I totally agree about the CPS investigator. And ditto on the ketamine coma. Thank goodness my doctor eventually hit on something that gives me reasonable relief and reasonable quality of life.Maclilly wrote: ↑Fri Oct 06, 2023 2:01 pm
Yes I understand there was a settlement with Dr. Smith and some other person was dropped just before trial. This case is only against the hospital. I want to thank you for watching the trial and giving these summaries. I'm at work and can only catch up on weekends. Watching the documentary I was very sympathetic to Maya but had concerns about the mom. I also have concerns about the CPS investigator. As a former GAL, I don't think she acted appropriately. She might very well have been right, but her actions and words were cruel and inappropriate. She seemed tainted. It is a mess and I am so curious how this turns out. ergo Ketamine Infusions and use nasal sprain. But I would not to a Ketamine coma. I would have to be on death's door in pain before doing that.
Taking Care of Maya - FL CPS/Munchausen case
Taking Care of Maya - FL CPS/Munchausen case
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
I should probably revise part of my answer since I was in a mindset for how I would feel about it today. As to the ketamine coma, if I had been presented with this kind of opportunity in September of 2000 I would have jumped on it without hesitation. At that time I was at a point of such distress that I would have done anything and had promised myself that if the doctor I was about to see couldn't do something I would end the suffering. So yeah, I would have jumped on it in a heartbeat without hesitation at that point in time. I wouldn't judge anyone who takes this treatment if they have been through a long enough period of time to be pretty much desperate. If there isn't an end in sight, at the level of pain of CRPS you can't judge a person for doing almost anything.RVInit wrote: ↑Fri Oct 06, 2023 2:21 pmI totally agree about the CPS investigator. And ditto on the ketamine coma. Thank goodness my doctor eventually hit on something that gives me reasonable relief and reasonable quality of life.Maclilly wrote: ↑Fri Oct 06, 2023 2:01 pm
Yes I understand there was a settlement with Dr. Smith and some other person was dropped just before trial. This case is only against the hospital. I want to thank you for watching the trial and giving these summaries. I'm at work and can only catch up on weekends. Watching the documentary I was very sympathetic to Maya but had concerns about the mom. I also have concerns about the CPS investigator. As a former GAL, I don't think she acted appropriately. She might very well have been right, but her actions and words were cruel and inappropriate. She seemed tainted. It is a mess and I am so curious how this turns out. ergo Ketamine Infusions and use nasal sprain. But I would not to a Ketamine coma. I would have to be on death's door in pain before doing that.
After watching the testimony of the Dr who did the ketamine coma I am confident that he is on the up and up. Unlike Dr Chopra, who claims to have treated 100,000 patients, this man answered that he has treated a total of about 3 to 4 patients per month over the past 20 years. He practices in Monterrey Mexico. 3 to 4 patients every month is more in line with the true population of people who have this condition. When asked how many people he treats with the ketamine coma his response was approx 1 person per month. So this isn't a person that sounds like he's just grabbing people of the streets and diagnosing them all with a rare disease and then performing this extreme ketamine treatment on them. More later but it sounds like he trusted Dr Kirkpatrick to do the diagnosis and to make sure Maya qualified for his treatment. I doubt he will ever do this again, from the sound of it he would not have treated Maya with the ketamine coma had he known the truth about the length of time she was diagnosed and the lack of other more conventional treatments.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
The doctor from Mexico testified for a large part of the day, here are my impressions of his testimony.
He was an excellent witness, seems quite well versed in pain management, studied in the USA then went back to Mexico to practice. He is an anesthesiologist and specializes in pain management. That is very common for pain management doctors to be anesthesiologists. He came across as very knowledgeable. He had a relationship with Dr Kirkpatrick, and Kirkpatrick was the one that referred Maya to him. It seemed clear that he was taking Dr Kirkpatrick's word for the symptoms and history of Maya's illness. He seemed surprised when he heard of some of the treatment she was given after she left Mexico. I think he was equally good for the defense as he was for the plaintiff. The jury asked him a huge number of questions. I listed them all. Yup, It's a novel. i typed it elsewhere and didn't have spell check, so good luck. Also I remember I started one question and didn't finish, so when you get to that one, just ignore. I couldn't remember and it's too hard to try to reverse YouTube and find it.
My overall impression is that he seems less like a shyster than Kirkpatrick and Chopra. Maybe shyster is too strong a word, but Kirkpatrick and Chopra are treating a huge number of patients for CRPS, seemingly half the known population that is believed to even have it. The doctor from Mexico (I'm sorry, I forgot to write his name down) said he treats 3 or 4 per month. Only 1 or 0 per month get the ketamine coma treatment, it's for hard core cases that are unresponsive to anything else. He mentions the "suicide disease" as also did Dr Chopra and points out that even though the ketamine treatment has possibilities of complications - the patient is intubated, feeding tube, etc these are people who otherwise have zero quality of life. This treatment is not considered for any patient that gets reasonable quality of life from other treatments. I believe he does not know that Maya was only diagnosed a short time before Kirkpatrick referred her. There may also have been lying by the mother to both of them. The Dr mentions that because Beata was a nurse, he believes she has a high degree of knowledge. he didn't question the Dr who he had a long relationship with and the nurse who was saying the same. I doubt that he knows every bit of information that came from Kirkpatrick basically came from Beata.
----------------------------------------------------
Jury questions:
1. It has been mentioned that you hae an intake form for treatment. Is it a steadfast rule that all the boxes must be checked or do you determine yourself what you think. It is mainly the eligibility that as a physician we determine. But the whole medical
2. Is a medical coma used for other purposes? It's a procedure that we use only for CRPS. And it's a procedure that has been done in other countries
3. Is it highly controversial or unacceptable? These are patients that have a very poor quality of life and have a tendency for suicide if not otherwise treated. Whether it is unacceptable, I do not think so.
4. Can you confirm that someone with CRPS has a higher tolerance for pain? Not necessarily. CRPS has the most intense pain, and these are patients that have to figure out how to cope.
5. If you use a pain scale of 1 to 10, how would Maya describe it as a level 5? Yes, becaus they learn to live with it, they can do heir activiities sometimes and not show outwardly that they have high intensity of pain.
6. If Maya says she has level 10 can that mean it would be level 15 for a normal person? It's difficult giving an answer to that. All we can see is that CRPS is the highest level of pain known.
7. What was Maya's ASA class when you first identified her? 2
8. How did you communicate. In English
9. How long after the procedure did you momitor Maya? I think he misunderstood the question. he says the follow up was done in the USA
How long do you monitor after the infusion? We look for anxiety, irritability, abdominal pain, diarrhea, abnormal movements, all these are possible side effects
Did Maya experience side effects? Probably had some mental confusion for the first couple days, but she recovered soon
In the photo of the wheelchair was that a seatbelt to hold her in or a gait belt used for transfers? Most likely it was a seatbelt for the wheelchair. One of the things we fear the most is for them to have an injury because that will exacerbate the pain.
How do you establish if the previous diagnosis is a narrative or a legitimate diagnosis? For us to know that patient has CRPS we need to see the symptoms and signs the patient has had in the past and the present. And how those comply with the criteria for CRPS. (Note here, there were times during the cross examination that I wondered if this doctor was wondering if he had been bamboozled about Maya. Also, he was shown photos and video of her that supposedly was from the same time period where in the photo is was very clear that she had no dystonia whatsoever. That was when she was playing in the pool with her brother and she got on a raft and crossed her legs, there was no turning in of her feet and no sign of her legs being in any spasm. But the next video here she was on a wheelchair with her dystonia)
CRPS is a permanent condition. After ketamine coma what is the longest length of time a patient has gone before relapse? There are some patients that are out of symptoms to the date/ I think he means they are still asymptomatic. But he never answered if they just got their treatment last month. So, he did not give an actual time period. I think the translation is difficult and he's not understanding the questions because he doesn't appear to me like a typical witness that is just trying to answer questions in a way that is good for the side that is presenting him.
What is the shortest time a person's symptoms are relieved from ketamine coma? To the degree of being how they were before the treatment? Judge restates the question. I would have to say three months.
With CRPS can a lesion form from a minor abrasion? yes. I can give an example. Just a few days ago had a patient we were going to do a procedure and a nurse asked her to show her hand she had lesions from just touching
Can a cut or abrasion turn to a lesion? It is a lesion. It's difficult to say if this can happen because they appear spontaneously and can't necessarily tell the difference.
What symptoms did you document and observe in Maya? She had intense pain not related to any other condition. (self reported) hypersensitivity self reported, changes in temperature, dystonia. These were present either at the time of my personal evaluation or just prior to her arrival. (I think he's maybe not trying to say these are sumptoms that dr Kirkpatrick, who referred her, had told him she had.
In pain management situations what does withdrawal manifest as in intelligent patients? I don't understand very well
Where there any religious requests from the family? No
Do you know of any religious ceremonies were done with Maya? No
Did Maya complete her treatment fully? Yes
What is the reason you put Maya in the coma instead of just treatment? She had a bad quality of life. She had been through other treatments with no reduction in symptoms. (There will be follow up by defense on this for sure. They will likely ask him point blank was this reported by Dr Kirkpatrick, the family, or are you answering this due to your personal obervation. It can't be his personal knowlege, she flew down there for treatment as a referral by Dr Kirkpatrick. She had no other treatment, there is video showing that Dr Kirkpatrick recommended this on her very first visit just based on information from Beata)
What are the dates of the boosters? 3 weeks after the ketamine coma
He started with 3 mg per kg and gradually
what is the percentage of US patients does your practice treat? In general, none. Maybe 1% because I live in Mexico
Is your practice primarily ketamine treatment? No
What additional services does your practice provide? We treat acute post op pain, chronic pain, neuralgias, the most frequent are cancer patients.
has Dr Kirkpatrick ever received a referral fee from your practice? No
How many referrals from Dr Kirkpatrick? 25 or 30
you stated the Ketamine coma was a study you and Dr Kirkpatrick were performing. Was Mayas tratment a part of that study? To my recollection she was outside of the study.
Are there warmings that long term use of high dose ketamine can lead to psychological dependency? There is no evidence of this, but not enough studies for this
does Mexico regulate ketamine use? Definitely
Can the lesions on Maya be self inflicted? After seeing so many lesions from CRPS he does not believe hers were self inflicted.
----------------------------------
Plaintiff followup:
How many years has Dr Kirkpatrick been referring? since 2997. So he referred about 25 - 30 patients over 16 years, about 2 or 3 per years
What % of patients from outside Mexico? 80%
Includes European countries, New Zealand, Spain, Canada, England
What were the concerns of what would happen to Maya if she didn't have this treatment? It is difficult to know in one person what would happen. But chronic pain is a symdrome not a symptom, It can get to be fatal, many commit suicide with this condition.
Has he lost patients from CRPS without or with treatment? yes, a patient came for a ketamine coma. She was 3 years out, started to become a physician assistant. She had a relapse, after that she fell from her bed and fractured her leg. there were no resources to continue treatment, progressively she lost the ability to feed herself, we had to use IV analgesics, eventually she passed away
Was the seatbelt in wheelchair a hospital requirement? No a requirement but we suggest to all patients.
What is the purpose of that? Mainly a preventive
About withdrawal, were you talking abot immediate effects after the procedure or long term? Immediate
For long term, have you seen withdrawal? I wouldn't call it withdrawal, and all patients leave the hospital with no withdrawal. The maximum it last is 15 days, it's mainly the mental confusion
Is is like opioid withdrawal? No, it's mainly they are experiencing confusion, like any anaesthesia you come out slowly
As for the pain scale - do CRPS patients develop tolerance so their perception of pain is different than non CRPS? yes, and diagnosis may be delayed becoause of this
Would the average patient rate pain on a different scale than Maya? yes
Judge is not allowing him to ask questions related to doctors with no experience with CRPS viewing these symptoms differently
By the time that Maya had come to you had she already been through physical therapy, opioids, lower dose of ketamine, all the usual treatments? As far as he knows
----------------------------------------------------
Defense
Your fees for this patients were paid in cash in advance? No
how were they paid? Wire transfers
Are you board certified in the US? No
-------------------------------------------
Board certified in Mexico? yes
He was an excellent witness, seems quite well versed in pain management, studied in the USA then went back to Mexico to practice. He is an anesthesiologist and specializes in pain management. That is very common for pain management doctors to be anesthesiologists. He came across as very knowledgeable. He had a relationship with Dr Kirkpatrick, and Kirkpatrick was the one that referred Maya to him. It seemed clear that he was taking Dr Kirkpatrick's word for the symptoms and history of Maya's illness. He seemed surprised when he heard of some of the treatment she was given after she left Mexico. I think he was equally good for the defense as he was for the plaintiff. The jury asked him a huge number of questions. I listed them all. Yup, It's a novel. i typed it elsewhere and didn't have spell check, so good luck. Also I remember I started one question and didn't finish, so when you get to that one, just ignore. I couldn't remember and it's too hard to try to reverse YouTube and find it.
My overall impression is that he seems less like a shyster than Kirkpatrick and Chopra. Maybe shyster is too strong a word, but Kirkpatrick and Chopra are treating a huge number of patients for CRPS, seemingly half the known population that is believed to even have it. The doctor from Mexico (I'm sorry, I forgot to write his name down) said he treats 3 or 4 per month. Only 1 or 0 per month get the ketamine coma treatment, it's for hard core cases that are unresponsive to anything else. He mentions the "suicide disease" as also did Dr Chopra and points out that even though the ketamine treatment has possibilities of complications - the patient is intubated, feeding tube, etc these are people who otherwise have zero quality of life. This treatment is not considered for any patient that gets reasonable quality of life from other treatments. I believe he does not know that Maya was only diagnosed a short time before Kirkpatrick referred her. There may also have been lying by the mother to both of them. The Dr mentions that because Beata was a nurse, he believes she has a high degree of knowledge. he didn't question the Dr who he had a long relationship with and the nurse who was saying the same. I doubt that he knows every bit of information that came from Kirkpatrick basically came from Beata.
----------------------------------------------------
Jury questions:
1. It has been mentioned that you hae an intake form for treatment. Is it a steadfast rule that all the boxes must be checked or do you determine yourself what you think. It is mainly the eligibility that as a physician we determine. But the whole medical
2. Is a medical coma used for other purposes? It's a procedure that we use only for CRPS. And it's a procedure that has been done in other countries
3. Is it highly controversial or unacceptable? These are patients that have a very poor quality of life and have a tendency for suicide if not otherwise treated. Whether it is unacceptable, I do not think so.
4. Can you confirm that someone with CRPS has a higher tolerance for pain? Not necessarily. CRPS has the most intense pain, and these are patients that have to figure out how to cope.
5. If you use a pain scale of 1 to 10, how would Maya describe it as a level 5? Yes, becaus they learn to live with it, they can do heir activiities sometimes and not show outwardly that they have high intensity of pain.
6. If Maya says she has level 10 can that mean it would be level 15 for a normal person? It's difficult giving an answer to that. All we can see is that CRPS is the highest level of pain known.
7. What was Maya's ASA class when you first identified her? 2
8. How did you communicate. In English
9. How long after the procedure did you momitor Maya? I think he misunderstood the question. he says the follow up was done in the USA
How long do you monitor after the infusion? We look for anxiety, irritability, abdominal pain, diarrhea, abnormal movements, all these are possible side effects
Did Maya experience side effects? Probably had some mental confusion for the first couple days, but she recovered soon
In the photo of the wheelchair was that a seatbelt to hold her in or a gait belt used for transfers? Most likely it was a seatbelt for the wheelchair. One of the things we fear the most is for them to have an injury because that will exacerbate the pain.
