United States v. Albert Garza , 751 F.3d 1130 ( 2014 )


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  •                      FOR PUBLICATION
    UNITED STATES COURT OF APPEALS
    FOR THE NINTH CIRCUIT
    UNITED STATES OF AMERICA,                      No. 12-10294
    Plaintiff-Appellee,
    D.C. No.
    v.                      1:10-cr-00165-AWI-1
    ALBERT GARZA,
    Defendant-Appellant.                    OPINION
    Appeal from the United States District Court
    for the Eastern District of California
    Anthony W. Ishii, Senior District Judge, Presiding
    Argued and Submitted
    January 14, 2014—San Francisco, California
    Filed May 20, 2014
    Before: Richard C. Tallman and Sandra S. Ikuta, Circuit
    Judges, and Beverly Reid O’Connell, District Judge.*
    Opinion by Judge Tallman
    *
    The Honorable Beverly Reid O’Connell, United States District Judge
    for the Central District of California, sitting by designation.
    2                   UNITED STATES V. GARZA
    SUMMARY**
    Criminal Law
    Affirming a criminal judgment, the panel held that the
    district court did not plainly err by failing to sua sponte
    convene a hearing on the defendant’s competency.
    The panel held that there is no substantial evidence that a
    reasonable judge would harbor a genuine doubt about the
    defendant’s competency, where the defendant’s medical
    history evidence isn’t strong and there is no clear connection
    between the defendant’s putative dementia and any negative
    impact on his ability to understand the proceedings or assist
    in his defense.
    The panel rejected the defendant’s attempt to reach plain
    error in reliance on 18 U.S.C. § 4241(a), requiring
    competency hearings on reasonable cause, and 18 U.S.C.
    § 4247(b), governing commitment for the purposes of an
    examination.
    **
    This summary constitutes no part of the opinion of the court. It has
    been prepared by court staff for the convenience of the reader.
    UNITED STATES V. GARZA                     3
    COUNSEL
    Carolyn Wiggin (argued), Assistant Federal Public Defender,
    Sacramento, California, for Defendant-Appellant.
    Brian W. Enos (argued), Assistant United States Attorney,
    Eastern District of California, Office of the United States
    Attorney, Fresno, California, for Plaintiff-Appellee.
    OPINION
    TALLMAN, Circuit Judge:
    Albert Garza was sentenced to 20 years in prison after a
    jury convicted him of one count of “receipt or distribution”
    and one count of “possession” of child pornography. Garza
    appeals his conviction and sentence on several grounds. In a
    memorandum disposition we address all but one of Garza’s
    arguments. In this opinion we decide whether the district
    court plainly erred by failing to sua sponte convene a hearing
    on Garza’s competency. It did not, so we affirm.
    I
    A
    By monitoring an online file-sharing network, federal
    agents discovered that Garza was downloading child
    pornography. Warrant in hand, the agents went to his home.
    While some searched, a pair of agents interviewed Garza at
    length. During the interview, he confessed to everything. The
    search turned up two computers and a compact disc
    containing thousands of photographs and videos of child
    4                    UNITED STATES V. GARZA
    pornography. Garza was arrested and indicted for one count
    of “receipt or distribution” under 18 U.S.C. § 2252(a)(2) and
    one count of “possession” under § 2252(a)(4)(B).
    B
    Shortly after Garza’s indictment, his first lawyer hired Dr.
    Thomas Middleton, a clinical psychologist, to examine Garza
    and prepare a written competency report. The report paints
    Garza as mentally and emotionally crippled by various
    disabilities and the impact of his arrest. Middleton diagnosed
    Garza with anxiety and with dementia caused by uncontrolled
    diabetes. He concluded, if obliquely,1 that Garza was
    incompetent to stand trial.           Middleton based these
    conclusions on a single interview and several aptitude tests.
    He reviewed no medical records.
    Relying on Middleton’s report, the parties stipulated to,
    and the district court entered, an order committing Garza to
    the Attorney General’s custody for a competency evaluation.
    Garza was sent to a Bureau of Prisons facility in Los Angeles
    for several weeks. There, he was observed at length, tested,
    and interviewed by government doctors. A comprehensive
    1
    Middleton began his report by summarizing his task, which specifically
    included assessing “competence.” But in his conclusion Middleton never
    specifically says “incompetent.” He writes that “Mr. Garza does not
    appear to be able to rationally address his legal circumstances at this
    time.” Though this sentence is vague, the gist of the report makes its
    import clear. We will give Garza the benefit of the doubt and treat this as
    a specific diagnosis of incompetency.
