Boston Globe Health & Sciences Reporter Sarah Rahal

The Boston Globe health and sciences reporter Sarah Rahal who took Kevin Reddington's medication list and trial and built a timeline of who prescribed what when and for how long beginning September 15th of 2022 and ending well where it all ended. Lindsay Clancy was prescribed 13 meds from the 30 total prescriptions as you know psychiatric medicines written by everyone including the crossing guard at the elementary school it seems. Uncoordinated providers, psychiatrists, nurse practitioners, ER doctors, inpatient psychiatric staff. It is the crux of people's outrage especially all of those who support Lindsay. So pleased to welcome from the Boston Globe Sarah Rahal. What have you concluded before we get into what I was talking about with Sarah? What have you concluded here? What troubles you as you sit and wait for the verdict? Oh I mean this is a case that's been going on for a month, an hour. We're waiting for exactly what everyone else is waiting for. What does the jury think? What are they looking at? What are they taking into consideration? And medication has been the centerfold of this trial. Was her care adequate and common and in what ways did the system fail her? Because if someone like Lindsay Clancy who was a labor and delivery nurse from Duxbury, Massachusetts, pretty wealthy area, couldn't get help, who can? So we're kind of waiting to see what the jury is looking for. What are they hinging on? How long are they taking? This is, you know, we're 12 hours plus into deliberations. This is their third day deliberating after 21 days of testimony. 84 witnesses. It's a lot. It's a lot to uncover. It's a lot to go over. Some would say if they responded very quickly we would just be shocked. And then you have Kevin Reddington coming out of the courthouse saying if this was a hung jury it would be horrific. And that is very very possible. I mean, you know, the way I've had people describe, you've been, have you been, you've been in there. So we have two globe reporters in the courtroom. We have another outside. I'm strictly watching for health. So I'm watching live every day trying to find little tidbits here and there. It doesn't make a lot of use for me to be there because we already have a lot of court reporters who are covering the criminal trial aspect. But I'm kind of working all the outside angles trying to find people from around the nation who can provide perspective in ways that people from Massachusetts can't because they may be legally involved in this case. I'll tell you what, I have a fascinating, I got a fascinating DM from one of my Hot Mics listeners, viewers here. Billy, I sent you a DM. I stayed at that very hospital suffering from severe postpartum depression with my first baby. I can tell you firsthand the hospital and system is at fault. This is Susan. Why is no one going after McLean? They had me on 30 meds in two years and I almost took my life twice. I was a mess. Not proud of my situation, but thank God my husband and family stepped in as the number one psych hospital in the country. Can you imagine what rest of the country's treatment is like? They sent me home just like this poor woman. It's a business and they wonder why youth today. Happy to share my story. This woman was screaming for help. Watching this doctor makes me want, I think she's talking about Tufts, makes me upset. We'll rephrase that for her. They're all so arrogant and check a box and want to move on. What a story. We'll hear it. 30, she will come on. 30 medications in two years. You have addressed this better than anyone. When Kevin Reddington put up his unbelievable display of her meds, you really built out the timeline. How we all hear 13 medications and 30 prescriptions, but can you get into the weeds of that? Have you figured out which ones really clash and may have led to the PPP? It's actually worse than you said it was. It was 30 prescriptions in four months, around four months. We're talking September 2022 to January of 23. She received 13 different medications. That means a lot of the medications were the same and even given by different doctors or the same doctor who weaned her on, off, lower the dosage, increase the dosage. Before I get into anything, I'm not a doctor, but I can tell you that the doctors that have testified in this case have brought to light ways that psychiatry works. In so many instances, people described it as throwing pasta to the wall and seeing what sticks. It's not a perfect playbook. It really depends on the person. There's even been calls for blood testing, genetic testing to see what people are more receptive to before prescribing. But it seems like a lot of the experts who were brought in said that her initial treatment was quite common, that it is pretty common to give someone Ativan or Busporin for anxiety. The one that struck me was Klonopin, especially Benadryl for sleep. How does Klonopin differ from Lorazepam or Ativan, which are, you know, they're both benzos. I mean, they're similar. It's just a different type of anxiety med. So if one didn't work for her, a doctor, a different doctor may think this clearly didn't work for her. She's saying she's not better on it. Let's try something different. Look at this. That's Welbutrin at the top. I mean, it's