How do you establish if the previous diagnosis is a narrative or a legitimate diagnosis? For us to know that patient has CRPS we need to see the symptoms and signs the patient has had in the past and the present. And how those comply with the criteria for CRPS. (Note here, there were times during the cross examination that I wondered if this doctor was wondering if he had been bamboozled about Maya. Also, he was shown photos and video of her that supposedly was from the same time period where in the photo is was very clear that she had no dystonia whatsoever. That was when she was playing in the pool with her brother and she got on a raft and crossed her legs, there was no turning in of her feet and no sign of her legs being in any spasm. But the next video here she was on a wheelchair with her dystonia)
CRPS is a permanent condition. After ketamine coma what is the longest length of time a patient has gone before relapse? There are some patients that are out of symptoms to the date/ I think he means they are still asymptomatic. But he never answered if they just got their treatment last month. So, he did not give an actual time period. I think the translation is difficult and he's not understanding the questions because he doesn't appear to me like a typical witness that is just trying to answer questions in a way that is good for the side that is presenting him.
What is the shortest time a person's symptoms are relieved from ketamine coma? To the degree of being how they were before the treatment? Judge restates the question. I would have to say three months.
With CRPS can a lesion form from a minor abrasion? yes. I can give an example. Just a few days ago had a patient we were going to do a procedure and a nurse asked her to show her hand she had lesions from just touching
Can a cut or abrasion turn to a lesion? It is a lesion. It's difficult to say if this can happen because they appear spontaneously and can't necessarily tell the difference.
What symptoms did you document and observe in Maya? She had intense pain not related to any other condition. (self reported) hypersensitivity self reported, changes in temperature, dystonia. These were present either at the time of my personal evaluation or just prior to her arrival. (I think he's maybe not trying to say these are sumptoms that dr Kirkpatrick, who referred her, had told him she had.
In pain management situations what does withdrawal manifest as in intelligent patients? I don't understand very well
Where there any religious requests from the family? No
Do you know of any religious ceremonies were done with Maya? No
Did Maya complete her treatment fully? Yes
What is the reason you put Maya in the coma instead of just treatment? She had a bad quality of life. She had been through other treatments with no reduction in symptoms. (There will be follow up by defense on this for sure. They will likely ask him point blank was this reported by Dr Kirkpatrick, the family, or are you answering this due to your personal obervation. It can't be his personal knowlege, she flew down there for treatment as a referral by Dr Kirkpatrick. She had no other treatment, there is video showing that Dr Kirkpatrick recommended this on her very first visit just based on information from Beata)
What are the dates of the boosters? 3 weeks after the ketamine coma
He started with 3 mg per kg and gradually
what is the percentage of US patients does your practice treat? In general, none. Maybe 1% because I live in Mexico
Is your practice primarily ketamine treatment? No
What additional services does your practice provide? We treat acute post op pain, chronic pain, neuralgias, the most frequent are cancer patients.
has Dr Kirkpatrick ever received a referral fee from your practice? No
How many referrals from Dr Kirkpatrick? 25 or 30
you stated the Ketamine coma was a study you and Dr Kirkpatrick were performing. Was Mayas tratment a part of that study? To my recollection she was outside of the study.
Are there warmings that long term use of high dose ketamine can lead to psychological dependency? There is no evidence of this, but not enough studies for this
does Mexico regulate ketamine use? Definitely
Can the lesions on Maya be self inflicted? After seeing so many lesions from CRPS he does not believe hers were self inflicted.
----------------------------------
Plaintiff followup:
How many years has Dr Kirkpatrick been referring? since 2997. So he referred about 25 - 30 patients over 16 years, about 2 or 3 per years
What % of patients from outside Mexico? 80%
Includes European countries, New Zealand, Spain, Canada, England
What were the concerns of what would happen to Maya if she didn't have this treatment? It is difficult to know in one person what would happen. But chronic pain is a symdrome not a symptom, It can get to be fatal, many commit suicide with this condition.
Has he lost patients from CRPS without or with treatment? yes, a patient came for a ketamine coma. She was 3 years out, started to become a physician assistant. She had a relapse, after that she fell from her bed and fractured her leg. there were no resources to continue treatment, progressively she lost the ability to feed herself, we had to use IV analgesics, eventually she passed away
Was the seatbelt in wheelchair a hospital requirement? No a requirement but we suggest to all patients.
What is the purpose of that? Mainly a preventive
About withdrawal, were you talking abot immediate effects after the procedure or long term? Immediate
For long term, have you seen withdrawal? I wouldn't call it withdrawal, and all patients leave the hospital with no withdrawal. The maximum it last is 15 days, it's mainly the mental confusion
Is is like opioid withdrawal? No, it's mainly they are experiencing confusion, like any anaesthesia you come out slowly
As for the pain scale - do CRPS patients develop tolerance so their perception of pain is different than non CRPS? yes, and diagnosis may be delayed becoause of this
Would the average patient rate pain on a different scale than Maya? yes
Judge is not allowing him to ask questions related to doctors with no experience with CRPS viewing these symptoms differently
By the time that Maya had come to you had she already been through physical therapy, opioids, lower dose of ketamine, all the usual treatments? As far as he knows
----------------------------------------------------
Defense
Your fees for this patients were paid in cash in advance? No
how were they paid? Wire transfers
Are you board certified in the US? No
-------------------------------------------
Board certified in Mexico? yes
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Hello, and sorry I disappeared for the past week on this. I am started to get some emotional feelings here which is making it hard. I will explain my fears and how I am concerned it's going to affect me.
I have continued to watch the trial. Enough that I have fears about which attorney is likely going to handle the "medical stuff" on the defense side. I've seen enough to believe that one of the doctors was making a sincere and serious effort to collect enough information to do justice to what might amount to ah honest second opinion. The family did everything they could to prevent that. The mother was so dead set on her daughter has CRPS that they fought tooth and nail against any possibility of any other determination of her symptoms.
I now have an even longer list, and am more convinced that Maya had SOMETHING, but just not CRPS. She did need an accurate diagnosis, and she was eventually weaned off of a huge list of medications, some of which she was on HUGE doses of and basically the hospital was vindicated in some sense that she DID get better.
If she had CRPS and proper treatment for CRPS had been denied, she would NOT have gotten better. The plaintiff and Maya herself on the witness stand is trying to explain it all away as "good days and bad days". That is not how condition vs remission works. CRPS does not have good days and bad days. If diagnosed within 3 months it CAN (but not always) go into remission at some point. If not diagnosed and effectively treated within 3 months it is almost impossible for it ever to go into remission. So, if not remission you don't have GOOD DAYS and bad days. You either have remission or mot. Remission doesn't mean two good days, followed by one bad day, one week of good, 1.5 days of bad, 2 weeks of good, 3 days of bad. Remission means you are symptom free for a period of time and considered that you can go on your merry way unless and until you have a relapse. Then you are fully symptomatic again.
Here is what is bothering me about continuing watching this. The hospital is defensing against specific allegations and they may not present a CRPS specialist that will explain WHY what Dr Kirkpatrick (the doctor who diagnosed CRPS) did does NOT satisfy the Budapest criteria in the sense of HISTORY of Maya's condition. It's not the list of symptoms that tells you that she doesn't have it. It's the fact that true CRPS ALWAYS starts with the burning pain. If dystonia happens due to CRPS, it normally takes at least a couple of years. Allodynia also takes time to develop. But the pain is always first. You have have dystonia from something else then months later develop what you THINK is the worst pain every invented. That is NOT CRPS. Even though you are telling the doctor you have these two symptoms and they are BOTH on the CRPS list.
My fear: The defense may not present effective evidence for the jury to realize that her doctors are quacks. So, they believe she has CRPS. She wins the case and now she becomes the face of CRPS. Everyone who hears her story thinks this is the real experience of a person with CRPS.
In no way will that help anyone with CRPS.
Anyone who ever read the original thread that was set up to discuss this case might remember that prior to my seeing the special on Netflix I totally believed this girl had CRPS. I actually wrote a commentary about it where I indicated my belief that this child had been treated cruelly. Mostly because everything I read about it up to that point described my personal experience with suffering horribly until finally getting some reduction in pain, followed by an actual diagnosis (almost 5 years later) and then better reduction of pain after the good diagnosis. So, I was lock, stock, and barrel on this girl's side and believing she had CRPS, that she went through essentially what I went through and she should be getting that $220 million that her family is asking for.
Until I saw the Netflix special. I started to get puzzled about how the progression of specific symptoms just does not match any known case that I have ever heard of for CRPS. Then I though, well maybe a huge amount of editing happened and the Netflix special is missing a LOT of history. Then I started watching the trial. I have now seen a huge amount of her medical records and am familiar enough with the HISTORY of her symptoms, i.e. date of onset of that specific symptom, and no, I just don't think she has it. And I believe that SHE believes she does have it. She was sadly failed by her own family who prevented a proper diagnosis. She will probably for the rest of her life believe TRULY that she has this condition. She has indicated constant fear of relapse. And every time she feels the least tiny bit of pain she thinks it's her CRPS coming back.
I will write more about the evidence from this week in a little bit.
I have continued to watch the trial. Enough that I have fears about which attorney is likely going to handle the "medical stuff" on the defense side. I've seen enough to believe that one of the doctors was making a sincere and serious effort to collect enough information to do justice to what might amount to ah honest second opinion. The family did everything they could to prevent that. The mother was so dead set on her daughter has CRPS that they fought tooth and nail against any possibility of any other determination of her symptoms.
I now have an even longer list, and am more convinced that Maya had SOMETHING, but just not CRPS. She did need an accurate diagnosis, and she was eventually weaned off of a huge list of medications, some of which she was on HUGE doses of and basically the hospital was vindicated in some sense that she DID get better.
If she had CRPS and proper treatment for CRPS had been denied, she would NOT have gotten better. The plaintiff and Maya herself on the witness stand is trying to explain it all away as "good days and bad days". That is not how condition vs remission works. CRPS does not have good days and bad days. If diagnosed within 3 months it CAN (but not always) go into remission at some point. If not diagnosed and effectively treated within 3 months it is almost impossible for it ever to go into remission. So, if not remission you don't have GOOD DAYS and bad days. You either have remission or mot. Remission doesn't mean two good days, followed by one bad day, one week of good, 1.5 days of bad, 2 weeks of good, 3 days of bad. Remission means you are symptom free for a period of time and considered that you can go on your merry way unless and until you have a relapse. Then you are fully symptomatic again.
Here is what is bothering me about continuing watching this. The hospital is defensing against specific allegations and they may not present a CRPS specialist that will explain WHY what Dr Kirkpatrick (the doctor who diagnosed CRPS) did does NOT satisfy the Budapest criteria in the sense of HISTORY of Maya's condition. It's not the list of symptoms that tells you that she doesn't have it. It's the fact that true CRPS ALWAYS starts with the burning pain. If dystonia happens due to CRPS, it normally takes at least a couple of years. Allodynia also takes time to develop. But the pain is always first. You have have dystonia from something else then months later develop what you THINK is the worst pain every invented. That is NOT CRPS. Even though you are telling the doctor you have these two symptoms and they are BOTH on the CRPS list.
My fear: The defense may not present effective evidence for the jury to realize that her doctors are quacks. So, they believe she has CRPS. She wins the case and now she becomes the face of CRPS. Everyone who hears her story thinks this is the real experience of a person with CRPS.
In no way will that help anyone with CRPS.
Anyone who ever read the original thread that was set up to discuss this case might remember that prior to my seeing the special on Netflix I totally believed this girl had CRPS. I actually wrote a commentary about it where I indicated my belief that this child had been treated cruelly. Mostly because everything I read about it up to that point described my personal experience with suffering horribly until finally getting some reduction in pain, followed by an actual diagnosis (almost 5 years later) and then better reduction of pain after the good diagnosis. So, I was lock, stock, and barrel on this girl's side and believing she had CRPS, that she went through essentially what I went through and she should be getting that $220 million that her family is asking for.
Until I saw the Netflix special. I started to get puzzled about how the progression of specific symptoms just does not match any known case that I have ever heard of for CRPS. Then I though, well maybe a huge amount of editing happened and the Netflix special is missing a LOT of history. Then I started watching the trial. I have now seen a huge amount of her medical records and am familiar enough with the HISTORY of her symptoms, i.e. date of onset of that specific symptom, and no, I just don't think she has it. And I believe that SHE believes she does have it. She was sadly failed by her own family who prevented a proper diagnosis. She will probably for the rest of her life believe TRULY that she has this condition. She has indicated constant fear of relapse. And every time she feels the least tiny bit of pain she thinks it's her CRPS coming back.
I will write more about the evidence from this week in a little bit.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Oh fuck me.
So, after I typed the above I began listening to the testimony of the guy who determined the information used to calculate the damages. He made a commentary that the defense has no expert that is going to refute any of the CRPS doctors. If that's true, then what I said above for my fears is probably true.
The hospital's attorneys are either idiots, or they were so afraid she really did have CRPS that they didn't bother to bring in a CRPS expert to go through her HISTORY of symptoms to see if this was a reasonable diagnosis or not.
History doesn't mean you come to doctor's office and you give her the whole list of all your symptoms and she says, wow, you have 4 symptoms on the list for CRPS therefore you have CRPS. That does not qualify as HISTORY, which the Budapest clinic diagnostic for CRPS requires. History means on this date we visited this doctor and had these symptoms and received the following drugs and/or instructions. And not just one of those but every doctor visit and which date each symptom appeared. That is what is meant by history. Not just today's date a complete list of all the symptoms you can think of that you have today.
The order in which symptoms appear are important in diagnosing CRPS I.E. Severe burning pain beyond what can be tolerated should be the first thing you ever complain about for any SUBSEQUENT symptom to even be suspected of being attributable to CRPS. Anything she has PRIOR to telling a doctor the pain "feels like I'm on fire" or "burning pain" is NOT attributable to CRPS. Not saying she doesn't HAVE that , just that because of the specific mechanism of CRPS the secondary symptoms occur AFTER the glia cells become activated, which happens BEFORE the injury ever heals. Always. Period. Always. You don't sprain your ankle and then have CRPS burning pain 5 months later. The condition of CRPS starts during the time the immune system is in overdrive trying to heal the injury. for some reason the glia cells start getting agitated and from that time until you get effective treatment for CRPS pain, you will have severe, burning pain. Any of the other symptoms come months later, not days. Even the allodynia comes later (hypersensitive to the touch, you can't even stand fabric from clothes touching the body part that has allodynia).
Note: the visit to JHACH where the alleged tort happened was in Oct 2016, so this history is from the prior year.