    UNITED STATES V. GARZA                               5
    report was prepared.2 Dr. Lisa Hope, a forensic psychologist
    and the report’s author, wrote that Garza suffered from an
    anxiety disorder but not dementia. She concluded that he was
    competent to stand trial.
    Hope also concluded that Middleton’s dementia diagnosis
    was speculative. She noted that a proper diagnosis requires
    access to records that Middleton did not have and testing that
    Middleton did not do. Hope also reported that Garza was
    malingering—trying to appear incompetent—by deliberately
    throwing some of his aptitude tests. Oddly, she also wrote
    that Garza “appeared motivated for testing, and put forth
    sufficient attention and concentration . . . he would say ‘Yes!’
    out loud once he figured out [the answer.] Overall, he
    seemed to enjoy the testing process . . . .” Her report never
    reconciled this apparent contradiction.
    Potential malingering aside, Hope’s observations were
    consistent with her competency finding. She wrote that
    Garza exhibited appropriate behavior in his interactions with
    other prisoners and staff. She wrote about Garza’s
    commendable work history—he was steadily employed as a
    mechanic for decades until a heart attack left him unable to
    work. Moreover, Hope made clear that Garza understood his
    situation. He was able to describe the charges he faced and
    the identities and roles of the various actors in the criminal
    process. Garza told Hope that he liked and trusted his lawyer.
    2
    We unseal the sealed pages of the Hope report cited in this opinion
    only to the extent that unsealing is necessary for purposes of this opinion.
    The sealed materials, including the specific pages cited herein, otherwise
    remain sealed.
    6                UNITED STATES V. GARZA
    After Garza was released from medical custody and
    Hope’s report was circulated, the competency issue was
    dropped. Garza’s lawyer (a new one) never raised the issue
    with the trial judge nor moved for a hearing. None was ever
    held. Accordingly, the district court made no specific finding
    as to Garza’s competency.
    C
    Ultimately, plea negotiations failed and Garza went to
    trial. The investigating agents testified about how they
    located Garza and found child pornography at his home. A
    recording of Garza’s interview with the arresting agents was
    played for the jury. The jurors heard him admit to the agents
    that he had searched for and downloaded child pornography
    for years.
    Garza took the stand to testify in his own defense. On
    direct, his testimony hinted at incompetence. He testified that
    he’d seen numerous psychiatrists, that he was mentally
    disabled, and that “diabetes . . . was eating [his] brain.” This
    last statement, though it sounds over the top, is arguably
    consistent with Middleton’s opinion that Garza’s unchecked
    diabetes may have caused brain damage.
    This came later:
    Q: Have there been times during this case
    when you haven’t really understood
    everything that’s been going on?
    A: All of it.
    UNITED STATES V. GARZA                       7
    Q: Sometimes when we talk, do you
    understand everything I’m telling you?
    A: (Witness shakes head.)
    Garza’s lawyer elicited this testimony but did not move to
    have his client declared incompetent. Nor did the district
    court take any action on its own. Later, on cross-
    examination, Garza contradicted the arrest interview by
    testifying that he had never before seen child pornography.
    The jury convicted Garza on both counts.
    D
    At the sentencing hearing, the district court and both
    parties repeatedly mentioned Garza’s mental health, but never
    referred to his competency. Both Middleton’s and Hope’s
    reports were discussed. The district court said that it took “at
    face value” that Garza “does suffer from some mental defects
    or deficiencies . . . .” The focus of all this discussion was
    mitigation. The talk never strayed toward competency.
    In aggravation, the government argued, and the district
    court agreed, that Garza willfully perjured himself when he
    testified contrary to what he had told the arresting agents. To
    justify its finding that Garza’s statements were deliberate lies,
    the court, reading from its own trial notes, offered its
    impression that Garza was playing possum on the
    stand—pretending to be confused on direct only to become
    alert and engaged on cross. Both the judge and the prosecutor
    noted that Garza even anticipated one of the prosecutor’s
    questions. “I think Mr. Garza is malingering,” the court said.
