are physically unattractive (see
Berscheid, 1980; Dian. 1981,1986; Adams, 1984; Patzer, '
1985; Alley and Hildebrandt. 1988 for reviews). To sum
marize, researchers have discovered that physically unat
tractive people of all ages are perceived less positively by
observers of all ages than attracti ve people. Assuming that
faces with deformities are inherently unattractive, some
researchers have suggested that negative reactions from
observers are partly responsible for the emotional distress
noted in cleft children (Tobiasen. 1984).
The appeal of this concept of emotional dysfunction is
clear. Not only does the idea of reflected appraisals con
form to common sense notions of emotional development
(e.g., "children learn what they live"), but in the case of
cleft children. the concept is supported by a literature that
delineates society's negative views of physically unattrac
tive children. It should not be surprising therefore, that
this particular view of dysfunction has been frequently
cited in the cleft literature (see Clifford, 1973; Glass and
Starr, 1979: Edwards and Watson, 1980; Tobiasen. 1984)
as a useful theory of emotional dysfunction in cleft chil
dren and adults.
Although intuitively pleasing, such an explanation is
problematic for several reasons. Researchers have re
cently begun to question the benefits of physical attrac
tiveness. Often referred to as the "what is beautiful is
good
t
phenomenon, the benefits of physical attractiveness
have been noted as some of the most replicable and robust
findings in the social science literature. However, a recent
meta-analysis of the physical attractiveness literature
(Bagly et at, 1991) found major limitations in such con
el usions. The results of their meta-analysis suggest that
beauty serves as a strong cue for suppositions of social
ease. but has little effect on perceptions of intelligence,
honesty, virtue, helpfulness. potency, or general emo
408 Cleft Pal.re-Craniofacial Journal. July 1993, Vol. 30 No.4
tional adjustment. Other investigators have noted in
stances in which beauty may be a handicap, especially in
inferences about vanity, and self-centeredness (Cash and
Janda, 1984).
Additional doubts concerning the applicability of the
physical-attractiveness literature have recently arisen.
Several authors, both in the psychological (Zuckerman et
aI., 1991) and dental literatures (Pertschuk and Whitaker,
1987) have cautioned against oversimplified interpreta
tions of the ubeauty is good" phenomenon. These authors
have noted that a myriad of factors contribute to impres
sion fonnation, including vocal attractiveness. nonverbal
gesturing, mannerisms, and social skills. Others have
noted that frontal photographs, typically employed in
physical attracti veness research, are not representative of
real-life interaction. as three-quarter a"d profile views are
also captured in day to day interactions (Shaw et ai.,
1985). While some research has moved to impression re
search using video images and field research, these studies
are rare (e.g., Reis et at., 1980, used standardized diaries
to study naturalistic interactions). Not surprisingly,the
results of field-based versus lab-based physical attractive
ness studies have produced less clear results concerning
the benefits of beauty4 For example. Reis et al. (1982)
found that moderately attractive college women had more
dates and more same-sex socializing than did very attrac
tive college women.
Another problem with the "reflected appraisals" concept
of emotional development is the implicit equation be
tween perceptions of physical unattractiveness and physi
cal deformity. Both Reis and Hodgins (in press) and
Pertschuk and Whitaker (1987) caution against applying
the literature on physical attractiveness to craniofacial
populations. They propose that unattractive individuals,
even very unattractive individuals, may have profoundly
different social experiences from the facially deformed.
Reis and Hodgins cite the social science literature devoted
to physical stigmata as an alternate source for theory con
cerning social development in cleft populations (e.g.,
Katz. 1981). Katz postulates that the experience of a stig
matized individual is marked by societal ambivalence.
That i s ~ there are strong cultural traditions which dictate
help and sympathy for the handicapped, but such tradi
tions coexist with societal avoidance and discomfort with
handicapped persons. Reis and Hodgins postulate that the
experience of ambivalence (strong positive reactions and
strong negative reactions) should be markedly different
from that of the generalized ncgati vi ty thought to accom
pany physical unattractiveness. As additional support for
a distinction between the effects of unattractiveness and
stigmata, they note the societal distinction between stigma
and unattractiveness; there is a Cleft-Palate Craniofacial
Association but no association for "homely individuals or
parents of homely babies" (p.21).
Finally, the distinction between unat.tractiveness and cra
niofacial defect has profound conseqJences for concepts
of the development of self-esteem in cleft children. While
the prevailing theory of reflected appraisals clearly pre
dicts lower self-esteem in cleft children. recent work sug
gests that members of some stigmatized groups may
actually use their stigmatized status for self-esteem en
hancement (Crocker and Major, 1989; Hillman, 1992).
Briefly, Crocker and Major outline an attributionbased
model whereby the stigmatized individual may attribute
negative feedback to factors associated with their stigma
(e.g., he doesn't like me because I have a scar above my
lip) rather than to factors more closely aligned with the
self (e.g., he doesn't like me because I'm an unacceptable
person). In so doing, these theorists note, stigmatized peo
ple can and do protect their self-esteem. This effect has
been noted clinically in facially deformed populations, but
has not been studied explicitly (see Baker and Smith,
1939; Macgregor, 1979). The applicability of this model
to the cleft population warrants further study. While some
studies suggest that self-esteem is lower in cleft children
(Broder & Strauss, 1989), Brantley & Clifford (1919)
found higher self-esteem in cleft teens than in normal
teens.
Providing Treatment in the Absence of Theory
At first glance, differing theoretical models concerning
emotional development of cleft chi Idren may appear re
moved from the day to day concerns of the psychologist
interested in psychotherapy for cleft patients. A closer
examination reveals that different models of emotional
development may lead to divergent clinical treatments.
For example, if facial deformity can be considered as
equivalent to extreme unattractiveness, a clinician might
assume that any cleft child is regarded with unifonn nega
tivity, a victim of cultural prejudices against unattractive
persons. Therapy might consist of social skills training to
overcome initial negative reactions from peers and teach
ers. In contrast, if facial deformity is conceptualized in
line with Katz's (1981) ambivalence model, a therapist
would make an entirely different set of assumptions about
the cleft patient's social experience. Assuming that the
cleft child is met with extremely positive reactions in
some instances (e.g. teachers more likely to provide help,
parents inviting the child to birthday parties) but ex
tremely negative reactions in other instances (e.g., peers
avoiding interaction, being chosen last for teams)" therapy
that is focused on coping with inconsistent social experi
ences might be most appropriate.
Similarly, a therapist assuming low self-esteem in cleft
clients might focus on interventions aimed at enhancing
self-esteem. If a therapist accepts Crocker and Major's
(1989) attribution-based model, however, a therapy aimed
at making accurate and adaptive attributions for social
feedback would be warranted. In addition, if a therapist
assumes rhat the stigma serves to protect the self-esteem,
additional psychotherapeutic support might be necessary
Bennen and Stanton. PSYCHOTHERAPY AND FACIAL DEFORMITIES 409
for patients undergoing surgical interventions aimed at
cosmetic improvements. In other words, patients who re
ceive noticeable cosmetic benefits through surgery (i.e.
the stigma becomes less visible) may be less able to pro
teet their self-esteem by using their facial stigma. Thus
psychotherapy aimed at helping patients make other attri
butions for interpersonal events may be useful.
Shortcomings in current concepts of emotional dysfunc
tion in cleft populations leave the clinician with litlle
empirical guidance for psychological treatment. Not only
are we unsure about which treatments are most appropri
ate, we have little data that compare different treatments
for cleft clients. In the absence of theory. clinicians follow
general principles of psychotherapy (e.g., acceptance, em
pathyI warmth, skills training) on a case-by-case basis.
Evidence from the limited literature on psychotherapy for
physically handicapping conditions suggests that few em
pirical data are available in Ihose areas either (e.g., Ser
voss, 1983; Hoxter, 1986; lureidini, 1988).
II is not suggested that therapists currently providing
psychological treatments to cleft patients are offering in
effective treatments, or even that a specific theory of psy
chological dysfunction is necessary to help a given cleft
patient or family. Studies of the outcome of psychother
apy strongly suggest that on the whole, psychotherapy is
effective in reducing emotional distress for a wide range
of clients and emotional problems (Garfield and Bergin,
1984). A skilled clinician will also conduct a thorough
assessment of a client's social environment regardless of
population-based data. However. in order to develop pro
grams specifically for cleft patients, especially programs
designed to teach effective coping early in social develop
ment. a more specific plan is needed.
How can research contribute to the development of specifie
treatments for cleft children who are experiencing emotional
d i s ~ s ? How can research contribute to the development of
primary prevention interventions that might offset the effects
of facial defonnity? In the course of our research. we have
fonnul ated 'Ihe following suggestions:
I. Cleft palate centers and organizations should encour
age and promote cross-fertilization between social scien
tists outside the cleft area and scientists working primarily
in cleft palate. Researchers who focus on other stigmatiz
ing conditions (e.g., obesity) and scientists who develop
and refine theories of stigma (e.g., Katz, 1981; Jones et
al.9 1984) are rarely cited in the cleft literature. The infor
mation and insights they have to offer should become
integrated with infonnation specific to eleCting. Some at
tempts have been made to incorporate study of other stig
matizing conditions (e.g. Harper and Richman, 1978;
Brantley and Clifford, 1979). and further work in this
tradition should be encouraged.
2. Longitudinal field studies of cleft children in their
social environment should become a funding priority. Sur
vey studies and impression studies are useful, but the
information they offer is limited. Mental health interven
tions for cleft children can only be developed when we
understand what makes a cleft child's social environment
different from that of a normal child. We cannot expect to
treat psychological distress effectively if we cannot define
how the distress manifests itself in day to day functioning.
There are well-validated means for measuring social inter
action in an ongoing fashion which have been used in
studies of smoking cessation, weight control. and inti
macy (see Reis, 1983. for a review). The application of
similar assessment techniques to cleft populations may be
feasible.
3. Studies which focus on individual differences and risk
factors in cleft populations should be encouraged. As we
noted earlier. there are no clear answers regarding the
association between clefting and emotional distress. Iden
tification of mediating and moderating factors will enable
us to predict which cleft children are at risk for emotional
problems. For example, it may be that there are important
parental variables which will predict which cleft children
will experience emotional problems. Studies of individual
differences in cleft children. such as different coping
styles, may also be useful in understanding which cleft
children will experience emotional dysfunction. If such
variables prove to be important. we may be able to learn,
and eventually teach how some cleft children cope effec
tively with their facial differences.
4. Research concerning the mutability of attitudes to
wards physical deformity will enable therapists and com
munity leaders to launch programs intended to change
societal attitudes towards physical stigmata. If we accept
the premise that in some fashion, emotional problems
associated with elefting stem from negative societal
views, a logical research question is whether such atti
tudes are changeable. With the advent of popular televi
sion characters with visible (e.g., obesity) and invisible
(e.g., homosexuality) stigmata. we may be able to study
the extent to which societal treatment of stigmatized per
sons can change.
A focus on any of the above areas will bring valuable
information to those interested in developing and refining
mental health interventions for cleft children and adults.
As mental health interventions are developed, controlled
studies can be launched, and better matches can be made
between clients, 'therapists, and interventions. Although
there is much to be learned about the psychological treat
ment of cleft individuals, we believe that there is much to
be gained through the study of psychological problems
associated with clefting. When social scientists have em
pirically demonstrated psychological treatment needs for
cleft patients in conjunction with replicable, specific treat
ment plans, we believe that funding for mental health
services will be substantially easier to secure.
410 Clefl Palate-Craniofacial Journal, JUly 1993, Vol. 30 No.4
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PSYCHIATRY
RESEARCH
Psychiatry Research 59 (1995) 97-107
Deficits in short-term memory in adult survivors of childhood
abuse
J. Douglas Bremner*a,b,c, Penny Randalla,b,c, Tammy M. Scottc,d, Sandi Capellib,c,
Richard Delaneyb,d, Gregory McCarthyb,d,e, Dennis S. Chameya,b,c
of Psychiatry. Yale School of Medicine. West CT 06516. USA
bWest VA Medical Center. West CT06516. USA
CNatiolUl1 Center for Posttraumatic Stress Disorder. West VA Medical Center (/51). West CT 06516. USA
dDepartment of Psychology. Yale School of Medicine. West CT 06516. USA
cDepartment of NftUosurgery. Yale School of Medicine. West Htnen. CT 06516. USA
Received 6 March 1995; revision received 31 July 1995; accepted 8 August 1995
Abstract
Exposure to stress has been associated with alterations in memory function, and we have previously shown deficits
in short-term verbal memory in patients with a history of exposure to the stress of combat and 'the diagnosis of post
traumatic stress disorder (PTSD). Few studies of any kind have focused on adult survivors of childhood physical and
sexual abuse. The purpose of this study was to investigate short-term memory function in adult survivors of childhood
abuse. Adult survivors of severe childhood physical and sexual abuse (n =21), as defined by specific criteria derived
from the Early Trauma Inventory (ETI), who were presenting for psychiatric treatment were compared with healthy
subjects (n =20) matched for several variables including age, alcohol abuse, and years of education. All subjects were
assessed with the Wechsler Memory Scale (WMS) Logical (verbal memory) and Figural (visual memory) components,
.
the Verbal and Visual Selective Reminding Tests (SRT), and the Wechsler Adult Intelligence Scale-Revised (WAIS-R).
t Adult survivors of childhood abuse had significantly lower scores on the WMS Logical component for immediate and
delayed recall in comparison to normal subjects, with no difference in visual memory, as measured by 'the WMS or
the SRT, or IQ, as measured by the WAIS-R. Deficits in verbal memory, as measured by the WMS, were associated
with the severity of abuse, as measured by a composite score on the ETI. Our findings suggest that childhood physical
and sexual abuse is associated with long-term deficits in verbal short-term memory. These findings of specific deficits
in verbal (and not visual) memory, with no change in IQ, are similar to the pattern of deficits that we have previously
found in patients with combat-related PTSD.
Keywords: Physical abuse; Sexual abuse; Memory; Intelligence; Trauma; Posttraumatic stress disorder; Neuro
psychology
Corresponding author, West Haven VAMC (116a), 950 Campbell Ave., West Haven, cr 06516, USA.
0165-1781195/$09.50 1995 Elsevier Science Ireland Ltd. All rights reserved
SSDI OI65-1781(95)02800-C
10
98 J.D. Bremner et al. / Psychiatry Research 59 (1995) 97-107
1. Introduction
Childhood physical and sexual abuse is a prob
lem of enormous magnitude. Rates of sexual abuse
have been estimated from community samples to
be from 110/0 to 620/0 in women (Russell, 1983;
Finkelhor and Hotaling, 1984; Kercher and
McShane, 1984; Wyatt, 1985) and from 3% to 39%
in men (Finkelhor and Hotaling, 1984; Kercher
and McShane, 1984). Childhood abuse has been
associated with a range of adverse psychiatric out
comes, including depression (Briere et aI., 1988;
Swett et aI., 1990), anxiety (Briere et aI., 1988;
Swett et aI., 1990), dissociation (Putnam et aI.,
1986; Chu and Dill, 1990; Ross et aI., 1991), post
traumatic stress disorder (PTSD) (Greenwald and
Leitenberg, 1990), borderline personality disorder
(Herman et aI., 1989; Ogata et aI., 1990), alcohol
and substance abuse (Ladwig and Anderson, 1989;
Brown and Anderson, 1991), and other psychiatric
disorders (Green, 1978; Herman, 1981; Carmen et
aI., 1984; Bryer et aI., 1987; Bulik et aI., 1989; Hall
et aI., 1989; Palmer et aI., 1990). In spite of this,
few studies have examined the long-term conse
quences of exposure to childhood abuse.
Considerable evidence supports a relationship
between stress and alterations in memory (review
ed in Charney et aI., 1993; Bremner et aI., 1995a).
Studies in animals suggest that exposure to stress
results in deficits in short-term memory (Drugan et
aI., 1984). High levels of glucocorticoids released
during stress have been shown to cause damage to
neurons in the hippocampus (Sapolsky et aI., 1988,
1990; Uno et aI., 1989), a brain structure that plays
an important role in learning and memory (Squire
and Zola-Morgan, 1991). Neurotransmitters and
neuropeptides released during stress also have the
potential to result in an overconsolidation of
memory traces, which may explain the existence of
intrusive memories in patients with PTSD (Pit
man, 1989; Pitman et aI., 1993; Bremner et aI.,
1995a). Studies of war veterans suggest an associa
tion between the extreme stress of combat and al
terations in memory function, including the
forgetting of names or other pieces of important
personal information. Five percent of soldiers in a
major campaign in World War II had no memory
for events which had just occurred immediately
after they had participated as combatants (Torrie,
1944). Other studies in combat veterans and
prisoners of war from World War II and the Viet
nam war have documented amnesia and other dis
turbances of memory (Archibald and Tuddenham,
1965; Thygesen et aI., 1970; Eitinger, 1980; Gold
stein et aI., 1987; Bremner et al., 1992, 1993b). Em
pirical studies of short-term memory have shown
deficits in short-term memory, as measured by the
Logical component of the Wechsler Memory
Scale, in prisoners of war in comparison to combat
veterans without a history of containment during
the Korean war (Sutker et aI., 1988, 1991). We
have previously reported deficits in short-term ver
bal memory, as measured by the Logical compo
nent of the Wechsler Memory Scale and the Verbal
Selective Reminding Test, with no change in IQ, in
Vietnam combat veterans with posttraumatic
stress disorder (PTSD) in comparison to control
subjects (Bremner' et al., 1993a). We have also
found a decrease in volume of the right hippocam
pus in Vietnam combat veterans with PTSD in
comparison to matched control subjects. Deficits
in verbal short-term memory, as measured by the
Wechsler Memory Scale, were associated with
decreased right hippocampal volume in these pa
tients (Bremner et aI., 1995b). Other studies in
Vietnam combat veterans have shown deficits in
new learning and memory using different neuro
psychological tests than the Wechsler Memory
Scale (Uddo et al., 1993; Yehuda et aI., 1995).
Studies in children have s h o ~ a relationship be
tween markers of abuse and deficits in the arith
metic subscale of the IQ test (Lewis et aI., 1979).
The purpose of this study was to compare
memory function in adult survivors of childhood
physical and sexual abuse with that in healthy
matched controls. Based on our previous findings
in Vietnam combat veterans with PTSD, we
hypothesized that adult survivors of abuse would
have deficits in verbal (but not visual) memory,
with no change in IQ, in comparison to matched
controls.
2. Methods
2.1. Subjects
The patient group consisted of 21 adult sur
vivors of childhood physical and sexual abuse. Pa
99 J.D. Bremner et al. / Psychiatry Research 59 (/995) 97-/07
tients were recruited from the inpatient and
outpatient treatment units of the West Haven VA
Medical Center over a 12-month period. A long
period of recruitment was necessary to identify
patients with a severe history of abuse, based on
the criteria outlined below. All new admissions to
these units were briefly screened for a history of
abuse, and referrals were made for the study,
following which a more complete evaluation was
performed to determine eligibility. All but one of
the patients who were identified in this manner,
who met inclusion criteria for the study, and who
were eligible for study entry consented to partici
pate. Patients were included if they had a history
of severe childhood physical and/or sexual abuse,
as determined by the Early Trauma Inventory
(ETI), and an Axis I psychiatric disorder on the
basis of a semistructured interview, the Schedule
for Affective Disorders and Schizophrenia
Lifetime version (SADS-L; Endicott and Spitzer,
1978). Patients were excluded if they had a history
of exposure to combat trauma, a diagnosis of
schizophrenia or current alcohol or substance
abuse based on the SADS-L, a history of trauma
tic brain injury or neurological disorder, current
use of benzodiazepine medication, or a history of
loss of consciousness for > 10 min. Some of the
patients were being treated with antidepressant
medication at the time of the study.
The comparison group (n =20) comprised
physically healthy men and women of nonprofes
sional occupations who were matched with the pa
tients for age, sex, race, handedness, height,
weight, years of education, years of parental
education, and years of alcohol abuse. Subjects
with a history of traumatic brain injury, men
ingitis, neurological disorder, current alcohol
abuse by DSM-III-R criteria (American
Psychiatric Association, 1987), physical illness,
psychiatric disorder, or history of loss of con
sciousness for > 10 min were excluded from the
study.
There were no differences between patients and
comparison subjects in any of the demographic
variables that were measured in this study. Pa
tients were similar to controls in age (patients:
mean =39.7, SD =7.1; controls: mean =36.7,
SD = 10.0; t =1.1, dj= 39, P =0.28), race (pa
tients: 18/21 [860/0] white, 1/21 [5%] black, 2/21
[100A] Hispanic; controls: 14/20 [700/0] white, 4/20
[200/0] black, 1/20 [5A.] Hispanic, 1/20 [5%] other;
x
2
=3.61, dj =3; P = 0.31), sex (patients: 15/21
[71A] males and 6/21 [290/0] females; controls:
16/20 [8oo/0] males and 4/20 [2OU/o] females
(x
2
=0.41, dj= 1, P = 0.52), handedness (pa
tients: 18/21 [86%] right-handed and 3/21 [14A]
non-right-handed; controls: 19/20 [95%] right
handed and 1/20 [5%] non-right-handed;
x
2
= 1.34; dj= 1; P =0.50), years of education
(patients: mean =13.5, SO = 2.1; controls:
mean = 14.0, SO = 3.0; t = 0.59, dj= 39,
P = 0.55), and years of alcohol abuse (patients:
mean =10.9, SO =9.4; controls: mean =6.6,
SO = 10.2; I =1.39, dj= 39, P =0.17).
Patients were evaluated with the SADS-L for
comorbid psychiatric diagnoses. SADS-L data
were not available (or three patients. All patients
in the study met criteria for current PTSD related
