The longest witness list of the trial so far: fourteen Commonwealth witnesses, numbered 19 through 32 by East Idaho News, taking the case from the emergency rooms where the three children were pronounced or declared brain dead, through the intensive care unit where the defendant spent the following ten days, to the search of the house and the reading of her journals. Boston 25's court reporter has the first witness sworn at about 9:19 and the last stepping down at about 3:37; the day ran to a recess at about 3:39 with court to resume Tuesday at nine.
THE CHILDREN. Dr. Michael Snyder of Beth Israel Deaconess Hospital-Plymouth said the hospital had been told to expect three pediatric trauma patients in cardiac arrest and gave all three advanced life support. Five-year-old Cora was not breathing on her own and had no heartbeat when she arrived; he described bruising around her neck with bleeding under the skin, petechiae on her face, eyes and neck, blood around her nose, and pupils fixed and enlarged. THE TIME HE GAVE FOR HER DEATH IS REPORTED TWO WAYS AND IT MATTERS: Boston 25 records the declaration at 7:28 p.m., which is the exact time Dr. Mark Tenerowicz gave for Dawson at the same hospital on July 31; boston.com puts it at around 7:30 p.m.; East Idaho News carries no time at all. Both are recorded and the conflict is logged, not resolved. Dr. Andrew Capraro received eight-month-old Callan at Boston Children's - cold, limp, ligature marks and swelling on the neck, fixed and dilated pupils, the heart still beating on its own - and said the head CT showed significant brain swelling from a lack of oxygen and blood, consistent with strangulation by an object. Dr. David Casavant, who took Callan in the intensive care unit, described enormous swelling, no response to his name, to a stroked foot or to pain, brain death testing run with neurology while the heart still beat, and the withdrawal of life support on January 27, 2023 after Patrick Clancy was consulted and the family had the chance to say goodbye. The defense did not cross-examine any of the three and did not oppose the admission of the hospital records.
THE DEFENDANT'S OWN INJURIES, AND WHAT THE DEFENSE MADE OF THEM. Dr. Kelly McDonough of South Shore Hospital was told a woman had fallen from a window at height and treated her as a Trauma 1. On direct she gave the Commonwealth what it wanted: the lacerations to the neck and both wrists were superficial, no artery was involved, they needed no immediate care, and after the initial treatment they never bled again. The head CT was normal. On cross Kevin Reddington took the same witness the other way - the patient never regained consciousness, her core temperature was 82 degrees, she needed a warming blanket, and the reason she was flown on was a thoracic spine injury. Pressed on a cervical fracture and a complete cord transection at T5/T6, McDonough said she did not specifically recall, and without her notes in front of her she said she did not recall a good deal else. Sgt. Rose Stoffers of the State Police photographed the injuries at the hospital and described a patient who pulled her right arm back when it was drawn out from under the blankets.
TEN DAYS IN THE INTENSIVE CARE UNIT. Rachelle Amedee, the overnight nurse, described one-to-one nursing, a suicide-risk designation, two officers outside the door, and a code shortly after arrival at Brigham and Women's - Boston 25 puts it at 3:30 a.m., East Idaho News on January 24 into the 25th - with chest compressions, chest tubes and massive transfusion. The defendant communicated on a whiteboard while intubated, reporting confusion and that she could not feel her extremities; she was extubated on January 30 and was alert, oriented and flat. On February 2 she said she wanted to reach her lawyer, and Amedee wrote it down because it was the first thing she had said that seemed connected to the case. On cross, Amedee had not seen a lawyer consult with her afterward, and East Idaho News records the records showing 30 cc of spinal fluid from the nose and acute anemia from blood loss. Meghan Collins, the day nurse, described sedation, fighting the breathing tube, low-dose propofol, chest tubes, and after extubation a patient confused and agitated and picking at her lines - ICU delirium, which she said is common. Reddington put a document of January 25 in front of her showing the patient was under arrest, and drew out that she had asked to change her health care proxy from her husband to her parents and that her records recorded that she did not want to be resuscitated.
THE TWO PSYCHIATRISTS THE COMMONWEALTH CALLED, AND WHAT THE DEFENSE GOT FROM THEM. Dr. Sejal Shah was consulted on January 29 to decide whether the defendant had the capacity to change that proxy, walked the jury through the four criteria she applies, and said the team waited a day out of concern about delirium before executing the change, by which time the choice was unchanged. CNN reports her describing a patient who was calm and cooperative and, on January 30, denied hallucinations, delusions and suicidal or homicidal thoughts, with an organized and goal-directed thought process; boston.com attaches the organized and goal-oriented note to January 29. She saw the defendant again on February 19 and February 21. On cross she agreed the defendant was honest and not exaggerating her symptoms for advantage, that a person in psychosis can still plan and make decisions, that antidepressants carry warnings about increased suicidality, that SSRIs should not be given to a bipolar patient without another protective medication, and that she had been concerned about the sheer number of medications the defendant was on. Dr. Jhilam Biswas, the forensic psychiatrist, met her for twenty to thirty minutes on January 26 while she was intubated, and the answers came in writing: horrified, when asked about her mood, and then whether she had an attorney, whether her body was broken, whether her legs were straight, whether she could have visitors. Biswas noted no signs of psychosis and found her able to decide about spine surgery, but agreed on cross that it was a twenty-minute look with an incomplete record, and testified that psychosis presents differently from person to person, some having moments of clarity and others more continuous symptoms.
THE HOUSE, THE VIALS AND THE JOURNALS. Sgt. Robert Flynn of the Duxbury police swept 47 Summer Street with three officers, found the master bedroom colder than the rest of the house with the window open and a cell phone on the bed, and saw matted snow and medical equipment in the backyard below it. Det. Mark Farioli brought seven vials of blood and urine to the State Police laboratory and Leah O'Connell received them there on January 31. John Santos searched the basement, the kitchen and the master bedroom and seized the McLean Hospital discharge paperwork, an uncompleted postpartum workbook, two books on scary thoughts and postpartum anxiety, a notebook kept for Callan, laptops and an external hard drive - but not the nightstand drawer, which he assumed someone else had already searched and where medication and an Apple Watch were later found. Trooper Cory Melo closed the day with the journals. Shanan Buckingham read entries about being completely overwhelmed by the three children and feeling like she was drowning every day; Reddington read the rest of them, including that she did not know what was wrong with her and wanted help and to be well, the brain fog and living moment to moment, the guilt over sleep training a baby not yet four months old, and the affirmations she wrote about being calm and sleeping through the night.
