“That’s all, Mrs. Wrigley,” Ed Caldwell continued.
“Do I have to leave the room?” Pat asked.
“Yes,” the judge replied.
With a shrug and a disappointed grin, the defenses star witness left the stand while Ted Lindquist gripped Josh Thomas’s hand in congratulations.
That evening, Pat Wrigley told Dr. Eaton about the proceedings at some length.
“That district attorney twisted everything I said!”
“I warned you. Don’t say I didn’t.”
“And boy, were you right! I thought our system of justice was after the truth, though. Naive little me. I mean that could just as easily be me up there instead of Priscilla—I keep thinking that. If they could accuse her, they could just as easily accuse me, or anybody! And I didn’t do anything. It boils my blood! I don’t think I helped Priscilla much at all.”
Ed, too, was disappointed. He had to admit that Josh Thomas had done a hell of a job belittling Pat Wrigley. And there had been another setback. Ed had asked that Pat let him know the next time Sarah suffered from diarrhea so that he could obtain a stool sodium, and Pat had done so. Ed had stopped over at the Wrigleys to pick up the sodden plastic diaper for testing. But the sodium content had been normal, so that was a dead end. But he still had some ammunition. He had a string of character witnesses on tap—as many as the judge would let him put on the stand. He also planned to call four nurses; a surprise witness designed to cast doubt on Martin Blinder; Dr. Satten, he hoped; and, of course, Steve and Priscilla Phillips. Priscilla was to testify last. By that time, the jury should have formed some kind of attachment for her—if they were ever going to do so. Ed had worked it out. The end of the trial was the point at which she could best help herself.
Week 7
Many of Priscilla Phillips's friends had volunteered to take the stand as character witnesses, and Ed Caldwell and Al Collins had picked and chosen among them for those they felt would best impress the jury. In the end, Judge Burke allowed the testimony of only seven of these witnesses, ruling that the testimony was cumulative and that additional witnesses would not add to the quality of the testimony.
During the week, interspersed among other witnesses, Jim and Jan Doudiet, Marilyn Hansen, Nancy Dacus, and neighbors Bob Hamilton and Russell Mayhew testified, as did the director of the nursery school Erik and Jason had attended. A foundation was laid to show how each character witness knew Priscilla—and for how long—and then each was asked for an opinion as to the truth and veracity of the defendant. One after another, these witnesses insisted Priscilla was truthful, that they had upon numerous occasions entrusted their children with her, that they believed in her absolutely.
The defense also called four nurses to the stand: Debby Roof, Maria Sterling, and Susie Torrence from Kaiser-San Rafael, and Pat Middleton, a nurses’ aide from Kaiser-San Francisco.
Debby testified to her close friendship with the defendant, which—she said—had developed after the death of Tia. She admired Priscilla’s concern for, and commitment to, her children, she reported softly. On the matter of the contaminated formula, Debby insisted that Priscilla had never said that she had mixed the formula, although the nurse did remember that there had been a conversation at shift change about the formula. Debby testified that Priscilla may have said that there was enough formula and that it was in the refrigerator.
Debby also described how upset Priscilla had been over Mindy’s admission to the hospital. “I stayed forty-five minutes past my shift to try to comfort her,” she said.
On cross-examination, Josh Thomas asked her again about the formula.
“Your testimony is that Priscilla Phillips did
not
come up to you, Lesley McCarcy, and Jan Bond and say, ‘I’ve mixed the formula and it’s in the refrigerator?” he asked, his voice pitched to indicate disbelief.
“Yes, I can honestly say that she did not say that because I would have questioned it—it would have been a violation of a doctor’s order,” Debby replied firmly.
Nurse Maria Sterling had cared for Tia the first day she was admitted to the hospital and on many subsequent occasions. In her testimony, she too described Priscilla Phillips as loving and concerned.
“Mrs. Phillips was often very upset and crying over Tia. She was very concerned about the IVs, very involved in the treatment. She worked very closely with the doctors,” she added. “Toward the end of Tia's life, it was getting very hard, I think.”
“Did you feel sympathy and admiration for Mrs. Phillips?” Josh asked on cross-examination.
“Yes,” said the nurse.