    8                   UNITED STATES V. GARZA
    It then sentenced Garza to 240 months on the receipt or
    distribution charge and 120 months on the possession charge,
    both terms to run concurrently. Garza’s contribution to the
    hearing, his allocution, was this: “Just that I apologize, sir, for
    everything—I just want to get better. Sorry. I’m sorry.”
    II
    We have jurisdiction under 28 U.S.C. § 1291 and
    18 U.S.C. § 3742(a).
    III
    A defendant that “lacks the capacity to understand the
    nature and object of the proceedings against him, to consult
    with counsel, and to assist in preparing his defense may not
    be subjected to a trial.” See Drope v. Missouri, 
    420 U.S. 162
    ,
    171–72 (1975). And “the failure to observe procedures
    adequate to protect a defendant’s right not to be tried or
    convicted while incompetent to stand trial deprives him of his
    due process right to a fair trial.” 
    Id. at 172
    (citing Pate v.
    Robinson, 
    383 U.S. 375
    (1966)). Sometimes “adequate”
    means that the district court must sua sponte consider a
    defendant’s competency. The question is whether this is one
    of those times.
    Garza says yes. He argues that the district court plainly
    erred by failing to sua sponte hold a competency hearing.3
    3
    The failure to sua sponte hold a competency hearing will always be
    reviewed for plain error. United States v. Dreyer, 
    705 F.3d 951
    , 960 (9th
    Cir. 2013) (“This is because a defense counsel who is attuned to his
    client’s mental condition and recognizes that the defendant’s competency
    is in question would not leave it up to the district court to order a
    UNITED STATES V. GARZA                              9
    Failing to sua sponte hold a competency hearing is plain error
    only if “the evidence of incompetence was such that a
    reasonable judge would be expected to experience a genuine
    doubt respecting the defendant’s competence.” 
    Dreyer, 705 F.3d at 961
    (internal citations and quotations omitted).
    To raise a genuine doubt, there must be “substantial evidence
    that, due to a mental disease or defect, the defendant is either
    unable to understand the nature and consequences of the
    proceedings against him or to assist properly in his defense.”
    
    Id. (internal citations
    and quotations omitted) (emphasis in
    original). Relevant evidence falls into three broad categories:
    medical history, the defendant’s behavior in and out of court,
    and defense counsel’s statements about the defendant’s
    competency. See, e.g., United States v. Marks, 
    530 F.3d 799
    ,
    814 (9th Cir. 2008).
    Our review is limited. We ask only whether substantial
    evidence exists such that a reasonable judge would harbor a
    genuine doubt.4 See United States v. Mitchell, 
    502 F.3d 931
    ,
    986 (9th Cir. 2007). Whether the defendant is, in fact,
    competent is a separate inquiry outside our ambit.
    competency hearing sua sponte, rather, he would move for such a hearing
    himself. If his motion was denied we would then evaluate the district
    court’s denial of the motion rather than its failure to order a hearing sua
    sponte.”).
    4
    Even though this is a direct appeal, we look to our cases reviewing
    collateral challenges to the extent they also involve a “substantial
    evidence” inquiry. See, e.g., Deere v. Woodford, 
    339 F.3d 1084
    , 1086
    (9th Cir. 2003) (applying substantial evidence standard to pre-AEDPA
    habeas proceeding); Davis v. Woodford, 
    384 F.3d 628
    , 644–45 (9th Cir.
    2000) (applying substantial evidence standard to post-AEDPA habeas
    proceedings).
    10               UNITED STATES V. GARZA
    A
    The substantial evidence standard is “not easily applied.”
    Basset v. McCarthy, 
    549 F.2d 616
    , 619 (9th Cir. 1977).
    “There are, of course, no fixed or immutable signs which
    invariably indicate the need for further inquiry to determine
    fitness to proceed; the question is often a difficult one in
    which a wide range of manifestations and subtle nuances are
    implicated. That they are difficult to evaluate is suggested by
    the varying opinions trained psychiatrists can entertain on the
    same facts.” 
    Drope, 420 U.S. at 180
    . Accordingly, it is
    understandable that our case law lacks specific rules about
    when the standard is met.
    Nonetheless, general guidelines have emerged. For
    example, an appellant who has absolutely no medical history
    evidence indicating incompetency will almost certainly fail
    to upset his conviction. See, e.g., Mendez-Sanchez, 
    563 F.3d 935
    , 948 (9th Cir. 2009); 
    Marks, 530 F.3d at 815
    . Of course,
    a case may arise where the other indicators of incompetence
    are so powerful that we are compelled to find plain error even
    absent medical history evidence. It just hasn’t happened yet.