7/4/2015: patient presented with weak legs, severe asthma attack and was taking a specific amount of steroids, flonase, some other (I forget specific) drugs for asthma. Her vital signs are normal, including pulse rate on the low side of normal for a 10 year old
(She never mentions pain at this time, but on the witness stand she is NOW saying this visit involved 10/10 CRPS level pain. But that was not mentioned in the doctor visit notes anywhere, and this had nothing to do with alleged horrible treatment by JHACH)
9/16/2015 - visit to a pulmonary specialist. She is in a wheelchair. The pulmonary specialist makes a note that Maya had been diagnosed with RSD, which is the old name for CRPS. He notes her asthma history and the vital signs are listed on this medical record as normal, including pulse rate on the low side of normal for a 10 year old. She tells him "muscle pain all over my body" when he asks about the RSD pain
(Somehow there is no record of any doctor visit where she left with instructions that she should be wheelchair bound. That is just plain fucking weird. Putting a 10 year old whose body is still growing in a wheelchair is a big freaking deal. It has all kinds of implications for her - how long will she be in the wheelchair, possible atrophy, is she instructed to do exercises for her legs, etc. This appears to be the first diagnosis possibly by the mother since no record of why she's in the wheelchair. Also she had no record of visiting any actual doctor that diagnosed the RSD that was reported to this pulmonary specialist. However, during court when lawyers are arguing about exhibits there was a note by a psychiatrist. He asked Maya how she was originally diagnosed with CRPS. She said "mom did online research and mom and the doctor diagnosed CRPS.)
10/2/2015 Maya visits Dr Kirkpatrick at the CRPS clinic and now (after online research) Maya's mother (not Maya herself) is telling him Maya sprained her ankle, now has "burning" pain, and it's in both arms and legs.
(A couple of things are important to note. The sprain, description of pain as "burning", and location of pain are all new. And are all consistent with what Maya's mother would have seen on various websites while researching CRPS)
How fucked up is that. But, seems the defense might not put on a CRPS expert to explain her history and why 1) she doesn't have it, and 2) it makes perfect sense that removing CRPS treatment and replacing it with more moderate treatment of her individual symptoms made her better, and 3) all of the CRPS doctor's records indicate no real improvement. Although they SAY she got better, nothing in their paperwork indicates she ever got better. For instance her pain was still 10/10 as self reported, she still had dystonia, she still reported 0 quality of life.
But yeah, she was getting better from their treatment. Give me a break.
That child was failed by everyone. Everyone. (Well except that after JHACH removed the excessive drugs and she somehow got better even though she "had CRPS" and was "denied any treatment". )
So, after I typed the above I began listening to the testimony of the guy who determined the information used to calculate the damages. He made a commentary that the defense has no expert that is going to refute any of the CRPS doctors. If that's true, then what I said above for my fears is probably true.
The hospital's attorneys are either idiots, or they were so afraid she really did have CRPS that they didn't bother to bring in a CRPS expert to go through her HISTORY of symptoms to see if this was a reasonable diagnosis or not.
History doesn't mean you come to doctor's office and you give her the whole list of all your symptoms and she says, wow, you have 4 symptoms on the list for CRPS therefore you have CRPS. That does not qualify as HISTORY, which the Budapest clinic diagnostic for CRPS requires. History means on this date we visited this doctor and had these symptoms and received the following drugs and/or instructions. And not just one of those but every doctor visit and which date each symptom appeared. That is what is meant by history. Not just today's date a complete list of all the symptoms you can think of that you have today.
The order in which symptoms appear are important in diagnosing CRPS I.E. Severe burning pain beyond what can be tolerated should be the first thing you ever complain about for any SUBSEQUENT symptom to even be suspected of being attributable to CRPS. Anything she has PRIOR to telling a doctor the pain "feels like I'm on fire" or "burning pain" is NOT attributable to CRPS. Not saying she doesn't HAVE that , just that because of the specific mechanism of CRPS the secondary symptoms occur AFTER the glia cells become activated, which happens BEFORE the injury ever heals. Always. Period. Always. You don't sprain your ankle and then have CRPS burning pain 5 months later. The condition of CRPS starts during the time the immune system is in overdrive trying to heal the injury. for some reason the glia cells start getting agitated and from that time until you get effective treatment for CRPS pain, you will have severe, burning pain. Any of the other symptoms come months later, not days. Even the allodynia comes later (hypersensitive to the touch, you can't even stand fabric from clothes touching the body part that has allodynia).
Note: the visit to JHACH where the alleged tort happened was in Oct 2016, so this history is from the prior year.
7/4/2015: patient presented with weak legs, severe asthma attack and was taking a specific amount of steroids, flonase, some other (I forget specific) drugs for asthma. Her vital signs are normal, including pulse rate on the low side of normal for a 10 year old
(She never mentions pain at this time, but on the witness stand she is NOW saying this visit involved 10/10 CRPS level pain. But that was not mentioned in the doctor visit notes anywhere, and this had nothing to do with alleged horrible treatment by JHACH)
9/16/2015 - visit to a pulmonary specialist. She is in a wheelchair. The pulmonary specialist makes a note that Maya had been diagnosed with RSD, which is the old name for CRPS. He notes her asthma history and the vital signs are listed on this medical record as normal, including pulse rate on the low side of normal for a 10 year old. She tells him "muscle pain all over my body" when he asks about the RSD pain
(Somehow there is no record of any doctor visit where she left with instructions that she should be wheelchair bound. That is just plain fucking weird. Putting a 10 year old whose body is still growing in a wheelchair is a big freaking deal. It has all kinds of implications for her - how long will she be in the wheelchair, possible atrophy, is she instructed to do exercises for her legs, etc. This appears to be the first diagnosis possibly by the mother since no record of why she's in the wheelchair. Also she had no record of visiting any actual doctor that diagnosed the RSD that was reported to this pulmonary specialist. However, during court when lawyers are arguing about exhibits there was a note by a psychiatrist. He asked Maya how she was originally diagnosed with CRPS. She said "mom did online research and mom and the doctor diagnosed CRPS.)
10/2/2015 Maya visits Dr Kirkpatrick at the CRPS clinic and now (after online research) Maya's mother (not Maya herself) is telling him Maya sprained her ankle, now has "burning" pain, and it's in both arms and legs.
(A couple of things are important to note. The sprain, description of pain as "burning", and location of pain are all new. And are all consistent with what Maya's mother would have seen on various websites while researching CRPS)
How fucked up is that. But, seems the defense might not put on a CRPS expert to explain her history and why 1) she doesn't have it, and 2) it makes perfect sense that removing CRPS treatment and replacing it with more moderate treatment of her individual symptoms made her better, and 3) all of the CRPS doctor's records indicate no real improvement. Although they SAY she got better, nothing in their paperwork indicates she ever got better. For instance her pain was still 10/10 as self reported, she still had dystonia, she still reported 0 quality of life.
But yeah, she was getting better from their treatment. Give me a break.
That child was failed by everyone. Everyone. (Well except that after JHACH removed the excessive drugs and she somehow got better even though she "had CRPS" and was "denied any treatment". )
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
On cross examination of the man who says the family needs $220 million I think I see why the defense may be better off if they just allow the jury to believe Maya has CRPS.
Because - CRPS is a lifetime condition, no cure, she was diagnosed on what would have been the line between ever possibly going into remission and no chance of ever going into remission. (She claims "good days and bad days", which is cagey. She can explain why she is able to have a boyfriend, maintain a GPA to be first in her class, have multiple colleges offering her admiission, etc, etc, because all the great stuff is happening because......GOOD DAY. But then she can whimper on the witness stand and tell everyone 5 out of 7 days are bad, I have PTSD, etc etc.
The defense may feel that because she already had this diagnosis before she entered JHACH that her prognosis was already bad and they may just try to argue that given what her symptoms were when she entered, that CRPS is lifetime, and (they will probably go along with the "good days and bad days" being true in CRPS) becuase it helps them. She was already fucked, so we didn't fuck her worser. I guess.
IMO the defense STILL should have called in a CRPS expert because that would take everything off the table. Her family interfered with any attempt to figure out what was going on. And they were believing in a false diagnosis. Probably because her mother just found descriptions of what CRPS is, i.e. a list of symptoms that are all present at a final date and time and voila, that MUST be what she has.
I tried specifically, to research CRPS to find any mention of how the disease progresses in terms of you can't have dystonia before burning pain, you can't have burning pain 5 months after a totally healed injury, etc etc. I had a seriously hard time finding that, and I was specifically looking for that. So, her mother probably only found what amounts to a description of what CRPS is once you "have it" and what are the possible symptoms. That is pretty much all you will find. You will not find detailed discussion of the onset, how long it takes for this and that to happen, etc. But doctors DO know that information and sounds like the defense is going to fail to put any of that on. Shame.
Maya will become the face of CRPS. Sadly. And everyone will expect all CRPS patient to have many "good days" and be able to be first in their class, and all kinds of stuff that is not true. This will do real CRPS sufferers no good whatsoever. And probably everyone and their brother will start getting this diagnosis.
Because - CRPS is a lifetime condition, no cure, she was diagnosed on what would have been the line between ever possibly going into remission and no chance of ever going into remission. (She claims "good days and bad days", which is cagey. She can explain why she is able to have a boyfriend, maintain a GPA to be first in her class, have multiple colleges offering her admiission, etc, etc, because all the great stuff is happening because......GOOD DAY. But then she can whimper on the witness stand and tell everyone 5 out of 7 days are bad, I have PTSD, etc etc.
The defense may feel that because she already had this diagnosis before she entered JHACH that her prognosis was already bad and they may just try to argue that given what her symptoms were when she entered, that CRPS is lifetime, and (they will probably go along with the "good days and bad days" being true in CRPS) becuase it helps them. She was already fucked, so we didn't fuck her worser. I guess.
IMO the defense STILL should have called in a CRPS expert because that would take everything off the table. Her family interfered with any attempt to figure out what was going on. And they were believing in a false diagnosis. Probably because her mother just found descriptions of what CRPS is, i.e. a list of symptoms that are all present at a final date and time and voila, that MUST be what she has.
I tried specifically, to research CRPS to find any mention of how the disease progresses in terms of you can't have dystonia before burning pain, you can't have burning pain 5 months after a totally healed injury, etc etc. I had a seriously hard time finding that, and I was specifically looking for that. So, her mother probably only found what amounts to a description of what CRPS is once you "have it" and what are the possible symptoms. That is pretty much all you will find. You will not find detailed discussion of the onset, how long it takes for this and that to happen, etc. But doctors DO know that information and sounds like the defense is going to fail to put any of that on. Shame.
Maya will become the face of CRPS. Sadly. And everyone will expect all CRPS patient to have many "good days" and be able to be first in their class, and all kinds of stuff that is not true. This will do real CRPS sufferers no good whatsoever. And probably everyone and their brother will start getting this diagnosis.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Maya's testimony:
Maya bookended the testimony this week. It was the only good week the plaintiffs have had so far. Maya's testimony further sealed my opinion that her family has done her no favors in insisting on a CRPS diagnosis and treatment, and being 10 years old at the time I think she has no real chance of ever understanding anything true about what happened to her. Unfortunately, bad things happen, and I'm pretty sure the hospital is going to come out the bogey man on this.
Maya's Monday testimony:
Maya dutifully gave evidence that would certainly make a person who searches CRPS on the internet, sees a list of symptoms (with no mention whatsoever of the order they come on) and bingo, yep, she displays this condition. But I saw so many of her medical records prior to any mention of the classic symptoms of CRPS, and she did not have severe burning pain in a reasonable time frame from the alleged sprained ankle (which her mother treated, there was no doctor visit) to say that any pain she had after that time really was related to glia cells surrounding the nerves of her ankle became inflamed during the time her immune system was in full force sending red blood cells and other healing "agents" to her sprained ankle. So, we have testimony that came across very believable from a very attractive 17 year old who talked a lot about her faith, going to church, etc.
The defense has one attorney that I am very impressed with. In my IANAL opinion the man wields a sharp scalpel underneath a very measured, quiet, unoffensive volume and tone of voice. He conducted Maya's cross exam and I could see where he got quite a bit the defense will be able to use. Most of what he got out of her went to how great her life appears to be - she has a boyfriend for more than one year, she was first in her class, president of this club and that club, went to the Tribeka film festival (probably related to the Netflix special, but no mention of any of that). His final question caught her off guard and this is where I say he's a wolf in sheep's clothing. She had no freaking clue what all of this admission of so many great things could come back to bite, depending on whether the jury really can set aside emotion and use the facts.
After conferring with his colleagues, Mr Shapiro came back, smiled, and in the friendliest voice ever asked the following question: "Last time we talked (deposition), you mentioned a couple of colleges you were considering. Have you made a decision on which one?" Well, Maya smiled, laughed (so did the jury) and said that her horizons for college had expanded greatly and now she is considering many more options, including possibly going to New York.
Maya's Friday testimony:
This testimony was all about the damage done to Maya and goes to supporting the $220 million they are seeking. I think that's the total for everything, not entirely sure that is only for Maya. There was some of the money discussion that happened when Mom was very agitated and I missed some of it, and it's just too dry for me to truly want to go back and listen to all of it.
But the testimony itself contradicted quite a bit of her testimony on Monday, particularly the things she admitted quite freely and with a big old smile and very proud of on Monday. So, on Friday her life is miserable, she has 5 out of 7 bad days (try to convince me that a 17 year old boy is going to stick around for over a year with someone who is a complete sourpuss 5 out of 7 days of the week. Unless he's truly evil and just crossing his fingers for that big jury payout and going to marry her and live like a king. That seems awfully devious for a 17 year old. They don't tend to think that far ahead). She is entirely putting all the eggs in the basket of "good days and bad days". So that is why she is, at the same time suffering more horribly than any person could ever imagine, but having JUST ENOUGH good days to be having the time of her life. That good day and bad day is going to kill the defense because it's believable to a jury that had no previous deep knowledge of CRPS and apparently isn't going to be provided with the evidence to explain why she doesn't even have it, why good days and bad days certainly fit other diagnosis but not really CRPS, particularly given that her diagnosis came a little more than 3 months after the alleged ankle sprain and "good days/bad days" isn't the same as remission anyway.
(I should mention this: If you ever met me in person I can very easily give the impression that I am doing very well. I'm really good at hiding the CRPS. In fact, It took me years of being a member of this board before I ever even mentioned it. Most people who meet me have no idea. I have worked alongside people for years who never had a clue. I have met two people on this board, much later told one of them about it, and I would bet she had no clue of anything or suspected anything when we met in person. But....people I meet don't see me outside the 8 hours per day that I have no choice but to try to hang on to a job because I am single and have no friends or family that are going to support me should I need it. I don't have a whole lot of choice about keeping it all together for those hours that I am working and I don't have a whole lot else that I would call all that good. I hardly sleep, look at least 15 years older than I am, do not have a social life at all, spend every moment keeping myself busy with hobbies that I engage in completely alone and I do that so that my brain is not able to constantly have an awareness of how my entire left hip and leg feel. And that is what my life is like WITH what actually is considered pretty good treatment. Granted, it's probably worse than someone who gets it today because they won't go as long as I did before a diagnosis, but I've met several other CRPS patients (online group) that were diagnosed within 3 months who have had it for several years and never gone into remission. I don't know of any of them that are living anywhere near as seemingly normal as Maya's life is. None.
Anyone who is interested in the verdict may have to just go onto YouTube, click the Trials button and you will find this trial. I will give a heads up when the case goes to jury. I don't think I could handle seeing this girl get complete jury validation PLUS $220 million. I'm not sure if I could truly explain how that would make me feel, so I won't even try)
Maya bookended the testimony this week. It was the only good week the plaintiffs have had so far. Maya's testimony further sealed my opinion that her family has done her no favors in insisting on a CRPS diagnosis and treatment, and being 10 years old at the time I think she has no real chance of ever understanding anything true about what happened to her. Unfortunately, bad things happen, and I'm pretty sure the hospital is going to come out the bogey man on this.