just, there's everything. Lamictal, a mood, you know, is for mood. Valium, you know, is a benzo. Seroquel, an antipsychotic. Remron is an SSRI. Ambien, we all know. Prozac, an SSRI. Trazodone, a sedative. Welbutrin at the top. I mean, literally, they threw everything you could possibly imagine, you know, except Robitussin at her. This is, the drug list is just overwhelmingly scary. And at the end, you know, it's about primary care physicians, right? There was no quarterback to this. You bring up a great point, and that's kind of what led me to think who was in her corner, who looked at her holistically. Especially when someone's already mentally struggling, it's very hard for them to communicate to each new doctor what they're taking, what worked for them, what didn't. And it seems that Lindsay really knew medications. She googled everything. She researched enough to question whether something was working. And one would say that she was impatient. That's what at least the prosecution is arguing. But in some cases, if you're taking a medication and you don't see any sort of positive response, what's to encourage you to keep on that without a center, a home base that keeps you on track? And I think what Lindsay was really lacking here, and experts say, is that person who was looking at her entirely. One primary care doctor that could say, okay, she went to these separate doctors, they prescribed these things, it's not working, what other support could she receive? And fortunately, she sought help from so many different places that don't share a common record-keeping system. Not everybody uses Epic, and also it's not required for a lot of physicians, or for psychiatrists specifically. And why that is, really, is based on our Privacy Act laws, HIPAA really protects medical records, but even more so for psychiatric rhetorics, including psychiatric notes. It'll show that she received a diagnosis, but the actual notes of how she responded may not be there, and a doctor needs to get the patient's written consent to go to their previous doctors and say, can I have those records? And in so many situations, like a mother I talk to who lives here, who's managing her son's mental health at 13, she gatekeeps a lot of his records because she doesn't want providers to make assumptions that other providers have already made. And so it's really a teeter-totter of like, what is the right way to go about this? And should you have a central system versus, let's say you're really unhappy with one doctor's decision, and you want to try something different. It just has to be one person who knows that you're going to a different doctor, and keeps the record, keeps the tab of what you've been taking and when. It's completely, it's so basic. And I wonder, in your findings, a couple things. One, how did COVID impact this, where everything became just, hey, pop on a Zoom? Telehealth became a huge portion of the medical system. Who doesn't use telehealth as a first resort at this point? Because if you try to get an appointment in Massachusetts, you know, we're looking into this now, but you're waiting possibly three to six months, really, depending on where you're going and who you're seeing. Really? Yeah, it really can, it can wait. And that leaves our ER rooms really backed up. This is not just a result of the pandemic. Sure, the pandemic did a lot in terms of people not seeking as much help early on to where they're in a dire need now. And this is a place that really produces the best types of doctors. So you have a chance to say, she sought help in the best place possible for it. Healthcare is the bread and butter of Boston. And she worked at the largest hospital. It makes it a little bit confusing. I mean, it's not confusing as to why she sought help through someone she found online, because she was specifically looking for someone who would understand the postpartum aspect of this. And that is really unique. Even for me, finding postpartum psychiatrists who are trained in this to identify psychosis is a very niche group. Did you, in your research, find crossover between two drugs that are extremely conflicting? And you might have mentioned this earlier, but like things went, whoa, okay, I'm not a doctor, but I do know those do not need to have any sort of, you know, crossover connection. Yeah, again, not a doctor, but the doctors I have talked to really highlighted that last one. Amitriptyline. It is probably the most significant. What's it called? Amitriptyline. Amitriptyline. Amitriptyline. It's A-M-I-T-R-I-P-H-P-T-Y-L-I-N-E. And I could be pronouncing that really wrong with my Midwestern accent. Amitriptyline, there it is. Amitriptyline. It is really the last resort. And it's really important to note right now that this is not the common positive effect someone with psychosis should be receiving. I learned that lithium and ETC, which is like, used to be called like electroshock therapy, but it's not really a therapy, so they changed the name a little bit, are the most effective treatments. And Lindsay wasn't given either of those two options. Amitriptyline is a really significant drug. It has strong side effects. It is probably the strongest on the market, some doctors told me. And strongest antidepressant? Yes. It is a specific type of antidepressant that