“He prepared a report about her testing with a Rorschach, Wechsler IQ, Draw-a-Person and Thematic Apperception Test.”
“Did you bring a copy of that report?”
“No,” Satten said. Josh Thomas shook his head in disgust. “What were the results of those tests?” he asked.
“No severe psychopathology was found. In some tests, she was overly cautious and self-abnegating, with some feelings of loneliness and feelings of being badly treated.”
“Now when you evaluate somebody psychiatrically, what do you look at?”
“Basic personality factors. In the defendant I evaluated her capacity to express feelings of warmth, to express anger and keep in control, her capacity to relate herself to others and have feelings about them, her capacity to evaluate reality, to experience loss and to grow from that experience.”
“Would you say that Mrs. Phillips has a need for attention, praise, and sympathy?”
“No, she thinks well of herself.”
“I thought you indicated that she tends to put herself down?”
“Even so, she thinks well of herself, though she has self-deprecating tendencies,” Satten insisted.
“Now a patient, unless they’re completely hallucinating during your examination, can choose to withhold information from you, can they not?”
“That is true.”
“So that your evaluation of Mrs. Phillips is dependent in large degree on the material she revealed to you?”
“No. It’s based on the kinds of interactions I saw. I’m assuming there was a fair amount of truth in many of the things she told me. But misstatements about one thing or another were not especially important. It was the pattern of her emotional responses I was looking for.”
“Isn’t it a fact, Doctor, that persons who have committed certain heinous offenses that they do not want to face psychologically, bury them and rationalize their behavior or deny that it ever existed?”
“That frequently happens.”
“Did the author of the article we were just referring to on factitious bleeding in an infant indicate that there was usually a denial by the parents of the motives involved in the commission of the acts on the child?’
“Well, he described that the parents in the case had denied the acts.”
“In that particular article, the parents’ behavior was described as exhibited by their concern for and devotion to the child. Is that correct?”
“I believe so.”
“Thank you. I have nothing further,” Josh Thomas said. On redirect, Al Collins asked Satten to define the psychiatric term
hysteria,
which had been used by some psychiatrists to characterize the mothers suffering from Munchausen Syndrome by Proxy.
“It has two meanings in psychiatry. One has to do with a particular form of illness called hysterical neurosis, which is characterized by a patient blocking his feelings so that he feels relatively comfortable and without overt anxiety. Hysterical is also used to describe a personality type that is characterized by excitability, emotional changeability, irritability, and a high degree of seductiveness, as well as self-involvement and attention-getting. In my opinion, the description of the patients in the literature on Munchausen Syndrome by Proxy referred to the second sense of the word.”
“Did you find this type of hysterical personality that is identified with Munchausen Syndrome by Proxy in the person of Mrs. Phillips?”
“I did not.”
“Doctor, do you have with you the summary you made of the articles dealing with the abuse of children with drugs and/or Munchausen Syndrome by Proxy?” Collins asked awkwardly.
“Yes.”
“Did you find any correlation with respect to the mental conditions?”
“A high degree of correlation. There were twenty mothers described. Nineteen of them were either psychotic, hysterical, or severely disturbed with a history of Munchausen.”
“I have no further questions.”
Dr. Satten was excused subject to recall at a time when he could bring his notes. While the jury took its afternoon break, Josh Thomas made a motion that he assumed would fail, but for which there was some legal precedent. He asked that Priscilla Phillips be forced to submit to an examination by prosecution psychiatrist Dr. Blinder.
Josh argued that Blinder had already requested permission to examine the defendant prior to the preliminary hearing and been denied. And that until Dr. Satten had been brought forth as a witness for the defense—thereby putting the defendant’s mental state at issue—the prosecution had not pursued the matter further. If the court preferred, Josh added, he could appoint another psychiatrist in lieu of Dr. Blinder to examine the defendant for the People.
The judge, in response to arguments by both Ed Caldwell and Al Collins, asked for the research cited by all three attorneys before he would be ready to rule.