to their early trauma. Many patients also had
diagnoses of affective disorders. Five out of 18
(28A) patients evaluated with the SADS-L met cri
teria for current and 16/18 (890/0) for lifetime major
depression. In addition, 1/18 (6%) patients met cri
teria for current and 2/18 (110/0) for lifetime
dysthymia, while none met criteria for either cur
rent or lifetime bipolar disorder or bipolar dis
order not otherwise specified. There were a
number of patients with comorbid anxiety dis
order diagnoses. Seven out of 18 (390/0) met criteria
for current and lifetime panic disorder with
agoraphobia, and 2/18 (110/0) for current and 5/18
(28%) for lifetime panic disorder without
agoraphobia, 2/18 (110/0) had a history of current
and lifetime diagnoses of agoraphobia without a
history of panic disorder, 3/18 (170/0) current and
4/18 (22%) lifetime social phobia, 2/18 (110/0) cur
rent and 3/18 (17%) lifetime generalized anxiety
disorder, 1/25 (4
%
) current and lifetime simple
phobia, and none with current or lifetime
obsessive-compulsive disorder. No patients had
current or lifetime diagnoses of schizophrenia.
Other diagnoses included current bulimia in one
patient (60/0) and lifetime bulimia in two patients
(110/0), and current anorexia in no patients and
lifetime anorexia in one patient (60/0). No patients
had current or lifetime psychosis not otherwise
100
J.D. Bremner et ale / Psychiatry Research 59 (/995) 97-/07
specified, somatization disorder, somatic pain dis
order, undifferentiated somatization disorder, or
hypochondriasis.
Consistent with previous reports, comorbid
lifetime diagnoses for alcohol and substance abuse
disorders were increased in our group of early
trauma patients. Fourteen out of 18 patients (780/0)
met criteria for alcohol dependence and 1/18 (60/0)
for alcohol abuse, 3/18 (17%) for sedative/hyp
noticlanxiolytic dependence and 1/18 (60/0) for
abuse, 9/18 (500/0) for cannabis dependence and
2/18 ( 1 1 ~ ) for cannabis abuse, 7/18 (390/0) for stim
ulant dependence and 2/18 (110/0) for stimulant
abuse, 5/18 (28%) for opiate dependence and none
for opiate abuse, 10/18 (56%) for cocaine depen
dence and none for cocaine abuse, 1/18 (60/0) for
hallucinogenlPCP dependence and 2/18 (110/0) for
abuse, and 4/18 (220/0) for polydrug dependence
and none for abuse.
2.2. Assessment of childhood abuse
Research in the area of childhood abuse has
been limited by the lack of a comprehensive instru
ment with demonstrated reliability and validity
(Briere and Runtz, 1988). The current study used
the Early Trauma Inventory (ETI), which was
developed as part of a parallel project for the
assessment of childhood physical, sexual, and
emotional abuse. The ETI was developed by a
multidisciplinary team including one of the
authors of the current study (Kriegler et aI., 1993)
in collaboration with colleagues from the National
Center for PTSD, based on clinical experience, a
review of available existing instruments, and a sur
vey of the clinical literature on childhood abuse
(Finkelhor, 1979, 1986; Lewis et aI., 1979; Her
man, 1981; Herman et aI., 1986; Russell, 1986;
Briere and Runtz, 1987; Wyatt, 1885). The ETI
assesses the frequency of abuse experiences at dif
ferent developmental periods/academic epochs
(preschool, elementary school/junior high school,
and high school), the age of the individual when
the abuse began and when it stopped, the
perpetrator(s) of the abuse, the emotional impact
of the abuse on the individual immediately after
the event and across the life span, and the effect of
the abuse on social and occupational functioning
as assessed with a 7-point dual-valenced (positive
and negative impact) bipolar rating. In cases where
individuals reported abuse that occurred from
before age 4, and indicated that they believed it
had occurred since birth, abuse was scored as hav
ing occurred since birth. Immediate and long-term
sequelae for the events, such as medical health
seeking and change in custody status, are assessed
at the conclusion of the interview. Interrater reli
ability and validity studies of the ETI are currently
being performed and will be reported in a future
publication. The ETI was administered by a clini
cal psychiatrist trained in the use of the ETI by one
of the authors of the instrument. The Clinical psy
chiatrist was unaware of the information obtained
from neuropsychological testing. Asessments of
abuse in this study were based on self-report.
Although considerable variation exists with
regard to the definition of childhood abuse
(Kinsey et aI., 1953; Finkelhor and Hotaling, 1984;
Wyatt, 1985; Briere"and Runtz, 1988), there are no
empirical bases to justify the use of specific cri
teria. One approach is to identify subjects with a
history of very severe abuse, for whom there is no
question from their report that they have been ex
posed to childhood abuse. We have developed spe
cific criteria for severe abuse based on the ETI
interview to identify subjects with severe abuse.
Severe abuse was defined as a history of exposure
to physical abuse (being hit with an object, burn
ed, or locked in a closet, or suffering penetrative
sexual abuse) that had occurred once a month or
more for at least a year and that had extremely
negative effects on the individual when the event
occurred as well as.on current emotional, social, or
occupational functioning.
Histories of abuse were obtained in this study by
self-report. It might be argued that patients do not
accurately report their abuse. One should con
sider, however, other methods of validating the
history of abuse. Obtaining history from family
and friends has its own problems, as these in
dividuals may have been involved in the abuse or
be in active denial that abuse could have occurred.
Limiting study to individuals for whom there are
court records of abuse would represent a biased
sample, as our clinical impression is that the ma
jority of abused individuals do not enter the legal
system. One might also argue that deficits in
101 J.D. al. / Psychiatry 59 (/995) 97-/07
memory in these patients could result in deficient
memory for episodes of abuse. These memory
deficits, however, involve short-term new learning
(not recall of long-term storage). We hypothesize
that memory deficits are the result of abuse expo
sure; therefore, there would be no reason to expect
that memory for the abuse itself would be im
paired. It is also our clinical impression that
memory traces for these events are often very
strong (in circumstances where amnesia does not
exist).
Patients in this study, as would be expected from
the selection criteria, had experienced high levels
of physical and sexual abuse. All of the patients
experienced some form of physical and emotional
abuse, while 19/21 (900/0) experienced some form of
sexual abuse. As can be seen in Table 1, patients
endorsed experiencing a wide range of abuse ex
periences in the different abuse domains (physical,
emotional, and sexual abuse). Abuse experiences
in the different domains were related to each other;
that is, there were significant correlations between
severity of physical and emotional abuse (r = 0.50,
df = 20, P < 0.05), sexual and emotional abuse
(r =0.47, df= 20, P < 0.05), and physical and
sexual abuse (r = 0.60, df= 20, P = 0.004). These
abuse experiences had a very negative effect on the
patients' current lives. For example, 16/21 (760/0) of
patients reported that physical abuse had an ex
tremely negative effect on them emotionally, 14/21
(68%) an extremely negative effect on work perfor
mance, and 16/21 (760/0) on family life at the cur
rent time. Onset of the abuse occurred from
infancy for physical abuse in 16/21 (76%) patients,
emotional abuse in 16/21 (760/0), and sexual abuse
in 3/21 (140/0) (or 6/21 [29%] before the age of 5
years). Fourteen out of 21 (68AJ) patients reported
that the primary perpetrator of their physical
abuse was a male primary caretaker (e.g., father),
6/21 (290/0) a female primary caretaker (e.g., moth
er), and 1/21 (50/0) a female child family member.
For emotional abuse, 12/21 (570/0) reported that
the primary perpetrator was a male primary
caretaker and 9/21 (430/0) a female primary
caretaker; for sexual abuse, 3/21 (140/0) reported
that the primary perpetrator was a male primary
caretaker, 1/21 (50/0) a female primary caretaker,
2/21 (10010) a male known adult family member,
Table I
Frequency of exposure to traumatic events as assessed by the
early trauma inventory (ETI)
Abuse N Percent
(o/u)
Physical abuse
Spanked with a hand 19121 91
Slapped in the face 18121 86
Burned with hot water/cigarette 8/21 38
Punched or kicked 16121 76
Hit with objects 20121 95
Choked 15121 71
Pushed or shoved 17121 81
Tied upllocked in closet 9/21 43
SeXIIQI abuse
Exposed to inappropriate comments 16121 76
about sexlbody pans
Exposed to someone flashing 17121 81
Someone watched you dressing 8121 38
Forced/coerced to watch sexual acts 13121 62
Touched in private pans made 17121 81
you uncomfonable
Someone rubbed their genitals
against you 14/21 67
Forcedlcoerced to touch another 14121 67
penon's private pans
Had genital sex against your will 5121 24
Had oral sex on someone against
your will 11121 52
Someone performed oral sex on you 8/21 38
against your will
Someone had anal sex on you 8121 38
against your will
Emotional abuse
Often put down or ridiculed 19/21 91
Often ignored/made to feel you
didn't count 18/21 86
Often told you were no good 18/21 86
Often shouted at or yelled at 21121 100
Most of the time treated in cold or
uncaring way 19121 91
Parents controlled your life 19121 91
Parents fail to undentand your
needs 21121 100
Parents expected you to act older 14121 67
1/21 (50/0) a male child family member, 9/21 (430/0)
a known adult male, 3/21 (140/0) a known adult fe
male, and 2/21 (100/0) did not experience sexual
abuse.
102
J.D. Bremner et al. / Psychiatry Research 59 (1995) 97-107
The ETI was also used to develop an index of se
verity of abuse exposure so that the relationship
between severity of childhood abuse and memory
function could be examined. Childhood abuse se
verity indexes were developed for each of the
subscales of the ETI (physical, emotional, and sex
ual) by multiplying the total number of items en
dorsed as having occurred times the total number
of years during which the event occurred, times the
frequency with which the event occurred when it
was occurring most frequently (based on an in
teger from 1 to 6, with 6 being the most frequent,
definitions available upon request). The three
subscales were also summed to give a total abuse
severity index.
2.3. Assessment of alcohol abuse
The Addiction Severity Index (ASI) interview
was used to assess lifetime alcohol abuse. The ASI
evaluates the total number of years of alcohol
abuse over the individual's lifetime (i.e., drinking
to the point of intoxication, three or more drinks
per day, on a regular basis, three or more days in
a week) (McClellan et aI., 1985). Early trauma pa
tients with a history of alcohol abuse were match
ed on a case-by-case basis with controls with a
history of alcohol abuse on the basis of the ASI in
terview.
2.4. Neuropsychological testing of memory and
intelligence
All subjects were administered a battery of
neuropsychological tests as described below. (1)
Four subtests of the Wechsler Adult Intelligence
Scale (WAIS-R) were administered, including
Arithmetic, Vocabulary, Picture Arrangement,
and Block Design, to estimate an intellectual level
for each subject. (2) Two subtests of the Wechsler
Memory Scale (WMS) were administered accord
ing to the Russell revision (Russell, 1975). The
subtests include Logical Memory, the free recall of
two story narratives, which is felt to represent a
test of verbal memory, and Figural Memory,
which is felt to represent visual memory, involving
the reproduction of designs following a 100s pre
sentation. For both the WMS subtests, immediate
and delayed reproduction were tested, and a per
cent retention score was computed (delayed
recalVimmediate recall x 1(0). (3) The Verbal Se
lective Reminding Test (VeSRT; Buschke and
Fuld, 1974; Hannay and Levin, 1985) is a measure
of verbal learning in which a list of 12 words is
presented for immediate recall. On subsequent tri
als, only the words not recalled on the prior trial
are presented. The task is complete after two con
secutive perfect recall trials or 12 presentations. (4)
The Visual Selective Reminding Procedure
(ViSRT; Buschke and Fuld, 1974; Hannay and
Levin, 1985) is a task modeled on the verbal selec
tive reminding in which 12 designs are presented
one at a time for 3 s each, followed by an oppor
tunity for the subject to draw all from memory.
Each design that is not accurately reproduced on
a given trial is shown again until perfect recall is
attained or 12 trials are reached. Five indices of
learning and memory are obtained from each of
the selective reminding tasks: Total Recall, Long
term Retrieval, Long-term Storage, List Learning
(Consistent Long-term Retrieval), and Delayed
Recall.
2.5. Data analysis
A series of t tests were performed between
patients and controls for each of the subcom
ponents of the WMS, SRT, and WAIS-R. Two
tailed nonpaired tests of significance were used
throughout. Pearson's product-moment correla
tions were performed between scores on neuro
psychological testing and abuse severity scores.
The Bonferroni correction was applied to adjust
for multiple comparisons. Significance was defined
as P < 0.05.
3. Results
Adult survivors of abuse had deficits in verbal
short-term recall, as measured by decreased scores
on the Logical component of the WMS for imme
diate recall and delayed recall, but not..percent re
tention. Adult survivors of abuse also had deficits
in verbal recall, as measured by the VeSRT (Table
2). After adjustment for multiple comparison with
the Bonferroni correction, only the WMS Logical
immediate and delayed recall tests differed
significantly between patients and controls (P <
0.(03). Adult survivors of abuse did not have
Table 2
Wechsler Memory Scale (WMS) and Selective Reminding Test (SRT) scores in early trauma patients and normal subjects
Early trauma
patients (n =21)
Normal subjects
(n= 20)
P
Mean SO Mean SO
WMS Logical Memory
Immediate recall
Delayed recall
Retention (%.)
13.6
10.5
75.0
3.3
5.6
24.1
2Q.8
17.8
84.7
6.5
6.1
11.9
3.71
3.98
1.58
0.0007
0.0003
0.12
WMS Figural Memory
Immediate recall
Delayed recall
Retention (o/u)
10.2
10.1
96.4
2.9
3.2
6.9
10.9
9.3
82.9
3.4
4.2
20.8
0.66
0.73
2.96
0.51
0.47
0.007
Verbal SRT
Recall
Long-term storage
Long-term retrieval
Continuous long-term retrieval
Delayed recall
102.6
92.4
83.8
58.7
8.0
19.1
18.5
29.1
32.5
3.5
115.6
111.5
101.5
83.8
10.0
14.4
16.6
21.6
32.4
2.2
2.47
2.64
'2.21
2.48
2.24
0.019
0.013
0.033
0.018
0.03
VisuDl SRT
Recall
Long-term storage
Long-term retrieval
Continuous long-term retrieval
Delayed recall
126.3
124.4
121.1
111.5
11.3
16.6
21.4
23.4
30.2
1.0
126.3
125.1
123.9
120.4
11.1
30.7
30.8
30.9
31.5
2.7
0.004
0.08
0.32
0.92
0.44
0.99
0.93
0.75
0.36
0.66
.p < 0.05 after Bonferroni correction for multiple comparisons (df= 39 for all comparisons).
deficits in visual short-term memory as measured
by the WMS figural component or the ViSRT. In
fact, there appeared to be a tendency (which was
not significant after correction for multiple com
parisons) for the patients to have higher scores on
the WMS visual memory task than did the controls
(Table 2).
There were no significant IQ differences be
tween adult survivors of severe childhood physical
and sexual abuse and controls. Specifically, there
were no differences in WAIS-R scores between
PTSD patients (n =21) and controls (n =20) for
verbal IQ (patients: mean =101.0, SO =17.5;
controls: mean =103.0, SO =17.6; t =0.34,
dj= 39, P =0.73), performance IQ (patients:
mean =100.5, SO =18.4; controls: mean =107.8,
SD =19.5; t =1.21, dj= 39, P =0.23), or full
scale IQ (patients: mean =101.0, SO =16.5; con
trols: mean =106.7, SO =19.1; t =1.01, df= 39,
P = 0.32). Although there were no statistically sig
nificant differences, there was a tendency for the
abused patients to have slightly lower IQ. The
magnitude of difference was not nearly so large as
for memory. We elected not to compare memory
scores between the two groups with covariation
for IQ, because deficits in memory could cause
slight decreases in IQ (Le., memory function likely
contributes to some of the variance in IQ).
Severity of abuse was related to deficits in verbal
short-term memory in the PTSO patient group.
Overall severity of abuse, as measured by the
summed abuse severity score (sum of physical, sex
ual, and emotional abuse severity scores,
calculated from the ETI as described above), was
significantly correlated with deficits in short-term
verbal recall, as measured by the WMS Logical im
mediate recall subcomponent (r =-0.46, df =20,
P =0.035). In addition, severity of sexual abuse
104 J.D. Bremner et al. / Psychiatry Research 59 (/995) 97-/07
when considered alone was correlated with deficits
in verbal short-term memory, as measured by the
WMS Logical immediate recall subcomponent
(r =-0.48, df = 20, P = 0.026). Although there
were no statistically significant differences in IQ
between early trauma patients and comparison
subjects, it is of interest to note that there were
some relationships between IQ and abuse in this
study. Overall severity of abuse, as measured by
the summed abuse severity score, was associated
with decreased performance IQ (r = -0.45,
df= 20, P =0.039) and full-scale IQ (r = -0.44,
df =20, P =0.045). Severity of physical abuse was
associated with decreased performance IQ
(r =- O . S O ~ df =20, P =0.022).
4. Discussion
Adult survivors of childhood physical and sex
ual abuse had deficits in verbal short-term recall,
as measured by the WMS Logical component, as
well as immediate and delayed recall, with no dif
ference in IQ in comparison to matched control
subjects. There were no differences in visual
memory between adult survivors of childhood
abuse and control subjects. Overall severity of
abuse was related to degree ofmemory impairment
in the early trauma patients.
Stress at different stages of development appears
to have similar effects on verbal short-term
memory. In our previously reported group of pa
tients with contbat-related PTSD, exposure to
trauma in most patients occurred at about the age
of 20, while in the current group of survivors of
childhood abuse, traumatic exposure often oc
curred as early as before the age of 5 years. There
is a similar pattern of specific deficits in verbal
memory, with no significant change in IQ, in both
adult survivors of abuse and patients with combat
related PTSD. The left hippocampus is felt to be
involved in verbal memory to a relatively greater
degree than the right, while the right hippocampus
is involved in visual memory to a greater degree.
Thus, left hippocampal dysfunction might explain
our findings.
These- findings add to the growing literature in
support of a relationship between stress and al
terations in memory. A number of preclinical stud
ies suggest that stress is associated with deficits in
memory. For example, animals exposed to the
stress of electric footshock develop deficits in
short-term memory as manifested by deficits in
maze escape behaviors (Drugan et aI., 1984). High
levels of glucocorticoids associated with stress
result in damage to neurons of the hippocampus
(Sapolsky et aI., 1988, 1990; Uno et aI., 1989), a
brain structure that plays an important role in
learning and memory, with associated deficits in
memory (Luine et aI., 1994). Stress also appears to
result in overconsolidation of memory, which may
be related to neurotransmitters and neuropeptides
released during stress that facilitate the laying
down of memory traces (Pitman, 1989; Pitman et
aI., 1993; Bremner et aI., 1995a).
There was a relationship between overall level of
abuse exposure measured with the ETI and deficits
in short-term verbal memory in the patients in this
study. The relationship suggests that deficits in
short-term memory are clinically meaningful and
relate to exposure to the stressor of abuse itself in
stead of to other factors such as psychiatric patient
status. In addition, the current findings are a par
tial validation of the ability of the ETI to measure
abuse-related phenomena. Early trauma patients
also showed a relationship between IQ and level of
trauma exposure, where lower IQ was associated
with increased levels of abuse. This relationship
between trauma exposure and IQ was not seen in
our combat-related PTSD sample. Previous stud
ies in children with a history of severe abuse have
found a relationship between the arithmetic
subscale of the IQ test and markers of abuse
(Lewis et aI., 1979). Trauma at early stages of de
velopment may have an effect on IQ that is not
seen in patients exposed to traumatic stress at later
periods of development. Alternatively, since IQ is
remarkably stable throughout the lifetime, and ap
pears to have a heritable component, one might
consider that families in which there is lower IQ
may be associated with situations of abuse.
Therefore, low IQ may be a risk factor, rather than
an outcome, for exposure to abuse. Although our
patients did not have significantly lower IQ scores
than comparison subjects, it can be seen from the
data that with a much larger number of subjects,
it might be possible to demonstrate lower IQ in the
patients in comparison to the normal subjects.
One might argue that our findings of deficits in
105 J.D. BremMr et al./ Psychiatry Research 59 (1995) 97-107
verbal memory in patients with early trauma
related PTSD are attributable to an impairment in
concentration. Decreased concentration is a symp
tom of PTSD. However, emerging findings from
other groups using the continuous performance
test (CPT) in the evaluation of concentration in
PTSD patients have revealed no difference be
tween patients and controls in concentration. In
addition, a general concentration impairment
would not be expected to result in a specific deficit
in verbal memory function, but rather a general
effect on both visual and verbal memory.
Findings of deficits in short-term verbal
memory have implications for the clinical treat
ment of individuals with a history of severe
childhood abuse. These patients may have difficul
ties with learning that impair academic perfor
mance (P. Saigh, personal communication,
February 1, 1995). There is a tendency to direct
patients who are disabled by psychiatric disorders
toward rehabilitation programs. These programs
often involve a return to the university to learn
new job skills. Patients with a history of severe
abuse may have deficits in new learning and
memory that make academic goals difficult to at
tain. Rehabilitation that involves, for example,
training in job skills that do not require a large
amount of memorization may be indicated. In ad
dition, early treatment interventions may prevent
the long-term impairments in memory function,
and hence academic performance, that appear to
be associated with exposure to high levels of stress
as occurs with childhood abuse (Saigh, 1989).
Studies such as the current one that demonstrate
long-term impairment in academic performance,
which appears to be associated with childhood
abuse, underscore the magnitude of childhood
abuse as a major public health problem.
Acknowledgments
The authors thank Valinda Ouelette, R.N., for
assistance in administration of testing and Beverly
Homer for assistance in research administration
and data management. This project was supported
by a Veterans Administration Research Fellow
ship in Biological Psychiatry and a Veterans
Administration Career Development Award to
Dr. Bremner, as well as the National Center for
PTSD Grant. The authors also thank Dudley
Blake, Ph.D. (formerly of the VA Medical Center
site of the National Center for PTSD in Menlo
Park, Calif., and now in Boise, Idaho), and Paula
Schnurr, Ph.D. (White River Junction site of the
National Center for PTSD), for useful discussions,
as well as their contribution and those of other in
dividuals to the Early Trauma Inventory (ETI)
project, which involved the collaboration of in
vestigators from the four sites of the National
Center for PTSD (White River Junction, Vt.; West
Haven, Conn.; Boston, Mass.; Menlo Park,
Calif.). We also thank Carolyn Mazure, Ph.D., for
expert collaboration in instrument development
methodology in the ETI project.
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AM
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SIGNATURE-House Staff MD,
CONSULTING W-SlGNATURE TIME SEEN SERVICE
HAHNEMANN
UNIVERSITY -, HOSPITAL
Philadelph;a Pa.,19102
-

