2.Gregory Saathoff — Cross (Part 3)

MR. REDDINGTON: Morning.

MR. REDDINGTON: So Dr. Saathoff, as I understand it, you conducted your investigation or examination of Lindsay by Zoom, correct?

MR. REDDINGTON: Sorry. Zoom. You know, Zoom—

MR. REDDINGTON: ... Zoom television.

MR. REDDINGTON: Okay. And can you tell us when you were first engaged by the district attorney's office to assist them in this case?

MR. REDDINGTON: And is that a matter of significant import when you're engaged in evaluating a young woman that's charged with triple homicide, and you're hired by the government, the fact that there's a contract that wasn't signed by your school?

MR. REDDINGTON: Sure. I understand.

MR. REDDINGTON: So the contract with your school that you're talking about would be the contract for your compensation for your—opinion?

MR. REDDINGTON: Okay.

MR. REDDINGTON: You're getting paid, right?

MR. REDDINGTON: Yes, and—

MR. REDDINGTON: ... and the university is deriving a benefit monetarily from your testimony or working on this case for the DA, right?

MR. REDDINGTON: All right. And how much did the university get as a result of your involvement in this case?

MR. REDDINGTON: So you don't know what the hourly rate for your time is, right?

MR. REDDINGTON: You don't know how much money was paid by the district attorney's office to the university, right?

MR. REDDINGTON: You don't know how much money will be paid for perhaps yesterday, today, whatever, balanced billing. You don't know that either, right?

MR. REDDINGTON: You were retained or engaged in January of '26, right?

MR. REDDINGTON: This is an incident that occurred on January of '23, right?

MR. REDDINGTON: In January of '23 to January of '26. Three years.

MR. REDDINGTON: To being engaged on the case, right?

MR. REDDINGTON: And when you were engaged on the case, at some point the university must have been out of the picture, and you must have started to communicate with the DA's office, the police, or whoever.

MR. REDDINGTON: And you knew about this case. It had a significant amount of publicity, right?

MR. REDDINGTON: Did you know that other doctors on behalf of the district attorney's office were being hired to also evaluate Lindsay?

MR. REDDINGTON: Is it important to see someone to evaluate them as close in time as the incident is alleged to have occurred to your evaluation, or does it matter?

MR. REDDINGTON: In other words, is it better to see someone, like, you know, within a month or two after an incident or three, three and a half years later?

MR. REDDINGTON: And you would agree with me, sir, that you actually saw and questioned or interrogated Lindsay, what, two months ago?

MR. REDDINGTON: Okay.

MR. REDDINGTON: And when you went to interview her in purposes of your evaluation, you had already accessed the collateral information, sir?

MR. REDDINGTON: Before I go there, let me just review a few things here. On your CV, which the jurors will have to examine, you indicated to us your present employment. You have a private practice as a psychiatrist.

MR. REDDINGTON: Okay. So where do you see patients?

MR. REDDINGTON: They're your patients?

MR. REDDINGTON: What do you do for those people that are in jail?

MR. REDDINGTON: I see. So you don't have... When you said to the jury a little while ago, "If I'm treating my patient and I would prescribe a particular prescription for my patient, and I wouldn't tell my patient to do..." whatever it is you said. It's not people that go to an office or see you or even on the television to be treated. These are people that are in jail, right?

MR. REDDINGTON: So there's a difference between jail and prison, right?

MR. REDDINGTON: And this would be in Virginia, is it?

MR. REDDINGTON: So you're dealing with people that are serving hard time in the Iron Mansion, as they say. It's not a house of correction down the street, right?

MR. REDDINGTON: And you work on behalf of the state to evaluate prisoners to determine whether or not they are fit, if you will, to be released into society, right?

MR. REDDINGTON: And when you are talking as a forensic psychiatrist evaluator, would that be on behalf of the BOP, Bureau of Prisons?

MR. REDDINGTON: Okay.

MR. REDDINGTON: Yeah, I know that.

MR. REDDINGTON: Okay. But on your resume, sir, you indicate from 2019 through the present, that's a number of years, that you have been employed or engaged as a forensic psychiatrist evaluator on behalf of the United States Bureau of Prisons as it relates to probation or parole. Is that on your resume?

MR. REDDINGTON: And that means, sir, that you evaluate inmates that are trying to get out of jail, and you would evaluate them to determine if they're appropriate for parole, right?

MR. REDDINGTON: Okay. So when you indicate on your resume from 2019 through the present, you're employed as a forensic psychiatrist evaluator for the United States Bureau of Prisons, how many of these evaluations did you do in the years from 2019 through 2026, seven years?

MR. REDDINGTON: Two or three?

MR. REDDINGTON: Okay. 2016 through 2022, you're engaged as a consultant psychiatrist for the Elson Student Health Center. What is that?

MR. REDDINGTON: And like what? I mean, do you evaluate them? Do you treat them? Do you analyze them? What do you do for college students?

MR. REDDINGTON: And why? Were they, like, thrown out of the university or they were disciplined or something? Why would you bring them back? What does that mean?