Maya's Monday testimony:
Maya dutifully gave evidence that would certainly make a person who searches CRPS on the internet, sees a list of symptoms (with no mention whatsoever of the order they come on) and bingo, yep, she displays this condition. But I saw so many of her medical records prior to any mention of the classic symptoms of CRPS, and she did not have severe burning pain in a reasonable time frame from the alleged sprained ankle (which her mother treated, there was no doctor visit) to say that any pain she had after that time really was related to glia cells surrounding the nerves of her ankle became inflamed during the time her immune system was in full force sending red blood cells and other healing "agents" to her sprained ankle. So, we have testimony that came across very believable from a very attractive 17 year old who talked a lot about her faith, going to church, etc.
The defense has one attorney that I am very impressed with. In my IANAL opinion the man wields a sharp scalpel underneath a very measured, quiet, unoffensive volume and tone of voice. He conducted Maya's cross exam and I could see where he got quite a bit the defense will be able to use. Most of what he got out of her went to how great her life appears to be - she has a boyfriend for more than one year, she was first in her class, president of this club and that club, went to the Tribeka film festival (probably related to the Netflix special, but no mention of any of that). His final question caught her off guard and this is where I say he's a wolf in sheep's clothing. She had no freaking clue what all of this admission of so many great things could come back to bite, depending on whether the jury really can set aside emotion and use the facts.
After conferring with his colleagues, Mr Shapiro came back, smiled, and in the friendliest voice ever asked the following question: "Last time we talked (deposition), you mentioned a couple of colleges you were considering. Have you made a decision on which one?" Well, Maya smiled, laughed (so did the jury) and said that her horizons for college had expanded greatly and now she is considering many more options, including possibly going to New York.
Maya's Friday testimony:
This testimony was all about the damage done to Maya and goes to supporting the $220 million they are seeking. I think that's the total for everything, not entirely sure that is only for Maya. There was some of the money discussion that happened when Mom was very agitated and I missed some of it, and it's just too dry for me to truly want to go back and listen to all of it.
But the testimony itself contradicted quite a bit of her testimony on Monday, particularly the things she admitted quite freely and with a big old smile and very proud of on Monday. So, on Friday her life is miserable, she has 5 out of 7 bad days (try to convince me that a 17 year old boy is going to stick around for over a year with someone who is a complete sourpuss 5 out of 7 days of the week. Unless he's truly evil and just crossing his fingers for that big jury payout and going to marry her and live like a king. That seems awfully devious for a 17 year old. They don't tend to think that far ahead). She is entirely putting all the eggs in the basket of "good days and bad days". So that is why she is, at the same time suffering more horribly than any person could ever imagine, but having JUST ENOUGH good days to be having the time of her life. That good day and bad day is going to kill the defense because it's believable to a jury that had no previous deep knowledge of CRPS and apparently isn't going to be provided with the evidence to explain why she doesn't even have it, why good days and bad days certainly fit other diagnosis but not really CRPS, particularly given that her diagnosis came a little more than 3 months after the alleged ankle sprain and "good days/bad days" isn't the same as remission anyway.
(I should mention this: If you ever met me in person I can very easily give the impression that I am doing very well. I'm really good at hiding the CRPS. In fact, It took me years of being a member of this board before I ever even mentioned it. Most people who meet me have no idea. I have worked alongside people for years who never had a clue. I have met two people on this board, much later told one of them about it, and I would bet she had no clue of anything or suspected anything when we met in person. But....people I meet don't see me outside the 8 hours per day that I have no choice but to try to hang on to a job because I am single and have no friends or family that are going to support me should I need it. I don't have a whole lot of choice about keeping it all together for those hours that I am working and I don't have a whole lot else that I would call all that good. I hardly sleep, look at least 15 years older than I am, do not have a social life at all, spend every moment keeping myself busy with hobbies that I engage in completely alone and I do that so that my brain is not able to constantly have an awareness of how my entire left hip and leg feel. And that is what my life is like WITH what actually is considered pretty good treatment. Granted, it's probably worse than someone who gets it today because they won't go as long as I did before a diagnosis, but I've met several other CRPS patients (online group) that were diagnosed within 3 months who have had it for several years and never gone into remission. I don't know of any of them that are living anywhere near as seemingly normal as Maya's life is. None.
Anyone who is interested in the verdict may have to just go onto YouTube, click the Trials button and you will find this trial. I will give a heads up when the case goes to jury. I don't think I could handle seeing this girl get complete jury validation PLUS $220 million. I'm not sure if I could truly explain how that would make me feel, so I won't even try)
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
I think I forgot to mention something that came out last week and I suspect will be part of the defense case. Maya had been given 5 huge ketamine infusions by Dr. Hanna in the 7 days before he referred her to JHACH with severe stomach pains. (Dr Kirkpatrick testified that ketamine is actually a miracle drug for stomach pain such as Maya had. Oops, so why did Dr. Hanna have to refer her to somewhere else when he was infusing her already with huge doses of ketamine on 5 out of the last 7 days?) She entered the hospital with dystonia, lesions, and severe stomach pain. She was on huge doses of steroids for asthma, various other asthma medication, an opioid (unexplained, but dystonia involves muscle pain and Tramadol is good for that type of pain, but not recommended for children ), and other drugs and vitamins. 21 different medications and vitamins were on her list when she entered the hospital.
Due to the behavior of both mother and child, the hospital were actually attempting to facilitate a transfer to get her to Nemours. The family refused to sign the transfer paperwork because the diagnosis codes included one for conversion. Mr. Kowalski was asked by defense attorney if he or his wife ever attempted to speak to anyone at the hospital about changing the diagnosis code so something more to their liking and he admitted that he and his wife had made no attempt to discuss anything about changing the transfer paperwork. Had they signed the paperwork and transferred her, the suspected medical child abuse would have been dropped (unless Nemours also had the same experience with them and suspected the same). But the point is that the Kowalskis could have easily prevented the whole mess of court orders to separate the child from her mother had they not reacted so beyond the pale crazy in the first place, or, if Beata had just settled down to sound more reasonable, even if she didn't feel that way, just to get the damn kid out of JHACH which they claimed to be so bad for their daughter. Even the Netflix special includes a scene that someone recorded the audio where Jack Kowalski was pleading with his wife to quit the shit she was saying and doing at the hospital. He was screaming at her. And all she cared about was herself, she wouldn't even relent when he pointed out to her that if she just fucking pretended like she was sorry they would be able to take Maya out of that hospital and then they could do whatever the hell she wanted to do with Maya's treatment. Who the fuck recorded THAT??!?!?!? And why did anyone in the Kowalski family think it made them look good? It made Beata Kowalski look even more deranged.
I'm going to interject my admittedly unprofessional and just plain layperson opinion here. I believe that making medical decisions that are not in the best interest of your child puts you on a spectrum that on one end cand be seen as purely benign in terms of intent and on the other pure evil intent. The pure evil being the example of the parent that feeds their child poison in order to meet their psychological need for the attention and sympathy that come with having a child that has a serious, almost unable to diagnose, condition. That is flat out Munchausen by proxy.
On the other end could be a nurse whose daughter has a constellation of symptoms that all occurred over a long period of time, she does research, she honestly believes that she is right, she goes ahead and tells one doctor that there is already this diagnosis, then takes the daughter to the specialist and gives him the exact description she found in the online article and she truly does believe that she is right.
Both of these are medical abuse of a child. And I would bet any amount of money that there is no special diagnosis code the hospital has available to them for the benign version of that situation. So, they are stuck with what probably is the only "medical abuse" code that they can possibly put on the sheet. But I would also bet that a receiving hospital seeing this code along with others would probably not automatically assume the evil end of that spectrum and would do their own assessment.
Other things that came out this week:
Maya, her father, and her brother did get some psychiatric treatment, enough only to support that they are "suffering", but not enough to be therapeutic in any way. It would probably hurt their case if they did that.
In spite of maintaining their belief in her diagnosis and in spite of the original court releasing the family from any restrictions, Maya has not returned to any form of treatment for CRPS. She claims to be terrified of doctors and will probably never get over it and never be able to get treatment again. I guess that applies to the ones who never got a true history of the onset of symptoms, believed everything her mother told them, and gave her the drugs she and her mother were demanding while in the hospital. Go figure. Of course, they want the money that was calculated that her supposed treatment would require. And of course, the treatment she will require goes far beyond what she ever had or what she is currently getting (none) but still doing well enough to have the life she described for the jury when caught off guard by the seemingly friendly questioning by Mr. Hunter Shapiro.
A social worker named Cathi Bedy and a Child Protective Services doctor, Dr Sally Smith have become the face of the evil JHACH in the plaintiff case. Neither are employed by the hospital, they are both connected with CPS. Testimony from the guardian ad litem revealed that Cathi Bedy was interfering in phone calls between Maya and her mother, monitoring them even during times the court removed any permission to monitor the phone calls. She's the social worker with whom the family has already settled.
At some point there was concern that some of Maya's symptoms may be self inflicted. I have seen photos and video from the hospital that suggest that her dystonia and lesions began getting better at the hospital. Photos show her lower legs that appear relaxed, and also show her feet in what would be a normal position for how she's crossing her legs. That would definitely make the hospital suspect that Maya is faking it when she all the sudden has her feet turned in when in the wheelchair when they weren't turned in earlier.
I think the explanation lies elsewhere. Maya was on significant amounts of the type of medications that are known to have the possible side effect of dystonia. But she is convinced that it's part of her CRPS diagnosis. The hospital weaned her off all the drugs she was on and replaced her asthma and allergy medications with more moderate medications normally prescribed for asthma. It makes me wonder if removing the drugs that can cause dystonia might be the reason there are times in the hospital when not only hospital employees, but photos indicate the severe muscle spasm in her lower legs was relaxing. But she's also a 10 year old convinced that the only thing that would help her at all is ketamine, she's not getting ketamine, so whenever she's in her wheelchair she is, maybe even unconsciously, turning her feet inward even though her lower leg muscles appear to have relaxed. That's not necessarily "faking" it, but I also know that most people tend to see things as black and white and there is no in between. I highly suspect there is in between going on here in more than one aspect.
Due to the behavior of both mother and child, the hospital were actually attempting to facilitate a transfer to get her to Nemours. The family refused to sign the transfer paperwork because the diagnosis codes included one for conversion. Mr. Kowalski was asked by defense attorney if he or his wife ever attempted to speak to anyone at the hospital about changing the diagnosis code so something more to their liking and he admitted that he and his wife had made no attempt to discuss anything about changing the transfer paperwork. Had they signed the paperwork and transferred her, the suspected medical child abuse would have been dropped (unless Nemours also had the same experience with them and suspected the same). But the point is that the Kowalskis could have easily prevented the whole mess of court orders to separate the child from her mother had they not reacted so beyond the pale crazy in the first place, or, if Beata had just settled down to sound more reasonable, even if she didn't feel that way, just to get the damn kid out of JHACH which they claimed to be so bad for their daughter. Even the Netflix special includes a scene that someone recorded the audio where Jack Kowalski was pleading with his wife to quit the shit she was saying and doing at the hospital. He was screaming at her. And all she cared about was herself, she wouldn't even relent when he pointed out to her that if she just fucking pretended like she was sorry they would be able to take Maya out of that hospital and then they could do whatever the hell she wanted to do with Maya's treatment. Who the fuck recorded THAT??!?!?!? And why did anyone in the Kowalski family think it made them look good? It made Beata Kowalski look even more deranged.
I'm going to interject my admittedly unprofessional and just plain layperson opinion here. I believe that making medical decisions that are not in the best interest of your child puts you on a spectrum that on one end cand be seen as purely benign in terms of intent and on the other pure evil intent. The pure evil being the example of the parent that feeds their child poison in order to meet their psychological need for the attention and sympathy that come with having a child that has a serious, almost unable to diagnose, condition. That is flat out Munchausen by proxy.
On the other end could be a nurse whose daughter has a constellation of symptoms that all occurred over a long period of time, she does research, she honestly believes that she is right, she goes ahead and tells one doctor that there is already this diagnosis, then takes the daughter to the specialist and gives him the exact description she found in the online article and she truly does believe that she is right.
Both of these are medical abuse of a child. And I would bet any amount of money that there is no special diagnosis code the hospital has available to them for the benign version of that situation. So, they are stuck with what probably is the only "medical abuse" code that they can possibly put on the sheet. But I would also bet that a receiving hospital seeing this code along with others would probably not automatically assume the evil end of that spectrum and would do their own assessment.
Other things that came out this week:
Maya, her father, and her brother did get some psychiatric treatment, enough only to support that they are "suffering", but not enough to be therapeutic in any way. It would probably hurt their case if they did that.
In spite of maintaining their belief in her diagnosis and in spite of the original court releasing the family from any restrictions, Maya has not returned to any form of treatment for CRPS. She claims to be terrified of doctors and will probably never get over it and never be able to get treatment again. I guess that applies to the ones who never got a true history of the onset of symptoms, believed everything her mother told them, and gave her the drugs she and her mother were demanding while in the hospital. Go figure. Of course, they want the money that was calculated that her supposed treatment would require. And of course, the treatment she will require goes far beyond what she ever had or what she is currently getting (none) but still doing well enough to have the life she described for the jury when caught off guard by the seemingly friendly questioning by Mr. Hunter Shapiro.
A social worker named Cathi Bedy and a Child Protective Services doctor, Dr Sally Smith have become the face of the evil JHACH in the plaintiff case. Neither are employed by the hospital, they are both connected with CPS. Testimony from the guardian ad litem revealed that Cathi Bedy was interfering in phone calls between Maya and her mother, monitoring them even during times the court removed any permission to monitor the phone calls. She's the social worker with whom the family has already settled.
At some point there was concern that some of Maya's symptoms may be self inflicted. I have seen photos and video from the hospital that suggest that her dystonia and lesions began getting better at the hospital. Photos show her lower legs that appear relaxed, and also show her feet in what would be a normal position for how she's crossing her legs. That would definitely make the hospital suspect that Maya is faking it when she all the sudden has her feet turned in when in the wheelchair when they weren't turned in earlier.
I think the explanation lies elsewhere. Maya was on significant amounts of the type of medications that are known to have the possible side effect of dystonia. But she is convinced that it's part of her CRPS diagnosis. The hospital weaned her off all the drugs she was on and replaced her asthma and allergy medications with more moderate medications normally prescribed for asthma. It makes me wonder if removing the drugs that can cause dystonia might be the reason there are times in the hospital when not only hospital employees, but photos indicate the severe muscle spasm in her lower legs was relaxing. But she's also a 10 year old convinced that the only thing that would help her at all is ketamine, she's not getting ketamine, so whenever she's in her wheelchair she is, maybe even unconsciously, turning her feet inward even though her lower leg muscles appear to have relaxed. That's not necessarily "faking" it, but I also know that most people tend to see things as black and white and there is no in between. I highly suspect there is in between going on here in more than one aspect.
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Taking Care of Maya - FL CPS/Munchausen case
Thanks for taking the time to post all of this - I'm finding it all quite fascinating!
Taking Care of Maya - FL CPS/Munchausen case
I'm glad it's helpful. I am curious to see if what I think I'm seeing of the defense strategy is really what they are going to do. It could be effective, I wouldn't say it's a dumb strategy by any means. My only concern is Maya is good at explaining away anything that doesn't make sense as "good day".