,
,.'
FINAL IMPRESSION
CONSULTANT REO,
T;me' AM
'Called PM

EMERGENCY _.
DEPARTMENT'
, RECORD
-,
,
URINE
EKG
Drug Screen
o,Monitor
:. ..".
o SpIinlIColiar
C
. (....:
D. Dressing ,
o KneeIIl1lTlOb;-T
o Ace Applied
OSlin
o Betadine 0 Crutches
o Scrubs 0 Cane
CONDITION ON DISCHARGE
\ _. -, -.
o Same,'. (Explain):
to- .. RBClhpf
Z
WII.Cl"Pt'
S __ __-1---+=a.et;;:;;ert.
-L -iL_EMJ-==-__ __
I'tECORD ROOM
11
/A ".::;; . ::' .. ,
., .J
o
PATIENT NUM.".
Ir fJ(5'1t..LA 5"",- t4u!,:- CIt .;.' tJaJJ %./1,
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EMERGENCY ROOM .,.6RSES RECORD
'. Hahnemann Medical College and Hospital
:ATIDZt' II ....
DATE: TIME I" TEMP P R BP . NOTES
\ ,
-
'71
INTAKE , -......OUTPUT I
TJME.
MEDICATIONS
MEDICAnONS DOSE ROUTE SITE MOl RN
PARENTERAL J
URINE OTHER TIME AMOUNT I FLUID SITE
--+----------------1---t----t-----------+----1f----:r_
o CLOTHING TO _ o EYEGLASSES. 0 OTHER
o VALUABLES TO
o DENTURES
DISCHARGE/
=",:
t---------------------------------
..
TRANSFER
SUMMARY
TIME CONDITION
FORM 1196 REV 03 - 82 A
o
o
EMERGENCY ROOM CONSULTATION AND CONTINUATION RECORD
HAHNEMANN UNIVERSITY HOSPITAL
DATE _
E. R. NUMBER
NAME
4.s:t=e ' ,"C- .
"La"'...."'NT
G\ -

7
,--
.>--,
-
'--

i.
"'ORM 171107 (ft.V 1 - III A WHITE: Record Room CANARY: R.f.".. PINK: E......-.cy Room
..
0

DIAGNOSTIC REQUEST AND REPORT

DEPARTMENT OF DIAGNOSTIC RADIOLOGY
HISTORY NO.
Hahnemann University Hospital
.. AGE
LMP

., .
; .. :. ...
Rt. Lt: Both t8Ccervical Spine 0 CT Brain Scan
.,
DR.
.. DO Femur 0 0 c oCT Body Scan
X-RAYED HERE BEFORE?
___ .r.. ':_
oWALK 0 Thoracic Spine o UltrMound
OWHEEL CHAI.R
DO Knee o
o NO ... 0 YES, DATE: / /
0 Lumbosac. Spine

Multiple
o CARRIER DO Tibia-Fibula o
o Pelvis Unil. o Chest PA +Lat. o G.I. w/Air Contrast Both DO Ankle
o
Rt. Lt. rK Bifat.
Barium
DO Foot DO Coccyx oCerebral Artario.
0
o Chest AP or PA DO Clavicle o o Esoph/Swallow
---;:;:-;::;-f-------+-------+-------t---------f----------4
o Chest Dccub.
Rt. 0 !0 Small Bowel
o Skull oPulmon. Anario. DO Shoulder o DO Heel o
0
Lt. 0
Artario. Air Contrast Enema
o Orbits o Renal
tj
o Pon. Chest 0 Toe IDO Humerus o
Venogram
O
Barium Enema
O w/Flat Plate
I
o Cardiac Series 0 Paranasal Sinus o Celiac or Mesentenc
0
DO Ribs
o
!DOElbo
w o
w/Flat Plate
o Femoral Anerio.
0 Skeletal Survey (CA) Bones o Chest Fluoro o Gallbladder IDO Forearm
o
(run off) 0
O
Transhepatic
o Chest romo. 0 Myelogram oVenogram
0
DO Wrist o
Cholangiogram
TTube oVascular
OT.M.Joint o Abdomen-KUB 0 Sialogram
Gruntz,g 0
oTherapeutic
o Cholangiogram
i
I
DO Hand
o
o Nasal Bones oAbdomenErect-Supine o I.V.P. w/Tomograms o Finger
o Intervention 0
LaVSoft
o Obstruction Series o Drip I.V.P. w/Tomograms DOHip
o Tissue Neck
ODSA
DO
o Uro/Strep Infu. o Fistulogram o Cystogram o Anhrogra!'1
0
o Serial Film Oint. Bil. Slent o Bone Age o Shuntogram
o D
PERTINENT HISTORY
/
PR?VISIONAL DIAGNOSIS
/ J
1RES,:)ENT OR INTERN DATE EXAM DESIRED
V
_
i
;(/Jc7V/
---
MD. I
, ,
RADIOLOGIS7'S REPORT
NEIL 825117
MULTIPLE STUDIES:
:.- .1. '../ , .; I c:erV1C21 spir)e reveal no
CERVICAL SPINE:
e\/.1.0enCE:
d:i. =; 1DCa 'lion
or abnormal prevertebral
::?;?\/E?::\ 1. nCJ bony th2
neural foramina.
FACIAL BONES: Five views of the facial bones reveal no
of fracture or No alr fluid levels are seen w1thln
the sinuses or air in the orbits.
rnandible
v'Jere
t1ANDIBLE:
which reveal EVldence of fracture.
t-l.D.
TRANS: 8/22/88
Patricia Laffey, M.D.
BY:rb
FORM 333008 IRev 7/861
PATIENTS CHART
-- -

o
Q
-

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fm

'Z5UO
-
EMERGENCY ROOM NURSES RECORD
Hahnemann Medical College and Hospital
JATE TIME TEMP P R BP \J NOTES
PATIENT NUMBER
, ,
11' I r (J(!Yt..LA- 51'-r- +- (JaJ) %II,
Po A- .
- .
PI I JJL '-A-VJ h 1'.P \U1 Prf++v l\ 3 PrlU r
OJsS
MEDICATIONS INTAKE ...- c-r--....OUTPUT I
MEDICATIONS DOSE ROUTE SITE MOl RN TJME .
PARENTERAL
r---\. " J
TIME AMOUNT I FLUID SITE' = URINE OTHER
o CLOTHING TO _ o EYEGLASSES 0 OTHER
o VALUABLES TO
o DENTURES
DISCHARGE/
e:
TRANSFER
SUMMARY
TIME CONDITION
FORM 1196 REV 03 - 82 A
--
o
o
EMERGENCY ROOM NURSES RECORD
Hahnemann Medical College and Hospital
PATIENT NAME
NeiL
DATE TIME TEMP P R BP
WII.t <.'NkA {AJ m-+- A
/X- t'f9., Pr'nN'./
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PROGRESS NOTES
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INTAKE
- -
- MEDICATIONS OUTPUT
TJME . MEDICAnONS DOSE ROUTE SITE MOl RN
PARENTERAL
TIME AMOUNT I FLUID SITE NEEDLE URINE OTHER
o CL.OTHING TO _ o EYEGLASSES .0 OTHER
o VALUABLES TO
o DENTURES
DISCHARGE/
1::'"
TRANSFER
SUMMARY
TIME CONDITION NURSES' SIGNATURE
FORM 1196 REV 03 - 82 A
; ... .. ... 7: ... 31 say'4fJfllft . e.
Fall P --.:,:: " 6
''''';''NAME '_ /Jed -- DATE 1332;')....0
.-, . , ' e>
': ..-. po';." 24
2. Apply ice to areas of swelling of the scalp for 15 minut.. to
,6 hours,dUring the first 24.tt()urs after injury. " ',: ,
,.3. Li9!lt diet for 24 hours after injury. '
f 4. Avoid strenuous physical exereisefor at least 24 hoursafter the injury.
Return to the Emergency Room immediately if:
, 1. The patient becomes confused. vomits. is unsteady or clumsy
p:You are unable to awaken the patient. '
'3. The patient has a'seizure or convulsion
4., Headache gets worse.,
5. The patient complains of double or blurred vision.
I
o WOUND CARE
1. Keep the wound and bandage dry and clean,
2. Even with every precaution. any wound can become infected.
3. Return to the Emergency Room at any time if:
a. wound becomes red. swollen or hot
b. wound breaks open. drains or has bad odor
c. sore glands or red streaks develop
d. pain worsens
e dressing becomes blood soaked V
4. Keep injured arm or leg elevated high,il',than your heart level to
Plevent swelling and reduce soreness. / .

Ywch;nq th.
ccompanylng paUT. For vomiting. stop all foods anclliquids for several
hours. Later. try sipping clear liquids each hour. After f2110urs without
try a b.la.nd d.iet. For diar.rhea. drink plenty of etu,'liQuids. Eat '
. no IMlally;:When "',
Blear Liquids:' Jello. fr.llit IUI.ces (apple. cranberry,
(seven-up. glnger-aleh Don t remain on a clear liquid dietfotmorethan
72 hours. Call your doctor if diarrhea persists more thtin:72hours.
Blend meat. fish. poultry. potato. rice.
.. ---.:'" .
NOTE: AVOIO-milk and other dairy products. raw fi'uiIa
nuts. chocolate, and fatty or fried foods until you a,. better;- .
'. ...
o JOINT SPRAINS. SEVERE BRUISES:"-
Pain is usually mild when the injury occurs. but a
hours. Swelling also comes on gradually. " ,", .":-\'; ,
... ;;" :
1. Rest is the most important treatment. .';. ",'
2. Keep injured arm or leg eleval8d higher than Y,o.ur 'heart level to '
prevent swelling and reduce soreneb.- ,. : .. "': .
3. Coid packsshouhl be appliedfor the first 24-48 Use
between the ice bag and the skin to avoid frostbite.
4. Warm packs or soaks may be used after 48 hours,
, '
6. po not stand on an injured foot or leg until you can do pain;
then gradually return to normal activity. ,

o NECK & BACK STRAIN
. 1. .Rest the injured area. avoiding anypainful .. ,
'<c . .. '
2. Apply heat at least 3 or 4 times a day. .... .,
; .. ".
3. For neck strains. try sleeping with a low pillow or no pillow at all.
4. activities very gradually. "',' i-;.To

- I
o Cold packs for first 24-48 hours. Use a towel between the ice bag and
C
..... the skin to avoid frostbite.
'0
-0 Heat every hours for minutes until _
0
.beginning _
0::
o Soak in warm water every hours for minutes
W
for days.

Z o May take aspirin or Tylenol 1 or 2 tablets every 4 hrs. as needed.

MEDICATIONS/PRESCRIPTIONS
"C
..
Medication Amount Order,c!

Dose Directions _
o
u
CD
0::
>
II:
c(
o Drink gla"'s of fluid a day until ,
,
- 0 Make an appointment with a physician tetanustoxoid booeter in 1
month and again in 6 months to complete ybur immunization.
1:1 Do not drink any alcoholic beverages, drive a car, or operate any
dangerous machinery while taking the medication given or...-c:ribed for
you.
OTHER INSTRUCTIONS
L ..... "
:....:.,' '="""::::.1+.'2"-( . :-SC"'''-'7
...
Z
c(-- -- ....- ................ .......__....._ -..-....__......... __
(J IFYOU HAVE ANY FURTHER PROBLEMS CALLYOUR DOCTOROR CALLTHE EMERGENCYROOM.
FOLLOW-UP CARE
o Your appointment is on at _
,0 Call for an appointment to be seen in days.
o Clinic 448- _
Interpretation of X-rays and tests is preliminary only.
.You will be contacted if there is any further abnormality
'
that needs medical attention.
I understand that I have had emergency treatment only
and that I must arrange for follow-up care as
indicated above.
I understand the instructions above.
01t..llt<f: Q
0
40 l an. LlI-k.J.re.v. hC'
DATE TIME W1vsICIAN SIGNATURE 0
o Industrial Compensetion Clinic (Enter thru Bobst Entrance)
o City Compensation Clinic 216 N. Broad St. 6th Fir. (; day)
o Oral Surgery Clinic 326 N. 16th St.
o William Penn Bldg. 246 N. Broad St.
o Feinstein Bldg. 216 N. Broad St.
o Your own doctor -----------------
o Other
patient may return to work or school.
patient may not return to work or school
until
Restrictions: ,
.0. Signature:
I
r
,
- J- y-\._ /\
-.;,,------ ... ... " ..
SIGNATURE RELATIGNSHIP TO PATIENT . :-.AME.AU;HORIZED PERSON(Print)
_I ".

-:-;Alrthorization for Eme!gencv Department Treatment
----::;IH'S AUTHORIZATION MUST BE SIGNED BY THE PATIENT, OR BY AN AUTHORIZE&PERSQN,
__ .,': ,.....--' ----,------- .. ........;;-.....
__::-l! 1.<.=, . . '. .'
- .]q Em,fgencv'l)epiirtinenfof Hahnemanfi1'vfelficilIC011ege-ailafiospitarTcOilserit:uislrChcare;tnCfUarng
If further treatment is required. or If c:DlIlPlications_arise or if hospitalization is necessary. IDIl.undersigned ..
stands a personal phvslcian 15 !O De selected by or on behalf of the patient within 24 hours. ,l(1l2a3P
0
' .
--- precedures. surgicid and medical treatment. and blood transfusions, .." physicians.and other health care
::;0 u maV in their professional jiJagemenDJinecemrv..:.--------.-,;-,,_.;'....-- ,:;V.'"; --,
. I
;
. - - - --- .. . - - - -- - -- - - - --- -
THE UNDERSIGNED HAS READ THE ABOVE AUTHORIZATION AND UNDERSTANDS THE SAME -,IA ..... '.
'CERTIFIES THAT NO GUARANTEE OR ASSURANCEliAS BEEN MADE AS TO THE RESULTS THAT' ",', '."J." ,
I'vtAy BE OBTAINED.
\-"\...
:./
rliis is to
'''-;'' . _:. --'--(), ----. ,--rvE' , __ _ _ ..,. __" __ .. _ . __ .. __d1_.:;;,l _ _:_.,,_+: ._"." __
!
DATE.
'at ()D,'2f) p.m. is being discharged against the of the. attending.. physic:ian and. the
I.r' ' .J -'---.-_ -. ---.- ;-.- __,9 .-----------------+-
hospiUl administrator; I have" !leen inflStmed of -all risks involved itiif:hospital.

