Dr. Paul Zeizel
Defense
- Role
- Clinical and forensic psychologist. First met the defendant on February 4, 2023, eleven days after the killings, at Reddington's request and under a court order, while she was handcuffed to a bed in the intensive care unit at Brigham and Women's Hospital; he did not treat her before the killings. The outlets do not agree on how much contact he has had with her: ABC News and USA TODAY give approximately sixty meetings over three years, LA Magazine over thirty-five hours and more than fifty visits, the Associated Press more than thirty-five hours over dozens of visits, and the Boston Globe reported him saying more than forty-five times on the preceding day. LA Magazine reports he confirmed that part of his role was evaluating whether she was competent to stand trial.
- Direct
- Reddington
- Cross
- Buckingham
- Listed as
- Paul Zeizel
- TESTIMONY COMPLETE, ON HIS SECOND DAY. He had been called Tuesday and was still on direct examination when Wednesday began. He resumed at about 09:52 to 10:05 after the delayed start, finished direct at about 10:17 to 10:20, was cross-examined until about 11:36 to 11:44, was redirected across a recess, took a short further round from the Commonwealth, and left the stand at about 12:35 to 12:41.
- DIRECT — the autumn of 2022. He traced a months-long deterioration from her medical records and his own examinations: increasingly depressed and withdrawn, fatigued, struggling with basic hygiene, having difficulty caring for the children, and describing what LA Magazine reports she called a busy brain. ABC News reports him describing derealization — a sense of detachment from one's surroundings — alongside symptoms of psychosis.
- DIRECT — November 29, 2022. East Idaho News alone reports him placing a visit to the nurse practitioner Rebecca Jollotta on this date and describing psychotic dissociation and a flattened affect.
- DIRECT — the perinatal clinic in December 2022. She presented saying her brain was damaged, that she should kill herself and that she was never going to get any better. East Idaho News dates the clinic visit to December 2 and identifies it as the South Shore clinic; the Associated Press gives only December 2022.
- DIRECT — the suicide hotline. She called twice in December and got no help. East Idaho News reports him dating the first call to about December 4 and saying she was turned away because she had no plan, and a second call around December 15.
- DIRECT — the paranoia. She feared other people could hear her thoughts, and her concern was that if people could hear her thoughts her children would be removed from her care. He testified she was having paranoid symptoms of psychosis. LA Magazine renders the fear as police or child protective services taking the children.
- DIRECT — anhedonia. Her records showed she presented with anhedonia, which he described as an inability to feel joy: no laughter, no pleasure, living life without pleasure.
- DIRECT — the medications and the programs. East Idaho News reports him naming Seroquel, Remeron and Klonopin, a partial hospitalization program in Rhode Island that Patrick Clancy took her to on December 15, a voluntary four-day admission to McLean Hospital in early January 2023, and her leaving it to attend her daughter's birthday party on January 7.
- DIRECT — mid-January 2023. While she was tapering her prescriptions the intrusive thoughts became unrelenting and, in his words, were getting worse and were telling her to kill herself. ABC News reports him distinguishing intrusive thoughts from ordinary ones: ego-dystonic, unwanted, and interfering with the ability to get through the day. By January 2023, he said, she could barely get through her day.
- DIRECT — hallucinations. WJAR reports Reddington asking whether she complained of hearing things that were not there, and Zeizel answering yes.
- DIRECT — psychosis and ordinary function, the day's central defense answer to the Commonwealth's case. He testified that people in a psychotic state can still do the everyday tasks of living. The Associated Press ties the point to driving and searching the internet, and to the fact that on the day of the killings she took her daughter to the doctor, played with the children in the snow and searched online for a pharmacy and a restaurant; East Idaho News reports him describing her building a snowman in the backyard with the children and Googling directions to a restaurant that same day. Reddington put it to him that the absence of unicorns in the corner, of slurred speech and of an inability to walk did not, to a degree of medical certainty, mean she was not psychotic, and he agreed it did not.
- DIRECT — psychological testing. He administered the Hare Psychopathy Checklist, which measures for antisocial personality disorder, and a mental status examination, and found she does not have any type of antisocial personality disorder, also known as sociopathy.
- DIRECT — the sociopathy searches. Reddington took him to her internet searches asking whether sociopathy can be cured and asked whether they showed she believed she was a homicidal maniac or fell in the same period as her searches on the effects of medication; Zeizel took the second reading, and said she continued to search the effects of medication, heaviness and psychosis.
- DIRECT — THE OPINION, at about 10:17 to 10:20. In his opinion she had a mental disease or defect, which he identified as bipolar disorder with postpartum psychosis; she was unable to conform her behavior to the rule of law; and she had no appreciation for the wrongfulness of her act. Carried in those terms by the Boston Globe, Boston 25, CBS Boston, the Associated Press, WJAR, ABC News and LA Magazine. East Idaho News alone renders the second limb as a loss of substantial capacity to appreciate the wrongfulness of her act.
