He had not been visible for the better part of a decade, but the reputation of Dr. James Grigson lingered long after he last testified in a capital murder trial. In truth, it lingers still -- two weeks after his death from cancer at 72.

Grigson once was known to every district attorney and most of the better criminal defense lawyers in the state. In the 1980s and early '90s, he was praised, reviled, criticized, reprimanded and relied on as no other forensic psychiatrist in state history.

Nicknamed "Dr. Death" for his willingness to testify against capital murder defendants, Grigson was a witness in hundreds of death penalty cases. His pleasant manner, down-to-earth vocabulary and air of certainty helped persuade juries that the defendant -- just about every defendant -- would kill again if given the chance. That Grigson often had not met with the defendant did not deter him from forming an opinion about him and defending it to the hilt.

"He had a tremendous impact on Texas death penalty litigation," said Cynthia Orr, president of the Texas Criminal Defense Lawyers Association. "He really provided ammunition to the state to try and establish one's future dangerousness when ordinarily it would have been pretty tough to do. He was willing to go further than anyone else."

And do it simpler. He did not use notes or charts and never lapsed into medical gobbledygook.

"He was an outstanding communicator who really connected with a jury," said Dallas criminal defense attorney Dan Hagood, a former prosecutor who used Grigson in several trials. "He could really talk about medical terminology and make it understandable, using emotionally recognizable phraseology. He had a great sense of humor. He just had a way."

Dallas lawyer Doug Mulder, a one-time first assistant in the local DA's office who left to do defense work in 1981, said Grigson had vast knowledge of his subject and was one of the finest forensic psychiatrists in the country.

"But you know," Mulder said, "I don't think Grigson ever told the jury something they didn't already know. It think it just reinforced what they thought."

Grigson's eagerness to make absolute judgments earned him the praise of prosecutors and the scorn of professional psychiatric organizations. He was twice reprimanded by the American Psychiatric Association, once for using the results of a competency examination against a defendant during the punishment phase of his trial, the other time for claiming 100-percent accuracy in predicting how dangerous a defendant he had never examined would be in future years.

The psychiatric establishment considered his opinions little more than quackery. Paul Appelbaum, a University of Massachusetts psychiatry professor whose complaints ultimately led the APA to expel Grigson, complained that future behavior went well beyond what science can purport to know.

Grigson, stung by the rebuke, fought the expulsion with a lawsuit, to no avail. He blamed the action on anti-death-penalty doctors in the group. Later the Texas Society of Psychiatric Physicians also booted Grigson from its ranks.

Many forensic psychiatrists faulted Grigson for becoming, in essence, part of the prosecution team.

"The problem with Dr. Grigson was not that inmates were placed on death row, but that he was fundamentally biased in his assessments, and was performing cursory evaluations and drawing broad and damning conclusions from only limited information -- a problem of credibility and objectivity," New York University psychiatry professor Michael Weiner wrote in 1996.

The danger of making such bold predictions became apparent in the case of Randall Dale Adams, convicted of the 1976 murder of a Dallas police officer. Grigson labeled Adams an "extreme sociopath" despite Adams' lack of a criminal record, and said there was no doubt he would kill again, even in prison. Adams was later exonerated of the crime after another man confessed and has not been in trouble since.

Mulder, who prosecuted Adams and still believes he committed the crime, said the bad publicity Grigson received concerning that case and others never fazed him. For Adams' appellate lawyer, however, the case soured him forever on the doctor.

"In my humble opinion, he was a totally discredited, worthless witness who unfortunately was a very charming and amiable man and who was used to achieve some very horrible, unjust results," Randy Schaffer said. "If the facts did not fit his theory, he would change his theory to fit the facts. He was such a complete tool of whoever hired him first, that for money he would say literally anything."

Defense attorneys fearful of the effect of Grigson's testimony began to call him and discuss their clients, with the result being Grigson could not be hired by the state in those cases. Orr said Grigson soon caught on to the tactic and was not happy about the lost income, so she and others began to pay him as a consultant. He would have little involvement in the defense and usually would not testify, she said. The point was to make sure the prosecution could not use him.

Prosecutors sometimes did the same thing, concerned that he might show up on the stand for the defense. As he grew in demand, even some lawyers who liked him felt that Grigson may have become too taken with the role of professional witness. The ones who did not like him held him in contempt.

"I think he probably did more to cause disrespect and distrust for psychiatric testimony than any other doctor in the history of the country," Schaffer said.

Grigson was at the center of an important U.S. Supreme Court decision. In 1981, the court unanimously decided that defendants could not be examined by a psychiatrist without their permission, nor could the information obtained be used at trial unless the defendant was warned that it would be.

Before that, capital defendants were routinely examined by Grigson, who did not tell them he might testify against them at time of punishment.

Over time the practice of using forensic psychiatrists -- "killer shrinks" in criminal justice jargon -- as part of the case for the death penalty became less popular. Prosecutors found that juries could just as easily be persuaded by the facts of the case, the defendant's previous criminal history and the testimony

The calls for Grigson's assistance dwindled and he turned his attention to civil cases.

A few months before his death from lung cancer, Grigson told a reporter that he had no regrets. He said he saw his role only as a doctor who was there to distinguish the mentally ill defendants who needed to go to the hospital from the ones who were faking it and needed to go to prison -- and of course from there to the great beyond.

"Wherever he ended up," Schaffer said, "I suspect there's a long line of people waiting to talk to him about his opinion on their dangerousness."