,

(.......P)
ER RECORD
71
GlUESPJE, .1L
-
....Dl%.aM3
"
08/20/88
32
-
ALa1 EVEETh .JANEl I>DD479 s ..5%83320 . -_,..
.. ..
m
CLERK' A"L REG 11MI 09122PJt JJOIII 03/ RACE.... RELIGlt:1tl
SlA1USI S LANGUAGE. SERVICE CODE' ERR X-RA1.' GZSII.1
PM1S GROUP' GROUP
CHIEF CmtPl.AIN1' IN.JURl 10 FACE/ltUGGING
BROUGHl Bli POLICECAR 012
* * *..*.. PAll1Nl ADDRESS it*.***... .. EJERGENCl CONlACl .
Z020 WALNUl S1. CORNELIUS GILLESPIE FA1HER
PHILA PA 19101

HO"EI
******* PA1IENl EMPL01ER *****.**. WORK'
**.**.. (iUARANTOR .....it...,
******** GUARAN10R *.********* .
CilLLESPlE, NEIL SELF
ZD2'D WALNUl & OCCUPA1I ON I &'lUDNl
PHtLA PA 191D1- SOC SEC NOI
SPECIAL CODE'
*************************.. 1 *********.**********.**
COMPANY NAJitE I EFFEC1IVE DAlE'.
INSURANCE PLAN CODE 1 EFFEC1IVE DAlE .(PARl EI)'
SUBSCRIBER' CO. CODE I EIP DAlE 1
PAl RELA'J1 ON 10 1NSORED I VERI F 1 CAlION CODE I
POLICl.1 GROUP#I INSUR APPRV CODEI
************************ Z *******.....**********.....****
CEmPANl NAJitE 1 EFFECll VE DAlE'
PLAN CODEI EFFEClIVE DAlE (PARl il.
SUBSCRIBER' CO. CODE. EIP DAlE .
PAl RELA1ION 10 INSURED' VERIFICA1IOJt CODE.
POLICl.. GROUP.. INSUR APPRV COJ)I
****** PRIOR HOSPllALl2A110N ****** ********** ACClDENl DA1A **....***
DAlE I 11MEI
DAlE. NA1URE.
WORK RELinED I N
Ii***** MlSCLLANEOUS OA1A *****.***
DIS1RICl CODE I

........... ., . t , "
..11.1.5...._, Nl1.
iR REtIlJtJ)
)
-+
__ __ __ _ _ . n f\" I
_._........... -
NEIL J. GILLESPIE,
CASE NO.: 12-11213-C
vs. CASE NO.: 12-11028-B
FLORIDA, et al.
_______________________________/
APPENDIX - 2
Exhibit 12 FDLE, NO Florida criminal history for Neil J. Gillespie
Exhibit 13 HCSO, NO criminal history for Neil J. Gillespie
Exhibit 14 Gillespie certified as Eagle Scout, December 3, 1971
Exhibit 15 University of Pennsylvania, Wharton Evening School, ABA, Dec-23, 1988
Exhibit 16 The Evergreen State College, BA, December 16, 1995
Exhibit 17 Letter from Terry D. Silver, CPA, December 13, 2001, Re: Neil Gillespie
Exhibit 18 News stories of Gillespies business, Bucks County Courier Times
Exhibit 19 Mr. Rodems law firms representation of Gillespie, DVR
Exhibit 20 Gillespie letter to Mr. Cook, Barker, Rodems & Cook, Re: Hate Speech
Exhibit 21 Letter of Dr. Karin Huffer, Re: Neil Gillespie and the ADA
Exhibit 22 Gillespies Nov-11-06 letter to Judge Neilsen, ADA; Mr. Naumans response
St ep 5 of 5
Your Sear ch Resul t s
Your Sear ch Cr i t er i a
FDLE f ound NO Fl or i da cr i mi nal hi st or y based on t he i nf or mat i on pr ov i ded. No cr i mi nal
r ecor d check w as conduct ed f or ot her st at es or f or t he FBI . Thi s r ecor d ( or st at ement t hat
t her e i s not a r ecor d) i s based on a r equest f r om a member of t he publ i c.Thi s cust omer used
t he FDLE i nt er net sy st em t o sear ch f or t he Fl or i da r ecor d. FDLE i s pr ov i di ng t hi s t o r espond
t o t he cust omer ' s r equest .
Help underst anding t hese result s

Fi r st Mi ddl e Last Dat e of Bi r t h Age Race Sex SSN
Name Nei l Joseph Gi l l espi e 03191956 W M 160525117
Maiden/ Alias - - - - -
* Name Aliases/ Also Known As DOB SSN Sex Race Height Weight Eye Hair
Print Home

Email Results to: neilgillespie@mfi.net New Search
Page 1 of 1 FDLE Criminal History Information on the Internet
9/12/2010 https://www2.fdle.state.fl.us/cchinet/CCHCandidates.aspx
12
SANCHEZ. BARBARA
From: LINDSEY, HOWARD
Sent: Wednesday, August 31, 2011 1:56 PM
To: SANCHEZ, BARBARA
Subject: RE: PRR - Neil Gillespie
Ms. Sanchez, I have spent approximately 45 minutes searching diligently to locate any
record of arrest or otherwise for Mr. Gillespie. At this time I am unable to find any
paper record or video of this individual and my search covered June 20, 2011 thru June 22,
2011. Please let me know if I can be of any other assistance.
Corporal Howard Lindsey #5243
Operations Corporal
HCSO DDS (Orient Road)
(813)247-8311
hlindsey@hcso.tampa.fl.us
-----Original Message----
From: SANCHEZ, BARBARA
Sent: Wednesday, August 31, 2011 1:03 PM
To: LINDSEY, HOWARD
Cc: ADLER, EDWINIA
Subject: FW: PRR - Neil Gillespie
Good Afternoon Cpl:
Please review the email below and attachments. Please research to assure if there are any
records in your areas. Please provide me with the records and completed cost sheet (as
soon as possible please) .
Barbara Sanchez, Records Custodian
Records Section
Hillsborough County Sheriff's Office
Post Office Box 3371
Tampa, FL 33601
Office (813) 247-8153
Fax (813) 247-8295
Email: bsanchez@hcso.tampa.fl.us
This agency is a public entity and is subject to Chapter 119 of the Florida Statute
concerning public records. Email messages are covered under such laws and thus subject to
disclosure.
From: SANCHEZ, BARBARA
Sent: Monday, August 29, 2011 9:51 AM
To: LIVINGSTON, JAMES P
Cc: OLIVER, SARAH; ADLER, EDWINIA
Subject: PRR - Neil Gillespie
Good Morning:
Attached is a public records request from Neil Gillespie. Please review the attachment
and provide the record from your area. Additionally, please complete the attached cost
1
13
I
sheet and return with the records.
SUSPENSE: 9/2/11
have included additional information regarding previous communications.
Barbara Sanchez, Records custodian
Records Section
Hillsborough County Sheriff's Office
Post Office Box 3371
Tampa, FL 33601
Office (813) 247-8153
Fax (813) 247-8295
Email: bsanchez@hcso.tampa.fl.us
This agency is a public entity and is subject to Chapter 119 of the Florida Statute
concerning public records. Email messages are covered under such laws and thus subject to
disclosure.
From: SOCRECADMK@hcso.tampa.fl.us [mailto:SOCRECADMK@hcso.tampa.fl.us]
Sent: Monday, August 29, 2011 10:16 AM
To: SANCHEZ, BARBARA
Subject: Message from KMBT 600
2
NEIL J GILLESPIE
TROOP 124- LEVITTOWN PENNSYLVANIA
HAVING SATISFACTORILY COMPLETED THE REQUIREMENTS
IS HEREBY CERTIFIED AS AN
EAGLE SCOUT
BY THE
BOY SCOUTS OF AMERICA
DECEMBER
3 1971
DATE
777

HONORARY PRESIDENT

PRESIDENT

CHI Ef SCOUT EXECUTIVE

14
V N' .1 V E R SIT A S
PENNSYLVANIENSIS
OMNI BVS HAS LITTERAS LECTVJtIS SAL'/TEM DICIT
,urn. academiis antiquus m.os sit scientiis litterisve
'. humanioribus excultos titulo ius-to condecorare
nos igitur auc-tpri-tate Curatorum nobis com.m.issa
NEIL JOSEPH GILLESPIE
ob studia a Professoribus approbata. ad gt'adum
ASSOCIATE IN BUSINESS ADMINISTRATION
admisimus eique omnia iura honores privilegia. ad hunc
gradum pertinentia. Ubenter con.cessimus
Cuius rei testimonio nOtnina nostta die mensis
Decembris XX\\\ Anno Salutis MCMLXXXVll\ et Vniversitatis
conditae CCXL1X PhUadelphiae subscnpsimus
HIe GRADVS CONLATVS EST CVM LAVDE
s ~
{::::) p R. ~ E
r
5
M ... A . . u n P 1 ~
~ u 1 1 e. ~
DECANVS
Sigilli Custos
15
THE EVERGREEN STATE COLLEGE
In recognition of completion
of the course of study approved by the faculty
)Veil joseph (jillespie
is awarded the degree
BACHELOR OF ARTS
with all its honors, privileges and obligations, Conferred at Olympia,
Washington, the Sixteenth day ofDecember,
Nineteen hundred and Ninety-Five.
v
16
YAMPOLSKY, MANDELOFF, SILVER & COMPANY, P.C.
Certified Public Accountants
1420 WALNUT STREET. SUITE 200
TELEPHONE (215)5454800
PHILADELPHIA. PA 19102
FAX (215) 985-1161
December 13, 1991
To whom it may concern:
I have been requested to set forth a history of my relationship with Mr. Neil
Gillespie, which is as follows:
1) I have known Neil since 1978 when I became his accountant. At that time,
Neil was an automobile sales person.
2) Several years after I began performing Neil's personal income tax work, he
began his own used automobile business which was incorporated under the
name of Kar Kingdom, Inc. The Company operated from a rental location for
approximately two years, at which time Neil purchased a car lot in
Langhorne, Pennsylvania to further the growth of the business. Under
Neil's,direction, Kar Kingdom, Inc. continued to grow from one year to the
next, realizing sales approaching $2,000,000 per year and employing
approximately seven individuals.
3) Kar Kingdom, Inc. operated successfully through mid 1988, at which time the
lot was sold due to a down turn in the automobile business in Langhorne.
4) During 1989 and 1990, Neil was instrumental in the formation of two
Companies, Automotive Specialists, Inc. and Global Business Services, Inc.
Neil lent his professional expertise to Automotive Specialists, Inc. while
he offered professional business consulting services through his Company,
Global Business Services, Inc.
5) Neil maintained his personal residences in Philadelphia ~ r o m 1984 through
1989, most of this period residing at the John Wanamaker House.
6) While Neil's business interests have suffered due to the ongoing current
recession, our office continues to consider Neil as a quality client and a
friend.
17
Page 2
Neil Gillespie
December 13, 1991
We would be happy to provide any other information required regarding Neil
Gillespie if requested.
Sincerely,
Terry D. Silver
TDS/kw/Gillespie

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One-room Edgehlll school near Oxford Valley Mall
. . . built in 1894 and saId 14st month
Spared
Middletown businessmen
buy Wstoricschoolhouse
By Joe C1allnl
Courier Times Stat( Writer
The site of the historic Edgchlll School In Middletown Township
will not become I car wash, but a car lot mil!ht be in its futurC'.
The structure was recently by two township business
men atter a car wash firm hacked out of a deal to buy it. And one oflhe
ways the two are considering using the properly Is as a used car lot.
Nell Gillespie. owner of Kar Kingdom. aod Daniel Day. a realtor
paid $87,500 for the.tormer school, located at the Intersecllon of Routes
I and 213 and next to the Joshua Tree 'restaurant. That is the same
amount bid by National Pride at a public aucllon laslyear.
Nallonal Pride, which had hoped to build a car wash on the site,
was unable to complete the sale because of high Interest rates and a
Ilght loan market. .
Gillespie and Day made settlement on tbe property Jan. 20 but
have not decided what to do with it.
"We arc considering sa ving the building and keeping it In the
style It's In," Oay.sald.
One-room schoolhouse
Although thp. structure was converted to a house years
ago. ft is one of the last one-room schoolhouses In Lower Bucks County.
The sale of the house prompted township officials to see if they could
.save the building.
Barbara Russell, chairwoman of the township's Historical Pres
ervallon Commission, had urged township supervisors to do what they
could to save the bUilding and the township convinced Nallonal Pride to
withdraw a permit to demolish the building while alternallves were
considered.
. Before a fin'al decision could be made, however, National Pride
decided not to go through with the purchase and the became
the property of Day and Gillespie, who were unsuccessful bidders at the
public aucllon.
"We bought It as an Investment," Gillespie said.
Day said one of the possible uses of the building Is as an office,
but he said he and his partner have not reached a final decision yet. .
Used car 101 .
On Jan. 23 Gillespie wrote to Middletown building Inspector E.
Max Einenker to say h.e hoped to use the property for the sale of used
cars.
Elnenkel responded four days later. however. that the zoning or- .
dinance affecting the property "specifically prohibits any use which in
volves, 8S its matn usc, 8 direct servJce to the general public. II
The two would then need to apply for a zoning variance and Day
said he and Gillespie still are considering what use they can make of
the building and the property.
Courier Times photo bv Art Gentile!
Neil Gillespie, president of Kar Kingdom in Township, displ.ays the Lo'itdon Roadster.
.,
i
ew roadster has'408
Middletown dealer offers spiffy sports car
' .. !
Chandler
. Courier Times Business Editor
Kingdom, a Middletown
Township business, has be
come the exclusive area auto
dealer for the London
:-fu}adster, an Americanmade
convertible that looks like a
.'British sports car of the 1940s.
:::';':,'''A lot of new cars today all
; JOl;)k alike," said Neil J. Gilles
;'pie. president of Kar Kingdom,
.which is located at Lincoln
and Route 213: .,
;':"':':.;4But no one is going to con
,:rase this car... he continued.
;' '''It's an original. U
London Roadster is Kar
::l.I;1pgdom's first line of new
,Cllrs. Gillespie said. Up until
now. the dealership only sold
used cars.
The top-of-the-Iine London
Roadster model sells for $16,
985, Gillespie explained. "It
really is a fun kind of car," he
said.
The car is manufactured by
London Motors Corp. of Dear
born, Mich.
"The company has been in
.business for 19 years." Gilles
pic said. "Up until now, the
'company sold directly to the
public through ads in the Wall
.Street Journal and the New
York Times, .' .
.,: "But now, they decided to in
crease their market sharc hy
establishing dealers."
. Gillespie, a Levittown native
and a graduate of Bishop Egan
Hil!h School, said hc found out
about the London Roadster in
an advertisement in the W.all
Street Journal.
"I called about getting a
dealership," he said. "I flew
out to Detroit and liked it. It's
very similar to the early MGs
(a British sports car) of the late
1940s and early 1950s.
".It's a very high-quality car.
It's 78-percent hand made. ,," .
The London Roadster has a
l.8-liter, 4-cylinder' engine. 'It
has rack pinion steering,
disc brakes iii the front and
drum brakes in the rear, an in
dependent fou'r-wheel s'uspen-'
sian, and a non-rust, fiberglllss
body on a steel frame. .
A customer interested in
buying a London Roadster
must know how to drive a car
with manual transmission.
. "It's modeled after the line.
of real sports cars, and they
didn't come with an automatic
shiH," Gillespie said. ':
. Kar Kingdom was started in
1980. Gillespie said. Its office
building is located in the for
mer Edge Hill School building:
which was built in 1894 and used
as a school until the 1940s.. ,i
, "I
After that. the building was
used as a residence up 'until thl!
time Kar Kingdom bought i.t .
In order to display thc' Lo!!:
don Roadster, GlIlespiebui!(.l!
showroom adjoining Kar Kin'g
dam's office building. The. deal,
ership also recently built a ser:
vice center to handle' all of its
cars. . .. . ;:'
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18
IN THE SUPREME COURT OF THE
STATE OF FLORIDA
NEIL J. GILLESPIE
Petitioner, Case No.: SC11-1622
Lower Tribunal No(s).: 2D10-5197
05-CA-7205
vs.
BARKER, RODEMS & COOK, P.A. and
William J. Cook,
Respondents.
________________________________________/
PETITION FOR WRIT OF MANDAMUS
APPENDIX, VOLUME 14
Respondents Representation of Petitioner in Florida Vocational Rehabilitation
Exhibit 1 2001, 03-22-01, Letter, Gillespie to Mr. Cook, Barker, Rodems &
Cook, Florida Vocational Rehabilitation (DVR), DLES CASE NO: 98-066-DVR
Exhibit 2 Second Amended Petition for Administrative Hearing, 06-07-98
Exhibit 3 Third Amended Petition for Administrative Hearing, 07-02-98
Exhibit 4 Petitioners Motion for Final Summary Order, 10-02-98
Exhibit 5 Petitioners Notice of Withdrawal Of Request for Hearing, 11-09-98
Exhibit 6 Order Dismissing and Closing the File, Final Order, 11-12-98
Exhibit 7 2001, 03-27-01, Mr. Cook, Barker, Rodems & Cook, to Gillespie, re DVR
19
Neil J. Gillespie
1121 Beach Drive NE, Apt. C-2
Saint Petersburg, Florida 33701-1434
Telephone and fax: (727) 823-2390
May 21,2001
William J. Cook, Attorney at Law
Barker, Rodems & Cook, PA
300 West Platt Street, Suite 150
Dear Bill,
Thank you for letting me know about the Copernic Internet search tool. This
search tool is similar to the ForeFront Direct product with which I was involved.
While using Copernic recently I came across some information illustrating the
negative attitudes some people have toward persons born with cleft palate. Given the
number of disability questions raised by John Anthony during my recent deposition, I
thought you might find this data informative. Enclosed is the printout of the web page.
Sincerely,
Neil J. Gillespie
enclosure
20
Guess What?!! Page 1 of2
Guess What?!!
[ Follow Ups ] [Post Folowup ] [Tel Us Your Cleft Stories ]
Posted byHushG.. RecktIMm on December 12,19100 at 18:59:37:
In Reply to: anyone born with deft pallet and bare lip. ITom the UK? posted by Donna on February 03,
19100 at 05:10:45:
I hate people with hare-lips. I think you all
are disgusting and should be killed at birth.
God has punsished your parents for their sins.
Follow Ups:
Re: Guess Wbat'!!J V 10:02:294/11/101 (0)
Re: Guess Wbat1!, You're jackass, that's what" Frank 23:36:17 12/17/100 (0)
Post a Followup
Name:
I
E-Mail:
Subject:
IRe: Guess What?1!
Comments:
:
:
I hate people with hare-lips. I think you all
are disgusting and should be killed at birth.
God has punsished your parents for their sins.
~
..:.J
rtiOnal Link URL:
http://www.cleft.net/storieslmessages/971.html 5/7/01
I
Guess What?!! Page 2 of2
Link Title:
Optional Image URL:
Submit FplJow Up I Reset I
[ Follow Ups ] [Post FoUowup ] [Tell Us Your Cleft Stories ]
http://www.cleft.net/storieslmessages/971.html
5/7/01
Gillespie p1 of 2
1
DR. KARIN HUFFER
Li censed Marri age and Fami l y Therapi st #NV0082
ADAAA Ti t l es II and III Speci al i st
Counsel i ng and Forensi c Psychol ogy
3236 Mount ai n Spri ng Rd. Las Vegas, NV 89146
702-528-9588 www. l vaal l c. com
October 28, 2010
I created the first request for reasonable ADA Accommodations for Neil Gillespie. The
document was properly and timely filed. As his ADA advocate, it appeared that his right
to accommodations offsetting his functional impairments were in tact and he was being
afforded full and equal access to the Court. Ever since this time, Mr. Gillespie has been
subjected to ongoing denial of his accommodations and exploitation of his disabilities
As the litigation has proceeded, Mr. Gillespie is routinely denied participatory and
testimonial access to the court. He is discriminated against in the most brutal ways
possible. He is ridiculed by the opposition, accused of malingering by the Judge and
now, with no accommodations approved or in place, Mr. Gillespie is threatened with
arrest if he does not succumb to a deposition. This is like threatening to arrest a
paraplegic if he does not show up at a deposition leaving his wheelchair behind. This is
precedent setting in my experience. I intend to ask for DOJ guidance on this matter.
While my work is as a disinterested third party in terms of the legal particulars of a case,
I am charged with assuring that the client has equal access to the court physically,
psychologically, and emotionally. Critical to each case is that the disabled litigant is able
to communicate and concentrate on equal footing to present and participate in their cases
and protect themselves.
Unfortunately, there are cases that, due to the newness of the ADAAA, lack of training of
judicial personnel, and entrenched patterns of litigating without being mandated to
accommodate the disabled, that persons with disabilities become underserved and are too
often ignored or summarily dismissed. Power differential becomes an abusive and
oppressive issue between a person with disabilities and the opposition and/or court
personnel. The litigant with disabilities progressively cannot overcome the stigma and
bureaucratic barriers. Decisions are made by medically unqualified personnel causing
them to be reckless in the endangering of the health and well being of the client. This
creates a severe justice gap that prevents the ADAAA from being effectively applied. In
our adversarial system, the situation can devolve into a war of attrition. For an
unrepresented litigant with a disability to have a team of lawyers as adversaries, the
demand of litigation exceeds the unrepresented, disabled litigants ability to maintain
health while pursuing justice in our courts. Neil Gillespies case is one of those. At this
juncture the harm to Neil Gillespies health, economic situation, and general
diminishment of him in terms of his legal case cannot be overestimated and this bell
21
Gillespie p2 of 2
2
cannot be unrung. He is left with permanent secondary wounds.