Off Topic
I was just perusing your thread that you set up which I never saw before. I depend on looking at "active topics" to see if there is something new I never saw before and happened to see it a little while ago. When I look at the Index, holy cow, there are so many threads I've never read. I'm only up to page 1 of your thread!! I may "see" you there in a bit, and in case I respond to something from a long time ago the reason why is it's all new to me.
![Laughing :lol:](./images/smilies/icon_lol.gif)
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Taking Care of Maya - FL CPS/Munchausen case
RVInit wrote: ↑Sat Oct 14, 2023 5:17 pmOff TopicI was just perusing your thread that you set up which I never saw before. I depend on looking at "active topics" to see if there is something new I never saw before and happened to see it a little while ago. When I look at the Index, holy cow, there are so many threads I've never read. I'm only up to page 1 of your thread!! I may "see" you there in a bit, and in case I respond to something from a long time ago the reason why is it's all new to me.![]()
Off Topic
Thanks for taking time to look at it! ![Very Happy :D](./images/smilies/icon_e_biggrin.gif)
![Very Happy :D](./images/smilies/icon_e_biggrin.gif)
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Taking Care of Maya - FL CPS/Munchausen case
Have you considered working with 'Unread Posts'?
[/offtopic]
Be assured that a walk through the ocean of most souls Would scarcely get your feet wet
Taking Care of Maya - FL CPS/Munchausen case
keith wrote: ↑Sun Oct 15, 2023 3:04 amHave you considered working with 'Unread Posts'?
[/offtopic]Off TopicOh, lordy. 40 pages of unread topics come up when I click Unread Posts. That's probably a good idea, I could skim through them all and see which topics I might be interested in, I would be less likely to miss something that might interest me. There have been times I've noticed a topic that I wished I'd seen sooner. I tend to binge and then I'm gone for a few days. So, an "active topic" can disappear before I notice it. Thanks for the reminder about Unread Posts, good idea.
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Taking Care of Maya - FL CPS/Munchausen case
Off Topic
There have been posts in the past which in effect grumbled at the number of active topics or about missing things, which all seemed to me to be resolvable by the use of "Unread Posts", which is the only think I use unless I wish to find a specific topic.
The "Mark all read" button, just above the table is also your good friend.
Look at the topics that interested you, refresh the table, check there's no more topics or recent posts that interests you, then click "Mark all read" and everything goes.
If topics are reasonably active, but no-one has posted since your last visit, you don't need to check the topic and feel disappointed.
And the little icon button at the left in "Unread Posts" takes you to the first unread (by you) post in the topic, you don't have to scroll to find it.
The "Mark all read" button, just above the table is also your good friend.
Look at the topics that interested you, refresh the table, check there's no more topics or recent posts that interests you, then click "Mark all read" and everything goes.
If topics are reasonably active, but no-one has posted since your last visit, you don't need to check the topic and feel disappointed.
And the little icon button at the left in "Unread Posts" takes you to the first unread (by you) post in the topic, you don't have to scroll to find it.
Taking Care of Maya - FL CPS/Munchausen case
Edit: The defense has a good team of attorneys. Mr Hunter is kind of a "bulldog", an older gentleman, seems to be handling most of the medical witnesses so far. Mr. Shapiro is an artist. Quiet voice, respectful on cross exam but underneath that respect he's wielding a scalpel. I would hate to be crossed by him.
There is another younger attorney that is also quite good, I think his name is Mr. Hughes. Ms. Crowells (sp?) is another one on the team. She seems to be handling a lot of "this and that" arguing for exhibit entry, and also she's handled a few witnesses. All in all, I think the hospital has good representation. The plaintiff team actually seem more like what I think of as a defense team on a criminal trial. They are loud, argue with defense witnesses, there is nothing particularly artful or impressive about them. I suppose they are competent, but doubt I would seek out either of them to ever represent me, not that I've ever hired an attorney so far, but just saying.
![Laughing :lol:](./images/smilies/icon_lol.gif)
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
The Kowalski family is suing Johns Hopkins All Children's Hospital for false imprisonment, negligent infliction of emotional distress, medical negligence, battery, and other claims more than a year after the family matriarch, Beata Kowalski, took her life following allegations she was abusing her daughter, Maya Kowalski.
The false imprisonment is for the handful of days during which the hospital was attempting to facilitate a transfer to Nemours, which the family wanted to do because JHACH was refusing to give Maya huge infusions of ketamine. The family refused to sign the transfer paperwork because they did not agree with the diagnosis codes on the bottom of the paperwork and they insist had they signed it that Beata would have been admitting to child abuse.
negligent infliction of emotional distress - I think that is related to the Kowalski claims that Maya was miserable the whole time she was in that hospital. Also Maya claims that a doctor "was laughing at me". She described that when a doctor was in the room doing an examination she told him all about the proper treatment for her condition. I wish I could remember her exact words because I almost spit my drink out as she said it. Considering that I almost spit my drink out, I suspect that the doctor didn't so much as "laugh AT Maya" but probably had a spontaneous chuckle. She was ten years old. Telling the doctor that basically he had no idea what he was doing but she was going to tell him what she needed and when. Listening to her admit how she talked to the doctor while she's on the witness stand is just one of many incidents that give the impression she's a spoiled brat, little princess. There has already been some stuff come out that her behavior was pretty much as bad as her mother's. Which again, even her own husband screamed at her about begging her to stop it. (at home, not in the hospital. If you want to see this, watch the Netflix special, it was a doozy)
Medical negligence - The hospital weaned her off 21 various and sundry medications and she left the hospital with only 2 medications. All evidence shows she started getting better while still in the hospital. The court order she was under did not allow her to return to the ketamine and all the other over the top medications. She continued to get better to the point where, for the first time in a more than two school years she returned to school, using crutches, but no wheelchair. She was required to participate in physical therapy. There is no freaking way the family should win on this one. Except for the hospital strategy to not get an expert for the CRPS allows Maya to claim that all the obvious symptoms went away but she still had pain, good days and bad days are her fallback to explain how she excelled in school, participated in extracurricular activities, president of several different clubs, boyfriend, movies, the while bit.
Battery - The family made a powerful claim on this one, but the defense hasn't had their turn yet, so have no idea. But of all the claims so far this one the family did make a very good case for. Someone at the hospital decided they needed to get before and after photos because they saw evidence that the dystonia and lesions were going away, but that Maya had started scratching herself in order to show that she was still having lesions due to not getting her desired treatment. So, on a day when she was going to be brought to court, they wanted before and after photos. So, they made her strip down to bra and her normal shorts, which were little more than briefs that she walked around in anyway and they took photos. I guess she wouldn't consent. The hospital says she did finally relent. There is a photo that shows someone holding her hands, but in the photo it looks like Maya is fully participating in the hand holding, it's not just Maya's hand limp and the adult holding her. Maya is squeezing the person's hands with both hands, she's fully engaged. She claims she was further molested in the other photos, but you just can't see it because the photos are close up and the people "holding me down" are out of the photo. The first photo shows her whole body and nobody is "holding her down". But you can see part of her mouth and she does look distressed if you look at that. So, they may have chocked up a win on this one.
The false imprisonment is for the handful of days during which the hospital was attempting to facilitate a transfer to Nemours, which the family wanted to do because JHACH was refusing to give Maya huge infusions of ketamine. The family refused to sign the transfer paperwork because they did not agree with the diagnosis codes on the bottom of the paperwork and they insist had they signed it that Beata would have been admitting to child abuse.
negligent infliction of emotional distress - I think that is related to the Kowalski claims that Maya was miserable the whole time she was in that hospital. Also Maya claims that a doctor "was laughing at me". She described that when a doctor was in the room doing an examination she told him all about the proper treatment for her condition. I wish I could remember her exact words because I almost spit my drink out as she said it. Considering that I almost spit my drink out, I suspect that the doctor didn't so much as "laugh AT Maya" but probably had a spontaneous chuckle. She was ten years old. Telling the doctor that basically he had no idea what he was doing but she was going to tell him what she needed and when. Listening to her admit how she talked to the doctor while she's on the witness stand is just one of many incidents that give the impression she's a spoiled brat, little princess. There has already been some stuff come out that her behavior was pretty much as bad as her mother's. Which again, even her own husband screamed at her about begging her to stop it. (at home, not in the hospital. If you want to see this, watch the Netflix special, it was a doozy)
Medical negligence - The hospital weaned her off 21 various and sundry medications and she left the hospital with only 2 medications. All evidence shows she started getting better while still in the hospital. The court order she was under did not allow her to return to the ketamine and all the other over the top medications. She continued to get better to the point where, for the first time in a more than two school years she returned to school, using crutches, but no wheelchair. She was required to participate in physical therapy. There is no freaking way the family should win on this one. Except for the hospital strategy to not get an expert for the CRPS allows Maya to claim that all the obvious symptoms went away but she still had pain, good days and bad days are her fallback to explain how she excelled in school, participated in extracurricular activities, president of several different clubs, boyfriend, movies, the while bit.
Battery - The family made a powerful claim on this one, but the defense hasn't had their turn yet, so have no idea. But of all the claims so far this one the family did make a very good case for. Someone at the hospital decided they needed to get before and after photos because they saw evidence that the dystonia and lesions were going away, but that Maya had started scratching herself in order to show that she was still having lesions due to not getting her desired treatment. So, on a day when she was going to be brought to court, they wanted before and after photos. So, they made her strip down to bra and her normal shorts, which were little more than briefs that she walked around in anyway and they took photos. I guess she wouldn't consent. The hospital says she did finally relent. There is a photo that shows someone holding her hands, but in the photo it looks like Maya is fully participating in the hand holding, it's not just Maya's hand limp and the adult holding her. Maya is squeezing the person's hands with both hands, she's fully engaged. She claims she was further molested in the other photos, but you just can't see it because the photos are close up and the people "holding me down" are out of the photo. The first photo shows her whole body and nobody is "holding her down". But you can see part of her mouth and she does look distressed if you look at that. So, they may have chocked up a win on this one.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
There was huge argument prior to the testimony of the first witness and judge limited it to just anything that could go to intentional infliction of emotional pain. He also reminded the jury that he will be giving them instructions as to dates. The dates are going to become really important to all the claims of the family. For instance, once the family refused to sign paperwork for the transfer that caused all the hearings regarding child abuse to move forward and the hospital no longer had any way control over whether Maya could leave the hospital, so the false imprisonment can only be considered during a short time period after she entered the hospital and the various hearings, dependency, etc, started in the court system.
First witness was a psychiatrist that looked at all the evidence and decided that Beata's suicide was a result of spontaneous altruistic surrender. Basically Beata felt so out of control, no longer had any control over the situation and finally decided the only way to get Maya "safe" was for her to commit suicide. The psychiatrist did everything he could to avoid saying safe "at home" because during cross exam he figured out that if he said "at home" that was somehow going to be good for the defense. So, he was refusing to admit that the purpose was to get Maya out of the hospital. The suicide note that Beata left indicated pretty clearly that she was intending the effect of the suicide would be to "get Maya home" and this doctor did not want to say anything to give two pieces of evidence that it was to get Maya "home". Primarily because if that is the case, then it's hard to attribute the suicide to the hospital for fault as they were not the ones in control of whether Maya got to come home.
They jury didn't hear the following, but I wonder if they ever will, I think the judge is not going to allow much of anything related to the dependency hearing. He made a small exception based on what the psychiatrist was going to say. He allowed Mr Shapiro to ask a leading question having to do with the day before Beata's suicide, she asked the judge (not this judge of course) if she could hug her daughter. That judge denied her request.
Also, in argument it came out that it was the Kowolskis themselves who slowed how and asked for a delay for the final hearing that would have had a good chance that Maya would have been able to come home. Throughout this whole thing I am stunned at the poor choices the parents made. Not saying poor to the point of child abuse, although technically not in the best interest of the child or themselves. She may have been a crack nurse, but she had piss poor judgement throughout Maya's symptoms, her behavior at the hospital, and after things got out of control with DCF/courts.
What else came out during cross exam is that the psychiatrist personally knew the plaintiff attorney. They had tried to make it like they accidentally bumped into each other and he was hired for one case, then for many other cases, but each one he didn't want to know what side the attorney was on. Turns out that were fraternity brothers in college and also for five years of intensive amount of time on the case he's charging $11,000 and admitting that he's doing a serious amount of pro bono. He explained that by saying he had a "particular interest in this case". Also slipped in earlier during his resume that he briefly worked in what would probably have been a low paying job by saying " I think health care should be free", but then the majority of his work life has been at very prestigious and well paying work. There are cracks in his credibility.
But two jurors asked questions that indicated they probably bought into his testimony, can't remember exactly what they were. One of them asked a question exactly like a lawyer would ask it, I got a kick out of that, but given what the question was....not good for the defense.
First witness was a psychiatrist that looked at all the evidence and decided that Beata's suicide was a result of spontaneous altruistic surrender. Basically Beata felt so out of control, no longer had any control over the situation and finally decided the only way to get Maya "safe" was for her to commit suicide. The psychiatrist did everything he could to avoid saying safe "at home" because during cross exam he figured out that if he said "at home" that was somehow going to be good for the defense. So, he was refusing to admit that the purpose was to get Maya out of the hospital. The suicide note that Beata left indicated pretty clearly that she was intending the effect of the suicide would be to "get Maya home" and this doctor did not want to say anything to give two pieces of evidence that it was to get Maya "home". Primarily because if that is the case, then it's hard to attribute the suicide to the hospital for fault as they were not the ones in control of whether Maya got to come home.
They jury didn't hear the following, but I wonder if they ever will, I think the judge is not going to allow much of anything related to the dependency hearing. He made a small exception based on what the psychiatrist was going to say. He allowed Mr Shapiro to ask a leading question having to do with the day before Beata's suicide, she asked the judge (not this judge of course) if she could hug her daughter. That judge denied her request.
Also, in argument it came out that it was the Kowolskis themselves who slowed how and asked for a delay for the final hearing that would have had a good chance that Maya would have been able to come home. Throughout this whole thing I am stunned at the poor choices the parents made. Not saying poor to the point of child abuse, although technically not in the best interest of the child or themselves. She may have been a crack nurse, but she had piss poor judgement throughout Maya's symptoms, her behavior at the hospital, and after things got out of control with DCF/courts.
What else came out during cross exam is that the psychiatrist personally knew the plaintiff attorney. They had tried to make it like they accidentally bumped into each other and he was hired for one case, then for many other cases, but each one he didn't want to know what side the attorney was on. Turns out that were fraternity brothers in college and also for five years of intensive amount of time on the case he's charging $11,000 and admitting that he's doing a serious amount of pro bono. He explained that by saying he had a "particular interest in this case". Also slipped in earlier during his resume that he briefly worked in what would probably have been a low paying job by saying " I think health care should be free", but then the majority of his work life has been at very prestigious and well paying work. There are cracks in his credibility.
But two jurors asked questions that indicated they probably bought into his testimony, can't remember exactly what they were. One of them asked a question exactly like a lawyer would ask it, I got a kick out of that, but given what the question was....not good for the defense.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Defemse case:
They are playing a deposition by Dr James Lewis, psychologist
It sounds like a plaintiff lawyer asking the question, but this is being put on by the defense. Generally, his testimony is helpful to the defense. He was not given any medical records and was not aware of any psycological records of Maya or Beata.
He came to administar some testing and wanted to know if any medications that could affect the testing had been given. She had not been given her Tramadol that morning.