MR. REDDINGTON: So these are students—

MR. REDDINGTON: I'm sorry, I cut you off. Go ahead.

MR. REDDINGTON: Okay. These are students, right?

MR. REDDINGTON: In college, right?

MR. REDDINGTON: That have been thrown out or disciplined or suspended or something, and they're trying to get back into school, right?

MR. REDDINGTON: And when the parents of the students come, they retain you to advocate on their behalf?

MR. REDDINGTON: No, you work for the school, right?

MR. REDDINGTON: You evaluate them and then back the school up so that these kids can't get back into the school, right?

MR. REDDINGTON: No, that's all right. 1999 through the present, you worked for the United States Department of Justice and the United States Department of State, right?

MR. REDDINGTON: Okay. And that would be the United States Attorney's Office, the prosecutors. Like, they're the state prosecutors. You got federal prosecutors, right?

MR. REDDINGTON: Well, the defenders certainly don't work for the United States Department of Justice or the United States Department of State, do they?

MR. REDDINGTON: No, that's called the CJAC. That would be a totally different group of people. Those are people that defend people to try to have them not be abused by the system, if you will.

MR. REDDINGTON: 2015, you're a psychiatric consultant for the Virginia Office of the Attorney General, another prosecuting arm, right?

MR. REDDINGTON: 2013, Virginia Department of Correct— or dep— Virginia Department of Corrections, least restrictive measures for segregation. You evaluate people to determine if they should be in, like, max or disciplinary unit as opposed to general population. Is that what you do?

MR. REDDINGTON: Okay. And you certainly don't advocate on behalf of the prisoners that are being placed in seg or being placed in those closed units with higher security, right?

MR. REDDINGTON: The national security expert, 2007 to the present, Oak Ridge United Associated Universities. What is that?

MR. REDDINGTON: Okay. Critical Incident Analysis Group, CIAG, University of Virginia?

MR. REDDINGTON: Okay. Behavioral Analysis Unit, as you told us yesterday for the FBI at Quantico, right?

MR. REDDINGTON: Psychiatric consultant to the Virginia Department of Corrections, medium, maximum, and super max facilities, right?

MR. REDDINGTON: Continuing on with your experience, sir, as a witness in this case, you'd agree with me that you were involved as a psychiatric consultant with the macro task force on-site consultation for the Australian Police Service?

MR. REDDINGTON: Former Soviet Union project, Republic of Georgia, T-B-I-L-I-S-I, Georgia. You were involved with that, sir?

MR. REDDINGTON: Tbilisi, yeah. Critical Incident Response Group for the US Air Force, U assessment. You're in the assessment unit?

MR. REDDINGTON: Crisis Management Unit, investigative support for Operation Gray Sunset, Jordan?

MR. REDDINGTON: Crisis Management Unit, investigative support unit, critical incident response in Montreal, Quebec?

MR. REDDINGTON: FBI National Center for Analysis of Violent Crime, Operation New Hope?

MR. REDDINGTON: Bureau of Criminal Investigation, that's BCI for the Department of the State Police, would that be Virginia?

MR. REDDINGTON: You also have an interest in, and have studied or written about various topics in your career, correct?

MR. REDDINGTON: Okay. Psycho, hostage negotiations course, Crisis Management Unit. You were involved with that, is that correct?

MR. REDDINGTON: That was a number of years ago, though. I guess that was like 1996.

MR. REDDINGTON: But you've been involved with the FBI for a long time, right?

MR. REDDINGTON: Fair to say that you're a government man?

MR. REDDINGTON: Hostage negotiation course. How about Virginia Department of State Police? You involved with them as well, sir? Yes?

MR. REDDINGTON: Advisory positions. You deal with, Islam in Prison is one of your interests, right? That was a TV program or something.

MR. REDDINGTON: You talk about National Institute for Justice. Standing committee to advise the Department of State on unexplained health effects on US government employees and their families overseas, right?

MR. REDDINGTON: Analysis of pre-attack behaviors of the Las Vegas shooter, behavioral analysis unit for the FBI?

MR. REDDINGTON: Skipping ahead. Papers published. Now, when a doctor or psychiatrist or any doctor really, I guess, publishes a paper that's of interest to other doctors or people, that's called a learned treatise, right? Peer review?

MR. REDDINGTON: Okay. Can you tell me what is peer review? What does that mean when you're dealing with a person's focus and interest in writing about what they're focused on?

MR. REDDINGTON: Mm.

MR. REDDINGTON: So it's kind of a rigorous standard to make sure that what you're writing about is reliable and would be helpful to others that are interested in it, right?

MR. REDDINGTON: Okay. So for example, also it depends on the, where you're publishing it. You could put something in the National Enquirer or you could put it in International Psychiatric something or other, right? Which would be a better publication?

MR. REDDINGTON: So you certainly would agree with me that the International Journal of Law and Psychiatry is a respected, solicit learned treatises, right?

MR. REDDINGTON: And you would agree with me, sir, that you've been in here telling this jury all about Lindsay and how she didn't hear voices or did hear voices or exaggerated and lied. Have you written any articles at all on the concept of auditory hallucinations?