Additionally, Neil Gillespie faces risk to his life and health and exhaustion of the ability
to continue to pursue justice with the failure of the ADA Administrative Offices to
respond effectively to the request for accommodations per Federal and Florida mandates.
It seems that the ADA Administrative offices that I have appealed to ignore his requests
for reasonable accommodations, including a response in writing. It is against my
medical advice for Neil Gillespie to continue the traditional legal path without properly
being accommodated. It would be like sending a vulnerable human being into a field of
bullies to sort out a legal problem.
I am accustomed to working nationally with courts of law as a public service. I agree
that our courts must adhere to strict rules. However, they must be flexible when it comes
to ADAAA Accommodations preserving the mandates of this federal law Under Title II
of the ADA. While public entities are not required to create new programs that provide
heretofore unprovided services to assist disabled persons. (Townsend v. Quasim (9th Cir.
2003) 328 F.3d 511, 518) they are bound under ADAAA as a ministerial/administrative
duty to approve any reasonable accommodation even in cases merely regarded as
having a disability with no formal diagnosis.
The United States Department of Justice Technical Assistance Manual adopted by
Florida also provides instructive guidance: "The ADA provides for equality of
opportunity, but does not guarantee equality of results. The foundation of many of the
specific requirements in the Department's regulations is the principle that individuals
with disabilities must be provided an equally effective opportunity to participate in or
benefit from a public entity's aids, benefits, and services. (U.S. Dept. of Justice, Title II,
Technical Assistance Manual (1993) II-3.3000.) A successful ADA claim does not
require excruciating details as to how the plaintiff's capabilities have been affected by
the impairment, even at the summary judgment stage. Gillen v. Fallon Ambulance Serv.,
Inc., 283 F.3d. My organization follows these guidelines maintaining a firm, focused and
limited stance for equality of participatory and testimonial access. That is what has been
denied Neil Gillespie.
The record of his ADAAA accommodations requests clearly shows that his well-
documented disabilities are now becoming more stress-related and marked by depression
and other serious symptoms that affect what he can do and how he can do it particularly
under stress. Purposeful exacerbation of his symptoms and the resulting harm is, without
a doubt, a strategy of attrition mixed with incompetence at the ADA Administrative level
of these courts. I am prepared to stand by that statement as an observer for more than
two years.
Neil J. Gillespie
8092 SW 115
th
Loop
Telephone: (352) 502-8409
Septerrlber 26, 2006
The Honorable Richard A. Nielsen
Circuit Court Judge
Circuit Civil, Division F
800 E. Twiggs Street, Room 524
RE: Americans with Disabilities Act (ADA) Accommodation Request
Gillespie v. Barker, Rodems & Cook, P.A., and William J. Cook
Case number: 2005-CA-7205, Division F
Dear Judge Nielsen,
In reply to the telephone message from your judicial assistant Myra Gomez, I am
disabled and being treated for depression and anxiety, which limits my ability to
participate in court proceedings and meet deadlines. I request that you provide an
acconunodation for my disability under the Americans with Disabilities Act (ADA),
specifically the appointment of counsel to represent me in this lawsuit and counterclaim.
Thank you.
cc: Ryan Christopher Rodems, Attorney for Defendants
22.1
ADMINISTRATIVE OFFICE OF THE COURTS
THIRTEENTH JUDICIAL CIRCUIT OF FLORIDA
LEGAL DEPARTMENT
DAVID A. ROWLAND COURT COUNSEL
September 29,2006
Neil 1. Gillespie
8092 SW 115
th
Loop
RE: Gillespie v. Barke.r. R o d ~ m s & Cook, P.A., and William J. Cook, Case No.: 05-CA
007205, Thirteenth Judicial Circuit Court, General Civil Division
Dear Mr. Gillespie:
Judge Richard A. Nielsen forwarded to me your letter dated September 26, 2006, for response.
Please be advised the Thirteenth Judicial Circuit is aware of the provisions of the Americans with
Disabilities Act (ADA) and makes every effort to ensure persons with disabilities are given
accommodations in order to provide equality of opportunity and full participation before any court of this
circuit.
In your letter to Judge Nielsen you indicate that you are being treated for depression and anxiety
and are therefore requesting the appointment of counsel to represent you with your pending civil lawsuit
as a reasonable accommodation under the ADA. While depression and anxiety are conditions that mayor
may not be considered impairments under the ADA, depending on whether these conditions result from a
documented physiological or mental disorder, your specific request for the appointment of counsel to
represent you in a civil lawsuit is not a reasonable or appropriate accommodation under the ADA.
I can assure you the Thirteenth Judicial Circuit will fully comply with the requirements of the
ADA and will provide any appropriate accommodations that may be necessary to allow you equality of
opportunity and full participation in your case before Judge Nielsen. However, any further requests for
ADA accommodations should be directed to the attention of Gonzalo B. Casares, ADA coordinator for
the 13th Judicial Circuit, 800 E. Twiggs St., Tampa, Florida, 33602. Mr. Casares may also be contacted
by telephone at 813-272-6513, and selecting option 2.
Sincerely,
X . ~ ~
K. Christopher Nauman
Assistant Court Counsel
cc: The Honorable Richard A. Nielsen
419 PIERCE STREET ROOM 214 E TAMPA, FLORIDA 33602-4022 PHONE (813) 272-6843 FAX (813) 272-5522
22.2
NEIL J. GILLESPIE,
CASE NO.: 12-11213-C
vs. CASE NO.: 12-11028-B
FLORIDA, et al.
_______________________________/
APPENDIX - 3
Exhibit 23 13th Circuit Counsel David Rowland to Gillespie, Re: ADA July 9, 2010
Exhibit 24 Affidavit of Neil J. Gillespie, Re: Judge Cook and Rodems disqualification
Exhibit 25 Mr. Rodems Motion for Order Determining ADA Disability for Gillespie
Exhibit 26 Order by Hon. Wm. Terrell Hodges, Gillespie established a cause of action in
Gillespie v. HSBC Bank, Case 5:05-cv-00362-WTH-GRJ Document 32 09/25/06

Neil Gillespie
From: "Rowland, Dave" <ROWLANDA@fljud13.org>
To: <neilgillespie@mfi.net>
Cc: "Casares, Gonzalo" <CASAREGB@fljud13.org>; <rodems@barkerrodemsandcook.com>
Sent: Friday, July 09, 2010 3:28 PM
Attach: Response to Neil Gillespie ADA Request.pdf
Subject: Gillespie v. Barker, Rodems & Cook, Case No: 05-CA-007205, Thirteenth Judicial Circuit, General
Civil Division
Page 1 of 1
8/6/2012
Attached is a response to your July 6, 2010 ADA request for accommodation.

David A. Rowland
GeneralCounsel, Thirteenth Judicial Circuit
800 East Twiggs Street, Suite 603
Telephone: (813) 272-5905
rowlanda@fljud13.org

23.1
LEGAL DEPARTMENT
DAVIDA. ROWLAND GENERAL COUNSEL
July 9, 2010
Neil J. Gillespie
8092 SW 115`h Loop
Ocala, Florida. 34481
Via E-Mail: lleilhillesJ^ie r mli.net
Re: ADA Accommodation Request
Gillespie v. Barker, Rodems & Cook, Case No.: 05-CA-007205,
Thirteenth Judicial Circuit, General Civil Division
Dear Mr. Gillespie:
This is a response to your July 6, 2010 ADA request for accommodation
directed to Gonzalo Casares, the Thirteenth Judicial Circuit ADA Coordinator.
You request the same ADA accommodations previously submitted on February 19,
2010. Your February 19, 2010 ADA request was a request for the court to take the
following case management actions:
1. Stop Mr. Rodems' behavior directed toward you that is aggravating your
post traumatic stress syndrome.
2. Fulfill case management duties imposed by Florida Rule of Judicial
Administration 2.545 and designate the above-referenced case as complex
litigation under Florida Rule of Civil Procedure 1.201.
3. Offer services, programs , or activities described in Judge Isom's law review
article - Professionalism and Litigation Ethics, 28 Stetson L. Rev. 323, 324
(1998) - so the court can "intensively" manage the case.
800 EAST Twmos STREET SurrE 603 TAMPA. FLORIDA33602 PHONE: (873) 273-6843 WEB: wwwfljudl3.org
Neil J. Gillespie
July 9, 2010
Page 2
4. Enforce Judge Isom's directives imposed on February 5, 2007 which require
both parties to only address each other by surname when communicating
about this case and require parties to communicate in writing instead of
telephone calls.
5. Allow a 180-day stay so you can scan thousands of documents in this case to
PDF and find and hire replacement counsel.
As ADA Coordinator, Mr. Casares can assist in providing necessary
auxiliary aids and services and any necessary facility-related accommodations.
But neither Mr. Casares, nor any other court employee, can administratively grant,
as an ADA accommodation, requests that relate to the internal management of a
pending case. All of your case management requests - that opposing counsel's
behavior be modified, that the court fulfill its duties under Rule 2.545, that the
above-referenced case be designated as complex, that your case be "intensively"
managed as suggested by Judge Isom's law review article, that Judge Isom's
previous directive regarding communication between parties be enforced, that your
case be stayed - must be submitted by written motion to the presiding judge of the
case. The presiding judge may consider your disability, along with other relevant
factors, in ruling upon your motion.
S i n c e r e l y ,
cc: The Honorable Martha J. Cook
Ryan C. Rodems, Counsel for Defendant
Gonzalo Casares, ADA Coordinator for the Thirteenth Judicial Circuit
LEGAL DEPARTMENT
DAVID A. ROWLAND
GENERAL COUNSEL
July 9,2010
Neil 1. Gillespie
8092 SW IIS
lh
Loop
Via E-Mail: neilgillespic(Ct:mli.Jlct
Re: ADA Accommodation Request
Gillespie v. Barker, Rodems & Cook, Case No.: 05-CA-007205,
Thirteenth Judicial Circuit, General Civil Division
Dear Mr. Gillespie:
This is a response to your July 6, 2010 ADA request for accommodation
directed to Gonzalo Casares, the Thirteenth Judicial Circuit ADA Coordinator.
You request the same ADA accommodations previously submitted on February 19,
2010. Your February 19,2010 ADA request was a request for the court to take the
following case management actions:
1. Stop Mr. Rodems' behavior directed toward you that is aggravating your
post traumatic stress syndrome.
2. Fulfill case management duties imposed by Florida Rule of Judicial
Administration 2.545 and designate the above-referenced case as complex
litigation under Florida Rule of Civil Procedure 1.201.
3. Offer services, programs, or activities described in Judge Isom's law review
article - Professionalism and Litigation Ethics, 28 Stetson L. Rev. 323, 324
(1998) - so the court can "intensively" manage the case.
800 EAST TWIGGS STREET SUITE 603 TAMPA, FLORIDA 33602 PHONE: (813) 272-6843 WEB: www.fIjud13.org
23.2
Neil 1. Gillespie
July 9,2010
Page 2
4. Enforce Judge Isom's directives imposed on February 5, 2007 which require
both parties to only address each other by surname when communicating
about this case and require parties to communicate in writing instead of
telephone calls.
5. Allow a l80-day stay so you can scan thousands of documents in this case to
PDF and find and hire replacement counsel.
As ADA Coordinator, Mr. Casares can assist in providing necessary
auxiliary aids and services and any necessary facility-related accommodations.
But neither Mr. Casares, nor any other court employee, can administratively grant,
as an ADA accommodation, requests that relate to the internal management of a
pending case. All of your case management requests - that opposing counsel's
behavior be modified, that the court fulfill its duties under Rule 2.545, that the
above-referenced case be designated as complex, that your case be "intensively"
managed as suggested by Judge Isom's law review article, that Judge Isom's
previous directive regarding communication between parties be enforced, that your
case be stayed - must be submitted by written motion to the presiding judge of the
case. The presiding judge may consider your disability, along with other relevant
factors, in ruling upon your motion.
Sincerely,
i l f J ~
David A. Rowland
cc: The Honorable Martha J. Cook
Ryan C. Rodems, Counsel for Defendant
Gonzalo Casares, ADA Coordinator for the Thirteenth Judicial Circuit
- ----
- - . _.. _._.- _-_...
13TH JUDICIAL CIRCUIT
LEGAL DEPARTMENT
800 EAST TwIGGS ST., SUITE 603
TAMPA, FLORIDA 33602
o12H1621()396
...
QI
$00.449
VI
07,:1712010
J:
MaHed F=rom 33601
US POSTAGE
Neil J. Gillespie
BOQ2 SW 115th Leop
:l 7 'liff II( lIi,l /Iii I I 1.1I1i/lIlJ!!I,I" 1/11 j III lidIll/Idi "fd
--------------
NEIL J. GILLESPIE,
Plaintiff and Counter-Defendant, CASE NO.: 05-CA-7205
vs.
BARKER, RODEMS & COOK, P.A., DIVISION: G
J ~ COOK,
Defendants and Counter-Plaintiffs.
/
AFFIDAVIT OF NEIL J. GILLESPIE
Neil J. Gillespie, under oath, testifies as follows:
1. My name is Neil J. Gillespie, and I am over eighteen years of age. This
affidavit is given on personal knowledge unless otherwise expressly stated.
2. Circuit Judge Martha J. Cook is presiding over this lawsuit.
3. I am suing my former lawyers in this lawsuit. On information and belief,
Ryan Christopher Rodems is unlawfully representing Barker, Rodems & Cook, PA and
William J. Cook against me.
4. Plaintiffs Motion To Disqualify Counsel was heard April 25, 2006 by
Judge Nielsen. On May 12, 2006 Judge Nielsen signed Order Denying Plaintiffs Motion
To Disqualify Counsel. The Order holds that "The motion to disqualify is denied with
prejudice, except as to the basis that counsel may be a witness, and on that basis, the
motion is denied without prejudice." A certified copy of the Order is attached to this
affidavit as "Exhibit A". There has been no Order on adjudication as to the basis that
Page 1 of4
24
counsel may be a witness. The question of disqualification on the counterclaim has not
been heard at all.
5. Under Florida law the question is not whether Mr. Rodems may be a
witness but whether he "ought" to be a witness. Proper test for disqualification of counsel
is whether counsel "ought" to appear as a witness.[l] Matter of Doughty, 51 B.R. 36.
Disqualification is required when counsel "ought" to appear as a witness. [3] Florida
Realty Inc. v. General Development Corp., 459 F.Supp. 781. On information and belief
Mr. Rodems ought to be a witness.
6. On July 9, 2010 I filed Emergency Motion to Disqualify Defendants'
Counsel Ryan Christopher Rodems & Barker, Rodems & Cook, PA. The motion properly
raises the issue in paragraph 4. The motion properly considered de novo the question of
disqualification on the counterclaim. The motion also shows misconduct by Mr. Rodems
at the April 25, 2006 hearing sufficient to overturn the Order of May 12, 2006.
7. On July 22, 2010 Judge Cook issued "Order Denying Plaintiffs
Emergency Motion to Disqualify Defendants' Counsel Ryan Christopher Rodems &
Barker, Rodems & Cook, PA". A certified copy of the Order is attached to this affidavit
as "Exhibit B". In her Order, Judge Cook wrote "This is the third time that the Plaintiff
has motioned to disqualify Defendant's counsel, despite having been informed in an order
issued May 12,2006 that this issue had been DENIED WITH PREJUDICE." This
statement by Judge Cook is false. The Order issued May 12, 2006 clearly states that
"[e]xcept as to the basis that counsel may be a witness, and on that basis, the motion is
denied without prejudice."
Page 2 of4
8. Judge Cook also wrote, "The Clerk of Court is ORDERED to never accept
another pleading from the Plaintiff that indicates an attempt to disqualify Defendants'
counsel, as this matter has been DISMISSED WITH PREJUDICE."
willfully, with malice aforethought, falsified a record in violation of chapter 839, Florida
Statlltes, section 839.13(1) if any judge shall falsify any record or any paper filed in any
judicial proceeding in any court of this state, or conceal any issue, or falsify any document
filed in any court the person so offending shall be guilty of a misdemeanor of the first
degree, punishable as provided in s. 775.082 or s. 775.083.
willfully, with malice aforethought, engaged in official misconduct to harm Neil Gillespie
and benefit Ryan Christopher Rodems and his clients, by falsifying an official record or
official document as described in this affidavit, to deny Gillespie due process, in violation
of the Misuse of Public Office statute, chapter 838 Florida Statutes, section 838.022
Official misconduct. (1) It is unlawful for a public servant, with corrupt intent to obtain a
benefit for any person or to cause harm to another, to: (a) Falsify, or cause another person
to falsify, any official record or official document; (3) Any person who violates this
section commits a felony of the third degree, punishable as provided in s. 775.082, s.
775.083, or s. 775.084.
willfully, with malice aforethought, made a false statement in writing with the intent to
mislead a public servant, Pat Frank, Clerk of the Circuit Court, in the performance of her
official duty, in violation of the perjury statute, chapter 837 Florida Statutes, section
Page 3 of4
837.06 False official statements. Whoever knowingly makes a false statement in writing
with the intent to mislead a public servant in the performance of his or her official duty
shall be guilty of a misdemeanor of the second degree, punishable as provided in s.
775.082 or s. 775.083.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this 27th day of September 2010.
STATE OF FLORIDA
COUNTY OF MARION
BEFORE ME, the undersigned authority authorized to take oaths and acknowledgments
in the State of Florida, appeared NEIL J. GILLESPIE, personally known to me, or produced
identification, who, after having first been duly sworn, deposes and says that the above matters
contained in this Affidavit are true and correct to the best of his knowledge and belief.
WITNESS my hand and official seal this 27th day of September 2010.
~ ~
CECIUA ROSENBERGER
Notary Public
,
it1 Commission 00 781620
Exptres June 6, 2012 State of Florida
BondIdl1w T ~ Fain InuInoe....701.
Page 4 of4
Defendants.
/
-------------
I
EXHIBIT
3ft
NEIL J. GILLESPIE,
Plaintiff,
vs. Case No.: 05CA7205
Division: F
J. COOK,
Motion to Disqualify Counsel, and the proceedings having been read and considered, and counsel
and Mr. Gillespie having been heard, and the Court being otherwise fully advised in the
premises, it is ORDERED:
The motion to disqualify is denied with prejudice, except as to the basis that counsel may
be a witness, aJ.1d on that basis, the motion is denied without prejudice.
DONE and ORDERED in Chambers, this lZ"'Afday of May, 2006.
Richard A. Nielsen
Circuit Judge
Copies to:
Neil J. Gillespie, pro se
Ryan Christopher Rodems, Esquire
CIVIL LAW DIVISION
NEIL J. GILLESPIE,
Plaintiff, Case No: 05-CA-007205
Division: G
and
WILLIAM J. COOK,
(,;.,)
..
Defendants.
-----------_-----:/
ORDER DENYING PLAINTIFF'S EMERGENCY MOTION TO DISQUALIFY DEFENDANTS'
COUNSEL RYAN CHRISTOPHER RODEMS & BARKER RODEMS & COOK, P.A.
TillS CAUSE came before the Court upon the Plaintiffs motion, filed July 9, 2010. This is the
third time that the Plaintiff has motioned to disqualify Defendant's counsel, despite having been informed
in an order issued May 12, 2006 that this issue had been DENIED WITH PREJUDICE. "With
prejudice" that means that the motion in question is "finally disposed ... and bars any future action on
that claim."1 Moreover, because of the doctrine of res judicata 2 this motion must be DENIED.
The Plaintiff is again noticed (as he has been in two previous Court orders) that repeat filings
attempting to revisit the same issue can be found to rise to the level of a sanctionable offense.
3
The Clerk of Court is ORDERED to never accept another pleading from the Plaintiff that
indicates an attempt to disqualify Defendants' counsel, as this matter has been DISMISSED WITH
PREJUDICE.
DONE and ORDERED in Chambers at Tampa, Hillsborough County, Florida, on July
STATE OF FLORJOA )
201 OF HILLSBOROUGH)
THIS IS TOCERTIFY Tf-'.ATTHE IS A TRUE
AND CORRECT COpy OF THE DOCUMENT ON FILE IN A
WITNOEASy-'S' MF'LXuaND AND.oFFlCiAL SEAL . u..A/___
O
...""",\\\ . -' .t\.AR 20@. -- -..
/ Martha J. Cook
PAT FRANK
"CLE' CIRCUIT COURT JUDGE
... ..
\"" ....
I Black's Law Dictionary, 7 than. D.C.
2 Matters that have been "definitively settl by judicial decision." Black's Law Dictionary, 7
th
Edition.
3 Lanier v. State of Florida, 982 So. 2d 626 (Fla. 2008).
Page 1 of 2
EXHIBIT
Copies Furnished To:
Neil J. Gillespie, pro se (Plaintiff)
8092 SW 115
th
Loop
Ocala, FL 34481
Ryan Christopher Rodems, Esq. (for Defendants)
400 North Ashley Drive, Ste. 2100
Tampa, FL 33602
Page 2 of 2
IN THE CIRCUIT COURT OF THE TIDRTEENTH JUDICIAL CIRCUIT
IN AND FOR IDLLSBOROUGH COUNTY, FLORIDA
NEIL J. GILLESPIE,
Plaintiff,
vs. Case No.: 05CA7205
Division: C
a Florida corporation,
Defendant.
_____________--:1
DEFENDANT'S MOTION FOR AN ORDER DETERMINING PLAINTIFF'S
ENTITLEMENT TO REASONABLE MODIFICATIONS UNDER TITLE II
OF THE AMERICANS WITH DISABILITIES ACT
Defendant Barker, Rodems & Cook, P.A., moves the Court for an Order scheduling an
evidentiary hearing to determine PlaintiffNeil J. Gillespie's entitlement, under the Americans
with Disabilities Act (ADA), to reasonable modifications to the rules or procedures for litigating
this action, and as grounds therefor would state:
1. On December 29,2009, Plaintiff sent a letter to the presiding Judge's Judicial
Assistant complaining that Defendant's counsel had not cleared the hearing date on January 19,
2010 with him. In the December 29, 2009 letter, Plaintiff requested that the Court cancel the
hearing on January 19,2010, and also stated:
Please be advised there are five important outstanding motions that need a hearing ... In
the interest of economy please schedule my five motions together with anything Mr.
Rodems wishes to set. I will need two hours for my five motions.
(Exhibit "1")(Emphasis added). Subsequently, the Court entered an Order canceling the January
19,2010 hearing and scheduled all pending motions for a one hour hearing on January 26, 2010.
2. At the January 26, 2010 hearing, however, Plaintiff delivered a letter to Judge
25
Barton in open court, which stated in pertinent part he had disabilities and required
"accommodations." In direct contrast to his prior request that the Court schedule all five ofhis
pending motions for hearing on the same date over a period of two hours, Plaintiff stated:
Some ofthe accommodations requested are a limit on the number of motions considered
in a single hearing. This Courts December 30, 2009 Order setting "all pending motion"
[sic] is not acceptable. First a determination should be made of the pending motions, then
a reasonable schedule must be set to hear them.
(Exhibit "2").
3. At the hearing on January 26, 2010, after hearing the Plaintiffs assertions that he
was disabled, the Court began an inquiry into this matter, but Plaintiff requested additional time
to submit information to the Court. The Court granted the request and did not hear any oftIle
motions. On February 4, 2010, Plaintiff sent a letter to the Court stating "Regarding the ADA
accommodation information requested by the Court at the hearing January 26, 2010, I plan to
submit the information to the Court by Tuesday, February 9, 2010." (Exhibit "3"). On February
9, 2010, he sent another letter to the Court stating "The ADA accommodation information
requested by the Court at the hearing January 26,2010 is taking longer to prepare than originally
planned. I am sorry to report that it is not ready today as promised. It will be a couple more days,
hopefully by Friday, February 12." (Exhibit "4").
4. To bring this issue to resolution, Defendant requests that the Court schedule an
evidentiary hearing on Plaintiffs claim that he requires "accommodations" under Title II ofthe
ADA.
1
1 Under Title II ofthe ADA, "no qualified individual with a disability shall, by reason of
such disability, be excluded from participation in or be denied the benefits ofthe services,
programs, or activities of a public entity, or be subjected to discrimination by any such entity."
42 U.S.C. 12132. "A public entity shall make reasonable modifications in policies, practices,
2
5. To be covered under Title II of the ADA, Plaintiff must have a "disability,"2 and
even then, Plaintiffis entitled to "reasonable modifications
3
" only if he is a "qualified individual
with a disability." 42 U.S.C. 12132. Stated in plainer terms, ifPlaintiff is not a "qualified
individual with a disability," then he is not protected by Title II of the ADA.
6. Plaintiff bears the burden of proof (a) that he has a "disability"; and (b) that his
"disability" requires "reasonable modifications." Compare Weinreich v. Los Angeles County
Metropolitan Transp. Authority, 114 F.3d 976, 978 (9
th
Cir. 1997)("To prove a public program or
service violates Title II of the ADA, a plaintiff must show: (1) he is a "qualified individual with a
disability"; (2) he was either excluded from participation in or denied the benefits of a public
or procedures when the modifications are necessary to avoid discrimination on the basis of
disability, unless the public entity can demonstrate that making the modifications would
fundamentally alter the nature ofthe service, program, or activity." 28 C.F.R. 35.130(7).
"Public entity" includes "any State or local government" and "any department, agency, special
purpose district, or other instrumentality of a State or States or local government ...." 42 U.S.C.
12131(1).
2 Under Title II ofthe ADA, "[d]isability means, with respect to an individual, a physical
or mental impairment that substantially limits one or more ofthe major life activities of such
individual; a record of such an impairment; or being regarded as having such an impairment." 28
C.F.R. 35.104. "The phrase physical or mental impairment" includes "[a]ny mental or
psychological disorder such as mental retardation, organic brain syndrome, emotional or mental
illness, and specific learning disabilities." 28 C.F.R. 35.104. "The phrase major life activities
means functions such as caring for one's self, performing manual tasks, walking, seeing, hearing,
speaking, breathing, learning, and working." 28 C.F.R. 35.104. A "qualified individual with a
disability" is "an individual with a disability who, with or without reasonable modifications to
rules, policies, or practices, the removal of architectural, communication, or transportation
barriers, or the provision ofauxiliary aids and services, meets the essential eligibility
requirements for the receipt of services or the participation in programs or activities provided by
a public entity." 42 U.S.C. 12131(2).
3 IfPlaintiff has a "disability," then the "reasonable modifications" he may request are
those necessary for him to meet "the essential eligibility requirements for the receipt of services
or the participation in programs or activities provided by a public entity." 42 U.S.C. 12131(2).
3

