Perhaps, Dixon had to be crazy to commit a robbery in the middle of a hospital emergency room, abduct two ambulance drivers, shoot at one right outside the emergency room entrance, then kidnap the female driver to take her home since she was now his "woman." Not to ignore that he performed his very public show on the grounds of a federal VA Hospital.

By the time the Feds were through, he had been convicted of robbery, assault, kidnapping and firearms violations.

He later objected to the trial court allowing expert testimony "on the ultimate issue of his insanity defense" and refusal to give a jury instruction on the insanity defense.

In construing the provisions Fed R. Evid. 704, the insanity defense statute at 18 U.S.C. § 17(a), and the bill that enacted both, the Court noted an apparent contradiction. While the rule prohibits the expert from testifying about the ultimate issue, the insanity defense requires a showing that the defendant suffered from mental illness at the time the crime was committed.

Employing some deft logical maneuvers, the Court reasoned that the ultimate issue of the insanity defense pertinent here was whether "as a result of severe mental disease" the defendant was unable to appreciate the wrongfulness of his actions. Thus the expert could testify to the nature of the mental disease but not whether the defendant could distinguish right from wrong.

However, in this case, the expert’s answer came out in response to a hypothetical asked by the judge as to whether it was possible for a sufferer of the mental illnesses under discussion to appreciate the wrongfulness of his acts. The question was objected to and overruled. Later, however the judge issued a curative instruction to the jury.

The Court held that the hypothetical question asked by the judge did not remove the ultimate question from the province of the jury, because there was no inference required that the jury, in accepting the expert’s answer, resolve the question as to the defendant. Likewise, there was no error in allowing the expert to testify, as he did, that the defendant was not suffering from a mental illness at the time he committed the crime.

The fatal flaw requiring reversal was the trial court’s refusal to instruct the jury on the insanity defense. The defense had submitted the medical records alone showing a history of mental illness. Standing alone, without expert testimony to explain them, the records are not sufficient to meet the clear and convincing evidence standard necessary to require a jury instruction as to insanity.

However, on cross-examination, the government’s expert described the repeated hospitalizations and symptoms of various mental illnesses experienced by the defendant. This was sufficient explanation of the records to raise the issue to a jury question. Since the appeal here challenged the court’s removal of an issue from the jury rather than challenging the judgment exercised by the jury, a lower standard applied for reversal. The Court reversed and remanded on this basis.