MR. REDDINGTON: Have you read any of them?

MR. REDDINGTON: Yeah. Okay. You certainly have heard of Dr. Phillip Resnick, yes?

MR. REDDINGTON: And is it fair to say, and tell me if I'm wrong, is he a literally a world-known authority in your field for filicide or the killing of children by their parents?

MR. REDDINGTON: And is he also well-written as far as auditory hallucinations, same stuff you've been testifying about?

MR. REDDINGTON: And he published an article in the International Journal of Law and Psychiatry, which is considered to be, if you know, a landmark article about, and I caption, “Listening to Voices: The Use of Phenomenology to Differentiate Malingered from Genuine Auditory Verbal Hallucinations.” Now, did you read that article?

MR. REDDINGTON: So it is a peer reviewed article published in a recognized journal, correct?

MR. REDDINGTON: Your Honor, I would offer this under Commonwealth versus Sneed for the jury if they wish.

MR. REDDINGTON: Your Honor, while we have the copies being made for the district attorney, could I continue?

MR. REDDINGTON: Thank you. Leaving aside the peer review article and the article written by Dr. Phillip Resnick, sir, for a minute, papers that you published, and you have in your resume it says peer reviewed. So that's just what we were talking about, right?

MR. REDDINGTON: All right. Using the moral situational action model of extremist violence to assess fluctuating levels of risk in women, the relevance of risk promotive and protective factors. What does that mean, levels of risk in women with extremist violence?

MR. REDDINGTON: And it's research about women that are involved with extremist violence?

MR. REDDINGTON: Okay. Assessing, it's right there. Using the moral situational action violence risk model for assessing women involved in extremist violence: An empirical study. Is that similar article?

MR. REDDINGTON: Operationalizing theory: A moral situational action model for extremist violence. That would include guys plus women, I guess, right?

MR. REDDINGTON: That would include men plus women, I guess, right?

MR. REDDINGTON: 'Cause it doesn't say women. Suicide terrorism, performance, violence as a public plunge. You wrote that, right?

MR. REDDINGTON: That's another interest there. Crisis leadership and military community resilience. You wrote that, right?

MR. REDDINGTON: Painting by numbers: Capturing the pathology of sociopolitical conflict, dealing with depression amongst Palestinians. You wrote that, right?

MR. REDDINGTON: Psychological challenges of bioterror. You wrote that, right?

MR. REDDINGTON: Trauma and intergenerations transmissions in Kuwait. You wrote that, right?

MR. REDDINGTON: Recognizing borderline personality disorder in the family practice setting. You wrote that, right?

MR. REDDINGTON: Mortality among elderly patients discharged from a state hospital. It's one of your interests, right?

MR. REDDINGTON: Postpartum psychosis induced by bromocriptine. That's the one that you told the jury about originally that you published 40 years ago, right?

MR. REDDINGTON: Okay.

MR. REDDINGTON: Morality and the radicalization of women. What is that?

MR. REDDINGTON: What is that? What was that all about?

MR. REDDINGTON: Sure. It's just, I mean, you can look at your resume if you wish. I'm just going through it. It's under B, books and chapters. This one is the first one, and it deals with radicalization of women. A handbook, I guess, for terrorism studies. You remember that? It's only four years ago.

MR. REDDINGTON: Okay. Application of big data for national security: A practitioner's guide. You wrote that, right?

MR. REDDINGTON: Crisis guide of psychoactive drugs and poisons for the crisis negotiation unit. You wrote that, right?

MR. REDDINGTON: International handbook of threat assessment, right?

MR. REDDINGTON: Protection of children during armed political conflicts: A multidisciplinary perspective, right?

MR. REDDINGTON: The negotiator's guide, like when somebody's locked in a building and they're threatening to kill people or something. The negotiator's guide to psychoactive drugs, second edition. You wrote a chapter on that, right?

MR. REDDINGTON: The negotiator's guide, and it goes on and on with the negotiators and things like that. Terrorism negotiators, right? Is fair to say that's your focus?

MR. REDDINGTON: Well, I know you can talk about postpartum, but I mean, I'm asking you if your resume that you prepared, I imagine well before you were hired by this DA's office, sets forth your interest, right?

MR. REDDINGTON: Okay.

MR. REDDINGTON: I'm probably—

MR. REDDINGTON: I'm probably wrong.

MR. REDDINGTON: I apologize. I'm, I... You see it on TV, the negotiators, and they're, you know, trying to help people that are being kidnapped—

MR. REDDINGTON: On a bridge.

MR. REDDINGTON: Yeah.

MR. REDDINGTON: Just a few more, Doctor. Panels and symposia. You'd agree with, let's see, national security implicate... I just wanna run through a quick... Attachment theory, mental wellness as it relates to threat management. Threat assessments, corrections— ... psychiatry presentations, substance abuse and misuse in prisons, perspective on providing medical support during conflict and chaos, targeted violence in the media, lessons from history, the profiler of poisons, understanding the female extremist, crisis operations, leadership, how to fool doctors by injecting chemicals into muscle to obtain opioids, a prison inmate comes clean. Did I read all those topics correctly, sir?