entity's services, programs or activities, or was otherwise discriminated against by the public
entity; and (3) such exclusion. denial of benefits. or discrimination was by reason of his
disability. See 42 U.S.C. 12132 (emphasis added).").
7. As for the specific factual and legal issues to be resolved at the evidentiary
hearing, Defendants request that the Court schedule an evidentiary hearing to determine:
a. Whether Plaintiff has a "disability," as defmed by Title II of the ADA;
b. If Plaintiff has such a "disability," then what specific "modifications" he is
requesting to the Court's "rules, policies, or practices ... for the receipt of services or the
participation in programs or activities provided by" the Court. 42 U.S.C. 12131(2); and,
c. whether the requested "modifications would fundamentally alter the nature
of the service, program, or activity." 28 C.F.R. 35.130(7).
8. Additionally, because Plaintiff is pro se, the Defendants request that the Court
advise Plaintiff that the Florida Evidence Code shall govern the evidentiary hearing.
WHEREFORE, Defendant moves the Court to schedule an evidentiary hearing to
determine PlaintiffNeil J. Gillespie's entitlement to reasonable modifications under the ADA.
RESPECTFULLY SUBMITTED this 12
th
day of February, 2010.
Florida Bar No. 947652
Barker, Rodems & Cook, P.A.
400 North Ashley Drive, Suite 2100
Telephone: 813/489-1001
Facsimile: 813/489-1008
Attorneys fur Defundant
4
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by
u.s. Mail to Mr. Neil J. Gillespie, 8092 SW 115
th
Loop, Ocala, Florida 34481, this 12th day
February, 2010.
5
12-30-2009 03:34 NEIL GILLESPIE
PAGE2
Neil .J. Gillespie
8092 SW 115
1h
Loop
Ocala. l<'Iorida 34481
Telephone: (352) 854-7807
December 29,2009
VIA FAX: (813) 276 2725
Ms. Linda Greno, Judicial Assistant
The James M. Barton, II
Circuit Court Judge, Thirteenth Judicial Circuit
Circuit Court., Division C
Tampa. Florida 33602
RE: Gillespie Vo Rarker, Rodems & Cook, P.A., and Willjam J. Cook,
case no.: 05CA 7205, Division C
Dcar Ms. Greno:
This faxed letter is a follow-up to my voice message to you earlier today.
I am requesting the court cancel a hearing set for Tuesday, January 19, 2009, at 4:00 PM
set by attorney Ryan Christopher Rodems because Mr. Rodems set the hearing without
consulting with me about the date and time of the hearing.
Please be advised there are five important outstanding motions that need a hearing, one
dating to 2006: (in order, oldest to newest, by date)
1. December 14,2006, Plaintiffs Motion to Compel Defendants' Discovery
2. February 1,2007, Plaintiff's Second Motion to Compel Defendants' Discovery
3. July 16,2008. Plaintiff's Motion for Rehearing. This motion is Mr. Bauer's, and
js necessitated beealL'ie Mr. Rodems misrepresented to Judge Barton that there was a
signed written fee llbTfeement between plaintiff Neil Gillespie and defendant Barker,
Rodems & Cook, PA. For the record, let me state that there is NO signed written fee
agreement between myself and Barker, Rodems & Cook. No sueh agreement signed,
none exists, and Mr. Rodems has not produced one. The lack of a signed written fee
agreement between the parties is also a violation of Bar Rule 4-1.5(f)(2).
12-30-2009 03:34 NEIL GILLESPIE PAGE3
Ms. Linda Greno, Judicial Assistant Page- 2
The Honorable James M. Barton, Jl December 29, 2009
4. August 14,2008. Plaintiffs Claimof Exemption and Request for Hearing. This
motion was also filed by Mr. Bauer and be held to detennine plaintiff's exemptions.
5. December 15,2009, Plaintiff's Motion hold Mr. Rodems in Contempt for
violating Judge Rarton'5 ruling of October 1, 2009. Judge Barton ruled that the case was
stayed and the parties were prohibited from doing anything ofrecord for 60 days.
Nonetheless on October 13, 2009 Mr. Rodems filed ofrecord an amended notice of duces
.tecum during the stay period.
Please advise the undersigned when the above motions can he set for hearing. In the
interest of please cancel Mr. Rodems' improperly scheduled motion set for
January 19,2009. In the interest ofeconomy please schedule my five motions together
with anything Mr. Rodems wishes to set. 1win need two hours for my five motions.
Thank you fllr your kind consideration.
Sincerely,
enclosure: Plaintiffs Motion for Rehearing, July 16, 2008
AU calls on my home l\ffice telephone extension are recorded for quality Jlurpor.e.'l pUNlUllnt to the
business usc exemption or Florida Statllres chapter 934, specifically section 934.02(4)(a)( 1) and the holding of Rc>yal
Health Care Servs. JfIe. \I. Jefferson-Pi/ol Lift Ins. Cf)., 924 fo.2d 215 (11th elr. 1991).
Neil J. Gillespie
8092 SW IIS
th
Loop
January 26, 20I0
VIA HAND DELIVERY
The Honomble James M. Barton, II
Circuit Court, Division C
RE: Gillespie v. Barker, Rodems & Cook, P.A., and William J. Cook,
case no.: 05-CA-7205, Division C
Article I, Section 21 of the Florida Constitution claims to provide access to the courts to
every person for redress of any injury, but for an ordinary citizen justice is often not
administered fairfy and is frequently denied or delayed - Neil Gillespie
Dear Judge Barton:
I apologize for the late timing ofthis letter, but yesterday I became aware ofRule 2.540
Florida Rules ofJudicial Administration, Notices to Persons with Disabilities:
All notices ofcourt proceedings to be held in a public facility, and all process compelling
appearance at such proceedings, shall include the following:
"Ifyou are a person with a disability who needs any accommodation in order to
participate in this proceeding, you are entitled, at no cost to you, to the provision of
certain assistance. Please contact [identifY applicable court personnel by name, address,
and telephone number] within 2 working days ofyour receipt ofthis [describe notice]; if
you are hearing or voice impaired, call 71 I."
Yesterday I tried to clarifY this issue with Court Administrator Mr. Bridenback and left a
message for his assistant Tracy at (813) 272-5368, but no one called back. In addition to
the Rule 2.540 notice, I have a question about how and where to submit my ADA
Assessment and Report. I retained author and health professional Ms. Karin Huffer, MS,
MFT as my Americans with Disabilities Act (ADA) Accommodations Designer and
Advocate. Some ofthe accommodations requested are a limit on the number ofmotions
considered in a single hearing. This Courts December 30, 2009 Order setting "all pending
The Honorable James M. Barton, IT Page-2
January 26,2010
motion" is not acceptable. First a determination should be made ofthe pending motions,
then a reasonable schedule must be set to hear them.
The Court's Order setting today's hearing does not comply with Rule 2.540. Because the
George E. Edgecomb Courthouse, 800 East Twiggs Street, Tampa is apublic facility, I
believe any notice for a hearing there is subject to Rule 2.540. Also, none ofMr. Rodems'
notices for hearings in the courthouse have contained a Rule 2.540 disclosures throughout
this litigation. In all fairness, neither did any ofmy notices, but I amjust an ordinary
citizen and pro se litigant. (Note: the Court's web site cites Rule 2.065).
More importantly, while reading Rule 2.540, I noticed Rule 2.545, Case Management.
For whatever reason none ofthe judges assigned to this case have iinplemented any case
management in over four years. In addition, Rule 1.200 provides for Pretrial Procedure
and a Case Management Conference. In the past I asked Court Counsel about this and did
not receive a response. One ofmy letters to Court Counsel is enclosed. The problem is so
bad in this case that I believe it should have been designated Complex Litigation under
Rule 1.201, Fla.R.Civ.P because A "complex action" is one that is likely to involve
complicated legal or case management issues and that may require extensivejudicial
management to expedite the action, keep costs reasonable, or promote judicial efficiency.
But the conclusive evidence ofofficial wrongdoing in this case is from a lawreviewby
The Honorable Claudia Rickert Isom titled Professionalism and Litigation Ethics, 28
STETSON L. REv. 323,324 (1998). In it, Judge Rickert described the issue ofadversarial
parties and discovery problems, which she calls "cutting up". This is what Judge Isom
wrote: "When this litigious attitude begins to restrict the trial court's ability to effectively
bring cases to resolution, the judge must get involved to assist the process." So apparently
extreme measures such as $11,550 sanctions are not the next step in the process. It is
outrageous that Judge 180mwould ignore her own lawreviewin my case that was before
her Court on February 5, 2007. Clearly the 13
th
Judicial Circuit is prejudiced against me
as either a pro se litigant or a person with disabilities, or both.
Because of this newly discovered evidence I believe a motion for reliefunder Rule 1.540,
Fla.R.Civ.P is appropriate to overturn this Court's Order Determining Amount of
Sanctions, and Final Judgment ofMarch 21, 2008. This sanction ofattorney's fees is even
more outnlgeous given the fact that plaintiff's motion to compel defendants discovery
has not been heard and is pending since December 14, 2006. How can this Court award
$11,550 against me when defendants are guilty ofthe same offense?
I commenced two lawsuits pro se in August 2005 (one being the instant case) because I
could not find or afford counsel to represent him. One lawsuit in federal court involved a
credit card dispute, Gillespie v. HSBC Bank et ai, case no. 5:05-cv-362-0c-WTH-GRJ,
US District Court, Middle District ofFlorida, Ocala Division. The HSBC lawsuit was
resolved a year later with a good result for the parties. Plaintiffwas able to work amicably
with the counsel for HSBC Bank, Traci H. Rollins and David J. D'Agata, counsel with
Squire, Sanders & Dempsey, LLP and the entire case was concluded in 15 months.
The Honorable James M. Barton, n Page-3
January 26,2010
August 17 2005, Complaint filed, Gillespie v HSBC Bank, et al
September 25, 2006, Order establishing a cause ofaction (US District Judge William
Terrell Hodges)
October 23, 2006, Settlement Agreement and Release
November 17, 2006, civil judgment entered dismissing case
Apart from these proceedings I am a law abiding, engaged citizen. I am a former business
owner and graduate ofThe Wharton School (Evening Division), University of
and The Evergreen State College. Since 1994 I have been disabled, a
condition that affects me ability to represent himselfwhen confronted by a hostile lawyer
like Mr. Rodems who knows ofmy disability from his firm's prior representation. In
addition, Mr. Rodems sued plaintifffor libel over a letter about a closed bar complaint.
Tobkin v. Jarboe, 710 So.2d 975, recognizes the inequitable balance ofpower that may
exist between an attomey who brings a defamation action and the client who must defend
against it Attorneys schooled in the law have the ability to pursue litigation through their
own means and with minimal expense when compared with their fonner clients.
And there is more newly discovered evidence. Mr. application to the 13
th
Circuit JNC lists two other clients who complained to the Florida Bar that he charged an
inappropriate fee in a contingency case, Rita Pesci and Roslyn Vazquez. This shows that
Mr. Rodems and his law firm utilize a cormpt business model that works as follows:.
A. Usurp the clientts fiduciary interest.
B. Procure a signed agreement from the client by any means, including fraud.
c. Rely upon the parol evidence rule to enforce the settlement
Because Mr. Rodems failed to provide this infonnation in discovery, it was not available
for my defense on March 20, 2008 for the sanction hearing to determine attorneys fees..
And the discovery that Mr. Rodems was actively seeking appointment to the bench on
March 20, 2008 was a conflict and explains' his obsession with the status ofjudges both at
the hearing and during the course ofthis litigation. The Commentary to Judicial Canon 2A
states a judge must expect to be the subject ofconstant public scmtiny. Ajudge must
therefore accept restrictions on the judge's conduct that might be viewed as burdensome by
the ordinary citizen and should do so freely and willingly.
In addition to relief from judgment it is time for Plaintiff's FirSt Amended Complaint,
which will include a count ofBreach o"fFiduciary which is appropriate given the
facts and can be added under Rule 1.190(c), FIa.R.Civ.P and the relation back doctrine.
BreachofFiduciary Duty was first argued in this case in 2005, October 7,.2005, see
Plaintiff's Rebuttal To Defendants' Motion to Dismiss and Strike.
Mr. Rodems testified at the March 20, 2008 hearing on the attomey's fees that "I am
board-certified in civil trial law and I've been practicing law since 1992.." (transcript, page
14, line 23). Mr. Rodems also testified that "rve been trying cases for the last 16 years."
(transcript, page 15, line 4). On cross examination, Mr. Bauer asked: "How 57.105
,
The Honorable James M. Barton, n Page-4
January 26, 2010
actions have you been involved in?" (transcript, page 15, line 18). Mr. Rodems testified:
"I filed I believe two inthis case and I may have filed one or two other ones in my career
but I couldn't be sure exactly.n (transcript, page 15, line 20).
Since the March 20,2008 hearing, Mr. Rodems has filed two additional section 57.105
motions in this lawsuit. On July 31, 2008, Mr. Rodems submitted his third section 57.105
motion in this lawsuit, because I did not withdrawn my Complaint For Breach ofContract
and Fraud. Mr. Rodems submitted his fourth section 57.105 motion in this case; also on
July 31, 2008, because I did not withdrawal my motion for rehearing, which was
necessitated when Mr. Rodems lied to the Court at the October 31, 2007 hearing about
the existence ofa signed contingent fee agreement - there is no signed contract with
Barker, Rodems & Cook, PA and Mr. Rodems falsely told the court otherwise.
Furthermore, Mr. Rodems threatened to file another section 5'7.105 motion against Mr.
Bauer in April, 2007, and again in May, 2007, regarding appellant's. reinstatement ofhis
claims voluntarily dismissed, which the 2DCA upheld in 2D07-4530.
So far in this lawsuit Mr. Rodems has filed four (4) section 57. lOS motions and
threatened another - while in the balance ofhis sixteen (16) year career Mr. Rodems
testified that he may have filed one or two other ones but he couldn't be sure exactly. It
is clear that Mr. Rodems is misusing the section 57.105 motion as a weapon in his
"foll Duelear blast approaeh" because he has a conDitt of interest in this l a ~ s u i t and
should have been disqualified as counsel upon apoeUant's motion, Plaintiffs Motio"
to Disqlltl.lifv Counsel, submitted February 4, 2006.
As for Judge Nielsen's Order ofMay 12,2006, the Order states "The motion to disqualifY
is denied with prejudice, except as to the basis that counsel may be a witness, and. on that
basis, the motion is denied without prejudice." As for Mr. Rodems being a witness, the
nature ofthis case is that he is essentially a perpetual witness. The transcripts show that
his representation is essentially ongoing testimony about factual matters. Mr. Rodems
should be disqualified, it is long overdue.
Finally a letter written by Mr. Rodems surfaced relative to a lawsuit disclosed on his JNC
application, Wrest/eReunion. LLC v. Live NatioT4 Television Holdings, Inc.,. United States
District Court, Middle District ofFlorida, Case No. 8:07-cv-2093-T-27, trial August 31
September 10, 2009. Mr. Rodems lost the case and then wrote a letter attacking the
.credibility of Eric BischotI: .a witnesses. The letter is enclosed and may also be found
online at: www.declarationofindependents.netldoilpageslcorrente91O.html
Mr. Rodems' letter calls into question his mental well-being. After the jUlY spoke and the
case was over Mr. Rodems wrote the following; "It is odd that Eric Bischoff: whose well
documented incompetence caused the demise ofWCW, should have any comment on the
outcome ofthe WrestIeReunion, LLC lawsuit.. The expert report Bischoffsubmitted in
this case bordered on illiteracy, and Bischoffwas not even called to testify by Clear
ChannellLive Nation because Bischoffperjured himself in a deposition in late-July 2009
The Honorable James M. Barton, n Page - 5
January 26,2010
before running out and refusing to answer any more questions regarding his serious
problems with alcohol and sexual deviancy at the Gold Club while the head ofWCW.."
Mr.. Rodems also wrote, ' ~ T o even sit in the room and question him. was one ofthe most
distasteful ~ g s I've ever had to do in 17 years ofpracticing law. In fact, we understand
that Bischoffwas afraid to even come to Tampa and testify because he would have to
answer questions under oath for a third time about his embarrassing past"
Mr. Rodems continued his attack on the witness writing, "The sad state ofprofessional
wrestling today is directly attributable to this snake oil salesman, whose previous career
highlights include selling.meat out ofthe back of a truck, before he filed bankruptcy and
had his car repossessed. Today, after running WCW into the ground, Bischoff.peddles
schlock like ftGirls Gone Wild
tt
and reality shows featuring B-listers."
In conclusion, my fonner lawyer, the congenial Robert W. Bauer, complained about Mr.
Rodems in open court: " ...M r ~ Rodems has, you know, decided to take a full nuclear blast
approach instead of us trying to work this out in a professional manner. It is my mistake
for sitting back and giving him the opportunity to take this full blast attack. (transcript,
Aug-14-08 hearing before Judge Crenshaw, p. 16, line 24).
Thank you for your kind consideration.
cc: Mr. David A. Rowland, Court Counsel (letter only)
Mr. Mike Bridenback, Court Administrator in the 13th Judicial Circuit (letter only)
Mr. Gonzalo B. Casares, ADA Coordinator for the 13
th
Judicial Circuit (letter only)
Mr.. Ryan Christopher Rodems
NEIL GILLESPIE
~ - 0 S - 2 0 1 e e5:3e
PAGE1
Neil J. Gillespie
8092 SW l1S
lh
Loop
February 4, 2010
VIA FAX: (813) 276- 2725
The Honorable James M. Rarton, II
Circuit Court, Division C
800 E. 'l'wiggs Street, Room 512
RE: Gillespie v. Barker, Rodems & Cook, P.A.) and Wi1liam J. Cook,
casc no.: 05-CA-7205. Division C
Dear Judge Barton:
Regarding the ADA accommodation infonnation requested by the Court at the hearing
January 26,2010,1 plan to submit the information to the Court by Tuesday, February 9,
2010. Thank you.
cc: Mr. Ryan Christopher Rodems
-....;
02-10-2010 04:39 NEIL GILLESPIE
PAGE2
Neil .J. Gillespie
8092 SW 115
th
Loop
February 9,2010
VIA FAX: (813) 276- 2725
lbe Honorable James M. Barton, IT
Circuit Cowt Judge, Thirteenth Judicial Circuit
Circuit Court. Division C
800 He Twiggs Street, Room 512
R.E: Gillespie v. Barker, Rodems & Cook, P.A., and William J. Cook,
case no.: 05-CA-7205, Division C
Dear Judge Barton:
The ADA accommodation information requested by the Court at the hearing January 26,
20lOis taking longer to prepare tban originally planned. I am sony to report tbat it is not
ready today a.q promised. It will be a couple more days, hopefully by Friday, February 12.
"Ibis is still a question about wbere to submit my ADA assessment and report. Enclosed is
a copy of my email to Mr. Gonzalo B. Casares, ADA Coordinator for the 13
