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Keen calls it like he sees it, even when his opinion runs counter to what prosecutors, police and the county Board of Supervisors would like to hear from him.
The doctor says it's not unusual for families to question the manner of a loved one's death, especially a suicide. But it is quite unusual, he says, for anyone at the county's Forensic Science Center to amend a death certificate.
"We have to be convinced that the new information out there really is compelling," he says. "But I always will check into whatever anyone presents."
In the case of Kevin Keogh, "anyone" meant some of the best and well-respected forensic minds in the nation.
First, Karlene Keogh hired an attorney with the firm of Squire Sanders and Dempsey.
The lawyer first had to find reputable experts to examine Keogh's life and death. If that played out favorably, those experts would have to try to persuade Phil Keen to change the certificate from suicide to undetermined.
Only then could Mrs. Keogh even have a shot at getting CIGNA to reconsider its position.
The attorney asked respected Phoenix neurologist J. Michael Powers, and Steven Pitt, a nationally known Scottsdale forensic psychiatrist, to analyze the case.
For his part, Pitt studied the Keogh medical files, interviewed Mrs. Keogh, and then rendered his opinion last June 26.
"No disease process was ever established to explain Keogh's behavior," Pitt wrote to Mrs. Keogh. "Any attempt to diagnose Keogh with a specific condition would be speculative."
Still, Dr. Pitt concluded that "the known facts do not support and directly contradict a view that Mr. Keogh intentionally took his life."
Those facts, according to Pitt, included Keogh's lack of an impulsive nature, seeming stability at home and work (despite having become convinced his bosses had it in for him), no known prior suicide attempts, his Catholic faith, and the apparent absence of substance-abuse problems.
During his investigation, Pitt recommended that heavy-hitter Dr. Michael Baden also be brought into the fold. Though he's exceptionally busy, Baden tells New Timesthat the details of Kevin Keogh's demise lured him.
"Very sad, very interesting case," Baden says. "A medical mystery."
Baden's impressive résumé includes a stint as chairman of the Forensic Pathology Panel for the congressional committees that investigated the assassinations of President John F. Kennedy and Dr. Martin Luther King Jr.
Like Pitt, Baden studied Kevin Keogh's medical records and anecdotal data before drawing his conclusions.
"Lots of things could have caused this to have happened," Dr. Baden says. "All you need is disorientation and confusion, and things can happen. This man's personal background, the location and time of his death broad daylight, a busy street the fact that there was no guarantee he would die, all of it indicates to me that he didn't intentionally hurt himself."
Baden recounts another recent case of his in which, like Kevin Keogh, a New York man was convinced he had worms in his brain.
He says the tormented man decided to try to kill the worms by attaching a wire of some sort to his scalp.
Needless to say, he electrocuted himself.
"I'm not saying Mr. Keogh jumped out of his car to get rid of the worms," Dr. Baden says. "I'm saying people who think they have worms in their head can act bizarrely."
"Here's a man at the top of his profession who was showing serious signs of paranoia, though he continued to be competent at his difficult job," says Dr. Amin, an expert in neuropsychology. "We've got various possibilities here, which include a truly organic mental disorder that affected his brain and caused him to just fall apart in terms of delusions and paranoia.
"Almost everyone only saw this brilliant, strait-laced man. But you can have folks who have a little island of paranoia in their mindset. Perhaps that paranoia was well-controlled and hidden for a long time and just burst out under the circumstances, where the anxiety and stress he was feeling exacerbated the situation inside his head."
Dr. Keen says he read everything that Karlene Keogh's attorney sent him (which included the experts' opinions), discussed the case with colleagues, and then made up his mind.
"If we had a hypothetical," Keen says, "in which we did not know anything about this man's neurological history, if we didn't know that he had had seizures and these post-seizure states, if we didn't know that he'd had episodes in which his behavior was becoming more atypical, we'd look at this and say, 'Well, he must have pretty much gone off the deep end,' as in a suicide.
"But then you start looking at these neurological things that are not just anecdotal, are not just told by the family. And there's a variety of physicians looking at him, and they're having difficulty deciding exactly what's going on with him, too. You have some docs saying, maybe it's worms in the brain because we have a borderline [reading], maybe it's epilepsy, maybe it's something else.