    Often, even cases with detailed medical history evidence
    fail to convince us that a reasonable judge would have a
    genuine doubt. 
    Basset, 549 F.2d at 617
    , provides an apt
    example. There, the defendant, who had been deemed
    schizophrenic since childhood, was declared “presently
    insane” by two government psychiatrists just prior to trial.
    
    Id. at 617–20.
    He was then committed for treatment, and
    later released after other government doctors certified his
    competency. Nonetheless, the defendant later misbehaved
    toward his counsel at trial. That misbehavior could have
    arisen from schizophrenia or simple frustration. We decided
    UNITED STATES V. GARZA                     11
    the latter after noting that, prior to the crime, the defendant
    was a socially capable, average college student and that, in
    spite of the misbehavior, neither the court nor defense counsel
    raised the competency issue. 
    Id. Darrow v.
    Gunn, 
    594 F.2d 767
    (9th Cir. 1979), is similar.
    There, two government psychiatrists deemed the defendant
    normal. 
    Id. at 769–70.
    Another, hired by the defendant,
    labeled him a “paranoid schizophrenic living in a delusional
    world.” 
    Id. at 769.
    In spite of that finding, the defense
    psychiatrist claimed that the defendant was “aware of the
    nature of the charges against him and could cooperate and
    collaborate with the public defender’s office.” 
    Id. We found
    no substantial evidence. 
    Id. at 770–71.
    Basset and Darrow are but two unextraordinary examples
    of the many cases where we have found that some medical
    evidence—even some medical evidence of an extraordinarily
    debilitating condition—does not rise to the level of
    substantial evidence. See, e.g., 
    Davis, 384 F.3d at 644
    ; Boag
    v. Raines, 
    769 F.2d 1341
    , 1344 (9th Cir. 1985); Steinsvik v.
    Vinzant, 
    640 F.2d 949
    , 954 (9th Cir. 1981); Sailer v. Gunn,
    
    548 F.2d 271
    , 274 (9th Cir. 1977). The bar is plainly high.
    B
    But some cases do get over it. And that leaves the
    question of how to distinguish between the cases with
    medical evidence that do and the cases with medical evidence
    that don’t. There appear to be two key factors: strong
    evidence of a serious mental disease or defect, and a clear
    connection between that disease or defect and some failure by
    the defendant to understand the proceedings or assist in his
    own defense.
    12               UNITED STATES V. GARZA
    Turning to the first factor, the question is how strong have
    we required the evidence of a serious mental disease or defect
    to be. Historically, we have deemed it sufficient in either of
    two situations. First, where it is undisputed that the defendant
    has a serious mental disease or defect. See Torres v. Prunty,
    
    223 F.3d 1103
    , 1109–10 (9th Cir. 2000); Miles v. Stainer,
    
    108 F.3d 1109
    , 1112–13 (9th Cir. 1997); Moore v. United
    States, 
    464 F.2d 663
    , 665–67 (9th Cir. 1972). And second,
    where the existence of a mental disease or defect is disputed,
    but the defendant engages in bizarre or erratic behavior,
    especially in court. See Maxwell v. Roe, 
    606 F.3d 561
    ,
    574–76 (9th Cir. 2010); McMurtrey v. Ryan, 
    539 F.3d 1112
    ,
    1125–27 (9th Cir. 2008); Chavez v. United States, 
    656 F.2d 512
    , 519 (9th Cir. 1981); Tillery v. Eyman, 
    492 F.2d 1056
    ,
    1059 (9th Cir. 1974). But, where the defendant behaves and
    the medical experts battle over whether he is mentally
    disabled at all, we have not found substantial evidence. See
    Amaya-Ruiz v. Stewart, 
    121 F.3d 486
    , 492–93 (9th Cir.
    1997); de Kaplany v. Enomoto, 
    540 F.2d 975
    , 983–85 (9th
    Cir. 1976) (en banc).
    The second factor is a clear connection between the
    defendant’s serious mental disease or defect—established via
    the first factor—and some failure by the defendant to
    understand the proceedings or assist in his own defense.