th
Judicial
Circuit. Some of the confusion stems from the fragmented cowt system. Apparently there
is an ADA Coordinator for Hillsborough County, Ms. Sandra Sroka, and an ADA
Coordinator tor the Clerk ofthe Circuit Court, Ms. Lynn Ryder. My previous calls to
Court Administrator Mr. Bridenback, his assistant Tracy WelJs at (813) 272-5368, have
not been returned.
.!bank you for the Court's patience and understanding.
BARKER, RODEMS & COOK
PROFESSIONAL ASSOCIATION
ATTORNEYS AT LAW
CHRIS A. BARKER
Telephone 813/489-1001
400 North Ashley Drive, Suite 2100
RYAN CHRISTOPHER RODEMS
Facsimile 813/489-1008
WILLIAM ]. COOK Tampa, Florida 33602
February 12,2010
VIA HAND DELIVERY
The Honorable James M. Barton, II
Circuit Court Judge
Circuit Civil, Division "C"
Re: Neil J. Gillespie v. Barker, Rodems & Cook, P.A.,
a Florida Corporation; and William J. Cook
Case No.: 05-CA-7205; Division "C"
Dear Judge Barton:
As you will recall, a hearing was scheduled on all pending motions on January 26, 2010, and during that hearing
Plaintiff claimed he was disabled and entitled to "accommodations" under the Americans with Disabilities Act. He
asserted that he would provide certain information to the Court, but has yet to do so.
The motions scheduled for hearing included motions to compel Plaintiff's attendance at a deposition in aid of
execution and to compel complete responses to discovery, as my clients obtained a Final Judgment on March 27, 2008
against Plaintiff due to his violation of section 57.105, Florida Statutes and various discovery violations.
Clearly, Plaintiff's claim of disability has delayed my clients from moving forward and collecting on the Final
Judgment protecting their rights.
Therefore, I have filed "Defendant's Motion for an Order Determining Plaintiffs Entitlement to Reasonable
Modifications under Title II ofthe Americans with Disabilities Act." In it, I have requested that the Court schedule an
evidentiary hearing on this matter.
Pursuant to your direction at the hearing on January 26, 2010, I am requesting that this motion be set for an evidentiary
hearing as soon as possible.
Thank you for your time and attention to this matter.
Re, ectfullY'uhmi
W
Christopher Rodems
RCR/so
Enclosure
cc: Neil 1. Gillespie (wi encl)
1
Although the Plaintiff lists the Consumer Credit Protection Act in the first paragraph of his
First Amended Complaint, (Doc. 22), he does not allege any claims under the Act, or otherwise
mention the Act. Therefore, the Court will not further address the Consumer Credit Protection Act
in this Order.
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
OCALA DIVISION
NEIL J. GILLESPIE,
Plaintiff,
-vs- Case No. 5:05-cv-362-Oc-10GRJ
HSBC NORTH AMERICA HOLDINGS,
INC., a Delaware corporation; HSBC BANK
NEVADA,N.A., a National Bank formerly
known as Household Bank (SB), N.A.;
RISK MANAGEMENT ALTERNATIVES,
INC., a Delaware corporation,
Defendants.
______________________________________
O R D E R
The Plaintiff, proceeding pro se, has filed suit against the Defendants alleging
violations of the Consumer Credit Protection Act, 15 U.S.C. 1640(e) and 1692k,
1
the
Truth in Lending Act, 15 U.S.C. 1601 et seq., the Fair Debt Collection Practices Act, 15
U.S.C. 1692 et seq., and Florida law, with respect to various charges and fees assessed
against the Plaintiffs credit card account. (Doc. 22). The case is before the Court for
consideration of Defendants HSBC North America Holdings, Inc.s and HSBC Bank
Nevada, N.A.s motions to dismiss, (Docs. 4, 29), to which the Plaintiff has filed a response
Case 5:05-cv-00362-WTH-GRJ Document 32 Filed 09/25/06 Page 1 of 22
26
2
in opposition (Doc. 5). Upon review of the Amended Complaint and the record in this case,
the Court finds that the motions to dismiss are due to be granted in part and denied in part.
Factual Background
The following facts are alleged in the Plaintiffs First Amended Complaint (Doc. 22)
and are taken as true for the purposes of the motion to dismiss. The Plaintiff, Neil J.
Gillespie, is a resident of Ocala, Florida. On February 27, 2003, Gillespie opened a
MasterCard credit card account, issued by Defendant HSBC Bank Nevada, N.A., f/k/a
Household Bank (SB), N.A. (HSBC Nevada). Defendant HSBC North America Holdings,
Inc. (HSBC North America) is the parent company of HSBC Nevada.
At the time Gillespie opened the account, HSBC Nevada charged him a $59.00
annual fee. The initial credit line for the credit card was $300.00. Gillespie maintained his
credit card account in good standing and received credit line increases to $400,00, then
$500,00, and again to $600.00 over the next year. In mid-2004, Gillespie decided to close
his credit card account and pay off any remaining balance. By letter dated June 9, 2004,
HSBC Nevada notified Gillespie that his account had been closed. Due to the busy 2004
Hurricane season, Gillespie chose to reinstate his credit card account in order to pay for
hurricane related expenses. A $29.00 reinstatement fee posted to Gillespies account on
September 6, 2004.
On or about September 2, 2004, Gillespie requested, by telephone, an increase in
his credit line. In a letter dated September 6, 2004, HSBC Nevada agreed to increase his
2
See Amended Complaint, (Doc. 22), 22.
3
credit limit to $800.00, provided that Gillespie pay in advance a $50.00 automated credit
line increase fee. HSBC Nevada told Gillespie that the $50.00 fee would later be credited
back to his account, and that he should make his check for the fee payable to ACLI.
Gillespie mailed a $50.00 money order payable to ACLI to HSBC Nevada on September
7, 2004.
Gillespie contends that HSBC Nevada never credited the $50.00 automated credit
line increase fee back to his account. Instead, HSBC Nevada charged Gillespies credit
card account a $50.00 credit line increase finance charge on September 9, 2004, then
reversed the fee the same day. According to Gillespie, these two transactions cancelled
each other out, and did not take into account the $50.00 fee he had already paid and was
promised would be credited to his account. Gillespie contends that HSBC Nevadas
actions constitute a slight-of-hand theft.
2
While his account remained open, and throughout the entire dispute process, HSBC
Nevada continued to mail Gillespie monthly account statements, each providing a 24-hour
automated account information telephone number. On September 11, 2004, Gillespie left
Florida in order to avoid Hurricane Ivan, and traveled to Ooltewah, Tennessee. During this
trip, Gillespie used his credit card for various travel-related expenses. He relied upon
HSBC Nevadas 24-hour automated account information telephone number to ensure that
his credit card balance remained within the credit limit.
3
See Doc. 22, exhibit 2.
4
Gillespie contends that the automated account information telephone number
provided him with incorrect balance information, such that he unknowingly exceeded his
credit limit and was penalized with various overlimit fees. His September 20, 2004 credit
card statement showed an overlimit balance of $161.62, the majority of which was
attributable to various bank fees.
3
If Gillespie had received accurate information
concerning his account balance, and if he had received a credit on his account for the
$50.00 automated credit line increase fee, Gillespie argues that he would not have
exceeded his credit limit.
On November 13, 2004, Gillespie notified HSBC Nevada in writing that he was
closing his account. In his letter, Gillespie agreed to pay all legitimate charges, including
those for purchases, cash advances, cash advance fees, and lawful interest. He objected,
however, to paying any overlimit fees and late fees resulting from the allegedly inaccurate
account balance information provided by HSBC Nevadas automatic telephone service.
Gillespie also requested an updated account statement within 30 days.
By letter dated November 29, 2004, HSBC stated that Gillespies new account
balance was $1,121.27 and demanded immediate payment of $355. Gillespie did not pay
this amount, and returned the letter with various comments to the Chief Operating Officer
of HSBC Bank USA, N.A.
5
On December 6, 2004, HSBC Nevada sent Gillespie a Delinquent Account Notice
demanding payment of his account balance, which had reached $1,150.27. Gillespie
telephoned HSBC Nevada on December 20, 2004 to dispute the balance. HSBC Nevada
again contacted Gillespie by letter dated December 31, 2004. This letter notified Gillespie
that his account had been canceled effective October 7, 2004. However, HSBC Nevada
continued to charge Gillespie the $59.00 annual fee on March 20, 2005, and charged a
$29.00 late fee and $29.00 overlimit fee every month.
On or about December 31, 2004, HSBC Nevada placed Gillespies account for
collection with Defendant Risk Management Alternatives, Inc. (RMA), a collection agency
with its headquarters in Duluth, Georgia. RMA contacted Gillespie by letter dated January
3, 2005, notifying Gillespie that it was HSBC Nevadas debt collector on this account, and
demanding payment in the amount of $1,174.74. That same day, Gillespie received a
telephone call from a Roger Harrison at RMA offering to settle the entire dispute for
$900.00. Gillespie immediately agreed to the settlement, and agreed to send an initial
payment of $135.00 by January 25, 2005, with payment of the remaining $765.00 balance
in February 2005.
Gillespie sent the $135.00 payment on January 15, 2005, ten days ahead of
schedule. He spoke with a Holly Reynolds at RMA, who confirmed the terms of the
settlement and provided Gillespie with RMAs receive code to accept the payment. Despite
this settlement agreement, and Gillespies initial payment, RMA continued to call Gillespie
another 21 times throughout the month of January, 2005.
6
On January 24, 2005, RMA called Gillespie and informed him that RMA would no
longer accept the settlement agreement and demanded payment of $1,089.27. RMA
called Gillespie again on January 25, 2005, demanded the same payment, and threatened
to call Gillespies family if he did not pay the entire $1,089.27 immediately. RMA also
claimed to have contacted Gillespies uncle, which was not true, as Gillespies uncle had
passed away a short time before. Gillespie eventually changed his telephone number to
an unpublished number to avoid any further contact with RMA.
On January 20, 2005, HSBC Nevada provided Gillespie with an account statement
listing a payment of $135.00, and demanding a payment of the remaining balance of
$1,089.79. The statement did not mention the settlement with RMA. HSBC Nevada also
charged Gillespie another $29.00 overlimit fee and assessed a $21.05 finance charge.
On January 31, 2005, Gillespie wrote to Martin Glynn, President and Chief Executive
Officer of HSBC Bank USA, one of HSBC Nevadas parent companies. In the letter,
Gillespie discussed the alleged harassment and threats from RMA, including the fact that
RMA broke its settlement agreement with Gillespie. He also stated that any further
settlement offers must be made in writing. Jory Berdan of Household Bank Credit Card
Services responded to Gillespie by letter dated February 24, 2005, acknowledging RMAs
breach and offering to settle Gillespies account. The terms of the new settlement offer are
not mentioned in the Amended Complaint, although Gillespie states that they were
contradicted by later HSBC Nevada correspondence.
7
To date, it does not appear that Gillespie has made any further payments on his
account. HSBC Nevada has continued to assess late fees, overlimit fees, annual fees and
interest on the credit card account. As of July 20, 2005, the outstanding balance had
reached $1,675.21.
Procedural History
Gillespie initiated this action on August 17, 2005 (Doc. 1). In his original Complaint,
Gillespie alleged three claims against HSBC Nevada: (1) a state law claim for fraud, based
on the alleged slight-of-hand theft over Gillespies $50.00 automated credit line increase
fee; (2) a claim that HSBC Nevada violated various provisions of the Truth in Lending Act,
15 U.S.C. 1601 et seq. (TILA), by failing to disclose in advance the various fees and
finance charges it assessed against Gillespie, and by failing to provide Gillespie with
accurate account balance information; and (3) a state law claim alleging violations of
Floridas usury laws. Gillespie also asserted a claim against RMA, alleging that RMAs
collection activities violated the Fair Debt Collections Practices Act, 15 U.S.C. 1692, et
seq. He seeks as relief compensatory damages, punitive damages, statutory damages,
interest, costs, expenses, and attorneys fees.
On October 17, 2005, HSBC North America and HSBC Nevada filed a joint motion
to dismiss all claims against them. (Doc. 4). Gillespie filed a response in opposition on
November 4, 2005 (Doc. 5). Before the Court could consider the motion, Gillespie sought
and obtained leave to file an Amended Complaint (Docs. 8, 12). The Amended Complaint
8
is identical in all respects to the original Complaint, with one exception. Gillespie has
added a common law claim of negligence against HSBC Nevada, apparently based on
HSBC Nevadas alleged hiring of RMA to act as its debt collector. Neither the original or
the Amended Complaint allege any claims against HSBC North America.
In granting Gillespie leave to file his Amended Complaint, the Court also provided
that HSBC North Americas and HSBC Nevadas motion to dismiss (Doc. 4) would apply
to the Amended Complaint, and granted leave to file another motion to dismiss focused
solely on the new negligence claim. (Doc. 12). HSBC North America and HSBC Nevada
did so on April 5, 2006. (Doc. 29). Gillespie has never responded to this second motion
to dismiss and the time for responding has elapsed.
On July 7, 2005, approximately six (6) weeks prior to Gillespie filing this suit, RMA
filed a voluntary petition for relief under Chapter 11 of the United States Bankruptcy Code,
11 U.S.C. 101-1330. On September 6, 2005, RMA filed a Notice of Pendency of
Bankruptcy Case and Automatic Stay of Proceedings with this Court. (Doc. 2). As such,
all claims against RMA are stayed pending notice that the automatic stay in the bankruptcy
proceeding has been lifted.
Motion to Dismiss Standard of Review
In passing on a motion to dismiss under Rule 12(b)(6), the Court is mindful that
[d]ismissal of a claim on the basis of barebones pleadings is a precarious disposition with
a high mortality rate. Int'l Erectors, Inc. v. Wilhoit Steel Erectors Rental Serv. 400 F.2d
9
465, 471 (5th Cir. 1968). Thus, if a complaint shows that the Plaintiff is entitled to any
relief that the Court can grant, regardless of whether it asks for the proper relief, it is
sufficiently plead. Dotschay v. Nat. Mut. Ins. Co., 246 F.2d 221 (5th Cir. 1957). As the
Supreme Court declared in Conley v. Gibson, 355 U.S. 41, 45-46 (1957), a complaint
should not be dismissed for failure to state a claim unless it appears beyond doubt that the
plaintiff can prove no set of facts in support of his claim that would entitle him to relief.
See also Cook & Nichol, Inc. v. The Plimsoll Club, 451 F.2d 505 (5th Cir. 1971). The
Federal Rules of Civil Procedure do not require a claimant to set out in detail the facts
upon which he bases his claim. Conley, 355 U.S. at 47. Instead, all that is required is that
the claimant set forth a short and plain statement of the claim sufficient to give the
defendant fair notice of what the plaintiffs claim is and the grounds upon which it rests.
Id. However, while notice pleading may not require that the pleader allege a specific fact
to cover each element of a claim, it is still necessary that a complaint contain either direct
or inferential allegations respecting all the material elements necessary to sustain a
recovery under some viable legal theory. Roe v. Aware Woman Center for Choice, Inc.,
253 F.3d 678, 683 (11th Cir. 2001) (quotations omitted).
In addition, when considering a motion to dismiss pursuant to Federal Rule of Civil
Procedure 12(b)(6), the Court is limited to a review of the allegations set forth on the face
of the complaint itself, as well as any attached and/or incorporated documents which are
central to the plaintiffs claim. Brooks v. Blue Cross & Blue Shield of Florida, 116 F.3d
1364, 1369 (11th Cir. 1997). Review of such incorporated documents will not convert a
4
See Doc. 22, 4.
10
motion to dismiss into a motion for summary judgment. Id., see also Harris v. Ivax Corp.,
182 F.3d 799, 802 n. 2 (11th Cir.1999). However, the Court will not consider factual
arguments made in motions or other papers, or other evidence not attached or
incorporated by the face of the complaint itself.
Discussion
I. Claims Against HSBC North America
Defendant HSBC North America seeks to be dismissed from this case because
Gillespie has not alleged any claims against it. It appears from the face of Gillespies
Amended Complaint that HSBC North America is a separate and distinct entity from HSBC
Nevada.
4
It is also clear from the Amended Complaint that Gillespie has not made any
allegations against HSBC North America other than to aver that it is the parent company
of HSBC Nevada. Thus, it would appear that dismissal of HSBC North America is
appropriate.
Normally, a parent corporation is not liable for the acts of its subsidiaries.
See United States v. Bestfoods, 524 U.S. 51, 61 (1998). Gillespie, however, argues in his
opposition that HSBC North America should remain in this case because it is the head of
the hydra. See Doc. 5, p. 3. While not entirely clear, it appears that Gillespie is arguing
that HSBC North America, in its role as parent of HSBC Nevada, either exercised some
sort of control over the actions of HSBC Nevada in this case, or should be held vicariously
5
There are three ways in which a parent can be held liable for the acts of its subsidiaries:
(1) an alter ego theory to pierce the corporate veil; (2) vicarious liability based on general agency
principles; or (3) direct liability where the parent directly participated in the wrong complained of.
See In re Managed Care Litigation, 298 F. Supp.2d 1259, 1309 (S.D. Fla. 2003). Gillespie has
not alleged any facts in his Amended Complaint to support any of these theories.
6
In his original complaint, Gillespie asks the Court to mail a copy of the complaint to United
States Senator Richard Shelby and John C. Dugan, Comptroller of the Currency. (Doc. 1). In its
first motion to dismiss, HSBC Nevada asks the Court to strike this request on the grounds that it
is impertinent and scandalous. Gillespie has omitted this request in his Amended Complaint,
therefore it is no longer a part of this case, and HSBC Nevadas request is denied as moot.
11
liable for the actions of HSBC Nevada.
5
However, Gillespie has made no such allegations
in his Amended Complaint. Indeed, none of the five claims even mention HSBC North
America. Given the complete absence of any allegations or claims in the Amended
Complaint against HSBC North America, the Court concludes that dismissal without
prejudice of HSBC North America is appropriate.
II. Claims Against HSBC Nevada
A. Fraud Claim
HSBC Nevada seeks dismissal of each of Gillespies claims against it.
6
The first
claim against HSBC Nevada is a state law claim for fraud. HSBC Nevada asserts that
