5.Paul Zeizel — Direct (Part 1)
363 linesCOURT CLERK: The record will return back to the matter of Commonwealth versus Lindsay Clancy. All parties are present excluding the jury.
THE COURT: All right. Counsel, are we ready for the jury?
MS. SPRAGUE: Yes.
BAILIFF: All rise. Jurors entering.
BAILIFF: Court is back in session. You may be seated.
COURT CLERK: Your Honor, for the purpose of the record, we return back to the trial, Commonwealth versus Lindsay Clancy. All parties are present, including the defendant and including the eighteen jurors.
THE COURT: All right. Attorney Reddington.
MR. REDDINGTON: Thank you. Call Dr. Paul Zeizel, please.
COURT CLERK: Good afternoon. Do you solemnly swear that the testimony and the evidence you shall give to the court and the jury in the matter now pending between the Commonwealth and the defendant at the bar shall be the truth, the whole truth, and nothing but the truth, so help you God?
PAUL ZEIZEL: I do.
COURT CLERK: Thank you, sir. You may have a seat.
THE COURT: All right. Good afternoon, doctor.
PAUL ZEIZEL: Good afternoon, Your Honor.
THE COURT: Mr. Reddington.
MR. REDDINGTON: Thank you, Judge. Good afternoon. Tell us your name and spell your last name for the record, please.
PAUL ZEIZEL: Good afternoon. Paul Zeizel. Z-E-I Z-E-L.
MR. REDDINGTON: And what do you do for work, sir?
PAUL ZEIZEL: I'm a clinical and forensic psychologist.
MR. REDDINGTON: And briefly, what's the difference between a psychiatrist and a psychologist?
PAUL ZEIZEL: A psychiatrist goes to four years of medical school and does a residency in a specific field in medicine. A psychologist goes to graduate school, generally four years, and gets a PhD or a PsyD, Doctor of Psychology, in psychology. The difference in terms of clinical practice, psychologists are trained very extensively in counseling, testing, interpretation of testing, and that then continues to various treatment modalities working with children, adolescents, couples, families, and it can extend beyond that, neuropsych testing, issues of guardianship, child custody cases, and there are many variants in that. So psychologists are in the domain of treatment, testing, and evaluation of mental health conditions.
MR. REDDINGTON: Can psychologists prescribe medication?
PAUL ZEIZEL: Generally, no, but the Department of Defense will allow psychologists in the military and overseas to sometimes prescribe medication. But 99% of psychologists do not have prescription privileges.
MR. REDDINGTON: As far as the testing that you referenced, what is it you referring to regarding testing?
PAUL ZEIZEL: So there's testing across various domains. If a person comes in with, let's say, concerns about intellectual functioning for a child, they would have a perhaps school psychologist or educational psychologist who would do testing on cognitive levels of functioning, or neuropsych testing, or testing that deals with issues of ADD, attention deficit disorder, or ADHD, attention deficit hyperactivity disorder. There's other testing that would include, for example, forensic testing. That's the integration of mental health and the law. That requires a psychologist to know about the different types of forensic testing issues that might be there. So this would often be things that would be pertaining to deception, malingering, personality assessment, and sometimes sociopathy or what's known in the DSM-5 TR, which you've heard about, antisocial personality disorder. In addition, as I briefly mentioned, guardianship, conservatorship, custody issues with parenting, risk assessments for certain jobs that individuals might have working for government in top secret positions, police officers, military as well.
MR. REDDINGTON: So for example, some of the testing, what is the MMPI?
PAUL ZEIZEL: So-
MR. REDDINGTON: Minnesota Multiphasic something?
PAUL ZEIZEL: ... Yes, it's called the Minnesota Multiphasic Personality Inventory, and there are various iterations. There's MMPI-3, there's the RF. Some are focused on forensic assessment. It is a test that is been around since the 1940s that was originally used to determine a sample size of white men going into the military who would be good leaders. Today, the sample is based on a much more diversified population, including women and different racial, ethnicities, and it's divided into two parts. One part has what we call a validity and reliability scale and a lie scale. Re- validity-
MR. REDDINGTON: The lie scale, is that also referred to a, as the K scale?