- CROSS — who pays him. The Commonwealth opened on his work as a defense expert, noting that much of his recent work has been for the Committee for Public Counsel Services, the state's public defender agency. He answered that as recently as July he had submitted written testimony for the prosecution in a Suffolk County case. East Idaho News adds that he is an independent contractor for a company under contract to the Department of Corrections, that he earned about $340,000 in 2024 and about $300,000 the year before, and that he has worked on this case for forty-one months; those figures are reported by that outlet alone.
- CROSS — the relationship with defense counsel. Asked whether he had done quite a bit of work with Reddington over the years, he called that an expansive term; told the question required a yes or a no, he answered yes.
- CROSS — ERRORS IN HIS REPORT. WJAR gives the two the prosecutor named: that the visit to Women and Infants was on December 20 and not the 15th as he had it, and that he had testified on Tuesday she was on trazodone when in fact she was prescribed Zoloft. The Associated Press reports more generally that prosecutors pointed out mistakes in his report.
- CROSS — what he had not read. East Idaho News reports that he was asked whether he had reviewed Dr. Phillip Resnick's report and said he had not, although his own document lists it as a source; after a defense objection and a sidebar he said he had perused it without reading the whole thing, and that he had reviewed the Tewksbury records but not every page. LA Magazine reports Buckingham questioning whether he had reviewed the entirety of the medical record and confronting him with Tewksbury notes he acknowledged he had not reviewed.
- CROSS — the Zoloft bottle. East Idaho News alone reports the prosecutor holding up a Zoloft bottle: thirty pills in the prescription and twenty-three left, so only seven gone. The same outlet reports her noting a 25mg Seroquel prescription for sleep in December 2022.
- CROSS — the first meeting, February 4, 2023. He had described her as foggy about what had happened and not knowing where she was; the prosecution put it to him that she was lucid enough to give him her husband's phone number from memory. His answer was that not knowing where you are does not mean you cannot have a conversation. Asked whether she asked about her children in those first conversations, he said she did not. East Idaho News adds that he was asked whether he knew she had by then changed her health care proxy from Patrick Clancy to her parents, and was not aware of it.
- CROSS — how he learned about the voice. He said he had not only overheard the speakerphone call but had spoken to other people about their interactions with her, and that it was not a fishing expedition. He named Sheila Cavanaugh, a chaplain at Brigham and Women's Hospital, as having relayed to him that the defendant said she heard a male voice instructing her to kill her children and then herself.
- CROSS — THE RECORDS DO NOT CONTAIN THE VOICE. Asked where in the records, between September 2022 and January 2023, she told any provider that a voice told her to kill herself, he answered that it is not in the records. He agreed that when she described intrusive thoughts she never described them as a voice telling her to kill herself, and that as far as her own reports went it was simply that she felt she wanted to die. Asked whose voice the intrusive thoughts were, he said she did not identify whose voice it was, and agreed the only time she specifically described a male voice was in recounting January 24, 2023. He said there are multiple layers to hearing intrusive thoughts, and East Idaho News reports him saying he had asked her about it many different ways over time rather than once.
- CROSS — SHE DID NOT ACT ON THE EARLIER VOICES. Asked whether, at any time between September 2022 and January 2023 when she heard a voice telling her to harm herself, she failed to act on it, he agreed — and volunteered that she sought help instead. Boston 25 places this exchange at the close of cross-examination.
- CROSS — masking. The prosecution returned to his evidence that psychotic people can have normal interactions and put the pediatrician visit with Cora on the day of the killings to him, arguing that a person in a psychotic state carries significant distress and that masking it would take an enormous amount of control. He answered that voices run on a continuum, some nominal and whispering and some yelling and screaming, and that the more upsetting and demanding the voice the harder it is to resist. East Idaho News reports his answer to the extreme-stress proposition as: it depends.
- CROSS — whether she got help. The prosecution pressed him on his evidence that she went to the emergency room and did not get help, noting she had declined an offer of inpatient treatment in December 2022. He answered that help is in the eye of the beholder, that his testimony was based on his evaluation of her, and that it was not for him to doubt what she believed about the offer. Judge Sullivan then called a brief sidebar.
- CROSS — THE TEWKSBURY DAILY RECORDS. Buckingham read from the state hospital's daily notes covering the anniversary of the killings and what would have been the children's birthdays. On what would have been Callan's first birthday, four months after the killings, the defendant was recorded interacting with peers with no visible distress; on other birthdays and anniversaries she is recorded as generally sociable and pleasant upon approach, with no behavioral issues and no trouble sleeping. The Associated Press reports the notes mentioning her parents visiting and her talking with other patients but never anything she did to remember her children. The Patriot Ledger adds dominoes with peers and a coffee group; LA Magazine adds her propelling herself down a hallway in her wheelchair, playing games and eating with her mother. East Idaho News reports excerpts read from 2024 and 2025 records and dates one entry to December 24, 2023, which it gives as Cora's birthday. He said he did not doubt the records. He agreed with Buckingham that, given this individual's history, her sleeping habits would be an important thing for the hospital to monitor.