MR. REDDINGTON: Invited lectures talk about extremism, extremism, terrorism, the future of policing, children and long-term abductions, how to prevent terrorism, mass shooters, US prisoners, religious rights, religious radicalization, terrorism, and the unknown enemy. Basically, that's what your focus is, sir, correct?

MR. REDDINGTON: And that's coupled with your experience of the two people or so that you recall dealing with in your... It's not a practice, but working for the Bureau of Prisons or the state for Virginia, the people that are in jail. That is the sum total, to be respected, of Dr. Saathoff, correct?

MR. REDDINGTON: I mean, you treated two people. You've written a lot about terrorism and other issues that we went through.

MR. REDDINGTON: Oh.

MR. REDDINGTON: I'm sorry, 'cause I read your resume right, right?

MR. REDDINGTON: Okay. And I related what you indicated to the jury, your experience of when I asked you about patients or treating people. I said that right, right?

MR. REDDINGTON: Now, in all of your experience, sir, have you ever treated a woman suffering from postpartum psychosis?

MR. REDDINGTON: When?

MR. REDDINGTON: So this would be women, 1980s, about 30 years ago or 20 years ago, depending on which one, in a prison that you were-

MR. REDDINGTON: ... Oh, it wasn't.

MR. REDDINGTON: State hospital.

MR. REDDINGTON: Were they committed? Were they there because they wanted to be there, or were they committed by order of the court?

MR. REDDINGTON: Yes, what?

MR. REDDINGTON: Okay. So other than that, sir, do you have any interest, writing, knowledge about postpartum depression, postpartum psychosis?

MR. REDDINGTON: What did you-

MR. REDDINGTON: What did you just say? Can you repeat that again? You're treating women with what?

MR. REDDINGTON: So when you defined for the district attorney the concept of, let's say, psychosis yesterday, were you referring in any degree to a woman who has had a baby and is in a period of postpartum depression, shall we say?

MR. REDDINGTON: Okay. And when and how were you treating those people?

MR. REDDINGTON: So what would you do? Would you analyze them? Would you talk to them, counsel them? What would you do while they're in the hospital?

MR. REDDINGTON: And generally, what would the symptoms be, sir, in your experience?

MR. REDDINGTON: Yeah.

MR. REDDINGTON: Are you aware, sir, in your practice or studies of the number of women that commit suicide during the postpartum period? Are you aware of that?

MR. REDDINGTON: Do you have any clue at all?

MR. REDDINGTON: Would you agree with me, sir, that one of the unfortunate components, who has had a baby and is suffering from postpartum depression and living with it, that can, on a dime, turn into postpartum psychosis very quick, right?

MR. REDDINGTON: And you indicated, sir, that there, according to the DSM, is a four-week cutoff for symptomology, and then you mentioned that there are others. Is it the World Health Organization that you said that talks about a year?

MR. REDDINGTON: There are some other psychiatric organizations that talk about different periods of time: six weeks, eight weeks. Right?

MR. REDDINGTON: So when a woman is dealing with these symptoms and goes to a doctor, or even you when you were treating, as you indicated 15, 20 years ago you were treating, is it important to take a blood test?

MR. REDDINGTON: I'm sorry. My bad. Is it important to take a blood test?

MR. REDDINGTON: Yeah, you just went through the whole thing about we're gonna have the team, and they're gonna evaluate, and we're gonna prescribe. I'm just asking, is it important to take a blood test of the patient?

MR. REDDINGTON: Based on what?

MR. REDDINGTON: So if you're a psychiatrist who's been practicing private practice for about, I don't know, a month, maybe two, and is prescribing antipsychotic medications, selective serotonin re-uptake inhibitor medications, benzodiazepine medications to a young woman who is complaining of what the young woman perceives to be difficulties postpartum, is it important to take a blood test to find out what, if any, prescription drugs they have on board in their system?

MR. REDDINGTON: Yeah. I mean, you're treating this patient, right? And they, they're coming off the- hypothetically with you, but you... They're coming off the street to see a psychiatrist to help, right?

MR. REDDINGTON: And if they're already been prescribed drug after drug after drug by a particular doctor with her two months of robust experience, is it a fair statement that you should take a blood test of that person?

MR. REDDINGTON: Go ahead.

MR. REDDINGTON: It depends. Can I just ask you to spell those two drugs that you just pronounced for the stenographer, please?

MR. REDDINGTON: Yeah.

MR. REDDINGTON: Okay.

MR. REDDINGTON: I... That's not a hard one. I just... The record has to be accurate, that's all.

MR. REDDINGTON: Okay. Now, Doctor, are there other tests in your experience that are or can be or should be administered to a young woman or a woman who's had a baby and is coming to a doctor, like Dr. Tufts, for example, are there other tests that can be administered to determine if in fact that person is suffering from postpartum depression?

MR. REDDINGTON: Postpartum depression, sir.

MR. REDDINGTON: Postpartum depression is my question.