PAUL ZEIZEL: Yes, it could be considered part of the K scale, and it's whether someone is being dishonest with the test. But it will change slightly because people on some tests, psychological tests, will want to come across as faking good. Some people will want to come across as faking bad. Faking good would be a mother whose children were taken away. She would like to get them back, so she wants to come across as the healthiest person there is. Conversely, faking bad is someone seeking a, let's say, a workman's compensation claim, and they may have a tendency to exaggerate the nature of their injuries.
MR. REDDINGTON: So in this case, for example, forget about workman's comp. Let's talk about a murder charge. If a defendant submits to a psychological test, such as the MMPI, and the interpretation by a psychologist of the results of that test, if the person wanted to pretend that they were suffering from a disease, a defect, would that test ostensibly be able to tell the psychologist that?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was the MMPI administered by the government's doctors on this case to Lindsay?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Did that have a K scale as to whether or not she was lying or exaggerating or malingering or trying to fake that she had some disease or defect?
PAUL ZEIZEL: Yes, it had a K scale.
MR. REDDINGTON: And what were the results of the government's doctor's tests on the Minnesota Multiphasic Personality as it relates to the K scale?
MS. BUCKINGHAM: Objection.
THE COURT: Yeah, can I see counsel over here?
MR. REDDINGTON: So, doctor, could... let me just, as we say, lead you a little bit. Yes or no answers would be fine. Were you aware that a test was administered by the government's doctor, I think it was Dr. Heilbrun, to Lindsay Clancy in the course of the government's evaluation?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And did you consider the results of—and the interpretation of that test as part of your opinion for this jury?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And to that extent, as you discuss whether or not somebody is faking or somebody is exaggerating, do you have an opinion based upon your review of the discovery in the case to a reasonable degree of medical certainty as to whether or not Lindsay Clancy, in the course of that evaluation, was malingering or lying or exaggerating?
PAUL ZEIZEL: Yes, I do.
MR. REDDINGTON: Tell the jury.
PAUL ZEIZEL: My opinion in the testing of Ms. Clancy regarding the MMPI was that—
MS. BUCKINGHAM: Objection.
THE COURT: Just that, just the doctor's... your opinion, doctor.
PAUL ZEIZEL: She was not faking. There was no evidence of any malingering. She presented as an honest citizen.
MR. REDDINGTON: Okay. Now, regarding your background, I may have jumped the gun. Tell us briefly what your educational background is.
PAUL ZEIZEL: I have a bachelor's degree from Queens College. I have a master's degree from Harvard University and a doctorate in clinical psychology from William James College.
MR. REDDINGTON: And your career spans how many years, sir?
PAUL ZEIZEL: I've been licensed for thirty-seven years.
MR. REDDINGTON: And would you consider yourself to be a forensic psychologist?
PAUL ZEIZEL: Yes, I do.
MR. REDDINGTON: And as you indicated, that's the interface between medicine and law. Is that correct? Forensic—
PAUL ZEIZEL: And mental health and law, yes.
MR. REDDINGTON: Mental health and law. Okay. In this case, your experience obviously is something somebody has to evaluate. Can you tell us your history as a psychologist, in other words, your experience that you've had in the field?
PAUL ZEIZEL: Yes. Well, in the field, I've have, as a forensic psychologist, been involved in over one thousand cases, testifying for both the Commonwealth as well as for respondents' counsel. I testify more for respondents or defendants these days. I've been qualified in every court in the Commonwealth, with the exception of Nantucket, because I've not done any cases in Nantucket County. I have a small private practice. I have done work with governmental agencies, a psychologist for the DEA, Drug Enforcement Administration, and I've worked as a federal contractor, as a vendor overseas, for the State Department in Afghanistan.
MR. REDDINGTON: How long were you in Afghanistan?
PAUL ZEIZEL: I was in Afghanistan from November 2007 to roughly mid-February 2011.
MR. REDDINGTON: So for that four-year period while you were in Afghanistan, what was the nature of your work?