dismissal is appropriate because Gillespie has failed to state a claim upon which relief can
be granted pursuant to Fed.R.Civ.P. 12(b)(6), and because Gillespie has not alleged his
fraud claim with the sufficient level of particularity required by Fed.R.Civ.P. 9(a).
To allege a claim of common law fraud in Florida, Gillespie must allege: (1) a false
statement concerning a material fact; (2) knowledge by the person making the statement
that the representation is false; (3) the intent by the person making the statement that the
7
See Doc. 22, 18.a., 21, and exhibit 2.
8
Id., exhibit 2.
12
representation will induce another to act on it; and (4) reliance on the representation to the
injury of the other party. Knight v. E.F. Hutton and Co., Inc., 750 F. Supp. 1109, 1114
(M.D. Fla. 1990) (citing Lance v. Wade, 457 So.2d 1008, 1011 (Fla. 1984)). See also
Romo v. Amedex Ins. Co., 930 So.2d 643, 651 (Fla. 3d DCA 2006); Hillcrest Pacific Corp.
v. Yamamura, 727 So. 2d 1053, 1055 (Fla. 4th DCA 1999). HSBC Nevada contends that
Gillespie has not sufficiently alleged either a false statement of a material fact, nor any
injury attributable to his reliance on HSBC Nevadas statements. The Court disagrees.
Gillespies fraud claim centers on the representations made by HSBC Nevada
concerning his $50.00 automated credit line increase. Gillespie alleges that HSBC
Nevada told him that if he made that payment in advance, it would be later credited back
to his account and he would receive a credit limit increase. In other words, he would
receive a refund of his $50.00 payment. According to the Amended Complaint, while
Gillespie did receive the credit limit increase,
7
he never received a refund of the $50.00.
Instead, HSBC Nevada charged his credit card account an additional $50.00 fee, and
reversed that charge. Simply put, HSBC Nevada double charged Gillespie for the credit
line increase, and only credited him back for one of the charges. The partial copy of
Gillespies September 20, 2004 account statement further demonstrates this fact.
8
The fact
that HSBC Nevada did not credit Gillespie as it stated it would, thereby resulting in a loss
9
The Court seriously questions whether Gillespie will be able to establish that the other
overlimit fees, late fees, and finance charges are a direct result of this allegedly false statement.
However, that is a discussion for another time, and at the very least, Gillespie has sufficiently
alleged damages in the amount of the $50.00 automated credit line increase fee which permit
this claim to go forward.
13
of the $50.00 and additional charges to Gillespies account, establishes both a false
statement of a material fact and a resulting injury.
9
The Court further finds that Gillespie has satisfied the heightened pleading
requirements of Fed.R.Civ.P. 9(b). He has stated with particularity all of the circumstances
constituting the alleged fraud in this case. More specifically, Gillespie has identified the
precise statements he alleges are false or misleading, including the time place and identity
of speaker; how he was mislead by those statements; and what HSBC Nevada obtained
as a consequence of the alleged fraud, i.e., the additional $50.00 as well as other
subsequent charges and fees. Although Gillespies fraud claim could have been read as
HSBC Nevada contends - that the $50.00 promised credit was really just a reversal charge
- if a complaint shows that the Plaintiff is entitled to any relief that the Court can grant,
regardless of whether it asks for the proper relief, it is sufficiently plead. Dotschay v. Nat.
Mut. Ins. Co., 246 F.2d 221 (5th Cir. 1957). Gillespies fraud claim may go forward as
alleged.
B. Truth in Lending Act Claim
Gillespie also alleges that HSBC Nevada violated numerous provisions of the TILA
throughout the existence of his credit card account, including after his account was closed.
10
See Doc. 22, 58-59; 15 U.S.C. 1637(c)(2).
11
See Doc. 22, 60-61; 15 U.S.C. 1637(b)(3), (4), (7), and (8).
12
See Doc. 22, 70.
13
See Doc. 22, 62; 15 U.S.C. 1637(a).
14
For example, Gillespie contends that HSBC Nevada did not comply with the TILAs
disclosure requirements when it solicited him over the telephone to open his credit card
account in February 2003.
10
He also contends that HSBC Nevada violated the TILAs
disclosure requirements in September 20, 2004 when it did not refund his $50.00
automated credit line increase fee, and as a result of not crediting his account for this
amount, did not provide him with the correct account balance, total amount of credits to his
account, the correct finance charge, and did not correctly identify and credit other
charges.
11
Gillespie alleges that HSBC Nevada violated these same disclosure
requirements in each subsequent monthly statement.
12
Gillespie also challenges HSBC Nevadas 24-hour automated account information
telephone line, stating that it provided him false and inaccurate account balance
information, and failed to disclose that reliance on such information would result in finance
charges and overlimit fees.
13
He also contends that HSBC Nevada failed to identify that
his $135.00 payment on January 15, 2005 was made as part of a settlement agreement,
and failed to include any of the terms and conditions of his February 24, 2005 settlement
14
See Doc. 22, 67, 70.
15
Id., 63-66
16
15 U.S.C. 1666c provides that all payments received from an obligor under an open
ended consumer credit plan by the creditor shall be posted promptly to the obligors account.
17
HSBC Nevada also seeks to use the September 20, 2004 account statement to disprove
Gillespies contentions that HSBC Nevada did not disclose it would charge overlimit and late fees
on closed or cancelled accounts. However, that statement was created while Gillespies credit
card account was open and active. Therefore it does not establish any disclosures with respect
to closed or cancelled accounts.
15
agreement in any of his future account statements.
14
Finally, Gillespie asserts that HSBC
violated the TILA when it failed to disclose that he would be charged annual fees, overlimit
fees, and late fees on a closed account in violation of 15 U.S.C. 1637(a), (c) and (d).
15
Taking the allegations set forth in Gillespies Amended Complaint as true, which the
Court must at the motion to dismiss stage, and refraining for passing on the merits, it
appears that the majority of Gillespies TILA claims are properly alleged, and provide a
clear and plain statement sufficient to place HSBC Nevada on notice of the allegations
against it. Indeed, HSBC Nevada does not challenge many of Gillespies assertions.
Rather, HSBC Nevada limits its challenges to Gillespies claims concerning the September
20, 2004 account statement. According to HSBC Nevada, the portion of Gillespies
September 20, 2004 account statement which is attached to his Amended Complaint
directly contradicts his allegations that HSBC Nevada did not credit back the $50.00
automated credit line increase fee on his September 20, 2004 account statement,
16
and
did not disclose the correct amount of credits and charges on that same statement.
17
18
HSBC Nevada argues that if this claim is not dismissed with prejudice, the Court should
order Gillespie to provide a complete copy of his September 20, 2004 account statement. The
Court will deny this request. The portion of the statement provided with the Amended Complaint
supports all of Gillespies allegations such that dismissal is not appropriate. Moreover, if HSBC
Nevada believes that this is an incomplete document and that other portions of the document are
necessary at this point in the litigation, it could have easily attached them to its own motion to
dismiss. Gillespie is correct, HSBC Nevada, as the lender in this case, has just as much access
to Gillespies account statements as Gillespie does. HSBC Nevada has not demonstrated that
it will suffer any undue hardship by producing the complete account statement, and the Court
doubts that it could, given that it readily submitted Gillespies Cardholder Agreement.
16
Because the Court has already found that, from the face of Gillespies Amended
Complaint and incorporated documents, Gillespie has sufficiently alleged that HSBC
Nevada did not credit his account for that $50.00 fee as promised, the Court is satisfied at
this stage in the litigation that Gillespie has also sufficiently alleged that HSBC Nevada
improperly failed to disclose its credit of the $50.00 automated credit line increase fee and
did not provide the correct balance, credits and charges on the September 20, 2004
account statement.
18
Accordingly, Gillespies TILA claim may go forward as alleged.
C. Usury Claim
The third claim HSBC Nevada challenges is Gillespies assertion that HSBC Nevada
violated Floridas usury law, Fla. Stat. 687.01, et seq. HSBC Nevada contends that this
claim should be dismissed both because Gillespie has not pleaded any of the elements
necessary to establish a claim of usury, and because Florida law does not apply to
Gillespies credit card account. The Court agrees.
Under Floridas usury law, it is considered usurious and unlawful to charge a rate
of interest in excess of 18% for any loan, money advance, line of credit, or other obligation
19
Doc. 22, 91.
20
Id., exhibit 2.
21
The September 20, 2004 statement listed miscellaneous finance charges of $58.26, as
well as the monthly finance charge of $10.72.
22
In his opposition papers, Gillespie contends that his March 20, 2003 account statement
(continued...)
17
where the principal balance is $500,000 or less. See Fla. Stat. 687.03(1). A creditor who
willfully violates Floridas usury law is liable to the borrower for double the amount of
interest collected. See Fla. Stat. 687.04; Jersey Palm-Gross, Inc. v. Paper, 639 So.2d
664, 667 (Fla. 4th DCA 1994). Although Gillespie cites to the correct Florida statutes, he
does not explain how his credit card account with HSBC Nevada violates this law.
Gillespie alleges that HSBC Nevada charged him a nominal interest rate of 18.9%, an
annual percentage rate of 22.9%, and periodic interest rates as high as 224%.
19
Not only
does Gillespie fail to explain how he arrived at these interest rates, but the partial copy of
his account statement which he attached to his Amended Complaint directly contradicts his
allegations.
20
That statement lists a finance charge of $10.72 on a balance of $494.85.
Simple math shows that the nominal interest rate charged is well under 18%. Even if
Gillespie is correct that all of his late fees, cash advance fees, and overlimit fees also
constitute interest, the nominal interest rate would still only amount to approximately
13.9%.
21
Given the contradictions between Gillespies account statement and the
allegations in his Amended Complaint, the Court cannot say that he has properly alleged
a claim of usury.
22
22
(...continued)
demonstrates how he calculated his interest rates. See Doc. 5, p. 6. This is a factual argument,
inappropriate for consideration at the motion to dismiss stage. Moreover, Gillespie has not
included any allegations concerning this statement in his Amended Complaint, nor attached it to
his Amended Complaint, so that the Court cannot consider this statement incorporated into his
pleadings. The Court also does not see anywhere on the partial copy of the September 20, 2004
statement an annual percentage rate of 0.00%, as Gillespie claims.
23
HSBC Nevada has attached a copy of the Cardholder Agreement to its motion to dismiss.
See Doc. 4, exhibit A. Gillespie refers to his credit card contract with HSBC Nevada throughout
his Amended Complaint, and many of the issues he references, such as interest charges, the
effect of closing an account, and other fees and charges, are directly related to the Cardholder
Agreement. It is therefore clear that the Cardholder Agreement has been incorporated into the
Amended Complaint, and may be considered by the Court without transforming the motion to
dismiss into a motion for summary judgment. Brooks v. Blue Cross & Blue Shield of Florida, 116
F.3d 1364, 1369 (11th Cir. 1997).
24
Doc. 4, exhibit A, p. 4.
18
Even if Gillespie had established that HSBC Nevada exceeded Floridas 18%
interest rate cap, this claim fails for a more basic reason. Gillespies Cardholder
Agreement with HSBC Nevada clearly states that it is governed by Nevada law.
23
Specifically, the Agreement states that Gillespies credit card account will be governed by
federal law and the laws of the state of Nevada, whether or not you live in Nevada and
whether or not your Account is used outside Nevada.
24
Under Nevada law, [p]arties may
agree for the payment of any rate of interest on money due or to become due on any
contract, for the compounding of interest if they choose, and for any other charges or fees,
so long as the interest rates, fees and other terms are reduced to writing. NV Stat.
99.050. See also, Mapes v. Palo Alto Town and Country Village, Inc., 584 F. Supp. 508
(D. Nev. 1984). Because Gillespie has not alleged any violations of Nevada law, nor
25
Gillespie argues, without any legal support, that because he did not sign the Cardholder
Agreement, it is void under the statute of frauds. Doc. 5, p. 7. Such a bald conclusory statement
cannot save this claim from dismissal. In addition, it is unclear from the Cardholder Agreement
whether a signature is required for the Agreement to be enforceable. It is also unknown whether
Gillespie signed any papers consenting to this Cardholder Agreement at the time he opened his
credit account. These unresolved questions are all factual disputes, which cannot be decided on
a motion to dismiss.
26
Doc. 22, 96; Doc. 5, p. 8.
19
alleged that the Cardholder Agreements choice of law provision somehow does not apply
to this case, he has failed to state a claim upon which relief can be granted. Gillespies
Florida usury claim will be dismissed without prejudice.
25
D. Negligence Claim
Gillespies final claim against HSBC Nevada is a common law claim for negligence
under Florida law. From the very brief allegations asserted, it appears that Gillespie is
arguing that HSBC Nevada was negligent in hiring RMA to act as its debt collector with
respect to Gillespies credit card account, apparently because RMA is now in Chapter 11
bankruptcy and cannot be sued.
26
To bring such a claim, Gillespie could pursue either a
negligent hiring theory, or a common law negligence theory. Gillespies barebones claim
does not specify the legal theory upon which it is predicated. However, under either theory,
Gillespie has failed to allege a claim upon which relief can be granted.
To allege a prima facie claim of negligent hiring, Gillespie must assert that:
(1) the employer was required to make an appropriate
investigation of the employee and failed to do so; (2) an
appropriate investigation would have revealed the unsuitability of
the employee for the particular duty to be performed or for
employment in general; and (3) it was unreasonable for the
27
The Court seriously doubts Gillespie could establish such a relationship in any event.
20
employer to hire the employee in light of the information he knew
or should have known.
Malicki v. Doe, 814 So.2d 347, 362 (Fla. 2002) (citing Garcia v. Duffy, 492 So. 2d 435, 440
(Fla. 2d DCA 1986)). Gillespies Amended Complaint does not allege any of these
elements. In fact, he does not even establish or allege that RMA was HSBC Nevadas
employee.
27
To the extent Gillespie is instead proceeding under a simple common law claim of
negligence, this claim also fails. To allege a prima facie case of negligence, Gillespie must
aver that: (1) HSBC Nevada owed a legal duty to Gillespie; (2) HSBC Nevada breached
that duty; (3) the breach legally caused an injury to Gillespie; and (4) damages resulted
from the injury. See Pinchinat v. Graco Childrens Prods., 390 F. Supp.2d 1141 (M.D. Fla.
2005). Again, Gillespie has not alleged any of these elements, and has not responded to
any of HSBC Nevadas arguments challenging this negligence claim.
Because Gillespie has not alleged any of the elements necessary for either a prima
facie claim for negligent hiring or for common law negligence, his claim must be dismissed.
And while the Court has great doubts Gillespie could ever succeed on such a claim, the
Court will provide him with one more opportunity to properly allege this claim.
E. Punitive Damages and Attorneys Fees
HSBC Nevada also requests to have Gillespies claim for punitive damages in his
state law fraud claim stricken because it is based on conclusory allegations in the absence
21
of a reasonable basis in fact to support a claim for fraud. See Doc. 4, p. 9 (citing Porter
v. Ogden, 241 F.3d 1334, 1340 (11th Cir. 2001). Because the Court has determined that
Gillespie has sufficiently alleged a claim for common law fraud, his request for punitive
damages may also go forward.
Gillespie has also included in his requests for relief under each of his claims a
request for attorneys fees and costs. HSBC Nevada has moved to have Gillespies
request for attorneys fees stricken, arguing that a pro se litigant is not entitled to attorneys
fees. The Court agrees. See Kay v. Ehrler, 499 U.S. 432 (1991); Ray v. U.S. Dept. Of
Justice, 87 F.3d 1250 (11th Cir. 1996); Celeste v. Sullivan, 988 F.2d 1069 (11th Cir. 1992).
The fact that Gillespie may have some paralegal experience or training is of no relevance.
Accordingly, any requests on behalf of Gillespie for attorneys fees shall be stricken, and
Gillespie is instructed not to include any such requests if he chooses to file a second
amended complaint.
Conclusion
Accordingly, upon due consideration, it is hereby ORDERED and ADJUDGED that:
(1) Defendants HSBC North America Holdings Inc.s, and HSBC Bank Nevada,
N.A.s motion to dismiss (Doc. 4) is GRANTED IN PART AND DENIED IN PART. All
claims against Defendant HSBC North America Holdings Inc., to the extent any are alleged
in the Plaintiffs First Amended Complaint (Doc. 22), are DISMISSED WITHOUT
PREJUDICE. Count IV of the Plaintiffs First Amended Complaint against Defendant
22
HSBC Bank Nevada, N.A. is DISMISSED WITHOUT PREJUDICE. The Plaintiff may not
recover attorneys fees while proceeding pro se, and therefore all references to attorneys
fees are STRICKEN, and the Plaintiff may not assert any claims for attorneys fees in any
future pleadings. In all other respects the Motion to Dismiss (Doc. 4) is DENIED.
(2) Defendants HSBC North America Holdings Inc.s, and HSBC Bank Nevada,
N.A.s motion to dismiss negligence count (Doc. 29) is GRANTED. Count V of the First
Amended Complaint is DISMISSED WITHOUT PREJUDICE.
(3) All claims against Defendant Risk Management Alternatives, Inc. are hereby
stayed pending notice that the automatic stay under 11 U.S.C. 362 has been lifted.
(4) The Plaintiff shall have twenty (20) days from the date of this Order to file a
second amended complaint correcting the deficiencies discussed in this Order. Failure to
submit an amended complaint within this time period will result in the dismissal with
prejudice of the above-listed claims.
IT IS SO ORDERED.
DONE and ORDERED at Ocala, Florida this 25th day of September, 2006.
Copies to: Counsel of Record
Neil J. Gillespie, pro se

Amended Disability Motion No. 12-11213 CA11 US Eleventh Circuit

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