MR. REDDINGTON: Depression. I know you wanna say it's the same thing, but postpartum depression is my question.

MR. REDDINGTON: I'm asking if there's any tests at all that a psychiatrist can or should administer to the patient coming to them for help.

MR. REDDINGTON: You look that up last night?

MR. REDDINGTON: No. You knew about the Edinburgh scale?

MR. REDDINGTON: You administered the Edinburgh scale?

MR. REDDINGTON: Have you administered the Edinburgh scale?

MR. REDDINGTON: Nurses. Okay. In any event, it's a scale that is a useful tool to determine the level or degree of depression that a person may be expressing that is suffering from postpartum depression. Correct?

MR. REDDINGTON: And do you know what the numbers are on the scale? Like, is it 1 to 23, or is it 1 to 50, or do you know what it is?

MR. REDDINGTON: And when you say—

MR. REDDINGTON: And when you say a self-report, the patient would then advise what symptomology they're suffering at that particular point in time, right?

MR. REDDINGTON: And then the doctor would then determine whether or not there is a risk, or an extreme risk, or a deadly risk of this person committing suicide, harming someone else, whether it's a baby or anybody else, and determine what the level of their postpartum depression is, right?

MR. REDDINGTON: And did Dr. Tufts administer Edinburgh test to this young woman?

MR. REDDINGTON: Right. And what was her highest score?

MR. REDDINGTON: 23 out of 30, right?

MR. REDDINGTON: And over 15, the patient is in pretty serious trouble, right?

MR. REDDINGTON: Right. And she was a 23, right?

MR. REDDINGTON: Right. They increase as time went by, right? She was getting worse, right?

MR. REDDINGTON: Yeah. All right. And in addition to the regular blood test, which costs like, I don't know, about 100 bucks to administer a blood test to see what somebody's got in their system. It's not a lot of money, right, for the insurance company?

MR. REDDINGTON: Blood test. It's not a lot of money for an insurance company to pay, right? To cover.

MR. REDDINGTON: Okay. So do you feel that it is reasonable medical procedure for a psychiatrist dealing with a woman, the Edinburgh scale off the charts or serious trouble, who is on medication as we went through, the antipsychotic drugs, the SSRI drugs, the amitriptyline at the end of the period of treatment with these people, the benzodiazepines. It's helpful to take a blood test, right?

MR. REDDINGTON: And is that, in your opinion, sir, to a reasonable degree of medical certainty, a step that should be taken by a competent doctor?

MR. REDDINGTON: And then there's an additional blood test that you can use when you're dealing with a woman who's suffering from postpartum depression, or coming to the doctor for help, and they have significant narcotics or prescription drugs in their system, and that would be an enzyme test, right?

MR. REDDINGTON: Okay.

MR. REDDINGTON: Well, it costs a lot of money, doesn't it? Like, it costs a couple of grand.

MR. REDDINGTON: All right. In any event, sir, are there any other concerns that one would have if they're competent and they're treating somebody that's come to them for help, in addition to a blood test and perhaps enzyme test to determine the metabolizing aspect of the person's system, metabolizing or processing these drugs that are in their system, the enzyme test. Are there any other tests or concerns that you have with a woman whose postpartum depression complaints come to your doorstep?

MR. REDDINGTON: Did they do a thyroid test on Lindsay?

MR. REDDINGTON: That's not a lot of money that the insurance company would complain about, right?

MR. REDDINGTON: One of the things that I just don't wanna forget, sir, is that the district attorney asked you while we're talking about the drugs, about the Lamictal, otherwise known as lamotrigine. Did I pronounce that right?

MR. REDDINGTON: Lamotrigine. And she said that Lamictal, it has a side effect of a rash, right? You recall that, sir?

MR. REDDINGTON: No, I think she said rash.

MR. REDDINGTON: You may—it's up to the jury what their recollection is, but you may have said serious rash, but we both agree, it's a serious rash, right?

MR. REDDINGTON: In fact, it can be fatal, right?

MR. REDDINGTON: It can be fatal, right?

MR. REDDINGTON: Okay.

MR. REDDINGTON: Well, if one person out of 1,000 gets Stevens-Johnson syndrome or prudigo nigricans as a result of taking that medication, that's something that we should not tolerate as doctors, right?

MR. REDDINGTON: So you've heard of, as it relates to Lamictal, as a prescription drug, what's called the TEN. You've heard of that, right, as a side effect?

MR. REDDINGTON: And that means what?

MR. REDDINGTON: So if you have a young woman who is a nurse, an RN, who worked for seven years in a very prestigious hospital's labor and delivery unit, who was so nervous about drugs that were being prescribed to her that she would at night sit in her kitchen on her phone and Google all sorts of side effects of narcotics, the drugs, the Seroquel, lamotrigine, all of these drugs, is it a unreasonable decision for her to say, "I don't wanna take that drug," in your opinion?

MR. REDDINGTON: Yeah. That's what she did. That's what you told us yesterday. That's what the DA asked you yesterday, right?