PAUL ZEIZEL: The nature of my work was basically the equivalent through the military. They get analogies with the military as a combat psychologist. I was embedded in the field. I would do evaluations for what we call critical incident debriefings and when there would be multinational forces. And in Afghanistan, it was the ISAF coalition, International Security Assistant, Assistance Forces. That would be countries that were deployed over there, England, Germany, France, Spain, Italy, Portugal, Romania, Bulgaria, Australia, New Zealand, a total of thirty-eight countries. I could go on, but I'm not going to. And I'd be loaned to various countries in different parts of the country to do debriefings after a critical incident, which would be what's called a TIC, T-I-C, troops in combat. I'd fly out, usually on a helicopter, do the debriefings of the people who survived those attacks, engaged in those attacks, and ensure that they were stable enough to continue and, if you will, fit for duty.
I would also do evaluations on violence assessments, individuals who had problems maintaining their ability to function safely in a war zone where everyone carries at least one weapons, usually two, to ensure that they were able to be healthy for their work, and I would do various types of training and debriefing. I was also loaned out to other governmental agencies, the US Marshals, the FBI, CIA, and with each of those agencies, there would be various issues that were necessary. People getting hurt, people killing, individuals who attack them, and when that occurs, as one would imagine, there's great trauma that goes with that. And these people were not necessarily negatively impacted in the moment, but we would make sure that they were healthy enough to continue their work if need be.
If they were psychologically impaired, I would be involved in helping get them sent over back to Europe, to Landstuhl, Germany, sometimes to Dubai, and help with individuals who suffered themselves with issues back from the United States. I would have to do death notifications with the military. I would help with issues of conflict with other soldiers and contractors and agencies, dealing with all the issues that one might expect could come up in various parts of a war zone. I was often sent to what are called FOBs. Those are forward observation bases, generally about a hundred people, more or less, in those bases, multi-international. And I was also sent to COPs, C-O-Ps, combat outpost, very remote, in the middle of nowhere on mountainsides where you walk up goat trails just to get to where your small base is. And the billets were often cots and tents that were erected on rocks and no electricity, quite remote.
PAUL ZEIZEL: And I was on many, many dismounted patrols, with the belief that having a psychologist or someone psychologically trained to deal with what it's like to be in a war zone would be therapeutic. If not therapeutic, re- ... explainable and helpful. I did many of those events.
MR. REDDINGTON: At some point, did I ask you to become involved to some degree in this case, Doctor?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Can you tell the jury when that was?
PAUL ZEIZEL: I received a phone call from Attorney Reddington late in the evening on February 3rd, 2023. It was late because I was already in bed sleeping, and the phone rang. It was about 11:30.
MR. REDDINGTON: And without getting into the details, did I advise you that I was representing a young woman by the name of Lindsay Clancy, and that she was severely injured, and she was in a hospital?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: As a result of that, what did you do?
PAUL ZEIZEL: That next morning, I went to Brigham and Women's Hospital, went to the front desk where one would normally check in, and there was a woman there who was... I felt was a volunteer. I explained who I was. I explained that I was asked by Attorney Reddington to evaluate Ms. Clancy on the surgical ICU unit.
MR. REDDINGTON: Were you able to access her to speak to her?
PAUL ZEIZEL: Eventually, yes.
MR. REDDINGTON: And when you say eventually, what's the timeframe we're talking?
PAUL ZEIZEL: I was initially told I couldn't go. I had to wait 30 minutes. Attorney Reddington called the chief counsel of the hospital to enable me to have access to the unit where Ms. Clancy was staying.
MR. REDDINGTON: When was it that you were able to get into the unit to see her?
PAUL ZEIZEL: 12:30 in the afternoon.
MR. REDDINGTON: What date?
PAUL ZEIZEL: February 4th.
MR. REDDINGTON: So it would be January 24th- ... seven, so this is almost—
PAUL ZEIZEL: 11 days.
MR. REDDINGTON: ... days later, right?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: You're also aware that I needed a court order to get you into the hospital.
PAUL ZEIZEL: That's correct.
MR. REDDINGTON: And were you able to ultimately get in the hospital, go to the surgical unit, and meet with Lindsay?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Jurors have had a chance to look at photographs of her laying in the bed with tubes and- ... wires and all of that. Is that what she looked like when you first saw her?