Susie Torrence, the Filipino nurse who had often worked day shift at Kaiser-San Rafael, was used by the defense to point out and emphasize some of the mistakes made by Kaiser hospital personnel during the treatment of Tia and Mindy.
She testified to unusual incidents involving both Tia and Mindy. The wrong bottle had been hung for an IV, so that Tia had received 12.5 milligrams of potassium chloride per 500 cubic centimeters instead of per 1,000 cubic centimeters, she explained. And two different medication errors were made involving Mindy. Medication was administered at the wrong time, and then, in an unrelated incident, via the wrong tube.
Pat Middleton testified that for much of her stay at San Francisco, Tia Phillips had been on one-to-one nursing care, with the nurse remaining in the patient’s room. Pat also explained how much she liked caring for Tia.
“I asked to care for her. In general she would come in real sick and start to perk up after a few days, and then she was so happy and lovable.”
On cross-examination, Josh scored some points when Pat Middleton acknowledged that even when one-to-one nursing was ordered, there was some flexibility about whether the nurse was in the room the whole time.
“I was not there one hundred percent of the time,” she admitted.
Ed Caldwell then called Dr. Daniel Chaffin, a psychiatrist in private practice who had worked with Blinder at Langley Porter Neuropsychiatric Institute, to the stand.
Chaffin testified at some length about the
Diagnostic and Statistical Manual of Mental Disorders. DSM-2
(the second edition) was used by hospitals and insurance companies to list official psychiatric diagnoses, Chaffin explained.
DSM-1
had been published in about 1957, and
DSM-2
in 1968, with a major revision issued in 1972.
“Is Munchausen Syndrome by Proxy listed in
DSM-1?”
“No.”
“Is it listed in
DSM-2?”
“No.”
“And for hospitals and insurance companies, you must have a diagnosis that is listed in the
DSM?”
“That is correct.”
“And did you make a study of Munchausen Syndrome by Proxy, Dr. Chaffin?”
“I could find only one article about it, and that’s the article from
Lancet.
I also asked my colleagues if they had ever heard of Munchausen Syndrome by Proxy and they had not,” he answered.
“Now, Dr. Chaffin, I understand that you supervised Dr. Martin Blinder at Langley Porter. Was he ever the chief of an inpatient service there?”
“Dr. Blinder has never been chief of any clinical service or any other known service at UC or Langley Porter,” came the response.
Josh Thomas sent a hurried note over to Ted Lindquist, who nodded his head in response. Lindquist rose and quickly left the courtroom as Caldwell continued his questions.
On cross-examination, Josh belittled Chaffin's research methods. Chaffin admitted that he had not instituted a computer search for the literature on Munchausen Syndrome by Proxy.
“Why not?”
“It’s costly and I did not feel it was justified because the literature on the subject is so scanty.”
“In your research, did you come across an article called ‘Munchausen Syndrome by Proxy, Definition of Factitious Bleeding in an Infant’ in the February 1979 edition of
Pediatrics?”
“No.”
“Did you research child abuse in general, Doctor?”
“No. It was too big a task.”
“How long did you spend reviewing the case?”
“Eight to ten hours. And I am strongly convinced that Munchausen Syndrome by Proxy does not have the scientific merit to justify its use in a court of law, and most especially in trying to justify the motive in a person,” he said.
That evening, Josh talked to Ted. “What about Blinder?” he asked. “Did you ask him about the inpatient service?”
“Yeah. He’s madder than hell—says Chaffin’s lying. He called it scurrilous. It should be easy enough to track down whether Blinder was or wasn’t the head of that clinic.”
“Yeah, get on it.”
“I’m on it; I’m on it!”
On Friday, Harry Wrigley took the stand. A man in his middle forties, Wrigley walked with a cane. The custodian had reason to dislike the Kaiser health care system as he believed that a misdiagnosis on their part had almost killed him, and because of this, Ed had hesitated about calling him. But after his wife’s fiasco, the attorney decided to risk it: Pat Wrigley’s testimony needed shoring up.