MR. REDDINGTON: And in your opinion, sir, after we just went through all of this with the TENs, with the toxic epidural necrolysis, and all the rest of that, and she's a nurse, and she's looking up these drugs that she's being prescribed and says, “I don't wish to take that drug.” In your opinion, to a reasonable degree of psychiatric certainty, based on your experience, is that a reasonable decision for her to say, “I don't wanna take it”?

MR. REDDINGTON: Doctor, you're an intelligent man. You're a doctor. You've got a lot of experience dealing with the prison system. We've already gone over all of that. You understand my question, don't you?

MR. REDDINGTON: I'm just asking, is that a reasonable decision for Lindsay to make to say, “I don't wish to take that drug,” based on all the side effects, whether or not it's rare that people die, whether or not it's rare that they break out on their skin with these permanent lesions and bleeding pustules? Is it reasonable for her to say, “I don't wanna take it”?

MR. REDDINGTON: Yeah. And certainly we don't wanna leave it with the jury that she's so vain that she just didn't wanna take something that she might get a little rash.

MR. REDDINGTON: In any event, now—

MR. REDDINGTON: Have in mind there's no blood test. There's no enzyme test for metabolite test. There's no thyroid test, but we still have the pill factory through Dr. Thompson and into Dr. Jollotta for that period of time. You're telling this jury that that is, in your opinion, reasonable little, little drug doses that she was prescribed. Is that what you're telling this jury, sir?

MR. REDDINGTON: Yeah, the drugs, one right after the other, and then stopping the SSRI, not weaning off, stopping it flat out. Is that reasonable?

MR. REDDINGTON: Is it reasonable, sir, in your opinion to tell someone who's on an SSRI, such as—

MR. REDDINGTON: Is that that one sentence in all of the medical records where it makes reference to the fact that she said something like, “I should have stuck with the plan”? Is that what you're referring to?

MR. REDDINGTON: Okay. My question, sir, was Dr. Tufts, Dr. Paul, Dr. Jollotta—

MR. REDDINGTON: I apologize again. It's—

MR. REDDINGTON: ...my bad. Nurse practitioner Jollotta, up to that point, bringing us into November—these people that in other emergency room visits that she had, she was not going out looking to score drugs off of drug prescriptions. Is that fair?

MR. REDDINGTON: And she, in fact, looked up Tufts, but she didn't even know who Tufts was. She went online and Googled postpartum depression and found an expert. Isn't that right?

MR. REDDINGTON: But she was only practicing for, like, a month or two. Was she, in your opinion, to a reasonable degree of psychiatric certainty, an expert?

MR. REDDINGTON: So the young lady goes online, Googles, trying to get help, goes to see the expert, Dr. Tufts, ultimately deals with nurse practitioner Jollotta and counselor that worked in that medical field business, Latiesha Dukes, I believe is her name.

MR. REDDINGTON: And then she had the need to go to an emergency room and went to Mass General Hospital, right?

MR. REDDINGTON: And she was with her husband, Pat, right?

MR. REDDINGTON: And she had been complaining about lack of sleep, insomnia, right?

MR. REDDINGTON: She had been complaining about inability to emote, feeling hollow, not myself, right?

MR. REDDINGTON: And a number of other complaints that were brought to the fore, and the hospital made a recommendation that she go to McLean Hospital, which is a locked ward mental institution in Massachusetts, and she chose not to do that, correct?

MR. REDDINGTON: So then what she did is went back to her home and immediately hooked up again, if you will, with Tufts, right?

MR. REDDINGTON: In December, one of the people at the South Shore perinatal unit advised her to go to a hospital for—that specializes in postpartum women. That would be Women and Infants Hospital in Rhode Island, right?

MR. REDDINGTON: And she went there, like, the next day, right after they called, right?

MR. REDDINGTON: And her husband dropped her off for that day program, right?

MR. REDDINGTON: And she participated with the coloring, with the conferences, or with the discussions, with the—and evaluations with the doctor, right?

MR. REDDINGTON: For about eight hours. It was about an eight-hour day, right?

MR. REDDINGTON: And on that date, in December twentieth, she was turned away, basically, right?

MR. REDDINGTON: Did they help her?

MR. REDDINGTON: Did they help her?

MR. REDDINGTON: Did they help her?

MR. REDDINGTON: You're not gonna say to this jury that because Lindsay was outside of the, let's say, four-month cutoff, that she was not a good candidate for postpartum depression treatment? Is that what you're telling the jury?

MR. REDDINGTON: Oh, okay. I'm sorry. I thought you said because of the timeframe from giving birth to the time that she went to see them.

MR. REDDINGTON: Okay. And Women and Infants basically discharged her after about eight hours, right?

MR. REDDINGTON: And her husband was up skiing, and then she contacted him, and he had to come down and pick her up and bring her home, right?

MR. REDDINGTON: And the reason that she was discharged from Infants Hospital in Rhode Island included a statement, RO, rule out, issues regarding prescription medications, correct?

MR. REDDINGTON: And she indicated that she was gonna go right back, right back to Tufts, right?

MR. REDDINGTON: And she did, didn't she?