PAUL ZEIZEL: Yes. However, she was also, with her right arm as I recall, shackled to the bed with handcuffs.
MR. REDDINGTON: So did that little soft little things that tied her hands to the side of the bed, were they handcuffs?
PAUL ZEIZEL: They weren't soft. They were regular, but appeared to be metal handcuffs that police officers, and perhaps officers in this court, use for detaining people and arresting people.
PAUL ZEIZEL: They were not soft.
MR. REDDINGTON: ... while she's laying in the bed, did she have the tubes and the wires for treatment in the emergency—the intensive care unit, I should say?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was she intubated at that point, if you recall?
PAUL ZEIZEL: She was not.
MR. REDDINGTON: So she was able to speak?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was she able to move other... Oh, obviously, she's chained to the bed, so she couldn't get up.
PAUL ZEIZEL: She could not get up. She couldn't move below her sternum, the chest bone.
MR. REDDINGTON: Now, at that point, had you and I met and talked about this case at all?
PAUL ZEIZEL: No.
MR. REDDINGTON: What was the reason I asked you to go to the hospital?
PAUL ZEIZEL: You were worried about her mental health, given the significant event that had just taken place a few days earlier. You were concerned that she had absolutely no ability to have visitors. Visitors were not permitted to meet with her, from family members to friends to a priest. No one was able to see her.
MR. REDDINGTON: So as a result of that conversation we had, you went to the hospital, went into her room, and you were able to speak to her. Is that correct?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Can you tell the jurors, if you recall, what type of law enforcement presence, uniform, cops, guns, stuff like that. What did you notice?
PAUL ZEIZEL: I noticed literally outside of her hospital room were two state troopers in their blue uniforms, sitting each in a chair on either side of the doorway to Ms. Clancy's room, with a nurse sitting in the corner of her room.
MR. REDDINGTON: When you went in to see her on that date, was it your understanding she had recently been extubated? In other words, they removed the tube from her mouth?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And do you recall the conversation that you had with Lindsay at that time?
PAUL ZEIZEL: Yes, I do.
MR. REDDINGTON: Tell the jurors what your memory is.
PAUL ZEIZEL: The conversation I had with Ms. Clancy at that time was one where I asked if she knew where she was, so I did what's called a mental status exam, a brief mental status exam. It's orientation to time, place, location. She didn't know where she was, wasn't quite sure what time it was. She knew who she was, and she told me that she remembers what happened, but it was very fuzzy and foggy. At the time, she had been on medication for the significant pain post-surgery while in that hospital room.
MR. REDDINGTON: And during the course of that interview with her, did she express any concern to you about her husband, Patrick?
PAUL ZEIZEL: Yes, she did.
MR. REDDINGTON: Tell the jurors what she indicated to you.
PAUL ZEIZEL: She said, since 11 days prior to my meeting with her, which would have been January 24th, 2023, she had no contact with Patrick. She wanted to know how he was doing. She wanted to know if she could call him and find out where things are with her and with him and how he was faring, and to just speak with him.
MR. REDDINGTON: She expressed concern about her family?
PAUL ZEIZEL: Yes, she did.
MR. REDDINGTON: Did she express concern about what had happened?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Did she ask you, or did you offer to her, the ability to speak to her husband, Patrick?
PAUL ZEIZEL: She asked me if she could use my cellphone to call her husband.
MR. REDDINGTON: Did she do that?
PAUL ZEIZEL: Yes, she did.
MR. REDDINGTON: Did you hear the conversation?
PAUL ZEIZEL: Yes. I told her we'd call, it would have to be on speakerphone.
MR. REDDINGTON: And tell us about that conversation.
PAUL ZEIZEL: So that first phone call, I believe on the 24th, he did not pick up. We left—she left a message. I did not leave a message. We then called back two days later on the 6th.
MR. REDDINGTON: And after the two days had transpired, and the call was made on the 6th, did she have a chance to talk to Patrick?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Were you there?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was she still chained to the bed?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Were the cops still outside the room?
PAUL ZEIZEL: Yes, not in blues. They were in civilian clothing, jeans, flannel shirts.
MR. REDDINGTON: And tell us what she said to Patrick, in your presence, on speakerphone at that point.