And Harry provided strong support for his wife’s testimony. He described Sarah’s diarrhea as virtually constant. As Pat had testified, Harry indicated that Sarah had suffered at least thirty episodes of diarrhea, with five episodes more severe than the others. He testified that once he had been forced to put Sarah into the shower in order to clean her after an episode of diarrhea. He described a bout that had occurred the previous day. And finally he mentioned that Sarah’s adoption had become official May first.
“There was a front-page article in the Vallejo
Independent Press,
with a picture of the whole family,” he said, showing the article.
Ed Caldwell next called Edith Horne to the stand. The teacher’s aide from Carol Loma Vista School described her function.
“My job is to take attendance, work in the physical education program, assist the instructor, change the diapers, and feed those children who can’t feed themselves,” she said. Then she testified to Sarah’s perfect attendance record at school.
“Is there a place on your attendance form to mark if a student is sent home after she arrives?” Ed asked.
“No.”
Ed asked how many times Sarah had diarrhea in school. “About ten times. Most of the children have one change of clothes, but Sarah has three. Once the diarrhea filled her socks and shoes and we had to send her home without shoes. But she has never been sent home early because of diarrhea.”
“When was the last time she had diarrhea, Mrs. Horne?”
“Last week—on Wednesday and Thursday.”
“Was Sarah ever sent home ill from school?”
“Yes, twice. But she was not marked absent because she arrived at school in the morning.”
“Thank you.”
On cross-examination, Josh asked about Sarah’s diarrhea. “Has Mrs. Wrigley ever told you of any explosive diarrhea episodes where Sarah lost a quart of fluid in an hour?”
“No.”
“Thank you, Mrs. Horne.”
Steve Phillips followed Edith Horne to the stand. He was pale and nervous. He was enormously frightened of making some terrible mistake or forgetting something vital. He and Al Collins had even worked out a system to enable him to remember key events, and a hand signal to be used during cross-examination if he felt in need of a breather.
Carefully, in one of his most effective examinations, Al Collins led Steve through the background of the illnesses of his daughters. Steve began by describing the adoption of Tia, giving a brief history of Priscilla’s problems with pregnancy, her hysterectomy, and their attempt to adopt a Vietnamese child. Then he testified about Tia’s first hospitalization. He pointed out that he had been the one to feed her just prior to her episode of projectile vomiting, and he went on to describe her staring spells that he attributed to the pain medication she was receiving.
“I never went more than a day without visiting Tia,” he said quietly. “I spent one whole night with her—the night before her hyperalimentation—just holding her and rocking her. She had an IV in her scalp where it could easily come loose, and I didn’t want that to happen.”
Steve also noted several other times before Tia became sick at home when
he
had fed her and not Priscilla. This included January seventh, when she had been admitted to the Emergency Room at Kaiser.
“I prepared and fed her her formula that entire day,” Steve said firmly.
“I raised the subject of adoption on the way home from the hospital after Tia died,” Steve also testified, to dispute an earlier suggestion by the district attorney that it had been Priscilla’s idea.
He described at some length the police search of his house, focusing in particular on the bag of syringes they had taken from the garage.
“I pointed those out to the police,” he said. “The needles and syringes were by prescription from the Kaiser pharmacy for use in heparinizing Tia’s central venous catheter. We had a lot left over because the line she ended up using didn’t need them. I always disposed of the needles we did use by cutting them with wire cutters before putting them in the garbage,” he added.
In an attempt to establish a possible alternative to the prosecution’s contention that Priscilla had contaminated Mindy’s formula, Al Collins asked Steve about his job as a counselor at juvenile hall.
“I’m responsible for the physical safety of the boys and girls, aged eight to eighteen, and for preparing written reports, and for some crisis therapy. These kids are put there if they are considered a danger to themselves or to the community.”
“And which unit do you work in, Mr. Phillips?”
“The senior boys’ unit. It’s a maximum security unit for boys accused of serious crimes such as assault and battery, rape, and so on. I have to prepare behavior-observation reports that are used by the juvenile court as a recommendation for disposition. Some boys are sent to the California Youth Authority as a result of these recommendations and the boys and parents know this.”
On cross-examination, Josh Thomas asked, “Have you received threats to yourself or your family as a result of your job, Mr. Phillips?”