MR. REDDINGTON: And would you agree, sir, that every time a doctor said to Lindsay to do something, whether it was to make an appointment somewhere, whether it was to take another drug, any advice, that she was on it immediately? Is that fair?

MR. REDDINGTON: Well, not just that. She attended them right away. When she was told, for example, at McLean, you read those records, that she should hook up with her provider, and she did the very next day, right?

MR. REDDINGTON: Okay. So she wasn't avoiding seeing healthcare professionals, was she?

MR. REDDINGTON: And she was continuing to express concern about her state of mind. She felt that her mind, her brain, was being damaged. Isn't that right?

MR. REDDINGTON: Those are in the records, right?

MR. REDDINGTON: And she felt that her brain being damaged was permanent, and she was never going to get better, right?

MR. REDDINGTON: She was complaining not just to her physicians, but she was complaining to people in her community that she was having intrusive thoughts, dark thoughts, suicidal thoughts, and homicidal ideation. She said that, correct?

MR. REDDINGTON: Just voiced? Is that what you just said, just voiced? Is that like talking about the Red Sox?

MR. REDDINGTON: She's talking about homicidal ideation of her children.

MR. REDDINGTON: I asked you about her complaints of intrusive thoughts, complaining to doctors, complaining to friends, complaining to neighbors, family, about dark, intrusive thoughts of suicide and homicidal ideation. Didn't she?

MR. REDDINGTON: Okay, so—

MR. REDDINGTON: So we'll put homicidal ideation aside for a minute. Would you agree that for that period of time, short as it may have been in her life, November into December, that she was reaching out to people that would listen to her for help?

MR. REDDINGTON: Would you agree, sir, that she would tell, for example, neighbors or friends with the Learning Sprouts School, her family, her doctors, that she was having these dark, intrusive thoughts of suicide? Yes or no.

MR. REDDINGTON: Anyone that she would come in contact with at Learning Sprouts, whether it's another mother, whether it's a friend, whether it's a teacher, whether it's an administrator, whether it's somebody that just watches the kids in the playground. Did she tell anyone that she had dark, intrusive thoughts to your investigation?

MR. REDDINGTON: When someone says with her history up to this point in December that they're having dark, intrusive thoughts to a professional, in your opinion, sir, to a reasonable degree of medical certainty, does it make sense that the professional should ask the person whether or not these are voices that they're hearing in their head, or whether or not they are just thoughts that they're having?

MR. REDDINGTON: And would you agree with me, sir, that when you have a young woman that, again, by all accounts, done nothing wrong in her life, exemplary citizen, has these issues and sees the doctors, that to a reasonable degree of medical certainty, a physician should do a little bit more than asking, "Do you have a plan?" I mean, is that accepted practice just to say, "Do you have a plan?" And if they say, "No," you're okay?

MR. REDDINGTON: Okay.

MR. REDDINGTON: She was also told that counsel had asked you yesterday about other recommendations that were given to her by Women and Infants and that you said that she did not follow through on that. But she did see Dr. Tufts pretty much the next day, right?

MR. REDDINGTON: Okay. And she said that she was gonna go see Dr. Tufts the next day, right?

MR. REDDINGTON: And just to mention, before I forget it, the Lamictal. I think you mentioned to the jury that—she had a prescription for Lamictal that she was able to fill, right?

MR. REDDINGTON: But she didn't take it, right?

MR. REDDINGTON: And then Tufts told her that she was going to, she meaning Tufts, was gonna give her a scrip for Lamictal, and she said, "No, I already have one," right?

MR. REDDINGTON: Okay. Sorry.

MR. REDDINGTON: Sir, I know, I know. You wanna tell me that it's a wonderful drug. Did she tell nurse practitioner Jollotta, "I already have a scrip. I don't need it"?

MR. REDDINGTON: Among other things, when people are in trouble, and they're having dark, suicidal thoughts, whether or not it's voices in their head, whether or not it's thoughts that they can't go on anymore, they can't live life, they have to kill themselves, many times they're told to call suicide hotlines, right?

MR. REDDINGTON: Aspire. What is Aspire?

MR. REDDINGTON: When did she call Aspire saying that she had thoughts of killing herself?

MR. REDDINGTON: But she did call them, not once, but twice, and told them?

MR. REDDINGTON: So she complained and told them that she was going to kill herself, right? Twice.

MR. REDDINGTON: Right?

MR. REDDINGTON: So here's a young woman with all of what she's been through, who now is to the verge of killing herself, and reaches out to people that her healthcare providers told her to call for help, said that she was gonna kill herself, and what did Aspire do?

MR. REDDINGTON: They didn't make a decision to do anything.

MR. REDDINGTON: Did you read the records dealing with Aspire? Did they do anything other than tell her, "No, you're not someone that we can help"?

MR. REDDINGTON: And did you read a transcript or listen to a tape or how do you know that?

MR. REDDINGTON: So this, sir, obviously is a murder trial, and you are a witness for the government, and you've indicated that you've read the records. You just told this jury that in the conversation that she had with the people from Aspire, that she expressed suicidal ideation, was asked if she had a plan. Where are you getting that from?