He never spoke to Dr Smith (she is being made the bad guy, along with Cathi Bedi, who probably was a bit of a bad guy). He lives 10 minutes from the hospital, he took some notes, but went straight home and dictated his notes. He had moved from up north, not familiar with hurricanes, he had his file cabinets in his garage. He maintained his handwritten notes up until hurricane Irma flodding ruined everything in the bottom two drawers of his file cabinets.
His testing was verbal, he took down her answers, scored them and made his computerized report immediately.
The main thrust of his testimony is that there was significant psychological issues with Maya, one thing she volunteered is that her mother, Beata, was abused by Beata's father in Poland. She was very disturbed by that and had tried to ask her father about it, and neither of her parents would talk about it.
(Maybe this is a good place to say that week before last Maya proferred some testimony that some unknown male at JHACH had come into her room, pulled her pants down, looked at her private parts and left. The judge did not allow this into the trial because She just told this to her lawyers recently. He told her to contact the police, and she could certainly file a different lawsuit against JCACH but it was not going to come in here)
So, the psychologist was asked a lot about Munchousen by proxy by the plaintiff lawyer. He explained that it takes a team, and in his opinion, a doctor, to diagnose it.
Maya told him that she believed her mother had lots of psychological distress.
He talks at length about something that I have toughed on in some of my commentary. He says any chronic pain diagnosis always recommeneds psychological counseling to help with the pcyhological effects of having severe chronic pain. On the other hand, and I can attst to this - Before a doctor is going to treat anyone, especially a child, with extremely invasive treatments, such as ketamine, opioids, benzodiazapenes, the treating physician should either themselves conduct a full psychological workup, or, they should refer the patiet for such evaluation because there could be an underlying psychological element that is either causing or contributing to their pain. And in particular, such as Maya's case, when these drastic treatments were being given and she kept having to go back for more and more and more, there "would have been" additional psychological evaluation done in order to determine if something hadn't been missed.
The evidence in front of the jury shows that Dr Kirkpatrick and Dr Hanna just took the mother's word for everything and immediately recommended the most drastic treatment possible including recommending her to go to Mexico for a ketamine coma. (He just happened to be involved in a study on the ketamine coma,but said that Maya was outside that study) Kirkpatrick and Hanna never considered anything else. The mother came in with a textbook description of CRPS (obtained from a website) and they said OK, let's start ketamine. Maybe should mention they charge a shit ton of money for these treatments, insurance doesn't pay for it, Maya's family had GoFundMe to help pay for all this stuff.
The plaintiff attorney then asked if JHACH did full psych workup and he keeps saying it's the one who is treating her with invasive forms of pain treatment.
He says Munchausen by proxy is a medical diagnosis and in this case it was a "working diagnosis" by the doctors in her case. he says he saw the same factors in Maya/Beata that he has seen in every case that he was involved on a team where doctors concluded Munchausen by proxy.
He also points out that he was not the first person that came to the conclusion, or suspected, that Maya's pain was either caused or exaggerated by existing psychological conditions.
He made recommendations that Beata be fully evaluated by a psychologist/psychiatrist.
There is evidence that they found Zanaz and other drugs prescribed for Beata in early October and she took 0 of one of them and 1 or 2 of the other. They were prescribed to be taken every day.
He says ketamine is a cousin of PCP. He had only seen rare patients being treated with ketamine for CRPS and all were adults.
I will continue his testimony on a separate post, after I finish listening to it. To be continued...
They are playing a deposition by Dr James Lewis, psychologist
It sounds like a plaintiff lawyer asking the question, but this is being put on by the defense. Generally, his testimony is helpful to the defense. He was not given any medical records and was not aware of any psycological records of Maya or Beata.
He came to administar some testing and wanted to know if any medications that could affect the testing had been given. She had not been given her Tramadol that morning.
He never spoke to Dr Smith (she is being made the bad guy, along with Cathi Bedi, who probably was a bit of a bad guy). He lives 10 minutes from the hospital, he took some notes, but went straight home and dictated his notes. He had moved from up north, not familiar with hurricanes, he had his file cabinets in his garage. He maintained his handwritten notes up until hurricane Irma flodding ruined everything in the bottom two drawers of his file cabinets.
His testing was verbal, he took down her answers, scored them and made his computerized report immediately.
The main thrust of his testimony is that there was significant psychological issues with Maya, one thing she volunteered is that her mother, Beata, was abused by Beata's father in Poland. She was very disturbed by that and had tried to ask her father about it, and neither of her parents would talk about it.
(Maybe this is a good place to say that week before last Maya proferred some testimony that some unknown male at JHACH had come into her room, pulled her pants down, looked at her private parts and left. The judge did not allow this into the trial because She just told this to her lawyers recently. He told her to contact the police, and she could certainly file a different lawsuit against JCACH but it was not going to come in here)
So, the psychologist was asked a lot about Munchousen by proxy by the plaintiff lawyer. He explained that it takes a team, and in his opinion, a doctor, to diagnose it.
Maya told him that she believed her mother had lots of psychological distress.
He talks at length about something that I have toughed on in some of my commentary. He says any chronic pain diagnosis always recommeneds psychological counseling to help with the pcyhological effects of having severe chronic pain. On the other hand, and I can attst to this - Before a doctor is going to treat anyone, especially a child, with extremely invasive treatments, such as ketamine, opioids, benzodiazapenes, the treating physician should either themselves conduct a full psychological workup, or, they should refer the patiet for such evaluation because there could be an underlying psychological element that is either causing or contributing to their pain. And in particular, such as Maya's case, when these drastic treatments were being given and she kept having to go back for more and more and more, there "would have been" additional psychological evaluation done in order to determine if something hadn't been missed.
The evidence in front of the jury shows that Dr Kirkpatrick and Dr Hanna just took the mother's word for everything and immediately recommended the most drastic treatment possible including recommending her to go to Mexico for a ketamine coma. (He just happened to be involved in a study on the ketamine coma,but said that Maya was outside that study) Kirkpatrick and Hanna never considered anything else. The mother came in with a textbook description of CRPS (obtained from a website) and they said OK, let's start ketamine. Maybe should mention they charge a shit ton of money for these treatments, insurance doesn't pay for it, Maya's family had GoFundMe to help pay for all this stuff.
The plaintiff attorney then asked if JHACH did full psych workup and he keeps saying it's the one who is treating her with invasive forms of pain treatment.
He says Munchausen by proxy is a medical diagnosis and in this case it was a "working diagnosis" by the doctors in her case. he says he saw the same factors in Maya/Beata that he has seen in every case that he was involved on a team where doctors concluded Munchausen by proxy.
He also points out that he was not the first person that came to the conclusion, or suspected, that Maya's pain was either caused or exaggerated by existing psychological conditions.
He made recommendations that Beata be fully evaluated by a psychologist/psychiatrist.
There is evidence that they found Zanaz and other drugs prescribed for Beata in early October and she took 0 of one of them and 1 or 2 of the other. They were prescribed to be taken every day.
He says ketamine is a cousin of PCP. He had only seen rare patients being treated with ketamine for CRPS and all were adults.
I will continue his testimony on a separate post, after I finish listening to it. To be continued...
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Dr Lewis' report mentions that the parents were able to get at least one hospital to treat Maya with morphine. his report talks about how these drugs affect a child, they contribute to neruodevelopmental difficulties and why less invasive type drugs should be used with a child.
He talks about a specific incident where the school denied the request for Maya to be Homeschool Homeebound. It infuriated the mother and the mother talked about how furious she was with Maya. And that got Maya upset and furious as well. This is an example of "unwitting" Munchausen by prozy. And he explains that the treating doctor would have** told the mother that when you have a child with suspected chronic pain, try not to show your own anger emotions in front of her, don't tell her how angry you are ans cause her to be angry, that kind of thing. Have discussions with your husband outside of Maya's presence and then if Maya needs to be told something, (she's 10 years old) use judgement about how you tell her things. Lewis says he does not know if the treating doctor did this or not. He doesn't know if he instructed Maya's mother to be careful not to make her condition worse. He says the records show that Beata said that Maya's last flare-up occurred after this instance of Beata discussing the denial of Homebound Homeschool.***
** Assumes facts not in evidence, i.e. ethical, non-quack doctor (IMO)
(My commentary here is that I have seen lots of tidbits of evidence that show Beata treated Maya like she was an adult, talking to her about things that a parent would not normally confide in a 10 year old child. It makes me wonder how did Maya, age 10, find out that her mother was abused by Maya's grandfather in Poland. Who the heck tells that to a 10 year old)
*** a letter from Dr Hanna was displayed on screen during some testimony last week. I stopped the feed so I could read the entire thing. Keep in mind, this is a letter written by a treating physician, medical doctor treating Maya. Every other paragraph was closed with a (!). Here is an example: "Maya has severe pain! We saw her last week and gave her a huge ketamine infusion. In spite of that, she is now once again in severe pain!! She can't go back to school. This would harm her further!"
I am not making this up. The letter was a full page with at least 15 or more sentences ending with an exlamation point. It was typed. I have no idea who typed it, but he had signed the bottom of the letter.
Dr Lewis did a complete clinical and trauma interview of Maya of exactly what was making her sad, anxious, depressed, concerned, and diestressed. Accoring to Maya everything that was making her have all these feelings was her knowledge of her mother's emotional distress. She never mentioned anything about herself as bothering her, it was all her reacting to her mother's constant psychological complaints. She was worried about hermother. She was depressed because her mother was depressed. She talked about overhearing the doctor in Mexico telling her mother that Maya had a 50/50 chance of dying from the ketamine coma. It wasn't that Maya was reacting all by herself about the homeschooling denial. Maya herself said that her mother was upset about it and that made Maya upset.
Mom should have told her in a different way. Maya was locked into her mother's emotions. The mother could have given her the information in a more calm way, not showing how angry she was about it. Maya's treating doctor should have talked to the family about how to keep from shwoing extreme emotion around Maya or getting her upsset.
His report mentions that in the three hours that he spent with Maya, not once did she ever spontaneously mention that she was feeling any pain.
(This is significant to me because supposedly she has CRPS, supposedly in a flare-up. With a flare-up you do not have one second of one minute of one hour of one day of no pain. You aren't going to sit still for 3 hours with a doctor talking about emotional things and not at least mention that my arms and legs feel like they are on fire. )
Dr Lewis told her at the very beginning to immediately tell him if she at any time felt any pain. She never did.
Her testing revealed interesting things. Above average intelligence in general. A relative deficit in processing speed.
She indicated that she could tell she had issues with memory. All those drugs she was taking have different half lives, so depending on how much over what time period, there are lingering affects of them. Some of her lower scores could be because of these drugs, especially given that she tested as intelligent, but had puzzling low scores in specific areas compared to her OWN intelligence scores. Such as the processing speed.
Maya described her mother's distress, hearing that she had a 50/50 chance of dying, how much money her parents were spending on her treatments - all these things were highly distressing to her. She said "I heard HIM (doctor in Mexico) had to sign papers because the infusions had a 50% chance of killing her.
At the time of the testing she had been separated from her mother for at most 4 days. The plaintiff attorney is trying to get him to say that could cause Maya's emotional distress. Dr Lewis has been clear about Maya's distress being tied directly to her perception of her mother's distress, the money her parents are spending on her treatments, the chance of dying from ketamine coma. She never once mentioned "I miss my mommy". And a 4 day separation doesn't cause the kind of issues Maya is having in the hospital at this point.
At no time did Maya even ask "when can I see my mom". She never mentioned a single thing about her separation from her mother.
He found Maya to be depressed. He thought someone who was not directly going to make any money from Maya's treatment should do a complete evaluation of Maya's medical condition. Dr Kirkpatrick charged $10K each for ketamine treatment at that time. Dr Hanna charged less, but still quite a bit.
He never talked about his evaluation with anyone from JHACH or Dr Smith. It was for court.
Jury gets to go home for the day.
He talks about a specific incident where the school denied the request for Maya to be Homeschool Homeebound. It infuriated the mother and the mother talked about how furious she was with Maya. And that got Maya upset and furious as well. This is an example of "unwitting" Munchausen by prozy. And he explains that the treating doctor would have** told the mother that when you have a child with suspected chronic pain, try not to show your own anger emotions in front of her, don't tell her how angry you are ans cause her to be angry, that kind of thing. Have discussions with your husband outside of Maya's presence and then if Maya needs to be told something, (she's 10 years old) use judgement about how you tell her things. Lewis says he does not know if the treating doctor did this or not. He doesn't know if he instructed Maya's mother to be careful not to make her condition worse. He says the records show that Beata said that Maya's last flare-up occurred after this instance of Beata discussing the denial of Homebound Homeschool.***
** Assumes facts not in evidence, i.e. ethical, non-quack doctor (IMO)
(My commentary here is that I have seen lots of tidbits of evidence that show Beata treated Maya like she was an adult, talking to her about things that a parent would not normally confide in a 10 year old child. It makes me wonder how did Maya, age 10, find out that her mother was abused by Maya's grandfather in Poland. Who the heck tells that to a 10 year old)
*** a letter from Dr Hanna was displayed on screen during some testimony last week. I stopped the feed so I could read the entire thing. Keep in mind, this is a letter written by a treating physician, medical doctor treating Maya. Every other paragraph was closed with a (!). Here is an example: "Maya has severe pain! We saw her last week and gave her a huge ketamine infusion. In spite of that, she is now once again in severe pain!! She can't go back to school. This would harm her further!"
I am not making this up. The letter was a full page with at least 15 or more sentences ending with an exlamation point. It was typed. I have no idea who typed it, but he had signed the bottom of the letter.
Dr Lewis did a complete clinical and trauma interview of Maya of exactly what was making her sad, anxious, depressed, concerned, and diestressed. Accoring to Maya everything that was making her have all these feelings was her knowledge of her mother's emotional distress. She never mentioned anything about herself as bothering her, it was all her reacting to her mother's constant psychological complaints. She was worried about hermother. She was depressed because her mother was depressed. She talked about overhearing the doctor in Mexico telling her mother that Maya had a 50/50 chance of dying from the ketamine coma. It wasn't that Maya was reacting all by herself about the homeschooling denial. Maya herself said that her mother was upset about it and that made Maya upset.
Mom should have told her in a different way. Maya was locked into her mother's emotions. The mother could have given her the information in a more calm way, not showing how angry she was about it. Maya's treating doctor should have talked to the family about how to keep from shwoing extreme emotion around Maya or getting her upsset.
His report mentions that in the three hours that he spent with Maya, not once did she ever spontaneously mention that she was feeling any pain.
(This is significant to me because supposedly she has CRPS, supposedly in a flare-up. With a flare-up you do not have one second of one minute of one hour of one day of no pain. You aren't going to sit still for 3 hours with a doctor talking about emotional things and not at least mention that my arms and legs feel like they are on fire. )
Dr Lewis told her at the very beginning to immediately tell him if she at any time felt any pain. She never did.
Her testing revealed interesting things. Above average intelligence in general. A relative deficit in processing speed.
She indicated that she could tell she had issues with memory. All those drugs she was taking have different half lives, so depending on how much over what time period, there are lingering affects of them. Some of her lower scores could be because of these drugs, especially given that she tested as intelligent, but had puzzling low scores in specific areas compared to her OWN intelligence scores. Such as the processing speed.
