Transcript of Stephen Miles' trip to Fairview Southdale emergency room

By Glenn Howatt



Stephen Miles used his laptop computer to record many of the conversations he had with others, including his Dec. 30, 2005 visit with a Fairview Southdale emergency department physician.

Many laptops have built-in microphones that can record audio to the computer's hard drive. Miles believed that many people, especially doctors, were conspiring against him, and the recordings were an attempt by Miles to protect himself, according to father Roland Miles.

A transcript of the emergency room visit was provided to the Minnesota Health Department, which investigated whether the Edina hospital had inappropriately released Miles just hours before Miles allegedly killed his stepmother.

Although regulators later determined that the hospital did not violate government hospital regulations, Miles' attorney, Marsh Halberg, said the recording raised issues that department investigators failed to address, including why the doctor attempted to end the exam of a paranoid, mentally ill patient when he refused to be touched.

A copy of the transcript was obtained by the Star Tribune from the Minnesota Health Department under the Minnesota Data Practices Act, and most of it is reprinted below.

The visit began with Miles asking questions about the bones in his head. Miles was convinced that a physical deformity in his head was causing him problems. He agreed to go to a hospital so that a physician would interpret an MRI taken two weeks earlier with hopes of identifying the malady.

"This was a ruse by [his parents] to get him to the hospital," Roland Miles said in a written statement to health department investigators. "He agreed to go the next day and we felt that was the best way to handle the situation."

In the transcript, which was prepared by Roland Miles and submitted by Halberg to investigators, the doctor is not identified by name.

Stephen Miles: Could I have an x-ray of my head today?

Doctor: No.

Stephen Miles: Why not?

Doctor: Because there's not an emergent reason that you need an x-ray of your head.

Stephen Miles: During the last four months I have had sensations of rotation in my head.

Doctor: You have an MRI of your head that has to be read. You need to talk to your doctor about that, but we ... this is an emergency department. So if there is something life threatening. .

Stephen Miles: Yeah

Doctor: ... that, that ...

Stephen Miles: My not having that bone to protect my brain is life threatening.

Doctor: OK, I don't think that you have anything.

Stephen Miles: I'd prefer if you didn't touch my head. Thanks.

Doctor: Okay. Alright, well, I think we're done.

Roland Miles: Take a deep breath. Just a second, just a second.

Doctor: No, no. We're all done.

Roland Miles: Could he describe something else that happened to him?

Doctor: No. I'm not going to ... I think we're done here.

Roland Miles: Like for example....

Doctor: He doesn't want me to examine him. OK, I'm not going to examine him. I'm not going to interpret his x-rays or his MRI.

Roland Miles: He's of the opinion that something has to be done immediately. And he is starting to do self-help ...

Doctor: Mm hmm.

Roland Miles: ... on himself

Doctor: That's a dangerous thing to do.

Roland Miles: Describe to him, Steve. Can you describe what you did today, Steve, or yesterday. What you did to yourself. What did you do?

Stephen Miles: I, uh, was examining my head in the mirror.

Roland Miles: And you were going to try to remove something from your head, weren't you?

Stephen Miles: I removed some hair from the top of my head.

Roland Miles: You were going to try to remove a filling from your mouth, weren't you? What were you going to do?

Doctor: Is he seeing a psychiatrist? Is he under care of a psychiatrist?

Roland Miles: He has had the same one.

Doctor: OK, it seems like there have been some obsessive thoughts here...

Roland Miles: Yes.

Doctor: ...that he is very concerned about, some fairly bizarre things.

Roland Miles: The last time a psychiatrist saw him he said he was psychotic.

Doctor: Mm-hmm

Roland Miles: Steve, what were you doing with the ... bent fork tine?

Stephen Miles: I was trying to eat. What was I trying to eat? Oh, beef roast.

Roland Miles: Steve you had a hammer. You were going to try to pop out your filling.

Stephen Miles: Dad, dad, dad, these thoughts you're having, these are psychotic. I think you are having hallucinations of sight. I think you're having sight hallucinations.

Roland Miles: Do you think this is a hallucination? [Roland holds up the fork.] You made this, did you not? Did you make this?

Stephen Miles: What is this?

Roland Miles: And you were going to try to pound out your filling with it.

Stephen Miles: No, I didn't make that.

Roland Miles: Yes, you did. I pulled it out of the thing and you grabbed me by the neck, did you not?

Stephen Miles: No, I didn't. You are having more hallucinations.

Roland Miles: Steve, you were talking about having to do something immediately with your problem. And people are afraid for your health.

Doctor: I'm going to have to answer this page here. Have you had him evaluated?

Roland Miles: Yes. The ... last doctor said he was psychotic. He was a psychiatrist, [name redacted].

Doctor: I've got to answer this page, so I'll let you talk and I'll be back.

After the doctor left the exam room, Stephen Miles left the hospital and sat in the car. Roland Miles continued to talk to the doctor, asking him to hospitalize his son because of concerns that he might become violent.

The doctor told Health Department investigators that he ended the interaction believing that a plan was in place for the parents to drive Miles to Fairview's Minneapolis hospital for evaluation.

Miles' parents changed the plan, they told investigators, taking him home instead, because the Minneapolis hospital didn't have beds and that previous attempts to have him evaluated there had been futile

GLENN HOWATT