Steinberg Had 'A Big Grin,' Doctor Says

Steinberg Had 'A Big Grin,' Doctor Says

By RONALD SULLIVAN

LEAD: When Joel B. Steinberg was told that Lisa Steinberg had suffered permanent brain damage, he grinned broadly and made a gruesome joke, a hospital physician testified yesterday.

When Joel B. Steinberg was told that Lisa Steinberg had suffered permanent brain damage, he grinned broadly and made a gruesome joke, a hospital physician testified yesterday.

'' 'What you are saying is she's not going to be an Olympic athlete, but she'll survive,' '' the physician quoted Mr. Steinberg as replying.

The description of Mr. Steinberg at the St. Vincent's Medical Center caused several jury members to wrinkle their faces and shake their heads, and it generated a wave of murmuring in State Supreme Court in Manhattan, where Mr. Steinberg is on trial for murder in the fatal beating of Lisa, the 6-year-old he raised.

The physician, Dr. Patrick Kilhenny, a neurological resident, also testified that Lisa had died from a blunt trauma, or head blow, that Mr. Steinberg is charged with having inflicted. Dr. Kilhenny said there was no medical evidence that Lisa had choked to death, as Mr. Steinberg contends. 'Smile on His Face'

Dr. Kilhenny, testifying for the prosecution, said he examined Lisa when she was taken unconscious to the emergency room last Nov. 2 and told Mr. Steinberg of his findings a few minutes after examining the girl.

''What did you think of his reaction?'' asked Peter Casolaro, an assistant district attorney.

''I thought it was inappropriate,'' said Dr. Kilhenny, adding that his reaction was ''one of disbelief.''

''Objection!'' shouted Mr. Steinberg's lawyer, Ira D. London.

''Did he have a reaction?'' Mr. Casolaro asked.

Glancing at Mr. Steinberg and facing the prosecutor, Dr. Kilhenny said, ''He seemed to have a smile on his face, and it didn't seem appropriate to me.''

Under Mr. London's cross-examination a few moments later, Dr. Kilhenny said: ''He smiled. It was a big grin.''

Mr. Steinberg sighed, removed his glasses and ran his hand down his face.

After the exchange at the hospital, Dr. Kilhenny said, Mr. Steinberg left. Dr. Kilhenny added that he called the police on the suspicion that Lisa was a victim of child abuse.

Dr. Kilhenny said that when Lisa arrived at St. Vincent's at 7 A.M., she was unresponsive. He said that after neurological tests, he determined that the girl had suffered irreversible brain damage from a blow that had caused extensive bleeding in the head. He said X rays confirmed the findings.

Dr. Kilhenny said he decided to interview Mr. Steinberg in an effort to find out how the brain damage had occurred.

Dr. Kilhenny sat easily in the witness chair as he recalled the hectic moments in the emergency room. He said that he questioned Mr. Steinberg extensively and that the reply that Lisa had become sick from eating vegetables and had choked on vomit ''did not seem consistent with my physical findings.'' Lisa died Nov. 5. Symptoms of Reye's Syndrome Under cross-examination, Dr. Kilhenny conceded that Lisa had symptoms consistent with Reye's syndrome, a rare and often fatal disorder that attacks children and is characterized by neurological disorders, brain swelling and liver enlargement. Mr. London, who contends that Lisa died from a seizure, also elicited from the physician that Lisa suffered from a blood trauma to the liver.

Last Thursday, two paramedics and a nurse testified about Mr. Steinberg's reactions in the emergency room. The nurse, Nancy Dodenhoff, was asked whether Mr. Steinberg said anything to her. ''He asked me how she was,'' she said, but his tone of voice ''was very flat.'' She said she told him that Lisa was probably brain-dead.

Mr. Steinberg, she said, replied, '' 'Have you found anything else wrong with her?' ''

''Did the defendant cry?'' a prosecutor, John McCusker, asked. ''No,'' she said. ''Did he show any physical reaction?'' ''No.'' The paramedics, John Filangeri and Brian Gearity, described Mr. Steinberg as ''very cool, very calm, even unconcerned.''

''Did you ever see a parent act in that manner?'' Mr. McCusker asked.

''In my experience, no.'' Mr. Filangeri said. ''I just couldn't believe anyone could act that cold and uncaring.''