After recess, the jury filed back and took their seats quietly. Into the expectant hush of the packed courtroom, Ed Caldwell spoke clearly.
“At this time, the defendant will call Priscilla Phillips to the stand.”
ii
The passivity forced on Priscilla throughout the weeks of testimony had taken its toll. She perceived it as a sort of punishment that no one remembered events as clearly as she did, and that when the witnesses did recall accurately, often the emphasis drawn from their testimony—even about the most innocuous of her actions—damaged her character. Her naiveté had been stripped from her like a bandage drawn suddenly from a wound. The trial was not about what had happened. Not even her own lawyer cared about that; he cared about the theater of the trial, the presentation of his client. The trial was about nuance; the trial was about what she wore.
Now it came down to Priscilla’s performance. She welcomed the opportunity to speak for herself, but she had not lost sight of the difficulties she faced. Essential to the defense she and her attorneys had adopted was the principle of her normalcy. But under the theory of Munchausen Syndrome by Proxy, the desirable qualities of a caring, concerned mother became, by definition, abnormal qualities, and all the characteristics usually valued by society turned into indexes of depravity. So how was she to appear normal? If she suffered from Munchausen’s, then Priscilla’s intense involvement with her children—for which she had been praised by friends and doctors alike—became a plea for attention, as did her interest in community affairs.
Indeed, everything about the situation was double-binding. Priscilla had to toe an invisible line on the witness stand and present to the twelve jurors an impossibly complex series of characteristics. On the one hand, she had to persuade them that she was sane, competent, and self-assured. On the other hand, she must seem appropriately upset by her circumstances without appearing emotionally needy. It was necessary to express some emotion—so as not to appear cold and calculating—yet she must not seem hysterical. She could be assertive but not aggressive. And in the matter of her children’s illnesses, she should seem concerned with their welfare yet not meddling or attention-seeking.
Except for a bout of weeping that interrupted her controlled narration only once—when she described finding Tia in a bed of vomit and diarrhea just before her last admission—Priscilla maintained her composure. Even under Josh Thomas’s occasionally savage cross-examination, she raised her voice only once. Josh asked her about the
Redbook
article she had once planned to write on Tia’s life and death. Priscilla had written a notation in one of her notebooks concerning the type of article
Redbook
was interested in. The notebook had been among those seized by the police in their search of the Phillipses’ house and thus had ended up in the hands of the prosecution.
“Your notation on this article reads ‘Five Hundred Dollars for Young Mother’s Story—practical and useful information about a mother solving problems of marriage and family life, one thousand to two thousand words.’ Correct?” the district attorney asked.
“Yes. And I copied that directly from the magazine.”
“And you already had a title—”
“No, I did not.”
“The words here: ‘Adoption had always been a part of our family plan, so it was natural?...’”
“That was not a title but a leadoff sentence, and that’s as far as I ever got.”
“When did you first put that in the notebook, Mrs. Phillips?”
“Sometime after Tia died.”
“You were considering writing an article about Tia’s illness, the progress of her illness and death?”
“I was considering writing an article about the beauty of Tia's life, and my decision at that point was that we had decided to adopt another child, so I wanted to wait until Mindy arrived and then write an article so that it would have a happy ending, and that’s why I never did it.”
“Wouldn’t it have been extremely painful for you to review the course and progress of Tia’s treatment and the agony she went through?”
“That’s not what I planned to write about. I planned to write about the beauty of her life in spite of her illness.”
“Well, the beauty of her life, Mrs. Phillips, was that she spent about eighty-five or ninety percent of it in one of the Kaiser facilities, isn’t that a fact?”
“That is not the beauty of her life,” Priscilla retorted angrily.
“How soon after her death was it that you first thought about writing an article?”
“I can’t say exactly.” Priscilla was in control again. “I had a lot I wanted to share right from the moment she died. It was sometime after that that I read an article in
Redbook
about a child who had problems like Tia. And it touched me deeply and that’s what made me select
Redbook
as a possible place to write about Tia, because they had very touching articles similar to the experiences I had. They were often about ill or hospitalized children or how adoptions or that sort of thing had touched a family.”
