A Mother's Trial (38 page)

“Yes, about twelve to thirty verbal threats. And there’s always the possibility that they’ll carry them out. The parents sometimes make threats, too.”

“And have you passed these threats on to the police?”

“On occasion I’ve passed them on to my supervisors, but not to the police. There’s nothing they could do.”

“Well, in view of these threats, you’ve taken all possible steps to keep the existence and whereabouts of your family secret, then?”

“No, that’s not a fair statement.”

“And did you publicize the hospitalizations of Tia and Mindy?” Josh continued, in an effort to counter the theory that some crazed juvenile had poisoned Steve’s children.

“No. But a note on Mindy’s arrival—with our address—was in the
Terra Linda News.
We made no attempt to keep our address secret,” Steve replied.

In an effort to underline Steve’s violent reactions to some situations, Josh Thomas asked him questions about the meetings with Carte and Callas and with Dr. Stein, during which he had made threats.

Steve admitted that he had made a comment about throwing someone through a wall. Although he could not recall threatening Dr. Stein, he did agree that he sometimes talked quite violently.

“But I have a tendency to verbalize stuff rather than do it. I do remember getting upset with Stein when he told me from then on Tia was to be treated at San Francisco. I said I wouldn’t drive to San Francisco, but rather to Marin General and then bill Kaiser for it. But I never did that,” he added.

Josh ended his cross-examination with a question regarding the list of Kaiser employees that Steve had asked Dr. Carte to send him so that he could check for potential enemies. Carte had refused, and Steve had never followed through.

“After you called Dr. Carte and he refused to send you the list, did Mr. Caldwell ever have a subpoena
duces tecum
issued for that information?  Did you ever suggest to Mr. Caldwell that perhaps he ought to issue such a subpoena so you could study the list for potential enemies?”

“No, I didn’t. I assume the subpoena you’re talking about would get the records? Is that—”

“You’ve heard of a subpoena
duces tecum,
haven’t you?” Josh was needling him now.

“Yeah, oaky. I understand the word now. You said it a little slower. The answer is, no, I did not.”

“All right.” Josh had a final question. Steve had talked about Priscilla’s burn on direct examination, making it sound accidental. Josh believed there was another possibility. “Now, do you remember how soon prior to the preliminary hearing Mrs. Phillips was burned?”

“I believe it was the weekend prior.”

“And she was scheduled to start the preliminary hearing on Monday, is that correct?”

“To the best of my knowledge, that’s correct.”

“Thank you. No further questions.”

Shortly afterward, Steve Phillips was excused and court was adjourned for the weekend.

“You did fine,” Ed told him as they walked out.

Steve turned to Priscilla.

“Pris?”

She nodded in agreement.

“Thank God,” Steve said.

Week 8

The second week in May was to be the decisive one in Ed Caldwell’s overall plan for the defense. He had scheduled only two witnesses: Dr. Joseph Satten and Priscilla Phillips.

Dr. Satten, after sixteen hours of interviews with Priscilla, Steve, and Marietta, had finally reached a conclusion, and it was all that the defense had hoped for. Caldwell believed Satten would make a powerful appearance, not only because of what he intended to say about Priscilla, but because Ed felt he would make a strong contrast to the prosecution’s psychiatrist. There was no artifice about Joe Satten. He was not the type of forensic psychiatrist—and unfortunately Ed knew several in the field—who would sell out to the highest bidder.

Furthermore, Satten was experienced. He was unlikely to become flustered on the stand, even under the battering cross-examination techniques the district attorney liked to practice. So Ed Caldwell entered the final week of his case with confidence.

Caldwell had asked Satten to focus primarily on the issue of whether Priscilla could be suffering from Munchausen Syndrome by Proxy. In his background research on the case, Satten testified that he had reviewed the medical records of Tia and Mindy; police tapes of Priscilla Phillips and others; Martin Blinder’s preliminary hearing testimony; and articles on the syndrome. In addition, he had completed a lengthy evaluation of Priscilla Phillips’s mental status.

“And what did you conclude, Doctor?” asked Al Collins, who was handling the direct examination.