Maya described her mother's distress, hearing that she had a 50/50 chance of dying, how much money her parents were spending on her treatments - all these things were highly distressing to her. She said "I heard HIM (doctor in Mexico) had to sign papers because the infusions had a 50% chance of killing her.
At the time of the testing she had been separated from her mother for at most 4 days. The plaintiff attorney is trying to get him to say that could cause Maya's emotional distress. Dr Lewis has been clear about Maya's distress being tied directly to her perception of her mother's distress, the money her parents are spending on her treatments, the chance of dying from ketamine coma. She never once mentioned "I miss my mommy". And a 4 day separation doesn't cause the kind of issues Maya is having in the hospital at this point.
At no time did Maya even ask "when can I see my mom". She never mentioned a single thing about her separation from her mother.
He found Maya to be depressed. He thought someone who was not directly going to make any money from Maya's treatment should do a complete evaluation of Maya's medical condition. Dr Kirkpatrick charged $10K each for ketamine treatment at that time. Dr Hanna charged less, but still quite a bit.
He never talked about his evaluation with anyone from JHACH or Dr Smith. It was for court.
Jury gets to go home for the day.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
Tuesday will be a full day. Wednesday is a planned day off for the jury. I can't remember if this is a working day for the lawyers and judge or if it's a day for them to wind down, regroup, whatever.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall
Taking Care of Maya - FL CPS/Munchausen case
It's directed verdict argument time! The jury was let go at 3 PM today so they could have the directed verdict arguments
Mr Altenbern, defense ( not sure I'm spelling it OK) is giving the order of what he wants to argue.
1. Intentional infliction of emotional pain regarding Beata Kowolski:
Won’t repeat the standard. There should be a gatekeeper on this before going to a jury. The standard is discussed in cases already mentioned by judge. Th elements are three fold. Intentional or reckless conduct, extreme conduct – shocking atrocious not OK in civilized society, must cause extreme emotional distress. Reasonable person standard. “But for” causation. Must be the legal cause of suicide.
If you analyze the evidence that has actually come in vs opening statement, doesn’t believe any of the 3 things have been proven. Plaintiff are trying to say it started in Poland when Beata father was arrested. The defense says it started when they brought Maya to the hospital. They were already to see Dr Hanna who gave her high dosage of ketamine in the two previous days. Jack brought her, Beata came later, and demanded ketamine treatment. She said she was going to take her directly to Hanna to get ketamine if she removed her from the hospital. The testimony came in that supposedly the hospital threatened to have her arrested and they changed their mind. Hospital behaved in good faith. They tried to establish if there was medical child abuse. At that point Dr Sally Smith got involved. Whether medical negligence took place or false imprisonment, were the hospital’s actions go so far as to be shocking, morally outside any acceptable behavior. There is never anything in the hospital that takes place distressing to Beata except possibly the phone calls that Cathi Bedy listened in on. Nothing else having anything to do with the hospital rises to any level of intentional behavior by anyone at the hospital in relation to Beata.
It was Jack who was relating anything about the hospital to Beata. The only testimony about Beata being under any distress came in from Jack . He said it was upsetting, but upsetting isn’t the test for this tort. What we know about Oct 13 and the time she committed suicide, she never saw a doctor or priest to tell them she was in this kind of distress as to possibly commit suicide. She saw Dr Duncan and Dr Duncan indicated the hospital cooperated fully with Duncan’s evaluation of May and Dr Duncan made no indication that Beata was in a state of emotional distress. No neighbors came in to testify to the jury that Beata was in emotional distress and we heard lots about how active this family was with neighbors. Mr Kowolski never told the hospital that anything they were doing was distressing his wife and they needed to do something.
The evidence isn’t there. We know Beata never saw or heard some of the things that were presented as being distressing to Maya. Cathy Bey’s interruption may be described as being rude or impolite, but do not rise to the level of intentional emotional distress. Under the law, every case required it to be direct, intentional, or reckless toward Beata herself for these counts we are discussing. We know that on Friday she goes to a court hearing where DCF had the burden of proving medical child abuse. She wants to hug her child, judge says no, she goes home and a short time later she wrote two notes. One was to the judge and the other to her family. While she complained in some part of one of the notes about the hospital, she never directed a note to the hospital. In the note to the judge she blamed the judge for destroying her family, etc. She left home for a while, Mr Kowolski thought she may have taken a gun, thought she was depressed, but he never tried to Baker Act her or call the police. They left her at home, came back, didn’t see her, didn’t look for her. She had hung herself at some point and they found her later. The way it was done took a lot of planning, not the impulsive way the psychiatrist described.
Judge is asking for case law that talks about direct vs indirect. Response is that you have to intentionally cause harm directly to the person, knowing that harm may come to them, etc. Even their own witness says the things that happened within the last 72 hours of a suicide are crucial and she had no interaction with the hospital during that time. She had been denied by a judge to hug her daughter and she wrote a suicide note that blamed the judge for destroying her family. She didn’t blame the hospital. She complained about them for not giving the treatment she wanted, but she never said they destroyed her family. He believes they are entitled to directed verdict on these two counts.
The judge is saying something about not having to get to the point of “in good faith” and he thinks the cases that mention that are wrong.
Plaintiff - New Lawyer I’ve never seen before:
Was JHACH a substantial cause of Beata’s suicide. Concurring cause. Contributes. Judge actually interrupts at this point, and says it’s an issue of the law that is squarely before him. This attorney seems very unprepared.
To the issue of direct, he says there is nothing that says it has to be directed to Beata. Under hospital theory a person could beat their child in front of them and the parent can’t have emotional distress. (good point) It wasn’t just the doctors, it was Ms Bedy (who they already got some money from). Another interruption by judge to ask for case law. The attorney says the instruction doesn’t say direct, so that means indirect must be also allowed. Ke keeps bringing up Cathi Bedy. He insists that it doesn’t have to be directed to the victims (Beata). Isn’t suicide sufficient evidence of distress? The distress is obvious. The hospital only needs to contribute or be a factor. (So I guess they are also suing the judge who she directly blamed for destroying their family?)
He doesn’t seem to have much more, he invites the judge to ask him more questions. He says there is plenty that this should go to a jury. There isn’t anything in the potential jury instruction that says the hospital behavior has to be directly to Beata. This attorney is a mess. Now another plaintiff attorney is bringing up more things about Maya and saying that because this stuff is “getting back” to the parents it applies to their intentional emotional distress as well. A note that Maya has scratches on her forehead and the hospital is wondering if it might be self inflicted. This is an internal note and I was surprised as this is an example of one of several notes that are going to the jury as exhibits, nobody knows who wrote them, no context, nobody is actually testifying about them, they will just be available for the jury to see. That seems odd. And the defense has made their objections quite clear.
Judge asks: What if Altenbern is correct about that the behavior has to be directed towards Beata? Statements made about her that she found out about.
Now Mr Anderson is going to give his 2 cents in. The judge makes a quip about it. (he started out by telling them that having the last word doesn’t necessarily mean your side will win the argument. I am certain he’s talking about Mr Anderson)
He says every single thing that Jack saw, heard, experienced, was going back to Beata and the hospital was involved in a conspiracy yada yada yada. He is not helping at all. He’s way over the top.
Holy shit - He is interrupted by the judge, we need to excise out that just because their was a hotline for abuse that the hospital was obliged to use in any suspected child abuse situation, The hospital cannot be liable for anything that was caused by the court or CPS. Anderson responds that the sequence of events created pressure on Beata, perpetrated by Bedy, let’s take away this, if this doesn’t get her, let’s do this, if this doesn’t get her let’s do this. OMG. He is full on conspiracy theory at this point. That every thing that Cathi Bedy did was deliberately to “get Beata”. And if that didn’t work, we’ll do something else. Keep the pressure on. And ultimately that mother is going to break. OK, now I get it. So, at one point after Beata committed suicide, Bedy wrote a text message where she said she wasn’t surprised about the suicide.
I can’t say I am surprised about the suicide myself, and that’s just based on the Netflix special and what has come out so far in the plaintiff case. Beata displayed overreaction to everything, poor judgement, rash and erratic behavior. Hearing her husband scream in utter frustration at her to stop her bullshit also says something.
The judge is now frustrated and told Anderson that he wants to get through at least one of these motions before they leave today, and he’s going to start enforcing the one argument one lawyer rule.
Altenbern’s turn again
The idea of conspiracy – this is speculation upon speculation at this point. There is no evidence and an insult. When they arrived at the hospital they were demanding treatments outside of what the hospital was allowed, they had two previous hospitals months in time separated that had indicated in their records that they believed that Munchausen by proxy was a possibility here. It’s important to point out that she has no direct nerve damage, the CRPS diagnosis says that the pain is caused by nerves behaving a certain way and the factitious disorder says the same thing is happening but because of psychological causes. The hospital is faced with a mother and daughter not behaving reasonably, they are trying to figure it all out. They never said she was “faking it”. You’ve heard the testimony from all the experts that the therapy is the same and as a last resort maybe go to ketamine. There is a disagreement whether the lesions are consistent with CRPS, but that doesn’t rise to the level of intentional.
Invites the judge for a question. The judge says the conduct obviously has to be so outrageous, not just mean. But given that I have to take everything in the light most favorable to the plaintiff. We see some evidence of a person trying to maliciously separate Maya from her mother. Do I need one overwhelming direct conduct toward Beata. Altenbern says there is a number of things they complain about that really don’t add up, and also attribute it to the hospital, when the truth is that the court was the one making the decision whether to separate or not. Putting her in the EEG room was in order to see if her behavior would be the same when she thought she was alone. Taking photos was because they already saw the character of her “lesions” had changed. They started to look more like scratches. So they wanted to take before and after photos because she was going to be leaving the hospital. Those things were not done maliciously. Those were reasonable things for the hospital to do under the circumstances. They don’t just decide this is what we are going to do to some random family.
By that point in time there are lawyers involved and the court was the overwhelming pressure on everyone. A suicide that takes place after nothing happened in the hospital but very distressing things happened in court in the 72 hours right before the suicide.
Taking 21 A and B under advisement
Mr Altenbern, defense ( not sure I'm spelling it OK) is giving the order of what he wants to argue.
1. Intentional infliction of emotional pain regarding Beata Kowolski:
Won’t repeat the standard. There should be a gatekeeper on this before going to a jury. The standard is discussed in cases already mentioned by judge. Th elements are three fold. Intentional or reckless conduct, extreme conduct – shocking atrocious not OK in civilized society, must cause extreme emotional distress. Reasonable person standard. “But for” causation. Must be the legal cause of suicide.
If you analyze the evidence that has actually come in vs opening statement, doesn’t believe any of the 3 things have been proven. Plaintiff are trying to say it started in Poland when Beata father was arrested. The defense says it started when they brought Maya to the hospital. They were already to see Dr Hanna who gave her high dosage of ketamine in the two previous days. Jack brought her, Beata came later, and demanded ketamine treatment. She said she was going to take her directly to Hanna to get ketamine if she removed her from the hospital. The testimony came in that supposedly the hospital threatened to have her arrested and they changed their mind. Hospital behaved in good faith. They tried to establish if there was medical child abuse. At that point Dr Sally Smith got involved. Whether medical negligence took place or false imprisonment, were the hospital’s actions go so far as to be shocking, morally outside any acceptable behavior. There is never anything in the hospital that takes place distressing to Beata except possibly the phone calls that Cathi Bedy listened in on. Nothing else having anything to do with the hospital rises to any level of intentional behavior by anyone at the hospital in relation to Beata.
It was Jack who was relating anything about the hospital to Beata. The only testimony about Beata being under any distress came in from Jack . He said it was upsetting, but upsetting isn’t the test for this tort. What we know about Oct 13 and the time she committed suicide, she never saw a doctor or priest to tell them she was in this kind of distress as to possibly commit suicide. She saw Dr Duncan and Dr Duncan indicated the hospital cooperated fully with Duncan’s evaluation of May and Dr Duncan made no indication that Beata was in a state of emotional distress. No neighbors came in to testify to the jury that Beata was in emotional distress and we heard lots about how active this family was with neighbors. Mr Kowolski never told the hospital that anything they were doing was distressing his wife and they needed to do something.
The evidence isn’t there. We know Beata never saw or heard some of the things that were presented as being distressing to Maya. Cathy Bey’s interruption may be described as being rude or impolite, but do not rise to the level of intentional emotional distress. Under the law, every case required it to be direct, intentional, or reckless toward Beata herself for these counts we are discussing. We know that on Friday she goes to a court hearing where DCF had the burden of proving medical child abuse. She wants to hug her child, judge says no, she goes home and a short time later she wrote two notes. One was to the judge and the other to her family. While she complained in some part of one of the notes about the hospital, she never directed a note to the hospital. In the note to the judge she blamed the judge for destroying her family, etc. She left home for a while, Mr Kowolski thought she may have taken a gun, thought she was depressed, but he never tried to Baker Act her or call the police. They left her at home, came back, didn’t see her, didn’t look for her. She had hung herself at some point and they found her later. The way it was done took a lot of planning, not the impulsive way the psychiatrist described.
Judge is asking for case law that talks about direct vs indirect. Response is that you have to intentionally cause harm directly to the person, knowing that harm may come to them, etc. Even their own witness says the things that happened within the last 72 hours of a suicide are crucial and she had no interaction with the hospital during that time. She had been denied by a judge to hug her daughter and she wrote a suicide note that blamed the judge for destroying her family. She didn’t blame the hospital. She complained about them for not giving the treatment she wanted, but she never said they destroyed her family. He believes they are entitled to directed verdict on these two counts.
The judge is saying something about not having to get to the point of “in good faith” and he thinks the cases that mention that are wrong.
Plaintiff - New Lawyer I’ve never seen before:
Was JHACH a substantial cause of Beata’s suicide. Concurring cause. Contributes. Judge actually interrupts at this point, and says it’s an issue of the law that is squarely before him. This attorney seems very unprepared.
To the issue of direct, he says there is nothing that says it has to be directed to Beata. Under hospital theory a person could beat their child in front of them and the parent can’t have emotional distress. (good point) It wasn’t just the doctors, it was Ms Bedy (who they already got some money from). Another interruption by judge to ask for case law. The attorney says the instruction doesn’t say direct, so that means indirect must be also allowed. Ke keeps bringing up Cathi Bedy. He insists that it doesn’t have to be directed to the victims (Beata). Isn’t suicide sufficient evidence of distress? The distress is obvious. The hospital only needs to contribute or be a factor. (So I guess they are also suing the judge who she directly blamed for destroying their family?)
He doesn’t seem to have much more, he invites the judge to ask him more questions. He says there is plenty that this should go to a jury. There isn’t anything in the potential jury instruction that says the hospital behavior has to be directly to Beata. This attorney is a mess. Now another plaintiff attorney is bringing up more things about Maya and saying that because this stuff is “getting back” to the parents it applies to their intentional emotional distress as well. A note that Maya has scratches on her forehead and the hospital is wondering if it might be self inflicted. This is an internal note and I was surprised as this is an example of one of several notes that are going to the jury as exhibits, nobody knows who wrote them, no context, nobody is actually testifying about them, they will just be available for the jury to see. That seems odd. And the defense has made their objections quite clear.
Judge asks: What if Altenbern is correct about that the behavior has to be directed towards Beata? Statements made about her that she found out about.
Now Mr Anderson is going to give his 2 cents in. The judge makes a quip about it. (he started out by telling them that having the last word doesn’t necessarily mean your side will win the argument. I am certain he’s talking about Mr Anderson)
He says every single thing that Jack saw, heard, experienced, was going back to Beata and the hospital was involved in a conspiracy yada yada yada. He is not helping at all. He’s way over the top.