you would give to a psychotic patient. And so it's being prescribed by Jennifer Tufts, who is being criticized for being two months out of her degree and certification. Speaking of no coordination, there's no oversight. I mean, you got to be working with someone maybe who's got a little more experience as you get going, you know what I mean? And Tufts did get questioned about this on the stand, not specifically that drug, but specifically why she was prescribing Lindsay when she had gained knowledge that she entered herself into an emergency room or an in-house psychotic unit. And she testified that she had no access to those medical records because they're not on the same shared system, which also plays into a role of the prosecution that Lindsay may have been doctor shopping, not providing her doctors with the accurate information. Withholding is what the prosecution is saying, right? Yeah. Right. And so I can see the... And maybe there's truth to that because they're going to take your kids away and she's doing everything she can to not have her kids taken away, which is a mother's instinct. But maybe there's something in there. There's nuance here, right? Not everything's black and white. Now we know. The jury's made up of nine women and three men and the prosecution are two women. And gender could really play a big role in this case, just talking to experts. But either way, which do you see nine women more likely to feel, how could you do this? It's on you. Moms can judge other moms. On a basic level, it's the carpool lane, like, oh, look at her. She has to go after her job. She always sends her nanny. And then on a deeper level, it's Jesus. This is your primary function in life. Take care of your kids. How could you do this? It ends with her. Do you get a sense of what the majority of women and they're all, of course, it's not a voting bloc, but. Certainly, I can't. Yeah, I can't speak on behalf of all women. I can tell you that we have covered a lot of different perspectives of this case and the advocates that are showing up in pink in large numbers outside of the courthouse and even have made their way inside the courthouse to show their support are coming from all over the country. They're driving 17 hours or even it's it's gotten to the point where we have to look at the people in white as well, the ones that are asking for justification for the children and want to see some sort of action taken. Geez. Yeah, I think I look to me. My prediction is possibly hung jury. And that would be but but other than that, it's, you know, 90 percent of me feels it's lack of criminal responsibility. And and this is more a referendum on the state of our psychiatric medical establishment than it is on her actions that night taken quite literally. It's too big. It's too big a moment. But a hung jury would be would be brutal because then we got to do the whole thing again. There are probably more than 16 witnesses that were directly impacted or witnessed her behavior that have to come back. And we can tell that so many people are so afraid of touching the spotlight of this trial because of the of the, I guess, scorch online of people scrutinizing them in this case. Even experts I reach out to who I try to get their medical opinion about this won't come anywhere near it because they know that it's just too dramatic to issue an opinion, even if it's a medical one. And in this case, things like postpartum psychosis aren't in the DSM, which are it's it's kind of like the psychiatry Bible. Some people would call it it. If anything good comes from this case, one would hope that it's more awareness and maybe more treatment, availability and educational training for people entering this field to recognize a case like Lindsay's. Is it true the DSM was written in 1952, updated in 2013, and maybe like they took a highlighter and changed a little punctuation in 2022? I mean, it's that antiquated. Kind of. I mean, it does get updated. I think the last update was in 2013. Some could argue it's a bit outdated. Others could say medication and technology are advancing so fast that we hope that we'll have more information in the coming years that could provide even better context for a new version. I always, you know, just speaking from personal experience, I saw a psychiatrist for years. I just got in trouble a lot when I was a kid. I don't know what it was. It was drawing attention to myself in weird ways. I don't know. Please don't read into that, folks. You could have a field day with that. But I did. You know, he was really judicious. He never prescribed me medication. It was psychoanalysis all the way. He said he would if he needed to. Hey, look at me now. He didn't need to. But I feel like because I've been through it as a parent. Psychiatrists today are prescription writers. They don't even need to see you that often. And it really is spaghetti at the wall. I think how many families, raise your virtual hand, have been through a bunch of, you know, side effects and setbacks and scary moments because of the meds that we end up putting our kids on. I think it's absolutely referendum time. What kind of feedback are you guys getting to that point? That's just my personal experience. Oh, my inbox is full. I mean, every single day we run a new story about the gaps