MR. REDDINGTON: Hmm. How about the second time she called Aspire? Why would she call Aspire again if they wouldn't help her the first time? In your opinion as a psychiatrist. Looking for help?

MR. REDDINGTON: And yet again, she didn't get any, did she?

MR. REDDINGTON: To a reasonable degree of psychiatric certainty, with treating the patients to the extent that you've told this jury that you have, what kind of a devastating effect would that have on a person who's ready to kill themselves, that's called Aspire hotline twice and has been turned away?

MR. REDDINGTON: And after being discharged from Women and Infants Hospital and reaching out to Aspire, you'd agree with me that one of the concerns that the doctor at Women's Hospital in Rhode Island had is the medication that she had been prescribed by Topson nurse practitioner, Jollotta, right?

MR. REDDINGTON: And that's one of the reasons that they could not treat her. It wasn't just that, “No, we don't, we don't think that you're postpartum depressed. We just think that there's a complicated overlay involving the medications that you've been prescribed,” right?

MR. REDDINGTON: And these medications obviously included selective serotonin reuptake inhibitors, right?

MR. REDDINGTON: And—

MR. REDDINGTON: … Right. And one of the things that a doctor would be concerned about, especially with a woman who's had a baby and has stopped breastfeeding the baby, is the effect that that may have on the woman physically, mentally, emotionally, when they stop breastfeeding a baby, right?

MR. REDDINGTON: And you've heard of gamma-aminobutyric acid, otherwise known as GABA, right?

MR. REDDINGTON: And can you tell us, please, what that is, sir?

MR. REDDINGTON: Can you tell us, please, what that is, sir? What is GABA?

MR. REDDINGTON: No, I'm asking about the actual acid in the person's system, their blood, that is gamma-amina-B-U-L-R-Y-C acid. It's got nothing to do with Lamictal. It's got nothing to do with Seroquel. It's got nothing to do with the drug industry. This is in the body. When a woman stops lactating, a woman stops breastfeeding—

MR. REDDINGTON: … There is a physical effect on the person, the body, right?

MR. REDDINGTON: What is that effect?

MR. REDDINGTON: Would you agree with me, sir, that the GABA—make it easier to type—is basically affects, its primary effect is on the neurotransmitters in the brain, right?

MR. REDDINGTON: Okay. That sounds pretty complicated. Neurotransmitters, I mean, is that like where you have a spark plug on a motorcycle, and then you can actually gap it and get it to kick over? It's a neurotransmitter in the brain. That sounds like it.

MR. REDDINGTON: I figured.

MR. REDDINGTON: But nevertheless, it's still basically you're talking about the actual organic matter of the brain, right?

MR. REDDINGTON: And would you agree, sir, that when a woman is pregnant, that there are progesterone hormone surges during that pregnancy?

MR. REDDINGTON: It doesn't, their hormone doesn't just change. It can actually surge, and it can be quite impactful to the person, right?

MR. REDDINGTON: And would you agree with me, sir, that one of the metabolites of progesterone, which has been unleashed on a person, a woman is pregnant, with the progesterone hormone surging through their body, that you have a metabolite that actually enhances or increases the GABA activity of the neurons in the brain, right?

MR. REDDINGTON: And what is that metabolite, sir, that increases that activity in the very organ of the brain?

MR. REDDINGTON: Is it a allopregnanolone, if you know?

MR. REDDINGTON: No, it's not, or no, you don't know?

MR. REDDINGTON: Immediately after a woman has a baby, would you agree, sir, that the progesterone that we just talked about and the allopregnanolone that you don't know about drops precipitously according to the medical treatises, right?

MR. REDDINGTON: And what does that mean, sir? Tell me when it says that the progesterone and the allopregnanolone in the body drops precipitously. What does that mean, precipitously?

MR. REDDINGTON: And a sudden drop, sir, you would agree would cause, has a significant potential of causing serious GABA dysfunction, right?

MR. REDDINGTON: Do you know that or you're just agreeing with me?

MR. REDDINGTON: Okay. Do you want me to keep going?

MR. REDDINGTON: I don't care. I'm just saying that, that—

MR. REDDINGTON: Yes, Your Honor.

MR. REDDINGTON: Thank you, Judge. Sir, when we left off, I believe the question was that, and you agreed, the sudden drop can cause significant GABA dysfunction. You recall that question where we broke off talking about the—

MR. REDDINGTON: …the GABA? And you're familiar with the concept of, in that regard, talking about the gamma-aminobutyric acid, and its effect on the progesterone and its effect on the brain synapses or the… It's referred to as brakes, B-R-E-A-K-S. You've heard of that term, right?

MR. REDDINGTON: You're aware, sir, that when you get to the point where you have that precipitous drop in the progesterone and the allopregnanolone dropping precipitously, that in fact it constitutes and causes significant neurotransmitter malfunction referred to as broken brakes?

MR. REDDINGTON: Can you tell me what a neurotransmitter in the brain is?

MR. REDDINGTON: Sure. I don't know.