PAUL ZEIZEL: She had told Patrick that she loved him very much. She was unable to express a lot of emotion, but she expressed love for him, and she had said that she heard a male voice ordering her, telling her that she didn't have any choice, but she had to kill her children and then kill herself.
MR. REDDINGTON: Now, doctor, have in mind your background, your career, your... Did you tell Lindsay Clancy to lie or make that up and pretend that she was hearing voices?
PAUL ZEIZEL: No.
MR. REDDINGTON: Did you have any conversation or any suggestions to her at all that she should say she heard voices or anything like that?
PAUL ZEIZEL: Absolutely not.
MR. REDDINGTON: Why did you let her call her husband on your cellphone?
PAUL ZEIZEL: I let her call her husband out of human compassion.
MR. REDDINGTON: As time went by, did I then... Oh, by the way, you've testified for me on other matters, have you not?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: We go back about 20 years?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And we socialize together?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: So we're friends.
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And as you worked on the case, can you tell the jurors what information you had access to that would allow you to continue with your investigation as a psychologist?
PAUL ZEIZEL: I had access to her clinical records, many of that were discussed here. Emergency records, Jan—sorry, grand jury minutes. With the longitudinal nature of my evaluation, I have records from Brigham and Women's, South Shore, Spaulding Hospital, and most recently, Tewksbury Hospital, which go back to, I believe, March 27th or so, 2023, till today.
MR. REDDINGTON: How many times have you seen Lindsay since that day in January of '24?
PAUL ZEIZEL: So I've met with—
MR. REDDINGTON: I'm sorry.
MR. REDDINGTON: ...2023.
PAUL ZEIZEL: I've met with Ms. Clancy over 45 times since then, and that was at the writing and the issuance of my report to Attorney Reddington. That was in middle of June, and I've seen Ms. Clancy since then 20 times probably, or 15, inclusive of being in this courtroom and sometimes meeting with her in the holding unit.
MR. REDDINGTON: And you've had occasion to visit with her in Tewksbury Hospital many, many of those times, right?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And you've had occasion to visit with her in the lockup to this courthouse, correct?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And she's been treated very well by everybody, the court officers, everybody. Is that correct?
MS. BUCKINGHAM: Objection. All of this.
THE COURT: Yeah. That, sustained.
MR. REDDINGTON: Well, you've had a chance to see her in the lockup, right?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Why would—
THE COURT: No. Overruled.
MR. REDDINGTON: Why would you see her in the lockup?
PAUL ZEIZEL: I would see Lindsay Clancy in lockup because the nature of presentation in this court has been gut-wrenching for anyone who would be exposed to such horrific—
MS. BUCKINGHAM: Objection and move to strike. It's non-responsive to the question.
THE COURT: All right. Can I see counsel here?
MR. REDDINGTON: I withdraw it. Let me move forward.
THE COURT: All right. All right. So that answer, leads your, that answer is stricken.
MR. REDDINGTON: In Tewksbury Hospital, have you had to see her to evaluate her in addition to your testimony for a jury?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Why?
PAUL ZEIZEL: Because the nature of mental health is something that's not a static or what we'd consider historical piece of information. Static information means a date of birth. That's never going to change. Dynamic issues are things that are subject to change, like the weather, like your health, like your mood. So to do an evaluation for a case that Ms. Clancy's involved in, which is a triple homicide case, requires an examiner to ensure that she's competent to stand trial and that her mental health is stable enough to be able to go forward with court proceedings.
MR. REDDINGTON: Is there an additional component, and has there been an additional component of her suicidal ideation while she's been, since she's been in custody at Brigham and Women's, and then, of course, transferred years ago to Tewksbury?
MS. BUCKINGHAM: Objection.
THE COURT: Sustained.
MR. REDDINGTON: Thank you.
THE COURT: May I see counsel?