in postpartum care, the types of medication people receive, their gender thoughts on the trial, the social norms and expectations of parenting, and the support groups that exist or don't exist at all. The actual role of suicide hotlines and when you ask for help, what help is perceived to be enough. It's kind of hard. I think the conversation is usually, if you ask for help, you either get an ambulance crashing into your lawn or are put on a wait list. That's kind of where we've seen things end up. And in Lindsay's case, she called the suicide hotline twice. And the unfortunate acts of January 24th, or 23, it's only a month after her second call. And so she did try to get help. We hear from people all the time about how they try to get help. It's so hard when you are communicating to a provider, here's how I'm feeling. And they put you through a standard pipeline of let's take this test. It's called the Edinburgh test. Let's give you a score. And anything typically above 15 to 17 on that score is alarming. Lindsay took that test twice and it increased to a total of 23 was her highest score. What should have happened next is still not something that's been out in the open. And I think everyone is kind of looking for someone to blame in this aspect when it could be multiple parts. Yeah. I mean, I think as a culture, we've all struggled with nuance. We've had battles with nuance, but of course there's multiple parts. And the internet always likes to have a specific person to blame. And the internet doesn't drive the algorithm nuance. So I think we all know that. The internet has taken this case by storm in ways that I haven't seen before. So many people are actually sharing their voices of their experiences that may be clarifying for them or at least therapeutic in some way to have a community to talk to. And I think in some ways there are a lot that have spewed some information that wasn't actually presented the same way in court that has led to a very dramatic effect online. I worry that we're never going to hear from Patrick again, given all the backlash he's received online. And if we have a hung jury, that may have to happen again. Well, you'll hear from Patrick when his civil suit takes, he has his own civil trial, I think malpractice civil trial. Of course, a lot of people are hating on him for trying to collect more money after he's collected on the house and a few other things. It's interesting we haven't seen him since his testimony. I find that odd, but I don't know. He's not as bad as if you think he was a passive enabler or passively unhelpful to his wife. Just watch the death of the pastor's wife on Netflix, which came out this weekend, and you will see the worst human being that ever lived. Sarah, thank you so much. You notice there's a comment at the end. Thank you so much. I really appreciate your time and your reporting is just excellent. Very important angle. Thank you so much. Let me say that consequential because it may be a very important part of the change that's to come if it's to come in psychiatry. One huge thing I just want to leave off on is that we're in a point where we're able to watch this trial. I'm able to collect this information from a CVS receipt that was submitted into evidence and build a timeline that is very visual for all of us to understand. However, it's also really important to know the things that we don't know because we're not the jury, and the jury does get access to evidence that has not been publicly provided in trial. Like the 9-1-1 call of Patrick Lancy. You're the Boston Globe, right? You guys opted not to report on that. The judge also ruled that the media could not release the 9-1-1 call because it was that graphic. You guys didn't even release the details of it. I feel horrific for anyone that had to listen to it even multiple times. There was visible cringing from the jury, our reporters wrote, and many breaking out into tears. Yeah, that's the jury. I mean, they heard that. We didn't. So if by some miracle, I still don't think it will happen, but if they did find first-degree murder in all of this and did those nine women hold her accountable, maybe that 9-1-1 call that they heard and we didn't had something to do with it. It's also important to watch what they're asking for. So on Friday, I believe, they had asked a question and they wanted to see the prescription bottles and the knife that she used that night on herself. And that leads one to think maybe they're building their own timeline because they don't have access to the internet and are really not supposed to be talking to people about this case or looking it up online. So it's interesting to know what specifically they're looking at. And they are diving into what did she take? What didn't she take? Were the bottles filled? How long did she stay with which provider? And maybe building their understanding of this. And I would think that would benefit Lindsay. That curiosity alone. Sarah Rahal, thank you very much. She's doing all the reporting here and health on the science perspective from the Boston Globe. We appreciate you. Thank you, guys. And you're lovely. Thank you. Bye-bye. Take care. So, wow. The drug list is everything. And boy, she did an amazing job of putting that in a digestible way for everybody in the globe. Just