    Where the defendant’s mental problem—even if severe—has
    no discernible impact on the proceedings, we have not found
    substantial evidence. See 
    Davis, 384 F.3d at 645
    –46; 
    Boag, 769 F.2d at 1343
    –44; 
    Steinsvik, 640 F.2d at 952
    –54; 
    Bassett, 549 F.2d at 620
    –21. Even a mentally deranged defendant is
    out of luck if there is no indication that he failed to
    understand or assist in his criminal proceedings. See, e.g.,
    
    Steinsvik, 640 F.2d at 951
    –54. And even if that same
    defendant did fail to understand or assist in his proceedings,
    UNITED STATES V. GARZA                     13
    he would still be out of luck unless his mental impairment
    caused the failure. See, e.g., 
    Amaya-Ruiz, 121 F.3d at 492
    –93. We must see a connection. A defendant who
    refuses to work with his lawyer out of spite alone is not
    incompetent even if that defendant has a serious mental
    disease or defect. See, e.g., 
    Davis, 384 F.3d at 645
    –46.
    Our cases finding substantial evidence have consistently
    turned on these two key factors. Our most recent case and
    one of our oldest are prime examples. In 
    Dreyer, 705 F.3d at 958
    –59, all the medical experts diagnosed the defendant with
    frontotemporal dementia. 
    Id. And because
    the dementia was
    the stated reason why the defendant chose not to allocute at
    sentencing, we found substantial evidence that a reasonable
    judge would harbor a genuine doubt about his competency.
    
    Id. Both factors
    were present. There was no dispute that
    Dreyer suffered from a serious mental disease or defect and
    it was that disease or defect that prevented him from assisting
    in his defense by preventing him from allocuting.
    Similarly, in Rhay v. White, 
    385 F.2d 883
    , 884 (9th Cir.
    1967), it was undisputed that the defendant had a “history of
    chronic mental disturbances, paranoid traits, violent
    behavioral explosions and previous institutional diagnoses,
    from the time he was a boy to his commission at age 22 of the
    murders.” Equally clear was that his inability to control
    himself hindered his defense, as defense counsel had to ask
    for recesses throughout the trial to allow his client time to
    cool down because he was “very close to a psychotic break.”
    
    Id. at 885.
    14               UNITED STATES V. GARZA
    C
    By attempting this rough categorization we do not mean
    to imply more uniformity than exists or to create rules where
    only rough guidelines are appropriate. Substantial evidence
    is, inevitably, a case-by-case analysis. And we acknowledge
    the presence of outliers. See, e.g., 
    Deere, 339 F.3d at 1086
    –87 (finding substantial evidence based solely on
    disputed medical evidence without extreme behavior). This
    discussion of the substantial evidence standard is meant only
    to provide general guidelines. Guidelines we now apply to
    Albert Garza.
    IV
    There is no substantial evidence such that a reasonable
    judge would harbor a genuine doubt about Garza’s
    competency. Garza has medical history evidence but neither
    of the two key factors is present. Garza’s medical history
    evidence is not strong—it is disputed whether he has a serious
    mental disease or defect at all, and his behavior, both in and
    out of court, was far from erratic. Nor is there a clear
    connection between any mental disease or defect and any
    failure on Garza’s part to understand the proceedings or assist
    in his own defense. Thus, Garza’s case falls among those
    with some medical history evidence that nonetheless fail to
    exhibit substantial evidence.
    A
    Garza has shown neither of the two hallmarks that
    separate the cases with medical history evidence that reach
    substantial evidence from those that do not. First, Garza’s
    medical history evidence isn’t strong. Although dementia
    UNITED STATES V. GARZA                           15
    certainly qualifies as a serious mental disease or defect,
    Middleton and Hope dispute whether Garza has it.5 Because
    of the dispute, Garza needs strange behavior to satisfy the
    first factor. But he exhibited none. According to Hope,
    “Garza was housed in the general population . . . without
    incident. [And he] was generally able to adapt to the demands
    of incarceration.” “There were no signs of odd or bizarre
    behavior” during his weeks in federal medical custody. The
    trial was no different. Garza sat through the trial and testified
    without incident, much less an incident like what we’ve
    required in the past. See 
    Maxwell, 606 F.3d at 570
    –71
    (suicide attempts); 
    Tillery, 492 F.2d at 1057
    (laughing at the
    jury, ripping off clothes, screaming).