MR. REDDINGTON: So doctor, while you're evaluating her, whether it be in Tewksbury, when you're visiting with her here, her present state of mind was always an interest to you. Is that correct?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And in addition to all of the police reports, grand jury minutes, photographs, and things that you have described for us, sir, have you also had occasion to review all of the medical records, without going through every one of them, dealing with Jennifer Tufts, Jollotta, drugs that were prescribed to her, et cetera?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Were you able to take a family history and a school history from Lindsay?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Were you able to take a medical history from Lindsay?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Were you concerned about her status as a woman who had recently had a child, Callan, in the spring of 2022?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And what timeframe was it that you were focusing on, for purposes of your evaluation, as to her mental state after having Callan, when she was postpartum?
PAUL ZEIZEL: The timeframe started in roughly September 2022 through January 2023.
MR. REDDINGTON: And during that period of time, you were aware that she had certain symptomology. Again, we could go through every single one of them, or we can just say, yes, she did express that she had symptomology. The jury's heard the evidence up to this point.
PAUL ZEIZEL: Yes. Many times.
MR. REDDINGTON: And did she see doctors?
PAUL ZEIZEL: To many, to other people.
MR. REDDINGTON: Did she see doctors?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Dr. Tufts?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was that the first time that she was expressing anxiety and her concerns about insomnia, and that she went to see Dr. Tufts, and she was prescribed the SSRI?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Okay. July, June, August of 2022, what was her mood at that point?
PAUL ZEIZEL: Her mood was waxing and waning at times, but struggling as well, in common sense ways. Having three children, ages five and under, not an easy task.
MR. REDDINGTON: So in the fall of 2022, when she went to see Dr. Tufts, that's when she was prescribed the first SSRI.
PAUL ZEIZEL: Zoloft, yes.
MR. REDDINGTON: And that would... And again, when she had the second baby, that would be Dawson.
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Did she have also indicia, symptomology of anxiety, and the symptoms that she had described, that required that she had to be placed on some medication?
PAUL ZEIZEL: Yes, she did.
MR. REDDINGTON: What was that medication?
PAUL ZEIZEL: I believe that was Trazodone, if I'm not mistaken.
MR. REDDINGTON: When she was in nursing school—
PAUL ZEIZEL: Yeah.
MR. REDDINGTON: ... prior to that, was she placed on medication?
PAUL ZEIZEL: Yes, she was.
MR. REDDINGTON: And that was because of public speaking nerves? What was the medication?
PAUL ZEIZEL: There were multiple medications. I believe it was Propranolol, and I believe it may have been Trazodone and Wellbutrin, but I'm not totally positive that, of that.
MR. REDDINGTON: Do you recall that she was prescribed an SSRI when she was in nursing school?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: What was that?
PAUL ZEIZEL: That was Zoloft.
MR. REDDINGTON: When she saw Dr. Tufts and she took the Zoloft, it was 25 milligrams initially. Is that correct?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Was it increased?
PAUL ZEIZEL: It was increased to 50 milligrams sometime later, yes.
MR. REDDINGTON: And how did she react to that?
PAUL ZEIZEL: She didn't take the medication initially. She waited a few weeks until she started on the lower dose.
MR. REDDINGTON: So my question was, how did she react to the increase in the Zoloft?
PAUL ZEIZEL: Poorly.
MR. REDDINGTON: What does that mean?
PAUL ZEIZEL: It was not a therapeutic uplift for her. She didn't do well. She didn't feel better. By all reports from Ms. Clancy, she did not get better.
MR. REDDINGTON: How about sleeping? Did she have any complaints about sleeping?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: What was that?
PAUL ZEIZEL: Her insomnia got worse with the passage of time.
MR. REDDINGTON: As September turned into October, it turns into November, around the time of Thanksgiving, had she continued to seek help from medical healthcare providers?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: The answer is yes.
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Who did she seek to get help from?
PAUL ZEIZEL: Well, the initial person, I believe, was her mother-in-law, Sue Clancy, and who was a labor and delivery nurse who knew people.
MR. REDDINGTON: But who did she see as a result of Sue Clancy?
PAUL ZEIZEL: She saw, I believe it was, Julie Paul initially.
MR. REDDINGTON: And what group was she affiliated with?
PAUL ZEIZEL: South Shore Perinatal Health.
MR. REDDINGTON: Did Ms. Paul, Nurse Practitioner Paul, prescribe medication for her?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And did she continue to deal with South Shore Perinatal?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: When, at some point, did she stop dealing shortly, a short period of time, with Nurse Practitioner Paul?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Why?