- CROSS — the workout program. He testified that she told him she lost money in summer 2022, after Callan's birth, in what he called a scam; asked why he called it that, the Patriot Ledger reports him saying that if you spend on marketing and lose all your money with no effort to get it back, it is a scam. He did not say how much was lost. East Idaho News identifies the program as Beachbody, reports the prosecutor answering that lots of people do the program, and reports him questioning whether it mattered in the big picture of the trial.
- CROSS — CONFIRMATION BIAS AND THE TREATER-EXAMINER PROBLEM, the spine of the cross-examination. Asked whether he was familiar with confirmation bias, he was, and East Idaho News reports him saying the facts come to you and you do not go to the facts, and drawing the distinction that a therapist is an advocate while an examiner looks for the truth. Buckingham then put the two roles together: a letter he wrote seeking accommodations for her transport in which he called her his patient; his appearances at her arraignment and at court hearings at Reddington's request; and a January 2023 news conference at which he appeared alongside Reddington, footage of which was played in court. He confirmed she was his patient.
- RECROSS — the closing round, after redirect. Asked whether he had ever spent as much time with a defendant he was evaluating for criminal responsibility, he said there had been one other; asked how many others he had cared deeply for, one; asked how many defendants he had given press conferences about, none. East Idaho News adds that he had made no lockup visits during trial because he was sequestered. CBS Boston reports Buckingham putting to him that the defendant continually refers to the deaths as her tragedy, and his answer that it is just one of the things she will say. She closed by establishing that the defendant is on constant one-to-one monitoring at Tewksbury against the risk of suicide, and that she has made no attempt to harm herself since January 24, 2023.
- REDIRECT — the answer on confirmation bias. He defined it as reaching a conclusion before you form an opinion, invoked tabula rasa, and said that in a proper evaluation you draw no conclusion, the conclusion finds you, and that failing to work that way is what puts you at risk of the bias. LA Magazine reports him adding that his conclusions came from his own evaluations and that he did not look to other providers.
- REDIRECT — caring for the patient. He said he became involved out of compassion, agreed that he cares about the defendant, and said that caring is not a violation of professional standards — not at all — and that developing empathy and rapport is appropriate and meaningful. Asked whether he was avoiding the truth or giving his opinion, he said he was telling the truth; CBS Boston reports that answer struck from the record after an objection. East Idaho News reports him saying he would not tell the truth just to help her out, and explaining that the accommodation letter was about keeping her from being chained to a van in transport.
- REDIRECT — the news conference. East Idaho News reports him explaining that the Commonwealth's examination of Patrick Clancy had made him angry, that he was very emotional, and that he was upset because he thought the praise being heaped on McLean was misleading. CAUTION: East Idaho News prints that same sentence twice, once for Zeizel at 11:40 and again for Thorndike at 12:55, and the Boston Globe and ABC News give Thorndike a different sentence at that point. The attribution to Zeizel should be treated as uncertain.
- REDIRECT — the blocked question, at about 11:45. Reddington began a question, the Commonwealth objected, he asked to approach, and after a brief sidebar Judge Sullivan called a recess. THE OUTLETS DESCRIBE DIFFERENT QUESTIONS: the Boston Globe reports him appearing to begin asking why it took the district attorney's office so long to retain three doctors of its own, and names them as Kirk Heilbrun, Avram Mack and Gregory Saathoff; East Idaho News reports him attempting a hypothetical about a young woman who kills her children, is in a wheelchair and is indicted. Recorded as a conflict; not resolved here.
- REDIRECT — THE TEWKSBURY RECORDS, THE OTHER HALF. After the recess Reddington went back to the daily notes and drew out what the Commonwealth had not read. She is, the records show, sociable with her parents and with other patients and extremely well regarded and well liked on that unit by everyone — which, he said, does not mean she is not in mental distress. Asked whether the records suggested she was laughing and partying and having a good time, he said no: Lindsay Clancy has bad days and worse days. He added that she speaks about her children often, that she really loves them and misses them and thinks of them every single day, almost every moment of the day. The Boston Globe treated that answer as the first time in the trial that the jury heard how the defendant now feels about her three children.
- REDIRECT — suicide risk now. Asked whether she continued to show suicidal thoughts at Tewksbury, he said she is in good hands at the moment but that there is always a concern that suicidal ideation sits directly below the surface. East Idaho News reports him explaining that he visits her in the lockup to make sure she is stable and fit to be at trial.