“I found an essentially normal mental condition and specifically none of the distortions of thinking or emotion that have been described in the articles of Munchausen Syndrome by Proxy, or that one might expect if Mrs. Phillips had committed the alleged acts,” Satten answered firmly.

“What are the elements that make up Munchausen Syndrome by Proxy, Dr. Satten?”

“There are two. One, somebody deliberately creates symptoms in the illness of a child and then lies about them. Two, the mother has a history of Munchausen Syndrome and in addition has a severe mental disorder that is described by some as psychotic and by others as hysterical.”

“And does Mrs. Phillips evince either of these symptoms?”

“No. She has no severe psychosis nor a history of Munchausen Syndrome—that is, fabricating her own symptoms in a hospital setting. Nor does Mrs. Phillips have the symptoms of an abusing mother,” he added.

“Now, Doctor, I would like to list some attributes and ask you whether these could be used to diagnose Munchausen Syndrome by Proxy: capable, responsible, and devoted to her children; and telling church members that her daughter was ill.”

“No. Those are not the attributes of a person with Munchausen Syndrome by Proxy.”

“Thank you, Dr. Satten.”

As soon as the doctor was called to the stand, Josh had motioned to Ted to investigate Satten's previous record as a witness. Ted had made a couple of calls to district attorneys in the East Bay and made a rather significant discovery. Dr. Satten was known on occasion to forget to bring his notes with him, and this could prove to be a significant lapse. A district attorney was allowed to examine all the material an expert witness had used to form a conclusion, including notes, tape recordings, and articles. If a witness failed to bring such material, the prosecutor would be badly hampered in cross-examination. And if an expert witness—particularly one who had testified numerous times in the past—neglected to bring such material, it could be construed as intentional. It suggested a way to cast doubt on the witness’s impartiality. Josh intended to find out whether the doctor had brought his notes, but as it happened, Satten’s answers to his very first series of questions opened up a different source of attack—one which horrified Ed Caldwell.

“When you first met with Mrs. Phillips, Dr. Satten, what background did you have on the case?”

“I had a verbal report from Mr. Caldwell.”

“And what happened in this first meeting?”

“Mrs. Phillips denied the allegations. She told me about her past. I did not tape this interview, but I did tape six or seven others, beginning with the second,” he added. Taping his patients was a technique Dr. Satten used often, as he had found in the past that the accused’s own words could make a very powerful and direct statement. He believed that more often than not this openness worked to the advantage of a client: in fact, frequently such a tape, when played in court, convinced a jury more clearly than anything else of the mental state of a defendant. But of course this case was different than the norm. Usually Dr. Satten was called in to establish that a defendant’s mental condition had prevented him from acting rationally. On this occasion he had been called upon to assert the mental health of the defendant.

When he heard Satten’s answer, Ed Caldwell squirmed in his seat and almost put his head in his hands in despair. He could not believe that an experienced forensic psychiatrist had actually taped a patient. Satten should have recognized how dangerous this could be! Ed wondered what was on those tapes. Priscilla had believed she was in a confidential doctor-patient relationship with Satten, as indeed both Ed and Satten had encouraged her to think. There had been no reason for her to hold back. Ed knew Josh Thomas would jump all over this information, but it took the district attorney a few questions to arrive there. He was still intent on the doctor’s notes.

“Do you have the notes for that first interview with Priscilla Phillips, Dr. Satten?”

“Not with me. I brought a copy of my CV and a list of the articles I studied in connection with this case and my review of those articles.”

“Are you aware that your notes would be something asked for—that I would want to review those?”

“No, I was not aware of that.”

“You didn’t realize I would want to have access to them?”

“No. I just brought what I had relied upon to form my opinion.”

Josh looked up at the judge. “Your Honor, I would like a court order that Dr. Satten be required to produce all the material he reviewed so that I can effectively cross-examine him.”

“Yes, I will grant that. You may, of course, exclude all the documents furnished to you by the police and prosecution, Doctor.”