    Second, there is no clear connection between Garza’s
    putative dementia and any negative impact on his ability to
    understand the proceedings or assist in his defense. To the
    contrary, we know Garza understood the nature of the
    proceedings because he described them, accurately and in his
    own words, to Hope. And Garza was, in fact, able to assist in
    his defense. He testified. He allocuted. And his counsel had
    no complaints. Garza’s own testimony that he didn’t know
    what was going on is simply not credible in light of his
    explanation to Hope and his sharp, if false and unsuccessful,
    testimony on cross-examination. There is no substantial
    evidence here.
    5
    We think that no reasonable judge would doubt that Hope got the better
    of the debate. Middleton was tentative. He repeatedly noted that a review
    of Garza’s medical records would have firmed-up his diagnosis, but he
    never reviewed those records. Hope did. She also conducted more tests
    and observed Garza for far longer than did Middleton.
    16               UNITED STATES V. GARZA
    This conclusion draws further support from two obvious
    places. First, Garza’s lawyer dropped the competency
    challenge after Garza was evaluated in federal medical
    custody. That he chose to yield the issue, rather than seek a
    hearing, is telling. See Hernandez v. Ylst, 
    930 F.2d 714
    , 718
    (9th Cir. 1991) (“[A] defendant’s counsel is in the best
    position to evaluate a client’s comprehension of the
    proceedings.”). That he never raised the issue at trial, even
    after Garza’s testimony on the subject, is even more so.
    Second, the district court was well aware of Garza’s mental
    health issues. He said so. And he reviewed the two doctors’
    reports before the sentencing. Yet, instead of holding a
    hearing, he found that Garza was malingering and that he
    committed willful perjury on the stand. These findings, made
    by an experienced trial judge with a far better vantage point
    than ours, give us confidence in our conclusion.
    B
    Garza makes another argument, attempting to reach plain
    error by statutory, as opposed to evidentiary, means. He
    relies on the statutes providing for competency proceedings
    in federal court, including 18 U.S.C. § 4241(a), which
    obligates district courts to sua sponte hold competency
    hearings on reasonable cause:
    The court shall . . . order [a competency]
    hearing on its own motion, if there is
    reasonable cause to believe that the defendant
    may presently be suffering from a mental
    disease or defect rendering him mentally
    incompetent to the extent that he is unable to
    understand the nature and consequences of the
    UNITED STATES V. GARZA                      17
    proceedings against him or to assist properly
    in his defense.
    18 U.S.C. § 4241(a) (emphasis added). Subsection (b)
    provides that “prior to the date of the hearing, the court may
    order a psychiatric or psychological examination” and it
    refers to 18 U.S.C. § 4247(b), which allows the court to,
    “[f]or the purposes of an examination[,] . . . commit the
    person to be examined . . . to the custody of the Attorney
    General.”
    Relying on these statutes, Garza makes two arguments.
    The first runs like this: Garza was committed under §§ 4241
    and 4247, so the district court must have had reasonable
    cause to believe he was incompetent. Since the district court
    had reasonable cause, Garza argues that we must find
    substantial evidence that a reasonable judge would harbor a
    genuine doubt. This logic ignores our obligation to review all
    the evidence before the district court, not just the evidence it
    had when it committed Garza. All the judge had at that time
    was Middleton’s report and the parties’ stipulation; Hope’s
    contrary report and Garza’s courtroom performance came
    much later. We have just explained why all the evidence,
    taken together, fails to establish plain error. It is simply
    irrelevant that some of the evidence would do the trick if
    evaluated in isolation.
    The second argument appears to be that any defendant
    committed for examination under § 4247 is, by virtue of the
    committment, entitled to a competency hearing. This
    argument is not without textual support, as § 4241(b) does
    imply that the “examination” will be ordered “prior to the
    hearing.” But the more specific language trumps the general,
    and that specific language requires a hearing on “reasonable
    18               UNITED STATES V. GARZA
    cause.” It makes perfect sense that the examination ordered
    under § 4247 might, as it apparently did here, dispel
    reasonable cause. A § 4247 examination does not
    automatically entitle a defendant to a hearing.
    V
    There was no plain error here because no reasonable
    judge would harbor a genuine doubt about Garza’s
    competency; no reasonable judge would harbor a genuine
    doubt about Garza’s competency because there was not
    substantial evidence; there was not substantial evidence
    because Garza’s medical history, his behavior in and out of
    trial, and his defense counsel’s statements do not reveal a
    defendant incapable of either understanding the nature of the
    proceedings against him or assisting in his defense.
    AFFIRMED.