“And what about those other notes you kept at the beginning of Tia’s illness—this daily journal?” He lifted and waved another spiral-bound notebook.
“That was for a different purpose. That was just something the nurses suggested I do, to write up how to cope with a hospitalized child, that sort of thing. I had to drop that after a few weeks because it was so painful.”
“And do these entries reflect the beauty of Tia’s life, Mrs. Phillips?”
“Objection—”
“Sustained.”
The questions and answers continued for hours. Priscilla was on the stand over the course of three different days. In a phenomenal display of memory, she recounted the histories of Tia’s and Mindy’s illnesses, remembering without notes exact dates for procedures and treatment, names of diagnoses and chemicals, which elbow or ankle had been sites for cut-downs. Medical terms flowed effortlessly from her lips, and she never stumbled over the occasionally complex terminology. It was an impressive display, but it, too, held a negative potential because the ease and familiarity with which she discussed medical treatments also emphasized the unusual extent of her involvement in, and understanding of, those treatments.
At the end of Priscilla’s testimony, neither Ed Caldwell nor Josh Thomas was certain how she had come across to the jury. Ed had tried to bring out her qualities of warmth and concern, and to paint her as naturally gregarious, religious, deeply depressed by the loss of her children yet bravely struggling to continue on. Josh had sketched a different portrait: that of a cold, interfering, attention-seeking woman, callous enough to detail Tia’s illnesses in her baby book and list at its back all the people who had sent contributions to a memorial in Tia’s memory or who had written in condolence. Neither attorney felt that he had completely succeeded.
Meanwhile, controversy was brewing about Dr. Satten’s notes and the tapes of his interviews with Priscilla. Ed Caldwell had stayed up all night Monday listening to the tapes, deciding that four of them were prejudicial because they recorded some derogatory remarks his client had made about attorneys and the judge. He also found that Priscilla had revealed to her psychiatrist the planned strategy for her case. On Thursday morning, in the judge’s chambers, Caldwell explained his findings to the judge and to Josh Thomas, who had not been permitted to hear the tapes. At that time, the judge ruled that the noncontroversial tapes and all of Satten’s notes be turned over to the prosecution while he reviewed the four tapes Caldwell believed were prejudicial. In a separate action, Burke also ruled that there was no legal reason for Priscilla Phillips to submit to a psychiatric exam by either Dr. Blinder or by a court-appointed psychiatrist.
By the time Dr. Satten returned to the stand on Thursday, Josh Thomas had studied the doctor’s notes and reports. Josh concentrated on one report that Satten had never mentioned during his earlier testimony: that of Dr. Paul Berg, the Oakland psychologist who had actually tested Priscilla Phillips.
Josh picked up Berg’s report, instructing Satten to read excerpts that the district attorney believed were damaging. The jury heard how Priscilla had reported to Berg her belief that she was the more dominant in the relationship with her husband. They heard about her earlier marital problems, including numerous arguments and some physical fights, which she usually started. In her interview with Berg, Priscilla had also described Tia as more like a friend than a daughter—someone who gave as much as she received.
“I loved her so much. My relationship with Tia was the most gratifying I ever had in my life,” she had told the psychologist.
Josh ended with a point he felt needed more emphasis than it had yet received.
“Don’t you think that the fact that Mindy Phillips was hospitalized on the anniversary of Tia’s death is significant from a psychological point of view?”
“No. I think it’s a strange coincidence,” came Satten’s response.
On redirect, Al Collins cut to the heart of Paul Berg’s report. He asked Dr. Satten to read aloud a paragraph from Berg’s summary.
“After considering all the historical, clinical, and testing materials, I must admit that the situation is very enigmatic and baffling to me. My simplistic conception of this kind of situation is that when a person murders their child, one invariably finds a significant and serious degree of emotional disturbance. I have within the past year evaluated four such situations and in every one found extreme mental illness—save the case of Priscilla Phillips.