PAUL ZEIZEL: Nurse Paul left.
MR. REDDINGTON: And why was that?
PAUL ZEIZEL: She got a transferred position. It had nothing to do with her patient load or—
MR. REDDINGTON: So that's—she was transferred.
PAUL ZEIZEL: She was transferred, yes.
MR. REDDINGTON: Okay. So as a short period of time, she was transferred. Who was the next person that she dealt with?
PAUL ZEIZEL: Rebecca Jollotta.
MR. REDDINGTON: Did Rebecca Jollotta have a particular position? Was she a nurse practitioner?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And how long did she deal with Rebecca Jollotta?
PAUL ZEIZEL: Three appointments.
MR. REDDINGTON: And during that period of time with Rebecca Jollotta, was she prescribed medication?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: What was the medication?
PAUL ZEIZEL: I believe it was Seroquel.
MR. REDDINGTON: How did she react to that?
PAUL ZEIZEL: Poorly.
MR. REDDINGTON: And as time went by, going into the holiday season, Thanksgiving, do you recall what her symptomology and complaints were to the healthcare providers at that point, whether it be Tufts or Jollotta, anybody?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: What were they?
PAUL ZEIZEL: She had many concerns about her health. She wasn't feeling well. She felt out of touch with herself. She felt numb. She experienced disassociation—
MR. REDDINGTON: All right. Stop right there. What is disassociation?
PAUL ZEIZEL: Disassociation is a psychological construct that means you feel removed from your body. You don't feel in touch with your body. You feel different than the way you normally do. You look back at your life, and you say, "Something is wrong with me. I'm not feeling the way I normally do."
MR. REDDINGTON: Did she express, for example, when the jurors looked at the medical records on November 27th of 2022, to a nurse practitioner, Jollotta, that she felt that she was out of her body and that she had a disassociated state?
PAUL ZEIZEL: Yes, and that's sometimes known as a depersonalization. You feel removed from your body. You feel removed. You feel as if you are not in your full body.
MR. REDDINGTON: Now, at that time, was she also complaining of other symptoms? And to cut to the chase, was she saying that she could not emote, she couldn't feel love, she couldn't feel happiness, she felt heavy?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: She couldn't walk. She couldn't bathe. She had difficulty relating to people. Is that fair to say?
PAUL ZEIZEL: Absolutely. She couldn't get out of the bed. She had total flattened affect.
MR. REDDINGTON: Did she then seek additional help?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Where?
PAUL ZEIZEL: She went to, I believe, the emergency room initially at South Shore to go to Mass General.
MR. REDDINGTON: And did they prescribe additional medication for her?
PAUL ZEIZEL: I believe they did, yes.
MR. REDDINGTON: Did she make any expressions to her treating physicians up to this point about, in her opinion, what the medications were doing to her?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: What did she say?
PAUL ZEIZEL: She said she was in a brain fog. The medications were making things worse. They were not helping. They were not helping her.
MR. REDDINGTON: Now, as that time went on into the period of Thanksgiving up to around Christmas, did she continue to reach out to people for help, such as suicide hotlines?
PAUL ZEIZEL: Yes. She reached out to—
MR. REDDINGTON: The answer's yes.
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Why did she call a suicide hotline?
PAUL ZEIZEL: She was worried about killing herself.
MR. REDDINGTON: And did she get any help from the suicide hotline?
PAUL ZEIZEL: She was turned away.
MR. REDDINGTON: How about the second time she called the suicide hotline?
PAUL ZEIZEL: She was turned away.
MR. REDDINGTON: How about when she went to the Women and Infants program in Rhode Island?
PAUL ZEIZEL: They told her she was not a good fit for the program. She was—
MR. REDDINGTON: Why?
PAUL ZEIZEL: Because she was overly medicated.
MR. REDDINGTON: And did she continue to seek help from healthcare providers?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And what was the next thing that happened as far as dealing with healthcare providers for Lindsay in her postpartum stage?
PAUL ZEIZEL: She went to the Mass General emergency room.
MR. REDDINGTON: What happened there?