Holy shit - He is interrupted by the judge, we need to excise out that just because their was a hotline for abuse that the hospital was obliged to use in any suspected child abuse situation, The hospital cannot be liable for anything that was caused by the court or CPS. Anderson responds that the sequence of events created pressure on Beata, perpetrated by Bedy, let’s take away this, if this doesn’t get her, let’s do this, if this doesn’t get her let’s do this. OMG. He is full on conspiracy theory at this point. That every thing that Cathi Bedy did was deliberately to “get Beata”. And if that didn’t work, we’ll do something else. Keep the pressure on. And ultimately that mother is going to break. OK, now I get it. So, at one point after Beata committed suicide, Bedy wrote a text message where she said she wasn’t surprised about the suicide.
I can’t say I am surprised about the suicide myself, and that’s just based on the Netflix special and what has come out so far in the plaintiff case. Beata displayed overreaction to everything, poor judgement, rash and erratic behavior. Hearing her husband scream in utter frustration at her to stop her bullshit also says something.
The judge is now frustrated and told Anderson that he wants to get through at least one of these motions before they leave today, and he’s going to start enforcing the one argument one lawyer rule.
Altenbern’s turn again
The idea of conspiracy – this is speculation upon speculation at this point. There is no evidence and an insult. When they arrived at the hospital they were demanding treatments outside of what the hospital was allowed, they had two previous hospitals months in time separated that had indicated in their records that they believed that Munchausen by proxy was a possibility here. It’s important to point out that she has no direct nerve damage, the CRPS diagnosis says that the pain is caused by nerves behaving a certain way and the factitious disorder says the same thing is happening but because of psychological causes. The hospital is faced with a mother and daughter not behaving reasonably, they are trying to figure it all out. They never said she was “faking it”. You’ve heard the testimony from all the experts that the therapy is the same and as a last resort maybe go to ketamine. There is a disagreement whether the lesions are consistent with CRPS, but that doesn’t rise to the level of intentional.
Invites the judge for a question. The judge says the conduct obviously has to be so outrageous, not just mean. But given that I have to take everything in the light most favorable to the plaintiff. We see some evidence of a person trying to maliciously separate Maya from her mother. Do I need one overwhelming direct conduct toward Beata. Altenbern says there is a number of things they complain about that really don’t add up, and also attribute it to the hospital, when the truth is that the court was the one making the decision whether to separate or not. Putting her in the EEG room was in order to see if her behavior would be the same when she thought she was alone. Taking photos was because they already saw the character of her “lesions” had changed. They started to look more like scratches. So they wanted to take before and after photos because she was going to be leaving the hospital. Those things were not done maliciously. Those were reasonable things for the hospital to do under the circumstances. They don’t just decide this is what we are going to do to some random family.
By that point in time there are lawyers involved and the court was the overwhelming pressure on everyone. A suicide that takes place after nothing happened in the hospital but very distressing things happened in court in the 72 hours right before the suicide.
Taking 21 A and B under advisement
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Taking Care of Maya - FL CPS/Munchausen case
From what you're reporting, it sounds almost like her husband (Jack is the husband, correct?) wasn't trying to do anything to help Beata, and may have been making her situation worse by telling her everything that went on. I wonder if part of the suit is that he's feeling guilty for neglecting his wife's distress and wants to find someone - anyone - else to blame for her suicide...
Taking Care of Maya - FL CPS/Munchausen case
Yes. I agree that he was making things worse as well. This family was making a huge big deal about everything, not communicating to anyone, and insisting that things they clearly didn't even understand were evidence that the hospital was intentionally harming Maya.Kriselda Gray wrote: ↑Mon Oct 16, 2023 7:04 pm From what you're reporting, it sounds almost like her husband (Jack is the husband, correct?) wasn't trying to do anything to help Beata, and may have been making her situation worse by telling her everything that went on. I wonder if part of the suit is that he's feeling guilty for neglecting his wife's distress and wants to find someone - anyone - else to blame for her suicide...
For instance, they go on and on about her commode being "out of Maya's reach." Just as a caregiver for my mother, I can speak to that one. You can't put the commode touching the bed. Otherwise, you have to move it every single time you have to go to bedside to help with anything, deliver food, refill water, give medication, check if they need anything.
The exact placement of bedside commode depends on can they get up themselves or do they need help. If they can get up themselves to use it, nobody will be in the room when they use it. So, they are swinging their legs over the edge of the bed to sit up. You can't have the commode close enough that every time they are swinging the legs over they are kicking the commode. They will hurt and bruise the ankles, legs, whatever part is kicking it. So, it has to be far enough away so they don't kick it every time they swing their legs out. Then, if they are using it themselves sans help, they will be standing up, taking a step or two, maybe holding on to the arm, turning, sitting.
Maya had dystonia, hadn't used her legs in a long time and couldn't stand on her own. Just think if the commode had been close enough for her to use by herself. She would have been using her arms, having to hold the arms of the commode, and since she had no strength in her legs, all that weight pushing to hold her up against the commode that damn thing would have fallen over with Maya falling on top of it. It would have been downright dangerous if they had put the commode within her reach to expect her to get up and use it herself without the use of her legs.
Her family are morons. And of course, Jack is going home every night and telling his wife all this shit about the commode being out of her reach and all this other crap that he does not understand, won't ask questions, and just assumes that it's all done out of maliciousness. And you would think the mother being a nurse would be fully aware that her daughter not being able to use her legs would have tipped that commode over trying to get onto it by herself without help. So what does it matter that it wasn't put where she could easily use it by herself. She wasn't supposed to be trying to use it by herself.
And to read the freaking comments of people watching it. They are also all angry about her freaking commode, which she can't even use by herself safely, being "intentionally put out of her reach".
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Taking Care of Maya - FL CPS/Munchausen case
OI! If she can't use her legs, she probably should have had a catheter rather than a commode, anyway (unless, of course, a catheter would somehow interfere with her care or cause her more problems.)
Taking Care of Maya - FL CPS/Munchausen case
Defense ase:
Case Manager with DCF, Charlotte LaPorte
There was a lot of discussion prior to her testimony because the judge doesn’t want things from the depending hearing and other prior court cases to come in. He is going to allow the defense to ask leading questions to a certain extent because of this.
She was required to listen in on phone calls between Beata and Maya starting from Nov 15 2015, an email from her to Beata explained that she wanted to set the ground rules so that she would not have to ever interrupt within the call. The email says she wants the phone calls to be high quality mother daughter interactions, so stick to positive topics, do not ask about pain, medical stuff, etc. The email also says that in the event that she should need to interrupt for Beata to please be understanding and calm abut it and simply stick to high quality interactions with Maya – ask about school, hobbies, is she having fun in the activity room, what she’s doing in the activity room, etc.
Interesting. They play two calls that the jury had already heard. They insinuated that it was Cathi Bedy that was the one listening in to the call. Charlotte LaPorte verified that this was HER voice on the calls. She had to interrupt a couple of times because Beata kept trying to mention court, medical stuff, things that were making Maya anxious. She explains to the jury that she really hates to have to do that, she prefers the calls to be positive interactions where Charlotte would not have to interrupt at all.
She has to arrange and coordinate Beata and the hospital. She had to coordinate with social workers at the hospital, not hospital staff. Cathi Bedy was the social worker.
She had to remind Beata numerous times about not getting into anxiety producing topics, and she had to interrupt. She tried talking to Beata separately to ask her to please stay on topic and please not put Charlotte in the position of having to interrupt calls with Maya.
She said several times Beata claimed that Maya never got mail or drawings and Beata was saying the hospital was interrupting. Charlotte said she was supposed to receive things FIRST so she could make sure Beata was sending things that would be approved for sheltered child to receive. Apparently Beata was trying to buck the system and send direct. She was asked to resend to Charlotte so it could be approved so Maya could receive it. This happened multiple times.
Would Beata have liked to have more calls then possible? Charlotte explained that calls had to be facilitated and there were not enough employees to facilitate daily calls. They all had to arranged, coordinated, and Charlotte herself had to sit in on them as well.
(I wish she would look at the jury a little bit. All the plaintiff witnesses were instructed to look at the jury and communicate directly to them, and they seem to really respond to that. Charlotte is not unfriendly on purpose but it doesn’t have the friendliness of the plaintiff’s witnesses. The hospital attorneys should have told them at least sometimes look over at the jury)
Cross Exam:
Witness is reviewing emails that Beata sent regarding Cathi Bedy being in the room on phone calls on speakerphone. (There is nothing in the sound of the calls that make it seem that Maya was on speakerphone)
Charlotte is saying the email refreshes her recollection. She did not ever insert herself into the phone call, she was in the room because she had to bring a phone in the room. A sheltered child can’t have a phone that can be used at whim.
What is the purpose of monitoring the calls?
(Sidebar! The defense is trying all morning to bring in stuff about DCF and the court. The judge has already said if you want to sue DCF then sue DCF. He is OVER questioning trying to make anything DCF may have done into the hospital’s responsibility)
The plaintiff gives up because they simply can’t think of any questions that don’t get them into trouble by bringing in DCF.
Redirect:
They are stressing how often Charlotte had no choice but to have discussions with Beata about the topic of conversation with her child. I truly think this goes to what I already suspect is that Beata treated Maya like she was an adult, there were no normal boundaries about what is appropriate to say in front of a child. It would be one thing for Beata and Jack to have private discussions about how we can handle, or what options should we pursue for things like the denial of Homebound Homeschool status. But to discuss it with a 10 year old is off the charts. I think that Beata could not keep her phone calls appropriate because she wasn’t in the habit of ever being appropriate with how she communicated with Maya. All she wanted to do was dwell on pain, medications, what new thing are you unable to do now? This exactly what the psychologist yesterday was talking about, that Maya didn’t know how SHE felt because it was all about how her mother felt and then she felt however her mother felt.
It’s no wonder to me that Maya was so miserable in the hospital, every phone call with her mother was a reminder of pain, court, etc because Beata couldn’t stop talking about that shit with Maya.
The camera is on Jack now, he’s sitting there smirking. Not sure why he’d be smiling today, this is just the second of defense witnesses and I bet the jury is already wondering if the impression they have so far might not be accurate.
Jury questions indicate some of the jury are so far up the plaintiff butt that they are even being sarcastic in their questioning. I think the defense is cooked. I can’t say I’m surprised, her following in the live comment section is at the point of acting like a cult. They demand that any commenter be banned if they even suggest that maybe we should wait and hear all the evidence before coming to such baked in conclusions. I actually saw someone get banned for that suggestion. There is cult like mentality regarding Maya.
Case Manager with DCF, Charlotte LaPorte
There was a lot of discussion prior to her testimony because the judge doesn’t want things from the depending hearing and other prior court cases to come in. He is going to allow the defense to ask leading questions to a certain extent because of this.
She was required to listen in on phone calls between Beata and Maya starting from Nov 15 2015, an email from her to Beata explained that she wanted to set the ground rules so that she would not have to ever interrupt within the call. The email says she wants the phone calls to be high quality mother daughter interactions, so stick to positive topics, do not ask about pain, medical stuff, etc. The email also says that in the event that she should need to interrupt for Beata to please be understanding and calm abut it and simply stick to high quality interactions with Maya – ask about school, hobbies, is she having fun in the activity room, what she’s doing in the activity room, etc.
Interesting. They play two calls that the jury had already heard. They insinuated that it was Cathi Bedy that was the one listening in to the call. Charlotte LaPorte verified that this was HER voice on the calls. She had to interrupt a couple of times because Beata kept trying to mention court, medical stuff, things that were making Maya anxious. She explains to the jury that she really hates to have to do that, she prefers the calls to be positive interactions where Charlotte would not have to interrupt at all.
She has to arrange and coordinate Beata and the hospital. She had to coordinate with social workers at the hospital, not hospital staff. Cathi Bedy was the social worker.
She had to remind Beata numerous times about not getting into anxiety producing topics, and she had to interrupt. She tried talking to Beata separately to ask her to please stay on topic and please not put Charlotte in the position of having to interrupt calls with Maya.
She said several times Beata claimed that Maya never got mail or drawings and Beata was saying the hospital was interrupting. Charlotte said she was supposed to receive things FIRST so she could make sure Beata was sending things that would be approved for sheltered child to receive. Apparently Beata was trying to buck the system and send direct. She was asked to resend to Charlotte so it could be approved so Maya could receive it. This happened multiple times.
Would Beata have liked to have more calls then possible? Charlotte explained that calls had to be facilitated and there were not enough employees to facilitate daily calls. They all had to arranged, coordinated, and Charlotte herself had to sit in on them as well.
(I wish she would look at the jury a little bit. All the plaintiff witnesses were instructed to look at the jury and communicate directly to them, and they seem to really respond to that. Charlotte is not unfriendly on purpose but it doesn’t have the friendliness of the plaintiff’s witnesses. The hospital attorneys should have told them at least sometimes look over at the jury)
Cross Exam:
Witness is reviewing emails that Beata sent regarding Cathi Bedy being in the room on phone calls on speakerphone. (There is nothing in the sound of the calls that make it seem that Maya was on speakerphone)
Charlotte is saying the email refreshes her recollection. She did not ever insert herself into the phone call, she was in the room because she had to bring a phone in the room. A sheltered child can’t have a phone that can be used at whim.
What is the purpose of monitoring the calls?
(Sidebar! The defense is trying all morning to bring in stuff about DCF and the court. The judge has already said if you want to sue DCF then sue DCF. He is OVER questioning trying to make anything DCF may have done into the hospital’s responsibility)
The plaintiff gives up because they simply can’t think of any questions that don’t get them into trouble by bringing in DCF.
Redirect:
They are stressing how often Charlotte had no choice but to have discussions with Beata about the topic of conversation with her child. I truly think this goes to what I already suspect is that Beata treated Maya like she was an adult, there were no normal boundaries about what is appropriate to say in front of a child. It would be one thing for Beata and Jack to have private discussions about how we can handle, or what options should we pursue for things like the denial of Homebound Homeschool status. But to discuss it with a 10 year old is off the charts. I think that Beata could not keep her phone calls appropriate because she wasn’t in the habit of ever being appropriate with how she communicated with Maya. All she wanted to do was dwell on pain, medications, what new thing are you unable to do now? This exactly what the psychologist yesterday was talking about, that Maya didn’t know how SHE felt because it was all about how her mother felt and then she felt however her mother felt.
It’s no wonder to me that Maya was so miserable in the hospital, every phone call with her mother was a reminder of pain, court, etc because Beata couldn’t stop talking about that shit with Maya.
The camera is on Jack now, he’s sitting there smirking. Not sure why he’d be smiling today, this is just the second of defense witnesses and I bet the jury is already wondering if the impression they have so far might not be accurate.
Jury questions indicate some of the jury are so far up the plaintiff butt that they are even being sarcastic in their questioning. I think the defense is cooked. I can’t say I’m surprised, her following in the live comment section is at the point of acting like a cult. They demand that any commenter be banned if they even suggest that maybe we should wait and hear all the evidence before coming to such baked in conclusions. I actually saw someone get banned for that suggestion. There is cult like mentality regarding Maya.
"It actually doesn't take much to be considered a difficult woman. That's why there are so many of us."
--Jane Goodall
--Jane Goodall