She led Ted to her front room and he sat gingerly on one of the three upholstered pieces of furniture and took out his tape recorder. The room was heavy with knickknacks and pictures of Jesus.
“I have seven children and fifteen grandchildren,” Mrs. Portillo told Ted. “After my husband died in 1967, I started taking in foster children. I have had twenty-six. And Cindy—we called her that because Catholic Social Service asked us not to call her Mindy—was the last.”
“Was Cindy sick with diarrhea while she was with you, Mrs. Portillo?”
“No. She was very shy at first and everybody—my family’s in and out of here all day—everybody thought she was retarded, but then after a few weeks she was lovable and friendly. She played with my children—they used to like to take her to the swings at Holly Circle Park.”
“Was she walking?”
“Oh, yes.”
“And did she have diarrhea?”
“No. She was constipated once. I gave her Milk of Magnesia.”
“Mrs. Portillo, may I ask why you’re on crutches?”
“I was mugged a few years ago. I needed some surgery,” she answered simply. “It’s hard for me to get around now and I don’t think I’ll have any more foster children.” She looked at the floor. “Cindy was the last.”
“Thank you for your help. You’ll be receiving a subpoena in the mail, and on the day you’ll testify, I’ll come pick you up and drive you over to Marin and then back.”
“All right,” she said.
Later that afternoon, Ted drove back to the Civic Center to report to Josh, who was working late in his office. Ted was on his way down the long hall leading from the elevator to room 155, his footsteps loud in the deserted corridor, when Josh leaned his head out and saw him.
“Well? Well?” he said eagerly. “What happened?”
Ted put on the longest face he could muster and hung his head, shaking it as if in total disappointment.
“Well, Josh, you’re just not going to believe it,” he began.
“What? What?” Josh was frantic.
“I’m sorry, but we’ve got a real problem with Mrs. Portillo,” Ted went on, his voice a mournful dirge, his eyes on the floor. And then he looked up and gave a huge grin.
“Wait till you hear this!” he said.
On Friday, Josh Thomas went on the attack against Pat Wrigley.
“Did you hug the defendant during recess?” he asked.
“Yes.”
“While you were waiting for an absent juror yesterday, did you stick your tongue out at anybody?”
“Yes.”
“Who?”
“You.”
“Now you testified that you took Joseph out of Mount Zion against medical advice?”
“Yes.”
“Did you sign a form acknowledging that?”
“No.”
“You said Joseph was critically ill when you took him?”
“He was still in very serious condition.”
“You used the term critical on Tuesday, didn’t you?”
“All right, critical.”
Josh handed the witness a copy of Joseph Wrigley’s discharge summary from Mount Zion. “Does this summary say that Joey was ‘critically ill?’” he asked.
Pat Wrigley shrugged. “No, those words do not appear here,” she acknowledged.
“How much formula was Joey getting at discharge?”
“Seven hundred to eight hundred cc’s a day, to be given ad lib, or without restraint.”
“Can a patient who is critically ill be receiving that much formula, Mrs. Wrigley? That’s your definition of critical, isn’t it?”
“That is not my definition of critical.”
“Your Honor, I object—argumentative,” Caldwell interrupted.
“Sustained.”
Josh now turned to a paper Pat Wrigley had written about Joey as part of her master’s thesis.
“Didn’t you write that because of the love and affection your family bestowed on Joseph, that his gastrointestinal problems started clearing up immediately and were completely gone at the end of approximately four months?” he asked.
“Those words occurred on a paper I wrote but they’re out of context the way you’re stating it. I was referring to his problems of explosive diarrhea and malabsorption. Later in the paper I said the diarrhea continued.”
“Mrs. Wrigley,” Josh asked as he shifted to a new tack, “was Sarah walking when you first got her?”
“No. Just one or two steps.”
“Did Miss Vetter relate any diarrhea problems Sarah had suffered when she was with the foster mother?”
“No—she didn’t relate it, but that doesn’t mean it didn’t exist.”
“Did she relate any problems with convulsions?”
“No.”
“Any problems with balance or ataxia?”
“No.”
“Did she wear a helmet the first time you visited her while she was still with the foster mother?”
“No.”
“Thank you, Mrs. Wrigley.”
On redirect, Ed Caldwell tried to salvage his witness. Mrs. Wrigley had brought in a photograph of Joey Wrigley at his most emaciated, and this was entered as evidence. Ed then asked her about the difference between malabsorption and diarrhea as symptoms of severe gastrointestinal problems, and how these could be distinguished from simple diarrhea.
“Malabsorption is life-threatening because you can’t absorb nutrition. Diarrhea can be life-threatening if the child is not gaining weight,” Pat said. “Joey’s malabsorption cleared up in four months, so that his condition was no longer life-threatening. But the diarrhea—the ordinary diarrhea—continued for two years,” she added in explanation.
Proudly, Pat Wrigley held up a newspaper clipping of Sarah winning a blue ribbon in the twenty-five-yard dash during the Special Olympics held the previous week. This, too, was entered as evidence.
“Sarah will be legally ours next Thursday, May fourth, at nine A.M.” she added, smiling.
In her seat, Priscilla Phillips put her hand over her face and dropped her elbows into her lap.
“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 chara
cter 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.”
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