Pausing from time to time to look down at his notes, Josh Thomas continued to question Dr. Satten, skipping from point to point. He established that it was not necessary to examine a person to diagnose Munchausen Syndrome by Proxy. Then he moved on.

“Did you make a written report to Mr. Caldwell about your findings?”

“No, but we had phone conversations and three conferences in my office. I formed the opinion early on that Priscilla Phillips did not show the mental disturbance associated with a child abuser, but I did not formalize the opinion until after I interviewed Mr. Phillips and Mrs. Phillips’s mother.”

“Did you review Mrs. Phillips’s medical records?”

“Yes, the records of her two deliveries, her hysterectomy, and the burn.”

“Were you informed about the proximity of the burn incident to her scheduled preliminary hearing?”

‘No. But I don’t think the burn incident was unusual. I would characterize it as a stupid accident.”

At the noon recess, Steve went up to Dr. Satten and the two men walked off to the little lake behind the Civic Center.

Steve had grown fond of Satten. After meeting with the doctor for a formal interview at the beginning of April, and again—with Priscilla this time—two weeks ago, Steve found himself relying on the older man as a kind of touchstone for his own emotions. Stretched this way and that by bitterness, anger, fear, and confusion, in the last few days Steve had begun to distrust all his emotions, uncertain which—if any—were appropriate anymore. Unashamedly he reached out to the father-figure for reassurance.

The two men stopped by the water’s edge. The hills beyond were dusky brown, burned dry by the hot May sun and two years of drought from which the county was only just now recovering. Dr. Satten turned to the younger man.

“Look, Steve, Priscilla does not have, nor has she ever had, any mental problems. She’s a strong, determined woman, with plenty of community support and emotional strokes from you, her friends, and others. She isn’t needy in the way that is typical of a child-abuser. She has plenty in her life that is tangible and real to satisfy her. She had no special sick need to live through her children, or to punish them. Her personality is part of what makes her special.”

Steve shook his head despondently. “But sometimes I feel we’re not gonna make it. Our whole world is caving in on us, you know? And I don’t know who to trust anymore.”

“It's frightening—opening yourself up—I know that. No one likes to risk that.”

“Yeah. And suddenly, all the stuff we’ve tried to build for—” Steve stopped, then gamely went on. “It’s all starting to go—” and he pointed at the ground. “And I think it’s just gonna continue in that direction.”

Satten put an arm around Steve’s shoulders. “That could happen, Steve. But I want you to trust your instincts about Priscilla at least.”

“Okay. I guess I just gotta come to terms with the fact that I may have nothing when this is all over, that if the four of us can just walk away from this—even with no resources left—we’ll be damned lucky. If I come to terms with that, that’s a helluva weight off my shoulders.”

“I think you just did come to terms with it, Steve.”

 “Yeah.”

“Come on, let’s get back. We’re not dead yet, you know. There’s life in the old horse left,” Satten joked gently. “And you’re a strong family. You’re going to handle whatever comes along.”

“Whatever comes down the pike?”

Satten smiled and nodded. “Right, he agreed.

After lunch, Josh Thomas questioned Satten about the articles that he had reviewed on Munchausen Syndrome by Proxy.

“In about half the articles I read, the mother expressed relief at being found out,” Satten remarked.

“But in some cases the parents denied involvement?”

“Yes. But in all but one article—the Kurlandsky article called ‘Munchausen Syndrome by Proxy: Definition of Factitious Bleeding in an Infant’—the women were described as being severely disturbed. And I believe that only a psychotic or a near-psychotic could commit the acts involved in this case.”

Josh Thomas rummaged through the pile of material on his table and came up with the Kurlandsky article.

“This says that ‘to date the psychiatric evaluation of the parents has been unrevealing,’” he read. “Does it not also say that there was a healthy male sibling, and that during the time of the second child’s illness, the mother lived in at the hospital and gained the respect and intimate friendship of the staff because of her helpfulness?” Josh asked.

“Yes.”

“Were there any psychiatric tests done on Mrs. Phillips?”

“Yes. Dr. Lowell Cooper, who is a psychologist, prepared a psychological test report.”

“And do you know what psychological tests he used to evaluate the defendant?”