PAUL ZEIZEL: On 12:30, she said she needed to go to the hospital. She went to the emergency room. She was sent to McLean Hospital in Belmont. It's a Harvard-affiliated hospital.
MR. REDDINGTON: Now, that McLean Hospital, when you say was sent to, fair to say that even though they had to transport her, it was a voluntary commitment?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And what was her state of mind that caused her to have a voluntary commitment to the locked wards of McLean Hospital?
PAUL ZEIZEL: She was worried about killing herself, and she uttered concerns about killing her children.
MR. REDDINGTON: How about, did she relate any intrusive thoughts and dark thoughts, things of that nature ... during this period of time, October, November, and December?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Tell me about that.
PAUL ZEIZEL: She said she had, quote, "Horrible thoughts," unquote. She felt that people could actually hear her thoughts. The thoughts were so loud that strangers could hear them sometimes.
MR. REDDINGTON: Did she express at that point, for example, that she was concerned about school teachers with the Little Sprouts School, with the kids, that they could read her thoughts and that she would lose custody?
PAUL ZEIZEL: Yes. It's called ideas of reference. You believe other people can hear what you're thinking, and that can have a very negative interpretation for the person believing that, feeling that, and thinking that the outcome is gonna be a negative one, that their children may be relieved from their care.
MR. REDDINGTON: Now, as it relates to the concept of a psychosis, can you tell me, in 25 words or less, what a psychosis is?
PAUL ZEIZEL: A psychosis is what's considered a major mental health disorder. It's when people have disorganized thinking, and the symptoms most typically are hallucinations. There are different types of hallucinations. 80% of people with psychosis hear voices. There are different types of voices that one can hear. Benign, "Get a glass of water"; benevolent, "You're a good person. Keep it up"; or malevolent, threatening them, telling them, ordering them to do something horrible. And you believe those voices.
MR. REDDINGTON: Now, during that period of time, when she got out of the McLean Hospital, what medication was she titrating or getting off of?
PAUL ZEIZEL: I believe she was getting off of Seroquel.
MR. REDDINGTON: Was she able to do that?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Relating back to November 27th with the disassociated state, is that an indicia, is that an indication or harbinger of psychosis?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And is a psychosis, is that something that would be, somebody would be suffering from a psychosis for a month at a time, two months at a time, or is that short periods? Or how does that work?
PAUL ZEIZEL: People with psychoses have intermittent symptoms. They can function fine one day, and the next day they can be hearing voices. They could be seeing things, feeling things, smelling things. To be clear, those additional types of hallucinations did not plague Ms. Clancy. She only had auditory hallucinations. But hallucinations are like the waves at the beach. They come and go.
MR. REDDINGTON: They're called waxing and waning?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: And would you tell me, doctor, in your opinion, is an individual ... And we refer to postpartum psychosis. Is that a particular affliction that afflicts women that have had babies, and they go through a period of postpartum depression and then ultimately postpartum psychosis?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Can you tell us, is a person, even if they are in the throes of psychosis, are they able to make a phone call?
PAUL ZEIZEL: Yes, they can.
MR. REDDINGTON: Are they able to drive a car?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: Are they able to say, "Hi, Hawaii, I'd like to have a hot dog"?
PAUL ZEIZEL: Yes.
MR. REDDINGTON: They don't, they don't have to look at the unicorn in the corner, right?
PAUL ZEIZEL: That's correct.
THE COURT: Mr. Reddington, it's 4:00, so it's a good time to—
MR. REDDINGTON: Sure.
THE COURT: ... take a break. All right. So members of the jury, we're gonna recess until tomorrow morning. I would expect our schedule tomorrow to be similar to the schedule we had today, hopefully without the technology issues. And I'm just gonna remind everybody the same instructions. Don't read anything about this case or similar cases. Don't talk about it. Don't listen to anything. And keep an open mind. Go home. Have a nice evening. We'll see you tomorrow morning at 9:00. Okay?
BAILIFF: All rise. Please, jurors, exit.
THE COURT: All right, Doctor, if you want, you may step down.
PAUL ZEIZEL: Thank you, Your Honor.
THE COURT: Bye.
MR. REDDINGTON: I hesitate to ask. Can we approach?
THE COURT: All right.